Preparing for Surgery: Take 5

Staged Reconstruction - that's what the doctor calls this series of "procedures."  (Hey, anything I have to have anesthesia for, and sign 20 pages of waivers prior to, I consider slightly more than a procedure, but there it is.)

Tuesday, November 8, is my next, and I thought, last surgery.  But when I went to the doctor last week to talk about what he would be doing (more on that later) he said something about doing this in "stages."  Isn't 5 enough?  Trust the surgeon, Luke/Rebecca.........say it with me, now.  I trust the surgeon.  I trust the surgeon. I trust the surgeon.  Rod says to trust the surgeon.  It's still a little hard to not have control here.

So, in September we had a "little look" at everything and I went in fully expecting that what I had was pretty much all that was going to be.  Considering what he had to work with post-mastectomy (very little) and based on the compliments from my other doctors and anyone else who wanted to have a look, I felt both lucky and still a bit dissatisfied.  But, I figured I got the "picky gene" from my mom and I had myself ready; if the doctor said this was as good as it got, it was okay.  As always, it's the uncertainty that gets you.

But, he didn't say that.  He said, now that everything had "settled" (I know, it sounds funny now, kind of like a house settling, but it's fairly accurate) he could see what else needed to be done. So, fat grafting (taking fat from elsewhere - and more about THAT later) and probably switching out the implants for different ones, and some excess skin removal where nobody but me (and he) notices.  2 hours or less, outpatient, I have no idea what kind of anesthesia, and a week from tomorrow beginning at 7:45 a.m.  I don't have to be there until a respectable 6:30 a.m. and I don't have to spend the afternoon/night before (in which I have to work my longest day) graffiti-d up with Sharpie marker because he's not around until the morning of the surgery, so he'll do it then.  You know it's a slow news day when I'm excited that I get to take a full shower at 5 a.m. the day of a surgery!

I'll have to wear "compression garments" (read: Spanx-like) for 2 weeks, 24/7 because he gets the fat from the abdomen, and "we want to avoid fluid buildup."  Oh yes, we do! (I guess it's better than the long-line bras.  I hope.  I pray.)

He has to get the abdominal fat via liposuction, and for a special low, low breast cancer patient price (not covered by insurance,) he'll just get the rest while he's at it. I've known about this for a couple of months, and so have not bought ANY new pants.  Here's where I really ought to tone down my expectations, but I just can't help it.  And to those, including me, who feel liposuction is just a risk no one need take, I say - he's gonna do it anyway, so risk already being taken.  In for a penny, in for a pound.  Or maybe 2 or 3. Maybe it ought to be "out for thousands for dollars, out with some pounds?"  (Wonder if the implants weigh more than the fat he'll remove?)  Hmmmm.

Fat grafting is how you get a little more "padding" where there used to be mammary tissue higher up than the actual "mounds." (I've learned some new terms.)  Fat needs to establish itself and "hook up" with the blood supply, so you can't graft a lot of it at once or it dies.  Hence, the potential need for future grafting, depending on how this batch thrives and if more is needed.  The discussion of tattoos is, temporarily, off the table.  I'm glad I don't have to argue that any more, this time around.  We'll get back to it later.


I've already called the anesthesia department at the hospital and gotten them to put a note in my folder re: IV line in arm rather than hand.  Rod (because his office was closed due to a power outage for the first time in about 20 years) waited patiently through a 3 1/2 hour run to the hospital for pre-admission bloodwork and EKG, and to the surgeon's office to drop off the "if I don't make it, it's not your fault" signed paperwork - and to get my $200 worth of compression garments approved. (For the record, I was told I should just buy two: one to wear and one to wash.  Really? This is my underwear for two weeks, day and night, and TWO?  Silly, silly people.)

Tomorrow (and in a rare display of sympathetic behavior on her part, I have to thank Dr. Eskow's receptionist, Grace for giving me an appointment in less than 24 hours) I go get a physical that I didn't know I needed (and I've never needed for previous surgeries) until my paperwork arrived in the mail on Saturday.  ("Please have the results of this forwarded to our office no later than a week before your surgery.")  You do the math. It's just barely getting done.

But it's all getting done, and we move ahead, bit by bit.