Sunday, June 24, 2012

The difference 3 months can make...

I wanted to create a post to show specifically how much permanent breast implants "settle" after the exchange from temporary expanders. The following pictures are my results.



10 days post exchange
3 months post exchange
Not too much difference there. You can tell that the implants are sitting a little bit lower than they did immediately after surgery. See? Gravity hits implants, too. LOL!




10 days post exchange, left side
3 months post exchange, left side
You can see the difference in "settling" a little better. The dreaded armpit caves are still there, however, they don't seem to be as pronounced as they were immediately following surgery. I will have an additional surgery on June 25, 2012 to correct these caves & extra skin, as well as nipple reconstruction.




10 days post exchange, right side
3 months post exchange, right side
Again, you can tell the slope of the breasts has changed. Since all the breast tissue is gone, 3 months after the exchange, I can tell the difference in where the implant begins. I can choose to have fat grafting (a procedure where fat is taken from another part of the body & transpanted to another part) should I decide that my breast slope doesn't look as natural as I would like.




10 days post exchange
3 months post exchange
I was standing in a different postition, but you can see how much fuller the implants are. They really did "fluff" out, just like I was told! On the left side, I am beginning to see (and feel) a breast crease again! Immediately after surgery, the implants were stiff. I was instructed by my surgeon to massage them, to help soften them. Now, they feel like breasts. I can't wait to have my nipples reconstructed tomorrow!!



The next set of pictures impressed me when I saw them.....


10 days post exchange
3 months post exchange
 CLEAVAGE!! VAVOOM! :)
Right after surgery, I really had to press to get that cleavage picture. Tonight, 3 months later, it's easy for me to squeeze them together and I love the cleavage I have!


The next set of pictures, well, all I can say is that I haven't been able to do this since November 1, 2011....the date of my double mastectomy. WEAR A BRA!!!


I can wear and fill out a 36C! I don't have to wear one since they are forever perky now, but I like the shape that a good bra gives. Once my sides are corrected, it will be more comfortable to wear one. Watch out Victoria's Secret, I'll be ready!




Tuesday, June 19, 2012

An anniversary and another surgery

June 13th was my one-year anniversary from my diagnosis. I can’t say I really celebrated. It was a very reflective day for me; remembering what was and what my journey has entailed. A year ago, I had NO clue what was getting ready to happen, but I guess that’s how life is.

I want to think that I handled my mastectomy rather well. I’ve been told that I did. It’s strange, hearing people in your life, even complete strangers, congratulate you and tell you how strong & brave you are. I’m sure other breast cancer sisters can relate when I say this, or maybe it’s just my opinion, but I certainly didn’t feel brave or strong this past year. I remember fear. Fear of the unknown…..of anesthesia, pain, recovery, JP drains, stitches, filling the expanders, IV’s, PICC lines, my body image, how I would manage my household, how I could possibly hug my children & my husband, the effects this fight would have on my children & husband, complications, what people would think, what I would think, what my children would think, what my husband would think, pathology reports, radiation, medications, money (or lack of), mounting medical bills, chemotherapy, death, CANCER. I’m sure there’s hundreds more that I don’t have time to list, but that’s a good start.

I tried to put a good game face on during all this, and on most days, I did. But I certainly did NOT feel brave or strong. I simply put one foot in front of the other and got through each day. What other choice did I have? Cancer patients rarely have many options other than refuse treatment and let life take its course. I prayed to God to give me strength for whatever was to come and He did. Some days, I sat on the floor and just cried for hours. Other days, I could forget about all I have lost to cancer and enjoy the day. Those are the good days and I hope many more are in store for me. Today, my eldest daughter had her senior pictures taken. She was beautiful and I am SO thankful that I am alive and able-bodied to be with her today.

I can tell that I have changed a lot over the course of the past year, not only physically, but spiritually & emotionally too. Although I am still trying to find my way out of this maze of self-acceptance, I truly believe I am and will be a better woman because of all this. I want to DO something more with my life. I want to help others; I want to make a difference. I want to be a better mom and a better wife. I want to find myself again; that “new” me I keep hearing so much about. I know I will and I also know that I am on my way to finding her.

Next Monday, surgery #4 is scheduled to take place. Yep, you read that correctly- 4 surgeries in 6 months. This is the last surgery to complete my breast reconstruction. I may have to have additional surgeries on down the road to revise my breasts or replace the implants, but THIS is it. I will be going through areola and nipple reconstruction and my surgeon will also be revising the divots under each armpit. I’m not sure why, but I am really nervous about this surgery.

The areolas will be reconstructed from skin grafts taken from my hip/thigh area. My new nipples will be reconstructed using an origami-type folding technique on my existing scars. It’s really cool how the surgeons are able to do this! The completed, reconstructed nipples look like they are real. After all the scars have had time to heal, it’s hard to tell you’ve had reconstruction. I may have to have tattooing to get the color of the new nipples and areola’s consistently pink, but this final touch will bring this long road to an end.

I am hoping that this final surgery makes me feel more complete. Maybe that’s why I’m so nervous- because this is it, the last one. Although I am trying not to have any expectations, I am hoping that when I catch a glimpse of my bare chest in the mirror, I won’t turn away. I am hoping that I will see the reflection of a beautiful, strong, woman who is finally complete and whole again. Maybe I won’t see the huge, angry red scars that scream across my chest. I won’t see blank mounds anymore. I will need to wear a bra and on days that I don’t, I will have headlights! And YES, I am really looking forward to that.

Thursday, June 7, 2012

Chicken

I’m too scared to blog. There, I said it.

My goal when I first started my blog was to give an accurate depiction of my struggles through mastectomy and breast reconstruction. As more people began reading, most of them personal friends & family, I felt like I needed to “show” them that I was as brave and courageous as they all said I was. I’ve given glimpses to a few of my personal struggles, such as my acceptance of my new body, but I haven’t been as honest as I originally intended. I’m terrified to really admit my true feelings but I know that if I continue to keep these thoughts locked away, I’ll never progress. It seems I’ve been stalled for a couple months now.

Next week, on June 13, it will be exactly one year from the day I received the call that no woman ever wants to get. My life has changed drastically in the last year, but I survived. I should be grateful to be alive, and I am. I should be celebrating a new chance at life! After all, I won! Right? You see it all around at the events for cancer & breast cancer awareness- the “rah-rah”cheers of successfully fighting like a girl and kicking cancer’s ass. The celebration I should be having is on hold right now and I’m not sure how long it will be on hiatus. I don’t feel like celebrating. I guess you can say that I am a mess; physically, mentally, and spiritually. Yes, I’ve survived cancer, but at what cost? I’ve come home to a train wreck and I don’t know what to do.

You want the real deal? The raw emotions that I feel, and have felt, are constricting. I’m embarrassed to bare my soul, maybe partially because I feel I have failed the “sisterhood” of which I now belong, but here goes.

Breast cancer has utterly shattered every aspect of my life. I’ve watched the pieces fall around me; the sound is deafening at times. My marriage is suffering tremendously. There’s a new, unknown distance between me and my husband. There’s distance between me and my children. My career, once thriving and exciting, is now almost unbearable. Finances, I’m sure you can guess, are stretched tighter than I could ever describe. My self-esteem, self-worth, self-love- which used to come so easily- now eludes me.

I can’t figure out if I’m in mourning, if I’m angry, if I’m in the midst of a pity party, or if I’m shell-shocked. I know without a doubt that I’m depressed and have been for months. I am grateful for the clarity to recognize that fact. I’ve sought counseling and the help of a psychiatrist. I’ve began taking anti-depressants a few weeks ago, and although all this is helping, it hasn’t been enough to pull me out of this hole. The confidence I once had is lost and unfortunately, it’s impacting everything.

I have big issues with this “new” body of mine. I have gained about 30 pounds since my mastectomy last November. (I guess I have to admit that I eat when I’m depressed.) I have lost my breasts. Although my plastic surgeon has done a wonderful job, the new boobs don’t look like my old ones. They are merely numb mounds which sit upon my chest. I have no feeling in my chest, my sides, or my left armpit. Soon, I’ll have numb nipples to go with them. I am hoping that this addition will help me feel more complete, but I am concerned that it won’t.

Intimacy has become a huge obstacle now with my wonderful husband.  I do NOT feel sexy. It’s like that word doesn’t even exist in my vocabulary anymore. Bless his heart, he is trying to give me space, time to adjust, and still be affectionate. But I think I’m confusing him more than anything….he doesn’t know what to do. Sex is almost non-existent. We used to enjoy close intimacy and we both enjoyed my breasts. I probably enjoyed them more than he did. They were very sensitive and erotic. That part is now gone. Although I desperately want him to show me that my chest is still womanly and attractive, I don’t want him to touch- it still feels painfully sensitive in some areas and I’m embarrassed that I can’t feel light touches nor can I stand the way I look. Talk about mixed signals. We’ve been given advice to concentrate on other areas. Sounds like a great idea, but gaining 30 pounds has made me extremely self-conscious and embarrassed. I don’t even want this man that I love to touch my hips, or anything below my waist for that matter, because of how much bigger everything is.

And of course, it doesn’t’ help any that its summer time. This is the time of year where shorts, tank tops, and sundresses are everywhere. I’m too embarrassed to wear shorts. Hell, I don’t even own a pair. I’m too embarrassed to wear tank tops or sundresses because of the swelling in my arms, the scarring from surgeries, the caves at my armpits, and the bulging that’s on both of my sides. (Surgery on June 25th should help some of these problems) So it looks like I’ll be sporting the jeans that are getting too tight and one of the many baggy T-shirts that are slowly filling my closet. We won’t even entertain the thoughts of discussing a bathing suit. A counselor suggested that I need to use positive affirmation- telling myself that I am still beautiful. I’m supposed to tell myself that crap while all these women are rocking their barely-there summertime outfits. Yeah right. How can I possibly believe that my husband could find ME attractive? Gals, you know what a confidence booster it is to receive a compliment from a man, even strangers. Or one of “those” looks.  I don’t even get a glance over anymore.

My kids are suffering because I have become so withdrawn. They know something is off- I’ve been offered backrubs, chores….all kinds of affectionate tokens of their love- to help bring their mom back. I wonder what kind of example I am setting for my children by not being able to bounce back from all this as easily as I had hoped. How can I teach my precious daughters to love themselves and accept their own changing bodies when I want nothing more than to ignore my own body because I hate it so much?  I try to reconnect with them every night over dinner, to show them that I am still here. I’m just a little lost.

My career that used to be so awesome, you ask?  I’m not feeling too confidant there, either. Things that I used to be able to tolerate now grate on my last nerve. I’m not excited to be there anymore. Yes, I’m grateful to have a job, one that pays well; I just miss that spark that I used to have. I go in everyday and try to do my job to the best of my ability but I feel so isolated there. I work mostly with men, but even the women there are only cordial to me. I think that my coworkers aren’t sure how to talk to me anymore either. It’s almost like I’ve forgotten how to connect with people. I was told by my HR department that I have no more protection under FMLA since all my leave has been used and that my position isn’t guaranteed even though I’m facing another surgery in less than 3 weeks. My immediate supervisor has been very cool about all my time off, but it still makes me nervous. Sometimes I wonder if I have job security or if I need to be ready for the unemployment line.

Our finances have pretty much sucked since the end of November. I was out of work longer than we had planned for and I’ve had my share of medical complications from all this. Our household bills don’t allow for only one income. Although we have had to borrow money from family, we haven’t had anything disconnected or repossessed, so we’re succeeding at barely scraping by. It will probably take us the remainder of the year to get ahead.

So with all of this going on, I’m finding that I have and am still becoming more withdrawn, more isolated, more depressed, and more insecure. Don’t get me wrong, I have identified lots of issues and have taken some action. Being on anti-depressants and seeing a counselor are pretty big steps. You’d think that I would get tired of feeling this way and make changes to help improve my appearance if it really bothers me as much as I say it does. Well, it bothers me more than I can describe but yet I’m not motivated enough to change it. I’ve started making changes to my eating habits- I am painfully aware of the consequences of my food choices over the last four months. I haven’t started exercising for a number of reasons, being newly diagnosed with lymphedema in my left arm & another surgery coming up being a couple of them. I’m still on physical restrictions, strapped for money, and have no energy.

I say the Serenity Prayer often.
                “God- grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference.”

I guess you can say I’m still working on the acceptance thing.

So now that I have bared my soul, I hope that some of these feelings will be removed. I will update everyone on the medical progress that’s been made over the last couple months soon. Maybe I’ll have the courage to blog again in the coming days.

Wednesday, March 28, 2012

SQUISHY!

SQUISHY BOOBS! Hallelujah!

I made it through my expander swap surgery just fine. Surgery was Monday, March 19, now 10 days later, all the dressings have been removed. I'll talk more about this in a minute.

Surgery was pretty uneventful. After we checked in, changed, and I got that dreaded IV, Ward & I waited for Dr. Appel to come. When he did, we went over what was to happen, like we didn't know-HA! He grabbed his black sharpie marker and drew ALL over my chest. We waited a bit longer and it was time to go. Ward said surgery was less than 2 hours long, which was less than expected. Recovering from the anesthesia was the worst of it and I didn't feel a lot of pain. I felt sore on my sides, but overall, I felt good. It was NOTHING like my mastectomy surgery.

A lot of women who have had expanders to implants have said that the difference was immediately noticeable and the relief from the expanders was heaven. I was skeptical about this, I think that's my nature, but it's turned out to be true for me also. The relief was immediate and wonderful. The heaviness, tightness, and general yuckiness was gone.

The first 3 days, I was wrapped in a surgical compression bra. I couldn't see anything and had no clue what the new girls looked liked. I think that waiting period was harder for me than the days leading to surgery were. When it was finally time for me to take a shower (I SO needed a shower!), I was able to take the compression bra off.

I want to say that I try my best to not have expectations in all situations. That being said, when Ward helped me out of the garmet and we removed the big dressings, I finally I had my first look. All I could do was cry. Almost hysterically. Part of the tears may have been due to some relief that all this was over, but I was honestly disappointed in what I saw. The new implants looked so flat and WAY smaller than the expanders. My goal was to be a full "C" and what I was looking at did not even come close. I had been counting down the hours, so excited to get the implants, and now they just looked awful.

Again, a lot of women who have experienced this before me have said that the initial unveiling would not be the final results. The implants would need 8-12 weeks to soften & conform to the pockets that the expanders created. Even though I have read about this & heard first-hand experiences about this, unfortunately, all that meant nothing the first time I saw my new boobs.

Don't get me wrong, I am THRILLED to be rid of the expanders, but I don't think I could honestly go into that surgery without some sort of expectation. I mean, really. I was too excited. After all the hell I've been through since November, I deserved some nice boobs! I don't think it's a stretch to admit that I've been flirting with some depression for the last couple months, trying to accept and adjust to all this. Seeing these flat, small things on my chest just brought things to a head. I was so upset that evening and I decided that I truly regretted my decision to go through a double mastectomy. All that pain, all those tears....for this?!? Thank goodness God has placed certain people in my life to help me in times of despair.

I talked with my dear friend, Laura. She's been there. I talked & cried with my dear husband, who has been so patient, loving, and wonderful through this. I was still distraught, so I went on a massive search through my house to find the number of an angel who had helped me so much when I was first diagnosed. I found it.

Jill had moved to CT last year, not long after I made the decision to have a bi-lat. (See my blog from July 10, 2011 titled "God's Angels") We have not talked since before my mastectomy. WAY too long. I called her the day of the reveal, totally distraught. To my amazement, not only was she thrilled to hear from me, but she had just arrived to NC to visit some friends! God certainly knows what He's doing! She came over the next day. After a great visit and a long chat, I showed her my results. Her reaction is something I'll never forget. The first words out of her mouth were, "Oh my goodness, Amy...they are BEAUTIFUL!". She was so sincere and excited! Jill is a no-nonsense kind-of-gal and I knew she meant what she said. She helped me critique what would change with the implants. Then, she showed me her chest again to show me how the implants would change. They really would soften enough to look like real breasts. They really would drop & settle into the pocket and look real. It was exactly what I needed.

I will never forget what she said and how she said it. In a way, Jill gave me permission to feel beautiful again. Something I haven't felt in months...losing my breasts has been pretty traumatic. But Jill made me believe that my breasts will be beautiful. They already are beautiful. I am still beautiful. She helped free me of all this self-doubt I've had, all this regret, and her sincerity allowed me to let go of whatever it is that has been holding me back. I love her so much. I still have a lot of work to do and acceptance to gain, but seeing her and hearing the conviction in her voice, was a HUGE step forward in my journey to morph into that beautiful butterfly so many breast cancer survivors talk about. I get it now.

Fast forward to today. I had my first check-up with my surgeon and the steri-strips are removed. I was nervous because I didn't want anymore problems with healing or necrosis. Thank goodness, the incisions are healing beautifully. Dr. Appel was pleased with the way everything looks, which was very encouraging. I still have some strict restrictions and I need to be careful for the next month to ensure that I heal properly. He has also told us to start massaging the implants to help them settle. Push in & up not down & out. LOL! I see Dr. Appel again in a month for another check and we'll discuss any revisions I want (fat grafting to help fill in those caves) and nipple reconstruction. He's also is referring me to another specialist to address the pain & cording in my left arm, so I feel good about that, too.

Although I still have a lot of healing to do, I can already tell that the implants are changing, softening, and dropping so I was ecstatic to notice CLEAVAGE for the first time today. Watch out world, my girls are on their way back! :)

PICTURES BELOW:

Before exchange (790cc expander, each side)-



10 Days following Exchange (750cc Cohesive Gel (Silicone) Implants each side)-


Front view, today

Front view, today (new incisions are on the sides)

Left side, today


Right side, today (and the dreaded armpit cave)



Last but not least..........drumroll please.........




CLEAVAGE!!!!!!!!!!!!!!!!!!!!!!
So excited to see this again! :)


Saturday, March 17, 2012

The process of Expansion: PHOTOS

I wanted to do a post specific to the process and progression of my results with Temporary Tissue Expanders. These devices were placed under my chest muscles at the time of my mastectomy. They have a thick outer shell and a port in which the surgeon would add saline, a little at a time, to stretch the muscle enough to form a pocket for a permanent breast implant. You can read more about them here. I'm going to warn you now that the pictures below are graphic.


After mastectomy (Total 250cc's per side):

This photo was taken about 4 weeks after my mastectomy. My plastic surgeon has placed 250cc's of saline in each expander immediately following my mastectomy, so I wasn't totally flat.

1st Expansion, 90cc's each side (Total 340cc's per side):
                                                                         Before

                                                                   Immediately After
(The surgeon uses a magnet to locate the port that allows addition of saline. He or she literally marks an "X" for the spot and uses a syringe to add the fluid. Although my skin is numb, my muscle isn't so I felt the prick of the needle. After the fluid was added, I would feel pressure. I felt like I had an iron-clad sports bra on that was 4 sizes too small. The pressure got worse towards the end of the expansion process.)

                                                                              After

3nd Expansion, 90cc's each side (Total 520cc's per side):

                                                                      Halfway done!

Over-expanded, (Total 790cc's per side):
My final implant size with be 750cc silicone. I am over-expanded to 790cc's per side. They do this to "over-stretch" the chest muscle and allow for a better pocket for the implant. It will create a more natural breast. You can see my drain scars. I'm numb all the way to there.
The "caves" under my arms are evident in this picture. That was one thing I was not expecting after mastectomy. This will be corrected some at the time of implant exchange. If it's not to my liking, I can have a revision to smooth out my sides a little more.
The expanders are often uneven. They are not devices intended for aesthetic beauty. They are intended to stretch. They are hard, lumpy, misshapen, and uneven. They are so hard, they do not move at all.

But under a cami, they look ok. I usually wear another shirt over my cami. I look like I have a super duper miracle bra on, but it passes.

My final implants will look like natural breasts and they will feel like natural breasts. They will have a more natural slope and not stand at attention like the expanders. They will appear smaller than the expanders but my surgeon says I will have a nice, full C-cup when completed.

Goodbye, Transitional Rocks!

I have mere hours to go on my countdown to squishy boobs! This waiting sucks. I've never been a patient person, but I am really, truly, honest-to-goodness OUT of patience with the immovable objects on my chest. I'm so excited because I have about 36 hours to go and this phase of reconstruction will be over. Hallelujah!

This has been my hard part- the waiting for a return to a "new normal". During the last four months, I've recovered from a double mastectomy & a sentinel node biopsy on my left side, and I have over-stretched my chest muscles enough to accommodate 750cc's of lovely, smooth, squishy silicone implants on each side. I've been so busy doing that, it has interrupted my life and took precedence within my everyday, normal routine. I ran into complications with lymphedema, cording, and lymphatic scarring & have barely managed to juggle work, kids, physical therapy, counseling, and doctor appointments. But I've made it and it's almost over. Hallelujah!

I've been stuck in a "transition" phase for four months now and it's almost over. Hallelujah! I've got the illusions of breasts, but they are not breasts at all. I've been adjusting to tightness, heaviness, stretching, and soreness. I'm trying to adjust to the scars. I'm struggling to adjust to the loss of my nipples. I've been adjusting to the numbness I have. It not only encompasses my entire chest, but includes my sides and parts of my back. My left underarm and part of my left upper arm is also numb to the touch. Believe it or not, I have ran into things with these rocks! Shut doors on them, bumped into things, it's funny. I can't feel it. I've only been able to sleep, and quite poorly may I add, in two positions since November. I wake up throughout the night. No bubble baths until after exchange. Avoiding mirrors. Scar cream applications. Stretching.
I'm SO ready for a bubble bath! To sleep on my belly! To sleep all night! To glimpse at a sensual, natural form in the mirror! To feel a speed bump and the jiggle that follows! It's the little things that you take for granted.

When I was trying to decide my treatment route, I knew that I didn't want to have to endure chemo again. There's plenty of reasons not to want to endure chemo, but I also knew that in addition to all the physical side effects, I didn't want to drag out this treatment over an extended period of time. Surgery would be a "quicker" fix. Well, for me, that wasn't true. In fact, many aspects of this course of treatment have been harder than I've ever known chemo to be.

This has been the hardest thing I have ever done. I underestimated the emotional effect that losing my breasts would have on me. I now know why October is more pink than scary. I get it now. I am truly thankful that very public awareness of this disease is forefront & in your face that one month of the year. Breast cancer can be absolutely devastating to a woman. It can test every inch of her being. Her self-esteem, her sexuality, how she perceives things in the world after cancer. Breast cancer is silent and it doesn't care how much money you have, what you do, how old you are....none of that. It has brought me to my knees quite a few times these last four months.
I'll probably write more about these changes within myself after I get through this surgery. My perception has definitely changed and is still changing. I'll get to deal with the lyphedema after surgery, I'll get to heal. I'll be making decisions on nipple reconstructions that will happen around June. June will be my 1 year anniversary from diagnosis. Isn't it amazing? It will take almost exactly 1 full year to complete my treatment course. I had it easy and didn't have to do chemo on top of all this. That's a perspective in it's own right.

For now, I'm going to work on another post,showing you my expansion process. Then I'm just going to count these hours down. Hallelujah!

BRING ON THE SQUISHY BOOBS!

Tuesday, March 6, 2012

Don't take squishy boobs for granted...

Progress! It's only been a couple of weeks (not a month) since my last blog! Woohoo! Boy, have there been some developments. Things are moving pretty fast again.

First of all, I just want to say thank you to the people who reached out to me after my last blog. I'm not going to name any names, but the messages & phone calls meant a lot. Thank you. I want everyone to know that I really am ok. Even on my bad days, I'm still thankful for all the gifts God has given to me. Bad days are just that.....bad. Blogging helps me (when I remember to do it) work through these feelings that ramble through my head. I'm just thankful to have so many people who care about me. :)

Second of all, I have a huge announcement. My exchange surgery is FINALLY scheduled. YAY!!! I'll be ditching these rock-hard, heavy, misshapen mounds for soft, subtle, SQUISHY, silicone implants on Monday, March 19, 2012 at 10:30am. It will be an out-patient procedure at Presbyterian Main Hospital in uptown Charlotte. I cannot express how excited I am!

That has made me feel a lot better and it gives me something to look forward to. I am nervous, too, I can't lie. There's always concern anytime you have to be intubated with anesthesia and I'm concerned about the "after" results. I realize that there will be more adjusting, more grieving of what was, and some patience to settle into my new breasts. BUT...I will be rid of these expanders! That's the best part and believe me, NEVER AGAIN will I take squishy boobs for granted. I swear that's my new slogan. I'm telling all my friends....don't take your squishy boobs for granted! Someone needs to make a T-shirt!

My third bit of info isn't as happy. After seeing Dr. Appel for my pre-op check, and his thorough examination of my arm, he confirmed my fear. I have developed mild lymphedema in my left arm, even though he said that only 5% of women with a Sentinel Node Biopsy develop this condition. My hands were still swollen that morning and my wedding rings wouldn't budge. He prescribed me some Dilaudid to take at night to help me sleep and sent an order to physical therapy for treatment of the lymphedema. I asked him about a compression sleeve to wear for treatment, but he said that the sleeves were used more for moderate cases. I could go back to Peggy for manual lymphatic draining, so I was happy to have a plan. He said that it we could effectively treat it, we could probably prevent it from becoming a moderate case. Thank goodness!

When I went to PT, I didn't think I was swollen. I could take my rings off and had good range of motion, so I was surprised when Peggy told me that she could tell that my arm and shoulder were swollen. She took some measurements and quickly agreed with Dr. Appel's diagnosis. That was a bummer. She did not agree with his statement about compression sleeves for treatment.

Let me break from this for a quick second and just say that there is a lot of debate within the medical community concerning lymphedema, lymph node removal, and all that. It can attack someone randomly after axillary lymph node biopsy/removal. Someone with only 1 node can be affected, so can a person that has had 20 removed. The same is true in the opposite scenario. Some people say that compression sleeves are a great preventative treatment, some say only in extreme cases. There are different studies to verify both theories, but there hasn't been enough research on this subject to have a concrete conclusion.

Back to Peggy- she was going to do some manual draining, which was very painful, and she was also going to check with my insurance for a referral to the lymphedema clinic. She thinks (and I agree) that I would benefit from a compression sleeve. It will help what is already swollen and hopefully help or prevent any more fluid from collecting in my arm and hand. Summer time is not far away and I know that heat has to make it worse if this is anything like regular edema. I'll find out on Thursday if I'm going to the clinic before or after my exchange surgery.

A lot has happened in the last couple of weeks and that's been a good thing for me. The physical therapy and lymphedema have also slowed me down in regards to soreness. It kept me from going to my dear friend Laura's 1 year anniversary party. Missing that really sucked. I'm frustrated that I have to go back to physical therapy twice a week and miss more work. I feel like I need to be working more, especially since I learned that I was out of FMLA time, but my schedule is what it is. I'm trying to not stress about this for two reasons. One, everything will work out...I know it will because it always does. Two, if I don't take the time to focus on myself and take care of me; I'm not going to do anyone any good. Not work, not the house, not the kids, not my husband. Ward has been such a wonderful support- he encourages me when I need it most and picks up my slack whenever he can.

Am I still exhausted? Some days. It has gotten better since I have nighttime pain medicine. I can usually get between 4 or 5 hours of good sleep before I'm up & down. That's a big improvement, but still not what I would say a good night's sleep was. I am aching to sleep on my belly! Do I still feel lost? Yes, some days. My sleep is better, my pain is more manageable, and I'm still seeing my counselor so all that is helping a lot. Again, it's a process. Am I still having self-image doubts? Yes. That one may take a little time. Do I feel stuck? Sometimes....but I have something today that I didn't have a couple weeks ago & that's a countdown.

13 days until I have squishy boobs!

Friday, February 17, 2012

The break I never wanted

So I said I would post more and yet I've done the exact opposite. I think I'm lost and trying to navigate my way back to my new normal. The last 6 weeks have been very eventful in regards to my daily routine. I've gone back to work full time, although my first week back my children decided to share a nasty cold with me. I've finished expanding after reaching a whopping 790cc's in each side. Physical therapy discharged me because my range of motion in both arms was above 170 degrees. Sounds like things are pretty good, right? That statement couldn't be farther from the truth.

In my last blog, well over a month ago, I talked about grieving and the wonderful counselor I see seems to think I'm still grieving. All I know is that I seem to be shutting down emotionally.

Although I'm back at work, I never imagined it would be this difficult. I felt a lot of pressure to return to work, and in all actuality, I should've listened to my dad (AGAIN!). He tried to tell me that I should just stay out until my exchange surgery, which is slated for mid-March. I argued with him, which I apparently love doing, explaining that I was feeling better and was going stir-crazy in the house. Plus, financially, we are struggling. Short-term disability only paid a fraction of my normal pay, and though we were stretched to the max, we were making it.

So my hard-headed self went back to work. While trying to adjust to my schedule, I began to realize that I was in trouble. It's no secret that trying to get a good night's sleep is very difficult when your turtle shells are overexpanded. But add some problems with my left side and it's damn near impossible.

I've had issues with my left arm since my mastectomy surgery in November. My range of motion was always less and it's always hurt. While I was seeing my physical therapist, we had a hard time deciding what was wrong- was it a pinched nerve from the expander? Was it muscular pain? It seemed likely to be a nerve since the pain I was feeling started in my left chest, traveled through my armpit with intensity and radiated through my lower arm to my elbow. Towards the end of my time with Peggy, she found (felt) evidence of cording. Technically, it would be Auxiliary Web Syndrome. In laments terms, it means that the lymphatic drains on my left side have developed scar tissue due to the sentinel node biopsy that was performed during my mastectomy.

Since I've stopped seeing my physical therapist, the pain has gotten substantially worse. My range of motion is declining once again and this morning, my hand was swollen to the point that my wedding rings wouldn't budge. That is super scary because the first thought that raced through my mind was lymphedema- a condition where the lymph fluid can't drain propery and there's no cure once you have it.

All these factors- increasing pain, decreasing sleep, full-time work, house, & kids- have made me a miserable person. I think all this is wearing on me and my emotional state.

I'm very frustrated that this is happening and I'm still a month away from exchange. I'm so exhausted that I have to push myself just to function through the day. Although I take pain medicine and muscle relaxers on a daily basis, it barely puts a dent in my pain level and sleep is impossible. I'm so tired that I fall asleep pretty quickly but I'm constantly waking up throughout the night.

My emotional state isn't much better. This is, by far, the hardest thing I've ever done. I still struggle to look at myself in the mirror. In a shirt, I look ok. Similar to the old me, just a little smaller and a lot more perkier. Just out of the shower, though, it still brings me to tears. Don't get me wrong, I'm SO happy that I'm cancer free. I KNOW that I made the right decision to have a bilateral mastectomy. BUT....I'm still second-guessing myself some days, wondering "what if?". I feel so "less-than". I miss my breasts and it's hard to see these weird, heavy, tight mounds that sit upon my chest. Instead of nipples, I have angry, red scars that still scream out at me. I have an ache deep down in my gut that tells me I'm missing something.

I knew going into this that I would have to get used to a new normal, I just never imagined it would be so difficult. Of course, there's no way to prepare for this sorta thing. I don't like these feelings of being stuck, of hating the way I look, feeling unattractive. The word "sexy" doesn't exist to me right now. (My loving, patient husband would strongly disagree.) I really do feel lost. Like I'm barely keeping my head above water.

My friend Laura still checks on me, almost daily, and I love her. I can spill my guts to her and she GETS it. I'm so blessed to have her. I'm seeing a counselor at the Buddy Kemp Caring House at least every other week. I've made reservations to 2 support groups for next week. I blogged today. Hopefully these little steps are steps in the right direction, to lead me out of this fog and back to my happy life. I really do have so much to be grateful for and I am.

I see Dr. Appel again on Wednesday and I can't wait. I've really missed him over the last 4 weeks! I spoke with him today and he wanted to know how I was doing. I told him all about my arm and he's placing an order for me to get back to physical therapy. He said we would talk in detail about it when he saw me next week. I'm sure he'll want to check out this arm...you can actually see the cording when I lift it. Weird!

So there is progress being made, even though it's baby steps. I'm sure once I can control this pain, get into PT, and get some MUCH needed sleep, I'll feel like my old self again. That's gonna be good because I sure do miss Amy.

Tuesday, January 3, 2012

Getting Real

It's been a while since I've blogged....again. I've had a lot of progress with expansion in the last month, and some setbacks I wasn't quite expecting. Taking the advice of a wonderful friend who is also on this journey, I'm getting real with myself and plan to blog more. I will update everyone about the fills, aka expansion process, a little later. This blog entry is about bringing you up to date on my experience with the emotional side of a double mastectomy and reconstruction.

Let me preface this, like my friend did when she posted her similar experience, with saying that what you are about to read should not be misinterpreted as a pity party, a cry for help, me feeling sorry for myself or anything like that. Please understand that I am simply going to try to articulate some very real things that I have been processing over the last few weeks.

I have been told by countless people, friends, and family (whom I adore!), that I have been "so strong", "an inspiration", and "brave". While I appreciate these terms of endearment, I feel like I have purposely tried to project all those things outwardly. Inside however, unbeknownst to those closest to me, including my husband, I have been having lots of feelings that I didn't want anyone to know about. Hiding negative feelings is not a good thing at all. Hiding negative feelings for an extended amount of time can be even worse. I have been suppressing true, heartfelt issues since I was released from the hospital and the first bandages were removed.

I broke down last week after shutting down emotionally for a couple of days and finally told my husband, Ward, what was going on inside my head. Although he had a feeling of what was going on, I don't think he could've known what I really thought about my mastectomy and my body image. He even admitted that I had done a pretty good job of concealing my feelings. And believe me; I never intended to keep anything from this man. I felt that if I could just keep focusing on the positives, these negative things would resolve on their own. That was a mistake.

To be honest, some days it is very hard to look at the wreckage that is now my chest. You guys have seen the pictures that I've posted. Don't get me wrong, I'm SO VERY PLEASED WITH MY PROGRESS. I think the reconstruction is going great and I know that my ending result is going to be awesome. I trust Dr. Appel and I do think he is an extremely talented and caring plastic surgeon. I like the way I am filling out in my clothes and I really am excited about the end goal.

I know that my breasts don't define me. I know that I've been told many times I still look great. They're just boobs. I've told myself these things and other people have said these things, so I get it. But the reality of the situation is that my breasts are gone. My nipples are gone. Although I have temporary expanders placed within my chest muscles that are getting bigger each week, they look nothing like breasts when I get out of the shower. Rather, they are like lopsided, misshapen, hard shells that intrude into my personal space. They don't move at all. I mean, NOT a bit. My scars haven't faded a whole lot and since my complexion is so fair, they are still pretty red. So on top of these hard, misshapen mounds that sit on my chest, I have red horizontal scars that cover these imposter boobs fully. And no nipples. Although there are more and more moments during the day that I forget about the expander's presence, I'm aware of them every day. To say that this has been a big change physically and emotionally would be a gross understatement.

From the beginning of this whole thing, I was afraid of how I would feel when the mastectomy finally happened. Although I feel like I tried to process all of this even before surgery, there was no way to ever really prepare myself.

I was afraid of feeling like this, of hating the way I looked in the mirror. I was angry about being BRCA1+ and all the "female" anatomy parts that I have lost over the years. I'm always very compassionate with myself, something that I wasn't years before, but admitting this extreme sadness, dislike, and anger felt harsh. I want to be brave and strong and ok with all of this and it upset me greatly to think that maybe I wasn't.

I reached out to my friend Laura and we met for some coffee and dessert last week after my emotional fit. It was a huge relief to know that I wasn't crazy - she had a similar breakdown before Christmas. She understood everything I said....all the feelings I have, issues that I know I will have. I understood things she talked about. She helped me so much just by listening and then by telling me personal issues she has faced. I felt a real connection to her because we both have some adjusting to do in our new bodies.

She told me about free counseling services that are offered to cancer patients, current or former, as well as to their families through the Buddy Kemp Caring House in Charlotte. She suggested that I make an appointment, which I did.

I went to counseling yesterday and met an awesome lady that was very easy to talk to. Too bad I didn't recognize the stages of grief that I was experiencing over the loss of my breasts. It never occurred to me that I was experiencing that, but I did feel a lot better. So, in taking my friends advice, I'm planning on using the next couple of weeks to seek out more counseling and maybe even go to a few support group sessions that they offer in Charlotte. They are free and I think it will help me move through all of this in a healthier, more productive way.

It's such a weird thing to be in the middle of reconstructing your breasts. On one hand, I'm amazed at my progress through the last 2 months. I've had 2 surgeries and have begun having some volume again in my chest. It's truly awesome. My energy is coming back slowly but surely. My strength is also building through PT and daily stretching. The fills I have every week are fascinating to watch.

On the other hand, I am grieving my breasts. I am frustrated that I'm not released to return to work yet. I am annoyed at the pain I have in my left arm due to some scar tissue that's accumulated in one of my lymph drains and/or the pressure of the left expander and/or possible nerve damage (they still aren't too sure what's going on). I'm still doing PT twice a week and I'm still expanding. I have trouble sleeping at night because of the hard expanders...they don't move and side sleeping is a challenge.

Now I need to learn how to have all these feelings be heard and acknowledged. I need to focus on this and learn how to accept the new breasts that we are building. It's nice to have some direction in the midst of confusion and believe me, I'm ready to get real with all this and get through it.