Category Archives: Virginia Hospital Center

Lesson learned.

stupidAfter completing all my treatment and the pathology from my surgery came back “all clear,” a friend told me that I should ask about seeing Maureen, a nurse in our practice, for my survivorship appointment. My friend loved the binder she gave her with all her cancer details.  Diagnostic reports, treatment drugs and dosages, pathology reports, all in one neat, tidy place.  I feel like this is such a valuable resource as so many women are living so much longer after their breast cancer diagnosis.  At some point, I’m sure I’ll stop calling the oncologist for every little thing, afraid that it has to do with the cancer (not that I’ve made any of these calls, but most of my friends have at least once).  And at that point, I’ll need that binder o’ details for my primary doc.  Anyway, everything wrapped up for me in mid March.  I asked my doctor about the survivorship appointment, and after a couple of weeks, she apologized for making me wait, that there was some transition in the survivorship program or something like that.  She put me in touch with the scheduling office and we got something scheduled before school let out.  To make a long story short, the appointment has been cancelled and rescheduled several times since then, and I finally had it set up for this week. (And I should also say that this is the only time I’ve had anything not-glowing to say about my oncology practice.  They’re great.)

Last week, I got a call from the scheduling office, and knew what she was going to say.  They needed to reschedule my survivorship appointment.

Me (in a sincerely nice tone):  Hi, Brittany. (yes, she is a grown up named Brittany) I’m really trying to be kind. But I’ve been trying to schedule this appointment since April. And it keeps getting rescheduled.  And it’s usually about four or five business days before the appointment.  I understand that I’m not sick, and I don’t want to take away Maureen’s time from someone who is sick and needs to be seen.  But it really seems like maybe her schedule isn’t full and so it’s just cleared and she doesn’t come in. And every time I have to reschedule, it’s usually another six weeks before she has another opening. Can you help me understand what’s going on here?  My friend said this is a great appointment, and I’d really just like to get it taken care of. Can you help me with this, Brittany?

Brittany: Maureen is actually out of the country. We expected her back but she’s adopting two children and there are problems with the paperwork so she can’t get back into the country right now.

Me: ummm….

My appointment is now scheduled for October.  I’m going to go back to eating my humble pie, thank you very much.

 

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That First Shower

Not my shower.  A girl an dream, though... (source)

Not my shower. A girl can dream, though… (source)

After I’ve been sick, I always know I’m better when I feel like taking a shower.  And while I’m feeling marginally better when I hop into the shower, I always feel much better when I get out.  There is something so wonderful about that first shower.

After surgery, it’s much the same. I’m not saying I’ve never skipped a day (or two, even!), but few things make me want a shower so desperately as someone telling me I can’t have one. Needless to say, last Sunday, I was counting down the minutes until I got to the 48 hours post-surgery mark so that I could get into the shower.  But the first shower after surgery isn’t quite as wonderful as the one after a sinus infection.

First of all, with my crazy independent streak, even after my mastectomy, I did the whole shower by myself, drains and all.  But I had to have Clay on call, standing by should I need help or have any problems.  It was slow going, but I managed.  The really tough part of the first shower is that it’s also the first look.  It’s the first time that you get to see the scars, the bruises…  After my mastectomy, all that was kind of tough.  I didn’t really know what to expect, but I have to say that I found the drains more upsetting that the scars that time around.  This time, he used the same incision site, so no new scars, but where I had no bruising at all the last time, this time I looked pretty beat up.  We’re talking yellow, green, purple.  Clay said he could even see finger prints.  Thankfully, that’s all fading pretty nicely in just a week, and my plastic surgeon suggested that I take Arnica (a natural product with virtually no side effects) to help the bruising heal even more quickly.  I expected to see some pretty significant bruising on my thighs from the liposuction there, but there are only two teeny little spots of bruising there to go along with all the marker circles he drew.  The marker that he uses pre-surgery is pretty tough stuff and he didn’t scrub it off my legs, so I’m still waiting for that to fade (even alcohol won’t scrub it off).

This go-round, I was a lot better in the shower. I was still a little taken aback, though.  I struggled with how to explain this surgery to the kids– they knew that the first surgery took out all of the cancer.  I just explained that it was the last step to make sure I was all “back to normal.” Whatever that is.  Finishing up after that first shower, getting assistance back into my compression garb (my pecs were still too sore to pull the hooks closed), I struggled with whether I looked normal. I’d kind of forgotten what normal looked like.  And of course, I couldn’t expect to look completely normal– crazy bruising and swelling aren’t normal. This was the last step in the process, though, and if I wasn’t happy, I’d have a long time to be not happy about it.  I worried if I’d made the right decision.  And of course, I had.  I just needed a little time to work it out.  Somehow I just wasn’t expecting it when I got ready to head into that first shower.

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I’m with stupid.

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I feel like this is the shirt I need lately. (Note to creative-type readers, this is not the tee that I want, I don’t really see myself wearing it, so no need to get all crafty and gift me one!)

When I got my port put in, they put it high on my chest just under my clavicle on my right side. For the first week, it was very painful. The constant pain eventually subsided, but it was always a bit of a sensitive area. I was relieved that the port would come out during my mastectomy, but then I went home with the tissue expanders. I had them just shy of six months, and for the entire time, my right side bothered me. It wasn’t unbearable, but the constant tightness was always tighter on the right, and the spasms that started to really drive me crazy at the end were always on the right side. After last week’s surgery, despite the fact that I was far more bruised on the left, there’s almost no pain or discomfort there. Any residual muscle and back pains (very minor) and most of the weird, tingly irritation is still on the right side! As I was telling Sally this, I mentioned the irony: the cancer was on the left. That explained it, she told me. I chopped off a perfectly healthy breast and now it’s getting even.

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Brighter Days

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(source)

After a long surgery Friday and a rough, sore Saturday, Sunday was the start of better days. By yesterday, I really felt almost normal lots of the time. I’m still tender in some spots, but the freedom of being without those awful tissue expanders is amazing. All of the muscle tightness and spasms are gone, and that’s a huge thing! I could tell the difference instantly after surgery and I continue to be amazed (and relieved) at how much different I feel.

I think I’m going to have to work pretty hard to follow all the rules– restrictions on lifting and activity– because it really doesn’t hurt when I get close to the limits. But if that’s the most I have to worry about, I count myself very lucky.

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Recovery, Take Two

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Surgery went fine in Friday. I ended up being in surgery for almost five hours, but I like to think that’s because my surgeon is very thorough and wants to be sure he does the best job possible. I didn’t realize it right away, but that’s actually about as long as the original mastectomy. I didn’t need to stay in the hospital because the pain level was much lower, but it did take a while for me to shake the anesthesia. Having not eaten at all on Friday, I was shocked not to have an appetite until around Saturday afternoon. Even Sunday, meal time sort of felt more like I was going through the motions. For me, Pringles are the perfect post surgery food, light and salty, and they’ve been my go-to these past couple of days.

Speaking of pain, I really wasn’t expecting too much. It certainly wasn’t as intense as last time when I required a morphine pain pump to get through that first night. But the Percocet I took didn’t quite do it Friday night and I didn’t sleep well. Saturday was rough (though not at all unbearable), but thankfully that night the pain dropped off enough to let me sleep and Sunday was a much better day. I’m not supposed to lift anything over five pounds for a couple of weeks and reaching too high is tough at the moment, but I really do feel like I’ll be pretty much back into the swing of things pretty quickly. Back in the swing of things, that’s right where I want to be.

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Surgery: Check.

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Maxi skirt: check. Reading material: check. And that’s about all I’m going to need for the next few hours. I’m checked in and waiting for my 9am surgery time, eager to get this last surgery checked off my list. And since I haven’t been sleeping great, I’m looking forward to some peaceful, drug induced sleep. But first: fall fashion mags. Which I get to read in peace. Not so bad, really.

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Post Surgery Wardrobe

skirts

(This is one of the more pay it forward kind of posts– far more interesting to someone approaching this surgery themselves than to most. Feel free to skim if you’d rather not hear all about compression bras!)

The kids were back at school today, so I set off to get myself ready for this week’s surgery. Step one: coffee with a friend who’s been there. She brought along some encouragement, friendly advice, and these maxi skirts. For the record, I think some people look adorable in a maxi skirt, but I’ve never liked one on myself. I was thrilled that she would loan these to me since I didn’t see myself wearing them past the four week mark when I get to lose the almost to the knees bike-short style compression gear. When I got home, I set out to trying them, seeing which tops might go with them and cover the compression bras that I already have (though I’ll come home from the hospital with more)– the “nice” one I got at Nordstrom but couldn’t really wear after the first surgery, and the awful one from the hospital. The one from Nordstrom is a bit more streamlined, but it’s cut a lot higher and didn’t have quite enough compression the last time around. The icky hospital one is lower cut but has a lot of velcro that bunches and flips up in really awkward ways. To deal with that the last time around, I took to wearing a sports bra over it– just to keep all the flaps down. My secret weapon? An XL undershirt from the little girls’ section. Tank tops from the women’s section are too low cut and show the bra, but these from the little girls section are great for layering to cover the top of the bra. The last step will have to be all those scarves I wore to cover my bald head last fall, wrapping those around my neck will help hide some of the bulkiness of the bra. I was lucky to be able to wear bulky sweaters after my last surgery, but I’m not willing to wait for colder weather for this surgery, so when it comes to my wardrobe, I think it will just be a make it work moment.

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Countdown

countdown blood tests

I’ve never been the cross the days off the calendar type of gal, but I’m getting dangerously close to that point right now.  Two official countdowns going on in my mind– six days until school starts and ten days until my surgery.  This last week before school starts is usually long and short at the same time– long because it is the last week and we’re all ready for them to get back to school, yet short as we try to squeeze in every last bit of fun. One afternoon already this week, I spent some time at the hospital, getting ready for that second countdown. Once again, I answered a battery of questions (Do I have heart problems? Do I have kidney problems? Has anyone ever noticed that I stop breathing when I sleep?) all with a “no,” and was thrilled to be able to say that I am taking no medication at all.  The nurse remarked that I was easy, so healthy. Well, healthy except for that pesky cancer.  Anyway, after a quick blood draw, I was on my way home, ready for next week’s surgery.  I go back and forth, questioning the wisdom of scheduling surgery for the first week of school, but really, I am so eager to have this finished that it would have been a struggle to wait any longer.

This procedure will be outpatient, and since I’m the first procedure of the morning, I should be able to beat the kids home and maybe even get a nap, too.  The recovery isn’t supposed to be too bad, all of the muscle cutting/rearranging/stretching has already happened, and that’s the painful part.  This is just a swap out– trading the tissue expanders (which have done their job but I hate) out for my “real fake boobs,” the implants that are my final step in the road to normalcy. I’m also having a little bit of liposuction, oh yes, ladies, you can be jealous, for fat grafting– he’ll use that extra fat to strengthen weak skin and give me a more natural appearance overall. I’m sure I’ll have some lifting and exercise restrictions (and I’ll be in all that lovely compression gear) for at least a month or so, but my doctor said I can expect to be pretty much recovered in a week.  Which is good, because as soon as school’s in session, my calendar really starts to fill up, and I’m looking forward to a fun, and healthy, school year!

 

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On Being Flexible | Part One

I'm not that flexible

I’m not *that* flexible

Having just been to the doctor’s office this week, surgery’s back on my mind.  Immediately after the mastectomy, of course some pain and weakness are totally expected. Since I’d spent time with the physical therapist before the surgery, I knew that my range of motion would be limited at first.  I could raise my arms to shoulder level as soon as possible, and by the end of six weeks I should be able to raise my arms straight up over my head.  She cautioned me that I should take things slowly, but that I needed to work to get back a full range of motion.  Being overprotective would actually work against me, she said she’d worked with women who couldn’t raise their arms higher than their shoulders years after their mastectomy.  Determined not to have that problem, I worked on her exercises to have a full range of motion as soon as it was allowed.  At this point, I think my shoulders are as flexible as they ever were.  The pectoral muscles are still an issue.  They’re always a little tight, when the physician’s assistant described it as my body’s “white noise,” I think she got it just right.  There’s always a tightness, but I don’t always notice it.  Then there are times when those muscles are definitely spasm-ing (is that a word?) and while it’s not painful, it’s really uncomfortable.  Those muscle issues should lessen after my final surgery, though they could continue long after I’m “back to normal.”  In chatting with my doctor, I asked if exercise would lessen or exacerbate the muscle tightness.  He assured me that stretching is good, but strength building of those muscles might cause more harm than good.  So no push ups for me!  Can’t say I’m too sad about that!  (Though I do miss the plank and push up heavy neighborhood boot camp…)  Still, I can work on my arm muscles, and he encouraged me to strengthen my back.  Apparently, the way the muscles are pulled causes the shoulders to want to slump forward, so strengthening my back will help naturally pull my shoulders back into place.  Right now, I think I’m focusing on getting my groove back on the trails, but after I get the post-surgery green light, I’ll be adding some weights into my running routine to keep my arms and back strong.

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Re-Pre-Op

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Hopefully just one last IV for me for a very long time

I was back at the plastic surgeon’s office today, for my second pre-op appointment.  My surgery isn’t scheduled until after school starts, but he likes to do the pre-op appointments early to be sure I’ve had time to ask any questions and get everything I need.  I came away with two more scripts– heavy duty antibiotics to prevent infection after the surgery and more lovely percocet (which I probably won’t need).  He explained to me that this surgery is much less invasive and all the trauma has already been done, so it should be a pretty easy recovery.  The mastectomy involved cutting, moving, and stretching of muscle, and that hurts.  But this surgery will literally be a swap out, so no new cutting or stretching.  I also got a pamphlet for medical grade compression gear, we’re talking gear so tight it requires multiple sets of hooks and eyes just so you can zip it up.  So if your spanx just aren’t cutting it and you want something even stronger, I can totally hook you up.

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