Tag Archive | mastectomy

Breast surgeon check-up

I met with Dr. Engel’s nurse today, just for a check-up. The incision is healing nicely, but my arm is still sore. It hurts under my armpit, although I can’t tell if it’s because of damage to the nerve that serves that part of my arm, or if it’s just still healing. The other part that is still sore is the muscles in my chest. Everything hurts worst first thing in the morning, but as long as I keep moving it’s not too bad. I can probably stop wearing the Ace bandage, but my other choice is a sports bra. Sadly, I can’t wear one because the straps go over my port. I’m still trying to figure out what to wear instead.

We also discussed future visits. I’ll need to see the surgeon every six months for the next three years, with a mammogram on the still existing breast every year. After three years, assuming nothing changes, it goes down to yearly visits. My favorite – doctor’s visits.

Drains are annoying

Body parts are continuing to heal, although not as fast as I’d like. At this point, I’m not too achy or itchy, but the drains are really annoying. I managed to go outside today to get the mail, for the first time in a while, but I have no desire to go outside of the house anytime soon. The drains just don’t fit comfortably under my shirt, let alone under the coat, and it’s not something I’d want to explain if I went out in public.

The drains are set up to remove the buildup of fluid from under my skin. I have to empty them three times a day and record the amount of fluid in each. Once a drain has been emptied, I have to squeeze it before I recap the drain to provide the suction. It’s not anything I notice or can specifically feel or even see happening, but there’s always fluid in the tubes.

Drain #1 just emptied

Drain #2 just emptied

What I can feel is where the tubes come out of my body. It’s high under my armpit, so the Ace bandage tends to slip and not cover the site well. Also, as things are healing, I’m getting more sensation come back under my arm which means I can feel the extra stuff under my arm more. Don’t worry, I won’t show a picture of the tubes coming out of my skin. That’s definitely the grossest part of the surgery. StatsGuy has to help me put a new piece of gauze under the tubes and he would much prefer to do the task with his eyes closed, if I let him.

The actual incision site from the mastectomy, on the other hand, looks much better than I expected. I am also completely surprised I don’t have a bandage on the site. I just lay a piece of gauze over the incision so it doesn’t rub on the Ace bandage. I have to check the incision site several times a day to watch for infection, but it seems to be healing quite nicely. No more burning pain with deep breaths, at least. I’m just waiting for the drains to come out so I don’t have to worry about a specific arm movement causing problems with the tubes. If you’re interested, I’m putting a picture of the incision at the bottom of the post. Click on it to make it bigger, or just don’t scroll all the way down if you’d rather not see it.

 

 

 

 

 

 

 

 

 

 

My incision site, with leftover Sharpie still defining the inframammary fold

My incision site, with leftover Sharpie still defining the inframammary fold

Surgery day

Dr. Engel performed a modified radical mastectomy, taking some of the lymph nodes under my arm as well. He was able to get all the tissue he needed, and none of the lymph nodes were obviously abnormal. I’ll have the results from the pathologist early next week to see what it looks like under the microscope. Dr. Kang worked next, putting in an expander. Because of the amount of skin Dr. Engel had to remove, Dr. Kang was only able to put 50 ccs of fluid in the expander, while the breast tissue removed was just under 200 ccs.

My collection of bracelets

My collection of bracelets

Before I went into surgery, I got a collection of identifying bracelets. The red allergy bracelet refers to the reaction I had to steri-strips when I had my biopsy. The white bracelet is my personal identification bracelet. It even had a QR code on the front the nurse would scan any time she gave me medicine. The pink bracelet says “Do not use this extremity” since I shouldn’t use my right arm for blood pressure or giving blood ever again. The yellow fall risk bracelet is because I’m getting full anesthesia and the first time I get up afterward surgery, the nurse needs to accompany me to make sure I’m stable on my feet.

My gown pattern - not too bad this time.

My gown pattern – not too bad this time.

I had an IV put in my left hand. The anesthesiologist who was did it remarked on how small my veins were. It probably didn’t help that it had been almost 12 hours since I had anything to drink. Unfortunately, he put it so close to my wrist that any time I bent my hand back, it would hurt. That made it really tricky getting out of my hospital bed since I couldn’t push with either arm comfortably. I also found out my airway is classed as a one out of four – who knew I had such a high quality airway! It’s just one of the many fun facts I’ve learned by talking to the techs, nurses, and anyone else I come into contact while I’m being treated.

When I woke up after surgery, I had an Ace bandage wrapped tightly around my chest, and two drains snaking their way out of the bandage. Every once in a while, a nurse would want to look at the incision, which was always a bit tricky because she would just stretch the bandage a bit more to look under it. The bandage was so tight to my chest, it would hurt a bit to check under it.

My pain levels weren’t too bad. It certainly didn’t hurt much to lay in bed. Getting up was probably the hardest thing I had to do since I couldn’t push my torso upright with either arm. I didn’t realize at first that I had to ask for more pain meds, so I probably let the pain build a bit more than I should have before asking for another dose, but I paid more attention after the first time. I find the pain feels mostly like I pulled a muscle, or a set of muscles. Every once in a while, I’ll get a spike of pain if I move the wrong way and activate muscles across my chest, but it usually isn’t too bad.

The worst thing about being in a hospital is the lack of sleep. A nurse came in every two hours to check my vitals. She skipped the 2am time slot, but my IV drip ran out at 3am, so I got less than three hours of continuous sleep. At least the pain meds kept me sleepy so I had no problem going right back to sleep. Even so, I looked forward to a good night’s sleep in my own house.

Pre-surgery

My mastectomy was Tuesday morning, and there’s lots to say about it, so I’ll put up a couple of posts about it. Long story short, it went well and I don’t hurt too bad today (the next day). If you want all the details (I’ll spare you the gory details, I promise), keep reading.

I met with Dr. Kang the night before the surgery so he could mark up my breast to assist him in reconstruction. By the time he was done, it looked like he’d drawn a target on my breast in black Sharpie.

Sharpie lines on my chest.

Sharpie lines on my chest. You can also see my port on the upper right of my chest. The shadow on the left is just marker smear.

Dr. Kang marked the inframammary fold as well as the extent of breast tissue on the inner and outer margins, and a line right down the middle of my chest.

The night before surgery, I knew I wouldn’t be sleeping all that well so I stayed up late wrapping Christmas presents. I didn’t get quite all of them done, but I put a sizable dent in the pile. The other advantage of staying up was I could eat and drink up until midnight. I had a snack about 11:30 and kept drinking water right up through midnight. I felt a little like a gremlin with the number of times I was reminded not to eat or drink after midnight.

I had to be at the Women’s Hospital by 8am for my surgery. We were a little late, which didn’t really matter since I didn’t head down to pre-op until 11am. I was quite impressed with the size of the room – it is bigger than some hotel rooms the family has stayed in with a fold-out couch, a recliner, and a table and chairs.

The impressive room

The impressive room – there’s a flat-screen TV on the opposite wall

The bathroom even had a shower - not that I could use it.

The bathroom even had a shower – not that I could use it.

Too bad the hospital didn’t exist when I was giving birth to my kids. There was even an awesome view of Presque Isle Bay out the window.

The frozen waterfront

The frozen waterfront

Sadly, it was too cloudy to see a sunset, not that I would necessarily have remembered it after surgery and all the good drugs they gave me. I’ll provide the details of post-surgery in the next post. This one is long enough, and the lack of sleep is catching up with me.

What to bring to the hospital

I’m did a little research on what to expect for my mastectomy, and came upon some suggestions of what I’ll need in the hospital and afterwards. I’ll put the list up now (so I don’t forget), and then let you know whether or not they were useful afterwards.

Things to bring to the hospital, in no particular order:

-lotion and lip balm (everything is always so dry)

-hard candy for my dry throat after surgery

-a small pillow to hold the seat belt away from my chest on the way home. I got one after my initial appointment with the breast cancer facilitator. Now I just have to find it…

-toothbrush and toothpaste (for some reason, I tend to forget these things)

-my iPod so I have some music and podcasts to listen to while I’m sitting in the hospital. Better be sure to update the iPod before I head into the hospital

-a good book, or maybe just my Kindle so I have lots of choices

-elastic waist pants and a front button/zipper shirt since I won’t be able to lift my right arm up for a while. In fact, I’m heading out this weekend to buy a set of warm pajamas that button up the front as well

-my sleeping beanie hat so my head doesn’t get cold. Speaking of my head, check out the hair growth:

Look - you can actually see hair!

Look – you can actually see hair!

It’s not long enough to go out in public without a hat yet, especially in this winter weather, but there’s definite growth happening! (Compare it to the photo taken two weeks ago in this post.) You can even see a shadow of my eyebrows. I still haven’t had to shave, but hair is definitely growing. And yes, I take the pictures in my bathroom because that’s where I can find the most light.

The SCAR project

I was doing some research on what to expect for recovery from a mastectomy, since that is coming up quickly. I’m not sure it was all that helpful. Sure, I have a better idea of what to bring to the hospital, and I do believe I’ll do a bit of shopping so I have warm button-up pajamas that I can manage to put on after the surgery. However, I’m feeling much more anxious about the recovery process after reading some blog posts about how hard it was.

One thing I am not worried about is the actual losing of my breast. I found it much more traumatic to contemplate losing my hair than losing my breast. Even so, I am curious as to what it will look like when I’m done. In doing some blog hopping last night, I found this cool website: The SCAR Project that shows portraits of women after a mastectomy. It’s probably NSFW as they are images of topless women, although the number of breasts on each woman varies from zero to two. I am surprised how much the loss of breasts makes a woman look like a boy. It’s a struggle to flip the image into “female” for me. Still, it is a great set of photos.

Just one of the pictures featured within the SCAR project.

Just one of the pictures featured within the SCAR project.

Anaesthesiology meeting

I had my pre-surgery screening with the anesthesiology nurses today. This is a new process for the hospital to improve the flow of the surgical team, which is why I’ve never had to do it before. My most recent surgery was at an out-patient surgical center, and the last surgery I had at the hospital was from over ten years ago.

I mostly answered a bunch of questions about my health so the anesthesiologist could minimize my chances of dying during the surgery. You start out by filling out a 28 question form about your health. I’m not exactly sure why I bothered, because I then proceeded to the nurses office where she asked me about all the health problems I had just answered, plus about eighty others. She covered every possible health problem – skin, eyes, ears, kidneys, liver, heart (several times asked about heart problems, had I had an EKG, an EEG, or a chest X-ray? No, no, and turns out yes after my port surgery), and so on. Even seemingly random things like did you get a flu shot or a pneumonia shot? Have you ever had chicken pox, measles, or mumps? I really wanted to ask why they needed to know about all those details, but I figured the appointment would be twice as long if I started questioning their reasons, considering the number of questions they had.

Turns out I’m going to have a different level of anesthesia than I have in my two other surgeries. I found this out when the nurse mentioned I’d be on a ventilator while I was anesthetized, so my throat might be a little scratchy or sore after the surgery. I didn’t remember any such warning in the past, so I questioned why. Turns out, in surgery below the diaphragm, like the D&C I had after a miscarriage (my first pregnancy before Mr. Curiosity), you can get deeply anesthetized but still maintain your own airways. In light surgery, like for my port, they do “twilight anesthesia” where you’re only slightly out and, again, you maintain your own airways. The mastectomy is above the diaphragm and more in-depth, so I’ll be deeper under and need the ventilator.

The day before, the nurse will call and let me know what time exactly the surgery will be. There’s the usual rule of no eating or drinking after midnight, so I really hope the surgery won’t be too late in the day. I get cranky when I get hungry. I also need to call the plastic surgeon. I decided to go with reconstruction with an implant, so I’ll need an appointment the day before surgery so he can do his measurements.