Bits & Bites

We will be traveling for holiday joy with family. Well, at least one side of the family (mine) is joyful during this season. A side trip to Sanibel Island for a few days won’t make up for the missed vacation in Hawaii but should provide enough beach time for the family excitement ahead.

The critters and house always get tremendous care from our wonderful pet-sitting company, Nunn Better. Seneca does an amazing job with her staff, and our “Pack” usually has their favorite gal, Aubrey, to spoil them rotten when we travel. Of course we would rather they romp on the beach with us and visit their puppy cousins. I do worry about them. Ha! They are too busy enjoying respite from us and happy to avoid kennel-care.

Betsy & Scruffy

PeeTee & Lucy

After a reaaallllly long weight-loss plateau, I have dropped a few pounds. I continue to be fascinated how my body shape changes even without losing much weight. Don’t say I am toning up because my physical activity still is not up to pre-mastectomy level, but at least I’m moving again without discomfort. Although my goal seems to be only 14-pounds away, I think maintenance for me will hit when I can fit into the pair of really tight size 10 pants hanging. Who knows? Who cares. I’m pretty much eating what I plan to eat for life except there will be no hesitancy for treats in the future. This time of year. with my seasonal affective disorder flaring and the associated carb urge, it is a bit dangerous to venture away from my mantra: no grains, starch, added sugar.

My favorite/only plastic surgeon insisted on a huge hug rather than a handshake at the start of our visit this week. “What, after all we’ve been through you just want to shake my hand?” So, I pressed my artificial boobs into his chest and then flash him. “Are you satisfied with this?” I ask. He tells me I look great for just a little over 2 months since my tissue expanders were replaced with silicone. Scars are healing well. Skin flab might be removed after weight loss is done, depends on if I want more scars. We discuss how one foob hangs lower. Most women’s breasts are not even. I just never noticed because mine were hanging at my waist. He did not use any tissue matrix (we agreed) to reinforce the lower poles of the “pockets” holding my implants. So, I do have to watch and see if that one foob drops any lower. My symmastia (uniboob) has not recurred but I’m still at high risk for up to 2 years. In other words, I am like many women who undergo breast reconstruction after breast cancer – over 25% will require additional surgery after “permanent” implants are placed. I ain’t planning on it, but I am aware. The next step is to get nipple tattoos. (Just in case you were dying to know.) No nipple reconstruction. I don’t want “headlights” all the time, and the Barbie look is kinda weird. We are planning a trip to Baltimore in the spring to have mine done by a tattoo artist who works with academic reconstruction centers across the country. Always wanted a tattoo. Just thought it might be a green sea turtle…

Leaving you with a link to a fun read from the New York Times: Holiday Gifts From Your Kitchen Even non-chefs like make me can make healthy, lemon olive oil and dress it up in a pretty container.

Be reading you on the interwebs!

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Bra Fetish

My serious thing for shoes, silenced since I no longer need so many pairs given a life of leisure in the desert, has morphed into a bra fetish. It’s not that I have to wear a bra according to my plastic surgeon, but I gotta tell ya, silicone is heavy! Also, I want the implants to stay in place medially and laterally. Nothing like developing a uni-boob (did that during the expansion process) or having one of these drop into my armpit… Finally, at this point post-op, I am more comfortable having the implants supported by underwires. If am going to wear a bra, why not have one (many) that are beautiful? Just ignore the cost issue.

I went back to the delightful lingerie store where I was first professionally fitted after I lost about 100 pounds. (If you have never had a professional fit, do it! Nordstrom’s is great if you live in a large city.) The same woman who miraculously stuffed my former sagging boobs into glorious bras looked at my card – eek, they keep records – and before I had a chance to tell my story she pointedly said, “Those are not the same breasts.” No ma’m, they certainly are not breasts at all. After a brief conversation where she revealed that she had breast cancer also, it was back to bidness. Whipping out the tape measure, she said I was 36-38 C+. Great. Just like my feet – between sizes. And, like my feet, one is larger than the other. (The girls are still settling in, but I was itching to get out of the compression bras.) The style I specifically wanted was not in stock. No matter, I left with 2 not-so-expensive bras that have molding, not really padding. Here’s something you might not know. After your boobs get lopped off, there is no implant that will fill out the tips of a bra. (We will discuss nipples at a later date – no I don’t have mine any more.) So, molded bras give a nice appearance and help hide the wrinkles and bubbles lurking under my skin. Remember, the girls are still moving in! The saleswoman, call her Brabara, brought out a “sports bra” at the last moment. The only thing sporty was the fabric and the lack of underwire. Oh, and of course the cost was much more. Put it in the bag.

It only took 2 days to realize that I needed at least 3 underwires. One to wear; one to sleep in (yes, it hurts is uncomfortable even sleeping without a bra); and one to be in the wash – hand wash, drip dry. Having already freaked out my sweetie by the number of bras since my mastectomy, I sneaked into a department store that had the style that I wanted originally, careful to leave our joint credit card at home. The store was having a “fit event” with professional fitters everywhere and specializing in the brand I was going after. AND, you guessed it, everyone was in pink. At least the event identified the recipient and amount of the proceeds. I shoved down my revulsion to PinkOctober and put myself in the hands of someone who looked way too young. Whipping out her tape measure, she told me I was a 36 DD. Now, I know what a DD looks like, and it ain’t me. She told me to trust her about the size for this particular bra. Dam if she wasn’t right – after about 10 different styles. I tried a D and the underwires hit my implants. I left with 3 even more expensive bras.

Moral of the story. Do not buy bras without trying them on, preferably with a fitter. Brabara said in one style (same size, same company) the black bras were a band size smaller than the other colors! Turns out bras are like all clothing. Size does not matter. Fit does.

My attitude before weight loss

Noobs!

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!”

Being chauffeured after surgery

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?

Botox, Boobs, & Caffeine Addiction

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 boobs foobs.

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”.)

PeeTee with coffeePeeTee and more coffee

Quick Update (What An Inspiring Title)

Sorry, I’m just too tired/exhausted to blog inspirationally or cleverly or even in an interesting manner. This is a shout out to the blog-o-sphere on my current well-being and a chance to express myself.

Which to write about first, breast cancer surgery or food… That’s easy. I am 3 days post-op from a surgery to revise my bilateral mastectomy incisions and remove dead skin. Even though I now have external stitches (a la Frankenstein) my chest looks so much better! Two drains still hang from the sides of my chest, draining the space under my pectoralis major muscle where my foobs lie waiting to be inflated to adult-like sizes. Yesterday, much to my surprise, the plastic surgeon injected 120 cc of saline into each foob (now a total of 420). I didn’t hurt – until later. Just imagine someone stretching your pecs for you – from the inside! Hopefully adding the saline now will fill up the space, slow down the drainage, and on Monday I can get the darn drains removed. I hurt, yes, I do. Some women go through this with minimal pain. Some say it is worse than childbirth (wouldn’t know except from having delivered many babies). There is constant pressure, as if wearing a too tight bra. The sandpaper-like feel under my skin, which has no sensation, is much less.

Hey, as long as I am moaning like a little ol’ lady… I am exhausted. Good thing since the surgeon won’t let me exercise except to keep some degree of shoulder movement. A walk around the block after the temperature drops below 95° does me in. After the second surgery, I was told to do nothing for 3 days. We were out and about for almost 4 hours yesterday (on the 2nd post-op day) seeing the doc, grocery shopping, pet shopping, medical supply shopping, grabbing me some protein at a wonderful breakfast joint. I was grateful to be out of the house but collapsed into bed at 8.  (See, little ol’ lady) Who knew healing could be so exhausting?

Food – I am focusing on protein, but my appetite grows less and less. Eggs, whey protein shakes, Greek yogurt and cheese continue to be my main sources when I can choke them down. I nibble on almonds and pumpkin seeds when I feel a sag coming on. Throw in some grapes, berries and the occasional green veggie, and – hey, sounds pretty healthy except the amounts are way too low for someone trying to heal. Even coffee doesn’t taste very good – sob. Don’t look for updates on my weight because I’m not stepping on the scale. Drains, dressings, medications, weight loss of real boobs, weight from saline in the foobs – the scale is irrelevant now. (Hey, I can wear size 12 jeans, who the hell cares about the scale!)

My plastic surgeon has turned out to be a real winner. Not only is he the artist and technical expert that my breast surgeon assured, but his dry sense of humor is great. He treats me with tremendous respect, freely accepts Sue and me as a couple, and can pull out a joking attitude that I really appreciate and need. He never rushes through office visits. The office staff is tremendous. (Many doctors lose patients over their office staff members.) The icing on the cake (cake – gag) was right before the last surgery when he was marking up my chest again. My wonderful Sue made a comment about my weenie-ness, which I freely admit to having. He whipped around and said, “Don’t talk about my patient like that.” The he was back to his usual demeanor. I wanted to kiss him, but it was probably the pre-medication drugs hitting.

So now you are up to date. Although this is written without much censoring or even editing, I must add that I continue to be forever grateful that my breast cancer is essentially cured, that the love of family and friends can never be underestimated or undervalued, and that overall life is wonderful.

Now I’m off to find that bottle of Valium…

It’s Good to Have Options – Right?

Of course, I would rather not have breast cancer (even just this little bitty ‘ol Stage 0), but I do. And, I have treatment choices because women who suffered for years at the hands of surgeons who made decisions for them about treatment (“Hmm, long as we’re here doing the biopsy, let’s just cut off the entire breast so when she wakes up, nothing to think about!”), and women forced more detailed research trials and even got legislatures to mandate shared decision-making between breast cancer patients and their surgeons and oncologists.

I entered my surgeon-of-choice office yesterday armed from reading the best scientific evidence available on treating DCIS (ductal carcinoma in situ), a list of questions, and my partner in tow for moral support and to ask questions that I forgot and as an extra ear to hear what undoubtedly would fly over my discombobulated brain. One hour later I am overwhelmed – no closer to a treatment plan than when I went in except that the choice is truly mine.

First the options:

  1. Don’t treat.
  2. Lumpectomy without radiation.
  3. Lumpectomy with radiation (and various types but only one seems viable).
  4. Lumpectomy with radiation plus estrogen blocker of some type.
  5. Mastectomy with or without reconstruction.
  6. Bilateral mastectomy with or without reconstruction.

No treatment is not an option; so scratch that. I want to survive. The rest of the options do not change survival that much but do influence the risk of breast cancer recurrence slightly. Now the kicker, choices are greatly influenced by my weight loss and resulting tremendously saggy breasts. The one body modification I contemplated upon weight stabilization was some procedure to aesthetically lift the behemoths without scarring that could be a worse trade-off for the sagging. Lumpectomy itself is not that big of a deal, but add radiation and one ends up with a “baby breast”  and asymmetry that will be worse than sagging.  If I ever decided that I wanted breast reductions, the radiated side would be almost impossible to operate on because of the tissue changes. To remove just one breast is not acceptable to me. Sorry I don’t want to wear a bra just for a prosthesis, and I can’t be bothered attaching one to my chest, AND WHO CAN MATCH MY OTHER DROOPY BOOB? Mastectomies without anything – don’t think my body image could handle that. In fact I know that I could not. Bilateral mastectomy with reconstruction takes 2 surgeries with the associated risks (infection, bleeding, anesthesia, blah, blah, blah). I would have my breasts lifted in a major league way – new boobs of my choosing; overkill for a breast cancer that rarely kills; no nipples but a chance to get tattoos! (Talk about falsies…) Insurance will cover the reconstruction – has to by law. Again, thank you sisters who have gone before me.

I actually sat down and wrote out the pros and cons of each option, including the physical and emotional impact on me and others that I care about. It covers such things as I am scared shitless of surgery (memories of my cholecystectomy linger), have crappy pain tolerance (yes, there are drugs for that), and worry about recovery impact on Sue and her work schedule. At this point, the decision seems obvious. (Bilateral mastectomy with reconstruction.) But why is it so hard? My best friend, who is precious and wise, texted back, “because it is huge and life changing.” Immediately it occurred to me that it is also irreversible.

To make certain that I have all the information available and fully understand the outcomes of choosing reconstruction, my breast surgeon lined me up with a plastic surgeon for tomorrow afternoon. After that I will make my final decision and go forward because there will be no going back.

Did I mention that I was scared shitless?