Tag Archives: confessions

Henny Penny’s Got Nothing on Me

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I guess it’s a friend who’s “girls” give us eggs every year that brings to mind a little red hen running in circles, kicking up puffs of dust, as I look at my own girls today. The sky hasn’t fallen, but my left boob certainly has.

Maybe you can kinda see the lowerage of the left breast. The ace wrap between them is certainly evident. This "process" is NOT fun.

Maybe you can kinda see the lowerage of the left breast. The ace wrap between them is certainly evident. This “process” is NOT fun.

I wouldn’t say it’s quite an inch lower than the right, or that the world’s going to end, but I could be convinced.

In medical parlance, the lowerage is maybe a centimeter and a half. Or two. Almost an inch.

The spouse, who has eyed the “new” boobs waay more frequently than the old ones, actually agrees. And my dear friend Peggy who has walked me through the whole process, kindly says “well, maybe the one IS a bit bigger than the other.”

I don’t think it’s bigger, it’s just lower. So (feeling like the world’s worst patient yet again), I call the doc’s office. There’s not a nurse around, but one of the other lovely ladies says, “We want them to relax into their pockets. Does it feel like that’s what’s happening?”

Relax into their pockets? Gloriosky! Whoda thought? And why wasn’t this mentioned before? And why isn’t the right one doing the same thing? Or is it only a matter of time?

The next thing she says is, “Let’s have you come in (like TOMORROW) to make sure nothing odd is going on.” Nothing odd? This is odd in my book. The sky falling is odd too, but I doubt that’s what’s happening. The next thing she says is, “We don’t want the other side to be retracting and pulling up.” OK, the sky IS falling.

“Pulling up” is exactly what the right side feels like it’s doing. The one’s going down (and feels kinda nice), the other’s pulling up, and doesn’t.

So I’ve got specially constructed evening wear (see pic). It consists of a bra I’ve worn for weeks now, a roll of ace wrap in the middle that keeps the implants from cutting into the muscles attached to my sternum, and a pain patch on my skin that maybe works, maybe doesn’t.

This all because of a questionable condition called thoracic outlet syndrome on the right side. Which means the muscles there are overdeveloped, the nerves are compressed, and everything hurts. On that side only. Unless a miracle happens and the implant “falls into its pocket”. Like tomorrow.

I don’t care if my extremely patient doctor thinks I’m a nut when the miracle happens and he sees two perfectly level boobs at my appointment. Just my luck. He’s probably got that little bubble level app on his iPhone to check things out. Or something from his garage. Like the stud finder mentioned in a previous post.

I’ll let y’all know what happens. Henny Penny, too. Maybe she can stop her frantic circling and I can get some rest.

I’m gonna live, so why am I crying…again?

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So I’ve had this marvelous breast reconstruction thanks to a very skilled plastic surgeon (which means despite bruising and surgical tape and drain holes, I’m fine with what I see in the mirror), I don’t have to do chemo or radiation, I’m walking around alive, and yet here I sit in the bathtub, in the grips of yet another crying jag.

Either I’m one ungrateful sod or it’s something else.

A good friend, who also happens to be a psychiatric nurse practitioner with lots of experience in wimmen’s stuff, tells me it’s something else. A panic attack, actually.

How embarrassing.

Which means we’re not just talking about one panic attack. I’ve been having them every time I turn around. Friends have assured me all this crying is normal. I’ve had my breasts cut out, for Pete’s sake. Which sounded right at the beginning of it all–back when illness and survival and a decent reconstruction were still uppermost in my mind.

Well, I’ve admittedly won the lottery as far as all the the above is concerned, but here I sit in my lavender bubble bath, crying my eyes out. Again. For hours. Yes, really, hours. Thank heavens I have a sensible husband who isn’t prone to panic. He just holds me and understands there’s nothing he can fix. At least not this minute.

Given to us by a dear friend and worth reading daily.

Given to us by a dear friend and worth reading daily.

The latest crying jag happened when I got convinced we’d all be homeless because of a $3,500 vet bill–payable right now, before we left the surgeon’s office or it was just a matter of hours before our doggie would be permanently disabled.

On top of a bazillion dollars not covered by own medical insurance. On top of me being off work long enough to run my disability down to zero and put an end to FMLA “protection.” Not to mention the taxes that would be due if we took money out of retirement.

And did I mention the IRS audit? The one that’s turned into two audits? Yeah, I think I mentioned the first one in a previous post.

I’m usually pretty good at ignoring unpleasantness. Even where the IRS is concerned. A trait that drove my mother crazy. She was into unpleasantness in a big way. So another thing fueling the crying jag was my certainty I was morphing into Mom.

Apparently not. My nurse practitioner friend said I needed an antidepressant. Like now. Been there, done that, but never for this particular symptom. And never had it work as quickly as it did it this time. Thanks to whatever powers that be, I haven’t had another crying jag (panic attack?) since.

What upsets me now is the realization that my mom, famous for the aforementioned unpleasantness, never had access to (and would never have accepted), the kind of help available today. It’s unfortunate the term “mental illness” was ever coined. Perhaps just unfortunate it’s used so freely for the kind of help many of us need when life becomes suffering.

Certainly some entities need to be thought of as true illness of the mind. If only so their sufferers can access state aid, have livable housing, and their medical needs met.

But should those of us fortunate enough to recover normal life with therapy and medication be thrown into a pot so discriminatory as to create fear about getting some help? I think not. To do so is irresponsible. And sad.

So I am sad for my poor mother. I think she could have been helped just as I have been. And I am sad for the women I see in clinic who are afraid to accept drugs or therapy when emotions get so awfully out of control.

I can be sad, but even so am feeling daily more able to enjoy the miracle that is life. Come to that, I’m downright happy about having a chest my husband’s not afraid to look at. And I’m not planning more crying jags any time soon, thank you very much.

At least not until the IRS checks in again.

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Things that go soft in the night…

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I can’t stop looking at them. Or touching them. I’d best not go out in public right now for fear of getting arrested for indecent something or other. I can’t believe the difference between my new “real” breasts and the tissue expanders. They’re absolutely beautiful. Even with the bruising. And the surgical tape. And the drains. Thank you, thank you, thank you, Dr. N.

One of his lovely nurses told me they don’t want the implants moving around much just yet, so I have to use this gawdawful mastectomy bra for a couple of weeks. It looks like a girdle. From the 1940s. For breasts.

"Mastectomy Foundation Garment," or:  The Bra From Hell

“Mastectomy Foundation Garment,” or: The Bra From Hell

Well, I negotiated that down to an ace wrap. Much better. Until I noticed it was flattening things out. Back to the mastectomy bra, this time with some spouse assisted modifications–ribbons that tie in the front to keep the velcro from hell closed and off my hypersensitive skin.

And at night? I can sleep on my sides. Well, not just yet. The instructions say a 30° rise should be maintained for awhile, so I’ve got a bed wedge. But I’ve rolled to my sides a few times to test things out. Instead of looking down to see two tangerines poking out from the front of me (separated by a good two inches), I’ve got breasts squishy enough to meet in the middle.

Touch them (which just about everybody in my all-female office has done), and they’re soft. They feel real. They’re actual breasts (or quite the facsimile thereof). Halleluja!.

At least that’s how I feel right now. Hope it lasts.

I’ll letcha know.

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9/11. Glass half full?

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So I went to the doctor to pick out new breasts. At least I hope they’ll be breasts. Or like breasts. Breast-like will do in a pinch. The things my chest has been hosting are definitely not. And I’ve found some other blogs where women are talking frankly about their breast building “process” (note how I avoid the word “journey”). Damn, they’re brave. I’m just worried. Really, really worried. Some journeys take a lifetime.

Surgery is on 9/11. Anybody got a glass-half-full line for that one?

Ok, beat you to it. I still don’t have to do chemo. This is a very good thing.

So from the get-go I knew saline implants were out of the question. I’ve examined enough women who had those placed during the 90’s moratorium on silicone to know you CAN hear them slosh. And thank G-d silicone is supposed to be lighter, as these saline tissue expanders are heavier than I could have imagined. I’ve lost weight just lugging them around. I even chickened out and had them reduced.

What a world. They’ve got “gummy bear” implants now. Feel like candy, look like pears, but are textured like expanders and scare the heck out of me because they’ve got to be bigger than those are to prevent flippage. You know, that embarrassing condition when your breast turns upside down at dinner. Maybe while serving the spaghetti.

So, I’m gonna go with the old tried & true, half-round, slick model. These are meant to slip and slide and smoosh. Kinda like breasts. As a friend said, “my mind breathes a sigh of relief at the soft ones settling into the space that’s already there. Like real breasts after menopause.”

There is sense in that. It resonates. I can do resonate. I just can’t do journey. At least not the whole thing. At least not right now.

I’m wounded and can’t get my bra off.

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Anyone tired of pain and angst and wimmen’s stuff can go home right now. But I can’t get off this bus and writing’s a distraction, so I’m gonna stay right here and bore y’all to death.

I’ve taken the muscle relaxers (the ones that cause 6 hour crying jags). And the lorazepam (goody, now I get to wake up feeling like the world’s going to end). I’ve got one NSAID pain patch plastered to my front, another to my back, and my husband nearly broke his thumb trying to push the muscle spasm or rib or whatever it is that hurts like hell back to where it came from.

Ain't it cute? Don't it look nice and soft and squishy? Nawp. They lie. And where's the stud-finder, dammit?

Ain’t it cute? Don’t it look nice and soft and squishy? Nawp. They lie. And where’s the stud-finder, dammit?

So I lie on the “Miracle Ball” for the requisite minutes and then do it again out of sheer desperation. Now I’m sitting against a yogic torture device called a Spoonk that’s advertised as the Western answer to acupuncture. All this because I’ve got what feel like armadillo plates riding against my ribs and the suckers are pulling my back out of joint.

And I still don’t have to do chemo. Yay! That heads up my gratitude list every day of the week. But tonight I’m doing my best imitation of British whinging, just for fun.

Actually, the anatomic explanation above isn’t quite right. I quizzed my plastic surgeon about exactly where these tissue expanders live and learned they aren’t just lying quietly on top of my ribs “under the muscle,” as I so casually assumed. During surgery the pectorals are actually butterflied lengthwise, their points of insertion left intact, and the expanders jimmied between the layers like stuffing in mock duck.

All’s quiet for awhile (or else surgical pain overrides awareness of anything else), but a couple weeks later, when they whip out the stud-finder to start filling the expanders (see previous post), the muscles stretch and spasm. And in my case have pretty much never stopped. I wake in the morning with the equivalent of tennis balls stuck under my skin. That’s if I slept at all overnight. I don’t remember having any dreams at all during these last two months. Once things quiet down I should have quite the cinema line-up for REM sleep.

So maybe the surgeon’s right and I have what he calls “reactive” pectorals (he is a pretty smart guy). You mess with them, they kick back. Like the frogs’ legs my mother once made me watch her cook. I see this fairly often during cesarean section; we’re not anywhere near the pecs, but similar slabs of muscle in the abdomen can do the same thing. It’s usually handling the peritoneal membrane underneath them that causes spasm and vomiting even with adequate anesthesia, but in some folks “just” pulling apart the abdominal muscles produces the same effect.

Trouble is, these suckers are STRONG. There is no denying a pissed off pectoral. Because of where they are, they pull on the ribs and yank those circumferential items slightly off-kilter, causing spasm in other, unforeseen areas. Which has been my problem lately.

This is more like it. The deflated inflater. More like what I just got at Petco--a dog toy with "squeakless technology." Yep, that's what this thing is.

This is more like it. The deflated inflater. More like what I just got at Petco–a dog toy with “squeakless technology.” Yep, that’s what this thing is.

My husband was horrified to find thumb-shaped bruises where he’d been pressing on my back. I assured him I’d not complain to authorities, as this was likely due to my using twice the recommended number of non-steroidal patches (along with a handful of naproxen, if truth be told). This all messes with blood clotting abilities. Whereupon he’s horrified I exceeded the recommended dosage. Whereupon I’m amazed that we’ve been married lo these 23 years and my MO still surprises him.

Now something I forgot to mention is the saving grace of having a physical therapist who really knows her wimmin’s business. Also high on the gratitude list. Every whining complaint I’ve thrown at her has been no surprise. She’s heard it all before. Thank heavens.

Thank heavens I’m not the only one who feels these plastic things getting hot against my chest wall. That the saline ports are hard, and hurt. That tissue I’m told has been denervated may be numb-ish to the touch on the outside, but has plenty of sensation pushing through from the inside.

But hey, Dr. Susan Love says says most women don’t even finish their pain meds. Must be true, right? She’s written a fat book about everything breast. If Marcus Welby, Dr. Quinn, and Hawkeye Pierce joined her for a focus group and came to the same conclusion, well, maybe I’d suspend disbelief. We’ll just not consult Dr. House.

Thank heavens the therapist knew to insist I request a reduction in the bigness of these things before I had more trouble with an already compromised right hand (that would be from the heartbreak of thoracic outlet syndrome, which is a wastebasket diagnosis and doesn’t really exist, as we all know). As soon as they let a little–a measly 2 ounces–of fluid out of the right breast my hand stopped its neurogenic tingling, my breasts regained just the eensiest bit of squishiness, and I felt like a new person. This is what I’m told will happen when the expanders are exchanged for “real” implants. We’ll stick with the smaller size, thanks very much.

But now the pecs have caught on and decided to take up the slack. Hence the new muscle spasms and this new-ish rant of mine. Bear with me and I’ll apologize (again) next I see you.

What follows is something not for the faint of heart: placement of the expander within the muscle.

I really don’t want to freak anyone out, but can’t seem to post the link without opening the graphics.

“They’re heeere…”

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Foobs.

Fake boobs.

Rising out of nothingness…Suddenly. In Biblical fashion.

The surgeons very kindly took me seriously when I said the prospect of traditional dual mastectomy horrified me. They inflated temporary tissue expanders to about half capacity before I left the operating room. So when I explored my chest in the recovery room there were these little convexities–booblets–complete with my very own nipples, right where I’d expect to find them. Mightily encouraged (this is all hearsay, mind you–I’ve no memory of it), I am said to have gleefully exposed them to anyone who’d look–the spouse, my dear friend Peggy, and whatever nurses & techs were trying to keep me breathing instead of flashing the entire floor.

So I’ve discovered an inner extrovert. If it only emerges after anesthesia, I’m good.

I was apparently good that day, as the spouse was heard to say, “Gee–it looks like you’re nineteen again!” Bless him. We won’t talk about how he knew what I looked like at 19, except to say that it involved a communal swimming pool and some self-conscious skinny dipping. There are those who will remember the ’70s & how that used to be OK. Nowadays, if I’d been much younger, there’d have been arrests.

But, nobody gets to stay 19 forever, even a second time ’round. I left the hospital with the medical equivalent of saran wrap holding my chest together. This would stay on an additional two weeks, providing increased heat within really thin skin that needed to establish new circulation, and a way to peer at the nipples–which until the surgeon told me, I didn’t realize might dry up and blow away.

So now, three weeks out from the original surgery and with regular infusions of saline, foobs have emerged from the primordial booblets. Given my profession and the profound effect words have on women’s sense of self, I’ve always been careful to give body parts their correct names–at least with patients of a certain age  and comfort level. But special circumstances create the need for new vocabulary. An email friend who’s been through the same process tells me this stage is the “foob” stage. From the Latin, of course: fake boob.

Seems entirely appropriate to me, as these have certainly passed up my 19 year old booblet moment. Booblets are cute and unassuming. Foobs, well, foobs make their own way in the world. Anyone who accidentally runs into me won’t hurt me, but might come away with some serious bruises right about foob height. Which means we’re not talking “real” breasts yet.

I’ve got another one or two infusions to go before the tissue expanders reach their limit. Or I reach mine (this is not a comfortable process). A couple months after that, once things have stretched and settled to the extent they will, the expanders are exchanged for implants that feel much more like “real” breasts. And with any luck, I’ll start feeling real again, too.

Surgery sucks.

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Except when it saves your life.

But it’s awful in ways having my appendix and gallbladder out 20 years ago weren’t awful. Those surgeries felt like dental procedures in comparison. Of course, there is the thing about being somewhat younger back then. And the thing about once the last stitch is taken out at the two week post-op visit the deal is done. Finito. Fini.

None of that now. I’m already at the two week mark, but listen to me whine. Talk about being blindsided. I went blithely into surgery with my previous experience, expecting more of the same. Oh, maybe I’d use my time off for actual recovery and not plan any camping trips (I mused), but I had no real thought that things would be markedly different. After all, they weren’t even opening a major body cavity. Silly me.

In the be-ribboned world of breast cancer, I’ve won the lottery in several different ways. I don’t need anyone to tell me that. I deeply appreciate having found it in time enough that I’ll likely not be another woman trying to “live” with breast cancer until she can’t any more–often for less than five years.

Because a very experienced and persistent radiologist saw something that could hardly be seen, followed it up in slap-bang fashion with a series of biopsies that proved what he thought was there, leading to an MRI that showed something suspicious in the other breast, the decision to have bilateral mastectomies was a no-brainer. Waste time fishing around on the other side just to prove the “concerning” spot was indeed concerning (and what if it gets missed–the worst of it just micrometers outside the sample, or the real bad spot is just too small to show up…yet?), no thanks.

And because of his persistence and the expertise of his colleagues–the radiologists who nailed the lesions with their fancy x-ray guided biopsies–I get to go ahead with the plan to inflate the tissue expanders that were placed under my chest muscles rather than default to chemo or radiation and let cosmetics be damned. As it turns out, both breasts had cancer, invasive sorts of different types–a veritable smorgasbord of cancers and pre-cancers–but none was in my lymph nodes, nor in the little arteries and veins that course through the breasts, nor near enough to nipple and skin that I’d need those removed as well.

So. Onward. Stiff upper lip and all that.

Waitjustaminute. Not quite yet. I’ve got drains draining and pain paining, and have hit my wall for today. In other words, I am not feeling at all like doing anybody’s happy dance. I’m hoping against hope the appointment come Monday wherein they begin expanding the expanders and (hopefully) pull out these !#%! drain tubes will relieve some of their associated discomfort.

Discomfort. Now there’s a word. The expanders are flat things that resemble the stingray that killed Steve Irwin. The edges are thick, bump into each other through the muscles over my sternum, and slice upward into my armpits. The swelling associated with all this bumping and grinding gives me a bustline like Tarzan’s and the discomfort plays hell with my attitude.

Do you a favor. I won’t even get into the drains.

Until next time. Maybe.

It’s my party and I’ll cry if I want to…

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So I spent the last two days trying to take a friend’s advice. “Quit feeling sorry for yourself and write something interesting.” He was a little more tactful than that, but I got the message.

I did try, honest. He even gave me a good jumping-off point: my original mission statement for the Situational Midwifery blog–a soapbox about things encountered as a midwife. The things that piss me off about women’s health care. About how nothing has changed much under the sun. How women and their problems are often blamed for, well, women and their problems.

I’ve got half a lifetime’s worth of subject matter, but right now that’s not not exactly what’s rising to the top. Go ahead and look forward to future harangues, but for now they’ll be about my own stuff.

Participation is optional. Nobody is required to read a blog. I haven’t been a professional writer for more than half a lifetime now, so for all I know, it’s crap. Or it’s crap to men, or it’s crap to folks who haven’t faced something similar. I’m ashamed to say I’m one of those. I got so tired of my mother’s crying jags and worries and photos of grotesque surgeries that I was nowhere near as sympathetic as I might have been. At 15 years old. So I understand that point of view, too.

So read on, or not. Part of what I’m learning these days is to stand up for myself. My friend has given me yet another opportunity to do so, even though I’m afraid he’ll take this the wrong way. If I never hear from him again my husband (who loves this guy), will be really pissed. Then I’ve got two problems.

Sh*t.

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I hate having meltdowns. So I had two on Sunday. Sort of because my neck was killing me and Tylenol doesn’t cut it. And the chiropractor wasn’t in (lazy sod).  Retaliated by eating three ice cream bars. That helped. Then I got proactive and watched “Mastectomy and You”–the DVD my surgeon assigned. Like I get brownie points for  writing a book report. Or returning it on time. Like the stupid thing’s gonna help.

Should have been more protective of my mushy mind. Choose one source of information and stick to it, I say to my patients. Do I take my own advice? Noooo. The DVD pics bear little resemblance to the ones the plastic surgeon showed me. Not that they’re so bad, they’re just not so good, either. Hence the meltdown.

I swore I wouldn’t cry. Years ago Mom cried enough for both of us, wasting months wailing about which lifesaving procedure would, in fact, save her life. That she had months to waste should have been a clue. Her diagnosis was DCIS–now considered a high-risk precursor, but not cancer itself. Eligible for lumpectomy. In the 70s they didn’t know that and didn’t seriously offer anything other than modified or radical mastectomy. Didn’t offer reconstruction, much, either. If they did, it wasn’t until years after treatment, once survival was pretty much guaranteed. The fear was that reconstructed tissue and thick scarring might make a deep recurrence nearly impossible to see. Misogyny and concern rolled into a tight little bundle. And utterly believable as far as my mom was concerned. Lop off her breasts and replace them with something that could moot the whole point? No thanks.

Lord knows things have changed, and I’m grateful for it. Scoop out the offending bits and deal with the rest later. Unseen recurrence? Not likely. Leave the hospital with something that hurts, but pokes out instead of in? Priceless.

Mom and I were different in lots of ways. I guess every one of us is. After seeing those godawful mastectomy scars every day after my 15th year, the decision was made loooong before I was ever diagnosed. My best friend got leukemia. Possibly an infinitely worse diagnosis than mine. Ended up with stem cells, a stroke and a bald head. She rocked that look. Mom and her concave chest? Not so much. My aunt (her younger sister) didn’t even want to try it. Diagnosed two different times, she was stuck with two different reconstructions because silicone wasn’t on offer the first time. Her words to me? “Just do it.” No matter what the technique, just do it.

And her advice, I’ll take.

Hot diggity!

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Wow. I didn’t expect to be giddy with relief after the surgeon’s appointment today. Like Cinderella at the ball. Or Dorothy home in Kansas.

The three page birth plan is back in force. There will likely be no chemo. And probably no radiation. My hair won’t fall out and my skin won’t peel off. I won’t feel like I’m dying in the midst of “treatment.” Nobody batted an eye at my request for skin-sparing bilateral simple mastectomies and immediate reconstruction (the first steps of it, anyhow). The incisions are small, and the procedures will be done by folks I trust. All my externals will be left as they are–maybe even with some sensation. My friend Michelle just messaged me about the “awesome new rack” I’ll get for my troubles. LOL. I’ll be happy with just short of normal.

All the arcane testing done on my cells says they haven’t gone nearly as awry as “invasive” breast cancer implies. Chemo won’t work on “non-HER-2 expressors.” Or those with a “low Ki-67 proliferative rate.” Am I the only living woman with an urge to thank an under-acheiving cancer mutation? Mom viewed my decision to become a nurse as evidence of mediocrity. Well, hoo-yah!

We shall see. The above changes if it turns out some pesky cancer snuck into my lymph nodes. That will be determined with surgery and could require radiation. But by then I’ll have the expanders-soon-to-be-implants (yay silicone), and there’ll be no going back.

…I got to reading that last sentence, and realize there are friends and patients I know who’ve had a terrible time with aggressive cancers and all the misery chemo implies, as well as postoperative complications that require going back to the beginning and starting all over again. In the face of all that, my giddiness may well feel selfish and downright insensitive. I apologize. I’m enjoying the moment, though, and trust you don’t begrudge me that.