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! :)

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!

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!