Breast Reconstruction Part 3

Hello … I know I haven’t written in awhile. This past year and a half has been non stop, between recovering from surgery, working full time, starting my business, having more surgery and trying to have a life.

Last summer, my second reconstructive surgery was so much easier than the previous latissimus dorsi flap surgery. I could actually move post surgery!! Woo hoo! They never prepare you for any of this and I didn’t connect with anyone who had been through this surgery, so wasn’t able to ask questions and get an answer from someone who had experienced things first hand. I did go to a couple of support groups but no one in the group had reconstruction. I guess it’s true … a lot of women don’t have reconstruction done. And I get it, who wants to have more surgery when you’ve already been through surgery, chemo and radiation. You just want to get on with your life. Except it’s never that easy.

Part 3 of breast reconstruction coming up soon … this should be the last surgery. Almost 5 years after diagnosis, all surgeries will finally hopefully be done.

 

Treatment is Done Now Get Over it. Really???

This was an interesting article/post by another woman with breast cancer. I have read her blog for the last 3 years and although I have never met her I feel that connection to her … I laugh and cry sometimes when I read her posts and hear her story. It always resonates with me somehow.

The below is highlighting the fact that people think that when the gruelling treatment is over, you should just be happy and get back to your previous life. It doesn’t work that way and it is difficult to put into words the myriad of emotions you experience. However the article below does a great job of explaining what it’s like. Please read so that you understand just a little more than you did before.

http://www.huffingtonpost.com/entry/breast-cancer-dont-ask-us-to-get-over-it_us_57f18712e4b07f20daa10e51?timestamp=1475450545778

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.

Finally Friday … The Longest Week Ever!

This has felt like the longest week ever. TGIF!! I haven’t said that in awhile. I’m still in pain but it’s not as bad as last night. My mom told me to take a sick day but I felt obligated to go in and finish the project I was working on. Deadline is end of day today. I thought I’d be able to leave early and finish it over the weekend. Well no such luck. Got an email from my boss saying that he needed it tonight and Monday was too late. Are you kidding me?!?! There was no meeting scheduled for Saturday morning! Ugh. I could feel the frustration starting again. I let him know that my back pain had gotten much worse and that I could not work late so would not be able to get it finished tonight. His response was only to let him know what still needed to be done and he would finish it. There was no concern or acknowledgement of the pain I was in. Just a simple “sorry to hear you’re not feeling well” would have sufficed. It was the fact that he didn’t even acknowledge it that was upsetting! I could feel the frustration building … I’ve now passed 5 and am getting closer to 10. SIGH. I go for a short walk, grab some lunch and head back to my desk. The abdominal/back pain has not subsided. I make an appointment with my GP for Tuesday. If it gets worse I can always go to the walk in they have in the afternoon. 

My coworker is frustrated as well and starts venting, I listen and then share my frustration with her. All of a sudden I’m crying. What is happening?! I have never in 20 years, cried at work!! “Get it together” I tell myself. A minute later I’m fine but clearly I am overwhelmed again, something I’m not used to. Part of it is the fact that my eating and exercise all went out the window this week. Something I cannot afford. Oh and let’s not forget that I’ve been working all day while in pain. I will NOT be doing this again. I’m going to talk to my oncologist and HR and then figure something out. 

I continue working madly, trying to get everything done. My coworkers have now both left. It’s after 5pm and I am still working. Now my thoughts have turned into ‘I hate my job, I want to quit, this is not how life is supposed to be … At least not my life!’. Finally at 6:30 I send my boss an email with what I’ve completed and leave the rest for him to finish. I got most of it done but there was still a bit left to do (which he apparently needed completed that night). 

Home sweet home. My week from hell is finally over. All I want to do is NOTHING, turn my brain off and relax. I get my heating pad (for my back) and find a movie to watch. Beyond the mental and physical exhaustion, my entire left side and abdomen are in pain. Monday may have to be a sick day. 

No one prepared me for how rough it would be at times even after treatment was over. Like everyone else, I thought after completing treatment I’d be back to normal. Definitely not the case but I did make through the week and the weekend is here!! 

Beautiful Barcelona

   

  

 I’m in Barcelona. Got here yesterday evening. Was exhausted since I didn’t sleep much on the overnight flight. Woke up late and had to change rooms due to a bathroom issue. Anyways once everything was sorted out I finally went across the street for lunch to Elsa Y Fred. Sitting here and enjoying the food and atmosphere I forgot that I had Breast cancer and am still recovering. I don’t mean forgot for a minute, it just hasn’t been on my mind!! I think that means I need more trips out of North America. I’m not saying I think about it all the time but it’s not something I forget about especially since I’m not back to work yet. At home there are things constantly reminding me because I have Lymphedema and still working on the frozen shoulder. Those things should be resolved in a few months but it’s something that is there right now that I have to go to physiotherapy for and do exercises for every single day. 
Barcelona is a beautiful city! I’ve barely seen it yet but just the little I’ve seen is so lovely. 6 more days in Spain. 😊

ONE YEAR Since Treatment! ALL IS GOOD!!!

March 20th was exactly one year since I completed treatment. It brought up a lot of emotions … gratitude and happiness but also sadness, and anxiety. I’m so very grateful to be alive and in remission. I recently had a CT which came out clear. I was relieved and overjoyed the day I got my results but soon after my brain started thinking too much. Maybe it was because my Mom told me about her friend’s daughter whose cancer has come back 2 years later. It wasn’t breast cancer but still it makes me think too much. How did that happen? What was her initial diagnosis and prognosis? What was the treatment she received? All of this so that I can tell myself it was different from my situation and I will survive another 20 years! Right now I am only thinking as far as August where I will be 2 years from diagnosis. With each year the chance of recurrence goes down but with breast cancer it can come back at any time. Making it through 5 years doesn’t mean that you are cured, like some other cancers. Great.

I also read again that women who exercised had a higher 10 year survival rate. I’ve started to exercise a little more but to do 3-5 hours a week is not easy when you are not 100%. I still have fatigue and I get sick every month which puts me out of commission for 7-10 days. UGH! Recovering has been slow but I am getting my energy back. I notice an increase in energy every 3 months or so. I now sleep 9.5 hours on average and 7 hours feels like I’ve slept for 4. Oh well, that’s still better than before!The fatigue is difficult for people to understand. It’s an overwhelming exhaustion that hits you like a wave. At least that’s how it is for me. I can make it through the day now but usually can’t do too much in the evening. If I have evening plans I have to nap or rest in the afternoon. My days usually have to be planned. I also have to cook earlier in the day otherwise it doesn’t happen. Thank God for my Mother!!

The thought of going back to work makes me nervous. Not because of work itself but because I don’t know how I am going to manage getting enough sleep, exercising 3-5hrs/week and preparing meals and eating healthy, all while working full time. Maybe I can request working 4 days as my permanent schedule. I would also then only get 80% of my salary but if I can manage on that then maybe it’s worth it. Going back to work is 6 months away at this point so I will evaluate how I am feeling in about 4 months.

Making it to ONE YEAR post treatment is a victory and I am going to think positive, focus on living healthy and getting to my next milestone of 2 YEARS since diagnosis. That will be August 6, 2015.

Not gonna stop Living My Life

As I mentioned before I am planning a trip to London, Paris and a few cities in Italy. I’m so excited and looking forward to this trip!! The friend that I’m going with wanted to confirm our dates so that she could book her ticket. She’s coming back earlier than I am so we might also be flying there separately. While on the phone I mentioned to her that I went to see my oncologist and now have mild Lymphedema. I was a little down after leaving the hospital. I think because it was a reminder of everything that’s happened in the past year and a half. It’s not life threatening and causes more discomfort than anything else. I did have a bit of pain but that’s gone. My wrist is a little swollen and I’ve been wearing my compression sleeve. I knew there was a chance this could happen but I guess I was hoping it wouldn’t. It is something that can happen when your lymph nodes have been removed and also damaged by radiation. I had both. 

The friend without knowing much about Lymphedema said to me that maybe I shouldn’t be traveling and maybe I should cancel the trip. WHAT?!! My initial response was that I’m not going to stop living my life! She kept going, saying my health comes first. Does she think that I wouldn’t put my health first?! My health has been the priority since this whole ordeal started! Lymphedema is nothing to cancel a trip over and by August it will probably be gone. She then went on to say maybe I shouldn’t travel for the next year or so also because of the surgery. What the F@!$ is she talking about??? What does my surgery have to do with anything?! I’ve been on 4 trips since treatment ended and have been fine. A little tired afterwards but perfectly fine. I told her this. She was still worrying and continued with her Debbie Downer commentary and unsolicited advice. I then said I’d call my doctor and ask my cousin who is a surgeon and familiar with Lymphedema. I realized I was saying it to shut her up and had no intention of calling either of them. The following day I told her that my cousin said it was fine to travel as long as I wore my compression sleeve. I didn’t ask my cousin. Mentioned to my brother who is a physiotherapist and he said exactly that. She felt reassured. I also told her that she didn’t need to worry about me, I know what’s okay for me and what isn’t. Also that I intend to continue living my life without constant worrying. She didn’t respond. 

The entire conversation pissed me off. I think it’s because I didn’t like the fact that someone who isn’t that close was telling me how to live my life! She’s not my doctor or my mother. Who is she to tell me to reconsider my trip?!?! If anything I want to do even more with my life than before. I want to enjoy everyday and live a full, rich and happy life. I’ve been doing a pretty good job. I want to travel as much as possible. I still can’t believe she said that maybe I shouldn’t go. UGH!!! That was not concern, that was her not wanting to inconvenience herself if something happened. You may be thinking that I’m assuming but it was what she was saying and that’s what my gut is telling me. One thing I’ve learned is to trust my instincts. It’s disappointing that she would behave that way but I’m not shocked. This whole experience has taught me a lot about myself and others. Some good, some bad. 

I’m still going to enjoy the trip. I’m not letting her or anyone ruin things for me. Just because she is a worry wart and angry about what happened to her several years ago doesn’t mean she has to rain on my parade. I’m doing well and I’m not going to stop living my life! I hope she isn’t like this while we are traveling. BUT when people show you who they are, you should remember that and not expect them to be someone different. So she will probably be that way on our trip to some extent. As long as it’s minimal I’ll ignore it. 

5 MONTHS TO GO … LONDON PARIS ITALY!! 😄

Lymphatic Cording

Does the post op trauma never end?! It’s been just over a year since I had surgery and my arm and shoulder have had issues on and off ever since. Recently these issues have gotten worse. I’ve been dealing with FROZEN SHOULDER for the past few months. I’m still going to physiotherapy and massage therapy. It’s getting better but it’s a slow process. Last week I noticed pain in my wrist area, which progressed and when I straighten my arm there is pain from the axilla all the down my arm to my wrist. This happened several months ago and resolved in a few weeks with stretching. It’s now come back and seems to be a bit worse than the last time. My forearm is swollen and in pain. It seems to be from LYMPHATIC CORDING or AXILLARY WEB SYNDROME. The below explains a little bit about what it is.

“Axillary web syndrome (AWS), also known as cording, sometimes develops as a side effect of sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Both procedures involve removing just a few (SLNB) or many (ALND) of the axillary, or underarm, lymph nodes. Most people with breast cancer need to have at least one of these surgeries. Scar tissue from surgery to the chest area to remove the cancer itself also can contribute to cording.

If you develop axillary web syndrome, you’ll often be able to see and/or feel a web of thick, ropelike structures under the skin of your inner arm. Lymphedema therapists often call these “cords.” (In some cases, you may not see or feel the cords, but sensations of pain and tightness will tell you they are there.) You may first notice them when you’re doing something that involves raising your arm to shoulder level or above your head. If it happens, cording typically occurs anywhere from several days to several weeks after your surgery, although there have been individual cases where it appears many months later.” – breastcancer.org

I’m trying to exercise 3-5 times a week but when in pain with arm/shoulder issues it can make it very difficult. I’ll try to continue my modified workouts and hopefully at some point things will get back to normal or should I say my new normal.

All of this is exhausting. Every time I start to feel better and feel like I’m making progress something else happens. If it’s not one thing it’s another. Since November I’ve been sick (cold/flu) every few weeks. Each time I get sick it takes me forever to get better so then it feels like 1 step forward 2 steps back. On top of all that, the emotional effects of everything are also there to deal with. SIGH … Right now I feel drained. Part of that is because I’m physically really tired. Didn’t get enough sleep last night. That never helps.

At the end of the day, I’m still here living my life and I’m happy! 🙂
Looking forward to dinner with a friend tomorrow and also excited planning my trip to EUROPE in August. London Paris Milan Rome and Florence! Can’t wait!!