Breast Reconstruction – feel like the Bride of Frankenstein

I am now 17 days post surgery and am recovering well. I wish someone had described to me what it would be like so that I would not have been as nervous. Oh well, I made it through the worst part and it was fine even with a few bumps a long the way.

The first week after surgery was not pleasant. Surgery day I was anxious and emotional. At the hospital during pre-surgery prep the nurse got the IV in on the first try with minimal pain. Thank god! And she was really very nice. In those situations (sometimes any situation) one kind word can make you feel better, it really can make a difference. I was then prepped and ready in my hospital gown and off to the surgery waiting area. The anesthesiologist then came over to have a brief chat. It was the same person I had for my previous surgery. I had requested her, hoping she was available and she was scheduled that day so put her name in on my surgery. Happy about that! Also made me feel a little better. While walking over to the OR, all of a sudden I was overwhelmed with emotion. Maybe everything came back … I’m really not sure what happened but we had to take a pause before continuing. It was emotionally overwhelming, cutting off my breast and now having them start to reconstruct it. Breast cancer which now seems to be gone but you never know, and there’s always that fear lingering in the back of your mind. After a couple of minutes I was ok and continued down the hallway to the OR. Once there, I was being strapped in and the resident introduced himself, my surgeon came in, everyone was bustling around and then I felt light headed …

The nurse was tapping my shoulder waking me up. Surgery was over, I made it!! Woo hoo! She was asking how much pain I was in and checked everything. The pain was quite a bit, I was pretty sore even though I was on morphine. They gave me more drugs and waited for the pain to go below a 5/10 before they sent me up to my room. I could barely move. There was pain in my back, my front, my arm, and my stomach. I am guessing a few hours went by (not sure since it’s a blur) but I was finally ready to be taken to my room. This nurse was also very nice and told the two taking me up to my room to go slow as I was very sore. Every bump, every movement HURT!

Finally got to my room and my mom also came in to see me. Shortly after my brothers and Dad came to see me as well. My nieces made me a card and video, which was so sweet.

I was to be in the hospital until the next morning. The next 24 hours were not pleasant. I was so sick (nausea vomiting) I couldn’t eat. Also I could barely move so once I was lying down that’s the position I was going to stay in. Needed a nurse to help me out of bed and to the bathroom and then back into bed. Could not lean forward very much so always needed help with reaching anything. 3 of the nurses were great the other 2 were horrible! The nurse I had to call at 3:30am to help me to the bathroom was the worst. She was so unhelpful!! After I went to the bathroom she left so I made it back to my bed but could not properly get back in. When she came back, she helped me into bed but didn’t straighten out my sheets so I couldn’t get them over me properly, even though I had asked her to. She was such a miserable bitch. My nurse was on break which is why this woman was there instead. Finally another nurse came to help the lady I was sharing the room with and then she came over to help me. I was so frustrated at this point I started crying. Ugh. This other nurse was so lovely and my other 2 were great as well. When you’re helpless and in pain and can’t even get out of bed, it is the worst feeling when the person who is supposed to help you doesn’t give a shit and is barely helping. I complained about that nurse and they said she was from an agency.

The next morning was okay aside from the fact that I was dehydrated due to not being able to keep anything down. They had to keep me there an extra couple of hours because I needed fluid. After that my mom came to get me and was irritable and being bitchy. WTF?! I just had major surgery and she’s gonna act like that?!?! I was so angry after that I didn’t even want to speak to her. But unfortunately I had to stay with her for a few days since I needed help and live alone. The downside of being single.

I spent the first week in pain, and binge watching Netflix. Couldn’t do a whole lot and sleeping was uncomfortable but it was bearable. I had drains coming out of my back, there was fluid oozing out of the open area, had really bad blisters from the bandaid/dressing tape, and my stomach was purple from the bruising. My chest area wasn’t so bad but looked like patchwork and looking at myself in the mirror the first time was difficult. She had taken a piece of skin from my back and put it in the front so that there would be more space to create a “breast” since radiated skin is not very elastic. She took fat from my stomach and put it into the breast area so I now have the beginnings of a breast. There will be more work done later but I get a 2-3 month break.

After spending eight days at my mothers house I finally came home. While I am thankful that she was helpful it wasn’t always pleasant so I was very happy to be back in my own space. Oh and I was really excited to be able to take a shower again … no more sponge baths!! Funny how we take the simple things for granted.

I have a huge scar on my back and 2 scars in the front. I feel like the Bride of Frankenstein but I keep telling myself that eventually all will look kind of normal again. I will never look the way I did before but that’s okay. As long as I am cancer free and can wear a normal bra, I’m happy.

 

 

 

No it’s not breast augmentation!

I realize that I do not write nearly as much as I did before. I do love writing but I have now returned to work full time and trying to maintain my healthy lifestyle is so exhausting. Also I have decided to start my own business. Doing all of this while trying to still have a life and doing the things I enjoy is close to impossible. I generally don’t get enough sleep anymore. For me not enough sleep means less than 8-9 hours. Well, I will have lots of time to sleep soon enough … I am having reconstructive surgery in 10 days.

I am a little anxious about the 3-4 hour surgery as it’s longer than the mastectomy (90 mins) and I am in the hospital overnight. Then there is the 3-6 week recovery depending on how things go. I will be off of work for 6 weeks which at least is now in the summer so I can go for walks, sit on the balcony etc. Recovering in the winter would be depressing … Netflix binge watching!

It’s the latissimus dorsi flap, but muscle sparing breast reconstruction. A strip of my lat muscle will be moved around to the front under my chest and reattached. Then a tissue expander will be put in so that my skin can be stretched. Stretching the skin … that just sounds painful but it is what it is. Once that is done, there is the second surgery 3 months later to take out the expander and put in an implant so by Christmas everything will be done. It’s an elective surgery that I chose to have. I know some women opt to forego the reconstruction but I want to be able to wear a normal bra with no more prosthesis, wear my normal clothes again and just feel closer to myself.

So this is nothing like breast augmentation, actually part 2 is closer to being like just getting an implant but this is a 6 month process … Surgery part 1, stretching the skin, surgery part 2. A lot of people assume that it’s just like getting implants and it’s far from that. Because I have radiated skin the flap needs to be created using my lat muscle. Then, aside from the obvious where I have no breast – no breast tissue, no nipple, there’s also an emotional component that people forget about. Oh and did I mention that a nipple has to be created! The last part of the process but still a part nonetheless. This is all still part of the breast cancer treatment plan.  Being back in the hospital, doing rehab and physio, being off of work to recover … it all brings back memories of the last (close to) 3 years. Wow, it’s been almost 3 years since my diagnosis!! 2 years and 3 months in remission 🙂

I just want the surgery to be over, I will be relieved once it is done. My left side may look like the bride of frankenstein after but at this point I really don’t care.

 

Tamoxifen – Friend or Foe?? (may be TMI for some)

After having such a gruelling week I was looking forward to a nice, relaxing, stress free weekend … of course that didn’t happen.

It was 4am and I woke up in pain. The abdominal pain had not subsided and now I felt like I had just gotten my period. I told myself “that can’t be, I’m on tamoxifen” so I’m in a drug induced menopausal state. I got out of bed to use the bathroom and there it was, showing up 2 years later. WTF?! The week from hell wasn’t over and had just gone from bad to worse. All I saw was red everywhere. I showered, changed and took all off my sheets and threw them in the washing machine. My pyjama bottoms were soaked so those just went in the trash. Distressed, I finally went back to bed.

The next morning I called and left a message for my oncologist. The abdominal pain now made sense … all this time I was having really bad cramps. Never had such bad cramps before but also never had such a heavy menstrual cycle. This was worse than anything I had experienced before. There was no light day start, just jumped to ‘worse than my heaviest day ever!’ I didn’t do much the rest of the day as I could only make it through an hour and a half with both a pad and a tampon (and they were Supers). This is ridiculous!! What is going on???

I was getting worried since this was not supposed to happen. Although there could be several reasons for this, one of those reasons is uterine/endometrial cancer. Tamoxifen is generally prescribed to women who are diagnosed with ER+ (estrogen receptor positive) breast cancer. It is meant to reduce the chance of recurrence but every drug comes with risks and side effects.

Tamoxifen works by blocking estrogen’s effects: It interferes with estrogen’s ability to stimulate the growth of breast cancer cells. It is a SERM. 

  • Selective estrogen receptor modulators (SERMs) bind to estrogen receptors, preventing estrogen from binding. Examples of SERMs approved by the FDA are tamoxifen (Nolvadex®), raloxifene (Evista®), and toremifene (Fareston®). Tamoxifen has been used for more than 30 years to treat hormone receptor-positive breast cancer. Because SERMs bind to estrogen receptors, they can potentially not only block estrogen activity (i.e., serve as estrogen antagonists) but also mimic estrogen effects (i.e., serve as estrogen agonists). Most SERMs behave as estrogen antagonists in some tissues and as estrogen agonists in other tissues. For example, tamoxifen blocks the effects of estrogen in breast tissue but acts like estrogen in the uterus and bone.

Tamoxifen Side Effects:

  • Risk of blood clots, especially in the lungs and legs
  • Stroke
  • Cataracts
  • Endometrial and uterine cancers
  • Bone loss in premenopausal women
  • Mood swings, depression, and loss of libido

National Cancer Institute. (n.d.). Retrieved from http://www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet#q4

Benefits – Tamoxifen can:

  • reduce the risk of breast cancer coming back by 40% to 50% in postmenopausal women and by 30% to 50% in premenopausal women
  • reduce the risk of a new cancer developing in the other breast by about 50%

BreastCancer.org. (n.d.). Retrieved from http://www.breastcancer.org/treatment/hormonal/serms/tamoxifen

The above information is what Tamoxifen CAN do, not WILL do. Statistically, yes it can (and I think usually does) help, but there is no guarantee. In any study there are so many variables that we are not aware of. How many of those women in the study/trials fit my profile? No clue and no way for me to know.

There is a very small chance that it is uterine/endometrial cancer, but nonetheless I am kind of freaking out. I try to relax as much as I can, which is always easier said than done.

Just when things were starting to feel somewhat normal, this happens! UGH!!! I feel overwhelmed again. Is the drug just not working anymore, did my ovaries just wake up out of their coma, or is it something more serious??? I am now waiting … will see oncologist and then be referred to gynaecology, will have to have more tests (unpleasant ones I’m sure) and then we will know something.

Tamoxifen … the FRENEMY.

Treatment Over!!!

It’s been exactly 4 months since my last chemo session and 1 week since my last radiation treatment. Treatment is done!!! I made it through and am still intact and doing ok. I’m so thankful for everything and grateful to be alive. Each day truly is a gift.

My hospital was downtown so after my last treatment on Thursday I met with some friends after work at Rosewater nearby. It’s a Thursday after work hot spot now and by 6pm was packed. Nice lounge menu, food was good. We got there early so had a nice sitting area by the windows on the main level. I had a wonderful time. Christiane brought me beautiful flowers and a card. I read one line and started tearing up so had to put the card away until I got home. Of course when I read it later there were tears rolling down my face. What she wrote was heartfelt and touching. Sean had them write ‘job well done’ on the dessert plate which was sweet. It felt good to be social again and I wasn’t exhausted by 9pm?! Maybe I was just so happy to be done with treatment that I was wired lol. My life was at risk and I was fighting the battle that know one wants to be in so the people that were there for me have a special place in my heart. At a time like that you need support, I can’t emphasize that enough. I don’t know how I would have made it through without my mother, my family, and my friends. Even the people who simply said something kind or showed me that they care. It’s something that was appreciated more than they know. For those on and off friends, sorry but I’ve turned that switch OFF.

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The next evening I went to a friends surprise birthday party. It was a family friend and he’s very sweet. His wife planned the party and I had a nice time. These are a different group of friends and all in the suburbs near my parents. Not all of them know what’s going on with me so I had my wig and eyelashes on. Again I didn’t feel exhausted and stayed pretty late! I always feel a little weird not telling people because then I have to pretend I’m working and still living in the city. Oh well, maybe it’s better to just be normal for a night.

My mom had some family over on Sunday to have a celebration dinner which was nice. With CAKE! Yayyy! It’s been a really good week.

My skin is not too bad. Depending on how much of my décolleté you can see you may notice that the left side is red/brown and darker than the rest of my skin. It’s also itchy and sensitive. The entire area from my neck to the bottom of my ribs looks like I’ve been in the sun too long. Hopefully will get better soon. I’m also emotional at times. I’ve been crying more this past week. I think it’s being overwhelmed with emotion realizing that my treatment is done and everything I just went through. Also being thankful to be alive after eight months of hell. The radiation was the easiest part for me. Now it’s time to focus on rehab and recovery.

Right now have a few follow ups, consults, blood tests, and ct scan. First follow up and blood test down, all good. Next …

Typical Wednesday

My alarm goes off at 8:45 but I hit snooze. I never go to bed early so waking up before 11am usually doesn’t happen and if it does it’s a struggle. Not to mention that I now need 11 hours of sleep. I get out of bed 15 minutes later and get ready to go to the hospital. My mom is downstairs and has made French toast for me (she’s been great through this). I grab some water to take with me. 10am we’re out the door. My mom’s driving … Wed afternoon parking is always difficult so I usually go in while she finds parking.

I’m at the hospital now, I check in and fill out the weekly assessment before seeing the Dr (radiation oncologist or his fellow). I see the dr every wednesday. My mom is with me and I get called in. The usual dr that sees me isn’t there and I see another ‘fellow’. She comes in and says hi, and then rolls her stool over to my mom and asks how she’s doing. She just assumed my mother was the patient! Do I look that young? Did she not look at my chart? Did she think my mom was 43? Whatever happened she had no comeback. She could have just said she thought my mom looked young or I couldn’t possibly be 43! Haha. Anyhow she was embarrassed and we continued with the appointment. She asked how I’m doing and examined the radiated area. I’m doing fine, some redness and sensitivity but otherwise ok. Moral of the story … Never assume.

We now go back out into the waiting area and I scan my card to let the radiation therapists know I’m here. My room is on schedule. Unit 15 is where I go everyday and switch between the same few therapists. They’re all very nice. I get many compliments on my Kate Spade light turquoise bag. Bought it in August shortly after diagnosis. My cousin and I went shopping. Fun! The bag is my perfect hospital bag as there is nowhere to put my clothes when I change into the gown for radiation (annoying but whatever). So my bag fits my clothes and I love the spring happy colour of my very roomy bag. It’s a great tote and I love it!!

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The radiation therapist now calls me in. I change into the robe and wait for them to call me in. Once I’m called in they ask for my birthday to confirm. I lie down but there is a fold on the table which ends up being right at my tailbone. Ugh. So we put a folded sheet underneath (everyday). I lie down and everything including me is being adjusted. The lights go off and there is a panel above me. One of the two techs comes over and asks me to take a deep breath and hold and takes some measurements. I can see a ruler like image on my chest in the reflection above. She takes a few more measurements and then puts the nose clip on, puts the snorkel in and gives me the emergency button. My right arm is down holding the button and left arm is up. I’m semi comfortable minus the nose clip.

Now it begins with a panel moving into position on my right. I hear “first breath in, breathe out, second deep breath in” and now I hold my breath until I hear “breath normally”. Although I couldn’t breathe if I wanted to since the snorkel is attached to some sort of device and my air is cut off when I’m holding my breath. After that this happens a few more times as the panels move around me. They come back in and take a few more measurements, then leave and we repeat the process. Then I hear “you’re all done”. I sigh with relief … Until tomorrow.

Some sense of normal

I now have 2 weeks of radiation left … It can’t come too soon. My skin is noticeably darker now, like a partial tan. There’s a certain area which is sensitive but it’s not too bad. Going downtown to the hospital everyday is exhausting. Also, chemo fatigue can last for months afterwards. I’m also having numbness and tingling in my thumb, index, and middle finger every morning. It then goes away after an hour or so. What is that about?! Chemo side effect 3 months after chemo has ended. The gift that keeps on giving.

Another loft came up so we went to look at it today. I fell in love! It’s exactly what I’ve been looking for! The bedroom has 2 walk in closets. They’re his and hers but will be hers and hers :). The closets also have built in shelving, space for my clothes and shoes! The closet downstairs also has racks for my shoes. This place was made for me!!! Then the huge 2 storey wall which is all windows is beautiful. Thinking of living there makes me smile. Being in my own space will make me feel somewhat normal again. I will probably transition over from my moms place and decorate and keep my mind busy. It will also be a fresh new start. I’m excited and hoping that my offer is accepted. We will know soon enough. Stay tuned …

TGIF!

I feel like I’m working again … So happy it’s Friday!! Wooo! Radiation is Monday to Friday for 5 weeks. And I have a half hour drive to the hospital, sometimes longer with traffic. There’s additional fatigue from the radiation itself. It’s all exhausting but will be done in 3 weeks!

Today was day 11 and my skin is pink and sometimes looks a tad darker then my normal skin colour. The good thing is I’m not in any pain. I’ve been using pure aloe with baby aveeno on top. Seems to be soothing and working well so far.

Emotionally I’m feeling a lot better than before. Maybe because the end of treatment is near, maybe because my eyebrows/eyelashes are coming back so I look a little more normal again. Oh and the hair on my head is growing but it’s soft and fuzzy.

My only worry is that my ct scan come out clean next time. Prior to radiation there were still some cancer cells in my mammary node, which was inoperable. Chemo and radiation is supposed to get rid of it. It was pretty small and chemo reduced it but it was still in existence. Why can’t they all just die! Leave me alone, get out of my body, my life and stay out! I had a nightmare last night that the radiation didn’t get rid of all the remaining cells. I guess in the back of my mind I have that fear. I must think positive and know that as my dr told me the radiation will get rid of it.

Oh I’m sleeping better and not crying as much. Actually much less. 🙂