Tag Archives: mastectomy

After the sky falls…

Standard

Sooo, after returning to work early-ish following the exchange from skin expanders to implants, I’ve had quite the eventful run of complications. That means I’m sitting here at home again, recovering. Not really feeling inspired to write, but bored to death with feeling bad.

I felt so nearly normal so soon after the implants were placed that I thought I was home free. But one night, I noticed the left breast seemed to be sitting a lot lower than the right. No discomfort, but weird. I got an appointment with the plastic surgeon for the next day, and in the meantime amused myself by writing about Henny Penny and the sky falling, absolutely never suspecting there was a real problem.

OK, so the sky did fall.

While driving myself to Dr. N’s office, the left implant’s pocket started filling with blood & didn’t stop. I could tell something was happening because I felt like I couldn’t breathe on that side. In the rearview mirror I could see a really big bulge over the top of my shirt, near my clavicle. Thank heavens for this fancy hands-free car phone stuff–it let me call home and leave a message for my husband: “Keep your cell phone on–I may need you!”

It’s a blur, but I did get to the office. Dr. N inserted a drain to relieve the pressure and hopefully save the reconstruction on that side. A friend who wasn’t supposed to be at work that day (but heeded the little bird who told her to show up) was available to drive me to the hospital faster than if we’d waited for an ambulance.

After the requisite 8 minutes of chaos, the ER figured out who I was and what to do with me. I was just grateful my friend was willing to stay & hold my hand while I writhed and cursed in and out of consciousness. I cannot adequately describe how it feels when over a liter of blood tries to burst through your skin, so I’ll leave it at that.

I remember thinking they’re just going to let me lay here and die and I’ll never see Brian again. But he’d been called, and soon after the thought, he was there with me, scared to death, too.

All was resolved with a timely return to surgery. Dr. N was suitably impressed by how much blood I’d lost (about 1.5 liters), and happy to have seen the cause of it–one of the little blood vessels that forms during reconstruction was torn & could be seen merrily pumping away. So, that got fixed, a new implant was placed, and I went home the next day with–yes–yet another drain. Not to mention tearful, weak, and pitiful from sudden blood loss.

So relieved to have a husband willing to help with the care and feeding of a PICC line.

So relieved to have a husband willing to help with the care and feeding of a PICC line.

A week goes by uneventfully, tho’ I’m secretly terrified of a repeat. It happened once– who’s to say getting in the shower and washing my hair (as I’d done the morning of my appointment), won’t spring another leak? I’m Catholic. It’s gotta be my fault, right?

So it’s back to Dr. N’s for inspection and to have the drain removed. All seems well until about 5 hours later, when I start feeling achy and warm. That progresses to joints screaming and hot. My temp goes from 101 to 104 within about an hour, and Brian’s making frantic calls to the on-call doc, then Dr. N, then I’m in the car and being carried back to the hospital where I stay for the next few days getting IV antibiotics.

Thank heavens for modern medicine & modern antibiotics. Infection after trauma–surgical or not–is the kind of stuff that killed people when we didn’t have what we’ve got today.

I’m home now getting the antibiotics here, as there’s no oral equivalent of what they need to give me to be sure there won’t be a recurrence. I’ve got what’s called a PICC line–an intravenous catheter that starts in my upper arm and dumps into one of the really big veins near the heart.

So far, each day is a bit better, and I’ve woven for myself an explanatory fiction that makes me less afraid I’ll have another bleed. I can think of the infection as old-fashioned sclerotherapy (therapy that scars) inside that pocket, sealing off any potential little bleeders that might lurk there.

And there’s Dr. N’s assurance that “this never happens.”

Except in one case he had where a woman’s stove electrocuted her.

And me 😉

Henny Penny’s Got Nothing on Me

Standard
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?

Standard

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.

Empowered Blogger  

Things that go soft in the night…

Standard

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.

Empowered Blogger  

I’m wounded and can’t get my bra off.

Standard

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.

The Heartbreak of Phantom Bra Pain

Standard

One of the more irritating features of this breast-building business is the tissue expander stage. Folks who have augmentation without mastectomy will have smaller implants placed either behind the existing breast tissue (fat & glands we associate with breast shape), or behind both breast tissue and pectorals (the large chest muscles so popularized by Jack LaLane). It’s a choice they make with the help of their plastic surgeon.

Folks like me, who have breast and underarm tissue removed in any of the various mastectomy surgeries, have a couple of reasons for needing to go the tissue expander route. If their own skin is spared, there’s no support for the implant within that empty pocket, so space must be created behind the pectorals to both support and hold it in place. It needs to be a larger space, for a larger implant, as there’s no more breast tissue to help shape it. Those who have a complete mastectomy that includes removal of skin and nipple will also need tissue expanders to stretch not only muscle, but the overlying skin as well.

I’ve said it before, and I’ll say it again: this is NOT a comfortable process. Aside from the requisite stretching and burning, I have this sense of something foreign–something large and foreign–strapped to my chest wall. All the time. It’s uncannily like wearing a too-tight bra every waking moment. And every other one, too. I’m constantly reaching up to tug on the elastic, pull at the underwire, or actually unhook the back. But nothing’s there.

Oh boo hoo. There are waaay worse things that could be happening right now.

But it is really strange. It’s exactly the sort of deja vu experience I’ve had ever since my parents died. Where I think before my brain stops itself: “Dad’s gotta see this…” or “let me just call Mom…”

I suppose in addition to grooves in my brain that track to the Mom and Dad thoughts, I’ve got another groove that tracks to the “gotta get this bra off” thought. And not just the thought, but the actual motor impulse that has me reaching up to find the thing. They’re the kind of impulse pathways that plague amputees with phantom sensations they’d swear were coming from the missing limb. Or the missing breast.

So if I’d gone with my health ed teacher’s advice and worn better fitting bras all my life–bras that didn’t create the need to reach up and yank down–would I still be doing this? Maybe some PhD-type will do a study. And give us a new ICD-9 code: phantom bra pain. I want my name on it.