Tuesday, February 27, 2018

Another update

You take the good, you take the bad...

My appointment today went okay. It actually probably classifies as having gone well, but I'm not feeling that right now.

My breasts apparently look great. They're healing perfectly. We're going to keep letting them do their thing. This is good because they're the part of this surgery that has the most potential to go wrong.

My abdominal wound has gotten bigger. What you can see isn't bigger, but the wound is bigger inside. I can't even describe how big it is. I know it took a whole roll of gauzed (soaked in saline) to pack today.

Yup, Dr. K. changed my wound care regimen. It has to be packed with gauze that's soaked with saline twice a day. You use what's basically a really long wooden q-tip to pack the saline into the wound. I was referred to a visiting nurse to have this done. They're supposed to start tomorrow.

I've been told that abdominal incisions opening is pretty common, particularly where mine is. And that it will heal itself. 10 days was mentioned today; I will be super happy if that's all it takes.

This open wound is a speed bump I didn't anticipate. And I'm frustrated that I am having to deal with this. BUT... None of the docs or nurses seem worried (yes, they're keeping a close eye on the wound but they keep telling me it's common and looks clean and IT WILL be okay). So I need to not worry too. I need to let the visiting nurse do her job and I need to just heal.

I go back to Ann Arbor in two weeks for a follow up visit. I'm very much hoping the wound is healed by then.

One of the residents and my plastic surgeon both mentioned today that I'd need scar revision but that it can be done when we do phase two of the breast reconstruction. (Total side note... my favorite resident from my time in the hospital came in to see me today. She heard I was there and dealing with an open wound. She came in to look at it, tell me she's sorry I have to go through this, and to assure me that it looks good and it will heal. So kind.) I haven't decided yet. That's a long time ahead (about three months). I'm not worried about scars or how I look; I just want to heal and never get cancer again.

Yeah, cancer again. Today, as I looked at the list of my upcoming appointments at U of M, I got sad and frustrated. Probably didn't help the mood I'm already in. I have five appointments scheduled, with one of them being my next cystoscopy in April. I wonder if my abdominal wound will even be healed by then. I wonder what Dr. H. will think when she sees my mess of an abdomen. I wonder what the cystoscopy will show about the urothelial neoplasm of malignant potential we saw last time. I don't want to have to deal with another TURBT (bladder surgery) right now. One thing at a time.

And so I pray.

Monday, February 26, 2018

Speedbumps

Today is 24 days since surgery. It's not been an easy road.

At my appointment on the 13th, I got one drain out. Last night (well, at 3am today), one of my drains fell out on its own. The good thing is that its output was low enough that it was going to come out tomorrow anyway, so it's all good. But it sure surprised me when it happened. So I have two drains left. One more will come out tomorrow, due to low output. The last one is still pulling quite a bit so it will not be coming out tomorrow.

Last Friday, I woke up at 2:30am to an opening in my stomach incision. I knew enough not to freak out, but we did have to go to Ann Arbor to my plastic surgeon's office. He wasn't there so I saw one of his PAs. Kristina was very nice. She assured me that it's rather common, that it's going to be okay. She said my opening looks really clean. She put me on antibiotics anyway, just in case I develop an infection. She packed my wound and showed me how to, because I now get to pack it twice a day. One of the most gross things I've ever done, but I'll do it if it means faster healing.

I am being soooo lazy. I barely move off of our couch that has a built-in recliner. I sit in it to work on my computer all day and I recline it slightly to sleep at night. I get up like three times a day. Don't worry; I do exercise my legs throughout the day.

So... I go back to see my plastic surgeon tomorrow. I plan to ask him about the plan for the open wound. I plan to ask him how long he'll allow drains to stay in. I understand their importance so in that respect I'm not in a hurry to get them out, but I hate them, so I want them out. Most of all, I'm hoping they see some improvement in the open wound so I know I'm doing it right.

That's it for now. I'll update after tomorrow's visit.

Thursday, February 15, 2018

Things

So, I've been home just over a week now. Things go really well at times and just kind of "meh" at times. Today's not an awesome day, but those days are going to happen every now and again.

My followup appointment with my plastic surgeon went pretty well. I guess really, it went well with the exception of my disappointment in only getting on drain out. The doctor is happy and says things are going exactly as they should be. I go back to see him in two weeks. If any of my drains are ready to come out prior to that, I can call to make a nurse appointment to get that taken care of.

Me? I'm just tired. Tired of drains (the feel of having them in, the stripping and measuring three times per day, the fact that two seem to be going up instead of down right now). Tired of not being able to take a shower (I have a bandage from the drain removal that can't get wet). Tired of not being able to wear regular clothes. Tired of not being able to drive. Tired of not being able to take care of my family like I usually do.

But I'm also grateful. Still grateful that I had the opportunity to take control of something in my life and do this. To do something that should keep me healthier for longer with my family.

And so I'll put my feet up, try to get these drains out sooner rather than later, and just keep on healing.

Saturday, February 10, 2018

Hello from the other side

Surgery (phase 1) has come and gone. It was a week ago yesterday. Things are going well and I thought it's time to update here.

We headed to A2 the day before surgery so that Dr. K. could mark me up. We'd have had to leave home at 3:30am on Friday anyway, even earlier if the weather was bad, so going the night before worked well. Dr. K. used a purple Sharpie to draw his masterpiece and then went over the whole thing with a black permanent marker. Can't say that I blame him; I had to take two showers between then and checking in, so we needed to make sure it stayed on. A week later, though, and I still have marker all over my body. LOL

We went out to a delicious dinner Thursday evening. I knew my appetite would change for a while after surgery, so I very much enjoyed my "last supper" (as I kept referring to in my head LOL).

I had to take a shower with special soap before bed and again in the morning. And then I opted to wear pajamas and slippers to check in at 5pm. I knew they were what I'd be wearing home so why not make it easier on myself. After surgery tip: wear soft, loose pants that can ride low (under the hip drain sites) and a soft, oversized (literally two sizes bigger than you usually wear) top that buttons completely in front. Aunt Kim gave me the perfect pair of pajamas as a pre-surgery gift. :)

Pre-op was the same as usual. Lots of docs, residents, anesthesiologists, and nurses came to visit me. I remember last talking to my nurse about how it was time to head to the OR and the next thing I knew, I was waking up in recovery.

When I woke up, I was taken to my private room on the plastics/flaps/ENT floor. On this floor, there is staff to check you as often as needed. For my surgery, that meant every hour for the first two days, every two hours for the next day, and then every four hours the last day.

I woke up with a Bair Hugger blanket wrapped over my chest. It was set at 109.4 degrees. I had to wear that from after surgery on Friday until Monday morning. I kept spiking a fever in the middle of the night. Not hard to do when you have this super hot blanket wrapped around you.

When I woke up, I also found that I had two wires coming out of my chest and connected to a machine that was in my bed. This was the Doppler. Each wire was sewn and stapled somehow to me so that they could monitor the blood flow in my flaps (new breasts). This was connected until discharge morning, and the sound was very reassuring to me (I could tell at all times that things sounded just as good as they did in the OR).

I was connected to a pain pump as well. Now. this part, please remember, everyone is different. I, personally, didn't use it at all or take any pain meds. I haven't since I got out of surgery and only came home with scripts for Tylenol and aspirin. I was given Tylenol once daily for three days for my fever, I take one aspirin daily (for a month going forward) to again help with blood flow. But I haven't taken anything else. At this point, I don't anticipate I'll need to because it should just continue to get better. This isn't to say everything was roses. I was very stiff and sore. But to me, being sore and being in pain are two different things. If I can tolerate the situation without meds, that is always my preference. They left the pain pump hooked up for three days and then just unhooked it since I never used it. I am tired of hearing how "amazing" I am for not taking pain meds. Again, everyone is different. A healthy recovery is most important and being pain free is very helpful in recovery.

In the hospital and now, I cannot have caffeine, chocolate, or nicotene. Chocolate has long made my belly sick anyway, so I really don't eat it often. I don't drink coffee or pop, and I don't smoke, so these restrictions don't cause an issue for me.

I got to get into a chair on Saturday and got to take walks starting on Sunday. My kids came up on Saturday to see me (they stayed the night in the hotel in the hospital). They got to go for a walk with me on Sunday. I think it did some of them a lot of good to see me up and around.

I had a catheter in until Sunday morning. After that, I had a lot more freedom. :)

Starting Monday, I was able to walk alone. It felt good to get around and also to not depend on others for everything. I was allowed to unhook and rehook my Doppler lines for my walks. Was nice to have that independence and, because I knew what the Doppler was supposed to sound like, I was always quickly assured that things were still going as we needed them to.

I finally got the okay to go home on Tuesday morning. Things went quickly from that point. Staples and wires removed for Doppler, learned how to strip my drains, got my IV out, and got the heck out of there within a few hours.

Drains. My nemesis. LOL I have four. One from each breast and one from each hip. They're stiched into me and part of the drain lines and their whole bulbs are on the outside of my body. They drain the extra "surgical gunk" from your body. This is major surgery and it's traumatic on your body. The drains help your body to recover.

But now that I'm home, I have to strip them and measure them three times per day. And because of them, I constantly wear a mastectomy camisole that has pockets for the drains. My insurance company paid for my camisole, and I couldn't be more grateful. The mastectomy camisole is one of the best inventions ever! As for the drains, they cannot be removed until they are at less than 20 CCs two days in a row. And the doc (or his nurse) has to be the one to remove them. Two are already measuring low enough that they could come out. One is too high and one is waaaay too high. I have a post-op follow-up with my doc on Tuesday and I'm hoping at least the two come out then.

The drains make it hard to wear clothes. The camisole helps for sure. But your pants still have to ride low to not pull the hip drains and your shirts have to be oversized to not squeeze against your breast drain sites.

I was able to take a shower unassisted at home on Wednesday. Will do it again this morning.

Baby steps. That's where we're at. I need to take it easy and allow myself the time to heal. I have to let my body do its job.

Sleeping has been the. hardest. thing. since I got home. I can't lay flat yet. I can't sit certain ways based on the drain sites. Sitting anything but straight up hurts my tailbone, but sitting straight up makes it really hard to sleep because my head flops over. I finally found a way to lay on the couch propped so that I can still get up by myself. And I found a comfy way to sit during the day. I got my first good sleep since being home yesterday, and it felt heavenly. It's only going to get better from here!

Emotionally/mentally is hard for me. Nothing at all to do with having my breasts removed; that really hasn't affected me. But not being able to take care of my family like I usually do and relying on others for many things (lifting, reaching, picking things up off of the floor since I seem to have developed a case of the dropsies). I am a fiercely independent person so relying on others is the hardest thing for me.

I think that's it for now. I'd be glad to answer any questions you may have. And I'll update likely after my appointment on Tuesday.

<3

Wednesday, January 31, 2018

My messed up self

People keep asking me if I'm nervous. I've been able to say no, until this morning. The butterflies are settling in.

Today is my last day at work until who knows when. I have so much to do today to prepare to work from home for a while. Tonight is my last night at home for a (hopefully very little) while. Tomorrow morning, when I send my kids to school, it will be the last time I see them until the day after surgery.

I'm trying not to think about it, but it's in my face and hard not to think about. I feel nauseous today and it's all nerves. I highly doubt I'll sleep at all tomorrow night.

I'm a dang mess. Ugh.

Tuesday, January 30, 2018

3-2-1

Three days til surgery day.

My emotions are all. over. the. place.

I'm still 100% glad I'm having this surgery. I still know with all of my heart that it's the right thing for me to do.

But I am an emotional mess.

Probably doesn't help that I am in medical menopause. LOL My hormones are wacky, though I do take them nightly now. Besides, I really can't blame my emotions on hormones when I've always been an emotional mess with certain things.

Things like anesthesia.

And leaving my kids for any amount of time.

And missing my kids' activities.

And all of those things are happening. In three days.

I'll be in the hospital for "three to five days", which I'm assuming means I'll get out on Tuesday at the earliest, since U of M does all discharges by 11am. But I'm going to push myself to get out on Monday if I can. "Push myself" isn't necessarily a bad thing. I'm going to do all I can to heal well, eat, walk, poop, shower, whatever I need to do to get the okay to be discharged.

So I can get home to my husband and kids and get back to work (working from home for a while after surgery).

I did a three-week meal plan on Sunday. And I bought all of the necessary groceries except the fresh stuff. I also started packing my hospital bag which, just as when I was in labor, has more stuff in it for my husband and kids than it does for me. LOL I need to make sure my people are taken care of when I'm physically unable to actually take care of them.

And that weighs more on me than anything else.

I'm worried about my family. Like many moms, I am the one who does everything for everyone at home. I do it because I want to. I do it as a way to show my love. And I won't be able to for a little while.

And that bugs me.

But that's also a big part of what drives me to have this surgery.

I want to be around for a long, long time. To be able to enjoy life with my family and friends. To be able to take care of those I love.

And so...

I'm going for pre-op (to be marked up) in two days and am checking in to the hospital in three days.

It's getting closer.

Friday, January 19, 2018

Two weeks to go

My prophylactic double mastectomy with immediate DIEP flap reconstruction is two weeks from today.

Two. Weeks. From. Today.

I am heading to the hospital a day early to get marked up by my plastic surgeon. So that's less than two weeks away.

I am starting to feel anxious about it. Not really worried, per se, but anxious about the surgery in general. I just want to get it done so I can heal and move on. I want to see that my kids are okay and that I am okay. I want to start walking and driving again. I want to get back into being able to go to my kids' extra curricular things. I want to not miss any, which can't happen since one is the night of my surgery, so I want to heal and get back to living life.

I've made lists: things I need to take to the hospital, a 2-week meal plan of easy but still somewhat healthy things my family can cook, a grocery list to go with said meal plan, non-food things I need to make sure we're stocked up on before I'm laid up for a bit (or at least not able to go shop for easily). I have a to-do list at work to make sure nothing is undone when I leave and to make sure someone can take care of the basics for the (hopefully) few days I'll be in the hospital.

The next thing I want to get done is to make a calendar of what needs to be done daily (school drop-offs and pick-ups, practices, performances, games, religion class, doctor appointments) so that we can make sure we don't miss anything important.

I'm feeling more and more ready, but also more and more anxious. This two weeks can't pass fast enough, yet it's also coming way too fast.

And I've gotta say... one of my biggest frustrations right now is clothing. I need some new clothes because I've been losing weight but I have no clue what size to buy because so much can change after this surgery. I literally can't buy anything without it being a potential waste of money. Can't buy pants, shirts, bras (I'm going from a way-too-big size to a full B or small C cup, by choice), or underwear. And it's frustrating, because I don't even know what I'll need to come home from the hospital in. I honestly think I'll be coming home in pajamas.