Capsular Contracture

Hello To My Valued Readers!

I hope this finds each and every one of you doing well.  I look at the number of visitors my blog receives each day, and I'm shocked at the number of visitors my humble little blog receives.  However, I also get it.  I was once that patient facing a cancer diagnosis desperately searching the Internet for as much information as I could possibly find.  That in itself is why I continue to update this blog.  Although I don't update it as often as I did while I was going through treatments, I do make a real effort to update it as often as I can.  My intention is to keep my readers informed of my progress and to allow them to have a general idea of what to expect with various stages of treatment.  Notice I said treatment.  I'm well beyond the typical stages of treatment for breast cancer, but I would like to point out that once you've had cancer and complete treatments, it certainly doesn't completely go away.  There are regular checkups, follow-up surgeries, and many other things that can crop up along the way--therefore, I am still recovering from my cancer journey in many ways.  While it certainly doesn't affect my day-to-day life as it did while I was doing chemotherapy, it's still there just like a nagging doubt hangs out in the back of your mind and interrupts your sleep.

For those of you who have read each of my entries, you will remember that I've had issues with cording on my left side, which is my breast cancer side.  Cording is a fancy name for scar tissue that's attached itself to soft tissue beginning in my auxiliary area (armpit) and extending down the inside of my arm.  It's called cording because it feels like a thick cord.  The body's natural response to trauma is to heal itself, and that means creating scar tissue as a means of protecting an area that's been cut or traumatized.  I had surgery under my left arm to dissect my lymph nodes (determining if cancer had spread) then several months later, I had a bilateral mastectomy, and the remaining lymph nodes under my arm were removed, which meant more trauma.  This led to my body kicking into overdrive and creating quite a bit of scar tissue, and it has developed out of control. Not only has it extended down my arm and caused cording issues, it's developed a capsule around my left breast implant.

Because my left breast was also radiated, the entire area has been damaged as radiation causes cellular damage.  This coupled with the trauma of surgery has caused what's called capsular contracture.  This is a term used to describe the scar tissue that forms around a breast implant.  The result is a misshapen, distorted, hard, and painful breast.  It literally feels like someone put a softball under my skin because it's so hard.  The implant will migrate to the area of least resistance, which for me is up toward my collar bone and into my armpit (which is likely where the auxiliary area was dissected).

I've had this issue for well over a year, but it has become unbearable over the past six months.  As many of you may remember, I was going to do the DIEP flap this past July, but I changed my mind.  I decided against this surgery because it's so invasive and it can be quite risky.  While there are risks with this surgery since my skin has been radiated, I felt I should try this less invasive surgery before moving on to something bigger like the DIEP flap.  My Capsulectomy, which is the name of the surgery where the surgeon removes the implant as well as the scar capsule to release tissue then insert a new implant, is scheduled for December 27, which is this coming Tuesday.  I will leave the hospital with a much softer breast as well as two drains, and while the recovery itself isn't expected to be too bad, I cannot be active as activity increases fluid output, which can result in larger issues or even loss of the breast.  If you would like to see what a capsule looks like around an implant and what I'm referring to, I found a great You Tube video of a surgeon performing a capsulectomy. 

Therefore, I'll be spending the next few weeks Netflix binging and enjoying some time at home.  I will update my blog again to keep my readers up to date on how the surgery went, what it felt like, and what I experienced along the way.  Additionally, I will eventually be providing before and after photos as I know that's always a big request from readers who may be facing the same challenges.

I wish a very Merry Christmas and a Happy and Healthy New Year to all of my readers!

March 5, 2017 Update:  

Hello Everyone!  I wanted to provide an update on how my surgery went on December 27.  I woke up after surgery in very little pain.  I remember immediately feeling my left breast and feeling soft skin, and all the pressure that was under my arm and across my chest was gone.  While I wouldn't say the surgery I had is painless, it alleviated so much daily pain that I actually woke up relieved.

Everything healed great, and I was very happy with my results.  I had a soft breast, and I actually had normal looking cleavage again.  Everything went well until I developed a sudden fever about two or three weeks after my surgery.  I ended up in the hospital for three nights to receive bag after bag of Vanko via IV.  There was never a determination regarding what actually caused my fever, but the night before I went to the hospital I had been awake most of the night freezing in my bed, and my breast was aching worse than it had right after my surgery.  A early infection was suspected, but it was caught early.  I went home grateful it had been caught early, and I felt I had narrowly escaped without a bigger complication.

My drain stayed in tact for six weeks, which was quite frustrating.  My fluid levels would not drop below 40 ml per day (total), and my doctor wanted it lower than 30 total per day.  After my scare with the fever, he was even more unwilling to remove the drain with my fluid output so high.  At six weeks, it finally came out although my output still remained around 40 ml per day.  Needless to say, I was quite happy to finally cut the cord.  I felt great, and I was ready to move forward with my life.  I had a conference in San Antonio for work I was schedule to attend the following week, and I was cord free none to soon.

While in San Antonio, I was drying off after showering, and I inspected my incisions as I did each day, and a dark spot caught my attention.  Since my surgery, random sutures had worked their way to the surface of my skin, so my immediate reaction was it was probably just a stitch beneath the skin.  However, this was a circular area, and it concerned me.  I took a picture of it so I could compare the size each day to see if it was changing.  I also put antibiotic ointment on it, and I covered it with a circular bandaid as I thought perhaps my bra was rubbing the incision--at least that was my hope.  I'm placing photos below of my before and afters as well as what the spot looked like.

I returned home on Thursday evening, and I had a checkup with my doctor on Saturday.  I was worried about the spot, but I was trying to remain positive as I drove to the doctor.  It hadn't changed much in size, but I could also tell it wasn't a stitch.  When my doctor looked at the spot, I could tell by the look on his face it wasn't just a stitch.  The area of concern was an additional incision he had to make above my mastectomy scar due to damaged/thin skin from radiation, and he was very concerned about this particular incision.  He consulted with another doctor, and they both agreed the black spot was where my skin was so thin and was essentially pulling apart or breaking down, and the shadow of the implant beneath was showing.

When I did this surgery, I knew there were risks associated with it, and I knew it may not work.  It was a risk I wanted to take to avoid the DIEP if possible though.  If I had to do the DIEP, I wanted to make sure I had tried everything else first.  Unfortunately, this new situation was not fixable, and I was not facing the DIEP as my only option.  Fear of the skin pulling further apart and infection meant surgery couldn't wait too long.  I was scheduled for the DIEP for March 6 (a little less than two weeks ago).  While I'm dreading this surgery because of the recovery process, I know the overall outcome will likely be much more favorable.  I'm dreading an incision across my stomach and the pain that's sure to come with it.  I'm just tired of being cut up and laying on OR tables.  I'm just tired of surgeries.  But, I also miss having a normal feeling breast and not having pain in my breast and arm every day of my life.  I need to feel whole again.  So, tomorrow morning, I will once again lay on the OR table, and I hope and pray this is my last surgery.  I'll be posting an entry called The DIEP Diaries that will be updated regularly from beginning to end of my DIEP journey.  Please check back regularly for updates!

Teresa




3 comments:

  1. Hi, Teresa! I hope you're having a good day. I found you on Google searching for post radiation images. I was diagnosed with DCIS in December 2016. My first mammogram was November 2016. I have some questions for you. Is there a way we could talk or email? I'll be undergoing radiation in a couple of weeks, and I have questions about skin going back to somewhat normal. If you you're unable to contact me for whatever reason, I completely understand. Sincerely, Diane.

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    1. Hello Diane--I don't mind chatting via email at all. You can email me at teresatrussell40@gmail.com. I go in my my DIEP flap in the morning, so I may not respond for a few days as I'll be out of it, but I'll reply as soon as i can. Talk to you soon

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