Follow up #1

Accompanied (and chauffeured) by ace amazing friend Elyssa, I went for my first post-surgery follow up appointment.  We got in early and were seen in record time.  Today Dr. D's nurse took care of everything, and it was such a lovely visit. I didn't miss the witty verbal sparring that usually comes with time spent with this very smart, talented guy.  Frankly, I had questions, I was kind of physically "pfft" and I just wanted to feel better.  I know I'm not a billion years older than when I had my last surgery, but it seems a little tougher than it used to be.

However: I can now wear camisoles with the elastic support instead of the tight-banded bra.  I can take a shower and soften up the bandages until they fall off. I can wash my hair and wear deodorant! (Doesn't seem like much until you're told you can't do it.) I can sleep, not quite on my side, but what they call "3/4" which I know how to do, requires lots of pillows, and is going to take a load off my back that I've been sleeping (or rather not sleeping) flat on with no movement for the last couple of nights.

I have to continue the every 6 hours valium, I CANNOT get back to my beloved Advil for at least until the drains come out (1-2 weeks) and I can't drive until absolutely all the anesthesia is gone for good, so at least until Monday. I've been told in no uncertain terms that the less activity I do,  the less fluid I'll produce, and the less fluid, the sooner the drains go. (I have to produce less than 30 or 25 ml on each side in a day in order to be free of the annoying but familiar tethers.) No raising my arms higher than the top of my head, no picking up from the floor, no lifting, cooking, etc.  This is by far the most limited in movement I think I've ever been told to be, post surgery.  Remember how I said it feels tougher this time? Turns out it's not me, it's the kind of surgery I had. I am not a billion years older. Woohoo!

But apparently these new snazzy implants are going too be worth it, and he took out all the hardened scar tissue that had formed around the necrotic fat cells. (After years of watching "Bones" and other medical dramas, " necrotic fat" is a part of my everyday vocabulary, isn't that just delightful?)

I will say that I took a quick peek while Yue (the nurse) was un-mummifying me (muttering to herself something about why did they use SO MUCH gauze) and things look a bit more encouraging. Maybe I'll be able to see myself as a "girl" again someday for real! (Okay, even I heard that and I sound like Pinocchio.) But you get my drift.

Seriously, Dude?

As the anesthesia wears off (I'm drinking like crazy because a) you're supposed to and b) you get rid of anesthesia faster via visits to the bathroom) I'm remembering some of what what Dr D'Amico said in Pre-op.   Note that there was no conversation in Post-op.  He didn't come out to talk to Rod either, which is a first.  I know he had a procedure right after me, so maybe that was it.

But it's okay, since I'll see him on Thursday. Undoubtedly we will get the post game then.  And he did put my own sports bra on me in surgery (Huzzah!) instead of the plastic and Velcro surgical bra monster so by the time we get to Thursday afternoon I won't be trying to climb out of my own skin.)

In Pre-op he tossed a couple of curve balls at me.  (One wasn't technically at ME; it was to a nurse: "we will need blah, blah, blah, blah, TWO DRAINS, blah, blah.".

Yes folks, DRAINS, again.  I reacted as you, dear reader, would expect, and I daresay, encourage.  "Drains? Noooooo......."

His (IMHO) casual response was that of course new implants need drains. I told the nurse I had almost broken the record for length of time with drains, and he said that this time would probably only be 1 week "or until the fluid is down." I know what that means; it means as long as it takes. I'll (having thought it over more than 12 hours later) concede based on his previous results.  And after even more thought, realized that the only times I had drains were when implants were put in.

As he drew on me with a purple Sharpie he pitched again, another quick casual one. "And when these settle in for good we'll move a little fat from here (pats general direction of my abdomen) up to fill in spots."

I swing: "B-b-but I thought these new ones are shaped to fill in higher up?" And miss:

"You don't want them too high up, right?" Right. (Again)

But, like always, the long game is what's important.  And thanks to 3 kids, a husband, school parents, teachers, and students, I have cultivated a little patience. Besides, Amazon Prime is right there for me when it wears thin :)

Better Living Through Chemistry - and Chocolate Milkshakes

I'm home and in some "discomfort."  But it's mostly soreness in the muscles I'm sure the surgeon was shoving around while I was out and couldn't whine at him.  My throat (from the tube) "hurts more, actually.  But on the hospital's cute little pictograph of 1 to 10, 10 being what happened on Saturday when I jammed my pinky toe into the doorway of Rod's car while climbing out to get a pedicure (in flip flops, no less) and badly bruising my foot in the place where I broke it over 20 years ago, and 3 being now, after 1/4 of an oxycodone and a Valium.....

God bless Rod and the chocolate milkshake he stopped for on the way home.  And Ari who unpacked my stuff and brought me a strawberry Activia. (Gotta counterbalance that Oxy, and besides it says to take with food.  Milkshake is food, yes?  Of course, yes.)

But typing is a little dicey, what with the pain/meds and all, so suffice it to say I'm home and there's no place like it.  Except maybe Hawaii.  Hawaii is REALLY nice.

Ready or Not...

Passover was great, and somehow here I am, 5 hours until no more food/drink.  I'm just a little stymied by everything, and nothing.  My office at work is tidy, I've laid out all my "hospital clothes" and washed every dirty dish, including the giant matzah ball soup pot.  And with that, Passover cleanup is over.  There are stacks of clean things all over that need to go back to their various cupboards and hiding places until the next "occasion" and I waver between wanting to put them all back and wanting to direct my recovery minions to put them back when I get home from the hospital.

When I get home from the hospital.  When I get home from the hospital.  When I get home from the hospital.  I'm starting to think like Sheldon from The Big Bang Theory.  Knock Knock Knock.  Everything, three times.  What's the magic formula that will give me the confidence to not worry about tomorrow?

No crystal ball, no magic formula, no ability to knock, knock, knock on the door of every single one of tomorrow's medical team and tell them to get a REALLY good night's sleep, for goodness sake.

I can make sure my own personal support system, Rod, gets a decent night's sleep.  The rest is just going to happen whether I'm ready or not.  Who's ever ready for surgery, anyway?

1818

1,818 days.  That is how long it has been since I was diagnosed with breast cancer a second time, and how long the road over, under, around, and through reconstruction and treatment has been.  As of April 9, I will be able to say that the cancer has not recurred for five years, which is something of a custom among people who cannot medically call themselves "cancer-free."

183 days - that's how long it's been since I have written in this blog.  So, you may ask, what prompts this entry?  

Well, last fall I met with Dr. D'Amico and had the surprising conversation about new implants.  And there we left it.  In the intervening months, our health insurance has moved from United HealthCare (who I knew how to work with by now) to Cigna (who I definitely had NO idea how to work with.)  So last winter Marie (Dr. D'Amico's "in-charge" off all things financial) told me that we couldn't do anything until we had Cigna officially and I could get her an ID card, which was January 1.  Promptly after New Year's I faxed a copy of the card over and called the office. 

Since I had met again with him in October, and had decided to go ahead if the (new) insurance company would cover the surgery, all that was left was telephone calls.  Marie called and then the nurse called, and I told them all the times I could NOT have surgery and be incapacitated or otherwise hampered by recovery dos and don'ts (BHSS retreat, RAC trip, Passover seder preparation) and the date was set - April 7, 2015.  It seemed like FOREVER until April.

But a couple of weeks ago the paperwork came in the mail - all the signatures, witness signatures, dates, and initials, plus an appointment for a pre-surgical physical and bloodwork.  Done, done, done.  And now it's April 1 and last night was my last Advil and tomorrow is my first special washing with the antibacterial soap and now it's REALLYREALLYREALLY real.

I've got my Passover supplies and my timeline spreadsheet and that, at least, is under control until it isn't.  The sponge cake could fall, the chopped liver could be "too" something or "not enough" something, the matzah balls could sink...and I wish I could turn off the other worries just for a couple of days.  Just to get my head into the Passover prep game, get revved up about enjoying the evening with my family, and then enjoying the second seder with my family and my friends at BHSS.

I did not take this decision lightly.  Much of the fat that was transplanted to help with the hollows from the mastectomy has, sadly, died, and instead of melting away and leaving, it has surrounded itself with scar tissue.  These are lumps that, oddly enough, are painful.  (Ironic, isn't it?  Completely numb in the reconstruction area except the stupid dead fat thingies.)  At any rate, this tissue is called "encapsulated" and some of the surgery is called a capsulectomy for that reason.  There is also an "implant exchange" (mentioned in an earlier post) and a "flap revision" which I don't know what that is but I'm guessing it has something to do with adjusting everything so it looks all even and (someday) attractive and natural.

Today I heard myself telling someone that it was going to be a good thing, and since the insurance was covering it, not too bad in the expense department, although our new deductible and out-of-pocket are bigger than they used to be.  Am I crazy?  Am I risking my life for a "bargain?"  Is this a bad decision?

I don't think so.  I think that anesthesia is safe, and I think I haven't had a problem with it in all the years I've been having surgeries.  I think that the lumps hurt, and I think I can see them in photos where I'm wearing clothing that is not even that "revealing."  I think the doctor is pretty damn good at his job.  But what do I know?  I know it is scary anyway.