Tissue expander - implant exchange surgery: Update

Surgery went great today. We arrived at 7:30 am at UCLA to get checked in. On our way down the hall to the surgical center we ran into Dr.C and chatted with him briefly. I asked him about his recent trip (conference at a resort I spent a couple weeks at for work a couple years ago) and he gave me the quick low-down and we had a good laugh about a warning I gave him before he went (bed bugs at the resort). Although it's not the kind of thing he nor I probably needed to cause him to think about me while he was on his trip, I was able to give him valuable advice on how not to bring those buggers home to his family and it gave us something to laugh about the last couple times I've seen him. And, I'm thinking it's always a good thing if you make your doctors smile and laugh when you see them - especially if you'll be under the knife with said doctors so I'm always looking for ways to keep him and my other doctors smiling and laughing. LOL

I got called back for surgery prep so off we went (right on schedule, too). Got into that fashionable gown, paper hat and booties, etc. Saw Dr.C again and he marked me up with that lovely purple surgical marker and I got him laughing again - so much that he had to stop marking me for a second to avoid making squiggly lines heehee. Then the anaesthesiologist arrived and I got him to use my port for the first series of iv meds which was GREAT because that meant I was asleep when they put the next iv in my arm (right arm, of course). He gave me a tube of numbing cream and some cool cream holding bandages to take home with me (bonus! esp since I've been using press n seal wrap to hold my cream in place all this time haha) since I'll have my port another year for ongoing blood draws and a iv-delivered drug I'll be getting monthly for a year (more about that later).

We reminded every team member about my left arm - NO BP, NO NEEDLES - and we put a big long piece of surgical tape on my left arm with big lettering of that message to ensure nobody tried to mess with it - mission accomplished. Just after the doc put the first series of drugs into the port iv, I closed my eyes briefly and said a simple prayer: "Dear God, I give it to you. You have my complete trust and faith. Thank you for blessing me in countless ways on this day and every day." I opened my eyes and resumed talking to Bob and quickly things started appearing fuzzy. I woke up, looked at the clock in front of me, which said 11:30am (PT) and turned to Bob and said something like "gosh, when are we getting this party started?" and he laughed and informed me it was all done. =) Sweet! No nausea from the aneasthesia - yay! (my chart showed that has never been an issue for me at any of my previous surgeries and prior to this surgery the the doc mentioned it and was impressed - I told him I'm totally an overachiever and that got him laughing haha) The surgery went well and they wrapped me up in a lovely gauze halter contraption - the same style I had after the bilateral mastectomy. I get to sport this lovely fashion statement until Sunday afternoon and that is when I'm allowed to take it off, look at my new tatas, and take a shower. As I sat there in recovery I thought about how my breast cancer sister warrior powwow (aka support group) is on Thursdays from 11-12:30 at UCLA just one floor beneath the surgical center. I was thinking I should ask them to just wheel me down there to say hello but I know that Bob would think I was cookoo so I didn't say anything. Besides, by the time they finally got us out of the surgical center it would have been too late - but I was hoping I'd run into the gals on the elevator as they wheeled me down to the parking garage. Unfortunately, I didn't see any of them.

I can ALREADY tell the difference with the pesky expanders gone. I just felt under my armpits and can't feel them (could before), and felt the top of my chest area just below where my port is and can't feel them bulging out (could before) - this is SO AWESOME! Those things (expanders) took up so much chest real estate before and were so uncomfortable, I'm so happy they're out! Woot!

I was home by 2pm PT and felt pretty good - tired and hungry, but not in any pain (due to drugs, I'm sure). I had some soup and crackers and green tea and went up to bed. Bob woke me at 4pm to give me my next pain pill and I went back to sleep and woke up around 7pm to find Bob downstairs hooking up my new wii system! Bob and mom got it for me for my birthday and it arrived today while we were at UCLA. How exciting!

I still feel good, pain meds on schedule to ensure that continues. Cooper seems to be doing OK with me not able to pick him up. I sit down and someone else picks him up and puts him in my lap (with a pillow against my chest to prevent him from pressing on or knocking my incision areas). At bed time we did that in his room on the rocking chair and then when it was time Bob picked him up and placed him in the crib and I tucked him in and he was OK with that, thankfully.

Day 2 following surgery is usually the toughest, in my experience, so tonight I'm getting all the things I'll need arranged next to my bed so I can stay in bed and rest. Hopefully it won't be too bad since they gave me a full pill bottle of pain meds. Dr.H recommended a supplement (Bromelaine) for me to start taking tomorrow to help reduce swelling so that will go down quickly and allow me to keep my radiation simulation appointment in 2 weeks.

Thank you, God, for holding me and keeping me safe and comfortable - for instilling brilliance, talent and compassion in every member of my surgical team - for blessing me with a wonderful mom and husband to help me through this here at home - for precious Cooper - and for all the many friends and family members who continue to support me through this journey. For this, and many many countless other blessings, I thank and praise Thee.

To my friends, family members, colleagues, and blog followers - thank you all for your prayers and positive thoughts. I KNOW it helped because I had an excellent surgery experience today. Thank you to the UCLA team that took such awesome care of me today, as usual. I love Dr.C and the surgical center nurses - they're truly the best in their field as far as I'm concerned and I'm so blessed to have them as my care team.

Love,

Julie

PS - Here I am, ready for surgery - no make up, no brow pencil (though they're coming back quickly haha) - I'm au naturale! :)

Prayer request: surgery tomorrow

It's hard to believe but it's already time to get these pesky tissue expanders out and exchange them for some sleek, soft silicone implants! Tomorrow morning I'll have outpatient surgery at UCLA. I'm excited because these expanders are very uncomfortable and have been bugging me since June haha. Besides getting them out and getting the implants instead, Dr.C will be "cleaning up" the area - nipping and tucking, so to speak - so that the result will be nicer to look at than what I've got now. The expansion process has been to basically stretch/grow skin and that produces funny shapes and excess skin that is just kind of icky and I'm psyched that at this time tomorrow that won't be there anymore :). I would appreciate your prayers for a successful, complication-free, surgery and recovery so that I can stay on schedule and proceed with the next important step in my treatment process - radiation - which begins next month. Thank you! Love, Julie

Update - just back from the ENT

So...the verdict is still out on whether I have an infection -- ENT doc, Dr.V (who is very cool, I might add), says that it doesn't APPEAR to be one (I only have one out of three of the signs of a typical ear infection), but he said it COULD be the start of a sinus infection based on my symptoms and the redness he observed in my ear so they're all over me like flies on....well, you know. It also could be that the mucus in my salivary glands (from the chemo, and they're still swollen) could be backing up into the eustacian tube causing these symptoms and that could also lead to an infection. And a third, yet remote, possibility is that this could be the beginning stages of hearing loss brought on by the chemo I'm on (Carboplatin in particular) b/c it's a known side effect which unfortunately would be irreversible...so just in case I have a hearing test scheduled for Wednesday -- if they detect hearing loss they'll look at modifying the dose of my last chemo or something like that -- so now the prayer list expands to include stable hearing so I can get the full current dose of chemo for the last round. If I was to guess which of the three possibilities we're dealing with - I would guess the back up into the eustacian tube - b/c I have no other sinus infection type symptoms - no congestion or runny nose, no headache issue except a very brief piercing/jarring feeling when I stand up quickly, and I also haven't noticed any hearing loss, thankfully. So what we're doing about this right now is starting me on a high powered decongestant to see if that clears things up and if I still have symptoms in a couple days they'll get me in for a CT scan of my sinuses to look for possible infection because they'll want to treat it asap if there is one there. As a bonus, the ENT said he did not feel any angry or swollen lymph glands in my neck - that only the salivary glands were swollen - loved hearing that. I was due to have a boobie inflation appointment at 4 pm at UCLA today but when I called to inform them I was heading to the ENT to investigate the ear issue they said I needed to reschedule that because they don't want to take a chance at doing the inflation while there could be an active infection in my body so now I have to go there on Friday instead. My husband often tells me I'm too chatty sometimes - often sharing more details than is necessary - but I laugh at him and tell him that my chattiness and TMI sharing habit has actually saved me numerous times - today it saved me a roundtrip to/from UCLA (that's 80 miles roundtrip during rushhour in L.A.) and a possible unnecessary new health problem. So - listen up folks - there's really no such thing as TMI when you're dealing with your health and your doctors and nurses -- tell them everything because that's the only way they can help keep you on the right path. I wonder if any of you are thinking why in the world I would go in for another inflation when I've already declared I'm not doing anymore of those. Well, I MIGHT do an inflation if the doctor looks at me and says he needs more room to work to turn these puppies into masterpieces in January...but if he doesn't need anymore room to do that then I won't do any inflating because I'm fine with their current size or smaller. I'm really going in to have him tell me what he can do to fix the divets and stuff from my scars and other imperfections during my surgery in January -- because hearing what he can fix will make it a bit easier to appreciate the discomfort and unattractive appearance of these expanders.

Big days ahead

It's been nice having a week or so free from major appointments and procedures, especially after that scary experience with the first attempt to have the port installed. But this "break" is coming to an end and tomorrow the craziness resumes. Tomorrow is my first "tissue expansion" appointment at UCLA where the reconstructive surgeon will inject saline into the breast tissue expanders in my chest to stretch my skin to create more space for the implants that I will get put in after chemo is done but before radiation begins. Apparently there should be a series of these expansions but I'm going in with the thought that one is probably enough haha - it's going to create discomfort and frankly I'm sure I'll have enough discomfort between what I've had thus far and what's to come with chemo and radiation and future surgeries so I'm not about to "elect" for more of it just for bigger boobs after spending most of my adult life wishing my boobs were smaller haha. Hubby doesn't agree with me on this point but I am happy to remind him that it's my body and that he didn't marry my boobs - he married the whole me - and the whole me would be content with a B or small C set of knockers so he'll just have to be content with that too. Monday I go back to UCLA for outpatient surgery to get a port-a-cath installed. Tuesday morning I get my first chemo treatment. I met with Dr.B on Tuesday afternoon to have the chemo Q&A which was informative. He said that days 3-7 tend to be the hardest days in the cycle (day 1 being the day you receive the infusion/treatment) in terms of feeling bad. He said I can expect to lose my hair about 3 weeks into treatment so I will look at the calendar and plan a head shaving "party" at around that time so that it won't be a completely sad/depressing experience. I bought a wig, a hair piece to use with hats, two head scarves, and I'm shopping for hats so that I'll have lots of options once the hair is gone. So...anyway...it's going to be quite the week. I'm ready...I think. haha. Thank you for your continued prayers, encouragement, and positive thoughts!