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Sunday, March 27, 2011

Update to previous Addendum...

I'm doing better.  Still pretty blah, but overall better.  As far as the procedure goes, I have no more discomfort to speak of.  There's a tightness, almost like the feeling of a bra, but all in all, rarely do I have any real discomfort any more.

Psychologically, I'm doing better.  I realized when it was refill time, that I had more Lexapro left than I should, so I guess I kind of forgot to take some after surgery, and therefore crashed pretty hard in that second week. 

However, I'm also noticing some disturbing symptoms in my left arm, my radiated side.  It's a little swollen, but there's also a tingling and feeling of discomfort.  I've slacked off on wearing my compression sleeves since the surgery, and I'll start being more diligent about that this week, but I have noticed it in the past when I'm wearing my sleeve, too.  The swelling I can trace directly to smashing the back of my hand on the edge of a piece of furniture while playing Dance Central.  As the bruise has faded, the puffiness has gone down.

However, as much fun as I've had choosing sleeves, and as much as I didn't mind wearing them last year, I really don't like it now.  At this point, my hair has grown back.  If you didn't know me, you'd never know that I'm a "survivor."  And the sleeve is like a neon sign that says, "Hey, something's not quite right with this chick."   Not only does my body not feel like my body, not only does my mental state not feel like me, not only do people who know me look at me differently, but dagnabbit, strangers do too.  And it is a neon sign, like being obviously pregnant, that encourages people to just get into my business, like the elderly gentleman who approached me at the community center one day or the woman who hounds me there and thinks she's my best buddy because she, too, had cancer.  My sleeve was what prompted her to come up and talk to me, and now I can't get rid of her.

It's only recently that these things have bothered me.  I don't know why they do.  And I don't hold it against these people.  This is clearly MY issue, not their issue.  I just want to blend.  I want to be the wallflower I enjoy being.

I didn't get to see Dr. Mo for my appointment.  She had to reschedule.  I see her this coming week.  Then I imagine the rounds of medical tests will start.  Since I've met my co-insurance and deductibles for the year, I guess we might as well throw a few extras in there for good measure.  After all, they'll be free.

Thanks for everyone's concern.  I think getting back to work, having a reason to get out of the house, having some purpose for every day has been really good for me.  Who would have thought that teaching would keep me sane?  Generally, I feel it's the other way around....

Saturday, March 12, 2011

Addendum to previous post about being concerned...

I fully imagine and assume that the depression part is made worse by the fact that I'm not exercising right now plus the anesthesia and all of it is compounded by my 6 month check up coming up, which is more stressful than I'd thought.  It will involve a month or two of other things like echo-cardiograms and MUGA scans, which for some reason I assume will show heart damage from treatment (herceptin, Adriamycin, radiation), lung damage (radiation), pancreatic damage, nerve damage, and for sure cognitive damages.  Why do I assume this?  I have no idea.  Until last week, I was feeling fine.  I have no reason to assume the worst.  I just do.  It's not normally the way I function.  Normally, I am a head-in-the-sand-ostrich even in the face of obvious evidence.

To top it all, I have three friends recently diagnosed with rare, frightening, aggressive cancers; one diagnosed with a run of the mill cancer and the first treatment about killed him; one actively dying or maybe dead by this time today; and one friend who died right before Christmas.  Four of these friends have children under 10.

Concerned and not sure what to do

It's now been a week and two days since I had surgery.  For the most part, the slicing and stitching part is all fine and good, as long as I don't do something silly like try to scratch my back or lift or reach and lift (that last part is the worst).

I've gotten the all clear to wait four weeks before doing much of anything physically, and then back to life as I want it.




Something is not right.  I'm chalking it up to anesthesia.  I'm becoming quite concerned.

My affect is pretty flat.  I'm depressed.  I'm moody and weepy.  I'm excessively tired.  I feel purposeless and really can only muster up the most basic of reasons why it's better to be alive...mostly, it would be bad for my kids if I weren't. 

Worse, though, is the brain fuzziness.  I can barely read.  I can decode words, but I can't remember or follow a train of thought.  I can't remember anything.  Seriously.  A friend sent me an email this morning about something I've known I have to do.  I responded that I'd get to it ASAP. I immediately put it out of my mind.  And until I got another email from her, it was as if the original email had never existed.

It's like I'm at that point of alcohol consumption where everything is hard to do, but not yet over the edge where--rightly or wrongly--everything is Crystal clear.  Holding my head up takes effort.  Lying with eyes closed seems like the thing to do.  It's like those days when you are abruptly awakened shortly after falling to sleep and you are totally befuddled.  Seriously, I can sit and stare off into space and not know I'm doing it.

The logistics of every day life are overwhelming. 

I have trouble putting together cogent thought and over-react on a very emotional level.  My processing is so slow that it's negligible.  I feel the wheels turning, as if they are coated in rust and the gears are not quite fitting correctly.

I have an appointment with Dr. Mo next week (I'm not even sure I should be driving at this point).  But I'm really quite frightened.  I can not function this way.

Sunday, March 6, 2011

In Search of Justice for Henry (and the others like him)

Last Spring, my friend, Katie Granju, lost her son, Henry, to a drug over-dose.  He was addicted to prescription opiates.  Abuse of these drugs is very common now.  In fact, in having conversations among my children and their friends as well as with my college freshmen, I've come to the conclusion that it's also very common here in NW Ohio.  It's common at the public schools, the private schools, the parochial's everywhere.

Now, Katie is attempting to find justice for Henry.  I encourage you all to read his story as she's reporting it in her blog.  I encourage you to talk to your children.  I especially encourage you to not assume that your kids' school is immune from this problem.  It's an addiction of the middle class and upper middle class children. 

Friday, March 4, 2011

Bionic Boobs

Yesterday I had a third surgery on my boobs.  A year ago December, I had a double mastectomy, which was clearly the most traumatic physically and emotionally.  At that time, my plastic surgeon, Dr. W, started phase one of my reconstruction, which involved placing tissue expanders behind my chest muscles.  Over a period of weeks, those were injected with saline solution and expanded to keep the skin that remained after my mastectomy from contracting, making reconstruction more difficult later.

I loved my expanders.  Most people hate them.  I loved them.

In considering reconstruction, I kicked around the idea of autonomous replacement (tram flap surgery) where the surgeon uses abdominal fat and muscle and a tunnel to recreate a breast or two.  However, it's a highly invasive procedure that involves several days in the hospital, many hours under general anesthesia (and I have issues with that), and there's still no guarantee that the flap will take (I know one person whose flap died).  Other women with flap reconstructions have abdominal issues.  There's one in my exercise class who can't do many abdominal exercises because of her missing abdominal muscles.  To make a long story short, I opted to NOT do flap surgery.  Maybe some day, when my kids are older, when the procedure has been perfected more, when it doesn't involve removing abdominal muscle.  But for now, I'm happy with my decision to have the relatively simply reconstruction of saline implants.

You know, super model boobs.  Only, mine aren't super model size.

Women get breast implants all the time.  It's a pretty basic, easily accomplished procedure.  However, when done strictly for cosmetic reasons, there is still surrounding breast tissue and the implants supplement what is already there.  With reconstruction after mastectomy, there is no breast tissue and the implants are placed under the chest wall.  Placing them there serves two purposes.  Most importantly, in placing the implant under the chest wall, it's easier to detect any new tumors in the breast area...there is always some small amount of tissue left.  Of secondary importance is that since there isn't breast fat and tissue left, if implants were placed on top of the chest muscle, it would look like balloons under skin.

So, I have my two moderately sized implants under my pectoral muscle, and I can flex them like a body builder. 

One advantage for me in having had a mastectomy before my implants were planted is that I have very few nerve endings in my chest area.  So, there was very little discomfort.  The biggest discomfort was in restricting my movement.  If I took my pain meds on schedule, I had very little discomfort.

And then one day I noticed that my right breast was significantly lower then my left breast.  I'd read about implants slipping.  I'd feared it.  I was certain that is what had happened.  However, after revisiting Dr. W, she determined that my right side had done what it should have done, settled into a more natural position.  The left side, however, was brutalized by 6 weeks of radiation last spring.  Radiation is nasty stuff.  It changes the skin and muscle.  What that means for me is that I've lost some flexibility on that side.  My skin and muscles, especially the muscles, are tighter.  That's also the side I had lymph nodes removed, which damaged other muscles.  Therefore, the right side implant didn't settle.  There are other negative and permanent side effects of radiation therapy, most notably heart and lung damage, but no one can really see that.

So, while most women, especially after having babies (which I did 5 times) have asymmetrical breasts, because of a lack of breast tissue and being placed under my  muscle, my asymmetrical breasts looked really odd.  They looked like a very unskillful job of bra stuffing. 

To fix it, not much can be done to the left side.  Radiation has done its damage.  So Dr. W suggested raising the right breast.  This, however, involved stitching the implant to my rib, or rather the living tissue, the periosteum, that surrounds the rib.  And that is what she did to me yesterday.  She also removed some extra skin on both breasts.

I still don't have many nerve endings, and I'm rather glad I don't, because this is painful.  I don't remember why I felt like I'd been kicked in the sternum after my mastectomy, but I did.  This evening, I feel like a donkey kicked me in the rib.  Even with a maximum dosage of Percocet, whenever I move my right arm in a reaching motion, I feel a stabbing yet bruising sensation in my rib. 

But my boobs are even. 

Now to decide what to do.  Percs make me itch.  Not taking them makes me hurt.  I can take them with benedryl to cut down on the itching, and that combo knocks me out.  But I don't like the way that makes me feel.

In my next life, I won't have any reconstruction done.  It's not worth it, I don't think.