Archives for posts with tag: Surgery

I have been terribly remiss about keeping my blog updated; I apologize.  Life happens, a lot, as it turns out.  On last Friday we left for a weekend in Las Vegas.  It wasn’t a drunken wild west weekend where everything that happens in the 702 stays there.  It was quite the opposite, actually.  My entire immediate family was there for a small and all too brief reunion.  Our Grandma, Mary Lou, was in town for the first time in probably 13 years.  After she retired, she decided to move to a small town in Minnesota.  The last time I saw her, I was still in high school.  Our Grandma hadn’t met my husband or our girls.  I think she’d only met 3 of her 8 great grand children prior to last weekend.

My grandma, mom, sisters and our kids.

Our dad and brother were also there with us (Dad quietly endured us celebrating his birthday).

Dad & Tessa

Grandma, Tessa, Chance

Last weekend was the first time we’ve seen everyone since my surgeries, and I really wanted to show them that I was feeling and doing great.  It was also great to see everyone and be the big, noisy family we intrinsically are for just a few days.  I sat and talked with my grandma as much as I could while still getting to visit with everyone else.  I told her as much as I could spew out about the grown-up-me, my husband, and our girls in brief spurts.  Being that I’m 1 of 5, I couldn’t hog her.  But I really wanted to.  I also wanted to let her know what a difference she’s made in our lives.  It’s hard being so far away from family, especially when we grew up seemingly stacked atop one another for what felt like an eternity (at times).  These past few years have taught me so much about family and love.  I’ve missed being surrounded by both.  This is our family get-down song.  Or, at least, one of the many.  I’m inserting this in the middle of my post to really force you to listen to it.  I can be am pushy.

 

We returned home on Sunday, and life as we know it resumed from there.  On Monday I returned to Dr. Louie’s office for my follow-up/pre-op visit with him and Dr. Liu.  We combined my final stage 1 follow-up and noob revision/nipple reconstruction pre-op visit.  My recovery is going just fine; stage 2 is just under a month away and I need to be thinking “newpples”.  I really wanted to wear my prosthetic nipples to my appointment just to ask Drs. Louie and Liu what the differences would be in size, shape, appearance in comparison.  But I couldn’t remember where I put the prostheses and had to leave without them.  My left noob will be reduced in size so that it is symmetrical with the right, and Dr. Louie will origami my newpples using what I think is called a Cylindrical flap.  Dr. Louie made me this cool paper version, which I will now insert for your complete awe and future party trick bag.  In the first photo, you’ll see where Dr. Louie drew a nice set of noobs with the nipple sites indicated.  At the bottom of the page is the sketch and cut out of the cylindrical flap.

Newpple Origami Step 1

In Step 2, the flap is “lifted up” (or “peeled back”, depending on what you’re reading):

Newpple Origami Step 2

In Step 3, the “wings” of the cylindrical flap are brought together:

Newpple Origami Step 3

In Step 4, the top of the cylindrical flap is brought down to close the cylinder:

Newpple Origami Step 4

In Step 5, the negative space left from the skin used for the nipple reconstruction is brought together:

Newpple Origami Step 5

And then it is stitched closed:

Newpple Origami Step 6

There are so many methods for nipple reconstruction; I was really surprised when I happened upon this article.  I am a horrible geometry student.  I couldn’t even fold notes well in school.  So none of these methods would have ever occurred to me.  And that, people, is why someone other than me is making the big bucks.

Hopefully, this will be my first and only revision surgery.  While it is easier to reduce the size of one noob instead of increasing the smaller one, there is always the possibility that additional revisions have to be made.  I have had the pleasure of meeting other women who have gone through this process because I’ve published this blog.  One of those women is approaching her seventh surgery due to complications, heavy scarring, and necrosis of 1 nipple.  Another reader is recovering from her fourth revision surgery because her reconstructed breasts ended up so dissimilar after her first revision.  I have incredible faith in my surgeon’s abilities but appreciate the challenges associated with breast reconstruction.

Unlike my initial surgery, I have very little anxiety.  I am a little worried because I think we’re going to try and fly solo as a family for this recovery and hope for the best.  If I do have more pain than expected, we’ll be watching a lot of Disney movies with the girls, eating frozen dinners (or take out), and phoning in favors.  So I’m just trying to stay positive and start planning for June 22…and beyond!

The update photos posted below are a few days old but, as with before, there are no dramatic changes.  (Other than more natural light in our bathroom because Seattle actually got some damn sun, which has since left us.)

 

Cuidado!  Peligroso!

 

 

 

 

 

 

 

 

05/22/12 – Frontal on Day 69

05/22/12 – Noobies on Day 69

05/22/12 – Abdomen on Day 69

05/22/12 – Left Flap on Day 69

05/22/12 – Right Flap on Day 69

I was all ready to blow up this ish last night with a new blog post…and then ALL of our utilities were on the fritz and conspired against my new blog post.  There were several times during last night and very early this morning when nothing in this house was working; no water, power, phone, internet, magic box.  So, no blog post yesterday but nothing Earth shattering happened.

Yesterday I had another workout with Paul.  Since my physical therapy re-check wasn’t until today (after my workout), he took it easy on my upper body so I wouldn’t be super sore at my PT appointment today.  The obvious conclusion is that my lower body is now stiff as a board and creaky today.  I have always had pretty strong legs, but I felt like I really dialed in my leg strength and muscle tone before my surgery because I was preparing for being unable to use my upper body for strength, balance or anything really post-op.  So trying to get back to where I was before surgery now is really hard.  My balance, strength, endurance, and cardio feel so lame right now.  I knew well beforehand that I was going to have a long way to recovery, but I did (and still do) expected more of myself, I guess.  I just wanted so badly to not have to work this hard to get back to me.  I hoped/thought/demanded it would be easier and faster because I am unreasonable impatient and eager to move on with life.  I guess it’s better than being where I worried I might end up post-op, which was deep in self-image depression.  But, luckily, I had none of that.

Today my physical therapy appointment was ho-hum.  I gained about 15 degrees of motion on my left side since my last appointment, and I was given a few exercises to do over the next two weeks with only 1 or 2 lbs of weight added to start building my strength back up.  2 lbs doesn’t seem like much when I’m hauling our almost 30 lbs daughters around.  But it feels significant in different positions or while going through certain exercises.

Tomorrow…whew.  Tomorrow I have a busy day.  I have to see my breast oncologist at Seattle Cancer Care Alliance for (hopefully) my last visit to a breast oncologist EVER.  How exciting is that?  But after that I have to go into work for the rest of the day and (at some point later on), I need to make dinner for us and a couple of dinner guests, clean up, and pack us up for Vegas to see my family on Friday!  This will be the first time we’re going on an airplane together as a family.  We leave on Friday morning, so send me all of your good-traveling-juju and sage advice about being on planes with toddlers.  Please and thank you!

 

And now…

 

 

 

05/16/12 – Frontal

05/16/12 – Flaps

05/16/12 – Left

05/16/12 – Right

05/16/12 – Abdominal scar

 

Today I decided that since I had close to nothing newsworthy going on (just the POTUS cruising around my ‘hood), I should provide some additional photos beyond the typical 5 photos I upload.  I decided to post a few more photos of my abdominal scar because the focus here, and on most other women’s blogs on this subject, all focus on the breasts.  Or, at least the ones that I came across did.  But the abdominal incision is a pretty sizable one, and that isn’t a scar that will go unnoticed, should it ever slip out of its secret lair.  Whenever I am reaching for something and really have to extend myself, I worry that someone will see part or all of it if my shirt creeps up.  I don’t know why I worry about it.  It’s not like someone has seen or noticed it and asked me about it.  Seattle is way too passive aggressive for that.  It’s just a big, scary looking scar to anyone who didn’t see it at the beginning (for comparison purposes), but it’s healing quite nicely.  All of my scars have decreased in both size and color.  Everyday I am still so grateful to all of my surgeons, the physicians, and the other healthcare workers who have helped me so much through this process.  Again, my surgeons did such a great job with my prophylactic bilateral mastectomy and DIEP flap breast reconstruction.

So basically I just wanted to provide some visuals for how far I’ve come along now that 8 weeks into recovery from Stage 1.  Stages 2 and 3 will be combined since I only have a minor revision (to reduce my left noob and make it the same size as my right).  I’m interested in how I will feel seeing my body again after being healed from nipple reconstruction. I forget what my natural breasts looked like.  I guess I should’ve taken a lot of pre-op photos, but prior to this blog I wasn’t really one to take semi-nude photos of myself.  All of my semi-nude photos were typically of totally unsuspecting, unaware strangers.  I keed, I keed.  Maybe.

 

WATCH OUT!

 

 

Day 3 in the hospital.

03/18/12 – Day 4 in the hospital

Right side of my body, 5 days post op.

Left side image of my body, 5 days post op.

Week 1 / Day 7

 

05/10/12 – Frontal

05/10/12 – Flaps

05/10/12 – Abdomen

05/10/12 – Right

05/10/12 – Left

05/10/12 – Right edge of abdominal scar

05/10/12 – Left edge of abdominal scar

05/10/12 – Belly button

05/10/12 – Nipple site

 

 

 

Tonight’s post is short and photo free.  It’s been a tough day for a variety of reasons.

My left shoulder, clavicle and sternal area is afire with discomfort today.  The girls had parent & tot swimming lessons again this morning, and Olivia took out her unwillingness to participate on, what felt like, only my left noob and abdomen.  Being that flailing limbs are innate to swimming,  I can’t complain much that I took a few body shots.  But the after effects are massive today.

I also had a lot of wrangling to do with the girls before Mike got home from work.  They woke up feisty and just wanted to pull each other’s hair out, so there were many time outs and subsequent apologies issued this evening.  My physical therapist told me that I’m probably having so much shoulder and clavicle pain because I’m over compensating for my limited strength and ROM on the left side by using my entire shoulder girdle to do movements that usually only involve my shoulder itself.  Even after doing my prescribed stretches and a little self massage, I’m throbbing and my swelling is really uncomfortable.

Today I scheduled my nipple reconstruction for June 22.  When speaking with my reconstructive surgeon’s scheduling assistant, she wanted to bring my attention to the fact that not all of this procedure will be covered by my insurance.  That conversation led me to make about 12 other phone calls today between my insurance company and the hospital, wherein I found out that my insurance is (currently) not paying the claims submitted for my DIEP flap breast reconstruction.  There is an appeals process that we have to navigate our way through, but if my insurance denies payment we possibly have a long battle ahead of us.  I have thought and talked so much about this today that I’m just exhausted on the various issues and potential avenues that all of this could go through.  So, now I am even less interested in having my nipple reconstruction than I was before.  Mike has encouraged me to forge ahead.  I think that his position is subject to change once all of the related bills gets here.

For now, I’m hoping just to get to bed and not dream about selling my kidneys on the black market to pay for all of this.

 

P.S.  Check out the “baby bundt cakes” and “skin sombreros” here.

Confession:  I type my posts in Word and then cut and paste them into WordPress.  I just cut and pasted lost tonight’s post after 40 minutes of working on it.  I’m SUPREMELY annoyed with my own idiocy and out of energy.  I promise to reinvigorate my passion to blabber about reconstructed nipples, Stage 2, and scar revision.  AAAAAH!

UPDATED:

Today was the last of beautiful days we’ll have for probably a week (or longer).  The girls had music class this morning, and then we all went to our “secret beach,” which is actually just a place with public shore access.  It has sand, instead of sharp and/or slimy rocks, it’s small, it’s close, it’s often populated with people that want to take their kids to the water.  We had a great time, came home, the girls took a great nap, and then we commenced Round 2 of sun loving fun on our roof.

Pool party

I was able to take my walk and do about 4 miles today with the gorgeous weather.  I decided to brave a light color tank top with the warm weather (and no areolæ to tattle).  I think that UV proof clothing will be in my future because when I got home and showered it looks like part of scar around my nipple sites are a little sunburned.   While a little worrisome, it doesn’t hurt or look too horrific – just pink-ed.  Speaking of nipples, I called my plastic surgeon’s office last week and asked them if they could send me some literature about the nipple reconstruction and areolar tattooing.  Unfortunately the paperwork I received is really no more than after care instructions.  You can click below to view the literature I received from my surgeon’s office regarding nipple reconstruction:

Nipple Reconstruction

It is safe to say that whatever information I receive about this process, it is deemed either questionable or insufficient.  I have been poking around the internet looking at all kinds of things related to these procedures since I decided to have the BPM and reconstruction.  First off, I’m not sold on the nipple reconstruction.  I was 200% positive I wanted to have the prophylactic mastectomy, but I didn’t and still don’t feel the need to have non-sensory, aesthetic nipples.  Secondly, I’m a putz.  I’m worried that I will have some sort of every day, clumsy spill just after nipple reconstruction and tear one (or both) off or do something so that it flattens out completely and negates the nipple reconstruction.  I would be fine with having just the areolar tattooing and live without the nipple itself.  In the early stages of researching, I even found prosthetic nipples that seemed like a good idea, but the colors are all wrong for me. I have read here and there about the procedure and the complications.  I have watched YouTube videos about how the nipple is constructed, read forums about the healing process and timeline, and none of them seem so horrible.  But I’m still scared of damaging the nipples, necrosis, infection, sitting around for 4 more weeks.  But, I feel like I should persevere and see it through.  Why?

I have two daughters, and the BRCA1 genetic mutation is inherited.  Each of our girls has a 50% chance of inheriting this gene and being in my position in 20 years, maybe less.  My sister, Alyssa, also has two daughters facing this same situation.  I want to see this process through in case any of them turn out to be BRCA1 positive and have to think about all of these things I am now going through.  While it is my highest of all hopes and dreams that none of them have inherited the BRCA1 gene, I want to be ready, just in case, to say, “I have done this; it was scary, but not as bad as thought.  Look at me now.  Look at my reconstructed breasts.  Look at my happy, healthy, breast cancer free life.”

 

 

DAILY DOSE:

04/23/12 - Frontal

04/23/12 - Flaps

04/23/12 - Abdomen

04/23/12 - Right

04/23/12 - Left

I am totally guilty of being a prime example of our generation of immediate satisfaction.  We are all (mostly) spoiled rotten with access to (just about) a litany of information and an entire world (“www”) of potential connections.  So it may seem odd that I was totally floored today when one of my surgeons (Dr. Liu) sent me a message in regard to my concerns about my swelling.  Sweet, right?!  AMAZING!  I exchanged messages with Dr. Liu and have some clarity about my swelling.

I know now that my swelling probably isn’t due to fluid on my left side, which was what I was thinking.  Since Dr. Liu drained some fluid from my left side not long after I was discharged from the hospital, I thought that my left side might have more fluid hanging around there.  But it sounds like my swelling is tissue related and not due to fluid.  Dr. Liu let me know that the swelling will improve when new veins grow into my flap, and that process takes several weeks.  So, game on!  Not that I was giving up on or anything, but feedback and information is so helpful, comforting, and solid.  Nice guy, right?  Again, AMAZING!  And you thought doctors didn’t listen.  Pfffffffft.

Speaking of amazing, today was it for Seattle; such a sunny, gorgeous, fun day today.  We started our morning off with family breakfast at home (just like everyday), and then we headed over to our friends’ house for a play date and brunch.  Our friends, Heather and Jonathan, have an amazing house in Magnolia with an unbeatable view of Puget Sound.  They also have a specimen of a cutie pie son whom our girls had a good time playing with.  These are newer friends to us but we really, genuinely enjoy their company.

We coordinated this play date before I had my surgery.  We put it tentatively on the books because 1) we wanted to get together again and needed it scheduled, and 2) I had no idea what I would feel like at this point when we set the date.  I told our friends that I was having surgery, but I didn’t tell them what kind of surgery.  I am a fairly extroverted and open person, but I feel like discussing and taking people with me through this process isn’t for everyone.  It is very personal and some people are put off by the gory details of surgery and recovery.  Being that we’re all just getting to know each other, I didn’t want to unload this on them.  So when we were getting ready for our play date today, I found myself slightly anxious.  I tried on a couple of things and was thinking, “Does this outfit say post-op, nipple-less, reconstructed noobs?  Do I look like myself when I’m wearing this?  Do I look like I feel well and frisky and not patched together in this?”  I ended up wearing a jumper that kind of matched the girls’ outfits, which wasn’t at all embarrassing until I typed that just now.  In short, we had a great time together.  We didn’t talk about my surgery, because we (Mike and I) are helicopter-ish parents and our kids were being normal kids and we were trying hard not to freak out.  (This all has a point that I will get to when I’m done blabbering.)

When the girls awoke from their afternoon nap at home, we went back outside and took them to play with our neighbors’ two sons.  The husband, Allen, was in a skiing accident about a month before my surgery and his Achilles was ruptured.  So we’ve both been in some stage of recovery for at least 5 weeks, but him much longer than me.  Betsy (the wife) and I got a chance to briefly talk about my surgery and recovery.  She didn’t know which type of reconstruction I decided to do, and I told her about the DIEP flap and showed her my abdominal scar.  We discussed the sweet, sweet benefit of having my “marsupial pouch” surgically removed and turned into noobs.  She was also kind enough to tell me that my noobs looked “fantastic”.  Being that I was wearing a probably-too-tight-for-31-tshirt without a bra, I took this as the highest of compliments.  The conversation went on for a bit about the steps I have left to complete and the decisions to be made, but it was a nice chat between women.

When we came home, I knew that I wanted to really emphasize something in my post tonight.  Pre-surgery, I was so sad and anxious about what my reconstructed breasts were going to be like.  I went through a period of mourning for my natural breasts (and nipples) and was terrified that no one would ever say a nice thing about my boobs.  Actually, I was more worried that they would notice that these are not my natural breasts.  Not like I planned on walking around topless or anything, but I was seriously worried that everyday, in my clothes, people would be able to see and tell that I have reconstructed breasts.

And now that I am on the other side of it, I feel so excited about not having to worry about WHEN I will have breast cancer and the fact that my surgeons did such an amazing job with my mastectomy and reconstruction.  Other than a few extra pounds, some nipples and sensation, and an elevated risk for breast cancer – I don’t feel like I’ve lost much.  I certainly don’t feel any less feminine or sexy, which were big concerns of mine pre-surgery.  I feel I’ve gotten a lot of benefits out of this process.  Again, I no longer have a frighteningly high lifetime risk for breast cancer.  I no longer have the pocket of twin skin on my abdomen, and my previously full – then flat – and now full again – boobs look good.  Or, as Betsy said, “fantastic”.  Or, as I like to point out, smaller; firmer.  While I do have a large scar on my abdomen, I don’t mind it.  I have a sufficient amount of stretch marks to keep me in a one piece.  So, in closing tonight’s post, I just wanted to follow up on my first few, fear riddled posts and let women know that this is not as scary, freaky, alienating, un-sexy, or ugly as I thought it was going to be.  Day 3 in the hospital was a little bit of all of those things; but Day 39 is pretty damn good.

P.S.  I am still undecided about my nipple reconstruction.  I will touch on that tomorrow.

“I’ll take the Daily Double (dose), Alex.”

04/22/12 - T-shirt time!

04/22/12 - Frontal

04/22/12 - Flaps

04/22/12 - Abdomen

04/22/12 - Right side

04/22/12 - Left side

I have ZERO drains left!  This morning I went into Dr. Louie’s office and had my finally, pain in the side, JP Drain removed.  It was quick, painless, and as freeing as I dreamt it would be.  I can pull my pants up and down without worrying about catching my drain; I can walk close to the counters and not snag the tube on something; I can sit on the floor and play with our girls and not worry that they will mistake my drain for the next item of play.  In short, HOORAY!  My drain was pulled 13 hours ago but it’s still seeping Funky Cold Medina or whatever that is, so I’m currently wearing a designer gauze pad and some surgical tape.  I was told it should close up by the morning. Other than that, Dr. Louie just told me to continue to take it easy, not over do it, and heal.

04/03/12 - Drain site

I had the chance to ask Dr. Louie about my left side still being swollen and his comments were in line with what Dr. Liu told me.  The veins on my left side are significantly smaller than those on my right (common for everyone to have larger veins on the side on which they are dominant), so my left side is just processing any excess fluid slower than my right.  He said it could take a few months for the swelling to resolve, but if my left flap continued to be larger than my right then he could liposuction some of the fatty tissue out of my left flap to make it even with my right.  While I understand that this is an option if I want my flaps to be concordant, I don’t feel strong enough about how similar (or dissimilar) they are to undergo liposuction.  I’m so focused on getting back to our everyday lives, that liposuction of the flap sounds 210% unthinkable.  I can live with asymmetry.  And, yet again, I failed to remember to ask Dr. Louie about my rash.  It hasn’t gotten any worse, but parts of it have gone from rash to molting reptile.

04/03/12 - Rash/peeling

This afternoon I received a phone call from Seattle Cancer Care Alliance to schedule my first physical therapy appointment.  This I was excited about, until the scheduler asked me if I could come in tomorrow morning at 9:00 a.m.  I was taken aback by this because starting physical therapy at 2.5 weeks post surgery doesn’t seem in line with my reconstructive surgeons’ instructions.  I asked the scheduler if I was cleared by both Drs. Javid and Louie to start PT, and she didn’t know.  She said she was following Dr. Javid’s referral slip to schedule PT “sooner versus later” and called.  So the scheduler and I hung up, and I called Dr. Louie’s office to find out if it was ok for me to go to PT tomorrow.  I haven’t heard back yet (because I called at the end of the work day) but am interested to hear if it is ok for me to start PT tomorrow.

As far as accomplishments and pain today, my left side is still throbbing, stiff and sore.  My range of motion on the left side is still significantly limited compared to the right.  But last night I slept with my left arm propped up on a pillow like it was in the hospital, and when I had my usual 2 a.m. wake up my arm felt better than it had after the past couple weeks of sleeping without it supported.  So tonight I will sleep with a pillow under my arm again and see if the support overnight makes any impact tomorrow.  At this point, though, I just feel like throwing my left arm in a sling and letting it set there for a week. I didn’t hit any significant “back to me achievements” today that come to mind.  Me, our nanny, and the girls hit the mall for some retail therapy and indoor walking since Seattle weather is back to raining, pouring, boring.  Surviving taking twin toddler girls who are in the midst of a princess obsession to The Disney Store is quite an accomplishment, so I’ll post it here.

So that’s it for today!  Here’s your daily dose…

04/03/12 - Frontal

04/03/12 - Flaps

04/03/12 - Right side

04/03/12 - Left side

Today wasn’t a very eventful day.  We had one hell of a windstorm last night, so I was up late waiting for our house to blow apart in a million pieces.  I was awoken by the wind at about 2 a.m. and up for almost a full two hours.  After finally falling back asleep, I slept a little past 7:30 a.m. this morning.  I am not certain if I did something in my sleep or if my recovering body is suffering setbacks, but I awoke this morning completely stiff and sore in my upper left body.  From clavicle to scapula and down to my fingers, I feel like the Tin Man after a month out in the rain – but only on my left side.  I got up and inspected myself to see if my left flap was more swollen, bruised, or had to turn to stone (like I felt), but nothing changed over night.  I think I am not cleared for physical therapy until I am 4 weeks post-op, but I feel that with all of this stiffness, soreness, and extending immobility setting in I’m going to need much more than physical therapy to fix me.

I didn’t do much physically today because of this weather.  It is probably fortunate that I didn’t embark on my neighborhood walk today since I forgot, for the entire day, to put on my abdominal binder.  I failed to realize that I hadn’t worn it all day until I was getting up from our couch tonight and was trying to figure out why I was having pain in my abdomen.  My plastic surgeon, Dr. Louie, and the PS resident in Dr. Louie’s absence (Dr. Liu), both told me to wear my binder to support my incision.  I didn’t think that it would make such a difference, but now I know.

These past few nights, I’ve had some shooting pains on the underside of my “flaps”.  I’m not sure, but I think it’s because they’re healing where my doppler wires were recently removed.  The doppler wires are implanted during the DIEP flap reconstruction surgery.  While in ICU, my nurses (and surgeons) would come in every couple of hours and press on the underside of my reconstructed flaps where the doppler wires were.  The wires were hooked up to a speaker, and when pressed on you could hear the “whoosh whoosh whoosh” of blood flow into and out of the flaps.  This is done to ensure that the transplanted blood vessels are not failing and that the blood is successfully flowing.  The doppler wires are left in, even after being discharged, in case there are any complications (like necrosis) during recovery.  When I went in to the plastic surgeon’s office for my follow up, the wires were removed because I was complication and necrosis free.  On the underside of my flaps, I have these little holes that are slowly closing from where they entered the flaps.  I think this is where my discomfort is coming from, but what do I know.  I can’t even see under there.  I have to get a hand mirror or rely on my phone to see what’s going on in that underworld.

Today was also our last day of having immediate, on hand help from family.  My sister, Angie, returned home to Las Vegas today leaving us here to swim with the little fishes.  Before she left, Angie made about 200 lbs of chicken, meatballs, stew, and a lot of other things sitting in our freezer for when we run out of friends that are willing to feed us.  I really appreciate that my sisters took time out of their always busy lives to come here and care for me and my family.  It isn’t easy work to come into someone’s house and play by their rules, do things their way, and be humble about it.  But my sisters did just this , and more, for me, Mike and the girls; and, they did it well.  I am thankful for their love, time, help, food, and nurturing of my little family. I am also thankful for my friends that continue to take care of us, bringing us food, well wishes, and happy visits.

This week is going to bring new challenges since my sisters are gone, but hopefully they are injury free challenges.  We’ll see.  Hope for the best!

And now for the daily dose of forward progress…

04/01/2012 JP Drain puckered

04/01/2012 Left Doppler site

04/01/2012 Right Doppler site

04/01/2012 Bruise improving?

04/01/2012 Abdomen and new belly button

04/01/2012 Frontal

Am I the only person that thinks of this movie scene when I hear/say/read/write “two weeks”?

There’s really no breaking news to report when you’re blogging everyday about surgery recovery.  I’d offer to really ramp things up in the sake of maintaining interest, but that would be a complete disservice to my target audience (other women preparing for this surgery) and would probably involve some sort of self-inflicted wound.  I’m not into that kind of thing.  I’ve aged out of Emo.

Today I decided to walk as much as I wanted, which turned out to not be very much walking.  My sister, Angie, has replaced my sister, Alyssa, as my caretaker and walking companion.  Writing that sentence makes me feel about 65 years older than I am.  But taking stool softener and eating bran cereal two times a day makes me feel 70 years old.  Back to the story; Angie and I walked from my house to the pharmacy because I have a hot (temperature hot, not sexy hot) rash on my abdomen driving me crazy.  We then walked to Starbucks to meet our nanny and my two, cutie pie girls.  We hung out at Starbucks long enough for the girls to throw every rail car for the train set on the ground, have a few fights, and for the weather to get worse.  Then we walked home.  This arduous journey totaled one whole mile.  I felt fine while we were walking, but I was ready for a nap when the girls’ took their nap at 1:30 p.m.

I find that I get tired more because of my medication than anything, but still being unable to take pain free deep breaths does affect my endurance.  Even on a measly one-mile walk, I get winded because I can’t take deep breaths without my ribs and sternum hurting.   I also get tired because I’m still not standing 100% upright.  I’m almost there, but my abdomen is still tight from surgery and impeding my ability to stand erect.  Being hunched over also causes discomfort in my lower back, hamstrings and hips.  It’s a lot like that song, “the back bone’s connected to the hip bone; the hip bone’s connected to the leg bone; the leg bone’s connected to the aching bone.”

Other than these aches, pains, and hot rash I’m doing pretty well.  My range of motion on my right side is much better than my left but my surgeons told me to expect that after the onset of the swelling.  I am very much interested to see how much my ROM improves before I start physical therapy.  Also, I still am sleeping (uncomfortably) on my back.  I asked my sisters and my friend, Emma, today, “What do back sleepers do with their arms?”  I can’t figure out a comfortable arrangement.  Cross them like a vampire?  Prayer style?  Holding my own hands?  As a back sleeper, it’s awkward trying to find a comfortable place to put my hands when I’m usually just laying on top of them.

Day 14 scariness ensues below…

Day 14 frontal photo. A little increase in swelling on my left flap.

Increased swelling on left side, Day 14.

Day 14 abdominal incision (and a lot of dry skin)

As far as I can raise my left arm on Day 14.

Range of motion on my right side is far better than the left. Day 14.

It has been a few days since my last post and I apologize for falling off the task wagon.  On Sunday I continued my steady path of screwing myself up on my medications and causing myself a lot more hassle and pain.  Since I got so behind on my pain medication on Saturday, I decided that on Sunday I would try to go completely without it.  I have to say that the day (and my pain) was manageable until about nap time.  Sleeping is such a problem these days.  I am a life long stomach sleeper and trying to sleep on my back on this crazy contour pillow (to help keep my weight evenly distributed) is weird.  The contour pillow is comfortable, but it is very narrow.  So, even though I cannot yet roll over on either side, every time I do try to roll over I feel like I am falling completely off of my bed.  I have one of those jarring, falling dreams, wake up, flail my arms (as far as they will flail), and then jerk my arms back to my sides.  It doesn’t sound like much, but it is exhausting.  Anyway, Sunday, no pain medication = mistake.  I feel that there are just too many perchance things in my life to be going pain medication free.  Such as my cats still jumping on me; one (or both) of the girls discovering my drainage tube hanging and giving it a tug; and, running into stuff around my house because I’m not used to walking around hunched over and with my arms close at my sides.

The discomfort of a medication free Sunday rolled over into Monday (because I didn’t sleep well and was up about every 3 hours), and I had a bit of a breakdown at my breast oncologist follow up.  As always, my surgeon (Dr. Javid) and her surgical resident were doing their intake and asked me how I was feeling.  And, I should’ve known I would, I just started crying.  I didn’t realize how frustrated I was with my current state.  I was hearing myself tell Dr. Javid how I’m so frustrated with being unable to do simple things, like walk into our neighborhood “village” without consequences and just being so lethargic.  I don’t know that I’ve actively thought about these things, so it was a surprise that I vocalized them so quickly.  But they are true.  I don’t like just sitting around the house all day.  I feel well enough to walk a mile, or more, but if I did so my drain output would go through the roof and my back would be killing me from walking like Quasimodo.  I hate not being able to care for my girls and myself.  It’s a drag.  However, it was good to vocalize these things, realize that I needed to work on my patience, and get on with life.  Because there is so much life.  And, now I know for certain, so much BREAST CANCER FREE LIFE. Dr. Javid gave me my pathology results from my prophylactic mastectomy and all of my tissue was free and clear of cancer.  So all of this wasn’t for naught.  Our goal of going through this whole process so that I wouldn’t get breast cancer has worked.  Because I no longer have breasts, I am no longer at a ridiculously elevated risk of having breast cancer.  And it is an amazing feeling!  I’ve been thinking a lot about what an arduous process this has been, and I’m not even a full two weeks into recovery.  I can’t imagine what months (if not longer) of treatment, surgery, and recovery would do to me.  Cancer survivors are totally warriors.  They’re made of much tougher stuff than I am; that’s for certain.

Today (Tuesday) I had my follow-up at the reconstructive surgeon’s office.  It was a brief meeting, but mostly because I bombarded Dr. Javid with me being me the day prior.  Since I’d already unloaded on her and asked a lot of questions during that appointment, I didn’t have a ton of questions for Dr. Daniel Liu.  I did ask for a surgical bra since the surgical camisole wasn’t cutting the mustard, which I received.  I have to say that the surgical bra beats the camisole for me.  It doesn’t have anywhere to put the JP Drains, but since mine are out that is a non-issue.  I can close the surgical bra, wear it to bed so my “flaps” aren’t falling to the way side and causing additional  pain in my ribs and sternum.  And I can wear it under my clothes for a little bit more protection for my tenderness.  I was surprised by Dr. Liu telling me that the swelling on my left “flap” and underarm wouldn’t resolve for anywhere from 2 to 4 months.  I was thinking it would be maybe 2 weeks; but, no such luck.  It is going to take a couple of months for my surgical sites to settle and my body to reabsorb and process the excess fluid that built up in that pocket.  It hasn’t gotten worse, but the discomfort from the swelling is really bothersome and the area is still very, very tender.  Dr. Liu did remove my left abdominal JP Drain so I only have one left to go.  Dr. Liu told me to expect that since I’m down to one drain I should expect the output on the remaining drain to go up for the first few days; but he believes I’ll be ready to have that drain out within two weeks.

One thing I discussed with both Drs. Javid and Liu was my fluid output.  I was frustrated by it this entire week.  My goal was to get all of my drains out as soon as possible; they’re an uncomfortable hassle.  However, I know that they serve an important function.  So, as discussed, I was trying to decrease my physical activity in order to keep my fluid output low; but it didn’t work.  Both doctors agreed that any fluid produced is fluid that should come out via the drains.  So even if my activity created a large upswing in my output, that was a good thing.  Dr. Javid (I think) equated it to wringing out a sponge.  Sometimes you have to move the sponge around in every direction to get all of the liquid out of it.  So I’m going to just deal with the hassle of this lone drain, walk as much as I feel is healthy for me, and see how long it takes for my excess fluid to work its way out and, eventually, for me to get this bad boy out.

Before posting my update photos I wanted to post about trying to mother our girls while going through this process.  It is hard; every second of not being able to pick up our girls, hold them, play with them is just as challenging (if not more so) than I thought it would be.  I cannot wait for that part of this to be over.  I can’t even do so much as change a diaper (because I can’t lift their legs/bottoms up) or walk them down the stairs.  Heaven forbid the girls were to slip on the stairs but, if they did, I don’t have the strength right now to effectively hold on to them and stop them from falling further.  I have been cheating a bit and sitting down on the floor cross legged so they can sit on my lap and we can cuddle.  But this comes at a price.  We’re used to big, cozy, bear hugs and snuggling.  We try to remind the girls that they need to be gentle with me and that I have an “owie”, but it is just the nature of having a child in your lap that they will want to rest their head on your chest.  I will take the hit and let them do it; it hurts my sternum and my ribs quite a bit.  But I’m like a cuddle junkie getting a fix.  It’s totally worth it.  It hurts.  But it’s totally worth it.  I can still do story time, sing nursery rhymes, help out a little with meals, but I truly am limited in my ability to mother.  It’s been great having my sisters and our nanny to help care for the girls and keep them happy.  But I can’t wait for the day when me and the little ladies fly solo.

Finally, I found a good bedtime workaround for my abdominal JP Drains.  Figures that it would occur to me when I’m down to 1 drain.  I’m sleeping with my bathrobe on (instead of pajamas because they’re another complication) and decided to turn my pockets inside out.  I then put my drains in my out turned pockets so that they stay inside the robe with me and tucked away.  I have also put a little pill case in my robe pocket for my middle of the night medication dosages.  I set my phone alarm for every 6 hours for my pain medication.  If it goes off when I’m in bed, I just reach in my robe pocket and take out a pill.  They’re small enough that I don’t even need a sip of water to take it.  I was just feeling smart for thinking of these things and thought I would share them with anyone that may find it useful in the future.

Scary stuff below…

Abdominal incision day 13

Left side, day 13

Right side, day 13, last remaining JP Drain!

Full frontal, Black Dahlia-esque

Nifty bathrobe drain pocket

Close up of tissue transfer for future nipple reconstruction