Sunday, November 30, 2008

Five Weeks

Tomorrow will be five weeks. Alot of my swelling has gone down. Because of the reduced swelling, I can tell the right flap (breast) is noticeably smaller than the left. Also, some of the scarring from previous surgeries on the right that were not covered/removed by the flap are now making "ripples" in my skin. That doesn't matter though. I can MOVE!! Also, the flaps are slightly under my armpits. That does create a slight movement problem, but I've been told that can be resolved at the April revision surgery.

I continue to have healing problems in my abdominal incision. The physical therapist had me doing torso stretching, and that ripped my incision in one area. So no more stretching, and today I'm going to have Jim help me clean that area well, put on antibiotic cream and butterfly bandages, and then we will cover with a clear plastic dressing. I'm not sure what the clear plastic is called, but we use it when Jim has skin tears. It can stay on for up to a week and doesn't come off in the shower. I am concerned that the scar in that area is going to end up 1/4 inch or more wide because of all the stretching to it.

Emotionally, I'm a little down. Not getting enough outside time, I think. I have purposefully gone out for sunshine the last two days, but today is very gray, so no Vitamin D tonic for me today. Ennis (the last cat standing) also is down. I think we may both just be a little bummed out by having no other furries in the house.

Monday, November 24, 2008

Four Weeks Post-Surgery

Written 3 weeks ago on the FDMB:

It's been 3 weeks since my bilateral breast reconstruction surgery. I saw the surgeon last week in Baltimore.

The cosmetic outcome of the rearrangement of skin and fat from my belly to my chest is "above average." I will likely need only a little work when I get the "stage 2" outpatient revision surgery in late April. Just a few nips and tucks to make everything even up top and maybe a little lipo to take out the "handles" at the ends of my hip to hip incision.

The incisions still have a few weeks of healing before I am allowed to submerge in water (bathing, swimming). I am good to go with range of motion physical therapy (PT) on my chest and abdomen, but no core strengthening exercises until after another check-up in 6 weeks.

There is some damage in the intercostobrachial nerve (upper underneath part) of my right arm that may or may not resolve with PT or just on its own. I am having numbness and pulling in my belly in the waistline area. This is above the abdominal incision. That is from swelling where the surgeon cut through muscle to remove the blood vessels feeding the donor tissue. The discomfort in that area may take up to 3 months to resolve.

Some of the donor tissue is starting to "harden" in my left breast. Again the result of the surgical trauma, and I was instructed to frequently massage that area to break up the edema and soften the tissue.

All in all, my recovery is progressing "normally."

Week 4 Update:

I do feel better than I did a week ago. The numbness and pulling at my waistline is starting to resolve. The healing on my abdominal incision continues to be slow; there are large areas of scabs that pull out when moistened and the the whole incisional line is red and puffy. The quick oatmeal bath I took yesterday for dry skin set that incision's healing back about a week.

The incisions on my breast flaps only have small scab areas left, mostly at the corners of the flaps.The hard spot in the upper left breast has not changed in size and I am palpating it (as well as the other breast) a couple times a day. From what I read on the discussion board, the hardness might likely be fat necrosis, which the surgeon will have to remove during the revision surgery.

I want to recognize the tremendous help I received from Donna, my sister-in-law, and Linda Lee, a friend from FDMB. They each stayed with me for 10 days during my recovery. I can't imagine having gotten through this without their help in caring for me. Donna certainly had the harder "duty" because she got me straight out of the hospital, when I was my most feeble. Linda Lee had different challenges; she had to try to keep me in bed to rest as I kept trying to do too much.

Linda Lee and I did have a few outings while she was here. I am able to drive as long as I'm not on narcotic pain meds. We took her cat Josephine to the holistic vet twice for acupuncture and reiki. We added some other stops to those trips.

Jim now has me full-time, and I wasn't happy the first time he left me alone in the house. It was only for a few hours, and there was no reason for me to be fearful, but I was. I dealt with it by taking a nap. We are living on sandwiches, soup, and ice cream because I don't have the desire to make evening meals, but hopefully I will get over that soon. Thanksgiving is this week. Can I roust the energy to cook a turkey breast and all the trimmings? Hummm.

Ennis has been by my side almost every minute of my recovery. Or perhaps I should say I've been by his side, as he sleeps on my bed all day anyway.

The oddest thing is I am getting my stress rash on my hands. This is something I dealt with years ago, and it always threatens to flair up from time to time, but it hasn't shown itself through this entire cancer journey. Why it would start to flair up now is beyond me.

Wednesday, November 05, 2008

Nine Days Post Surgery

It's been nine days since my DIEP Flap.

The night before the surgery Jim (the birthday boy), Stefani, Cindi, and I went out to dinner in little Italy in Baltimore. I was so very stuffed on eggplant parm amd a huge bowl of strawberry gelati.

The surgery took only 4 hours. Dr. Chang said I had a "perfect anatomy" so the blood vessels were easy to find and reattach.

I was in ICU the first night, limited to ice chips. The next day I was moved to the "women's issues" floor, and continued to be limited to ice chips. Frankly, the ice chips turned out to be the best food I had while I was there. Patient care in ICU was a one to two staffing ratio, but care was just OK because I was there as a surgical follow-up, not as a critically ill patient. I remember very little from the entire experience because of the meds, but there was the ICU charge nurse, Christy, who spent time with me because I was very upset because I could not move, eat or drink, or see Jim. She even called Jim for me to make sure he was OK.

Jim was not going to be able to see me until 11am on the day after surgery, and once the charge nurse in ICU understood that I was not going to calm down until I saw Jim, she worked on trying to get him in earlier. However, Jim, thinking he was restricted until 11am, took a late, leisurely breakfast and didn't get to me until 10:30.

Cindy came to visit on Wednesday noon, bringing a card of well wishes from the FDMB. Stef was going to visit later that day, but I called her off because I was so fucked up from meds.

I don't recommend Mercy Hospital in Baltimore. The food was lousy, response to the call button was excruciatingly slow, I couldn't keep myself focused because of the meds. I was so eager to leave on Thursday that I left before my visit with the Occupational Therapist, which the staff didn't tell me about until I was walking out the door.

Back home to my own bed and my kitty Ennis. He had been looked after by Leslie (from the FDMB) and Nancy, my neighbor. My sister in law Donna flew in the next day, Friday, and has been doing a great job watching out for me.

Jim and I traveled to Baltimore and back Monday for my one-week follow-up with the surgeon. (Very exhausting trip; potholes are no fun; neither are stop signs.) The tissue transfer from the abdomen to the chest area is taking well. No necrotic tissue. I have minimal swelling and redness in the surgical areas.

I was able to have one of my 4 surgical drains removed, and got permission to have the visiting nurse remove the remaining drains as conditions warrant.

I am still on heavy movement, lifting, and position restrictions. I can't even think about standing up straight until week 3. I am to start wearing a belly girdle to compress the area to help it heal more quickly, but it seems too small to get it fastened. Shower restrictions are completely lifted. I have enough pain meds for about 2 weeks, when I will see the surgeon again.

My sutures and bandages are self dissolving, and that should start happening in a few days. The home visit nurse (Joan) came today but the remaining drains were not yet ready to be pulled. Maybe tomorrow.

Donna will be here until Monday. She is doing a project, repainting a crockery cookie jar so that the kitties on the lid look like Max and Ennis. I haven't had much of an appetite, but she has been doing a good job trying to keep me fed.

Linda Lee comes in on Tuesday for 10 days. She is bringing her cat Josephine. I really think Ennis could use the company. I have never met Linda in person, but she is one of my best friends. We met through the FDMB.

On Wednesday I have an appt with Dr. Gillis, the physiatrist, to start rehab. I want to use Michelle Cooper, the dear woman who was my first physical therapist on this road. My earlier insurance had no PT limits, but I believe Medicare does, which I will have to find out about.

Well, the biggest info about this post is that I have taken pictures of my torso. I took one set the morning before surgery. It shows the mess that Dr. Boob had left me in. The second set I took this morning, showing my progress at day 9. I don't want to shock anyone, so viewing the photos is entirely voluntary. The first set is here; the second set is here.