Sunday 31 December 2017

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!

Thursday 14 December 2017

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.

Friday 8 December 2017

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?

Monday 13 November 2017

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.

Monday 25 September 2017

Expanders, foobies, frankenboobs, rocks, boulders...what do you call them?

Expanders, foobies, frankenboobs, rocks, boulders. These are just a few of the names for tissue expanders coined by other breast cancer survivors.

After the mastectomy and lat flap reconstruction, it was an adjustment period getting used to these new foobies. I felt like I was walking around like a robot at times because the circumference of my upper body felt so stiff. The incision areas on my breasts felt hypersensitive and anything that touched them, even just the touch of a light shirt, made me feel uncomfortable. My lower back still felt inflamed from where the drains once were so I continued to sleep with multiple pillows stacked around me to prop me up in bed. I’ve been a side sleeper all my life so having to sleep on my back was awkward and uncomfortable and left me with many sleepless nights.

About a week after my surgery, I was feeling so tense in my back and asked my husband if he could give me a massage to try and loosen things up. As he began rubbing my back, he noticed a big bulge on the right-hand side of my lower back. It felt like there was fluid rippling under my skin. I jumped up to take a look for myself in the mirror and was shocked at how large the pocket was which seemed to develop overnight. The plastic surgeon had told me prior to surgery that it was quite common to develop a seroma after the lat flap procedure so I crossed my fingers that it was nothing more. Once you’ve been diagnosed with cancer, it’s hard not to have every alarm bell sounding in your head when a new side effect comes up.

I set up an appointment with my plastic surgeon the next day to get it checked out. As soon as he took a look at it, he confirmed it was in fact a seroma and told me it would need to be drained. Nothing serious but more of a nuisance than anything. If there was going to be a side effect, I seemed to get it! With a quick poke of a needle, a numbing agent was used to freeze the area of my back and then a syringe was used to extract the fluid. The syringe was nearly full with just over 50mL of fluid removed from the pocket in my back. He said it would likely continue to fill over the coming weeks until the surrounding tissue healed over and filled the pocket so I would need to go back and have it drained again.

The following week after my little seroma scare, the incisions on my breasts were finally fully healed over and I was able to go in my first tissue expander fill. My expanders had already been filled to 120cc during my mastectomy and lat flap reconstruction surgery four weeks prior and I would be getting an additional 60cc fill at this appointment. I was nervous going in as I didn’t know what to expect and was worried that it would be painful but the surgeon assured me that I would be okay. As I sat in the chair, he felt around my breast for the expander port which was located near the top of each breast and then inserted a needle into it. The saline was then inserted into each expander with a syringe that held the 60ml of fluid and took about one minute to fill on each side. Once I got past the initial poke of the needle, the actual fill wasn’t painful other than a bit of pressure from the fluid going in. It was weird to look down afterwards and see that my breasts were suddenly a cup size bigger! Once both of my expanders were filled, I needed to get the seroma drained again in my back. The fluid level had gone down with only 30ml extracted this time but it would likely need to be drained again in another week or two. Once the fluid reached a low enough level, my body would naturally reabsorb the excess.
Fill 'em up!
After my first fill, I went about my day and didn’t experience any pain or discomfort other than what I had already been experiencing post surgery. Still some tightness across my chest and back which was to be expected and twinges of pain here and there in my foobies, especially in my left breast. My radiated side was quite tight however the left side had excess skin (which would be removed during my implant exchange) and was allowing the expander to move and rub in spots. It wasn’t until I lay down in bed later that night that I noticed how much bigger these foobies felt which took some adjusting to. It took awhile to find a comfortable position but I found that bear hugging a soft squishy pillow in front of me helped provide some cushion and comfort between the rock hard boulders on my chest.

Up until my first fill, I had been wearing mostly loose-fitting tank tops that I could easily step into and shimmy on from the feet up as it was still hard to maneuver a top over my head. There were also a lot of tops that I didn’t feel comfortable wearing because the incisions on my breasts were still quite pronounced leaving me with lollipop like scars which poked through my t-shirts. I was anxious though to start getting an idea of what size I was after my first fill so with my best friend in tow, I went to try on some bralettes. Because of the incision across my back, I was looking for something with a soft wide band that wouldn’t dig in and it still felt quite uncomfortable with anything rubbing on that area. Underwire was also out of the question and anything halter style because my range of motion still needed a bit of work especially on my affected side. I found myself going back to the same style of bralette including this sheer floral lace bralette from Forever 21 and this Halo soft cup bralette from Wacoal as they were the most comfortable and supportive.

Despite only being at 180cc, I was pretty happy with the size they were at. I had asked other women who’d gone through breast reconstruction how many fills they had done and what worked for them but it’s really hard to know what the “right” size is for your own body. Everyone’s bodies are different so what 250, 500, or 750cc might look like on one person may look completely different on another. I’ve always been heavy chested all my life so I wanted to go smaller and aim for something that was more proportionate to my body. Prior to surgery, I was wearing between a 30E/F and 32DDD bra and had a very difficult time finding bras and bikini tops that fit. As it was, I was trying on bralettes in a size Small or around a 32C bra which seemed to fit comfortably.

The day I was scheduled to see my surgeon for my last fill, I decided to go shopping again, this time for bikini tops. Part of me was confident that I wanted to stay at this size but part of me didn’t want to go too small either so I wanted to try on a few things to confirm. Trying on bikini tops with these new foobs was much different. Anything with an underwire or added padding was not going to work so I went for something that wasn't heavily lined and provided ample coverage. My absolute favourite were these halter style tops from La Vie En Rose. They kept my foobies intact and covered, while still giving me the look of having some cleavage. Some of the strapless styles looked great but I was worried about having “scar slips” without noticing so found having an option with a strap would be more comfortable for me.


When I went in to see my surgeon later that day, he asked if we were doing another fill and I told him I was comfortable with the size they were at. He encouraged me to spend some more time getting used to the size and to come back to see him in a month just in case I changed my mind. In the meantime, I still needed to get the seroma in my back checked which was still looking puffy. He froze the area once again and drained the fluid that had been building up since the last time I had seen him 12 days prior. Only 15ml came out this time which meant my body was finally starting to reabsorb the fluid and the cavity in my back was filling in.

I had brought a long list of questions with me to ask after my checkup. My memory is still not the greatest these days so I write down all of my questions leading up to my appointments in case there’s anything I forget…which is a lot! I was anxious to know the details about my next surgery including how soon could I get it done. We had originally discussed waiting 6 months from my initial surgery date to allow for time to do the fills once every 2 weeks and for the scars to heal and strengthen. Since I wasn’t getting anymore fills though and the scars were already looking better than anticipated, he estimated that we could do the implant exchange in about 3 months which was much to my avail.

We then discussed the different types of breast implants available with options including saline, silicone, round, teardrop, and textured. My surgeon recommended that I go with the Natrelle round silicone implants rather than the textured teardrop implants as there is an extremely low risk (but a risk nonetheless) of developing a type of cancer called Anaplastic Large Cell Lymphoma (ALCL). According to the FDA, the risk of ALCL is higher in women who have textured implants, which have a bumpy surface, as opposed to smooth implants. I was worried at first about getting round implants and having Barbie like boobs but he assured me that they will still look very natural. The silicone implants will naturally sit lower in the breast at a standing position giving it a bit of a teardrop shape and take on a flatter and rounder shape lying down. When it comes to implant sizing, a number of factors are considered including diameter and projection. In order to stay within the same diameter and have similar projection to the current expanders, I would need to go up to either a 210cc or 240cc implant to match. It sounded like quite a size difference but the surgeon advised me that the implants sit more flat while the expanders project out quite a bit more. 


Over the next month, the incisions on my breasts and back were beginning to heal more and more, leaving a thin formation of pink scars. The skin on my radiated side was starting to stretch out and drop thanks to the lat flap transfer making my breast feel more natural. And the tightness was easing up across my back. The surgeon recommended that I get the scars massaged once the seroma in my back healed which would help loosen them up even more (I still haven’t done this but have plans to do this in the future). I was also finally beginning to sleep on my side comfortably which was a huge plus although it was still hard to sleep directly on my foobies because of how hard they were (think sleeping on two hard rocks).

I started going to physical therapy a couple of months after surgery to work on my range of motion and to find some exercises that would help regain my strength in and around my lat muscles where the flap had been removed. It wasn’t until I began doing the exercises that I realized how weakened the muscles were. The physiotherapist told me to work at it slow and steady so as not to injure myself along the way and set myself back. Hard for someone stubborn like me who just wants to get right back into things. As I regained my range of motion, I tried on some of my old clothes and found that a lot of tops fit differently in the bust. They got thrown into a donation pile along with the small fortune of bras and bikinis that no longer fit.

Since this surgery, I have lost a lot of feeling around the circumference of my body, making me more aware of the potential for scar slips which may have happened once or twice already. My breasts have some feeling around the outside close to the chest wall but what I mostly feel is just pressure. And while I have regained some feeling in my back from where the drains once were, there is about a 4-5 inch band across my entire back that I have absolutely no feeling at all. It’s strange to lose sensation on parts of your body and is eerie to touch but you get accustomed to it over time. To this day, I still have a lot of numbness in my underarm where the lymph nodes were removed during my first surgery last year and am cautiously aware when I go to shave.

After sixteen months of treatments and surgeries, I just want to move on and adjust to this new body of mine. While some people think this is a free boob job, to me this is trying to regain a sense of normalcy again after having to amputate my breasts. On October 2nd, 2017 I will be going in for my third and what I hope will be my last surgery since being diagnosed with breast cancer.

One week til I'm rid of these boulders!

Wednesday 12 July 2017

Bye Bye Boobies!

After months of anticipation, countless meal prep, cleaning of the house and trying to get myself in the best shape possible, the big day was finally here for my bilateral mastectomy with immediate latissimus dorsi flap reconstruction. I had been called by the hospital admitting department the day prior to instruct me to be at the hospital the next day at 7:00 a.m. One year and 13 days after my lumpectomy, I was going in for surgery once again to ensure that any residual cancer cells left in my breasts were gone.
When I arrived at the hospital, one of the intake nurses went through a long list of questions with me about my current medication, medical history, etc. and then had me change into a hospital gown. I would have two surgeons working on me that day, a general surgeon to perform the bilateral mastectomy and a plastic surgeon to perform the breast reconstruction. The general surgeon came into the room and asked me if I was ready. I don’t think you can ever truly prepare yourself mentally to go through this type of surgery but he assured me that I would do great.

The plastic surgeon then came in and began his artwork on me, drawing the lines of where he would be cutting away my skin, my body, my breasts. He would be removing the scar from my lumpectomy along with my nipples and taking a flap of skin, muscle and tissue from my back to help construct my breasts along with expanders. As he finished and left the room to prepare for surgery, I looked at my body in the mirror one last time and said goodbye, wondering if I would remember what it once was.

A few minutes later, the nurse came in and told me they were ready for me. We walked down to the operating room where the surgeons, nurses and anesthesiologist were gowned and prepping for what was likely to be a 4 hour surgery. I laid down on the operating bed and felt nervous about what my body was about to endure. In less than a minute though, the IV had already been inserted and the anesthetic was running through my veins, quickly rendering me unconscious.

The next thing I remember is waking up to the bright lights of the recovery room. As my senses awakened, I became increasingly aware of the tight sensation across my back and chest. I had been cut around almost the entire circumference of my body, save a couple inches around my breasts and spine, leaving it difficult for my rib cage to fully expand and take a deep breath. I suffer from mild claustrophobia so the feeling of being confined and constricted threw me into a state of panic and anxiety. It felt like someone had duct taped my body so tight and I wanted so bad to just cut it off so that I could take a deep breath. I tried to calm myself down by trying to slow each breath but it wasn’t working and I finally had to ask for some medication to deal with the anxiety.

Once the anesthetic began wearing off, I started feeling the nausea wave over me and was given an extra dose of anti nauseants to keep it at bay. As I became more stable, I was transferred to the post surgical floor for close monitoring over the next three days. When I came out of the elevator, I saw my husband sitting in the waiting area and smiled. It gave me so much comfort to see him there and to have him holding my hand as the nurses settled me into my room. I was hooked up to oxygen and an IV and had what felt like a blood pressure cuff squeezing and constricting my legs which I later found out was an intermittent pneumatic compression (IPC) system to help the blood flow through my veins and prevent blood clots.

Although I felt really tight across my body, it was more my back that I was experiencing pain and discomfort in. I didn't have a lot of sensation left in my chest (which was probably a good thing) and slowly realized I hadn’t even thought to look at what lie beneath my gown. I was nervous to see what remained of my breasts but knew that I had to face the inevitable. Once I looked down though I was pleasantly surprised with the results. The flaps from my back had been stitched into the middle of each breast and an expander had been placed underneath the skin with 120cc of saline. I actually had breasts! There were steri strips overtop the stitched areas to help close the wounds and a bandage across my back as added protection since I would be lying directly on it. I also had 4 drains coming out of my upper body, 2 in my breasts and 2 in my back, to help drain the excess fluid.

I was barely able to keep my eyes open that night even as the nurse came in every few hours to check my blood pressure and oxygen and to administer the next round of medication. Along with the anti nausea and pain meds, I was given antibiotics as a preventative measure as my white blood cell counts were still quite low even though it had been months since chemo ended. My breasts were also closely monitored to check for any changes in temperature or colour since there was the risk of my body rejecting the donor tissue.

When I awoke the next day, the hot flashes I had been experiencing since starting hormone therapy in December had increased ten-fold. I had cold towels on my head and neck to try and cool myself off but nothing seemed to be helping. Between the hot flashes, nausea and pain medication, my body finally had enough and I became sick. Thankfully it seemed to push a reset button on my body and I finally felt able enough to sit up in bed and get some food in me. Shortly afterwards, the general surgeon came in to see how I was doing and gave me an update on how my surgery went. He let me know that he successfully removed all the breast tissue and that he didn’t see anything suspicious but we still needed to wait for the pathology report to come back to confirm. That was a relief to hear!

The visitors started pouring in which was such a great distraction after everything I had just gone through. My best friend and my family were there with fresh flowers and fruit. I sat up in bed and felt somewhat normal being able to laugh and smile despite the circumstances. And my husband even offered to rub my feet and legs after being stuck in that IPC machine for the last 24 hours. It was a great way to relax after all of the stress and anxiety from the day before.

My plastic surgeon came in later that day to check up on me and I was surprised when he said he wanted me up and walking. The last thing on my mind was getting out of bed! He said the quicker I was getting up and moving, the quicker I would heal. So, I mustered up the courage to get out of bed later that day and was instantly taken aback at how hard it was to move my legs after being in bed for just a short time. I could barely lift my legs or feet managing only to shuffle my way along the floor. By the time I reached the door 10 feet away, I was exhausted and told myself I would have to try again the next day. I was physically and mentally drained from the day and what I really needed to right now was rest.

The following day, I noticed that I had a couple of reddish lines running down my wrists. I called the nurse in and upon looking at it, realized that the vein attached to the IV had collapsed. She tried to find another vein, and then another, and failed at each attempt leaving me in tears. It brought me back to my chemo days when my veins started to hide and the nurses had to poke me numerous times to get the IV going. A call was made to my surgeon and he came in to see how I was doing and to put in an order for me to start taking my medication orally. I was so thankful I wouldn’t have to go through feeling like a pin cushion again a hundred times over.

My family and friends came in again throughout the day to talk and visit and brought me some of my favourite foods. The hospital meals left much to be desired so I was thankful to have something other than creamed oatmeal and questionable meat. My husband had also stock piled my night stand with a bunch of emergency healthy snacks. When everyone had left for the day though, I realized I still needed to get up walking and asked one of the care aides if he would help walk me down the hall. He took my hand and talked me through each step encouraging me to make it a little further until I finally needed a break. It was hard to believe that just 2 days ago I was walking 5km and now could barely make it down the hall without feeling out of breath.

When I returned to my room, I felt nauseated and exhausted. The nurse came in to take my blood pressure which began reading abnormally high and I felt like I was on the verge of getting sick again. I was given an extra dose of anti nausea medication and crashed out for the night barely able to be roused awake for the nurse to do her checks. As I awoke the next day though, I felt like the storm had finally passed. My nausea and blood pressure were beginning to settle and I became hopeful that I would get the all clear to go home. After being in the hospital for 3 days, I was ready to leave.

The plastic surgeon came in to do his assessment around noon and determine whether I was ready to be discharged. I was out walking the hall with my husband following doctor’s orders and chuckled when I seen him walk into my room and then quickly out with a puzzled look on his face. When he finally noticed me, he smiled and told me it was a good sign that I was out of bed. I slowly made my way back to the room so he could have a look at my incisions which he said were healing great. I was told that if I felt comfortable going home, I could go home, but if I wanted to stay that was okay too. No thanks. I was ready to break out!

I'm going home!
One of the nurses came in and went through my discharge instructions before leaving: no showering for 3 days, no driving for 4-6 weeks, no lifting more than 5 pounds - just to name a few. When we arrived back home, my husband propped me up on the couch with half a dozen pillows around me for support and I began binge watching The Keepers on Netflix. SO good! Trying to find a comfortable position to lay down at night though was the most challenging. It was hard to put pressure on my back due to the pain and discomfort from the incisions but I couldn’t lay on my side or chest either. My husband didn’t want to risk rolling over in his sleep and hurting me so we decided that it would be best if we slept apart until I was more healed. Between the discomfort and the hot flashes that continued to rage inside my body, I was left with little sleep.

Peace out drains!
I quickly realized at home how little I could do and how much help I was going to need. I could barely get my arms into the sleeves of a button up shirt or lift myself up and down off the toilet, and getting out of bed was one of the hardest things to do. It's amazing how much you use your back and chest muscles for everything! I couldn’t prepare food, bathe myself, or bend down to pick up something off the floor. Even holding a full glass of water warranted the use of both hands to support it. So, I focused instead on what I could do like working on my range of motion and keeping myself moving. I began setting goals for myself, walking to the end of the driveway and then moving on to the end of the road. My legs were still a bit shaky so I held onto my husband for support and attached the drains to a lanyard around my neck. I reminded myself to stretch my arms overhead a few times a day and pushed just a little further each day.

A week after my surgery, I went to see my plastic surgeon for my first follow up appointment. He was pleased with my range of motion so far and told me that the 2 drains in my breasts were ready to be removed. I had been packing these 4 little drain bulbs around like a new accessory and was so relieved to have less tubing to pack around and untangle. What I was really looking forward to though was getting the drains out of my back. They were burrowed under the skin in the lower left and right quadrants of my back and were incredibly uncomfortable. At night, it felt like I was laying on a cot...without the mattress. Not fun.

In order for the drains to be removed, there needed to be less than 25-30ml of fluid output in 24 hours. So, I drained the fluid from each bulb every morning over the next couple of days in the hopes that I could finally get rid of these pesky things and was excited when they finally began measuring less than 25ml. I went to the local clinic to have the nurse remove the drains which I knew would be a painful process. My husband held my hand tight as she pulled the drains out a few inches at a time, finally removing the 8 inches of tubing that was looped under the skin in my back.

I cried tears of joy that day and celebrated having my drains out with some ice cream. But once the weekend had ended and my husband returned to work, everything came crashing down on me. My emotions began spilling over, leaving me in a pool of tears that wouldn’t dry up. I had been suffering from insomnia due to the relentless hot flashes and discomfort in my back, my freedom and independence felt like it had been stripped away, and I was going stir crazy being at home. I felt alone and isolated and that people only saw how "good" I looked on the outside and didn't see the layers of emotional anguish beneath the surface.

After letting myself have my own pity party for a couple days, I realized it was time to shift my focus and get back on track. It had been two weeks since my surgery and I was scheduled to go into the clinic to get the steri strips removed from my breast and lat flap incisions. As the nurse gently pulled them away, she let me know that everything was healing up nicely and the incisions were almost entirely closed up. I still had a ways to heal and tissue expander fills in the upcoming weeks but so far I was really happy with the results.

When I got the call the next day from my surgeon letting me know that the pathology report came back clear, I felt a huge sense of relief come over me. The chemo and radiation treatments had worked and whatever residual cancer cells had been lingering in my breasts were gone. It was time for me to move forward and keep making the most of this life that I was given. Best news ever!
BEST NEWS EVER!!!


Wednesday 14 June 2017

Reflections


Throughout the years, I have struggled with confidence and self love. I developed quickly as a young girl and became very insecure about my breasts and my body. My mind distorted the way I looked at myself, fixating on its flaws and feeling the constant need to live up to an expectation that didn’t exist. 
Over this past year though, I’ve gained respect for my body. I had surgery to remove part of my breast and watched my hair fall out. I got stripped down to a raw state both physically and emotionally and felt vulnerable. And that’s when I finally began accepting myself for who I was. The scars on my chest…those are my battle wounds. The hair I no longer had on my head…bald IS beautiful. Those curves on my body…embrace them!

I began looking at my body as a symbol of strength. My workouts were no longer measured in success by the number looking back at me on the scale but by the energy and strength I felt afterwards. The food I began putting in my body was to nourish and fuel it, not to starve it. My body was my vessel and I was going to use it to fight this thing.

While I have finally come to a place of acceptance, there is no denying that I’m scared of what lies ahead tomorrow. To face the loss of something that has always been a part of me and to see my body change. I’ve spent these last few days looking at myself in the mirror and silently mourning the skin I was once uncomfortable in.

But then I focus on the future. To hopefully hear those words one day that I am cancer free. To live my life freely and to be unapologetically me.


Saturday 8 April 2017

Reconstruction zone ahead


Feel it on the First! Early detection is key!
Despite going through surgery and treatments over the last 10 months, I have struggled with the uncertainty that I am “cancer free” moreso after the news from my oncologist in December. He had another pathologist look at my case and discovered there were a few microsatellites, or tumour cells, around the primary tumor removed 10 months ago. One of these cancerous cells had been cut in half during the surgery leaving the other half remaining in the breast. My oncologist assured me that the chemo and radiation should have destroyed them; however, he recommended a mastectomy to remove the entire breast tissue as a precautionary measure. I had already considered having a prophylactic (preventative) mastectomy but it now felt more real and also very unnerving that there were potentially cancerous cells still lingering in the shadows.

I followed up with my surgeon soon afterwards in the hopes of setting up a date to clear myself of any remaining cancer. Because I had just finished radiation, I was advised that my breast tissue wasn’t fully healed leaving me at higher risk of complications from surgery, including infection. The original lumpectomy site had taken almost 4 months to heal after becoming infected so that was the last thing we wanted to happen again. When he said he wanted to wait at least 6 months though, it made me panic at first. “How I can wait 6 months? What if something is growing inside me?!” He assured me that any residual cancer cells had been destroyed by the treatments and that the benefits of waiting greatly outweighed the risks. One of the benefits being that I would get immediate reconstruction done at the same time as the mastectomy.

Two weeks later, I sat down with the plastic surgeon who would be reconstructing my breasts to discuss my options. There are three options available here for breast reconstruction: implants, DIEP flap, and Latissimus Dorsi flap. I assumed I was getting implants since I thought it was the standard and hadn’t heard of the other 2 procedures. He told me however that there are too many risks and complications with using implants after radiation so that was quickly scratched off the list. We moved onto discussing the second option, DIEP flap, which involves removing the blood vessels as well as the skin and fat connected to them from the lower abdomen and transferring it to the chest to reconstruct a breast. The problem though was the lack of fat in my stomach area due to my petite size. Losing almost 15 pounds since going through treatment hadn’t helped either and I was just slowly gaining my weight back.

That left me with the last and only option, Latissimus Dorsi flap. This procedure involves making two horizontal incisions along either side of my back around the bra line and removing an oval flap of skin, fat, muscle, and blood vessels to reconstruct the breast. Expanders will then be placed in and pumped up with saline every 2 weeks to help stretch the skin until they reach a comfortable size. The surgery, scheduled for June 15, will take between 4 to 6 hours and I will be hospitalized for at least 3 days, with healing time taking anywhere between 8 to 12 weeks. I will have 4 incisions in total, 2 on my chest and 2 on my back, as well as drainage tubes to release any built-up fluids. In 6 months, the expanders will be replaced with a tear drop implant which will be a less invasive procedure with a shorter healing time.

Although I am excited to finally get this last part of my treatment done, I also wonder how I will fare through the process. I remember the day I took off my bandages from the lumpectomy and felt panicked thinking that I had lost half my boob. My breast was noticeably smaller, then swelled shortly after due to infection, then deflated from losing weight during chemo, and then began filling in slightly once I gained some of my weight back. I gradually learned to accept my body and began feeling more confident in myself than before. But as months went by and it healed from surgery and radiation, my breast was left full of thick hardened scar tissue making it difficult to sleep or put pressure on. Coupled with the lack of feeling and sensation, my breast has begun to feel alien to me, like it is no longer a part of my body anymore. I cringe when my doctors examine it and shy away when my husband goes to touch me. I can only imagine the grief and loss I will feel when I have both of my breasts removed and the time it will take to heal both on the inside and out. Physical scars may heal but it’s the emotional scars that can run deep and entangle us in a web of mental anguish and pain.

In the end, I must remind myself that the ultimate goal is to be healthy and to get rid of this stupid cancer once and for all. I am hopeful that the doctors won’t find any more cancerous cells or tumours in my breasts, and if they do, that they will remove it all successfully. But what I long for very much is that feeling of relief where I can finally say that I am cancer free. I want to wake up from surgery and say this is it. To feel that big weight lifted off my shoulders and to say I am finally done. This rollercoaster ride is far from over but I am determined to get through this next big hump, to move on with my life, and to start embracing my new normal.

Sunday 19 February 2017

Waking Up is Hard to Do

From the moment I wake up in the morning, my mind is already running a million miles a minute thinking about all the little aches and pains all over my body. Anxiety, fear and worry build up inside myself before I’ve even opened my eyes. Was that pain there yesterday? Is this something new? Has the treatment worked? I’ve exhausted myself mentally before I’ve even gotten out of bed. The fear of recurrence is a nasty beast. It becomes a disease in itself and consumes my thoughts throughout much of my day. Even though the chemo and radiation treatments were both draining on me, it felt like a bit of a safety blanket. But once that all stopped, I didn’t have that protection around me anymore and I felt more vulnerable.

As I prepare myself to start my day, I struggle to find the energy to get out of bed. There is being tired and there is fatigue. It began to set in about a couple weeks after radiation as predicted and hit me like a ton of bricks. No amount of sleep could ever make me feel truly rested. My energy ebbs and flows and I find myself sitting down to rest for a couple minutes which quickly turns into hours. And then as my head hits the pillow at the end of the day where I should be counting sheep and ready for a good night’s sleep, the viscous cycle continues all over again.

Through all of this, I’ve wanted to educate myself as much as possible to battle this cancer head on and win the fight. But in that, I have also had to face the realities of this disease. Breast cancer research has come a long way over the years and women’s chances of survival have increased; however, we are seeing higher incidents of it, including in young women. The research focuses on 5 and 10-year survival rates which are promising and give some hope but then they begin to steadily decline and that’s the part that scares me given my age. It becomes not so much a matter of if I’ll have a recurrence, but when. I still want to travel, make new memories, and maybe even start a family one day. It’s difficult to find a middle ground between being in denial of this reality and accepting it.

I’m still learning how to balance my life and fight with my inner demons. It feels like a struggle everyday. I try to eat healthy, but I’m also learning not to beat myself up when I want a treat once in awhile. I try to exercise to build up my physical strength again, but I also have to listen to my body when it needs to rest. I want to research as much as I can about this disease, but I also don’t want to overwhelm myself with information and think about every worst-case scenario. Going through treatment was one of the most difficult things I’ve had to face, but the fight doesn’t end there. It continues on now in different ways including living with the fear of recurrence and the unknown. We never know how long we may have on this earth, but it sure became a lot more real to me once I felt like my life was being gambled with.