Tag Archive | Dr. Kang

Lots of Checkups

The doctors keep checking up on me, just to make sure everything’s going fine. I know it’s going fine, but they need to check and see. I had a final checkup with Dr. Kang last week. I won’t need to see him for six more months and then we’ll have the discussion about whether we can put in the implant. Until then, I’ll just get by with a formed bra. One of these days I’ll head over to the Pennsylvania Artificial Limb and Brace Company to get my self a real prosthetic.

This week, I had some internal check-ups. A MuGA and a mammogram. I had a different technician for my mammogram, and she had a hard time getting the right position for the side-ways mammogram. She kept getting my shoulder pinched in the machine. Even less comfortable than just getting my breast squished. No results from either test, which I’m sure means they’ll be fine.

Next week, no doctor’s appointments. Hooray! I’ll have time to do some work around the house.

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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.

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.

 

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.

I’ve Entered the Despair Phase

When I first was admitted to the hospital, I was furious that I would have to spend days in the hospital. Who wants to spend days in the hospital? Stupid expander. Stupid infection. Can’t it all just be over. Now I’m at the point where I’m feel I’m never going to get out of the hospital. I’m not bored – just tired of being hooked up to an IV tree and stuck inside.

The lovely view out my window

The lovely view out my window

Today’s doctor’s visits didn’t go as well as yesterday’s visits. The Infectious Agents (IA) doctor wants the expander out (which is what Dr. Kang said they would say). Dr. Kang wasn’t quite as positive for today’s visit. While the redness seems to have declined (although the IA disagreed with that assessment), there’s a black spot within the oozy spot. Most likely, that blackness is the expander showing through. If we can see the expander, the sore will not heal over it and we’ll just need to take the expander out. It could be OK, but the spot will need to be gone tomorrow morning. Otherwise, it’s time to plan surgery.

Surgery will entail taking out the expander, cleaning out the area, and letting it heal with nothing in the space. I would actually be happy if we got the expander out. The big negative would be since we wouldn’t put anything in that space, I would need a drain. I HATE drains with a burning passion. Drains ruin my life. Once everything heals, Dr. Kang would go back and put in the implant. I’m torn – getting the expander out is a major bonus, but having a drain is one of the worst things.

Best case scenario, I could have surgery tomorrow night and be home within 24 hours. It depends on the availability of the OR. Tomorrow morning I’ll know more. It’s all so up in the air and dependent on how things are looking. We’ll see how it looks in the morning.

Improvements

It seems that the antibiotics are working. I saw Dr. Kang yesterday and he thought the redness had decreased since the day before. When I woke up this morning, I thought it had improved even more. The oozy spot seems to be smaller as well, and not as oozy. (I’ll save you the pictures.) Dr. Kang said if the infection continues to respond to the IV antibiotics, they’ll put me on oral antibiotics on Monday. If those work, I could leave on Tuesday, and still have the exchange surgery on the 10th. Good news to my ears. If the antibiotics aren’t working well enough, the expander needs to come out while I’m in the hospital, and the implant will be put in at a later date.

I saw the Infectious Diseases doctor yesterday as well. She wasn’t very helpful. She talked a lot, but I realized when she left, she didn’t say much of anything. The one bit of information she passed on what that it didn’t seem likely the blood cultures would come back positive for anything. I wasn’t showing any signs of infection (like a fever) beyond the localized site. (My nurse this morning said the 24 hour preliminary blood cultures came back negative.) Since they wouldn’t have any detailed information, they’d just keep me on the Vancomycin.

I slept better last night, once I was able to go to sleep. I’m sure it helped I didn’t have the nasty squeeze-your-leg wraps on. They’re used to make sure you don’t get blood clots because you’re not up and around. Thing is, I’m up and around, so I don’t need my legs squeezed regularly. The only thing worse than the squeeze-your-leg wraps is the fact the nurses need to monitor my kidney function. So, every time I pee, I’m supposed to pee into a “hat” in my toilet and then call the nurse to empty it.

The hat in my toilet

The hat in my toilet – so lovely

I did have a lovely breakfast this morning.

Breakfast - I've learned to order lots of things so I get a full meal.

Breakfast – I’ve learned to order lots of things so I get a full meal.

I’ve got leftover Thai for lunch, and Firefly on TV for the day. Should keep me occupied for a while as I wait for my antibiotics every eight hours, and another visit from Dr. Kang.