I am not at Room Temperature

I was properly chastised this week by my friend Libby for not updating the blog after my last surgery. I told her that I hadn't felt like sitting at the desk computer to type a long update. Libby replied that all I had to type was "I am not at room temperature."

The surgery went very very well, and I've already had two follow-up visits. The surgeon was able to resolve the last of the area where my skin was adhered to my chest wall. Consequently, except for the tightness from internal scar tissue, I have full range of motion in my arms. Not that I will ever play volleyball again.......

My foobs (or flaps, whichever you wish to call them) are reasonably symmetrical and well placed on my chest. The surgeon wanted to "diddle" a little more with them, but I told him he had accomplished my objective, and maybe sometime in the future, but for now I am THROUGH WITH SURGERY!!

The revision to my abdominal area added three inches to each end of my scar (removing "dog ears") and large black bruises on my butt (from the liposuction).

I am now where I hoped to be in February 2007. Finished with surgical revisions and whole. I will have the nipples tattooed on August 31. That's an in-office procedure done with lidocaine.

I have been cleared for exercise and swimming.

Thank you Dr. Bernard Chang, reconstruction surgeon extraordinaire!!

Emma Leah, August 15, 2008 to May 30, 2009

Emma Leah came to live with us on December 5, 2008. I introduced her on the FDMB as the perfect kitten--she likes people, she likes cats, she eats well, knows where to poop and pee, alert, attentive, smart, and cuddly.

But sometimes, God needs the babies. She left us yesterday, in organ failure, likely from dry FIP.

Emma loved the other kitten adopted with her, Casey. Despite their size differences, they ate, slept, and played together.

Emma started to become sick shortly after her second FeLV vaccination. She stayed with us another 10 weeks, but she was different, and as time went on, we knew she was sick.

So we will try to remember the three brief month of health she shared with us.



Emma Leah fully embraced her scratching post, making it a jungle gym as well as a place to get manicures. She was very careful with her nails, never using them on people or other inappropriate items.

Emma was just getting to that stage of growth where her tail lengthens to adult size, and she would have to grow into it. She used her tail to converse, to play with Casey, and to wrap precious self.

Emma loved to cuddle for naps. This was often my view of her as she took to my lap.



She would jump onto my back when I cleaned the litter boxes. She would join me in the shower, staying safely on the tub edge behind the clear vinyl shower liner. She made the orange kitty bed I got for Casey her own, and her woolie, nursing on it unrelentingly.

Emma was the ultimate explorer of all things permitted (and early on, unpermitted). Here she is trapped in Jim's shower.

Emma often slept under the covers with me, in my armpit, at my waist, or behind my knees. Many night I fell asleep sitting up, and when I awoke, there she was on my lap.

She loved to eat. She made a game of running to the feeding spot at meal time, and always made sure she shared everyone else's plates.

Her favorite toys had feathers on them. She fancied herself quite a birder.

She was a little overwhelmed by Ennis's massive size, and would gentle push him away, or leave the bed, when he came to close. This is a rare picture of the two of them together.

Upcoming Surgery, and Other Things

I received my surgery packet last week. My surgeon's office is nice enough to send out a packet with info about the surgery, as well as preparing for it and recovering from it.

This surgery is called "revisions." The surgeon will be "sculpting" the two breast mounds for symmetry and placement, adding fat to fill in a scarred area in my right foob that is "wrinkly," liposuctioning the little bulges at the ends of my abdominal incision, and making nipples.

The surgery starts in Baltimore at 12:30pm on Monday April 27, and I am expected to be released from post-op recovery around 4:30pm. Depending on how tired/disoriented Jim and I are, we may try to find a local hotel for the overnight instead of driving the ~2 hours home.

I have to go to my family doctor this week for a mini-physical, an EKG, and orders for bloodwork. Information in the surgery packet tells me I will be down for about a week, and on activity restrictions for three weeks.

This is the last procedure planned for general anesthesia. I am very happy about that. The anesthesia really knocks me out....for days now.

Jim is planning to have his right knee joint replaced in June, and then we have planned a 9-day cruise for September. We will be taking a ship out of Bayone, NJ, up the east coast into Canada and back.

I was away for a week recently, in the DC area caring for a friend who had been released home after 3 weeks in the hospital for peritonitis. I feel this is one of the ways I can "pay it forward" for all the care others have given me through my journey.

Emma, one of the new kittens, worries me. She has a fever of unknown origin that has been going on for almost a month now. She is going back to the vet today for another check-up. She has lost weight, isn't eating well, and is very lethargic.

My brother Les is being such a trooper through his lung cancer treatments. This is his final week of first-round chemo and radiation. He is having alot of trouble swallowing, because the radiation is affecting his esophagus. But he is happy that the end is near. I talked with him on Saturday, when he was out buying a bunch of flowers for the yard. You have to feel somewhat OK to garden.

That's all the news.

More on Les

Les is so upbeat about all of what he is going through. He has only two more chemos scheduled (his chemo combo is Taxol and Carboplatin) and only 9 more radiation treatments. He still has his hair, was feeling "like shit" the Tuesday and Wednesday after his Monday infusion, but recovered (as much as possible) by Friday. He also is having throat problems from the radiation treatments, but a DR prescribed magic mouthwash, which did wonders for my mouth sores. He also has not smoked since his surgery, and is repulsed by the smell of cigarette smoke.

Good for you Les. I love you bunches.

Update on Les

Some more info about Les's lung cancer. He got a report yesterday that said his lung cancer is non-small cell carcinoma, Stage IIIA. Les has not done research about prognosis, so I will not put what I know about it here. If Les doesn't want to know, I don't want to be the one to force it onto him.

Les is in remarkably good spirits. He has worked some, but it is physically difficult for him. Any time spent at work means the entire following day is spent on the couch.

He has been measured and marked for radiation and begins it today. He will have radiation every weekday for 25 session. He also will be getting chemotherapy during the time he is on radiation therapy. Les doesn't know the "flavor" of chemo. He will an infusion every Monday for 5 weeks, then an infusion every 3rd Monday for 4-5 months.

Reaching out to Kathy

I have a friend on the FDMB (let's call her Susan) who has a co-worker (let's call her Kathy) who has breast cancer. I've offered through Susan my contact information, but I'm told Kathy is a strong, independent person who doesn't reach out for help for herself. She is a single mom of one son, and is being cared for by her parents.

So I told Susan I would write something up to converse with Kathy. I thought my breast cancer blog would be a good place to put this.

Kathy,

I, like you, have been diagnosed with breast cancer. I am about 3 years post-DX, but still living with the effects of my diagnosis and treatment every day. I have made part of my cancer journey helping others with their cancer journeys, in whatever way I can.

Susan tells me you have been in severe physical pain from the treatments. I understand that. The chemo, and the Neulasta that I got to stimulate white cell production, put me in a world of hurt. Nothing nothing NOTHING made me comfortable. Even lying brought pain to my hips and ribs. And the pain made me the crabbiest person ever.

Yes, crying. Crying is a part of the pain (and other things).

For my first two infusions, I didn't know that there were ways to manage that pain other than the prescription pain killer I was given. My neighbor Mary, a nurse, showed me how to layer prescription meds with over-the-counter meds. I talk about the process I used here. Of course the pain wasn't gone, but it was very well masked. Kathy, talk to your doctors or the oncology nurses about better pain management. It is possible.

Susan tells me you are a fiercely independent woman and that being dependent on others is the hardest part of your journey right now. Might I suggest you take a brief look through your caregivers' eyes. Your parents are doing what they are doing out of the purest and most sincere love. Think of the fear in their hearts, when they think of the situation you, their daughter and the mother of their grandchild, are facing. Think of how they just want to hold you and take you pain and fear.

Kathy, please take a break from your independence, just for the time it takes to get through your treatment. Cherish the help that your parents and others are giving you on your journey. Your willing acceptance is a gift to your caregivers.

You will regain your independence in time.

Kathy, you are going through a process that will likely radically change who you are. I have known many people say they are glad for having gone through the experience of facing and fighting cancer. I am not one of those people; I would have much preferred not having to face and fight cancer.

But I am glad to have learned some of the lessons I learned and met the people I have met along my journey.

We can talk in the future about some of the things I have been doing to reclaim my balance and my life post-treatment. Maybe I will have some nuggets that will help you get back to a comfortable place. For the time being, though, for the treatment phase, my best advice is to let the current carry you, try to avoid the rocks, and grab for every life ring someone throws you.

Take care, and stay strong.

Venita

PS: My offer of an email or phone relationship is always open.

A Place Called Today

Lori recently sent this to me.

A Place Called Today

There is a place where I have found great peace. I don’t visit it as much as I should. It is a place called Today. In Today, I often have no problems. If I do have problems, there are usually no more than one or two. Interestingly, these problems are fixable. I have the tools I need right before me. Action can be taken. Today is run by a benevolent king named I Am. I Am seems to give me everything I need just in time. He is the eternal Present.

Unfortunately, I am often in a place called Yesterday. Yesterday is a frustrating place to live. There are a thousand little suburbs of yesterday stretching back as far as the eye can see. Each Yesterday has one or two of its own problems. These problems prove impossible to fix. I ponder them endlessly. Even when I dream up a solution, I don’t seem to have the tools I need. Yesterday is ruled by two evil parties, Remorse and Resentment. They are constantly taxing me with old problems, yet providing no answers.

Sometimes I get sick of the crowded conditions of Yesterday and venture into the wilderness of Tomorrow. The wilderness of Tomorrow is an infinitely vast place. There are no roads and it is very easy to get lost. There are millions of little trails that lead to Nowhere. There are billions of problems here also. They are supplied by Imagination. Imagination mixes the problems of Yesterday and Today to come up with an endless supply of new problems. There is a ferocious beast that prowls the wilderness of Tomorrow. Its name is Anxiety. It is always watching and pounces at will. The only way to escape it is to run back to Today. It will not go beyond the edge of the wilderness of Tomorrow.

The Spoon Theory

This is a very interesting writing that explains the energy conservation measures a person with a chronic condition goes through every day. It's long, but worth the time. http://www.butyoudontlooksick.com/navigation/BYDLS-TheSpoonTheory.pdf

Surgeon Update/Les Update

I didn't mean to concern some friends when I explained that I was having a follow-up with the DIEP flap surgeon. I had developed two lumps and wasn't sure what they were. My oncologist's PA also wasn't sure, so she suggested I go back to Dr. Cutter, who is local, to have them checked. No way, no one but Dr. Chang is going to do any procedures on these flaps.

So on Friday Jim and I took a drive down to Baltimore. Dr. Chang and his surgical assistant reassured me that the lump in my left flap is fat necrosis, and relatively small. He will be able to do a little liposuction on it during my revision surgery if it hasn't reabsorbed by then.

The other lump, between my right flap and my armpit, is not fat necrosis. They speculate that it is scar tissue. That makes sense to me because it is the spot that keep me from having complete range of motion in my right arm. Too much stretching there (as with yoga) leaves my right side pretty sore for the rest of the day. I have started a massage routine on the suspected scar tissue to try to soften it up.

We also talked about why I continue to have discomfort in spots about one inch above my abdominal incision. Turns out that's where they cut through the muscle to harvest the feeder blood vessels. Dr. Chang said it could be up to a year for that soreness to go away.

Dr. Chang and his surgical assistant spent some time "planning the project" on my chest. "We can lift this up a little bit here." "We can pull this in." "We can fill those scar lines with fat from the abdominal liposuction." It was a little uncomfortable being looked at as a canvas.

As the visit was ending, we complimented the surgical assistant on her new hair-do. Dr. Chang said "show them," and she whipped off a wig. She has alopecia areata, an autoimmune disease that causes her to lose her hair in round patches. And, where she has the balding/thin spots, her hair has turned pure white. She must feel pretty comfortable with her patients, or lack vanity, to just whip off her wig like that.

So the surgery is going to be April 27 at 12:30. We are to arrive at 10:30. Dr. Chang said I would likely be released from recovery about 4 or 4:30. Just in case we happen to run longer, or we are whipped by the procedure, I'm making an overnight reservation at the hotel across the street from the hospital.

I've talked with Les a couple of times since he's been home. He's taking some work phone call already, and doing some walking for exercise. He will see someone at the surgeon's office, maybe it's this week, to have the staples removed and to get the pathology report. He has appointments with medical and radiation oncologists in early March.

Les went home Friday

I don't think he was the ideal hospital patient. But he sounds good now that he is home. Sadly, Donna caught the flu while Les was in the hospital, so their younger daughter is there caring for both of them now.

I am so happy that this step of Les's journey is over.

Les called this morning

His voice is the most beautiful sound on earth. He is weak, in pain, and a little mumbly, but in very good spirits. He's out of ICU and into a regular room. What a weight that short phone call lifted for me.

Fuck

Les's older daughter just called. The surgeon found a spot at the top of Les's left lung, attached to the artery, and had to take the entire lung. Taking the entire lung will make for a longer recovery, but a better outcome.

Les is in recovery now, a little freaked out because he woke to find himself still intubated. His color, O2 level, and blood pressure are good. He will be transferred from recovery to ICU. They may hold him there for a few days because the hospital is full and there are no beds available outside of ICU. Future treatment will likely involve radiation.

I was about to break into tears, but my neighbor came by with her border collie puppy. Shotsi. Not spelled that way, I'm sure, but that's the phonetic. The puppy took me out of my funk.

In Surgery

Les should be in surgery now. The surgeon has indicated that he plans to take only the lower lobe of the left lung. Prayers, bright light, and calm for Les and his family, and skill for the surgeon.

Reality Checklist

Ennis, my diabetic cat, usually asks for food every two to three hours. Small frequent meals help him feel better. It doesn't matter to him whether it is day or night.

If I am sleeping--napping or out cold for the night thanks to a sleeping pill--Ennis wakes me. It often involves a cold paw applied to my cheek. Sometimes, it is just the presence of this big hulking cat standing next to my head and purring loudly.

It might be advancing age, it might be the effects of cancer treatments, but when I wake I go through a reality checklist. First I decide whether I can be woken. If not, I advise Ennis to go ask his "poppy," Jim. Ennis usually doesn't buy that and I get another cold paw on the face.

So I progress with my checklist. I observe the outside light--am I taking an afternoon nap, is it the middle of the night, or is the dawn breaking? I roll over to check the clock. Will my feet and legs move; will they hold me when I go vertical? Up to a sitting position. Do I need to use the restroom?

Get up, grab a can of food from on top of the TV, pop it and scoop it onto the plate on the bed, and head to the restroom. I continue my checklist. If it's nighttime, the checklist goes like this--Did I brush my teeth before I collapsed into bed? Am I hungry? Did I take my nighttime pills? What day is it going to be? Do I have plans for the day? What's the weather supposed to be?

If it's daytime, a different checklist--What day is it? When did I fall asleep and why was I taking a nap? Do I have plans to get up at a certain time? Is Jim home?

I deliberately ask myself these questions. BBC (before breast cancer), those realities used to just pop into my head. Not anymore; now I need a checklist.

Since Monday night, I haven't needed my checklist. I wake up and it hits me--my brother has lung cancer. I just focus on that, and all the other realities flood into my consciousness, smothering the fear I feel rising in my belly.

I hate cancer.

My Brother has Lung Cancer

Les is the person I love second best in the world, and a real close second to my husband Jim. Les has just told me that he may have cancer in his left lung. He has a tumor in his lower lobe that is something like 2x3 cm. Les said "may" because he has not yet had a sample of the tumor tissue pathologized. But as his doctor told him, PET scans don't lie. The PET/CT scan lit up the tumor in the lower lobe of his left lung.

I'm not sure what I should write here about Les's cancer because he reads this blog. But I don't think anyone who knows him, other than some of my friends, read this blog, so unless he asks me to stop I will write what's on my mind and in my heart.

Les has multiple sclerosis, diagnosed maybe ten years ago. He has been so brave in that struggle, still working full-time or more, despite what are now very serious physical limitations.

Les is four years younger than me, and the only one of my six siblings I keep in close touch with. Most of my siblings have hurt me, emotionally or physically, in some significant way. Les never has. He adores his wife Donna, and has two adult daughters he holds dear, and a number of grandchildren.

Our family of origin was very dysfunctional, and with the abuse, my siblings and I became loners or went outside the family for emotional support. I was not close to Les growing up, although he was a nice enough kid. I "remet" him at a family wedding in the 1980's and we hit it off like gangbusters. How could I not be drawn to this brother who was intelligent, and funny, and hardworking. We ruined many a wedding photo cracking up at the raunchy jokes we whispered to each other.

Les lives in rural northeast Texas, and easily picked up the Texas drawl when he moved there. He sounds like a native. He has worked for years for oil field service companies. He is very mechanically inclined; as as my sister-in-law says, he is handy as a shirt pocket.

Les tells me he has been going through diagnotic testing since December 19, 2008. It all started with a chest X-Ray, although I don't know the reason the X-Ray was taken. Seeing a suspicious area, testing proceeded to other imaging methods, as well as a bronchoscopy to remove a tissue sample for pathology. The doctor was not able to get deep enough into the lung to get a sample of the tumor, but other tissue taken from the procedure was clear of cancer cells.

Les is seeing a thoracic surgeon this Thursday. Les has been told that regardless of whether the tumor is cancerous or benign, it has to come out. Therefore, the doctors are not planning a needle aspiration of the tumor; they plan to go straight to surgery. Les says that by this time next week, either the lower lobe or the entire left lung will have been removed. Les has had pulmonary testing that shows he will be able to function with his right lung alone.

Yes, Les is a smoker. Our father died young of lung cancer, with metastasis to the brain.

A Long Overdue Update

It's been almost 3 months since my reconstruction surgery, and I am so sorry to be remiss in giving updates.

I am just flat-assed happy that I had this reconstruction done. I am finished with physical therapy, and have complete range of motion (ROM) in my left arm with almost no discomfort. My right arm ROM is vastly improved over pre-reconstruction status, although not 100%. But manageable, very manageable. And it may continue to improve over time. Experience shows that it takes me about a full year to fully recover from a major surgery.

My abdominal swelling is completely resolved, and I can button my jeans again. YEAH!!

I found myself slipping back into clinical depression after the surgery, and I really couldn't understand why. My therapist suggested I go back onto antidepressants, but the nurse practitioner that I wanted to see in the office was not taking new Medicare patients. (Why this place screws with mentally ill people has always confused me.) But over time, the depression lifted. I mentioned this at a cancer support group meeting, and someone suggested it might have been anesthesia-induced depression. I had never heard of such a thing, but it certainly made sense.

I have started exercising again, mostly at the YMCA. I try to do at least 2 yoga sessions a week, as well as something else. Sometimes the something else is a mile or two on the stationary bike. This week the something else was a class called "Dance NRG" (energy). Semi-aerobic, lots of bouncing and stretching, quite a challenge for the sensory neuropathy in my feet and the motor neuropathy in my legs, and a real brain teaser for my cognitive impairment--trying to remember the steps. I just might do that class again next week.

I am trying to get into an exercise study for breast cancer survivors. It would involve 14 weeks of supervised exercise at a pretty classy rehab facility. There would be pre- and post-study measurements. The one problem is that the study would have a randomly chosen control group. The control group would get the measurements, but be asked not to engage in an exercise program during the study period. I will not be part of the control group, even if it means not joining the study and thus not getting the possible opportunity for the supervised exercise.

I lack stamina right now, and I know exercise, and nutrition, will put me back to right. And we all know how bad I am about nutrition, so exercise is necessary.

Here's an example of lack of stamina. Yesterday, I did about 2 hours of running around chores, and then about 2 hours of housework. Nothing really physically challenging. I watched TV in my bedroom in the evening, and laid my head down at 10pm for a quick nap. I woke at 1:30am. I hadn't realized how pooped I was.

Jim has been away this week at Myrtle Beach for a guys golf week. It's been nice to get a little alone time, and not have to plan and make dinner every day.

We haven't had such a great 2009 so far. At New Year's, Jim and I both came down with a GI tract virus--vomiting and diarrhea. It wasn't the flu; no fever or muscle discomfort. Jim had it for 3 days; thankfully, mine was only one day. Then Jim had in-office surgery on his head for a basal cell skin cancer. The next day he was diagnosed with macular degeneration. We saw a specialist, and he had the dry kind in his left eye and the wet kind in his right eye. His left eye isn't too bad, but the right is. He has started treatment on his right eye, which involves the injection of a small amount of a chemotherpy agent into his eyeball. Every six weeks. The shot isn't painful, just frightening, so I will be pre-medicating Jim with some valium before his next shot. (There is no treatment for the dry type of macular degeneration.)

I had been suffering since early December with a full body rash. Our dermatologist gave me a cortisone shot and some acid mantle cream, and although the rash and itching were reduced, they did not fully resolve. When the DR saw me 10 days later, she declared that I had scabies, which comes from mites. The DR said I probably picked them up in the hospital. Both Jim and I had to be treated with a Permethrin cream, and our bedding, towels, and clothes had to be washed in hot water, or put into sealed trash bags for two weeks. I still have some itching, but I think it is just my normal winter dry skin.

And of course, there are our new babies. Emma Leah is a grey tabby with white bib and legs, and Casey is an orange tabby with white bib and legs. When we got them in early December, Emma was 4 months and Casey was 6 months old. Both came from shelter/rescue situations. Casey brought in a very nasty upper respiratory infection, which all the cats got, including Grandpa Ennis. It continues even now, with Casey finally on a course of Doxycycline Hyclate (an antibiotic) because he is now sneezing green snot.

Ennis isn't thrilled with the new cats, but he's becoming accustomed to them, especially now that he is over the conjunctivitis he picked up from Casey.

So what does the future hold? Jim is toying with the idea of going to Clearwater, FL, in March for part of the Phillies spring training. I am starting back on that book I still need to write for the AICPA. I have revision surgery on April 27, where the surgeon will be making cosmetic corrections to my breast flaps and adding nipples. Jim may have his other knee replaced this summer....he seems reluctant to go through it again. Other than that, we are just looking forward to the end of winter, even though we have been very fortunate with little snowfall so far.

Water Fountain in a Japanese Mall

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.

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 breastcancer.org 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.

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.