I am recovering better this time than any other – except maybe after the lumpectomy, when my tolerance for pain was still high and no other parts of me were damaged from anything else! I can remember the surgery was on a Monday and I wanted to go back to work on Thursday, but decided to take the rest of the week off just to be sure. The surgeon ended up calling that day and telling me the bad news about the transected tumor, which made me freak out and cry all day (then I spent Friday getting second opinions), so it wouldn’t have been a very productive day anyhow.
No nasty phone call this time!
I did have a lot of trouble recuperating from the anesthesia and the painkillers. I threw up for about 24 hours, until I decided not to take any more painkillers (and to take lots of anti-nausea medication). Once that all wore off, I was finally able to eat a real meal Thursday night and started feel much better quickly. Although I probably could use something stronger to help me sleep, I have only taken Tylenol since Thursday morning. I’ve been waking up the last two days at 4 a.m., only getting about six hours of sleep. No fun!
I really didn’t think through the plan to have the doc excise the yucky port scar. It’s on my left side; breast work was on my right. And let me tell you, that scar hurts as much as anything! So, I’m all hurty on both sides. Lifting anything (even a heavy glass of water) is going to be a problem for a while. There is also a certain “reach and turn” or “turn and reach” motion that you do all day, every day, without thinking, that I can’t do AT ALL! But I do think I’m going to be able to do some stuff I thought might take longer – like driving, pulling weeds (as long as there is no twisting involved and I don’t have to pull too hard) and walking. I plan to give these things a try on Monday or Tuesday. I actually have permission to start walking and driving any time I feel up to it and have been off painkillers for 48 hours. Well, you’ve already heard about how long the painkillers lasted! I still feel a little “stumbly,” like I’m just a little too tired to be walking around without someone to watch over me. So, I’m taking it easy and plan to go slow.
The worst part of the surgery was getting the IV started beforehand. I’m sure some of you are thinking, “Well, if that was the hard part, then this surgery really must have been a breeze!” Ha ha. Keep reading, sucker!
I was always a “hard stick” before I ever had cancer. The record before cancer was six pokes in one session – if I remember right, two were ineffective, three times the vein collapsed, then the last one they got the rest of the blood that they needed. I really thought the port I was required to get for chemo was going to be my friend! I figured I could use it for blood draws and save myself this trouble. The problem is, at the majority of places I went, they never accessed ports, so they didn’t have anyone on staff who knew how. If that wasn’t the problem, then they would tell me something like “that goes into a blah-blah vein and we need a blah-blah vein.” So, I don’t remember my port ever being used for anything except chemo. I know it was never used in any surgery I had, even though I suggested it! Since it was an awkward reminder of chemo and hurt whenever my kid hugged me, I decided to get it removed the first chance I had. It sure wasn’t helping me and I’m not planning on having chemo ever again!
As I was saying, my pre-cancer record of pokes was six. Last spring, during a breast MRI, it took over an hour to get an IV started – I lost track of the pokes because I was crying too hard! Seriously. I’m sure I wasn’t making it easy on the woman, but it HURT! I stopped being nice about the “hard stick” issue after that incident and now tell people up front, “Look, I’m a hard stick. If you don’t think you can do this, get someone who can. Want to hear all of my horror stories?” One time when I said that, they took a look at my veins and sent “across the street” to the hospital for a special nurse. He got it in one poke!
Then, I had chemo, which is extremely hard on your veins. Apparently on Wednesday, mine were about the size of a piece of thread. The nurses tried twice, then turned me over to the anesthesiologist. Frankly, I was a little disappointed about that. The last anesthesiologist who started an IV on me must have actually hit a nerve because the sucker hurt the entire time. I woke up from surgery and said, “can I get this IV taken out NOW?” They left it in for another 1/2 hour or an hour and I was aware of it the whole time! So, this time, I was thinking, “great, an anesthesiologist.” I even told the nurse my anesthesiologist horror story. She didn’t have any comments to make.
I’m a great patient these days!
Perhaps she passed along this information or perhaps Dr. Anesthesia was standing outside my room and heard me, because he came in, examined my inner elbow and hands and said, “I’m going to try to start it in your shoulder.” My shoulder? Ok, I was threatened with one in my ankle before, but never in my shoulder! This should be exciting! I asked, “Is this going to hurt? I’m not so sure I can take it.” (I told you I’m a great patient.) He said, “I’m going to give you a local anesthetic, so it won’t hurt as much as it would without it!” Great answer Dr. A!
So, that’s how I found out you can get a local anesthetic before people start poking around to find a vein. The nurses are REALLY going to hate me now!
He poked my arm with the local, which stung just a bit, then dug around for a vein. More anesthetic, more digging. Then, he moved back to the crook in my arm. More anesthetic, more digging. My arm was starting to do that floppy thing that your lip does at the dentist’s office. It’s a good thing you don’t talk with your arms.
Oh, and it is important to note that I could not FEEL any of this digging! He could have extracted a vein for all I cared.
You know, I can’t actually remember where he got the IV in! Thank goodness for the locals! He could have done it in my little toe and I wouldn’t have cared. (Don’t laugh. They once started an IV on me in this teeny little vein on my index finger between the knuckle on my hand and the middle knuckle. Good times! That vein has since entered the witness protection program.) I think it was in the crook of my arm. I’m looking and there aren’t big bruises in my hand, so I think it must have been in my arm.
So … what else to tell you? Let’s see, we haven’t actually talked about my breast yet! I need to get a little boob talk in so I can maintain my ratings among the porn sites on Google.
The shape of my new breast is much nicer than it was last week. The surgeon removed extra tissue that had been left behind (my mastectomy was done at a bizarre angle because of the previous lumpectomy). The expander also is notorious for it’s weird shape. It’s kind of like a football that goes horizontally across your chest! Yeah, makes no sense at all. So, the implant is shaped like a breast. The end result, I have to say, is not bad. It’s not me, but it’s not awful. It’s much harder than I expected, which, coupled with the pain, is what is causing me sleep problems right now. I have to believe this is going to get better! Most people I know talk about how wonderful the implants are compared to the expanders – I’m just not feeling it yet.
The big problem is, it’s about four feet higher than my real breast. Ok, I’m exaggerating. It’s only three feet higher.
Usually, people who want to keep their other breast have a lift and reduction on the real boob at the time of the implant exchange surgery. However, a lift severs your milk ducts (and may sever your nerves, although nerve damage can usually be avoided by a good surgeon). I really would like to have more children. At least one more. And I have a really, really hard time imagining myself with another child and not being able to breastfeed. It kills me just thinking about it – and I don’t even have a baby or any ability to get pregnant any time soon.
I just keep thinking, “hang on to the breast until you have a chance to have another kid.” But now I’ve had this surgery and I can start to see, even with a bit of swelling left behind, that it’s going to be impossible to hide the major differences in my breasts. I want is to look normal in clothing. I can deal with the not looking normal OUT of clothing for a few years. Few people would ever see it. These last few months, I just kept waiting for this surgery and regretting a bit that I had put it off – I just wanted to see if things would look better after. Well, the new breast looks great, on it’s own. With a nipple added, it could win a wet t-shirt contest all by itself. Side-by-side with my real breast (which I truly was very happy with until they cut off the other one), I look a bit freakish. But, again, like I’m ever going to actually enter a wet t-shirt contest! It’s just that I wanted things to look more even and level when I had clothes on. It isn’t happening just yet.
Things definitely look better WITH a bra on, which seems like that would be an easy thing to take care of. Even though I haven’t gone out in public without a bra since I was about 22, you’d be surprised at the number of situations where you are around people who you’d rather not share your very bizarre looking chest with, even through clothing. Just in the last couple of weeks, I’ve had multiple incidents where a delivery person has come to the door and I was still in PJs. Last weekend, a friend stayed over. Even though she knows what it looks like, I still feel horribly self-conscious about it around people outside of my immediate family (who see it every day and are as used to it as me, which isn’t really all that used to it.) Then, on Wednesday, just before the surgery, I got up early to do some planting. I didn’t put on a bra because I figured there was no point in getting one dirty – I was just going to hop in the shower in an hour and the neighbors can’t even see my house, let alone me. I forgot, of course, that the carpool would be picking Colleen up for school and I would have to see the mom and her kids.
In these cases, I ended up with my arms wrapped around my chest, trying to hide like a person who covers her mouth when she laughs because she is self-conscious about her teeth.
I’m trying not to worry about it too much. I’m still wearing the surgery bra and I’m supposed to for a few weeks. I know now that none of the above problems are going to be fixed with this surgery. So, I just have to decide if I’m ever going to be up for another surgery (or multiple surgeries if I go the mastectomy route) and if I’m going to be able to give up the huge desire I have to breastfeed again.
This dilemma of mine – to lose or keep my ability to breastfeed – is a pretty common one among young cancer survivors. The problem is, there aren’t that many of us out there. I believe there are about 2,000 women under 40 diagnosed each year with breast cancer. Of those, many would already be done having children or this diagnosis would push them to consider it final. A few hundred would be BRCA+, which would come with a recommendation of an immediate double mastectomy. And some would not be interested in breastfeeding even if they do plan to have more children. I’m guessing fewer than 500 are still planning to have to children and wanting to breastfeed. Spread that out across the country and you only have a handful per state per year facing this decision.
Needless to say, doctors don’t quite know what to tell me. My plastic surgeon is being amazingly patient. She is my age and just announced that she is pregnant, so I think she really understands. She sees enough young women with breast cancer reconstruction needs that she has to think about what if it were her – she has even told me this. She tells me, “I can make this look a lot better if you let me work on the other side.” And I say, “but I don’t know if I will need to breastfeed or not.” And she will say, “I understand. Just let me know when you are ready and I will make it look pretty.”
So, I know the look issue can be solved. I just don’t know when.
And I’m pretty worried about the feel of this expander. I’m trying to reserve those worries for later – give everything time to settle down, time to heal, time for the pain and swelling to go away. It’s just way more firm than I expected. I keep wondering if I’m going to have to have a different kind of surgery in the future – one that doesn’t require an expander – just so I can sleep again.