As Cammy christened them, my noobs are on board. Swollen – well the surrounding tissue – a little uneven, and sore, but they arrived with much fanfare.
As usual I required an elephant-sized dose of midazalom (sedative) before heading back to the OR. So I have little memory of anything until the recovery room when I awoke to a gravely voiced nurse asking me if I wanted more pain medication. I asked what she was giving me. “Morphine”, she rasped. Crap. The pain receptors in my brain and elsewhere really enjoy fentanyl so much more. “I can’t convince you to dribble in a dash of …” “NO. We only use that for patients being admitted.” OK, but I warned her that I would get really chatty with morphine. Not like a mean drunk chatty, but very mouthy. She quickly found this out when the computer terminals at each bedside started winking out. “It’s the server”, I sang. She mumbled across the aisle to the nurse who had pre-op’ed me to reboot. “Noooo. It’s a hospital-wide server issue. La-la-la.” Glaring at me, she pushed more morphine and went to call the help desk. As I drifted off, I heard her barking at everyone to stop rebooting because it was a server issue. “Now can I have my fentanyl?” All that got me was a really quick discharge from the recovery room and into the arms of my sweetie. I was poured into the back seat of the car (not wanting a deployed airbag to hit my
foobs noobs) and mumbled directions to the nearest Starbucks to cure my caffeine headache. Suddenly I grabbed my chest wall. “SOFT! SUE! THEY’RE SOFT!”
That night the phone range and on the other end was my surgeon! He called to advise me (starting with, “Hey, dopey”) that I would experience significantly more pain than he had led me to expect. Apparently my weight loss had left the “pockets” for the implants very loose and required mucho extra suturing, some into my sternum. (Ouch) Two days later, the great unveiling occurred in Dr. N’s office. All 3 of us were impressed despite the swelling and unevenness, which will subside with time. I do have 2 drains and a lot of restrictions on arm movements and exercise (specifically, no exercise). This morning, however, I got to take a shower and have not had anything stronger than Tylenol for over 12 hours. I’m stiff. I bitch about the drains and wearing a compression bra 24/7. I get back spasms, but this surgery recovery has been much easier than the mastectomy – much to Sue’s relief. By Monday I should be ready for a very nice dinner for our 20th anniversary. Isn’t that what you get on your 20th? New tits?
As I spent the last few days scurrying around (more like running in circles) trying to get many things accomplished prior to surgery, somewhere my mind kept poking me that it was time to slow down, to prepare for surgery. I had been busy “doing things” – laundry, cleaning, putting clothes on the lower rungs of the closet, getting meds filled, shopping at the medical supply store, arranging the bedroom for limited mobility for a couple of days, finding the darn garments to hold my surgical drains, finding shirts that button (no raising my arms above my shoulders), talking with family.
The worst experience, and the one that drove me nuts, was dealing with an abnormal pre-op electrocardiogram – one that was not indicated (I just had one 4 months ago at the same hospital for surgery) but was required by hospital policy, not my physicians. Of course it was abnormal. I have these foobs with magnets and other changes under my chest wall that make reading the electric current haywire. I was in a total panic – no, really, you should know by now that I can get that way internally while looking just fine on the outside. My surgery was being threatened with cancellation. No biggie, except we have this condo in Hawaii sitting empty now that we are paying for, and Sue’s next vacation isn’t for an eternity. So who knows when I could get rescheduled.
Fortunately, I have a cardiologist who knows my history. (Did I ever tell you about having intermittent congestive heart failure from being too fat resulting from a condition called “left ventricular dysfunction” that led to an abnormal stress test, which led to a, which showed that I have perfectly normal coronary arteries? Well, I did. My heart function returned completely to normal after losing about 70 pounds.) Even though my doc was not in the office because it was her turn to run the practice’s inpatient service, her nurse managed to get her this and old ones to compare. Bingo, I am cleared for surgery with a day to spare.
By last night I realized that I had not done any mental preparation for surgery. In fact, I had worked myself up beyond anxiety to anger over the unnecessary ECG. I even developed some nasty heartburn. No listening to the podcasts with the surgery to revise the incisions, so it should be possible to recoup that state in less than 24 hours – gulp. Blogging is part of my plan. Write out some of my feelings. Encourage myself. The rest of the day I will spend time getting my happy hormones (endorphins) going by a little exercise, reading more of Tina Fey’s “Bossypants”, playing with the pets then take time to review my list for the hospital before going through guided imagery and affirmations a couple of times. Most importantly, I will enjoy this beautiful day with Sue because tomorrow I will be totally out of control as I hurdle toward and through surgery.and affirmations that I found so helpful before the mastectomy. No time to sit quietly and chill. No time to enter the state of mind and body that has been shown to decrease anxiety and improve surgical outcomes such as decreased blood loss, less time in the recovery room and hospital, less pain medicine needed. That optimal state is not one of relaxation but of being prepared, a type of calm focus. I have today to help get all of me there. I remember learning this skill successfully before my mastectomy and before
It doesn’t matter that I have a reason to be anxious – major surgery in 6 days to replace tissue expanders with silicone, repair symmastia (foobs have grown too close), remove chest wall excess skin, which is essentially some body sculpting required from the 138-pound weight loss. Sure, I am excited to get this part done, and of course there is the potential for complications (29% of breast cancer patients undergoing this type of reconstruction experience repeat surgery within 3 years). Also, I have a bit of pre-op dread, although much less than usual probably due to desensitization from 3 major surgeries in the past 2 years.
No matter, my anxiety levels are creeping up quickly. I feel a combination of paralysis – straining to do my usual activities – and hyper-awareness in body sensations, emotional sensitivity, inability to self-sooth, and just plain ol’ feeling out of control. I have taken as much control of the situation (surgery) as possible by close collaboration with my surgeon, having the same anesthesiologist who understands my tolerance for meds as well as my need to feel in control while feeling totally out of control. I kept my mouth shut (mostly) during a pre-op visit when the nurse insisted on repeating unnecessary blood tests and an ECG (just done 3 months ago!) but refused another chest x-ray. HEY! I don’t want to get cancer from unnecessary radiation! 😉
My loss of coping skills are most obvious by the total abandonment of my routines. Of course my toe boo-boo got in the way of walking, but I am not back on the stationary bike. My appetite is crummy, but I feel a need to eat. EEK! That hasn’t happened in quite a while. My solution has been to eat nearly frozen grapes. The sweet crunchiness of seedless red or black grapes seems to satisfy me without providing too many calories. It’s more the out of control feeling because I eat grapes when I’m not hungry. I just want some grapes. My concern is that next I will just want some ice cream. Then suddenly I will weigh 250 pounds – like last time. WOW. That is some catastrophic thinking. I haven’t stepped on the scale, but my smallest clothes are fitting just fine. I am monitoring my food intake, well, mostly…
Let’s face it – I’m just scared. Scared of surgery. Scared I might be slipping from healthy eating to the beginning of bingeing. Don’t cut me slack because I have this Stage 0 breast cancer that is essentially “cured” and only am facing continued reconstruction. Life goes on. There will always be obstacles that I need to face (death of parents, career snafus, family disruptions) and must learn to cope. Ups and downs are to be expected, but feeling this way, this threatened over what I have accomplished so far is not anything I expected.
There… all better. Not really. But at least it’s out in the open.
During my pre-op visit 2 days ago as I’m going through the list of questions generated for my plastic surgeon (and he is trying not to roll his eyes or fall asleep or, even worse, laugh), his ears perk up when I mention the repeated pectoral muscle spasms that I have had since the bilateral mastectomy for cancer and tissue expander placement 4 months ago. Dr. N mentions that some women have very reactive pecs – must be all my work outs – and he has long thought that the Botox maker should do a study injecting Botox into pecs at the time of implant replacement. The academic physician in me said, “Go for it and let’s write a report for a journal.” He laughed saying he is so past that stage of his career, and I forget that I am past that stage, too. Any way, I am letting him do this (paying out of pocket but just the actual cost of the drug) because I won’t be allowed to do pushups forever. Plus, anything to prevent continued muscle spasm (short of not being able to function with my arms). OK, so I am bit leery of paralyzing my pecs, but I am more concerned with continued spams preventing proper positioning of the silicone
Now for the latest on the pet front. You are aware that we have a pack consisting of 2 humans, 2 dogs, 2 cats, right? Our chihuahua-terrible mix, Mr. PeeTee, is quite the coffee fiend who somehow knows exactly when I am down to 1/4 cup of my French press coffee. That is when patience evaporates from the 3 neurons in his brain (eat, sleep, & pee) and the whining and clawing begin. Without further introduction, here is the little monster finishing a cup along with his favorite brand. (Yes, he is wearing a diaper because the sucker refuses to be potty trained. Probably why he was on the chopping block at a nearby county “shelter”.)
This is what happens when you push your feet too far, too fast. OK, so I had an ingrown toenail partially removed on this toe exactly 1 year ago, and the toenail never grew out all the way. Also, wearing my KSO “barefoot” shoes should not place undue stress on the toenail. No matter, within 3 days of upping the intensity of my walks to include some jogging, BAM – ingrown toenail with low-grade infection. Now that’s normally no biggie, unless you have foreign bodies in your body, say something like foobs when the risk of infection spreading to that area becomes very serious. I had tried a week of soaking my foot and topical antibiotics with some improvement, but the risk of infection and more likely the risk of delaying surgery was looming. So, yesterday I was off to the podiatrist with the blessing of my plastic surgeon.
This will sound odd, but I thoroughly enjoyed the visit. The podiatrist is actually known for his expertise in ankle surgery – I kept apologizing for presenting with something so mundane. We had met last year for the same problem at the recommendation of my anesthesiologist-sweetie and because he is in the group with my orthopedic surgeon (he took care of my knee last year) who also happens to be married to the wonderful general surgeon who removed my gallbladder. The orthopod hadn’t seen me since 80 pounds ago, and we had fun reconnecting. Also, he and his wife and Sue all work together in the operating room so there was much to gab about. He did encourage me to NOT run or even jog saying nothing is to be gained and much is to be injured. I agree. Running is great for many people. I should have listened to my knees and ankles. Rapid walking will do fine from now on.
The podiatrist and I had connected over college football last year and spent the time during the removal of part of my toenail yacking about our favorite and most reviled teams. He was very concerned about my pain level as he injected my toe. Ha! Actually his technique for injection of local anesthetic was very gentle, or maybe I have much greater pain tolerance after the last 4 months. No matter, this morning my toe throbs but is walking is much easier.
So, now it is 4 days of antibiotics; a week of resting my toe; and back to the recumbent bike. Today is the pre-op visit for my next surgery when I get these awful tissue expanders removed, some repair work done, and nice soft silicone implants installed. I never thought that I would look forward to a surgery!
The recumbent bike stayed in the Arizona room, which now has temporary pleated shades (the cats eat any shade with strings) covering the six windows and a darker film on the door. A 20″ floor fan keeps me cool, and I open the room to the rest of the house before starting my 30 minutes on the bike. After 5 minutes of grumbling about aching knees, I lose myself in whatever I’m reading or watching on the iPad or giggle (yes, I am capable of giggling) at the dogs as they run wild in what usually is restricted cat territory. The 30 minutes pass quickly, and I’m ready for the next day. Walking has not been as consistent, but I’m working on it. My chest swells in the heat – nothing but a thin layer of skin between my foobs and the rest of me so the saline inside feels as if it is boiling in the direct sun!
Speaking of foobs, I moved up the surgery date to September 28. That means we give up our trip to Hawaii – heavy sigh. It was Sue who suggested spending our vacation time for surgery. I probably wouldn’t be able to enjoy Hawaii very much with the tissue expanders causing so much discomfort, and I refuse to wear a swim suit with the extra skin that I can hide so easily under camisoles and shirts. (Hey, no bra needed with these rocks.) This next surgery is supposed to be a “breeze” compared to the mastectomy. How much of a breeze can a 2½ surgery be when the plastic surgeon has to replace the expanders with nice, soft silicone implants, remove excess skin, make needed repairs (incisions and secure the division between breasts)? The recovery should be much quicker although — you know I just don’t want to think about that aspect until it gets closer.
I have a goal to lose 10 pounds in the next 6½ weeks, so I’m off to bike, walk, and plan the rest of today’s food. Here’s to anticipating my new chest and getting rid of