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




How I Rediscovered Myself Through Education

Hello Everyone!

Yes, it's been a while since I've posted in my blog, but as I've stated before, it's for good reason.  I've been so busy enjoying every moment of my life and simply living this beautiful life I've been blessed with that I don't leave a lot of time for myself to blog anymore.  In a sense, that's sad because I enjoy writing, and I know this blog has been and continues to be a blessing to others who are facing the breast cancer journey.  On another note, it's also a source of hope to those of you who are currently facing the journey as, to me, it's proof that your life does get back to normal and every waking second doesn't have to revolve around treatments, surgeries, and fighting for your life!  On that note, I'll take a moment to bring everyone up to speed on the journey my life has taken me since my last post April of 2016.

DIEP FLAP SURGERY
In my last post, I mentioned I had the DIEP flap surgery scheduled for July.  I did NOT follow through with this.  I struggled internally with the decision to go through with that surgery, and I finally made the decision to cancel the surgery.  My decision in no way reflects my opinion or trust of my physician as I am certain he would do a fabulous job.  My decision had more to do with the risks associated with the surgery.  I only weigh 115 lbs, and that doesn't leave much fat for them to take from my stomach area to use as a breast flap.  While I felt it would provide relief in my breast area, I felt I would be taking on a new set of risks associated with the incision from hip to hip across my stomach, and I didn't feel the results were worth that risk.  I have accepted the way in which my body now is, and I'm not willing to take on a large incision across my stomach just to have better breasts at this time.  While I may change my mind in the future, I feel the risk were greater than the rewards at this time.

CORDING
The cording is still there, but I've got it to a manageable level now.  I stretch every day, and I vigorously rub my underarm area and down my arm to keep the scar tissue stretched and from tightening back up.  I cannot stress enough how important stretching is for this.  It can be quite frustrating, but it's part of my every day routine now.

HAIR
Hair--the topic all of you are wondering about most (it's okay, and you're not vain for wondering).  I've had my hair trimmed several times, so it's difficult to say how long it would be if I hadn't trimmed it and such, but it's very healthy and I am so happy with how it looks.  It's long enough that it now tickles my shoulders and even the top part of my back.  The other night, I thought a bug was crawling on my shoulder, but it was just my hair! I'm posting a photo below so you can see the growth year by year.   Top left is October 2013 when I was in the middle of chemo, top right is October 2014, bottom left is October 2015, and bottom right was just taken last week.



JUST CALL ME MIMI
If you think your life won't get better after breast cancer, think again.  When I was diagnosed, I specifically remember saying "I used to say I never wanted to get old.  Now all I want to do is get old and know what it feels like to rock my grand babies".  Life has a funny way of giving you exactly what you ask for, and I couldn't feel more blessed!  In September 2015, my first grand baby entered this world.  At the time, my youngest child was 17 years old, and it had been a long time since I had held a baby.  It didn't take me more than five seconds to fall in love with him, and he's had me wrapped around his little, chubby finger since.  The joy he brings to me is something I can never describe, but I can tell you that I am so grateful for every second I'm blessed in this life and that I was given a second chance to be his Mimi!  I'm posting a photo of him right after his birth as well as his pictures we just took this past weekend celebrating his first birthday.





ONCOLOGIST CHECKUP
Yesterday, I made the two hour (one way) trip to Columbus for a checkup with my new Oncologist.  My former oncologist had left the breast center, and I was assigned a new one.  As I was driving to my appointment, it dawned on me that it was September 26--it was the three year anniversary date of the date in which I was told I had breast cancer.  I drove quietly remembering that day three years ago when I received that phone call and was told "you have breast cancer".  I could still hear my doctor's voice saying it in my mind, and I don't think I'll ever forget how I felt inside.  My doctor continued to talk about treatment plans, surgeries, chemo, radiation, and options, but I honestly didn't hear anything but a loud buzzing in my ears after I heard the word cancer.  His voice sounded a million miles away, and I sat there with a flood of tears running down my cheeks.

The word cancer immediately evoked a sense of dread and fear inside me, and it threatened to stop me in my tracks--all I could think of was death.  I lost all sense of logic and time, and I could feel myself sinking into an a well of fear.  It was like be swallowed up by a cloud of evil.  I cried off and on all day that day even though I received the news while sitting in a hotel room with my son and far from home.  I felt lost inside and completely and utterly helpless.  After a few moments in the car, I returned to the present time, and I smiled as a tear rolled down my cheek.  What a difference three years makes, and I knew in that moment regardless of how weak and hopeless I felt in that initial moment, I fought bravely, and I won.  Not because I beat cancer.  We are not promised tomorrow, and I'm always reluctant to use the phrase "I beat cancer".  I won because in spite of the fear and pain, I continued to move forward with my life.  I refused to allow cancer to control me or the choices I made, and I used the negativity cancer brought into my life and turned it into a powerful lesson for myself and everyone around me.  How did I do this?  Well, please feel free to continue to read on.

DEEP THOUGHTS
As I was driving home from work tonight, I thought about this blog and how I've been neglecting it.  I made the decision to post an update tonight, and I began thinking about what topic I would write about.  While going through treatments, some of my posts were quite deep (and if I may say so myself, insightful).  While I'm sure my followers enjoy the updates on breast-cancer related items, these generalized posts are missing the depth that some of my posts had when I really focused on writing as an outlet.  For me, writing is a way of expressing myself and what's deep inside me.  It isn't difficult for me to let my fingers fly on the keyboard, and everything I'm thinking just ends up on the screen.  Sometimes, things end up on the screen that I didn't even know I was thinking.

Rewind to this time last year (2015).  I was still working on finding myself and figuring out where I fit into this new world of post-breast cancer.  Cancer changes a person--it has to.  You cannot walk into a storm, fight like a warrior, and come out on the other side the same person as when you walked in.  That's why it's called "the other side".  Each evening, I would come home from work, and I would find myself looking for things to do at home.  One can only clean their house so many times--especially when there isn't really anyone in the house making a mess.  My son, who is my oldest, (and the father of Wyatt) is in the Marines, and he lives in California. My older daughter just graduated from college this past spring and lives on her own.  My youngest daughter is now a freshman in college and lives at the school.  Last year at this time, even when my youngest daughter was with me (divorce and shared parenting), she wasn't here that often.  She was a senior in high school and doing her own thing a lot.  For the first time in my life, I found myself with a lot of free time.  I decided I could find something productive to do with this free time, or I could squander it away.  I chose to be productive.  God did not give me a second chance at life to waste it!  I decided to return to college and finish my second degree I had begun in 1997.  With so many online classes and the fact that I work at Ohio University, I knew I could easily do it while continuing to work full time.  So, I applied, was accepted, and I became a college student again at the age of 42 during spring semester (January) 2016.  It was truly the best decision of my life--stay tuned, and I'll explain why.

Since I began during spring semester 2016, I have continued in classes.  I took classes during the summer, and I'm currently enrolled for fall.  I should graduate Fall semester of 2017 (I could graduate sooner, but working full time prevents me from taking a full-time load of classes).  I am not only a college student, but I'm also an Honors Student in the Mackenzie King Honors Program as well.  I have a 4.0 GPA, and I do not say this to brag.  I say this because I KNOW there are women out there reading this who are facing chemo brain and feeling as if they have truly lost brain cells thanks to chemo.  I'm hear to tell you that you can push past it!  Since I returned to school, I have rediscovered myself.  In some ways, I have learned new things about myself, and I'm a better person than ever before.  In other ways, I've found myself again.  Before cancer, I was very ambitious.  I enjoyed my career, and I worked hard at everything I did.  While I continued to work during treatments, my focus was beating cancer.  This caused me to lose my ambition and drive, and that's a very big part of who I am.  It took me a while to find that again, and I found myself struggling to find a foothold or my place.  In a sense, I had to figure out who the new me was before I could figure out where I even fit in anymore.  Returning to school helped me figure that out.  Not only have I expanded my education, but I've pushed through a fog that was lounging in my mind.  Anyone who says chemo brain isn't real is CRAZY, and I'm willing to debate that at any given time.  If you haven't lived it, you really shouldn't say it doesn't exist.  It certainly exists.  I found myself unable to remember certain words or how to spell them.  Occasionally, it still happens, but not to the degree it used to.  When I jumped back into my career after treatments were completed, I had to relearn a large portion of my job.  I couldn't remember how to do things I had personally developed prior to cancer.  I truly felt like I was walking through an unknown area that was shrouded in a dark, deep fog.  I was fumbling around trying to find my way with little light to guide me.  That's how chemo brain feels.

So, what's education got to do with this?  It has everything to do with this.  Let's talk about your butt for a moment.  A tight, BIG butt is all the rage right now.  The Kardashians made having a big butt popular again, and the gyms are full of women doing ridiculous amounts of squats to get a bigger butt.  Meanwhile, I'm wishing mine was smaller, but that's a different topic.  So, now you're thinking: this girl has lost her mind.  She's talking about butts all the sudden.  Stick with me--there's a point here, I promise.  To get that sought-after butt, women work hard, take photos in the mirror to compare progress and work out the glute muscles.  The only way to get the desired result is to work out the muscle.  Now, here comes the point.  The brain is like a muscle.  If you don't exercise it, it gets lazy.  Add some chemo to the mix, and it's not just lazy but it's also foggy.  What's the best way to clear out the fog and kick laziness to the curb?  Exercise!  Learning and education is the best exercise for your brain.  Not only does it help to kick chemo brain to the curb, it develops you as a person.  You grow and expand!  And finally, another notable side effect of education is that it provides you with a positive focus.  Rather than sit around worrying about IF your cancer will return, put your efforts into something positive for yourself such as learning and education.  Not only can it benefit you down the road, but it can redirect your thinking and rewire your brain.  Constant worry of a recurrence is a major concern of cancer survivors, and only YOU can take control of that.

On a closing note, I would like to say that returning to school saved my sanity and has made me a better person.  I am truly happy inside and out, and I am enjoying every moment of my life and the blessings I've been given each and every day.  For those wondering, my checkup went great yesterday at the Oncologist.  He told me to keep doing whatever it is I'm doing because it's working.  So, I'm sharing my secret with you.  It's exercising my brain.  It's growing as a person and simply being thankful for my life and those I'm blessed to call my family.  Finally, it's the fact that I no longer let fear control me.  I've stopped waiting for "when I can...." and just doing it.  Consider this:  I've always wanted to travel to Europe.  But the time was never right, I never had someone to go with me, and I began to feel like it wouldn't ever happen.  Then one day I realized "what am I waiting on--someone to go with me?  Go!".  So, I booked a solo trip to Greece.  I went to Athens, Greece for three days where I walked miles upon miles to view one historical site after another.  I stood in front of the Parthenon and soaked up the history that stood in front of me.  Then, I went to the Island of Crete for 7 days and experienced a culture that is like nothing I've experienced before.  I met people from all over the world and listened to their stories.  I walked on the walls on the Island of Santorini and stood next to the iconic blue domes.  I did it for me--nothing more and nothing less.  I stopped waiting to live my life and simply began living it, and I encourage each and every one of you to do the same.  Traveling alone was an amazing and liberating feeling.  One can truly only learn who they are when they are willing to spend time alone with themselves.  <3






2-Year Post Chemo/Surgery Update

2-Year Post Chemotherapy and Surgery Update 

I realize it's been quite a long time since I've updated my blog; however, this isn't necessarily a bad thing.  Anyone that has gone through cancer treatments knows that it can literally take over your life.  Your time is consumed with doctor appointments, treatments, surgery, worry, and stress.  This blog provided an outlet for me to express my deepest fears, concerns and also share my experiences in hopes that it would help others who were facing this dreaded disease.  While it certainly did that, I have also found that as I progress farther and farther outside of treatment time, cancer is on my mind less and less.  Unfortunately, a side effect of that is that I don't update this blog as often as I used to or should.  

For those wondering and using the timeline method (as I did), here are my hallmarks compared to where I am now.  
  • Diagnosed September 2013:  I am 2 years and 7 months from diagnosis.
  • First Chemo Oct. 2013 & Last Chemo March 2014:  I am 2 years and 1 month from my last chemo.
  •  Double Mastectomy Surgery April 9, 2014 (with expanders placed):  I am 2 years and 11 days from my double mastectomy surgery. 
  • Expander to Implant Swap Surgery July 2014:  I am 1 year and 10 months from my expander swap surgery. 
  • Began Radiation Treatment July 2014 & Completed September 2014:  I am 1 year and six months from my final radiation treatment. 
  •  Fat Grafting Surgery January 2016:  I am 3 months from my fat grafting surgery.
  •  DIEP Flap Reconstruction Scheduled for July 6, 2016. 
I do not wish to discourage anyone, but as you can see by the timeline, the diagnosis stage to the complete stage is a very long and drawn out process.  In fact, for me, it is still continuing since I chose reconstruction.  I will discuss various complications I've had for those who may be wondering what to expect after the fact.  

Cording
Cording has been an ongoing issue for me.  It began in late August 2014 when I was finishing up radiation.  While there isn't a lot of research on what causes cording (or how to fix it), it is thought to be caused from scar tissue and is often more prevalent in patients who also had to have radiation, which I did.  It began as a tight or stinging feeling in my arm on the radiated size.  It felt as if someone had shortened the tendons in my arm, and when I would attempt to stretch my arm, it pulled and was painful.  Think of a rubber band, and stretch it as far as you can.  As soon as you release tension on the rubber band, it snaps back to it's original size.  This is exactly how my arm felt when I would attempt to extend it--as if a rubber band was inside pulling it back, and it hurt a lot.  There is no surgery or real treatment for cording besides stretching and attempting to "break" the cords.  I was able to break many of them over the course of the past two years, but I still have several thick cords that extend from my pectorial muscle under my arm and down to my elbow.  I have to stretch my arm and chest every day to keep it at bay.  

In January 2016, I had fat grafting done in an attempt to soften some of the cording in my underarm area.  My plastic surgeon used liposuction to remove fat from my abdomen, it was liquefied and injected via needle along the band of cording under my arm.  While it did help some, and I felt relief when I woke up, it began to tighten up within two weeks of surgery.  For anyone considering this, the biggest benefit of this entire surgery was that he was able to break many of the cords while I was under anesthesia.  I have full range of motion in my arm, so this is something I couldn't have tolerated had I been awake.  The fat grafting itself didn't seem to do much that I can see.  

Hair
Two years ago today, I was still bald, I had no eyebrows, and my eyelashes were missing.  I have posted a picture showing me two years ago and me today to give you an idea of my hair growth.  My hair has grown very well, and it's very healthy.  It has always grown slow, so it's not nearly as long as many other women who completed treatment the same time as me, but I am happy with it.  I've had it cut four times, so there has been about three to four inches removed over time from the overall length.  While some people choose not to do this, I opted to do this to make the multiple layers more manageable and allow me to style my hair as it was growing out.  Growing out the top layers of hair is the hardest part as they have to catch up with the rest of your hair.  My layers have finally reached a point where I can now let the length grow out and it still has a shape and is something I can work with and fix daily.  I cannot express how good it feels to have hair again.  Only someone who has lost their hair will truly understand how awful it is to lose your hair in clumps and have to face your reflection daily.  It's not vanity, and anyone who says it is should have to make the choice to go shave their own head.  



DIEP Flap Surgery and Recent CT Scan
I recently had a CT scan of my abdomen in preparation for my DIEP Flap surgery scheduled for July 6, 2016.  This CT scan is magnified compared to a normal CT scan to allow the doctor who will be performing my surgery to see blood vessels in my stomach.  Essentially, a DIEP flap surgery takes healthy skin, fat and blood vessels from my abdomen and creates a boob on my radiated side.  The skin on my radiated side is permanently damaged from radiation.  It's stretched very tight, and it's putting a lot of pressure on the implant that's in place.  The implant is migrating under my armpit and is 1/8 inch higher than my right breast due to the skin shrinkage from radiation.  While this surgery is radical, it's the only way I will truly find relief from the cording and pressure on my left side.  

The CT scan results revealed a questionable spot on my colon that is identified as possibly being an underlying neoplasm or simply a colonic contraction that occurred at the time of the scan.  Since I always choose to be safe rather than sorry and given my history, I have an appointment in a couple weeks for a consultation to have a colonoscopy.  I am dreading having this done, but such is part of life in general and especially when you've had cancer.  I will certainly update with more information on this after I've had the test.  Surprisingly, I am not too worried, and I haven't let it get me down.  In this respect, I've learned to leave this up to God as my worries don't change whatever the outcome may be. 

Many thoughts and prayers to all the warriors out there fighting this horrible disease, and I hope in some way this has inspired and helped someone fighting the fight.  <3

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