Entries tagged with “mastectomy

Last week’s blog left you when I woke up in the recovery room after my double mastectomy.

Desiree stayed with me overnight at the hospital and the next  morning she was instructed in the care of my dangling drainage tubes and how to empty and apply suction to them in the morning and evening. She was a great nurse and I couldn’t believe she was so faithful in taking care of me when she was facing health challenges of her own.

There was no additional cancer found, and the lymph nodes they took were also found to be free of cancer. The cancer they did remove was estrogen reactive, so I was going to have to reduce estrogen in my bloodstream.

I failed the trial with the estrogen reducing drugs. I could not function with them – whether due to my fibromyalgia or some other reason, the drugs sent me to bed with bones and joints aching so deeply I could not function. I finally settled on Calcium D-Glucarate and DIM supplements. I get my estrogen tested periodically and so far it has been too low to measure.

When the surgeons operated, there were flat expandable inserts placed behind my pectoral muscles. Over the next few weeks I returned to Dr. Steele’s office every ten days or so for an injection of saline into these inserts. By doing these injections over time, my pectoral muscles were allowed to stretch and make room for my reconstructed breasts. It was a bit like going through puberty again, except for the hormones, of course. I grew slowly until I was approximately my pre-mastectomy size.

When the doctor and I agreed on the final size desired, we scheduled an outpatient surgery to replace the expandable inserts with “permanent” silicon inserts of the same size. I put quotes around permanent because at any point where there is a problem with the silicon implants they will be replaced.

So now I had the shape, but my breasts looked somewhat lonely or as I called it “blind” without any form of nipple on them. They reminded me of those cave dwelling fish that have no eyes at all.

Anyway, after the implant surgery healed we scheduled a nipple surgery where flaps were cut and folded around on each other to create a raised “nipple” look. There was no color, but the shape was there. Mine did flatten a good bit but not enough to make me want to go through another surgery.

More than a year after the surgery I was able to get areolas tattooed on the skin around and including the raised areas. I am well pleased with the outcome, especially when compared to my fears of looking deformed or maimed like some victims of the early years of mastectomies. To quote Meredith Baxter (the mom to Alex Keaton on “Family Ties”) after her reconstruction “I now have the boobs of an 18-year-old girl. Now how many ladies over 50 can say that?!?

Last year was great and awful – and often both at the same time.

In April I was blesssed with a beautiful granddaughter. While I was visiting and helping with her adjustment to life on the outside, I received a phone call from the mammogram center. I had missed my annual appointment and needed to come in. I scheduled the appointment for May and went on enjoying my visit with the new parents and baby. My daughter and I planned what kind of quilt I would make for the new addition to the family, even as I presented them with a newly knitted dress and bunny.

In May, I kept my appointment. I was ambivalent when they scheduled me to come in the next day for an appointment with the surgeon for a biopsy. It would be nothing. I knew it. It would be another one of those annoying cysts that pained me from time to time. I scheduled the appointment with very little concern. I had nursed my children, I was reasonably healthy for a person with fibromyalgia. I was eating well and watching my weight, losing a few pounds at a time – the healthy way. I still ate some white sugar, but had increased greens and decreased meat…

Then… I showed up for the appointment and asked the surgeon what he thought. “Its just a little fibroid cyst, right?” I asked. No, he said, it looks like cancer. It is small, though and will probably only require a lumpectomy. We will call you when we get the results. “Oh boy, I thought… that doesn’t sound good!”

The following day they called. I had had a sleepless night, tossing and turning, fretting, worrying, praying – giving the whole thing to God and taking it back again. They said it was malignant and scheduled me to go to an oncologist. The appointment came quickly and my daughter-in-law went with me, along with her sister who is a nurse and a good friend. Another sleepless night the night before, and we met the doctor with positive thoughts of a quick lumpectomy, over and done.

The Oncologist was not as encouraging as the surgeon in the mammography center had been. “We will probably have to take the breast, she said. Otherwise we will have to do radiation and if we do radiation, the reconstruction will not be good. So – one breast? Then she explained that if I had both breasts removed the chances for a full recovery and no recurrent cancer would be much stronger.

On the next visit to the Oncologist, we discovered that the cancer was estrogen positive. This meant that the estrogen in my body fed the cancer and enhanced the concept of removing both breasts. But she explained – I could probably keep my nipples. Keep them??? I hadn’t even thought of losing them, and now it seemed that had been a distinct possibility. She didn’t like the idea of me keeping my nipples though, because they contained breast tissue and could cause a recurrence. She had just had such a recurrence and was not pleased that her patient had to fight cancer a second time. I was insistent. I feared ending up with a maimed appearance. I had seen the results of mastectomies in the 70s and images of those incredibly scarred torsos flashed through my head. Nights were difficult. It is hard to sleep with fibro pain, but even harder to sleep with worries and fears of the future flashing through my mind.

I set about searching for surgeons. I had to find a breast surgeon and a plastic surgeon who took my insurance and who both worked at a hospital where my insurance would be accepted. For a time I was afraid I would have to go to Dallas. It isn’t far from Fort Worth, but still, I didn’t want to be that far from home. Searching for these specialists was taking much longer than I felt was necessary but I was bolstered by the information that the cancer was small and slow-growing.

With my insurance company’s help, the two surgeons and the hospital were located and the appointments were made to meet both doctors. The surgeon outlined a plan to remove both breasts and reserve both nipples. He further confirmed that the cancer was small and slow-growing and told me that it had probably taken five years for the cancer to reach its now-visible state. That eased my mind as the surgery was still not scheduled.

The visit with the plastic surgeon came next. He examined all the documentation and outlined his own plan for reconstruction. I felt like a fish out of water just gasping for air as he explained that the nipples had to go and reconstruction would be done “from scratch” with everything removed and then re-created slowly over several months to a year. He was somewhat comforting however, as he showed me photos of reconstructed breasts and they did appear to be somewhat normal looking.

A single lady in my mid-50s, I was a bit anxious about this. I was dating, but wow – this kind of drastic measure could ruin a marriage – what would it do to a dating relationship? How  would I feel when I looked in the mirror? This was only some of what went through my head. I was thankful for the blessings that were included – no chemo, no radiation, no long-term negative prognosis. So many women had a much darker future than I did. Some were still very young. There were ladies carrying toddlers and wearing kerchiefs on their heads to cover the chemo after-effects when I went to the cancer center. I knew I was being blessed and protected in many ways, but the fear was still hard to handle.

I was thankful for insurance, and even more thankful for the laws that require patients who want reconstruction to be allowed to have it. I wasn’t sure how it would all turn out, but I wanted reconstruction. The idea of seeing myself in the mirror with my most visible feminine attributes missing was disconcerting at best and extremely depressing at worst. What if… what if… what if???? thoughts raced and i repeatedly prayed and surrendered to God’s will only to jump back in and try to handle things without God. Oh dear! This was hard!

Finally the surgery was scheduled. Daddy came with his wife, Tina. My son Daniel and his wife Desiree came to the hospital. Desiree spent the night with me after the surgery and got the aftercare instructions. She would be helping me with drains and tubes during recovery.

Waiting in the pre-surgery waiting area, I was anxious. I felt immensely private about the surgery and had only told closest family and friends. I knew prayers were being sent on my behalf, well-wishes and all that, but I was scared. I was going into this a “whole woman” and coming out flat-chested as I had been as a child. This was drastic and I was tense, nervous, afraid. Daniel and Desiree kept telling me to breathe. I guess I kept forgetting.

Finally, into the surgery prep area and then into surgery. When I woke up I remember touching my chest with both hands in recovery. Flat. “They’re gone” the nurse said. “Everything went fine.”