32C

Friday, D and I went to my first follow-up appointment since my implant surgery. I had been feeling pretty down all week because I was a little disappointed with the results of my surgery and felt like I was probably going to be needing a third surgery. By the time the day of the appointment came around I was starting to feel better and since seeing the doctor I feel fine now. Basically, the plastic surgeon explained that he didn't do the lift as planned because once he put the small implant in my right breast it was actually lifted up a lot, and very much in line with the left breast, and doing a lift would not have been much more of an improvement. Knowing that, he decided to not cut up and scar up my right breast anymore. He also pointed out that the two implants may settle slightly so if we do a lift at all we would probably get a better result from doing it after first waiting a bit. I'll be following up with him regularly but in about 3 months we'll see how the two breasts are sitting and will decide whether a lift will be beneficial, at that time. He also still wants me to consider getting the nipple reconstruction. He pointed out that even though it doesn't bother me to have a scar in the place of a nipple on my left breast, doing the nipple reconstruction may make the two breasts look similar enough to distract from the differences that I currently see and had been bothering me. That's fine with me. I'm willing to remain open-minded and wait the three months to see how I feel.

The same day I went to Victoria's Secret to treat myself to a fancy new bra. I have one more week before I am allowed to wear normal underwire bras again. A sales girl measured me and told me I am now a 32C. I was really surprised to hear that because I feel like I still have pretty small boobs and look just like myself, but I guess it's all about the fullness up top, which I definitely have more of now. She asked me what I was looking for and I explained that after two surgeries for breast cancer I just wanted to treat myself to something nice but no longer need all the padding most of their bras come filled with. She told me she too was a cancer survivor, a different kind, and led me to some really nice padding-free bras. I found this absolutely gorgeous,classy, lacy number and of course...they didn't have my size. Later the same day I tried the huge Victoria's Secret at 34th street but again, no luck. While I was there I told a second sales girl my story and she told me four different people in her family had had breast cancer and one wasn't doing so well. We're everywhere.

With two surgeries now behind me and D starting a new job Monday, we decided to head to the North Fork yesterday for a much deserved break. We had been there over Columbus Day weekend and had absolutely loved it. We'd been dying to go back. We spent the day tasting good wines and eating great food (and stocking up on our favorite Pinot Noir Mustard). Back at the B&B we layed in bed watching TV on the laptop. It was such a perfect relaxing day.

Tomorrow it's my mission to find that damn bra in my size! (It's on backorder online.)

Spoke too soon?

Today is Monday, three days post implant surgery. A lot of the swelling has gone down and I've removed the top part of the dressing (as instructed by my doctor). When I first came home from the surgery my new boobs looked pretty similar: high, round & similarly shaped. Today, the right one looks more like it used to: it's sitting a bit lower on my chest than the left boob and it is sort of swaying out to the right side of my chest. My doctor tried to get away without doing the lift because he knew I was really unhappy about it and about having another scar; however, if this is any indication of what the final result is going to be, this just won't do. The two boobs still look really different as of right now. The goal is to get them looking as similar as possible. I'm worried that I'm going to have to get the lift anyway and that this is going to mean a third surgery. Looking at the steri-strips currently covering my stitches I'm also beginning to realize that just because my mastectomy scar didn't bother me the first time around, doesn't mean it's still not going to bother me now. What if it just looks worse now that it's been cut open a second time? So then, if I have an ugly lift scar and an ugly mastectomy scar, do I consider the fake nipple & areola tattoo? A fake nipple & areola would cover up most of the mastectomy scar. But I'm sure they come with their own issues too. I've heard of fake nipples dropping so much that they are hardly there anymore and of areola tattoos fading. All of this is just driving home the point that there is no good way out of this and that these boobs may be a work in progress for a long time. I'm in such a bad mood right now that some Chardonnay may be in order! (Don't worry I haven't taken any pain killers today.) Tomorrow, D and I are going to go try to find me a new bra. I'm still walking around in my zip-up sports bra even though the doctor said I could wear a regular bra as long as it doesn't have underwire, so maybe that will make me feel better.

P.Y.T. (Perky Young Thing)

So, yesterday went far better than we had expected. D’s brother drove us to the hospital and we got to the registration desk at 6 o’ clock on the dot. I was sent with other patients to get changed and checked-in. My doctor came by and went over the plans with me and then marked me all up. I was so nervous that when a nurse came by to go over my medical history, I just started crying. She gave me a big hug and made me feel a lot better. Once she was done, D, his brother & my mom were all allowed back to see me. The OR nurse came by, as did the anesthesiologist, to ask more questions. Before we knew it we were walking me into surgery. I said my goodbyes and the nurse walked me the rest of the way to the OR. On the way we met up with my anesthesiologist, who was joking around with another guy who seemed to look like the friend-of-a-friend anesthesiologist who took my case last time. I couldn't tell for sure though and I didn't ask.


In the OR room I was freezing cold, which made it hard to find a vein for the IV. They used a combination of blankets, some kind of thermal plastic film and a heater blowing warm air on me, which only made me feel a little more comfortable but at least helped the doctor find my vein and get me set up with my anesthetics and anti-nausea drugs. My plastic surgeon made me feel really comfortable and safe. Before I knew what had happened I was coming to. I couldn't see anything but I could clearly hear my anesthesiologist saying "Diane, it's time to wake up for school!" (which is exactly what he warned me he would say). At this point, I think they were wheeling me to recovery. Or maybe he said that while they were taking out my ET tube and then wheeled me over. I was so foggy and just starting to wake up at that time that I really can't be sure.


As I started to regain consciousness in the recovery room, I remember feeling like I couldn't breathe all that well through my nasal tube, plus the smell of the plastic & oxygen were sickening, so I took big gulps of air through my mouth. The more oxygen I got in me the more I seemed to wake up. My vision was blurry but I made eye contact with a nurse so they could see I was already waking up. D, his brother & my mom all came by almost immediately. They were told to just say "hi" real quick because I needed my sleep, and I agreed. I felt so groggy still. They gave me some good news: my doctor didn't have to do the lift (mastopexy) on the right side (the part I was nervous about). He only put in the implant and that was enough to gain the symmetry we were looking for. Everyone went back to wait for me in the waiting room and I started getting better and better pretty quickly. Soon I was sitting up in bed, then they gave me cranberry juice and saltines, and finally I was moved over into a chair. Before I knew it I could shake my head "no" without feeling tipsy and they were bringing me my clothes and kicking me out. Around the time that they were feeding me snacks and getting me ready to move to the chair, I saw a man who I swore this time was the anesthiologist-friend from my last surgery. I confirmed his name with my nurse and she called him over. We had a nice talk and I got to thank him for taking my case last time. I told him my husband and I owed him big time. I got a wheelchair escort out to the waiting room where my mom said no one had warned them I was coming out, so she had to call the boys, who had gone for a walk, to go pick up the car from the parking lot.


After waiting awhile for the car we were finally on our way. Mom went back to work and the boys drove me home. Back at home D got us some mid-east and Egyptian food for lunch and I took my drugs. Later, in the bathroom, I took off my surgical bra (a weird white velcro-closure sports bra that they send you home in) for my first look at the results. The first thing I was happy to see was that I was not going to have an ugly scar on my right breast too. Since he only did the implant, and no lift, my doctor made a small cut along the lower curve of my areola, so the scar will blend right into that area. I now have two round perky boobs. The right one is huge compared to the left but I think it's due to swelling. As my doctor had warned us, the left breast has already been traumatized so I wasn't going to feel any pain there. For the right boob, however, this is all new stuff, so it's all painful and tender and swollen. Hopefully once the swelling goes down they'll look pretty much the same size. While perky and round, the boobs seem to be pretty close to my old size. They kind of look like how my old boobs used to look like in a push-up bra, the only difference is now they are permanently pushed up...and who can really complain about that? Last night I was able to sleep comfortably on my left side for the first time in a long time (Of course, now it hurts to lay on the right side. Beggars can't be choosy, I guess.).


Today, D went to our regular yoga class (I can't workout for a month) while I slept in a little bit before cleaning up the apartment and having a small snack so I could take my drugs (antibiotics and percocet). D came back and made us breakfast. Since the doctor told D yesterday that there was no reason for me to spend the whole two weeks on the couch, we decided to go out. We picked up our dry cleaning and headed to Barnes & Noble to research travel destinations for our next big trip. We had a sushi lunch at our favorite spot and now we're back home just relaxing, especially since I took my drugs at the start of lunch and by the end of lunch they had me feeling all tired and woozy. Tomorrow I get to shower and Monday I get to pull off the top layer of my dressing. I'll keep you all posted. Thanks for all the well wishes and for checking in on me!

A Farewell to Boobs (as I know them anyway)

Tomorrow is my reconstruction surgery. As I write this I'm sitting in a cafe awaiting a plate of brioche french toast & strawberries. (It's about 130PM - - I specifically searched in advance for a place, close to my hair salon, that sells french toast all day.) I'm trying to fill myself up because last time I did a poor job of eating enough before the midnight deadline. I feel like a Gremlin with this "nothing after midnight" rule. Not being able to eat the morning of my mastectomy made me super cranky. And then I didn't eat for nearly 36 hours because I was "NPO" (non per os aka nothing by mouth) until the morning AFTER my surgery! Even then it was just a collection of disgusting orange flavored "clears" like jello and italian ice. My surgery is at 730AM and I have to be there at 6AM, which means we have to leave by 5AM and up even earlier. Yeesh! Yesterday I decided that if I needed to be ready for surgery and in bed so early in the evening then I wanted the whole day off from work today. I scrambled to get all my work done for the week. This morning I slept late before coming into the city for my hair blow-out (so I don't have to worry about lifting my arms to style my hair while I'm recovering). I visited D at his job before running an errand for him and now I'm sitting here just trying to relax and get into some sort of calm, positive mindset before heading into surgery.

Meanwhile, since my last post I have had my IUD (intrauterine device) implanted. Yowza! I was expecting a pinch during the procedure and maybe some cramping for a few hours after. My doctor told us it would be a "walk in the park" compared to what I've been through recently. I have no idea what she was talking about. It was BAD. As the doctor warned that "now you'll feel some pressure and like a bad cramp," an intense pain spread through my abdomen and before I knew it I was climbing up the wall. I think I squeezed all the blood right out of D's hand. The doctor asked me if I could please try to relax my butt cheeks. Fortunately, the whole procedure lasted just a couple minutes. Unfortunately, the rest of the night was even worse than the procedure itself. In the doc's office they gave me four Advil and I took them all. Almost immediately, severe cramping set in. The train ride home was excrutiating. Thank goodness D was with me. At home I was uncomfortable all night. I could hardly enjoy my dinner. By bedtime the pain was so bad I couldn't get comfortable at all and was really anxious. I had to be up early the next morning for some pre-surgical testing and a final appointment with the plastic surgeon. I couldn't get to sleep. As much as I hate the drug, I ended up taking a Valium in order to get to sleep. Somehow, the Valium neither knocked me out nor made the pain go away but it did make this feeling of calm come over me that allowed me to get to sleep. It was like the first drug the anesthesiologist gave me before my mastectomy. His words were "first I'm going to give you something that's going to make life a little easier," and boy did it! The Valium did the same thing the night of the terrible IUD cramps. Today is two weeks since getting the IUD implanted and believe it or not the bad cramps only started to subside in the past 24-36 hours. They didn't stick around all day every day. They would come and go and get worse at night. But they were definitely there. I called the doctor Monday and she said it is actually normal and my body is getting used to having some foreign object lodged in my uterus. I guess that makes sense.

The next day at our appointment with the plastic surgeon I asked so many questions that I think I drove the doctor crazy. I also think I insulted him on some personal level when I said I wasn't interested in getting a fake nipple, which he highly recommends. In order to end the conversation I told him I was willing to be open-minded and allow myself to change my mind later if my feelings changed. (I don't see myself changing my mind later.) Regardless, in the end I felt I aired out all my concerns and now I feel like I can go into surgery completely confident that he will do what he deems best but also keep my concerns in mind at the same time. Wish me luck!

Loose ends

I just got a very nice reminder that people are actually still checking in on this every now and then. It prompted me to go back and look at what I've posted so far and I realize I left a few loose ends on my last few posts so I'd like to tie those up now.

D and I ended up sticking with the original medical oncologist. We never even saw the second opinion oncologist. We decided within a couple days of seeing the original oncologist that we would just stick with her. I didn't have my Tamoxifen in hand right away because I was ordering it through Medco by Mail, for a discount. I started taking the Tamoxifen the Sunday before last, so about a week and a half ago. I had been feeling really apprehensive about it and thought maybe we should have a ceremonial "first Tamoxifen" moment. The night I took it for the first time I realized I just wanted to get it over with and if I waited for the new week to start I would certainly postpone it until the following weekend. I called D over and decided to just do it. I kind of sat there holding the tiny white pill and just staring at it for awhile. I couldn't bring myself to swallow it. It reminded me of how my brother & I both had issues swallowing pills as children (one of us still does...I won't name names but let's just say I routinely pop Singulairs, Advils & birth control pills with no problem!). I maybe got a little emotional, maybe. But then I tossed the pill into my mouth and it was done: I had officially started my 5 years on Tamoxifen.

More importantly, by episode 7 of season 1 I was sooo over Thirtysomething. What is wrong with those people? Why are they always whining and complaining?! And maybe the topics they discuss were relevant in the 90s but they definitely feel dated in 2011.

Anyway, after my surgery I had stopped reading cancer books (and switched to killing my brain cells with endless Netflix), but this past week I felt a need to return to them. Why I Wore Lipstick to My Mastectomy by Geralyn Lucas is a really great read (even if you are not dealing with your own or someone else's cancer) and really helped me prepare for my first surgery. Now that I have my second surgery coming up (Friday, February 18), I have all new concerns and thought I'd re-read the book from a new perspective. It was just as enjoyable and as helpful as the first time. I also looked up Geralyn on YouTube and she is so freaking adorable. Now I've moved on to Cancer: 50 Essential Things To Do by Greg Anderson. It's a guide for getting from diagnosis, through treatment, through recovery and through life, in a very holistic, body-mind-spirit sort of way. This one has been a little less helpful but really only because I already did or am doing most of what is advised, mostly as a result of trying to live my life this way even before my diagnosis. Even so, I have written down two things I will start to incorporate.

On a related note, I've been working on balancing showing honor & respect for what I've just gone through and what I need (some time off from school, extra rest) with really viewing everything that has happened as mostly a positive experience, and myself as really lucky. Knowing how good I have been feeling through most of this, and how lucky I was to have stopped this thing in its tracks at stage "0," I started the year sort of too gung-ho and feeling like I needed to just jump right back into everything. Work, school, catching up with friends, etc. I am realizing that sometimes I need to take a step back and give myself a break (like I did by taking the leave of absence from school or by cancelling a night out with a friend because I was just too tired and cranky).

Tomorrow after work, D & I are seeing my GYN to get my IUD implanted. I'm kind of nervous about it because I've always heard that it pinches a bit when they implant it and you could possibly be in some discomfort the rest of the night. Also, I've always had crazy reactions to different contraceptives, with only the pill that I've taken for years causing no problems, so I'm nervous that I'll end up with negative side effects from this thing. I guess time will tell.

Friday I have my pre-op testing followed by what I expect to be my last follow-up with my plastic surgeon before the implant surgery. I've got a lot of questions for the doctor. I need to be 100% confident about the next surgery before I leave his office Friday. Right now I still have some issues with the lift and areola reduction on the right breast. So, even though I know it is probably the best thing to do and that I probably will stick with it, I won't be putting my final stamp of approval on it until I've tackled every one of my concerns with him.

So, the other day I ran into a friend at work who is a lady I used to talk to quite often and who always asks when my husband and I will be having kids. She asked me this question again, of course, and I ended up telling her about the mastectomy and the Tamoxifen and the not being able to have kids for awhile. Turns out she had a lumpectomy and radiation and Tamoxifen 9 years ago. She's been fine ever since. Never had side effects from the Tamoxifen. Even the radiation wasn't that bad except that it sometimes made her feel really hot and one time she felt so hot, walking back to work after an appointment, that she thought she might faint. I never knew all this and was so glad she shared. She said the same about me. So who doesn't have a breast cancer story? Every time I talk to someone I find out either they had some kind of cancer, if not breast, or a family member of theirs did. I remember sitting in my first nutrition class ever, back in undergrad, and the teacher saying that something like 1 in 4 people will get cancer in their lifetime (this was...1999/2000-ish) and that if we each considered ourself and 3 friends of ours, at least one of us in each of those groups of four friends, would end up with cancer one day.

Hmm, probably shouldn't leave you on such a grim note. I do want to mention, actually, that I will probably try to start working on turning some things that I wrote during diagnosis, doctor appointments, surgery & recovery, into new posts to share. I realize that there are certain things people always want to know that I really haven't talked about here. What did I do when my GYN told me over the phone that it was cancer (but hadn't yet told me how positive the situation was)? Did I stay at work? Did I run home? Did I cry? What was the hospital like? What was recovery like? I touched on some of this stuff in my "Notes to My Family" emails/posts, but I think there is more I can share. Before that, however, you can probably expect an update from me on how the IUD and the pre-op and the follow-up went.

Wish me luck!