Freddie Kreuger’s HandiworkBeheading Medusa and Making Like Flat Stanley
Luckily very few people in our lives have experienced breast cancer. Even fewer have had a “double mastectomy with delayed immediate reconstruction” as the process we are in the middle of is referred to. Uh, does that mean it’s delayed or immediate? One of 10,000 questions we’ve explored.
If only it were elbow cancer, we could pull it out and show it to anyone who asked. Alas, it’s breast cancer and sometimes people are weird about breasts. Whipping them out in the middle of Costco is generally frowned upon, though it has almost happened. Twice. In spite of that, almost without exception each kind soul in our world actually DOES seem keen to know more about what’s going on under the hood, if only from a place of understanding and empathy.
Your pectoralis muscle went where?
You have the equivalent of two small deflated basketballs stitched to your chest wall why?
You're STILL relegated to lying flat as much as possible?
Medical Stuff Alert: Yep, this is my blog, it’s what we are experiencing and a lot of it isn’t pretty. Clearly the level of detail is what I’m comfortable sharing publicly… moreover I actually find it cathartic. In this post are a couple of photos of stuff that’s a lot less fun than triathlon. Don’t worry, there aren’t any full-on shots of my nekkid breasts, but there are some close-ups of where the drains came out with some red fluid, an incision, etc. If gory details aren’t your thing, please, by all means pass on this one! The last thing we need to do is scare people away - we need all the mojo we can get!
Rest assured, you can’t offend us with your mojo proclivity.
It’s gladly accepted in all forms including smoke signals, wizardry, drunk texts and karma points.
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FREDDIE KREUGER’S HANDIWORK: DECONSTRUCTION
The “Deconstruction Surgeon” is a fabricated title created early in this adventure when we came to realize there would be two surgeons involved at the initial surgery. More than one of a thing and I tend to get confused. Then we learned there could potentially be an additional or several additional surgeries. We now know there will be at least one more surgery, hopefully the final reconstruction in a couple of months. The deconstruction surgeon’s official paying title is a “Surgical Oncologist” which essentially means she has a shit ton of education and specializes in hacking out cancers. I see her “one job” as simply: Help me live. You know, little things.
To begin, an incision was made at my rib cage in a 180 degree semi-circle on each side. Then, the surgeon went to work carefully scooping out the breast tissue and a few lymph nodes for testing. The nerves and blood vessels to the skin were severed in the process. Although the nerves are not expected to regenerate, if all goes well the blood vessels will. As she explains it, the tricky part was scooping out as much breast tissue as she could, especially on the right side. That's the side where the cancer was found, lest it harbor a rogue cell with a wild hair up it’s bum. The surgeon balanced the precise scooping with leaving enough fat on the skin that blood vessels would have a place to regenerate.
These ain’t no augmentation incisions, Toto. Sixteen days post-op.
With all the deconstruction complete, my thin, fragile breast skin was handed over to the “Reconstruction Surgeon”. Her official title is a “Board Certified Plastic Surgeon” and by all accounts she wasn’t given a lot to work with. I can only imagine the stink-eye from across the operating table. Her “one job” as I see is is to take what’s left and make it as pretty as possible.
Placing a final breast implant at this surgery, our “Plan A”, went out the window pretty quickly. Stretching the thin skin over an implant and hoping for the blood vessels to regenerate would be an exercise in futility and a recipe for necrosis. Google “necrosis” with care - barf. Instead, she lifted and reorganized my pectoralis muscle and placed “tissue expanders” where the final implants will go. Think of these as small deflated basketballs that are tacked to my chest wall with sutures at 3, 6 and 9 o’clock. The expanders will be inflated in a series of saline injections to stretch the muscle and skin such that it can accommodate the (modestly sized!!!) implant. This is our new Plan A, formerly Plan B.
For those in the back of the class: This means my PECTORALIS MUSCLE WILL BE IN FRONT OF MY BREASTS! Nutbar. A "Something About Mary" reference comes to mind.
How did you get the frank above the beans? I can definitely already see and feel the difference and am still getting my head around that.
Me: "Doc, how will this impact my swim stroke?"
Doc: Blank look. Blinked twice. Moved on.
Finally, the plastic surgeon stitched me back up and placed a “surgical drain” on each side. These drains went from inside breast area down and out my side at the rib cage. Freddie Kreuger would have been proud! The drains soon became known as my “Medusa tubes” and the loathing commenced almost immediately.
Cranky. That’s how I felt swinging those dang Medusa tubes around the house all day.
Oh and desperate for a shower.
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BEHEADING MEDUSA
Once the drug-induced fog lifted I became keenly aware of the gross-factor and the practical implications of the surgical drains. Seeing and feeling them all day and all night provided no mental respite from being in recovery. The surgeon didn’t want anything even close to tight-fitting on my skin, including the specially designed camisole with pockets to hold the drain bulbs. Getting dressed for the rare “public” appearance for a doctor’s appointment produced a tear-fest of clothing changes and tube wrangling.
Kinda like this but only one per side. And not smiling.
The timeframe estimates for the drains to come out varied wildly and ultimately depended on the output of fluid. It needed to be below a certain level for three consecutive days and luckily there is an app for recording that! I found myself carefully squeezing fluid out of the bulbs over the bathroom sink channeling a low output, fantasizing about being able to shower and longing to wear a simple oversized t-shirt. In the end after all that obsessing and measuring, they came out rather abruptly. A bandage had become askew and a semi-urgent trip to the doctor resulted in a surprise beheading of the Medusa tubes. She didn’t even see it coming - oh happy day! Mark videoed the retrieval and when I finally got the nerve to watch I was seriously impressed with how much tubing came out from under the skin. And seriously glad I didn't watch. Ewe.
Woulda been nice to actually get to wear that camisole that's scrunched around my waist properly.
Just sayin’.
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MAKING LIKE FLAT STANLEY: LAY FLAT. LAY FLAT A LOT
Standing nekkid in front of the reconstructive surgeon at the first post-op appointment I knew right away she didn’t like what she saw. The right breast was much more swollen and red than the left. “How long has it been that red?” she asked with a wrinkled forehead. “Uh, since I first saw them… maybe day two.” I offered. She poked suspiciously at every bit of skin, watching the capillary reflex with skepticism. Her assessment? “It’s struggling.” Gah.
It’s not bedrest, but for now gravity is not my friend. The basic physics of it is my breasts will feel gravity whether I’m standing in the kitchen or sitting in bed. That gravity will cause fluid to pool, increasing swelling, thus pressure and thus less blood vessel regeneration mojo. The right side is probably struggling a lot more because it got scooped out a bit more thinly. The resolution is to lay flat. A lot. I get it, in the big picture I’d much rather forgo training right now then face skin grafts. I'd love to lose more weight off my butt, but not that way!
Making like Flat Stanley looks pretty much as unexciting as it sounds.
Like this ^. Or this ^. Or this ^.
I do feel that the Kona Cervelo T-Shirt plus two cats should count as extra mojo!
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CURRENT STATS: BECAUSE LIFE WITHOUT STATS IS NO FUN!
Days Post Deconstruction: 16
Mojo Level: 3/10 - Already hit what I hope is rock bottom and on the way back up!
Gratitude Level: 10/10 - Where to begin. Clearly there will need to be an entire post on this.
Perspective Mantra: Thankful to be battling to get back in the saddle instead of fighting for my life.
Restrictions: Lay flat a lot. Permission for "gentle stretching" but not to raise the heart rate above elderly couple stroll level. Don’t sweat. Don’t get incisions wet for more than a 5’ shower. Don’t go disco dancing on New Year's Eve. Most importantly, don’t whip ‘em out at Costco.
The permitted "gentle stretching" in cat pajamas while Mark generates mojo.
Good times!
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With much gratitude. - Jenn