The reconstruction saga continues: Part 1

When is enough, enough? I kept asking myself that same question everyday. Breast reconstruction is never a perfect process and I’ve spoken openly about my surgeries in the past (here and here) because I know I’m not alone. I had high hopes going into my last surgery but found myself feeling deflated the moment I removed the bandages and saw the indents and extra skin that still remained. A feeling that I know many can relate to. My surgeon told me to wait a few months for the implants to settle into place, but we both knew I would need another surgery to get my breasts to where I could feel like myself again.

My affected right breast had surprisingly caused me little to no complications throughout the reconstruction process. It was the perfect size and shape and only had a minor dip where the lat flap and breast tissue didn’t sit flush. But it was my left non-affected side that caused the most pain – both physically and emotionally. Every time I looked in the mirror, I saw the loose skin hanging from the bottom of my breast and the indents and valleys. Trying on bras felt like a demoralizing process. My left breast wouldn’t fit into bras that fit on the right and I would leave the store empty handed and deflated. I wanted nothing more than to fast forward a few months to get this next surgery done hoping this time would be the last.

I kept myself busy over the next few months exercising to strengthen my body again and travelling to both NYC for the AnaOno x Cancerland fashion show and Orlando for the annual YSC Summit (blog post to come later). It felt great to leave my worries behind and connect with other women who knew exactly what I was going through. But once I returned home and the reality set in that my surgery was coming up in just 5 days, a feeling of dread began to pit its way into my stomach. The thought of being put under again and, even more disconcerting, the thought of waking up and being unhappy with the results again. I wanted nothing more than for this to be all over. 

As the day before surgery approached, I found myself going through the all too familiar motions: food prep, laundry, cleaning the house and packing my bag before I was holed up for another few weeks. The same feeling of sandpaper across my skin as I scrubbed every inch of my body the night and morning before surgery. The same green and blue hospital gowns and sterile smells. The flashbacks from every time I sat in this same room with my husband awaiting yet another surgery. From the lumpectomy after I was first diagnosed to the mastectomy I underwent after finding out my margins weren’t clear to the implant exchange to get rid of the rock hard expanders in my chest. We were both done.

When my name was called to go back into the surgical area, I found myself speaking first with the anesthesiologist to address any concerns with being put under. The one thing about going in for multiple surgeries is you get to know your body really well: how it responds to anesthetic, how it wakes up, what makes it angry. In past surgeries, I woke up in a state of panic, feeling restricted by the bandages and finding myself calling desperately to the nurse for an Ativan. Full disclosure here…I also suffer from mild claustrophobia so the thought of being restricted amplifies the panic attacks tenfold during times like these. I also get nauseous when I wake up so the anesthesiologist reassured me she would administer both some anti anxiety and anti nausea medication intravenously to avoid that happening.

My plastic surgeon then came in to discuss the procedure and began his extensive drawing on me once again. I would be undergoing fat grafting, a procedure that involves taking fat from one area of the body and grafting it onto another. Although I had a petite frame, he found the best option was to remove fat from my stomach which would then be used to fill in the gaps around my breasts. The loose skin around my left breast would also be removed, requiring a 3-inch incision along the lat flap scars on the underside and sternum side of my breast. As I got wheeled into the operating room and the IV started in my vein, I looked around and thought to myself I hope I never have to see this room again. 

As the anesthetic wore off and my senses slowly awakened, I began to feel the pain and discomfort in my breasts where the surgeon had made his incisions. I couldn’t feel any pain in my stomach though and panicked for a second wondering if my plastic surgeon had in fact done the fat grafting. But the lack of feeling and numbness in that area quickly reassured me and I drifted off into sleep again. 

After a couple of hours in recovery, I was finally feeling well enough to go home. My husband Josh came in with my chariot (wheelchair) but first helped me get changed out of my hospital attire and into my regular clothes. I had packed items that were easy to get on including this oversized Amoena Valetta camisole top with built in shelf bra which fit perfectly over my bandages as well as a pair of loose fitting yoga pants and flip flops. Once back at the car, I wrapped a blanket gently across my lap to protect my stomach from the seatbelt chaffing and a ParkPuff to cushion against my chest.

I had been sent home with antibiotics and medication to help take the edge off from the pain but I could feel it start to creep up again as it wore off. My left breast ached where the plastic surgeon had made his incision and the hot flashes were starting to flare up in my body again like clockwork. All I wanted to do was to nestle myself in bed but sleeping can be a bit tricky too. I always find myself worried about squishing my breasts and having the incisions open up. So, out came the pillow fort again, two pillows behind my back and one on either side of me to hold my arms up and provide a cushion against my breasts. 

As I woke the next day, the pain in my breast felt like it had subsided but the nerves around where the fat was taken had clearly woken up. My stomach was extended and swollen and I felt pain and tenderness with every movement. The last thing I wanted to do was go in for my Zoladex injection but it had already been put off because of surgery so that the micro tablet didn’t get in the way of the fat grafting. I wondered though how I was going to handle a subcutaneous injection in my stomach when it hurt to even put on pants! But if I could make it through everything I’d been through thus far, then surely, I could get through this too. My gp oncologist froze the area with a topical spray and quickly gave me the injection so I could get back home and rest. 

And rest I did. I watched more Netflix than I thought possible and stayed in bed for over 12 hours, waking only long enough to take my pills and crawl back under the covers again. Two days had passed since surgery and I knew that once I finally found the energy to get out of bed, it was time to face my fears and take off the bandages. I could feel myself holding my breath as I unraveled the bandages, the fear of disappointment and heartache setting in once again. But as the last of the bandages came off, I found myself letting out a huge sigh of relief. While my breasts were not perfect by any means, the extra skin was gone this time and the indents had been filled out. I finally said to myself what I had been waiting for for almost 2 years. I am done.

I’m now one week post op and continue to live in my yoga pants (while the swelling keeps going down in my abdomen) and my super cozy AnaOno compression bra (which I have to wear until I see my plastic surgeon in two weeks). My stomach still feels tender to touch and the bruising is starting to come out leaving me with a painted yellow hue but the pain meds have become less frequent. And I finally got out walking again which is a huge plus. But what has been most rewarding is finally coming to a place where I feel comfortable in my own skin again and accepting that I am perfectly imperfect.

What to Pack for Day Surgery

Getting all packed up and ready to go for my fourth surgery first thing tomorrow morning. I’ll be undergoing breast revisions including fat grafting and removing excess skin with the hopes that this will be my last surgery. Although I am supposed to be in and out of the hospital within the same day, there are a few things I like to pack with me to not only keep me occupied but just in case my stay ends up being a bit longer than anticipated too. Here’s a list of items that I will be bringing with me for day surgery tomorrow:

1. Book/Magazine/Journal

As many of you know, there can be a lot of time spent waiting before going in for surgery. I always bring a book to help pass the time and to also distract myself a bit from the nerves and butterflies fluttering in my stomach as I wait for my name to be called. Lately, I’ve been reading The Subtle Art of Not Giving a F*ck which is a hilarious and thought provoking take on the things we value most in life and what it is that’s worth pursuing.

2. Cellphone, headphones & portable phone charger

Just as a book or magazine can be a good distraction, having your cellphone to listen to some music or just scroll through Facebook or Instagram can be a good way to get your mind off things as you wait. Remember to bring your portable charger though just in case you spend a little more time than anticipated waiting to get called in.

3. Medications

Even though I’m scheduled for day surgery and should be in and out of the hospital within the same day, I like to pack any medication I’m on on just in case things don’t go as planned. I normally take my Exemestane in the morning but will need to take it later in the day since I’ll be off food and water for a few hours pre-surgery.

4. Travel wipes and moisturizing products

Surgical iodine is often used to prep the skin before surgery to eliminate any bacteria but it stains your skin leaving you with a pinky/reddish residue. I pack these all natural Caboo bamboo travel wipes with me everywhere I go which work great to clean the iodine off. Eye drops and lip balm are also a staple in my day bag too so I can moisturize my eyes and lips post surgery and feel refreshed.

5. Mini fan

There’s something about surgeries that gets the hot flashes raging and feeling like a volcano is erupting inside my body. My best friend brought me a mini fan after my mastectomy and latissimus dorsi flap reconstruction surgery in June and it was the best thing ever to cool me off post surgery. They are cheap too and can usually be found at your local dollar store or any one of the big box stores.

6. Comfortable clothing

Getting into clothes after surgery can be extremely difficult between the pain and limited range of motion. I always opt for a top that either buttons or zips up or one that I can easily slide on. This Valletta tank top by Amoena is both soft and stretchy and has a built-in bra liner to give a little added support. For bottoms, I choose something that is loose fitting and easy to pull on like yoga or pajama pants. Slip on shoes are also recommended or a pair of hard soled slippers.

7. AnaOno compression bra:

AnaOno pocketed front closure bra

I’ve heard so much about the AnaOno bras and was excited to finally purchase this one through Gorgeous You, a company in Canada that carries mastectomy bras, swimwear and lingerie. This bra clips in the front and has 4 different settings allowing you to tighten or loosen it up to whatever feels most comfortable post surgery.

8. ParkPuff seatbelt pillow

SurvivorModa ParkPuff in Betty Bouquet

A few months ago, I won this amazing ParkPuff from SurvivorModa during the Cancer Grad breast cancer awareness month giveaway and I’ve been using it ever since. It folds and closes over the seatbelt strap in your car and provides cushioning on either side of your chest so you don’t have to worry about the seatbelt pressing into your chest and causing any discomfort post surgery.

9. Snacks!

If you’re like me, you will be absolutely starving post surgery! I’m an all time snacker and lover of food so having to refrain from eating anything after midnight is a challenge. I like to bring a simple and easy snack such as an apple, one of my homemade carrot muffins (recipe coming soon) or a granola bar (I love these honey oat ones from Kind) to get a little something in my belly post surgery and ward off the hunger pangs until I get back home.

Is there anything missing from this list that you would recommend packing for day surgery? I’d love to hear your suggestions below!

Hormone Therapy

Chemo, radiation, surgery. Our bodies feel like they've been put through enough. But for the large number of women with hormone receptor positive breast cancer, it is often recommended to take hormone therapy for 5 to 10 years which comes with its own set of challenges, most notably early menopause. Now that I’ve been on hormone therapy for almost one year, I wanted to share an open and honest blog post about my experiences going through it and the side effects that I continue to navigate my way through. 

So, what is hormone therapy?

Hormone therapy involves taking medication to reduce the amount of estrogen in the body and block its action by starving the cancer cells of its source. The pros? Reducing the risk of recurrence in early stage breast cancer up to a third. The cons? Being put into menopause much sooner than anticipated and dealing with the long list of side effects that go along with it.

Hormone therapy options

As I neared the end of my treatments one year ago, my oncologist set up an appointment with me to discuss the next steps in my long-term maintenance plan. I would be put on hormone therapy for 5 or 10 years and was given a list of hormone therapy options:

· Tamoxifen for 5 or 10 years

· Tamoxifen with ovarian suppressor (OS) for 5 or 10 years

· Aromatase inhibitor (AI) with ovarian suppressor (OS) for 5 or 10 years

He recommended that I look at the SOFT and TEXT trials to make an informed decision on what worked best for me. The trials found that the combination of taking an AI with an ovarian suppressor had significant benefits for high risk pre-menopausal women over taking Tamoxifen with an ovarian suppressor.

Based on the studies, I decided to go with the option of taking an AI and ovarian suppressor which my oncologist felt would be the most beneficial in my case as well. AIs are typically only used in post menopausal women but can be given to premenopausal women if combined with an ovarian suppressor. So, I was given my first Zoladex injection one month prior to starting on an AI called Exemestane to shut down my ovaries and put me into a chemically induced menopause for the next 5+ years.

***Update: According to new long term results (see link), the data now shows that the benefits aren’t nearly as great as once thought. While the AI + ovarian suppressor combo has a better DFS (disease free recurrence rate), the new results show it has the same OS (overall survival rate) as taking Tamoxifen with an ovarian suppressor.

What to Expect

The Zoladex injection is administered subcutaneously every 28 days and comes as a preloaded syringe containing a slow release tablet of goserelin acetate. My GP Oncologist administers the injection every 4 weeks and uses a topical anesthetic spray called Pain Ease to numb the injection site. The downside is it only freezes the top layer of skin so I still feel a poke from the needle once it’s inserted (it's a doozy at 16 gauge). Thankfully my doctor is quick with the draw and she’s done before I even have a chance to think about it. I’ve also been hearing a lot about Emla cream, an over the counter topical numbing cream, which can be found in some local drugstores and is definitely worth checking out.

Side Effects

The side effects from hormone therapy can only be described as a rollercoaster ride for me. Some days it feels like I’m coasting free while others I am struggling to get through. I’ve listed some of the side effects I’ve been experiencing since starting hormone therapy but please keep in mind these differ for everyone:

Hot flashes

I’m normally one of those people who are cold 24/7 and cozied up on the couch wrapped in a blanket. Once the hot flashes arise though, it feels like my body goes from 0 to 100 degrees in about 2 seconds flat leaving me red faced and agitated. I’ve learned the art of layering and having a fan on me at all times especially at night. The hot flashes seem to flare up most often when I get stressed out or anxious which leads me to the next side effect.

Anxiety and panic attacks

I never knew what anxiety or panic attacks were until recently. The feeling of agitation in my body where I don’t know what to do with my hands or feet. Or the shortness of breath and overwhelming thoughts. It pops up when I least expect it: driving to the store, having dinner with my family, or as I lie in bed at night. I’m trying to incorporate more relaxation techniques like yoga and breathing exercises to quiet the noise but it is a work in progress.

Inability to focus/concentrate

Even as I sit here and try to think of the words to say, it doesn’t flow as easily as it once did. My brain feels foggy and I get incredibly frustrated with myself at times. I wonder if people think I am listening when I ask them the same thing over but it is more frustrating for me than them because I wish I could retain and recollect the information.

 

Insomnia

Full disclosure here. I’ve always had some difficulty with sleeping but never to this extent for this long. I can’t count the amount of times I’ve watched the sun rise, blogged until the wee hours of the morning, and crawled into bed at 6am after finally pushing my body to the point of exhaustion. I’ve tried melatonin, magnesium, meditation, good sleep hygiene, you name it. I hate to take sleeping pills but getting a restful night of sleep is much better to me than not sleeping at all. But there is nothing more I crave than a pure restful night of sleep not induced by medication.

Bone and joint pain

As I lie down in bed at night, I can feel the deep ache in my upper legs. It feels similar to the achiness from the Paclitaxel I was on during chemo and then sits subtly through the day until night falls again. When I wake in the morning, my hands and fingers feel like they need to be carefully stretched so as not to break. Sometimes I wonder if I sound like an old 80 year old woman complaining about her aches and pains. Just get me a bottle of WD40 to lubricate my joints! Some of the things I’ve found helpful though are soaking in Epsom salts to relax the joints and walking and yoga to keep things moving.

Arthritis and osteoporosis

Prior to starting Exemestane, my oncologist ordered a bone density scan to check how healthy my bones were and to see if I was at risk for osteoporosis. While AIs are less likely to cause blood clots than Tamoxifen, they have a much higher rate of bone loss and fractures. Seven months after starting Exemestane, I noticed my right thumb joint was extremely sore and painful and I could barely manage to lift the water jug from the fridge. The first thought that went through my head was cancer but an x-ray confirmed that I had developed arthritis in my thumb (and possibly the rest of my hand), likely from the medication I was on. Right now I am taking calcium and vitamin D to maintain my bone health, but my oncologist has also recently recommended starting on a bisphosphonate in the near future called Zoledronic acid to strengthen my bones. I’m still on the fence about it though as it has its own set of side effects that are not to be taken lightly.

There are times when I wonder, is this all worth it? Do I continue through these next 5 or 10 years experiencing this myriad of side effects? But it is also feels like I am blanketed with this security and hope that the medication will reduce my risk of recurrence. How do you all deal with the side effects of hormone therapy?

365 new days, 365 new possibilities

365 new days. 365 new possibilities. As this year comes to an end, I reflect back on the struggles I've overcome, the friendships I've made, and the memories that will last a lifetime. Here’s a recap of some of my biggest moments from 2017 and what I'm looking forward to in the new year:

Finding support in the breast cancer community

I started off 2017 no longer blanketed in active treatment and was suddenly left to flounder my way through life after cancer. Feelings of fear and uncertainty quickly creeped up leaving me in one of the darkest places I had been since being diagnosed. Through social media, I found out about an event called the YSC (Young Survival Coalition) Summit for young breast cancer survivors and was hesitant to go at first because I didn’t know anyone there but I jumped in with both feet and am so glad I did. I made connections with survivors from around the world and finally found other women who really got it! Fast forward a few months later to attending Boobyball in Vancouver, a fundraising event to raise money for Rethink Breast Cancer. I went with a fellow survivor who flew down to meet me for the occasion and we made a weekend out of it getting glammed up in our best 80s aerobics attire, hiking the trails in Tofino and bonding over our love of travel, food, and fur babies!

Living life to the fullest

There was always a reason for me not to make plans: I had my monthly Zoladex injections, bloodwork, scans, appointments with my doctors and upcoming surgeries. It was hard to plan for the future when I didn’t know what would be happening from one month to the next. I was tired of putting my life on hold after spending half of 2016 going through chemo and radiation treatments. So I began to take control, make a plan to live life to the fullest, and not have it revolve around my appointments 24/7. I made time for myself and was fortunate enough to spend 3 weeks travelling throughout the islands of Hawaii as well as trips to Vegas, Seattle, San Francisco, Toronto, and exploring my home territory on Vancouver Island. Instead of saying I can’t, I began saying I CAN and accomplished things I would have never imagined like participating in the 5km CIBC Run for the Cure.

NED!!!

Yes, I finally got to hear those 3 beautiful words…NO EVIDENCE (of) DISEASE! I had a lumpectomy in 2016 but it wasn’t until halfway through my treatments that I found out the margins weren’t clear after getting a second opinion from another pathologist. Almost a year to the day from my first surgery, I went in for a prophylactic bilateral mastectomy with immediate latissimus dorsi flap reconstruction to ensure any remaining cancer cells were gone. When I got that call two weeks later from my surgeon with those words we all want to here, I finally found that breath of relief…I was NED!

From crazy chemo curls to pixie cuts

When my hair started growing back after treatment, the last thing I wanted to do was cut it. I didn’t want to risk cutting off any of that precious chemo hair growth but I was starting to grow a mullet which needed to be tamed. It was definitely all business in the front and a crazy chemo curl party in the back. I went in to see my hairdresser 9 months post chemo and played it safe at first with a quick trim but as the next month went by and my hair started to grow more, I realized how much I missed my short pixie hair. It was cute, easy to style, and a perfect cut for my fine hair. So, almost a year post chemo I went in and chopped the rest of my chemo curls off. It felt amazing to be in the driver’s seat this time and be cutting it off with a purpose and not because cancer was taking it away from me. 

So, what’s next for 2018?

Gratitude

I’m starting my new year with a gratitude jar, an awesome idea created by Josie Robinson. She has a simple guide to follow that’s called give THANKS: Think about what you’re grateful for. Have an open mind. Allow yourself to feel gratitude. Note your gratitude. Keep it in a jar or other special place. Share it with someone else. You can put a note in the jar every day, week or month and could be anything from clear scans, going on a trip away, or even just a message from a family member or friend. It’s important for us to focus on what we are grateful for and look at the positive aspects of life rather than just the negative. At the end of the year, it will be fun to go back and look to see what has happened throughout the year and remind myself of what I am grateful for.

No More Surgeries!

Well, that's my goal anyways. Breast reconstruction is never a perfect process and has taught me a lot of patience and understanding with my body. Like many women, I went into my reconstruction surgery with high expectations and came out with feelings of disappointment. There were indents, loose skin, and the implant was sitting to high and pulling to one side. After speaking to my surgeon, it was decided that I will need to remove the excess skin, do fat grafting to fill in the gaps and smooth things out, and skim off part of the lat flap so that it sits more flush with the rest of my breast. I am due to go in for another surgery within the next couple of months for breast revisions and hopefully count this one as my last!

Back to work

It’s been a long year and a half since I took a medical leave of absence from work. My career was finally starting to take off and I was focused more than ever on slaying my goals. But plans changed and a breast cancer diagnosis forced me to put my career on hold and focus instead on my health and wellbeing. The keener that I was told my boss that I would be back to work within 6 months but the reality was I would be off much longer. I am currently working with my doctors, counsellors and a rehabilitation team to successfully get me back to work in the near future. I’m anxious to return but also a bit nervous as I continue to work my way through the long term physical and emotional side effects of treatment and life after cancer.

Travel, travel and more travel!

I love to travel! Anytime an opportunity arises, I have my bags packed and am ready to go on another adventure. My parents used to take my siblings and I on numerous road trips growing up crammed into their old Cutlass Supreme. Needless to say, there were many fights but also a lot of good times and instilled in me the desire and passion to travel. Next up is the YSC Summit in Orlando to reunite with and meet new breasties from all over. But what I’ve really been saving up for is a trip to Italy with my husband. I’ve wanted to go ever since I did my grade 5 project on this beautiful country so my husband and I are planning to make it happen this year. Life’s too short and I’ve learned to live in the moment now while I have my health and happiness.

Happy New Year!

The good, the bad, and the ugly

It’s hard to believe that it’s already been 6 months since my bilateral mastectomy and immediate latissimus dorsi flap breast reconstruction. Prior to my surgery, I found a lot of the information online to be focused on mastectomies using a tissue expander or implant only and it was difficult to access any personal first-hand experience with this particular procedure. I’ve posted previously on this procedure (here and here) but I wanted to open the conversation more and share some of the good, the bad, and the ugly post lat flap.

June 2017 - 2 weeks post surgery 

December 2017 - 6 months post surgery 

The Pros

I didn’t have any major complications post surgery. 

Between getting an infection in my lumpectomy site last year and having a compromised immune system since chemo, you could say I was slightly paranoid going into this surgery. Thankfully, all that I had were some minor blips like a buildup of fluid in my back (seroma) which is very common after this procedure and some swelling. Other than that, it was smooth sailing (well as smooth as you can get for getting cut almost the entire circumference of my body!)

The scars across my breasts and back have smoothed out. 

What began as raised bumpy incisions, faded out to smooth scars. I’ve been using this Honest company healing balm which works like a dream as well as this Aveeno daily moisturizing lotion to keep the skin and scar tissue hydrated. Also, for aesthetic purposes, my plastic surgeon made sure to cut the incision across my bra/bikini line so it can be easily covered up if desired.

The tightness in my back has eased up. 

I went from walking like the Tinman from Wizard of Oz to feeling a lot more relaxed in my gait. Physiotherapy sessions provided me with a good list of exercises and stretches that I could easily do at home including working with resistance bands. I also took up this 30-day yoga challenge with Adriene which incorporated many of the poses recommended by my physiotherapist to stretch the back and chest muscles.

More natural shaped breasts. 

The lat flap has given my breasts a more natural appearance than just an implant alone. Because I had radiation prior to my mastectomy, the skin and tissue were really tight leading to possible issues with asymmetry. By using a piece of healthy tissue from my back and transferring it to the middle of my breast, it has allowed for more elasticity of the skin and offset the effects of radiation.

The Cons

Lollipop scars. 

Since I don’t wear a bra most times, I have to be very careful with my clothing choices. Anything white or light coloured easily shows the scars or lines through my shirt. I find myself trying on top after top with my eyes going straight to my chest. It’s hard not to notice something that I’m hyper aware of so I’ve begun sticking to darker colours or clothing made out of thicker material.

The tightness across my back. 

I know, I know. I just said that was getting better BUT it is still there. I find myself often explaining to people that it feels like I’m wearing a bra all the time that’s a little too tight in the band. Both my surgeon and oncologist recommended seeing a massage therapist to break down the scar tissue and also help with some of the tension on my affected side. I feel like I’m overcompensating at times and still have some issues with cording around my shoulder. While the yoga has helped a lot, it still needs a lot of deep tissue release (and time) to get things moving again. 

The loss of sensation in my back. 

While the appearance doesn’t bother me so much, it is troublesome not being able to feel a 2-inch wide band across my entire back. I have to look in the mirror when applying lotion to my scar as I can’t feel whether I’m applying it on the right area or everywhere but. It’s an eerie feeling. I once felt a needle like poke in my back around the scar line and wondered if I had been stung by a bee. It can be disconcerting not being able to identify pain, heat, or sensations in part of my back.

Am I happy overall with my decision to have breast reconstruction? Yes. But am I anxious to have all of these surgeries done and over with? Absolutely. I’ve spent so much time anticipating the end of surgeries and this whole breast cancer saga that I find myself constantly trying to push appointments ahead of schedule to speed things up. I am growing impatient and want nothing more than to put this all behind me. After my implant exchange surgery, I had my hopes up of being one and done. But I experienced the same disappointment that many women experience after breast reconstruction. The dents, the harsh edges, the loose skin. 

But I’ve come to have more respect and compassion for my body. It may not be perfect but it's a work in progress. Next step is seeing my plastic surgeon next week to discuss revisions and hopefully close this chapter once and for all.

Scanxiety

If you asked me what scanxiety was prior to my diagnosis, I would have responded with a confused look on my face. SCANXIETY? What does that even mean??

The tough reality is that we all experience this at some point after being diagnosed with cancer. Fear and anxiety at the thought of another scan. The waiting, the worrying, the what if’s. All those feelings come flooding back and you quickly realize that it’s not just about what will happen but remembering what did happen.

The hospital gowns, the poke of a needle, the sounds of the machine buzzing around you, the voices telling you to lie still, the pangs of hunger after fasting all night.

The shock, the denial, the fear, the anger, and the acceptance. It all comes back to that life changing moment when you’re told you have cancer.

I can’t help but notice how long the tech spends imaging a certain area and find myself searching their face for signs of hope and reassurance. Do they look relieved? Concerned? Often times I am met with a poker face leaving me with the dreaded feeling of anxiety awaiting the results. A scan prior to a cancer diagnosis was to check for a minor blip in our health. A quick little band-aid fix and we were on our way. But now a scan can mean something much more sinister.

Time seems to stand still and I find myself treading that fine line between denial and acceptance. There’s a sick feeling in the pit of my stomach trying to prepare myself for the worst while also hoping for the best. People often say things like “think positive” and “live in the present moment” but it’s hard not to think about the very harsh realities of it all.

Then the day comes when the results are in. As the doctor enters the room, my anxiety builds and I find myself once again searching their face for clues. Part of me wants to run while the other knows it’s time to face the truth. The news comes back though and everything is clear! Cue the music, the bubbly, the pomp and circumstance. While there’s a feeling of relief it’s not the celebration that one might expect. It feels like I’ve bought more time, but the question still lingers…will I be so lucky next time?

Out with the old, in with the foobs

Never in a million years did I think that my regular vocabulary would include things like breast cancer, reconstruction, expanders, and that I would have to “shop” for the right size and shape breasts to replace my own. But here I am six weeks post implant exchange surgery.

After waiting 5 months for my body to fully recover and strengthen from my bilateral mastectomy with immediate latissimus dorsi flap reconstruction, I had my expanders swapped out on October 2, 2017 for 210cc Natrelle Inspira smooth round gel implants. I was nervous going in for yet another surgery (my third in just over a year) but also felt anxious and excited to get these rock hard expanders out and move on with my life. Since I would be returning home the same day, I didn’t pack any personal belongings with me to the hospital other than the clothes I was wearing, my cell phone and a list of my current medications. Once I was checked in, the nurse went through my medical history and then it was time to gown up and wait. Surgeries were running behind that day so I anxiously waited until my name was called an hour later to go back into the surgical area.

The anesthesiologist spoke with me first and explained what she was going to do which helped calm my nerves and set up the IV line to get things started. My plastic surgeon then came in to draw out where he would be making the incisions to do the exchange. In order to minimize scarring, he would cut into the existing scar line from where the latissimus dorsi flap had been placed rather than going in from the underside of my breasts. Normally, a 2-3 inch incision would be made just big enough to remove the expander and swap for the implant; however, my left breast still had a couple inches of loose skin that needed to be removed which would require a bigger incision.

I walked down to the operating room afterwards where I was met again with the anesthesiologist, plastic surgeon, and nurses that would be working on me. Within moments of laying down on the operating table, I was put off into dreamland until I awoke almost an hour and a half later in the post anesthesia care unit (PACU). As the anesthetic began to wear off, I noticed the scratchiness in my throat from the breathing tube and slight pain in my left breast. My chest had been wrapped in a tensor bandage and I had an intermittent pneumatic compression (IPC) device pulsating on my legs to prevent any blood clots. I was still quite groggy from the anesthetic so I let myself drift in and out of sleep until I was ready to wake a few minutes later.

Once I was able to sit up on my own and move around, the IPC was removed and I was wheeled off to the recovery room. The nurse checked my bandages and pain levels and asked me shortly afterwards if I felt ready to go home. I was still a bit groggy but otherwise in good enough shape to make my move and bust out of the hospital. As soon as I got up though to put on my clothes, a wave of nausea came over me and I had to lay back down. Thankfully I still had the IV port in so the nurse administered some anti nausea medication which made me feel better almost immediately…and with it, very tired as well. I dozed off again and probably could’ve slept there all night but I wanted nothing more than to get back into the comfort of my own home and was finally released three hours post surgery.

Before leaving the hospital, I was given a prescription for some pain medication as well as five days worth of antibiotics. Because my immune system was still somewhat compromised since chemotherapy treatments and the history I’ve had in the past with infections, the antibiotics were given to me as a preventative measure just in case. On the drive home, I used a seatbelt pillow that was given to me from the hospital post mastectomy to help pad the area around my breasts as it felt tender from the bruising especially on my left side. When I got home, I laid down on the couch until my husband awoke me for dinner. I hadn’t eaten since 10pm the night before and was starving! My left breast was still in pain from being cut more so I took one of the prescribed pain meds and went to bed for the night.

Back at home 6 hours post surgery

When I woke up the next day, I still had a bit of pain in my left breast so I decided to take another pain med to help take the edge off. I’ve had issues in the past with pain medication making me ill but I figured since I didn’t have any issues the night before that it would be fine. Ugh was I ever wrong. I ended up feeling sick for hours until the medication finally worked its way out of my system. As I started to feel better, I noticed the bandages across my chest were beginning to unravel and soak through. The nurses had given me instructions prior to the leaving the hospital to wear a compression or sports bra once the bandages were ready to come off so I had my sister drive me down to the local pharmacy where I found this soft comfortable front closure compression bra by Ameona. Even though I could have removed the bandages that day, I just didn’t feel emotionally ready yet and decided to wear the compression bra over top until the next day.

 

I found myself in front of the mirror the next morning feeling anxious just as I did when I removed the bandages from my lumpectomy the year before and then again after my mastectomy in June. It’s hard to have part of your body amputated and hope that you can feel a sense of normalcy and happiness with your body again. After a few deep breaths though, I took off the bandages and felt a mixture of emotions. I was overall happy with the way my breasts looked but also disappointed as I began noticing the little imperfections. Roughly half of the scar on my left breast had been cut into to swap out the implants whereas the right had an incision about 2-3 inches long but there was still a bit of loose skin remaining on the lower part of my left breast and some denting/rippling in spots. Although breast reconstruction has come a long way over the years, it is still very difficult to restore breasts to their natural shape and size again. All of the breast tissue has been removed leaving only an implant and, in some cases like mine, donated tissue to work with to reconstruct new breasts.

Throughout the week following surgery, I had been experiencing some low-lying nausea which my doctor attributed to the antibiotics but the pain and bruising was beginning to subside in my breasts. My plastic surgeon had advised prior to surgery that the recovery time would be about 2 weeks but I was still able to get out walking and move around, just no heavy lifting or running. I still had to be careful with sleeping as the incisions needed time to heal but the pain and discomfort from the expanders was noticeably gone. I wore my new compression bra day and night but cheated and snuck on a bralette a couple times to see how they looked. The implants already felt so much squishier and looked much more full and natural than the expanders. Plus, the recovery from this seemed like such a breeze compared to my last surgery.

At my follow-up appointment two weeks later, the plastic surgeon removed the remaining steri strips on my breasts and cleaned the incision areas which were healing up nicely. Although I was hoping that this would be the last surgery, I knew there was the possibility for some minor surgeries later on to touch up any imperfections. I voiced my concern about the excess skin and denting but he advised that it could take months for the swelling to fully go down and for the implants to settle into place. Because of this, he didn’t want to even consider doing any touch ups for at least a couple more months until things had settled more into place. Patience is not my strong suit but I trust my surgeon and knew it was best to wait. In the meantime, I needed to take it easy for another 4-6 weeks which meant no running, no high impact exercises or basically anything that would jar my breasts.

Before I left the surgeon’s office, the receptionist handed me some paperwork which she explained was my registration and warranty for the implants. I had a little chuckle at first at the fact a part of my body was now warrantied and registered. But in all seriousness, implants are now registered for the safety and well being of patients in the event that there is a recall on faulty breast implants which, although very very rare, can happen. This whole thing is a learning process and something that I would have never imagined having to ever worry or think about but it is just part of my life now.

It’s now been six weeks since my surgery and am slowly trying to adjust back into a normal routine. I’ve just recently begun some gentle yoga and light weights and have noticed the implants settling more into place. The denting on the bottom of my left breast has softened up although there is still a fold of loose skin which I will likely discuss with my plastic surgeon about removing at my next appointment on December 28th. My body is not perfect and I am reminded of what I have endured every time I look in the mirror and see my scars looking back at me. But I am learning to practice self love and embrace this new body of mine and all of its imperfections. 

From every wound there is a scar, and every scar tells a story. A story that says, I survived.