Stitches Are Out!

Yesterday, I was back at Dr. Kang’s office to get my stitches out. He started by taking out every other stitch, and then said he’d take out the remaining stitches if everything looked good. Considering it’s healed completely, all the stitches came out. It was not the most pleasant of operations. Not as bad as getting a drain pulled out of you, but I could feel the stitches as he pulled them far enough away from my body that he could snip it off. I will admit to not watching. I can watch this kind of stuff in other people, but if I watch certain procedures on myself, I get a little woozy.

I asked Dr. Kang what was next. He said I have three possible options. Option #1 – I do nothing, and just leave the site as is. I would feel like I wasted all that effort with the expander, but it’s really nice not having an expander in place right now, and I’m not in a hurry to change things. If I decide I want to do something, I’ll have to wait four to six months and then, Option #2 – he’s able to put an implant in place. It’ll probably be smaller than originally planned for, but it would be something. If the skin isn’t stretchy enough, I may have to go with Option #3 if I want reconstruction – the placement of a new expander.

I already know that Option #3 is out. There’s no way I’m doing another expander. The question just becomes, do I want the implant, or do I say screw it and stick with what I have now. I’m not going to make that decision now. In fact, I can wait years if I want to and then finish reconstruction. I’ll wait until the pain and annoyance of the expander has faded significantly, and see what it’s like living lopsided before I make that decision.

I do have pictures. Not everyone will want to see them, so I’ll bury them under a bunch of whitespace. Scroll down if you’re interested in before and after the stitches come out. Close it out here if you’re not interested. You’ve been warned!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

With the stitches still in. There's a lot of dry skin around the whole area, and you can see my drain incision site.

With the stitches still in. There’s a lot of dry skin around the whole area, and you can see my drain incision site.

Stitches out. You can see how the whole thing looks kind of like a crater, and the skin doesn't slide along the incision site.

Stitches out. You can see how the whole thing looks kind of like a crater, and the skin doesn’t slide along the incision site.

Port Is De-Accessed

Alternately titled: I can give hugs without fear again.

My last dose of antibiotics was Wednesday, which meant I didn’t need my port accessed anymore. Yes – I could get that itchy thing off my shoulder. Bonus, no more danglies hanging off my front. I can wear a bra again, which makes it a little easier to be decent out in public. If I wear a bra, I actually look mostly even again. As soon as my drain access point closes up, I can even take a shower. Such things I have to look forward to.

The Visiting Nurse tried to convince me I had to leave the bandage over my port on for 24 hours. No, not so much. I’ll leave it on for a couple of hours, to make sure the incision site closes. I need to be able to itch that location, and another bandage doesn’t help me scratch.

Drain Is Out!!!

I feel so much freer today, now that my drain is out! It wasn’t nearly as uncomfortable as the drain from my mastectomy, partly because it went into my chest instead of into my armpit. Even so, I am thrilled to have it out.

Friday I called Dr. Kang about getting the drain out, because it had drained less than 30cc in 24 hours (the requirement for removing the drain). Even so, he wanted to leave the drain in until early in the week because of the severity of the infection. Being the model patient (would it result in me having to go back to the hospital if I don’t follow directions? Well then, let me follow the directions to the letter), I waited patiently all weekend and called Dr. Kang’s office again Monday morning. They managed to schedule me an appointment in between the visiting nurse coming at 10:30 to give me my antibiotics and draw blood and teaching at 3.

When I got to his office, the nurse apologetically made some comment about not being sure Dr. Kang would take the drain out, since she hadn’t had a chance to clear it with him. Luckily, he was satisfied with the drain output (20-25cc since Thursday) and took it out. Oh my, was it uncomfortable when he took out the drain. First he has to cut the stitch holding it in, and the he has to pull, and I could feel the drain under my skin as he pulled it out. Blech. One big bandaid over the incision site, and I was off and running.

The next big step is getting my port de-accessed, and I will have nothing dangling from my skin, unlike the picture below.

Aren't I just a mess - gauze pad covering my surgery site, drain dangling from a lanyard, and IV tubing from my port.

Aren’t I just a mess – gauze pad covering my surgery site, drain dangling from a lanyard, and IV tubing from my port.

 

Home All Day

It was so lovely to wake up in my own house, eat my own food, and have a delightful cup of tea with breakfast. Everything is not perfect (I still have a drain and numerous stitches), but I’m home so it’s better.

The visiting nurse came by at lunch time to check out my incision and administer my antibiotics. I got a big box via courier yesterday evening, full of everything needed to keep the wee beasties growing in my body dying at a rapid pace.

Seven days of antibiotics

Seven days of antibiotics

The antibiotics get pushed into my IV line over a two minute period. First you have to flush the port with saline, checking for a blood return. Then you push the antibiotics, then you flush with saline again, and finish with a Heparin flush (to prevent clots). The nurse asked if I had anyone in the house who could manage the process. No, I don’t think StatsGuy is up for such activities. Please send a nurse every day to do the antibiotics.

All the other items for flushing the port.

All the other items for flushing the port.

Finally Home

I finally made it home today. I was really banking on coming home last night, but it just didn’t happen. Dr. Colpan wanted to see what the cultures would grow so she could give me a specific antibiotic when I left, and it hadn’t been enough time since the surgery yet. So, I had to stay another night. While I understood intellectually why I needed to stay, I was heartbroken that I had to stay another night. I spent the night alternating between watching mindless TV, doing needlepoint on the family “I’m too sick to do anything else” embroidery, and crying. It was not a good night, which wasn’t helped by the fact that I couldn’t fall asleep.

The family's -itis embroidery.

The family’s -itis embroidery.

I woke up this morning in pretty much the same mood as last night. I’m sure the mood wasn’t helped by the pain in my arm from the Vancomycin. I asked the nurse to take the IV out as soon as my 5am dose was done. Even if I needed another dose, I’d need a new IV site because the one they were using hurt too much. I can’t even straighten out my arm because of the pain around the elbow. That’s a big bummer, since I’m trying to lay off my right arm so I don’t aggravate the drain. Luckily, I was done with the Vancomycin. I got to spend all morning not being attached to a machine.

My cultures finally came back positive – Staphyloccocus aureas, a common skin bacteria, and not the MRSA variety (although Vancomycin is used for MRSA). I got sent home with a prescription for a week of IV antibiotics that the Visiting Nurses will help me with. Turns out, they are equipped to access a port, so I didn’t have to get a PICC line. It does mean I have to leave the needle in that accesses my port for a week. That tape is going to be rough coming off.

My port all accessed and ready for antibiotics

My port all accessed and ready for antibiotics

We settled on a slightly more general antibiotic that can be given as an IV push once a day, as opposed to a more specific to Staph antibiotic that I would need infused three times a day, or oral antibiotics that might not get the job done and would require I go back to the hospital to get accessed for those IV antibiotics. Give me the drugs that decrease the chance I come back to the hospital, thank you very much.

That hospital's version of my antibiotic. In through the port this time.

That hospital’s version of my antibiotic. In through the port this time.

It felt weird to be home. There was a bit of sensory overload after six days in the hospital. Even so, I wouldn’t trade it for anything.

Successful Surgery

Surgery was scheduled for 6pm last night. The Infectious Agents doctor (I finally learned her name – Dr. Colpan) was disappointed the surgery was last night. She would have wanted to stop my antibiotics beforehand in the hopes of getting a good culture and some idea of the bacteria I’ve got growing inside me. Too bad – I wanted the surgery ASAP so I could get out of here sooner.

Before the surgery, I had to take off all my jewelry (they use a tool to cauterise blood vessels that could cause a spark on metal objects) and all my clothes (luckily, no catheter this time, just a breathing tube). I also had to wipe the area being operated on with a cleansing, antimicrobial wipe. Three minutes with one wipe, let it dry, and three minutes with the other. Three minutes is a lot of time to have to wash a small, tender area.

I had to go to the main OR, instead of the Women’s Hospital’s OR. Dr. Kang took what was available. By 6pm, the OR was pretty empty, so I got lots of attention from all the nurses prepping me. Dr. Kang showed up only a few minutes late and had to complete some paperwork and sign my breast. You have to be sure to mark laterality, just in case.

I was pretty woozy after the surgery and a little nauseous, but I never go to the pukey phase like the last time I had anesthesia. They game me a couple more drugs for nausea this time. My throat was quite dry and sore from the breathing tube, so I woke up every hour or so overnight to get a drink and go back to sleep. This morning, I’m feeling pretty good. I haven’t needed any pain meds, which is pretty awesome. The surgery site hurts every once in a while, but nothing too intense. It is weird not to have the expander in anymore. The right side of my chest is completely flat now. It’s covered in gauze, so I haven’t been able to look at it yet.

I do have two gown patterns to add to the collection:

The gown pattern for the Women's hospital. I've worn several of these during my current hospital stay.

The gown pattern for the Women’s hospital. I’ve worn several of these during my current hospital stay.

The gown from the main hospital's operating room

The gown from the main hospital’s operating room

Now I’m just waiting to see Dr. Kang and probably Dr. Colpan again to tell me when I can go home and what drugs I’ll be taking with me.

 

Surgery It Is

Dr. Kang came by this morning (at 7:45 – I was a bit surprised to see him so early!) . The site is still red, and black spot is visible, and it’s started dripping again. Looks like the expander needs to come out in order for the infection to clear. We tried to save the expander, but (unsurprisingly) it just isn’t happening.

I’m kind of excited to get the expander out (especially because it’s hurt since the beginning of the month, and I’m ready for that to stop) except for one thing. Since there’s an infection in the pocket, Dr. Kang won’t be able to put an implant into the site until the infection clears. That means he’ll be taking the expander out and putting nothing in its place. That makes a pocket where fluid can gather so I need a drain. Blech.

Surgery is scheduled for 6pm tonight. Luckily, Dr. Kang let me have breakfast. No food or drink after 9am. My breakfast arrived at 8:30 – plenty of time to finish before the ban started.

This morning's breakfast - French toast today.

This morning’s breakfast – French toast today.

The other good thing is since I’m already hooked up to an IV, I won’t have to worry about them trying to find a shriveled vein when I go into the OR dehydrated. I did have to get a new IV site yesterday since the old one started infiltrating (which means the fluid was being pumped into the tissue instead of the vein). The timing could have been better, since I was on a Vanco drip at the time. If it had just been the maintenance saline, I could have stayed off the IV until close to 9pm. As it was, I had a half hour or so free of my dancing partner. I took advantage of it and did a couple of trips around the hall.

My new IV site

My new IV site

It was very uncomfortable yesterday and I had a hard time finding a position the arm didn’t ache, but this morning it’s much better. Sleeping with it must have readjusted something since I can use the arm without it hurting today.