Bye, Bye Sidekick

Three weeks and a day after surgery the drain finally comes out.  Woo hoo!!!

Now time for recovery and slowly start to use my left arm again.  Of course, the first thing out of my doctors mouth was "no softball."  I still have to wait about three weeks before I can start light throwing and any other "impact" activities - running included.  She did say I could start to take easy bike rides on the bike path at the beach.  Yay!  And, next week I can start taking short swings with a golf club.  Baby steps.  The rest of my body is raring to go - so it is an internal struggle to continue to be patient.  I have been feeling much better overall this past week.  My energy levels continue to get better.  I'm still trying real hard to get back to eating healthy - now that my taste buds are happy again.

It's hard to believe how much time has gone by since this journey began.  The end is getting closer.  One more reconstructive surgery awaits.  I have about three more weeks of recovery from the first one before we can start to plan the next.  This gives me some time to mull over whether or not I want them to make some adjustments to my right breast to get a little more symmetry.  There was the mention of pain, and the levels being a bit higher because my right side is healthy and all the nerve endings are intact.  This does not sound pleasant.  So it is weighing on my decision.  There have been lots of decisions on this journey and none have been easy.  This one seems par for the course.

Another Round - Drug Trial

Drug Trial Day!  I'm in a rather chipper mood today.  It is my fourth day this week at the Cedars Campus, one would think I would be over it, but I'm feeling happy.

First stop, the Vampire Paul's lair.  I have an extra order to fill, my general practitioner wants to do my annual cholesterol test too.  This means that I had to fast all night, so no food or drink (a little water was okay) since midnight.  It is now 9:45am.  Vampire Paul starts laying out the tubes for the oncologist's order.  I notice that he didn't have the research kit out, so I mention it to him.  He goes to grab it and starts laying out those tubes too.  Today he took 11 (eleven) tubes of blood from me!!! And, on an empty stomach.  Needless to say, I was a bit woozy after he was done with me.

I head over to the exam room for prescreening process.  The nurse gets me some orange juice and a tuna sandwich so I won't pass out in front of the doctor.  We spend about 45 minutes on the exam, lots of questions, how I'm feeling, what medications I'm on, any new pain, how are the hives, etc...  While I am here, I pop a couple of Ativan to get me nice an relaxed for the next part.

Then, we head over to the short infusion room today for my torture session (shots).  We prepare my thigh again with the Lidocaine-Prilocaine cream.  And, then we wait (about an hour) for them to thaw and mix the shots.  Today takes a little longer, the regular pharmacist is out.  Since it is taking longer we put a little more cream on my thigh in case it has starting to wear off.  It is about 1pm and they are finally ready.

Crude little torture devices

And, the fun begins...The first one goes in right at the top of my thigh, in the heart of the muscle area.  As always, this one goes in with a ton of pain, gets a 10 every time.  Southpaw gets a big squeeze and a scream into his back.  Number two goes in two inches down my thigh on the top part again in a nice muscle area.  It is not as bad as number one, it gets a 6.5 rating on the pain scale.  The next two go into the side (outer) of my thigh.  Surprisingly, these both go in almost effortlessly.  I feel the initial prick of the needle, but don't feel the fluid squeeze in.  This is good, the needle prick gets a 2.5 on the pain scale.  The nurse dresses the area and now they will monitor me for an hour before I get released.

Southpaw checks bandages.

Snack time while we wait.

About 2pm, all looks good.  The nurse takes my vitals and I am free to go.  Yay!!

Today's treatment treat:

Chocolate Addiction Milkshake

Another run of the mill day at Cedars

Back at the Cedars Campus again, third time this week.  I am starting my day with getting an echocardiogram this the morning.  The one I had last month didn't get a good reading, perhaps the full expander over my heart was impeding the reading.  Now that it is gone, hopefully they will get a good reading.  I still have the surgical drain in, so the technician has to again work around something to try and get a reading.  Not the most comfortable procedure to have when the drain is still in my side.  The technician makes it work and we are done in about 30 minutes.

I head over to a restaurant on the edge of the campus to watch some tournament basketball games before my next appointment.  I have a little over an hour to kill, so I have a light lunch while I am there.

Next appointment is with the General Practitioner at the Adult Ambulatory Clinic back on campus.  This is just a routine check-in visit required by the Medi Cal breast cancer program I am in.  They review what has been going on the past six months, ask if I need anything, try to get me to have a flu shot.  I decline the flu shot.  Not interested in getting poked if I don't "have" to.  We schedule for my annual "pap" exam, write up a blood work order to check my cholesterol, and I am good to go.

Then, it's off to kill a little more time before my physical therapy appointment.  I walk over to the mall next to the campus and find a spot to watch some more tournament games.

Physical therapy is a few blocks down the street from the main campus so I drive on over.  The therapist takes measurements of my arm.  I only have slight swelling in the upper part of my arm, this is very good considering I only had surgery two weeks ago.  I told her that we put the compression sleeve on as soon as I got out of surgery and later that night I did the compression wrap on my arm, too.  She was very happy to hear this.  Since I still have the drain in, she could not do much else today, so we rescheduled the appointment for later.

A surprisingly easy day of medical appointments.  Yay!

My new BFF

Say hello to my little friend:

My Sidekick

The Robin to my Batman, or Tonto, Dr. Watson, Lou Costello, Stan Laurel, Gracie Allen, Jerry Lewis... you get the picture.

The drain stays in for one more week, which means the drain goes to Phoenix with me on our annual family trip to Spring Training (MLB).  Yippee!!!  My output yesterday for the day was about 65ml, which is way above the "safe" limit for the doctors to take out the drain.  So, better safe than sorry, the drain stays in.  The doctor said that she knew that I would not be taking it "easy" this next week and instead of having something go wrong (edema building up in the surgical area) she was leaving the drain in until I get back.  She did take out the stitches.  A little victory!

We also discussed a timeline for getting back activities (since I'm still limited to walking).  Once the drain comes out, after two weeks I can try to swing golf clubs again.  I have to still wait about four weeks though before I can try and throw a ball and swing a bat.  But, at least I have an idea of when now.  This makes me happy!!  We didn't touch the surfing question yet, they already think I'm crazy so didn't want to push too much, hee hee.

A little Yikes

Had a really tough night last night.  Thought my drain might have been infected.  About midnight as I was trying to get to sleep the drain area began to hurt a bunch.  The ache spread across my chest and the pain increased to a 10 on the scale.  My head was pounding, too.  I felt ill all over now and had a fever.  For the next three and a half hours I laid in bed, terribly uncomfortable and in a ton of pain.  I knew I had a doctor's appointment in the morning so I just thought I needed to tough it out til then, no need to go to the emergency room.  If I didn't have that appointment I probably would have gone.  I managed to get about three hours of sleep, but woke up feeling miserable.  I got in the shower, hoping it would make me feel better.  As I stood there in pain, holding the bulb to my drain, all I could think about was when was this going to be over and I was reaching my limit with this part of my journey.

I arrived at the doctor's office about 10am still feeling like shit.  I knew they were not going to take out the drain because this morning when I woke up it had 30ml in it already (double what it was before I went to bed last nigh), and the fluid was still pretty red.  The doctors examined the area, the drain site was not infected.  We discussed my activity over the past couple of days and people I encountered that perhaps made me sick.  I told them that I had a pretty active day yesterday.  I did a lot of walking.  I was feeling well in the morning and went to watch the marathon runners.  The race ended near my house, so I walked over to the finish to check it out.  The walk ended up being a bit further than I had anticipated.  In my mind I figured I could always catch the bus back to my house, not thinking that they have rerouted them for the marathon.  By the time I walked home, I had covered about five miles, which is just a bit too much activity for someone who a) just had surgery a little over a week ago, and b) has lymphedema in her left arm.

I rested for a couple of hours Sunday afternoon, then went to meet some softball mates and celebrate St. Paddy's day.  I had a paddy melt and a Guinness at the bar before heading to my friends house for a mellow evening of cards.  (I also did a pre-St. Paddy's day celebration the night before with some other softball mates - I had two Guinness and a corned beef ruben with fries).  Now, apparently people with lymphedema are not supposed to have a lot of salt.  This did not occur to me at all, nor do I recall anyone telling me this either.  This could have also been a contributing factor to my horrible Sunday night and suddenly higher fluid output from the surgical drain.

What ever the reason at this point, I feel like blah and just want to get some sleep.  The doctors agreed. They will check on me again in a couple of days.  I have to get my stitches out then, too.  I left the office, ran a couple of errands and went to bed.

Patience Grasshopper

The drain did not come out last Monday, nor did it today.  Blah!  It doesn't really hurt anymore (as long as I don't accidentally tug on the long tube), it is more of an annoyance.  I am constantly being mindful that it is there to avoid any mishaps.  Even in the doctor's office this morning, almost dropped it as I got off the table to get dressed.  That would not have been fun.  And, it hasn't leaked any since Monday.  This makes me happy.  Went to a movie on Sunday, and was having a little leakage.  A bit gross.  Okay, really gross.  Luckily I had a few layers so it wasn't noticeable, just uncomfortable.  Some strategically placed napkins until I got home did the trick.  Then, there is sleeping with the drain.  I am forced to sleep on my back to avoid any tugging on the tube.  I wake up several times a night and remember that there is this thing hanging on my left side that I cannot roll over on to.  Patience, a good night sleep will come.

Other than that, I feel pretty okay.  Especially after sleeping for about three and a half days straight (Wednesday through Saturday).  I weened myself off the narcotic pain killers over the weekend, so I get to be more mobile.  I can drive.  Yay!!  My energy is coming back and this makes me happy.  The recovery has been much easier and quicker this time around.  This is good!!

Hopefully on Monday the drain and stitches will come out.

Sleep, sleep, more sleep

Good to be home resting.  Slept away most of the day.  Pain pills make me sleepy.  Was awake long enough to eat a little here and there.  And, empty the drain from my operation (three times a day).  At least this time I only got one, and hopefully will come out on Monday.

Grenade with drainage fluid

Measuring cup for fluid

Recon Part 1

Bright and early check in at the hospital - 6:15am arrival, blah.  Did not get much sleep last night, so I am very tired.  It takes about an hour to check in, then up to the third floor where the nurse takes me to get ready.

About 7:30am, the anesthesiologist comes and sets up the IV.  He first gives me a small shot to numb the area.  Small shot, still has big ouch!  Then he places the IV, which I'm not sure why I got the numbing shot because it hurt a bunch.  And, South Paw wasn't in the room with me this time.  Boo!!  Next, the doctor comes in to confirm the procedure.  He marks the left side of my chest with a purple marker, "Yes."  And we are ready to go.

At 8:15am they wheel me into the operating room.  The nurse introduces me to the rest of the staff in the room.  There is a large table on one side stacked high with implants of all sizes.  They have me move from the gurney to the operating table and hook me up to a bunch of monitors.  And, then I am out.

At 10am, I am back in the post-op room and they are waking me up.  I am in a bunch of pain so the nurse starts giving me morphine in my IV.  My left arm is aching a bunch.  My mom puts on my compression sleeve and gauntlet.  My mouth is super dry.  I am very tired still, so I fall back asleep.  The nurse wakes me up every ten minutes to check my pain level.  It is still at a 10 so she gives me some more morphine.  By the time they are ready to move me, she has given me all the allotted morphine and I'm still in a bunch of pain.  Blah!!

At 11:30am they move me to the recovery room for observation.  It is a very crowded ward and noisy, not much privacy at all.  There is lots of pain still.  I am super thirsty.  They give me water and ice chips.  The water makes me nauseous so I move to the ice chips.  I am super tired still, so I fall asleep again.

About 1pm, I have had enough of the ward and I want to go home.  The ward is very noisy, I cannot rest comfortably.  And someone keeps knocking into my bed.  I buzz the nurse to see what I have to do to go home.  They take me to the bathroom first.  The walk there is dizzying and nauseating.  I get back to my bed and try to eat a little.  Apple sauce, saltines, and water go in and after a couple of minutes comes out.  Argh!!  I am very miserable and just want to go home.

At 2:30pm they discharge me and I'm on my way home.  Yay!!  Home safe, and it is quiet!!  Sleep time.

The operating staff took a picture of the expander that was in my chest.  This was filled with 550ml of saline.  It is not very flexible.

Expander 

The silicone implant they put in.

Implant

Reconstruction Eve

Hoping for the Best, Expecting the Worst...

At this point in the journey I have learned to go with the flow.  A bit of anxiety is setting in as I prepare for tomorrow's surgery part one of the reconstruction process - exchange of tissue expander for permanent breast implant.  The hockey puck that has been sitting in my chest for the past eight months is finally coming out.  Woo hoo!!  This is the good feeling I have.  The bad is again the not knowing how my body will feel when I wake up from surgery.  The last time wasn't very pleasant.  I have been told by the doctors, nurses, and other hospital staff that this procedure is not going to be as hard on my body as the first.  We shall all see.  One thing I have realized on my journey is that my body is not the norm and I take much of what people say with a grain of salt.  In about 24 hours we will all know the truth.

Here is what they say I should expect:  some chest wall discomfort, swelling and bruising which may take up to two weeks for full recovery.  There is a possibility of drains again, but will not know until time of surgery.  The incisions will initially appear as fine lines.  They will thicken over the course of the first month before they flatten and fade.  Scars take six to twelve months to fully mature.  The skin may feel numb and may partially resolve over the course of several months to years.  I'll be able to take short walks after surgery, but won't be doing much more for at least the first month.  I also should not push or pull with my arm for at least two weeks, and won't be able to lift more than eight pounds.  Blah, just when I was getting my energy back and enjoying doing more activities I have to go back to square one.

I guess in the grand scheme of things it's not so bad.  One day at a time and every day is a good one.