This Princess Has A Pea
Updates
Breast Cancer -versary #2
Feb 10th
Just the Facts: It’s now my 2nd Cancer-versary. I was diagnosed with breast cancer on February 12, 2010. And it has been an entire year since my last post on this blog. An update is due! Rest assured, the news is all good: I am fine! In fact, I think I’m healthier than I’ve ever been!
Details: Thankfully, the last year has been pretty quiet in terms of cancer treatment. It wasn’t without some ups and downs, though and they primarily revolved around my taking the prescription drug, Tamoxifen. The doctors recommended that I stay on Tamoxifen for its estrogen-limiting effect for a full 5 years following my breast cancer surgery. The clock started in June of 2010. Side effects were manageable at first, limited to some fatigue and hot flashes, but as the year went on, things got a lot worse. The fatigue became severe, and I also experienced mental fog and assorted “female” problems. But probably the most difficult side effect for me was significant hair loss. I was losing a lot of hair in the shower everyday and it seemed to be worsening with time.
My hair after about 11 months on Tamoxifen
I was more than a little troubled by this and so was my oncologist. When I saw her in July, she suggested I take a break from Tamoxifen to see if my side effects went away. From the beginning, taking Tamoxifen was like having an insurance policy. We were certain that my cancer was all gone after the surgery, but the drug was to ensure that any remaining cancer cells would not be able to grow. It wasn’t until a few months later, when I had been off the drug for a while, that I could see how much my quality of life was truly suffering while I was on Tamoxifen. By the next time I saw the doctor, the hair loss had slowed down and according to my hair stylist, I even had new “baby” hairs coming in all over my head. I had also begun to feel much better in general.
My hair today, after being off Tamoxifen for 8 months. Can you tell a difference? It's not completely back to normal yet but it's getting there! The baby hairs are the ones standing up! ha ha
My oncologist suggested that I stay off the Tamoxifen a few more months and consider re-starting it in early 2012. I had made it a year on the drug, just 20% of the recommended amount of time. But even so, she estimated my chances of recurrence to be very very low, all things considered. After being off the drug for about 8 months now, I can’t imagine going back on it, and I don’t plan to. The bottom line is: I am very confident that I am cancer free and will stay that way. I know it is a risk, but I believe in the path I’m taking. My next visit to the oncologist is later this month, and I expect a good report. After this visit I will see my breast cancer surgeon for a follow up in May or June, and then I will switch to a biannual rather than quarterly check-up schedule. That’s a milestone! It must mean that the docs are pretty sure I’m ok, too!
April 6, 2012 is the anniversary of my cancer surgery. (I’m so weird about anniversaries and dates. They are all emblazoned into my memory. And each one carries its own set of emotions and issues.) On one hand it seems like forever-ago that I had the mastectomy surgery. On the other hand, I’m still trying to get used to the sensation of the implants on my chest, and the lack of sensation in many other parts of my torso. But April 6 is an anniversary I celebrate! I think of it as the day I beat cancer!
The cancer may be gone, but like a ghost, it continues its haunting.
There is not a day that I don’t think about the possibility of a recurrence. The choices I make everyday with the way I eat, exercise, sleep, think, pray, etc are all framed within the context of being a cancer survivor. The haunting is fading with time, but on some level, breast cancer will remain a battle for me to fight from now on. Good thing I’m StrongerSarah! 
picture credit: the Girlfriend Book
What’s coming up? Routine check-ups with my oncologist, breast surgeon and plastic surgeon. According to my plastic surgeon, a new variety of silicone gel breast implants, called the “gummy bear” implants, may receive FDA approval sometime soon. He believes that this style would work much better for me. (I still have some problems with my implants.) Apparently the FDA has been “almost ready” to approve them for years now, despite Europe and pretty much everywhere else having approved them years ago. Should this happen, I may consider getting the new implants before the time when my current ones would normally need to be replaced (10 years or so). My plastic surgeon advised me not to “hold my breath” on the FDA approval. In the meantime, I’m very happy to be done with surgeries.
Prayer Requests: Besides a prayer of thanksgiving for my good health, my prayer is the following: that women would take their risk of breast cancer seriously, be proactive about their breast health and their health in general, and have their screenings done on time. Sometimes it’s easy to think of cancer/diseases as things that just happen to others. But breast cancer strikes 1 in 8 women. Some say that statistic is an underestimate!
As for me, I’m doing really well. And I expect to continue for another 50 years or so, at least! Thanks so much for your prayers and support through all of this.
Cancer-versary
Feb 12th
Just the Facts: A year ago today I was diagnosed with Invasive Mammary Carcinoma — a “pea” was found. Ironically, I had one of the last visits I’ll need with my plastic surgeon this week. In the course of a year, I’ve discovered I had breast cancer, had a bilateral mastectomy and had two follow-up surgeries to reconstruct my breasts. This journey really has no end, but, thankfully, I am through the rough part. My health is now excellent and on top of that, I’m pretty much looking myself. This year hasn’t been easy but it’s over, and I’m ready to focus on other things!
Details: On February 12, 2010, I answered my cell phone to hear a radiologist’s voice. I knew that since the doctor was calling (not a nurse), this was bad news. He proceeded to tell me that the biopsy I had two days prior had revealed Invasive Mammary Carcinoma. Life changed instantly as I realized what might happen as well as what would have to happen.
Later I would learn that I had not one, but two tumors. They both turned out to be sort of small, each slightly larger than a pea. My choices for treatment were really not too difficult to make. In order to be most aggressive in this fight, I needed to have both breasts removed. Thankfully, I found a wonderful breast surgeon and an equally incredible plastic surgeon. I had a bilateral mastectomy with immediate reconstruction on April 6, 2010. That was the day I conquered the cancer!
Following the surgery, we learned that my lymph nodes were cancer-free and that the margins from surgery were clear. My cancer had apparently been confined to the breast tissue, which was now gone. Later a special diagnostic test was performed on the tumors and it revealed that the cancer would not respond particularly well to chemotherapy, but would be responsive to hormone therapy. We rejoiced at that news! No chemo, although five years on the drug, Tamoxifen, was essential.
Through the summer I went through the strange process of tissue expansion in anticipation of a second surgery to place silicone breast implants. I am thankful such procedures exist, but it was both exciting and highly annoying. On August 31, 2010, the tissue expanders that had been placed at the time of the mastectomy were replaced with silicone implants.
Life with implants is somewhat strange too, but so much better than expanders. At first, I was very pleased with the outcome of the exchange surgery. Then, something went wrong. The internal sutures on the left side did not hold as my plastic surgeon had planned, and the left implant shifted. It was not good. So on December 27, 2010, I had that fixed.
I am technically still recovering from that surgery. It has been about 6 and 1/2 weeks. My plastic surgeon says that 8 weeks is the absolute longest it should take for the implants and sutures to be “set”. I am taking every precaution to make sure that things don’t shift again. For this period, being “careful” has meant among other things: no kettlebell training nor any form of weight training, no heavy exercise, no lifting anything heavier than a milk jug, and sleeping in a recliner with pillows propped all around me for support to avoid any shifting. Yes, I have been sleeping a recliner for almost 7 weeks. (And will continue for another week.) This is that important!
I see my oncologist every three months. I will be doing that for another 2 years, then less often. I go back to my breast surgeon for one more follow-up with him in a few months. And I still have a few things for the plastic surgeon to finish up, though overall we are generally pleased with the outcome of this last surgery. As far as we know (and we certainly HOPE) there should be no more breast reconstruction surgery. Just a few finishing touches. 
Those will be completed later in 2011, probably.
Sometimes I still can’t believe all this has happened. Aside from some symptoms from the Tamoxifen, I feel great. It’s weird to think that I am a breast cancer survivor. But I am! And as predicted, I am certainly STRONGER now!
What’s coming up: Some more healing, physically and mentally. More doctor visits. More plastic surgery. But the worst is definitely over.
Prayer Requests: A year later, I am cancer-free and strong. Please thank God with me!! The blessings I have received through this trial far outweigh the difficulties I have had to endure. It’s okay to pray that the cancer stays away, too.
This blog: Given that this journey is winding down in a big way, the blog is too. I can’t tell you how much the support from friends here has meant to me. But it is time to move on. I’ll only update this blog a couple more times, probably. It will have to be something huge to do so, and I’m hoping that there really isn’t anything else huge that happens. However, I’m leaving the blog here, in case there is someone who might want to learn about my journey. Unfortunately, breast cancer is running rampant, and we will all know someone who will be diagnosed with it at some time. I don’t know if reading about my journey would help someone else facing a similar path, but it will be here, just in case.
Thank you for reading and commenting over the last year. I pray that everyone who has reached out to me in any way would receive tenfold blessings in return.
Wishing good health and happiness to all!
((Hugs)),
Stronger Sarah
New Year, New Sisters
Jan 1st
Just the Facts: I had revision to breast reconstruction surgery 5 days ago. I handled the surgery and anesthesia well and returned home the next day, after 24 hours on antibiotics. The doctor actually did more revision work than he had planned, spending almost 5 hours instead of 3 in surgery. I went home with 2 surgical drains, but they were removed after a couple of days.
Details: On Monday, December 27, I underwent more plastic surgery to correct problems with my prior breast reconstruction. Alloderm was to be used over both of my breast implants. I was to receive new implants, and the left side was to be reconstructed, pulling it toward the middle. All of that was accomplished. In addition, the doctor revised the “pocket” that held the right breast as well. He discovered that this was necessary when he assessed the situation at the beginning of surgery, and discovered that the right side was beginning to shift just like the left had. This lead to an addition 1-2 hours of surgery to correct that problem, but I am very thankful that the work was done then. It potentially saved me from another revision surgery in the future.
I stayed in the hospital until the next morning when my course of antibiotics was complete. I had 2 surgical drains, one on each side, but the drain tubes were much smaller and easier to manage than those I had after the mastectomy. They still had to be tended, and pulling, twisting and catching them wrong had to be carefully avoided. I was only able to do sponge baths while I had the drains, but thankfully I was able to have the drains removed on Thursday and I’ve had no fluid build-up or other problems since then.
The pain has been a bit worse this time. That’s probably because so much work was done on both sides. The right side is especially tender. The pain meds help but I don’t like feeling groggy from them, so I’ve stopped taking them except at night. Of course, I’m still groggy from the general anesthesia anyway. But going off the narcotic pain killers is the first step toward feeling more normal, and that’s a good thing!
As usual, the “breasts” are covered with bandages. I can only tell so much about how they are going to look. But what I see looks SO MUCH BETTER than before!! I am thrilled, relieved, and also concerned that I will somehow “mess it up” again. Every time I use my arms to reach or pick something up, I think about taking it easy and worry that the glass of water, piece of laundry, etc that I just picked up will stretch or pull me too much. It’s nerve-wracking. I’m really looking forward to my appointment next week with my plastic surgeon so I can review what is safe to do. I DESPERATELY DON’T WANT TO MESS THIS UP! It looks good. I like these “Sisters”. I want to keep them!
This time around we have a recliner for me to sleep in. It has made a huge difference in how comfortable I am at night. After this type of chest surgery, lying flat is really uncomfortable. Being able to be in a semi-reclined position makes all the difference. I am so thankful for my recliner, but at the same time, I’m really looking forward to getting back to my real bed. Based on my past experience, it will probably take several weeks before I can tolerate lying flat.
Me: Nervous that I will damage the delicate work that has been done, but very hopeful. Thankful for a great doctor, good insurance, and a wonderful husband who has selflessly taken care of me every step of the way.
What’s Coming Up: Bandages come off on Thursday, when I see my plastic surgeon for a post-op appointment.
Prayer Requests: Please pray that this time I would heal properly, that the “Sisters” would stay in their current positions! Pray that my pain would continue to diminish and so would the grogginess. Pray that the blues would stay away.
Thank you: to Frances for taking care of my children while I was in the hospital and to Paige, who always finds the perfect way to help. Thank you, everyone, for reading, tweeting, commenting and encouraging me in so many ways. It has meant so much!!
All I want for Christmas
Dec 18th
Just the Facts: Surgery to revise my breast reconstruction happens on Monday, December 27. I will be in the hospital overnight for antibiotics. I have had my pre-op appointment with my plastic surgeon and the hospital pre-op appointment, to speak with an anesthesiologist. Everything is ready to go. The surgery will fix cosmetic problems, so by nature, it is much less serious than what I have gone through in the past. However, I have been very unhappy with the outcome of the reconstruction, and am excited that the problems will soon be corrected.
Details: All I want for Christmas is not my two front teeth, but two reconstructed breasts that face the front! Back in late August, my plastic surgeon (who I still believe is top-notch) performed the second phase of my breast reconstruction: exchange surgery. The hard and uncomfortable tissue expanders were traded for soft silicone-filled breast implants. He also did some repair work at that time, since my left side was troublesome-looking and had been ever since the mastectomy. The doctor re-sected and restitched the left “breast” to make it move more towards the right, creating a little cleavage. However, over the next few weeks, those internal sutures gave way, and the left implant began shifting back to what seems to be its desired destination: my left armpit. It is not evident with clothes on, but the reality is that the left side is messed up. One messed up side is one too many.
My doctor has other techniques to use to remedy the situation. This time, he will add Alloderm to give the left side more structure, and will move the “pocket” for the implant permanently towards the right by re-secting and suturing extensively in several different places. Alloderm will also be used over both “breasts” to correct fairly severe rippling, which often happens when someone “thin” gets implants. (If you are thin, your skin is thin and cannot camouflage the implant under it very well.) Excess skin will be removed from both sides, which should also help with rippling. Both of my scars will have to be re-opened for this surgery. I will receive two new implants, and I will need IV antibiotics for 24 hours. I’ll be in the hospital overnight and will have a surgical drain on each side. The drains will need to stay in place until there is minimal output, likely several days.
When I look, I see “DEFORMED” right now, and am so glad to be doing something about this. No one else (other than Tracy and the doctor) have seen the problem because it can be covered up in clothing. But in bathing suit season, it would be no secret. If there is a way to fix this, I want it done, and ASAP. Thankfully, we have excellent insurance which is paying for this re-reconstruction. Were it not for that, I would probably live with having a breast under my arm. I am truly grateful that I don’t have to do that.
Me: Looking forward to getting this over with! Excited about what the doctor described as my potential outcome. I will forever be changed from breast cancer and my mastectomy surgery, but hopefully I will not always be uncomfortable with the way I look. I am grateful too. This is cosmetic stuff, after all.
Prayer requests: That nothing, including a pretty severe cold (or is it the flu) that I have right now, will stand in the way of a smooth, uneventful surgery. Despite my earnest desire to have this surgery, anxiety over the process in general has crept in before my other surgeries in the past. Please pray for peace for me. Pray that my children and husband would stay healthy and that they would also be free of stress from this.
Not bad!
Sep 10th
Just the facts: Yesterday was a follow up appointment with my plastic surgeon following the Exchange Surgery ten days ago. Bandages were removed. The doctor is pleased with the way his work turned out and I think I am too.
Details: There were stitches and lots of dermabond across me when they removed the bandages Thursday. I guess they do the glue thing to minimize scarring. The scars are huge, reddish/purple and “angry” looking right now. Not much different from right after the mastectomy surgery, but that is to be expected. The scars really should fade to a white line eventually.
The implants do look pretty nice, I must say. What an improvement over the expanders!! I look human now! There is still some swelling and the implants will “settle” over time. My plastic surgeon gave me some special massage techniques to do to make sure that the settling process happens properly. It will make me look more natural, he says. It also will prevent capsular contracture, a condition which happens sometimes and could require early implant replacement. (The lifespan of the implants is typically about 10-15 years, after which time I will have them replaced.)
There are some imperfections. My doc worked hard for improvement, and even used techniques which included perforating my left pectoral muscle and the existing Alloderm in order to reposition the tissue for a more pleasing look. (Side note: the athlete in me GASPED at the thought of a perforated pec, but although I can’t test it at the moment, I sense there is no real loss of strength or function.) The doctor’s work seems to have turned out well. Although I see imperfections, in all honesty, no one else will probably ever be able to tell that anything is less than ideal there. It truly is amazing what my fine doctor was able to do.
I return to see the plastic surgeon in a few months for another follow up. Then we’ll talk about whether or not I might want the additional finishing touches which are available as part of complete breast reconstruction. No, I will not be going into details about those here. If you are interested in what in the world I might be referring to, you can read this.
I’m doing better after speaking with the doctor and getting through the big unveiling. I still don’t feel like ME, but I can tell I’m moving in the right direction.
Retail therapy continues to be high on my list. Tomorrow I’m heading to a store called the Unique Boutique, a store that supplies mastectomy patients with garments and items for their needs. Fact: Most insurance companies will pay for mastectomy patients to have four new custom-fitted bras. I believe this may be an annual provision also, but I know for sure that it works for me right now. I visited the Unique Boutique before my mastectomy to pick up some other things and I know the quality and caliber of the items they carry. These will be among my options as part of the insurance provision. I’m pretty psyched!
What’s Coming Up? Not a whole lot. I’m still on restricted activity for a while. My next appointment with the plastic surgeon is in late October. I see the oncologist again a month after that. There are no other appointments on the books at this point! WOW!
Prayer Requests: Praise and thanks. It is good to be here, and I would not be here except by the grace of God.
Note: Thank you for all the encouragement, kind words and comments this week. It is/was not easy to talk about being down, but I felt it was important to be REAL. Your kind words helped me so much.
Now Presenting . . .
Sep 8th
Just the Facts: It has been 8 days since my Exchange Surgery. Tomorrow I will see my plastic surgeon for the first time since surgery and the bandages will be removed. I have had a more difficult time recovering from anesthesia this time and more pain than expected but I’m beginning to feel much more like myself now.
Details: My tissue expander-to-breast implant “exchange” surgery for breast reconstruction was August 31. The last 8 days are truly a blur. I have literally been dizzy and groggy most of the this time. I am not sure why recovering from general anesthesia has been worse for me this time but I’ll blame it on the tamoxifen I’m taking. (Why not? I blame everything else that goes awry on the tamox. It’s convenient, if nothing else.) Today is really the first day that I haven’t felt like someone played games with my brain that zapped upwards of 20 points from my IQ. ( I only feel about 10 IQ points down today. )
Here’s another thing that has happened in these post-anesthesia days, and after other surgeries in the past. This takes courage to say. It doesn’t matter how much better off I am for having done whatever I did, or surviving what I survived, but after surgery, I get blue. Maybe you could go so far as to say: slightly depressed. I know I have been through a lot lately and it’s probably understandable even without the surgery, but the logical side of my brain is quite annoyed with all these emotions. After all, I have attacked and I like to believe, conquered cancer. I have muddled through a summer of the dreadful process of tissue expansion, and FINALLY, had the second and last stage of surgery for reconstruction, with the sole purpose of improving the way I look. I should be THRILLED. Meh. Instead, I am teary and blue, and can find little to be happy about. At least I know this will pass. I can’t wait. This is stupid.
So tomorrow, my most-excellent plastic surgeon will remove the bandages to reveal the (almost) final product. There is still some swelling, and I believe that the implants will still “settle” a bit more, so what we will see is still only “close” to final. But I can tell already that things are MUCH improved. I can’t wait to hear what the doctor has to say because honestly it’s tough for me to judge. I see some imperfections, but hey, all in all, what they are able to do is pretty incredible.
There will be a tense moment for me when the the bandages are removed and once again, the scars are revealed. It shouldn’t be that way, I suppose. When the bandages were removed revealing the scars for the first time a few months ago I was a bit unprepared. It was dramatic. Maybe even breath-taking, in not-such-a-good way. But the scars are just reminders of what I’ve survived (by God’s grace), and the ways I have been blessed. They have been a part of me since April 6 and have only been hidden 8 days. I don’t know why I feel even the least bit apprehensive about seeing them for the first time again.
Today I got a manicure and pedicure. Yeah, it’s fun. But when I walk out of the nail salon I feel all girly and pretty: a boost to my self-image. Boy, do I need it. The mastectomy surgery saved my life but was also a mental blow. Afterwards, I suddenly felt sort of un-feminine. Since then I’ve been consciously and unconsciously searching for ways to fill that loss. I have grown my hair to the longest length it has been since childhood. My wardrobe now includes skirts and dresses, of all things. And the nail salon trips: oh, yes. It should begin to improve now. Thank goodness — my bank account needs a break.
So, mid-morning tomorrow I get the full view. The doc will reveal the breasts he built me. I’m going to do my best to make sure the “blue” me stays home and the happy, girly me is the one who shows up in the doctor’s office. Maybe afterwards, the blue one will leave for good.
‘Twas the Night Before Surgery
Aug 30th
Just the Facts: Tomorrow is my Exchange Surgery. It’s outpatient, at Carolinas Medical Hospital in Charlotte. I’m the first one of the day for my doctor, so it will get started around 7:30 or 8:00 am. I hope to be home by mid-afternoon. I’m very excited to be getting this over with, and just a little bit nervous.
Details: I have been waiting months for this surgery and the day has finally come. I will say goodbye to my tissue expanders tomorrow and wake up from surgery with implants which should look and feel about a million times better than the expanders. I am SO psyched! But first, I have to go through the surgery.
It’s outpatient this time, thank goodness. The surgery is expected to take about 2.5 hours. My plastic surgeon takes his sweet time (a very good thing, in my opinion) so it may last longer than expected. I should be out of surgery by 11:00am EDT, if all goes as planned. This surgery is performed under general anesthesia, so I’ll then have to spend another couple of hours in recovery. I’m hoping to be home early to mid-afternoon.
I feel very positive about the surgery itself. I’m strong and in great health. I came through the mastectomy surgery well last April. I have not had problems with anesthesia in the past, and they will be using they same drug combination as last time. I do dread the sleepy, sluggish feeling that I felt for several weeks after the last surgery. But it shouldn’t last as long this time, since the surgery is shorter. Sometimes I do a little shudder when I think about the surgery and what they will be doing. But it SO needs to be done and I want to have this all behind me. No doubt, I’m ready.
I will have at least one surgical drain when I wake up. Its purpose is to keep the delicate tissue from becoming too moist. Today I located all my “drain management” equipment from last time, when I had four. What a nuisance! It’s just for a short time, I know. But ERRGH!
No recliner. We looked at them and tried a whole bunch of them out. Many seemed to be potentially hazardous to someone with tender places and/or stitches, given how difficult they were to open and close. So that’s off the table. (It’s a good thing, because we’re out of time now.) We’ll do the pillow propping thing on the sofa again. No big deal.
Now I am starting to remember what it felt like the night before my last surgery. I was very ready then too. Maybe moreso. And hyped up. I’m the same this time, but more nervous. I’m not sure why. Where is my sense of humor? I miss it!
Me: Excited. Nervous. Ready. Lots of things, but not worried.
Prayer Requests: Pray that the doctor and his team would do their jobs well, that there would be no complications and that everything would go as planned both with my surgery, and at home. Pray for a peace for Tracy as he waits.
Updates tomorrow: Tracy will be posting on my Facebook wall and here tomorrow to say that I’m out of surgery and doing fine. That WILL be the case.
Thanks for the encouragement, good wishes and prayers.
Exchange Ahead: Details
Aug 15th
Just the Facts: In sixteen days I will have outpatient surgery to complete this phase (the major part) of my breast reconstruction plastic surgery. This is a follow-up to the immediate reconstruction which began on April 6, after my complete double mastectomies. The upcoming surgery is known as “exchange surgery” in which the doctor removes the hard, saline-filled tissue expanders and replaces them with breast implants. The implants will be much more natural feeling. After a few weeks’ recovery, I should look and feel much better, and at that point most of the reconstruction will be complete.
Details: Breast reconstruction began for me right after the mastectomies. Literally, my surgeon finished his work, and then my plastic surgeon began the reconstructive surgery. That’s one reason I was in surgery nearly 6 hours back on April 6.
At that time, my plastic surgeon placed rigid plastic tissue expanders on my chest wall. They resemble dome-shaped baggies, and each one has a metal port. At the time of that surgery, he was able to add some saline to the expanders. I believe that was 100ccs in each side. It gave the effect of still having (small) breasts, which was wonderful, mentally! It was truly a blessing to never have to experience flatchestedness. More saline injections were needed to make me look like a grown woman, though.
After a few weeks, my plastic surgeon began the process of inflating the expanders with additional saline injections through metal ports. This was a very cool thing to observe. Remember, a sense of humor is absolutely REQUIRED here! Each week I returned to his office to be injected with anywhere from 30-50ccs of saline in each expander. This gradually stretched my skin, forming a somewhat normal looking bustline for me. Although we didn’t have much choice, Tracy and I were able to offer some input on how much saline was ultimately added, thereby choosing my final “size”. There was only so much room for discussion, since I literally have thin skin, according to the doctor. (Thin skin comes with lower body fat.) I could only go “so big” since bigger would have stretched my skin too thin, making the edges of the implants visible once the final surgery was done. Given that my build is fairly athletic these days (and I expect to keep it that way), I am content with the size we have achieved. It is acceptable, although I won’t stop traffic or anything.
I have had a love/hate relationship with the tissue expanders. I’m so glad just to have a feminine shape! But since the time I woke up from the initial surgery, they have been uncomfortable. They make it difficult to sleep, to move normally, and to give hugs. At one point, the pressure on my ribs from the expanders was so great I was in heavy pain and felt nauseous. On the other hand, the expanders have been a constant source of humor for our family. Everyone knows to (physically) avoid them in order to avoid injury to themselves! We have also laughed at the way they have morphed through this process. Seeing them grow was funny on its own, not to mention the tricks I can perform with the metal (magnetic) port just under the skin on each “breast”. But over time (due to my rigorous exercise, according to my doctor) the ports have shifted, which has made the overall breast shape distorted. Also, I have noted that for whatever reason, the expanders just look different every day. Maybe it has something to do with the barometric pressure or something! But each day I wake up and take a look to see what in the world I’m working with that day. It has been over three months since my last saline injection, and I’m finally finished with this waiting period, which was designed to ensure that my skin had adequately stretched, making a nice “pocket” for the future implants. As interesting as this has been, I will not miss the expanders at all when they are gone!
Some decisions about exactly which implants I will receive still remain, and will be made by the plastic surgeon during the surgery. My general size has been already determined, based on the total amount of saline that was injected. The doctor explained that there would probably be two options at surgery. He would order a set of implants in two different types: the High Profile and the Moderate Plus profile. The difference has to do with diameter and projection. Each type has more of one or the other. Personally, I’d like to maximize both. When my children were in preschool they learned a helpful adage, which perfectly applies in this scenario: “you get what you get and you don’t mind a bit”. I will be content with whichever I get, but If I could choose, I think I’d prefer a larger diameter. This would create a more normal looking cleavage (hopefully). After dealing with two mounds separated by a mile for the last 5+ months, I am really hoping to once again have breasts that exist in the same zip code.
The final decision making will be done by my plastic surgeon and his team in surgery that day. Apparently, they will try both types out, sit me up, take a look and vote. I can’t tell you how weird that makes me feel. But they do this all the time. I trust that the nurses, the doctor and the representative of the manufacturer of the implants want me to look as good as possible, and will choose the most natural looking implants. Nevertheless, I still cringe at the thought of the whole “trying on” affair while under general anesthesia!
The surgery itself will closely resemble the original breast surgery. I currently have two large horizontal scars from armpit to mid chest on each side. The plastic surgeon will open these again, so at least there will be no new scars. I had hoped that the incisions would be smaller this time, as the bigger the incision, the bigger potential for discomfort afterwards. (But you get what you get . . .) After the doctor experiments and chooses my new implants, he will then complete some additional reconstruction, focused primarily on my left side. For whatever reason, the initial work on that side did not turn out as well as hoped. This time, we are looking for more symmetry and balance. This is going to require additional use of Alloderm, a special type of grafting tissue. The Alloderm was used extensively in the initial surgery to form the bottom “sling” part of the future breast area. This time, it will be used to rebuild part of my chest wall and reposition my left “breast”. Unfortunately, use of the delicate Alloderm requires a drain or drains in the days or weeks that follow surgery, so that fluid doesn’t build up and ruin the special tissue. So, I can look forward to going home with a drain after this surgery, but one drain beats four (what I had last time). Hopefully I’ll be able to have the drain removed soon after. I will once again have numerous internal and external stitches, basically mimicking what I had from the prior surgery. I’ll probably just have a small bandage covering the whole thing.
My recovery should be easier than after the mastectomy, but very similar. The doctor said to expect to feel beat up again. I guess that means sleeping in my bed will not be happening for a while. Tracy and I are going shopping for a recliner for me this week, which should make sleeping and resting a bit more comfortable. I won’t be able to perform my normal exercise routine for at least a month. After a week or two, or around the time the drain is removed, I should be able to gradually build back starting with light weights.
What will be different is that this time I’m also dealing with a body under the effects of Tamoxifen. I love its ability to starve cancer cells of their needed estrogen, but Tamoxifen is making me feel like an old woman in many ways. I’m tired. I’m grumpy a lot. I like to sleep more than most anything else and I want my way. (Wait, maybe that’s nothing new? ) Bottom line, I’m not really sure what to expect. I think it will be much like last time, but who knows. At least we are in the home stretch of the whole ordeal this time. That’s a huge mental boost!
What’s coming up: A hospital pre-op visit with an anesthesiologist on August 18, an appointment with my oncologist on August 25, then surgery on August 31. School starts August 25, so I’ll have 5 days for some last minute prep and mini-nesting.
Prayer Requests: I am truly thankful for this plastic surgery. As much as I complain about the intricate details, I appreciate the fact that all this can happen. Please thank God for the gift of breast reconstruction. Please also ask Him for wisdom and skill for the doctor and the hospital personnel who will help me. Also please pray for no complications from surgery, and for quick healing and drain removal!