Back to Square One

I'll ask forgiveness in advance if I don't make a whole lot of sense. I'm medicated.

I finally got the call for surgery yesterday. My fabulous doctor (I really can't say enough about his fabulousness) put me on the emergency surgery list which meant after the regularly scheduled operations were done for the day the gotta fit you in or came in off the street and need surgery patients get to go.

Let's pause and talk about food. I love food. I mean, I LOVE food. So fasting and I don't really mix. I was ordered to fast from 9 am yesterday morning so I did get to have breakfast and more importantly coffee but by 1 pm I was hungry and by 4 pm I had to go to bed because I was downright bitchy.

We arrived at the hospital for 7 pm and got prepped. I was expected to go into the OR at 9 but alas a baby needed to be born ASAP and well, let's face it, that's a no brainer (the anesthetist (who, by the way, was Yum-my!) told me after the baby had been born in distress but was doing better so yay!)

So at 10 pm they wheeled me into the OR and got busy. I got home at 1:30 this morning.

The doctor removed the implant, removed the skin that was all gross from the big purple lump, fixed the flap and put a new expander in. In a month he'll start filling it again and then hopefully, in the early summer I'll have the swap out surgery again (the one I just had in January).

It's been a long road and it's taking a toll on my family, even though they'll never say that out loud. I'm so lucky to have them.

So, we're back to square one again. I'm okay with that. It needs to be done right or I'm going to end up having way more surgeries than this.

On an even more positive note I didn't start crying in the OR this time until they put the oxygen mask on my face....that's a record!

Limbo

Limbo  noun \ˈlim-(ˌ)bō\

1  often capitalized :  an abode of souls that are according to Roman Catholic theology barred from heaven because of not having received Christian baptism

 

2 a :  a place or state of restraint or confinement

   b :  a place or state of neglect or oblivion limbo

>

  c :  an intermediate or transitional place or state

  d :  a state of uncertainty
Source: Merriam-Webster online dictionary

I fall under definition in red.

My doctors office called me last night and said there was a chance I'd be going in for my surgery today, this afternoon. I was ordered to fast from midnight last night and await their phone call this morning.

There's something you should know about me. I'm a planner. I'm so OCD about planning that I plan for planning. No joke. So to be given 12 hours notice of surgery - something I'm terrified of facing....well, that doesn't sit well with me.

Don't get me wrong, I'm not mad at the doctor, just stressed with the situation. I'm happy that he's trying to expedite this. I understand why it's imperative to have the surgery sooner than later. I've got a nasty purple/black lump on the side of my breast filling up with fluid that could, at any time, pop open and expose my implant to the world, not to mention set me up for infection.

But 12 hours notice does not allow me time to prepare myself mentally for going under the knife again. I need to time to calmly think about why it's necessary and important. I need time to prepare my children. I need time to arrange for childcare and school transportation because my mother, who usually takes care of those things for me, is on a cruise and the moment and blissfully unaware of what's going on at home. I'm glad for that, I'd hate for her trip to be spoiled with worry.

So this morning I waited, hungry, tired, scared and desperate for coffee for the phone call telling me what time to be at the hospital. At 10:30 my doctor's secretary called to tell me that there was no OR time available today and that I'd be having surgery next week or the week after. It's not like OR time falls from the sky and so, unfortunately some unlucky person is going to get bumped on my account. I'm sorry for that. I'm sure it will be frustrating. It won't be someone critical, like a cancer patient. But he is a cosmetic surgeon so I'm sure there is someone out there getting a boob job or liposuction just because they want to and well, that poor person is gonna have to wait. My boob is literally about to pop.

So now, here I sit in limbo. Waiting. Waiting for the call to tell me when my turn is. Waiting to see if this means I'm off work even longer.

I'll admit I was relieved today. I wasn't ready. I didn't have a chance to properly prepare the kids. I wasn't feelin' it.

Of course it also means I psyched myself up for nothing and I've go to do it all over again next week.

Nothing Worth It Is Ever Easy

I've lived a pretty charmed life. Really, I have.

I didn't grow up rich, quite the opposite in fact. I didn't get everything I wanted. (though I did get everything I needed) 

I didn't have a lot of friends growing up, a few close ones but I was also bullied. Elementary school holds a lot of terrible memories. High school was much better but I'd never go back.

And yet, I feel like I've lived a charmed life. I have my dream job, my husband who I love with all my heart, three perfect children and some amazing friends and family.

But nothing in my life has ever been easy.

I got diagnosed with cancer at 37 years old, on the youngish side by breast cancer standards. I was one of the >1% who had occult breast cancer. Lucky me! Not only do I get breast cancer but I get an ridiculously rare one that makes diagnosis and treatment tricky. Thank God for my amazing team of doctors.

I made the decision to have breast reconstruction because, while I could have lived the rest of my life with one breast (and probably quite happily), healing from cancer isn't just physical, it's mental too and for me, I needed to feel physically whole in order to heal mentally. I want to look in the mirror and see two breasts. More importantly (as trivial as this sounds) I want to look down and see cleavage.

So I made the decision, despite my fear of surgery, my worst of which being I'd die on the table and leave me kids wondering why their mother opted to do something so vain  - something that ended up taking their mother away from them when they were mere babies. Yes, my oldest is 14 but she's still a baby in the grand scheme of things and still needs her mother.

But again, nothing for me can ever be easy.

After my first surgery I questioned why I'd even done it. I felt horrible, I was in pain and dealing with other demons. But it got better and once the doctor started to fill my expander and my new breast began to take shape, as it were, I started to feel really happy about my decision.

One month ago I had the second part of my surgery, the take out the expander, replace it with a silicone implant and reduce my left breast to match the new one.  And as you can see from my previous post, I was so happy with the results. I have the boobs of a 20 year old.

But remember, nothing for me is every easy and so, I had complications. First, an infection at the drain sight. Remarkably in all my surgeries this was my first infection. But it scared me nonetheless.

And then, a small purplish black bump appeared on the side of my new breast. Small at first and then it grew. Naturally it appeared after I'd been released from weekly visits with the Dr. I wasn't supposed to see him again until March. But this thing was big and ugly and scary looking. So I called him and went to see him.

So here's my diagram of what happened.

Now, my diagram is a little oversimplified but it will all make sense in a second. See, the flap is the muscle and tissue that the doctor took from my back and brought forward to build a new breast. But that brown part should be totally enclosed, a full circle to encapsulate the implant. But in my case part of the flap failed (separated) as shown in the nifty diagram so now the only thing separating my implant from the world is a paper thin layer of skin. The big purplish black bump was fluid that my body would have otherwise absorbed taking the path of least resistance and pushing the skin out.
The doctor stuck me with a giant needle and drained a lot of the fluid but it just collected again. And the thing is, skin wears.  We shed layers of it in small doses everyday. Eventually that paper thin layer of skin would wear away and expose my implant opening me up for infections and a new world of surgeries.

So, we're beating it to the punch.

I get to have more surgery. Soon. Like in a couple of weeks. Yay me. (this would be a great time for a sarcasm font) The doctor is going to take out the implant, fix the flap and either replace the implant, put a smaller implant in or put a new expander in. By the way he talked today he's leaning toward a new expander. Which means another surgery will follow in a few months to put a new implant in. He'll make the final decision in the operating room.

I've had time to process this now. I had my moment of tears, anger, regret, anger, tears and more anger.

Now I'm resigned to it.  I'm frustrated because it means more time off work, it means my summer plans are all shot to hell and it means I'm living in medical limbo for another several months. It means more stress to my family. It means more stress to me. It means a whole lot more fear for me. The same fears I faced when I got diagnosed with cancer. The same fears I've faced each and every time I lay down on the operating table and cry, praying that God will let me wake up again to see my children.

I hate this. I really, really do. But I've learned that your cancer journey isn't over the day you get your 'no evidence of disease' report. It's not over after your hair grows back and your memory returns. It's not over when your scars heal.

I am not whole again yet and my journey won't be over until I am.

One of my first thoughts, after my family,  when my doctor told me I'd be having surgery again was about my job. I love my job, passionately. And I miss it. But this time is different. Because while I am angry that I will be missing more time and worried that I'll lose my position in my school and get stuck in a school I hate and wondering what my colleagues are thinking (or saying), I'm reminded of something.

I'm here. I'm alive. I got to spend the last three years with my kids and my husband and my friends and family. I might be am replaceable at work. No matter how good you are at your job, everyone is replaceable at their jobs. But I am not replaceable to my family and friends. And my life is important to me. I want to live it happily and to the fullest and for me to be able to put cancer behind me I need to feel physically whole.

So as much as it sucks ass.....I'm going under the knife again. Lucky me.

Writers Block

I've been staring at this blank screen for a half an hour. I could just click the red x in the corner of the screen, close the page and not blog but I feel like there's something I need to say. I just don't know what it is yet.

Tomorrow I go for the second part of my breast reconstruction surgery. This is the one in which they take out the expander that was put in in July and replace it with an implant. They will also reduce and give lefty a little lift to make me a little more symmetrical.

This is the final to being normal. As of now I've decided to not have a nipple reconstruction. I don't really see the need. I might change my mind later but for now, I'm good to be a Cyclops.

I'm going to be off work for 9 weeks. I have a very physical job and the muscles I use in it are the very same ones that will be healing. And there's the mental healing as well.

It's estimated that only 10-20% of women in Canada have a reconstruction surgery after mastectomy. I can't speak to other women's choices on this but I did it because I wanted to feel whole again. To look at me with clothes on, when wearing my prosthetic you'd never know I only had one breast. But I knew.

There is nothing I love more than taking my bra off when I get home from work. But to have that lopsided feeling. To not feel comfortable, even in my own house. To not feel comfortable in my own skin.....I hated that. I beat cancer but it was still beating me by tearing down my self esteem.

And my self esteem is at an all time low. I am not losing weight, in fact I'm still gaining. I don't feel attractive. I don't feel like me. I want to feel like me again and I'm hoping that finishing the surgery will help me get there.

I remember back when I had the expander put in and I was in severe pain and felt like I was wasting the kids summer and I questioned why I did it. I thought I should have left well enough alone.

I know now that that was just the pain talking and I also know that I feel 100 times better than I did before the surgery. I'm looking forward to wearing a normal bathing suit, one in which my prosthetic doesn't float up over top of my bathing suit. I love that when I buy a shirt I don't have to worry about if it shows cleavage because once again I have cleavage to show! I also can't wait to buy new bras. And because my size will be a bit reduced I should be able to buy some really pretty ones from Victoria's Secret.

And yet I still feel like I'm missing something. I feel like part of me lost. But I don't know what.

So Here's the Skinny

I'm feeling a bit more like myself this evening so I thought it might be a good time to share what's been going on.

On Tuesday I had the first step in the Latissimus Dorsi Tissue Flap Breast Reconstruction. Long story short the Dr took muscle and tissue from my back, moved it forward to reconstruct a breast and he put in a tissue expander underneath it all.

So right now I'm like a b cup. In two weeks time he'll start filling the expander with saline and he'll do that once a week for about a month. This will stretch the skin and muscle in the area to be the proper size. (A large C or small D) 

Once that's been done it's going to just sit like that and settle. Skin stretches and sags and everything needs to be settled into place before we can proceed.

So about 3 months from now I'll have another surgery, which will involve taking out the tissue expander and replacing it with an implant. He'll also do a reduction and lift on my left breast to make everything even.

For the most part I'm feeling okay. I'm sore as hell in both my chest and my back but mostly it's because the Dr stressed to me that I could not put pressure on the side of the new breast - I need to allow for the new blood supply to heal and establish properly because if not the tissue will turn black and die.

That means I can not sleep on my side (right side for obvious reasons but I can't sleep on my left side either because my arm would rest on the side of my breast cutting off the blood supply.) So I can only sleep on my back. I don't like sleeping on my back and what's more because of the incisions on my back it's not really that comfortable.

I'm also favoring the arm when I'm sitting up and walking, making sure it's not resting on my side so I'm thinking by the time I'm allowed to put it down (about 2 weeks) my right shoulder will look like Carrot Top's.  (Sean and I ran into him in Vegas a few years ago, he's even freakier looking in real life)

 

 

I'm sure I'm being overly cautious but let's face it, I'm one of those people who has that shitty kind of luck.

 

 

Anyhow, I've gone through a stage of depression. I've questioned why I did it. Mostly when I'm uncomfortable and in pain. I'm on preventative antibiotics and they are making me sick to my stomach. I've developed an aversion to water again, completely psychological of course, but it's there none the less.

 

And I worry that this is going to take more than I thought it would..

 

But them I'm reminded of my dear friend Amy, who did this, not once but twice, two boobs. She's been down this road and today she's smiling and happy and living her life. I can do that too. It might be shitty and painful and uncomfortable for a while but it will get better. And I'm going to celebrate by buying myself a cute little dress for Christmas that shows my brand new cleavage!! 

Choices

I have to remind myself that I made this choice. I also have to remind myself that this time is different. This time the pain is for greater good

That's not to say that the pain wasn't for a  greater good last time,  it was for my survival, but this time I chose the pain. 

I am questioning my decision but only because I'm feeling so lousy right now. Each day as my body feels better so will my mind. 

But for now the medication, the smell of the tubing, the same homecare nurses, it's all painfully reminiscent of cancer. 

And so I keep reminding myself that this is not cancer, I chose this to feel better about myself, I chose this to get myself back and each day I will feel more like myself. 

And when I feel better I'm going to Victoria's  Secret and buying the most expensive and sexiest damn bra they have!!