Mastectomy Surgery with Tissue Expander placement.

I haven't been as diligent at updating my blog since I finished with Chemo.  The first two weeks after my final AC treatment, I was struggling to overcome that last chemo and simply feel "good".  Then I began to feel more and more like myself and began having energy to do more than walk from my bed to the couch.  I simply couldn't stand the idea of sitting on my couch or computer when for the first time in months, I had energy and the desire to leave my house.  I had four weeks between my last chemo and my mastectomy surgery.  However, only the last two weeks were "functional" times.

My mastectomy surgery was on April 10, 2014.  I had to report to the hospital at 6:15 a.m., and my surgery was scheduled to begin at 8:30 a.m.  I was extremely nervous about the surgery as I had never been under anesthesia for more than two hours in the past.  I had already been told I had heart damage from the chemo, so I couldn't seem to stop worrying that something would happen during such a long surgery.  My doctor's were anticipating I would be in surgery for about 6 hours.  My Surgical Oncologist, Dr. Povoski, would first do the mastectomy and lymph node dissection.  After he was done, my Reconstructive Physician, Dr. Chao, would insert the tissue expanders and close up.  I was a nervous wreck the morning of the surgery although I tried hard to hide it and keep my whits about me.  I was sitting in the waiting room with my husband, sister, brother-in-law, and two of my children, when I went to the front desk to let them know I needed to use the restroom (they had told me to tell them before I went because they needed a urine sample).  Rather than giving me a cup and sending me to the restroom, they decided to go ahead and take me to the Pre-op area and get things started.  I had to walk back to my family and quickly tell them goodbye.  Maybe it was best it worked out that way, but I was struggling to keep it together as I walked to the pre-op area.  Chuck went with me as I was allowed one person at a time.  He kept trying to reassure me that I was going to be okay, but I couldn't seem to stop the tears from coming.  Fear had a grip on me.

After some time, Chuck went out and sent my sister, Cindy, back.  When she walked in my room, I instantly began crying and she gave me a big hug assuring me everything was going to be fine.  As always, I felt better just having her there telling me it was okay.  The nurse came in to go over some pre-op questions before they took me to the OR holding room.  She told my sister to get both of my kids and bring them back so I could see them together before she took me to the OR area.  This also made me feel so much better.  I was able to hug and kiss them and reassure them (or maybe I was the one who needed reassurance) everything was going to be okay.  After hugging and kissing my children and THEM reassuring me it was going to be okay, it was time to go.  Cindy and Chuck got to hug me one last time before they were ushered out.  They then began wheeling me to the 5th floor OR room.  I was taken to the waiting area where they got my IV started.  Thankfully, my veins cooperated and there were no issues with that.  I was worried my veins would blow or there would be a problem; but, I had worried for nothing.  I lay there waiting to be taken to the OR, and I just prayed.  I prayed God would watch over the doctors and nursing staff responsible for my care.  I prayed God would watch over me and keep me safe.  To allow me to say I was cancer free when this surgery was over.  I prayed God would give my family peace of mind and comfort them while I was in surgery.  I just prayed!

A nurse came by shortly after to tell me she was giving me a shot of "happy juice".  She patted my hand and said "I know you're nervous and scared.  This will help with the fears and allow you to relax. We will be taking you to the OR soon".  She was right.  Within moments of her giving me that shot in my IV, I felt relaxed.  Once I was in the OR, they had me scoot from the gurney to the operating table.  There were people everywhere all around me; but I couldn't bring myself to look around.  The nerves were back.  Dr. Povoski was standing right by my bed and began talking to me.  I've had my share of surgeries; and he is the only doctor that's EVER been in the OR room with me before I was knocked out.  I can't think of a single doctor or time where I saw the doctor in that room prior to going under.  But there he stood--comforting me and truly concerned about how scared I was feeling.  I told him he was seeing my childhood friend, Stephanie Buckley, and he instantly knew whom I was talking about. We had previously talked about Connie Nelson, my sister's mother-in-law, who was also seeing him since I had been diagnosed.  The last thing I remember talking about with him was Stephanie.  I remember them putting the mask on my face and telling me to take a few deep breaths, and then my eyes got heavy--and I don't remember anything else until many hours later I woke up in the recovery room.  A kind, male nurse was sitting by my side asking if I was in pain and wanted something for the pain.  I said yes or something close to that; but he got the message well enough.  I remember waking up a few times before they finally told me they were going to transport me to my room and once I was settled in my bed, they would give me more pain medication.

Once they wheeled me to my room, I had to scoot from the gurney to my bed in my room.  I cannot BEGIN to describe how painful this was.  My chest felt like a truck had hit me, and every movement I made hurt.  I gave myself a pep talk to just grit my teeth and do it as quickly as I could.  Pain medication would be my reward.  In a few movements, I had myself in my bed; but tears were streaming down my face because it hurt so badly.  But I did it!  I also was extremely thirsty and begging for water.  They offered me crackers, and I do remember smartly saying "my tongue is sticking to the roof of my mouth because my mouth is dry.  There is no way I can eat crackers.  Water!".  My sister said after only a few minutes, I was loudly complaining wanting to know where my water was because it had been a long time since I had asked.  My sister said it had been about 1 minute.  LOL  Finally, I did get my water, which I downed most of it in one gulp and asked for more.

While I slept a lot during that night and into the next morning, I was also in a considerable amount of pain.  My chest was VERY sore, and it really did feel like I had been hit by a truck.  It wasn't necessarily the incisions across my breasts that hurt.  My breasts themselves were somewhat numb; but I was quite sore in that area that is comparable to the absolute worst bruise possible.  I had three drains on the left side as well as two drains on the right side coming from my sides.  The drains hurt like hell.  There is no other way to put it.  Every move you make pulls and tugs on them, and it burns and stings.  The expanders that were put in my breast were awkward and tight feeling.  They are nothing like implants.  I've had implants for ten years, and expanders are not even close to an implant.  They are a more rigid plastic and a bit uncomfortable.  During my pre-op appointment, my plastic surgeon had agreed to fill my expanders as full as he could so I wouldn't come out of surgery flat chested.  Not because I care about having boobs right at this moment, but I didn't want the shock of looking at my chest completely flat with no nipples at the same time.  So, you can imagine my shock the first time the nurse peeked at my incisions and I saw myself--completely flat chested with huge, ugly incisions across my breasts.  What happened to coming out of surgery with the expanders somewhat filled?!

My sister was standing there when this happened, and I looked at my sister while saying "Why am I so flat--what is this"?  Yes, I realize beating cancer, coming through a major surgery, and surviving this mess are the most important things; but I would also like to look and feel good as well.  Cindy immediately spoke up and said "Dr. Chao explained to us that he was only able to put about 40 cc's in each expander because the skin was pretty tight over them.  He didn't want there to be a lot of tension on your incisions while they are healing."  While this explanation made perfect sense, and I understood the reasoning, I was struggling with accepting a change from the plan I had in my mind.  As I've said before, I'm a planner, and when things deviate from the plan, I struggle to keep up.  Thank God for my sister who knows me so very well and got all the information to questions she knew I'd be asking when I was awake.  She didn't want me to freak out not having answers, so she made sure she asked them for me.

My sister, brother-in-law, and my children left to head home shortly after.  Chuck stayed in my room with me.  I couldn't reach or more my arms more than an inch from my body, so having someone in the room with me was pretty important--and an exhausting job for them.  I quickly became frustrated not being able to even reach for a drink myself without help.  I hated constantly asking him to get up to hand me things; but I honestly had no choice.  I simply couldn't do it myself.  I'm very thankful he was there to help me.  I had a roommate on the other side of a curtain who snored very loudly, talked very loudly to the nurses and cried, moaned and wailed often.  I tried very hard to be sympathetic toward her; but I quickly became frustrated because she would sleep easily without interruption yet every time I tried to sleep, she would make tons of noise and wake me up.  So, while I wanted to sleep that night, I didn't get much of an opportunity between her and the nurses coming into my room.  At one point, Chuck was making movements and body gestures to match the sounds she was making, and it was quite funny.  I finally had to tell him to stop because laughing truly hurt!

I was released the day after my surgery, and we headed home about 1:30 p.m.  The ride home seemed endless, and I felt every bump in the road during the 2 hour drive.  The next few days are a blur to me.  I hear the weather was glorious and warm.  I wouldn't know.  I spent it sleeping, eating, and taking pain medication.  I began feeling less pain and stiffness on day 4 after surgery.  By day 5, I was finally able to sit or stand up on my own without being pulled up by someone else.  Yes, you read that right.  I wasn't able to stand up from the couch or get up without being helped.  I simply couldn't do it alone.

Today, April 16, 2014, I had a check-up appointment with my surgical oncologist and my reconstructive surgeon.   My reconstructive surgeon removed 2 drains today.  Yes, I still have 3 drains, but I was happy to get two taken out today.  It's a start!  He said as long as my fluid levels stay low in the drains (which means I have to keep my activity level low), I will likely get the other three out next week.  My incisions were checked, and he said everything looked good.  I will get my first expander fill at next week's appointment.  The amount I am given will be determined by what I can tolerate and what feels safe to my doctor.  I then went to my surgical oncologist, and he informed me my pathology reports were not all back yet.  I am to call him on Friday to get my pathology report from the tissue that was removed during surgery.  My doctor did tell me there was no cancer found in the tissue from the right side, and the margins around the tumor from the left side were very good and clear.  He said he removed 15 lymph nodes during the dissection (15 were removed during my sentinal node dissection as well).  Of the 15 removed this time, 4 nodes were being tested further for cancer cells.  This tells me something in these 4 looked questionable, but no answers will be available until the final report comes in.  Therefore, I simply ask for prayer from each one of my readers that none of the nodes removed during this surgery contained cancer.  My first biopsy showed 5 out of 15 had cancer, and I would LOVE it if that did not change for the worse.

I will update again when I have further news.  Thank you to all my readers!

Teresa