Tuesday, June 7, 2011

reconstruction process

Since my first surgery to remove my breast and begin the reconstruction process is over, I am now focusing on continuing the reconstruction process. To be honest, I had read some about the process and knew that it would take 6 months to a year, but I really could not focus on the specifics of the process post surgery until I got past my mastectomy surgery. It was too much to wrap my mind around. So, on day 12 post surgery, when the surgeon took my drains out and gave me my first "fill" of my expanders, I went straight home to the Internet.  I found tons of information out there on various blogs and websites I had previously checked out for information, but as I was reading, I was reminded why at some point a few months ago I had to quit reading stuff about my situation on the Internet because I was getting all scared and anxious all over again!!!  So, I made a decision again not to rely on the Internet for information and just wait until I could talk to my surgeon the next week about what really is the future for me. 

This proved also to be tricky because if any of you reading has ever been to a busy surgeons office, you get the sense that they want to get in and get out of your room as quickly as possible.  So, I armed myself with a few questions in my head and attacked him with them the moment he entered the room. He was very patient and did answer all of my questions.  He confirmed with me that I will have fillings each week until I get to a desired size. He recommended around 700 cc of fluid in each expander to look normal for my body size.  Then, I have to wait 3 months and do nothing and have a final, more minor surgery to exchange the temporary expander for the permanent implant.  This surgery will be 1-2 hours, under general anesthesia, in the hospital, but you go home the same day.  He said that it is a much easier recovery-a few days even, because you are not under anesthesia as long (1-2 hours versus 5 1/2 hours) and that no tissue or muscle will be manipulated in any way, just doing the exchange through the same incision site and getting rid of any excess skin that I may have.  There will also not be any drains afterwards! Yes!! Since most of my breast is numb especially around the incision site, I probably wont have much pain or discomfort at all.  So, I confirmed with him, I am "going downhill from here" and he said "yes."  I felt tons better after that conversation because it was important for me to have accurate information about the reconstruction process and much of what I read on the Internet was inaccurate.  It was also important to me that I had crossed the most difficult part of this process, which was the mastectomy surgery.  The thought of having another surgery like that one was depressing, scary and overwhelming for me, so I am glad that this will not be the case.  Three months after my exchange surgery and if I choose to do this, I can have nipples constructed which will be in the surgeons office as a procedure and then the nipple color tattooed on. Another option that I am looking into is 3-d medical tattooing so I would not have to have the nipples constructed (comes with the benefit of not needing a bra), but just have a 3-d nipple image tattooed onto each breast.  But, I am not making any decisions about that until after my next and FINAL surgery, so I will post more on that later.   


Feeling like myself

It has been 4 weeks since my surgery and I would say I am 98% back to normal.  Praise God! I really started feeling like myself at about 2 weeks post surgery.  After that first week of intense pain, I started to see a slow progress emerging each day.  I can now do all normal activities and my energy levels are back to normal.  I feel great both mentally and physically. I did have a few moments especially the first week of feeling a tinge of regret about my decision, but I always came back to my reasons for making the decision in the first place and they ALWAYS trumped my temporary negativeness.  As far as the way I look, at first, I felt like I looked very "mangled" since I no longer have any nipples and have a long 6-8 inch scar across both breasts, but with each passing week they look better and better.  And by that, I mean they look more normal.  Maybe I am getting used to them too. My oldest daugther wanted to see me right away and she did look surprised and a bit shocked, but after about a week, she too told me that "you are looking better Mom."  My other daugther did not even ask to look at me because a lot of this does not even register on her radar.  Nathan has been super supportive and he reassured after seeing me the first time that "you know, that really does't look that bad" which I really appreciated because he did not lie and say I looked great, but also he did not freak out at the sight of me. 

Positives that I am focusing on now are: I am back to normal within just a few weeks, No more drains!!!!, No more pain!!!!!, I am looking better with each passing week, I have had no complications, I can now manage my children, house, dogs, work and exercise like I used to. Things I do not have to do again EVER: have a pap smear, mammogram or breast MRI AND one of the unexpected blessing in all of this-I don't even have to wear a bra, EVER! Woo Hoo! I haven't had the freedom to not wear a bra since the 7th grade and let me tell you, it feels really nice! And, I can wear any type of shirt now and not have to worry about my bra strap showing.   One of my friends told me to think of all of the money I will save now that I do not have to buy tampons or bras! Ha! I guess the savings for me is true, but my girls are entering into preteen age years and I know I will found on the Tampax and bra isles again soon! Of course, the biggest blessing is I have reduced my ovarian and breast cancer risk to as close to 0 % as humanly possible. 

So, things continue to look up and for that, I am truly grateful!


Blog has been down, but next piece of good news, the drains are out!!!!!

My blog has been down so I am going to try and "catch up" with blogging over the next few days.  So, bear with me.  But, I did want to devote an entire post to stating that at day 12 after surgery, I got my drains out!!!! I know that most of you probably have never had drains in their body, but I ca say it is one of the most uncomfortable things I have ever experienced in my life!!! To give you a little info on them, they are placed under your arm pit on the side of each breast to drain fluid from the empty breast cavity I now have.  My surgeon explained that our bodies are made up of mainly fluid, which does not have anywhere to go so when a new "spot" is created, the fluid will go there.  So, they placed these drains in during my surgery so that as I heal, the excess fluid can come out and not cause any infections or problems.  In the hospital, the nurse instructed me to "milk" them 3 times a day and to record how much I get per day and if they get below 30 cc in one day, that I could call my surgeon's office and have them removed.  My Mom took care of my drains for the first few days, but I eventually was able to take care of them myself.  The drain amounts came down each day, starting at about 160 cc in each breast.  I was really hoping on my surgeon appointment at day 12, I would be able to get them out, but since both drains were not below the 30 cc, I went into the appointment thinking there was no way.  But, to my surprise, he did take them out!!!!! And, he performed a filling of my expanders!!! I had told Nathan to not even come to this appointment since I thought all he was going to say was you look good and come back next week.  Dr. Robinson stated he did not like keeping drains in for over 2 weeks because of the risk of infection and that he was going to get rid of some of that excess space by expanding the expanders too.  He also stated that he would see me in a week and if I had some built up fluid, he could drain it off then.  I had been told that it was painful to have the drains removed, but the nurse took her time and to be completely honest, the first side did not hurt at all and the second, more sensitive side, mildly hurt for a few seconds.  And, the best thing about it, was I felt IMMEDIATE relief from having those out.  I was so pleasantly surprised and walked out of there very much encouraged! I am now able to sleep partly on my side, which is amazing too and I don't have to lug those drains around everywhere I go. So, today, was a good day and I am feeling great! Praise the Lord!


Its been a week since my surgery

Its been a week since my mastectomy with immediate reconstruction and things are going really well.  First, the surgery was successful and I am at home recovering.  This surgery was WAY bigger of a deal than the hysterectomy and I have even joked that I am not calling the hysterectomy a surgery anymore because this was a surgery! But, I can tell each day that I am getting better. There has been some pain and a lot of discomfort with this one.  But, I am encouraged with each passing day.  I also went to my post op surgeon appointment yesterday and she thought I was doing great.  And, the pathology report came back and all test results were negative for any abnormal cells so I have previved breast cancer!!!!

To give those of you who are interested a more detailed information about the surgery, here it is: My surgery was scheduled for 11 AM on Thursday May 5th.  I had to be at the one day surgery building at CMC at 9 AM.  Nathan was in Texas working and he was set to land in Charlotte at 8 AM.  I took the girls to school on Thursday and I really felt that both girls had less anxiety about this surgery than the last one.  I guess they are getting used to Mom having surgery.  My Mom also came with me for the surgery and she ended up having to pick Nathan up at the airport while I drove myself to the hospital, because I did not want to be late.  It was a good thing, because the hospital called me at 8:30 and said that the surgeries for that morning were moving along and they were ready for me.  When I got there, they immediately took blood work and checked me in.  Within another 15 minutes I was back in pre op.  All of the nurses and other who took care of me were very nice.  My anesthesiologist friend, Richard, was also there that morning and came in to see me before surgery.  It was a good thing because my veins were not cooperating with the IV (the nurse had tried 3 times!) so he with his mastered skills had to put my IV in.  After all of the prep and a prayer with Nathan, I was being wheeled back to the OR.  I do remember coming into the OR. It looked very similar with many people buzzing around and bright lights and big machines.  Within a few moments, I was asleep.  When I woke up, I was in recovery and I felt like I had been asleep for about 5 minutes.  I could see a clock in recovery and it said 5:22.  The room was spinning around and I remember saying, "excuse me mam, but the room is spinning."  She said no problem.  Then, I was out again. The next time I woke up about 30 minutes later, the room was no longer spinning and they were bringing Nathan and my Dad back to see me. I was very groggy and I could tell it was a much slower coming out from under the anesthesia than last time. I called both my girls, who were with Mom and had a brief, but positive conversation with them.  My Dad stayed for a bit, but he soon left and Nathan stayed with me for the rest of the night.  I do not remember much about that night except they gave me a morphine pump to use and I slept a lot.  The nurse also came in every few hours to "millk" my drains.  During the night I did use the morphine pump a few times, but it would put me to sleep immediately.  When I woke in the morning, Nathan went home to shower and change and my Mom came to help me at the hospital.  I knew that I wanted to go home that day, if possible, and to do that, I would have to get up out of my bed.  Both of my surgeons came by to check on me and said that I looked good and that if I wanted to go home, I would need to use the bathroom and manage my pain.  So, I was determined that I was going to get home.  The nurse gave me some oral pain meds, which took much longer to kick in than the morphine pump, about an hour.  When I went to sit up, I was very overwhelmed by the sharp pains that I experienced in several areas around both breasts and under my arms.  It was excruciating, to say the least and I had never experienced any pain like that before.  I looked at my Mom and said I did not think I could get out of the bed and she said, "Oh yes you are!" which helped me get my determination to do just that.  It was very slow with many winces and cries out in pain, but I did make it to the bathroom and I was able to go with ease (thank the Lord!). Then, my Mom helped me sponge off and after the pain meds started to kick in I could get a little more comfortable, if I did not move! I was able to go home after lunch that day and Mom took me home.  Nathan brought the girls home from school to see me and we had a short nice visit.  It was so good to see them.  Both girls were going to go to a different friend's house to spend the night so they packed their bags and I dosed on the couch.  I was so thankful for my friends who allowed the girls to come over for a fun, safe night.  I really felt good knowing that they were being so well taken care of.  My parents and Nathan took care of me that night and evening and it went okay.  Still sharp pains every time I moved, but the pain medicine helped me sleep.  I was able to sleep on my back, but definitely not my side.  The drains had to be "milked" and calculated every 4 hours or so.  Mom helped me with this since it was just too much for Nathan.  That was okay though, he was a trooper.  Since it was Mother's Day weekend, Nathan took the girls the next day to see his mother for the rest of the weekend, which was so nice because I was able to just let my Mom take care of me and the girls did not have to see me in so much pain.  By Sunday, I took the anti-nausea patch off that they gave me in the hospital and the next pain pill I took, made me sick to my stomach, so I was not having that and decided to switch to Advil.  I really felt that Advil helped alleviate the pain, just as well as the heavy narcotic except it did not make me sleepy.  Mom suggested I take a benadryl at night to sleep, which I did and that helped me sleep some.  Over the next few days, those sharp pains subsided and really I would describe how I feel as uncomfortable and tight, not really in pain.  I have been doing all of the arm exercises they asked me to like lifting my arms over my head and stretching them, as well as, the breathing exercises to ensure I would not get pneumonia.  I also walk 3 times per day, first around the house, then Mom's pool and I am now up to walking about 10-15 minutes around the block.  I still feel tired and I take one nap per day, but overall, I feel good about my progress.  The meals and visits from friends that I have received have been amazing and have taken the stress off of me to make sure that my family and "helpers" ie Mom and Dad, are being fed too! The next things I am going to focus on now is not having any complications like infection at the incision or hurting my expanders in any way. So, I am still in process and will continue recovering at home.  Thanks to everyone who has helped me in this journey!