Had a scheduled oncologist visit. Blood work shows that red blood count is a little low. Doctor says that's not unexpected considering my recent surgery. Looks like I should be eating a more iron-rich diet. My doctor thought my Stage 1 surgery results look very good. I am scheduled to get 1-2 more Lupron shots before my Stage 2/ovary removal surgery. I have a consult scheduled for Nov 23 with a new gyn who will most likely do the ovary removal. The doc asked me if I have any side effects from Arimidex, which I started taking in August. She said it can cause joint pain. I haven't noticed anything other than my normal, occasional knee stiffness. Advil works fine for that. She said if it gets worse, I can take 1500mg of glucosamine/chondroitin 3 times a day. Bone loss is also a side effect of Arimidex, so I'll have another bone density test in January.
I'm feeling good. I'm up to walking 1 1/2 miles on good weather days. Sleeping tons better, too.
Just this week I noticed a marble-sized hard lump in my right breast. Dr. S says it's either fat necrosis or scar tissue and is common and nothing to worry about. It'll be removed during Stage 2 surgery. He also said that abdominal tightness should start to subside in 1-2 months. It's already loosened up, but still has a long way to go as far as I'm concerned. It feels like wearing a tight waistband.
I'll be glad when all these doctor visits slow down!
Wednesday, October 28, 2009
Tuesday, October 20, 2009
October 19, 2009 Office Visit
I saw Dr. S. today. He's very pleased with my progress. They also took photos today for my official post-Phase I results. Even the photographer commented on how good everything looked. After going through this whole process, I guess I've finally gotten used to being viewed, poked, and prodded by assorted medical professionals!
Dr. S mentioned that mesh was used in my surgery. I was able to get more info about it during this visit. It's a natural mesh that my tissue will grow around, not a synthetic mesh. He used it to reinforce the abdominal area. He cautioned me again not to lift anything over 10 pounds, no sit-ups or crunches and to be careful not to stretch my abdomen too much. He also said I should avoid any heavy lifting for the next 6 months to a year.
He wants me to wear my abdominal binder or some type of support garment for now. I found some light-support underwear made by Hanes that seems to give enough support without squeezing too much. I can wear any type of bra now - even underwire if I want. Dr. S says my new breasts are part of me now and that I don't have to worry anymore about whether the flap will survive. I can sleep in any position now without worry. He also said to expect some "electric shock" type breast sensations as the nerves connections start improving.
I asked him what to expect during my Phase II revision surgery. He said he'd do a small amount of lipo at the outer edges of my abdominal incision to smooth out that area and then use it as fat grafts to "fluff up" any breast areas that need it. He'll also correct small dog-ears at the ends of the abdominal incision. The areolas and nipples will be created at that time. I'll wear foam shields over them until they heal.
I still need to have my ovaries removed, so Dr. S said that can be done during the same surgery. The doctor he recommended does a robotic-assisted laparoscopy. His office will give me a doctor referral since I need a surgeon that has privileges at that hospital. I want my uterus removed in addition to the ovaries. I've been discouraged from that by my previous GYN for reasons that aren't clear to me. In my mind, it will be one less thing to worry about. So, we'll see how the new consult goes. I've also requested the same anesthesiologist because he prevented me from all the nausea I've had in past surgeries.
We also discussed Phase II timing. I could have it done in December, but I've decided that I want to wait until later in January so I can enjoy my family and the holidays without trying to recover from another surgery. We had originally planned to do this in December since I'd already met my deductible for this year, but I've changed my mind. I just want to feel good and enjoy the holidays. I will have to meet next year's deductible for other things anyway, so I guess it really doesn't matter. I left his office feeling very relieved that I can finish this year out without any more surgeries. I'd say that a bilateral mastectomy and reconstruction is plenty for one year!
My biggest physical complaint right now is abdominal tightness. It's a bit of a strain to take a deep breath. I can, but it feels like my diaphragm is constricted to some degree. Dr S said this is normal and will improve greatly over time. I'll keep reminding myself of the progress I've already made and remember that "this too shall pass". I've started slowly walking again and am up to a mile now.
My next visit with Dr. S is scheduled for early January.
Dr. S mentioned that mesh was used in my surgery. I was able to get more info about it during this visit. It's a natural mesh that my tissue will grow around, not a synthetic mesh. He used it to reinforce the abdominal area. He cautioned me again not to lift anything over 10 pounds, no sit-ups or crunches and to be careful not to stretch my abdomen too much. He also said I should avoid any heavy lifting for the next 6 months to a year.
He wants me to wear my abdominal binder or some type of support garment for now. I found some light-support underwear made by Hanes that seems to give enough support without squeezing too much. I can wear any type of bra now - even underwire if I want. Dr. S says my new breasts are part of me now and that I don't have to worry anymore about whether the flap will survive. I can sleep in any position now without worry. He also said to expect some "electric shock" type breast sensations as the nerves connections start improving.
I asked him what to expect during my Phase II revision surgery. He said he'd do a small amount of lipo at the outer edges of my abdominal incision to smooth out that area and then use it as fat grafts to "fluff up" any breast areas that need it. He'll also correct small dog-ears at the ends of the abdominal incision. The areolas and nipples will be created at that time. I'll wear foam shields over them until they heal.
I still need to have my ovaries removed, so Dr. S said that can be done during the same surgery. The doctor he recommended does a robotic-assisted laparoscopy. His office will give me a doctor referral since I need a surgeon that has privileges at that hospital. I want my uterus removed in addition to the ovaries. I've been discouraged from that by my previous GYN for reasons that aren't clear to me. In my mind, it will be one less thing to worry about. So, we'll see how the new consult goes. I've also requested the same anesthesiologist because he prevented me from all the nausea I've had in past surgeries.
We also discussed Phase II timing. I could have it done in December, but I've decided that I want to wait until later in January so I can enjoy my family and the holidays without trying to recover from another surgery. We had originally planned to do this in December since I'd already met my deductible for this year, but I've changed my mind. I just want to feel good and enjoy the holidays. I will have to meet next year's deductible for other things anyway, so I guess it really doesn't matter. I left his office feeling very relieved that I can finish this year out without any more surgeries. I'd say that a bilateral mastectomy and reconstruction is plenty for one year!
My biggest physical complaint right now is abdominal tightness. It's a bit of a strain to take a deep breath. I can, but it feels like my diaphragm is constricted to some degree. Dr S said this is normal and will improve greatly over time. I'll keep reminding myself of the progress I've already made and remember that "this too shall pass". I've started slowly walking again and am up to a mile now.
My next visit with Dr. S is scheduled for early January.
Wednesday, October 14, 2009
Wednesday, October 14, 2009 - I decided to drive today for the first time since my surgery. I met a good friend for lunch then went to the grocery store for a few things. Wow - I never realized you used so many chest and abdominal muscles just to push a grocery cart. I felt funny asking the bag boy to carry my groceries to the car for me. I never do that. I was really tired by the time I got everything put away at home. I was very careful not to lift much, but still, it wore me out.
I realized that I'm not breathing very deeply since my abdominal area feels so tight. It doesn't hurt to breathe deeply, it just feels strange. I'm going to focus on breathing deeper because that may be one thing that's making me feel tired.
I realized that I'm not breathing very deeply since my abdominal area feels so tight. It doesn't hurt to breathe deeply, it just feels strange. I'm going to focus on breathing deeper because that may be one thing that's making me feel tired.
Monday, October 12, 2009
Monday, October 12, 2009 - Office Visit
Another nurse visit today. She removed the last drain today - I'm free! She also removed some stitches from my navel. Thank goodness I didn't look and couldn't feel it because it would have freaked me out. My navel is really the only area that still looks kind of red.
I'm also released to drive, stand up straight as long as it doesn't "pull" too much, and sleep without a pillow under my knees. She said to make sure I eat lots of protein which will help with the healing process.
I asked about the "mesh" that Dr. S. mentioned last week. It's an Alloderm mesh. I see Dr. S again on Monday so I'll ask more about it then.
I've been experiencing periods where my abdomen feels like it's tightening up. The nurse says it's muscle spasms and perfectly normal. It's not exactly what I would call painful - just uncomfortable.
I've slept more soundly the last few nights. It's a relief to be able to sleep on my side now. No more being awake for hours in the middle of the night. That alone does wonders for my mood!
My husband and I went into a couple of local stores after we got home. I can tell that my stamina isn't what it was before. I've been doing so much sitting the last 3 weeks. It's time to start walking again now that I can walk upright. I gently walked up and down my street about 6 times this evening. It felt good to be outside moving around.
Wednesday will be 3 weeks since my surgery. I never expected to be doing so well in such a short time. I'm very thankful!
My next doctor visit is Monday, Oct. 19.
Another nurse visit today. She removed the last drain today - I'm free! She also removed some stitches from my navel. Thank goodness I didn't look and couldn't feel it because it would have freaked me out. My navel is really the only area that still looks kind of red.
I'm also released to drive, stand up straight as long as it doesn't "pull" too much, and sleep without a pillow under my knees. She said to make sure I eat lots of protein which will help with the healing process.
I asked about the "mesh" that Dr. S. mentioned last week. It's an Alloderm mesh. I see Dr. S again on Monday so I'll ask more about it then.
I've been experiencing periods where my abdomen feels like it's tightening up. The nurse says it's muscle spasms and perfectly normal. It's not exactly what I would call painful - just uncomfortable.
I've slept more soundly the last few nights. It's a relief to be able to sleep on my side now. No more being awake for hours in the middle of the night. That alone does wonders for my mood!
My husband and I went into a couple of local stores after we got home. I can tell that my stamina isn't what it was before. I've been doing so much sitting the last 3 weeks. It's time to start walking again now that I can walk upright. I gently walked up and down my street about 6 times this evening. It felt good to be outside moving around.
Wednesday will be 3 weeks since my surgery. I never expected to be doing so well in such a short time. I'm very thankful!
My next doctor visit is Monday, Oct. 19.
Thursday, October 8, 2009
Thursday, October 8 - Office Visit
I went for another nurse visit today. I knew the purpose of the visit was to remove one or both remaining drains, but I promised myself that I wouldn't get my hopes up. I didn't want to repeat my drain meltdown from Monday. Lucky me, she did remove one of them, but Dr. S wants to wait until next Monday to remove the last one just to be on the safe side. I can handle that. When I'm down to one drain, I just stuff it into my pants pocket instead of pinning it to my clothes. For some reason, that gives me just enough of a mental boost to tolerate a few more days with that last wretched drain.
Still not sleeping that well because it's hard to get comfortable. I've learned to get up and do something until I get sleepy enough to go back to bed. I'm careful not to nap in the day so at least I have a shot at sleeping through the night. I'm not worried, though. Solid sleep will come in due time.
Still not allowed to drive or stand up fully straight because I don't want to stretch my abdominal incision. I must say, I'm so pleased at how well my abdominal scar is healing. The parts of the incision where the scabs are gone are just thin pink lines. I guess that's due to the dermabond he used. It's only at the ends of the incision that there's evidence of suturing below the skin. Dang, he's good!
More on Monday.
Still not sleeping that well because it's hard to get comfortable. I've learned to get up and do something until I get sleepy enough to go back to bed. I'm careful not to nap in the day so at least I have a shot at sleeping through the night. I'm not worried, though. Solid sleep will come in due time.
Still not allowed to drive or stand up fully straight because I don't want to stretch my abdominal incision. I must say, I'm so pleased at how well my abdominal scar is healing. The parts of the incision where the scabs are gone are just thin pink lines. I guess that's due to the dermabond he used. It's only at the ends of the incision that there's evidence of suturing below the skin. Dang, he's good!
More on Monday.
Monday, October 5, 2009
Monday, October 5, 2009 office visit
This was the first time I'd actually seen the doctor since my surgery 12 days ago, although I was in last Friday for a nurse visit. Dr. S was very pleased with how everything is healing. He was surprised that I'm managing without pain meds. I'm not trying to be a hero; I just don't need them. Tylenol and Advil do the trick.
I talked to him about my serious sleeping problems. For instance, I slept for 2 1/2 hours last night. I just can't sleep on my back anymore! He said that it's ok to start sleeping on my sides "lightly". No driving just yet. No need to wear the abdominal binder. No walking fully upright just yet although I can walk around as much as I want. No lifting anything over 10 lbs.
He broke it to me at the end of the visit that he wants to leave the 2 drains in for a few more days because it creates extra suction to hold the mesh in place. What mesh? I don't remember anything about that, although my husband said he was told about it after my surgery. I was completely thrown off guard by the drain issue, so I was doing my best to hold back tears. I'll find out more about this mesh when I go in next week.
It's funny how a week of sleep disturbance plus the news that I have to keep these drains for another week can really do a number of me. I kept from crying in the office, but cried all the way home. My poor husband. He was very sympathetic but I know he didn't really get it. He has a normal perspective on it - "just a minor setback", etc. But, to me, it was huge! I knew I was overreacting, but I just couldn't seem to get a grip. So, once I got home and had a little lunch, I decided that a side-sleeping nap was in order. I slept like a rock for 4 hours! I felt alot better once I woke up.
So, for anyone considering this surgery, please be warned that you'll probably have moments where you emotionally crater. It makes all the difference in the world if you have a reasonable and supportive husband. Thank goodness I do!
I talked to him about my serious sleeping problems. For instance, I slept for 2 1/2 hours last night. I just can't sleep on my back anymore! He said that it's ok to start sleeping on my sides "lightly". No driving just yet. No need to wear the abdominal binder. No walking fully upright just yet although I can walk around as much as I want. No lifting anything over 10 lbs.
He broke it to me at the end of the visit that he wants to leave the 2 drains in for a few more days because it creates extra suction to hold the mesh in place. What mesh? I don't remember anything about that, although my husband said he was told about it after my surgery. I was completely thrown off guard by the drain issue, so I was doing my best to hold back tears. I'll find out more about this mesh when I go in next week.
It's funny how a week of sleep disturbance plus the news that I have to keep these drains for another week can really do a number of me. I kept from crying in the office, but cried all the way home. My poor husband. He was very sympathetic but I know he didn't really get it. He has a normal perspective on it - "just a minor setback", etc. But, to me, it was huge! I knew I was overreacting, but I just couldn't seem to get a grip. So, once I got home and had a little lunch, I decided that a side-sleeping nap was in order. I slept like a rock for 4 hours! I felt alot better once I woke up.
So, for anyone considering this surgery, please be warned that you'll probably have moments where you emotionally crater. It makes all the difference in the world if you have a reasonable and supportive husband. Thank goodness I do!
Friday, October 2, 2009
Fri, Oct 2 - First Post-Surgery Office Visit
To get ready for my first post-surgery office visit today, I got in the shower last night. Showers have turned into lengthy processes these days, although I'm not complaining. I'm just thankful I can actually shower rather than taking sponge-baths. It took me at least an hour to shower last night. Another crappy night of sleep on the recliner and loveseat. Stalked Facebook and did emails and other Internet surfing until I got sleepy - ha! That was about 2-5am.
Had my first post-surgery office visit today. Dr. S's nurse removed both breast drains - hooray! I go back on Monday to remove the remaining 2 abdominal drains. What a relief. Didn't get to see the doctor, but I will on Monday. I feel like I should genuflect (no offense intended) when I see him. I think he's nothing short of a miracle worker and an artist to boot. If anyone is considering having this surgery in the Dallas area, contact me and I'll give you his name. The hospital has hotel rooms on site if you need to travel for surgery.
The nurse says I don't have to wear my abdominal binder any more - although I must admit I've never worn it except the day I was discharged from the hospital. It looks like a foot-wide ace bandage and it wouldn't stop sliding up my abdomen. So I wore it for a total of 1 hour on the drive home. I'm supposed to still avoid standing totally upright, but have not really used the walker Dr. S suggested. Too cumbersome. Guess my back muscles were stronger than I thought. I'm allowed to walk as much as I feel comfortable with, but not allowed to sleep on my side for another couple of weeks. I forgot to ask about driving. For now, my husband is taking vacation time and can drive me anywhere I need to go. I'm supposed to sleep on my back only with a pillow under my knees so my abdomen isn't too straight.
Still managing discomfort with Tylenol. Hope I finish my antibiotics soon because they're giving me heartburn. Pepcid seems to fix that.
Had a nap on my own bed plus sat in the backyard with my husband this afternoon. It's been a great day all around! More on Monday after my next office visit.
Had my first post-surgery office visit today. Dr. S's nurse removed both breast drains - hooray! I go back on Monday to remove the remaining 2 abdominal drains. What a relief. Didn't get to see the doctor, but I will on Monday. I feel like I should genuflect (no offense intended) when I see him. I think he's nothing short of a miracle worker and an artist to boot. If anyone is considering having this surgery in the Dallas area, contact me and I'll give you his name. The hospital has hotel rooms on site if you need to travel for surgery.
The nurse says I don't have to wear my abdominal binder any more - although I must admit I've never worn it except the day I was discharged from the hospital. It looks like a foot-wide ace bandage and it wouldn't stop sliding up my abdomen. So I wore it for a total of 1 hour on the drive home. I'm supposed to still avoid standing totally upright, but have not really used the walker Dr. S suggested. Too cumbersome. Guess my back muscles were stronger than I thought. I'm allowed to walk as much as I feel comfortable with, but not allowed to sleep on my side for another couple of weeks. I forgot to ask about driving. For now, my husband is taking vacation time and can drive me anywhere I need to go. I'm supposed to sleep on my back only with a pillow under my knees so my abdomen isn't too straight.
Still managing discomfort with Tylenol. Hope I finish my antibiotics soon because they're giving me heartburn. Pepcid seems to fix that.
Had a nap on my own bed plus sat in the backyard with my husband this afternoon. It's been a great day all around! More on Monday after my next office visit.
Thursday, October 1, 2009
Thursday, Oct 1 - Another fitful night of sleep. Couldn't stand the recliner anymore, so I moved to the loveseat. No good. Then to the living room couch which was much more comfortable. But when I tried to get up, I was like the proverbial turtle on it's back! I took a very mild sleeping pill before bed, so when that hadn't helped in 1 1/2 hours, I took a second one. Wow - a little too much for me, but I did at least sleep better. So looks like nights are going to be the hardest time for me for awhile until I can sleep on a more comfortable surface.
I went all day just taking Tylenol. That worked fine for pain. I did have to call the nurse because one abdominal drain kept leaking right where the tube emerges from the incision. She said that wasn't that ununual. We had already been careful to strip the tube thoroughly, but it didn't change anything. Well, for some reason, it's quite seeping as of this morning.
I have my first office visit on Friday morning. According to the nurse, if each drain produces <20cc>
Both breasts are looking less bruised. Abdomen still has some areas of dark bruising near the incisions. Swelling doesn't seem to be excessive and the whole abdomen is quite firm to the touch. I don't want to do much poking around, though.
As far as sensation goes, the skin areas that had started to regain sensation since the mastectomy (the low, center part of each breast about an inch or so in diameter) still have the same amount of sensation as before the DIEP. At least nothing was lost there. Dr. S says that it'll be 6-12 months before I start regaining much sensation, but I do feel internal sensation to some degree, if that makes sense. Not on top of the skin, but inside the breast. Certainly nothing like normal, but at least I know they're there! It's wonderful not to feel the seams of those darn expanders poking out under my skin. And wonderful not to feel my pecs right under my skin. I just couldn't get used to being able to flex my boobs! These already look more like real breasts even though they haven't softened up yet and are kind of wide and flatter than they will be when they're fully healed. It seems like they'll be a pretty good size match to the originals!
Dr. S said that he did nerve reconnections during the DIEP, so I'm looking forward to talking to him more about that tomorrow.
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