Tag Archives: breast cancer

Reconstruction, Health, and The End is in Sight!

Well, it really has been a minute – or more like a few – since my last post!  In February, I promised an update as well as a blog featuring my chef friend’s new spring menu – and failed on both counts!  I know, I suck.  But sometimes life just, well, is life.  And every day comes, whether we are ready for it or not, huh?  So let’s go back and do some catching up, shall we?

As my readers know, last July, I began the reconstruction journey, even after I adamantly declared that I wouldn’t do it.  Most days I regret starting the process, but it is what it is and all I can do now is look forward, rather than behind.  I had implants, very small implants, put in, just so that I wouldn’t be caved in anymore and could wear a swimsuit without embarassment – to me AND my family!  Well, unfortunately, the implant on my left side – my radiated side – developed a staff infection, and by September I was pretty sick and the plastic surgeon had to go back in and remove it.  When THOSE bandages came off, I was devestated to see that I was now even MORE caved-in than I had been before starting reconstruction.  Deeply depressed, I cried a LOT; and upon return to the plastic surgeon post-op, he promised me that he could and WOULD make it look better, that it could be done (because I seriously, at that point, had my doubts).  He said we would have to wait several months for things to heal again before we started over, but that there was an option that did not entail putting anything else foreign into my body that could be rejected again.  He told me about a procedure called “Fat Grafting.”  This is where he first goes in and liposuctions fat from whatever area of my body that I want him to (and PLENTY of people graciously offered theirs to me as well), and then in the operating room they spin the fat to separate it from liquid.  Once they do this, the liquid is discarded, and the fat is then injected into the breast area and molded into a breast.  The only catch about this, however, is that some of the fat may not stay in place and take on the blood vessels around it, but rather just dissolve back into the body; and it would take several procedures, because only so much can be transferred at one time.  So I was in – I didn’t care how many times we had to do it (or so I thought), because hell, liposuction AND build-a-boob??  Let’s do it!

My first procedure was January 29th, and I was not at ALL prepared for what I would wake up to physically – neither the severe pain nor the huge, shocking purple bruising that came with the liposuction.  The pain from THAT surgery was way worse than even the initial double mastectomy, and the recovery time was about twice as long.  He harvested fat from my belly and my sides (ie: love handles), and after the bruising went away, I WAS rather pleased with having a smaller gut, despite all of the pain it took to get it.  I was a little disappointed, as was the doctor, in the outcome once again on my left breast (if you can call it that).  He had had trouble, when injecting the fat during surgery, in getting the large scar to loosen and expand.  It had been opened and closed four or five times previously, so it is pretty tight.  Our plan was, in between that procedure and the next, for me to try a fairly new system called the Brava – a sports bra of sorts with a suction device, designed to pull the skin out naturally through suction, rather than inserting an expander under the skin (which, as a foreign object, I wasn’t willing to do).  The wait-time in between procedures had to be at least three months, the surgeon told me, so that the fat had a chance to take on blood supply.  About two months after the first fat transfer, my nurse called to tell me that my insurance wouldn’t cover the Brava system, because it is so new and considered “experimental.”  If I wanted to do it anyway, it would cost me about a thousand bucks.  Um, no thanks.  So now what???  They told me I could proceed and do the same procedure as before, and he would work on getting the scar out a little more this time.  So surgery was scheduled and I prepared for round two.

The second procedure was April 30th, and this time I was prepared for what was coming – but I really wasn’t.  This time, he said he only had a little that he could take from my belly, so I told him to take from my thighs.  Dear God.  He got most of the fat from my thighs, he later told me, and that was a whole ‘nother kind of pain.  I woke up in a compression garment that went from just above my knees all the way up to my ribs.  Whoa.  Then on top of that, my chest was tightly wrapped in ace bandage, and between the two things, I could barely breathe!  I used my cane for a couple of days due to the thigh pain when standing, sitting, walking – pretty much moving in any form or fashion!  But I’m almost three weeks out, and have been up and about for almost a week now – much sooner than after the last time.  Last time I didn’t drive until I was two weeks out; this time, I drove myself one time after about five days, but then waiting until my 1 week (and a day) follow up appointment with the plastic surgeon.  We were both a bit more hopeful this time when we unwrapped my chest, as there is definite movements outwards of the big, main scar, and the semblance of the beginnings of a tiny breast or pec even.  We are hoping that one more procedure will do the trick, two at the most – and that is a huge improvement over what he initially predicted with EIGHT procedures!  So yeah, I am finally seeing an end to this whole ordeal, and I’m looking forward to being able to wear a swimsuit this summer without too much embarrassment, as well as on our family cruise at the beginning of October.  Now I want to focus on my health, and toning up after weight loss and liposuction…and hopefully this whole cancer nightmare will be behind me forever, never to return!

bitch slap cancer

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The Mourning

Sept. 22, 2014

I came to a harsh realization today.

I had Cancer.  shutterstock_92336032

Breast Cancer.

Aggressive, invasive, triple-negative non-hormone driven stage 3 breast cancer.

Yeah sure, I know it was February of last year that I found the lump.  And I’m aware that the multiple biopsy results came on Noah’s 13th birthday in March of last year.  On April 10, 2013 my body was altered forever when a surgeon removed both of my breasts, all the way to the chest wall.  Chemo took my hair shortly thereafter, and by the end made it difficult to walk, even with a cane.  Radiation burned my skin, forever making that area slow to heal.  Scars were left, after several surgeries, from mid-sternum to underarm, on both sides.

Through all of that, I tried to stay positive.  I tried to keep smiling.  I tried to keep going and not think about anything but getting through the treatments and get it over with.  And I did it!  My PET scan was clear, showing no signs of cancer in November 2013.  Radiation ended February 19, 2014 – ending all treatments, and that was it.  I was done!  And every day since it ended, I woke up with an exquisite realization – I BEAT Cancer! breast_cancer_by_moydh-d4izagk

Time passed, strength returned, health returned.  I started working out again!  I started eating better again!  I started losing the 27 pounds that I gained during treatments!  Then, despite having said from the very beginning that I would have no part of reconstruction, I entertained the option for two reasons:  I did not like what I saw in the mirror, and some of my clothes were not fitting right.  Small implants should do the trick, I thought, to fill in the caved-in areas of my chest, fill my swimsuit, yet still omit the need for a bra. Sounded like a win-win to me!

I had my surgery on July 24th.  Within a week or two I felt great, and back to normal – despite the fact that you couldn’t even tell that I had gotten implants.  Five weeks after surgery, my skin split open on the radiated side, and turned into an infection that wouldn’t respond to antibiotics.  So last week, on September 18th, I was back in surgery to un-do all that had been done in July, remove the implant, and get rid of all of the infection.

Yesterday, I removed the bandages for the first time so that I could shower.  It was like someone had punched me in the gut.  It took my breath away.  The damage was worse now than way back after the double mastectomy last year.  I obviously was NOT prepared for what I saw, and I stood for what seemed like forever, mouth agape, staring at even worse caved-in scars than existed before.  There are no words, but the sense of loss overwhelmed me at that moment – and I believe that it was then that the mourning began.

The aftermath of multiple surgeries, implants, and infection
The aftermath of multiple surgeries, implants, and infection

Today, I can’t stop crying.  I have no way to explain it, except for an overwhelming sense of grief.  It isn’t about not being grateful that I beat cancer.  It isn’t about not being thankful that the staph infection didn’t get into my bloodstream and kill me.  I mean, truly, I hated my large breasts before cancer; but I never hated them enough to disfigure myself.  But it is a very odd place to be where I don’t look like a woman when topless; nor do I look like a guy when topless.  I feel like some androgynous person who gets called sir in the check-out line, and then called ma’am when they hear my voice.  I know that there is the option, after a while, to start over with something else that can be made from my own tissue, but that doesn’t take away from what I have to see today, and every day until maybe it can be repaired.  But truthfully, the more I see these scars, the less hope that I have for a repair that will look remotely like a breast.

I don’t know how to mourn.  I don’t know how to grieve a major loss and then let it go.  I know how to shove down feelings, sometimes to the point of omitting them from my memories.  I know how to stifle tears that start to choke me, for fear that if I let them go, they won’t stop and will overtake me.  When death has touched my family on rare occasions, I will usually cry at the intital news but then keep it together from that point forward.  I did fall apart after the loss of a baby and again when my oldest moved out, and that was enough for me.  To me, it doesn’t seem to be productive to fall apart, when I would much rather just face things, deal with it, and keep smiling and cracking jokes in order to cope.  So for whatever reason, now, all of these months and months and surgery scars later, my psyche has decided that THIS surgery was the one.  The straw that broke the proverbial camel’s back.  Floodgates are being pressed hard by weird, foreign, emotion-type things like the levees in New Orleans during hurricane season.

No matter how much I downplay it, no matter how much I laugh it off – body parts are gone forever.  No matter how many more procedures it takes to rebuild some semblance of a chest – they will never be the real thing or look like the real thing.  I know that my physical appearance doesn’t define me, and never has – so why in the holy f&*k is this driving me mad NOW???  I just don’t get it.  And this whole piece is NOT for advice on how to deal with things, or for great words of wisdom, or for anyone to tell me to “buck up, Buttercup” – because I’m telling myself that one plenty, thank you very much.  This piece was just how I know how to process things, and that is through writing.  I only share in hopes that if there is one person out there who goes through something remotely similar, that they will know that they are not alone, and that they can, should, and will go through a mourning of their own.

But, I came to a harsh realization today.

I had Cancer.

The Reconstruction

* I just realized that a previous blog post briefly covered some of this information, so my apologies for some repetition. I think I was in the hospital still when I wrote the last one – there were pain meds involved, and thus my recollection of it is a bit fuzzy *

So I guess it has been a while since I have updated in the post-cancer saga, huh? Well there wasn’t much to tell, thankfully, after treatment ended. I finished radiation in mid-February and then just went back to life as usual. My first 3-month checkup was in May, and all of my labs indicated that my tumor markers were normal. In September (well actually, next week) I am due to follow up with both my oncologist and my radiation oncologist – this will be six months out. In between, we finished the last school year, had a fantastic family vacation to Colorado, took an awesome anniversary trip to San Francisco and Napa, and then returned to get ready for Noah’s summer camp just before he started his freshman year of high school. I had been feeling great, working out, finally losing weight, and was getting better and better with each passing day. I knew that I needed another surgery to remove some skin and fat from each side of my scars, under my arms; plus I also needed to have my thyroid removed now that I have insurance. My surgeon had scanned my thyroid several years ago and discovered that there was an old, calcified nodule on it. Once I went in to discuss the thyroidectomy, she scanned it again just for kicks. Yup. Still there. I then started talking to her about possibly having small implants put in, only because I was caved in and my clothes were not fitting that great. She encouraged me to go and get a consultation from her friend and plastic surgeon before we scheduled the surgery – and so I did.

Two of my babies visiting me after surgery
Two of my babies visiting me after surgery

I went for my consultation, and after some discussion we devised a fairly simple plan for some small implants. The first surgeon would go in first and remove the thyroid, and then the plastic surgeon would take over to remove the skin and fat that was under the arms, and add the small implants. We scheduled it for the end of July, the week after we returned from our amazing trip to California. Three nights in the hospital and we came home for what I thought would be a short recovery. WRONG. Nobody, and I mean NOBODY, prepared me for the recovery after reconstruction. The pain. Nobody, and I mean NOBODY, prepared me for the pain after reconstruction. It was way worse than the double mastectomy had been, most definitely. It took weeks to move without flinching, and I was restricted from lifting anything over five pounds for six weeks…including Harrison. When I woke up from surgery, the first thing that I asked about was not the implants, but about the areas under each arm that needed to be removed – and they were still there. Something about not being able to get to them while I was under. Needless to say, I was NOT happy about that. Follow-up appointments revealed that while he had not been able to get to the areas easily while in the operating room, he could easily access them in one of his procedure rooms at his office. I went in a few weeks post-surgery to have the procedure done in-office, where he numbed me up and snipped and sutured. It’s not as flat as I would like on one side, but it can always be touched up at another visit.

Having my in-office procedure...awake and with a camera phone!
Having my in-office procedure…awake and with a camera phone!

Another one of the disappointments upon getting home and healing a bit was to see that I could hardly even tell that an implant had been added. My chest was so caved in that it pretty much swallowed up the entirety of each of the implants, moreso on the right side. So now, I find myself with a small bump on my left breast area, and no bump at all on the right side. Dear Lord baby Jesus, was this even worth doing? Ugh. So I discussed it with my plastic surgeon, and he said that he cannot go back in to fix it until November. I’m not sure that I get the reasoning behind it, but that is what he said. He said at that time, he will take the current implants out and place larger ones in (and the right one will have to be bigger than the left to accomodate the bigger cave-in). I am really, really hoping that it will be the last one.

Sidebar on the Thyroidectomy: A few days after I got home from the hospital, my surgeon who removed my thyroid called me. She had the pathology report back from the nodule that they removed from the thyroid. Cancer. GREAT. So now what? She said that the good news for me is that it was totally encapsulated inside the calcified, rock-like shell. It was 8mm of cancer, and the other good news is that no further treatment is required unless it is 10mm or larger. Whew. I barely skated out of more treatment! So for now, she is monitoring my meds and my TSH levels, and every six months I have to go for tests to make sure there is no cancer in my parathyroid.  At least this scar, the one on my neck, is healing nicely and hasn’t given me any problems whatsoever.

So now here I am, six weeks or so out from surgery. I don’t know if I was moving around too much or if I didn’t wait long enough to pick up Harrison, but my sutures that looked almost completely healed have opened up. First in one spot, then in two, then in three, until I saw four open spots over the weekend. I went last Friday and the doc looked at them, said that there is no infection, and that it is just really slow healing because it is the side where radiation took place. Even though I did wait the amount of time that my radiation oncologist said to wait, and then some, it apprently wasn’t long enough. The plastic surgeon said that the radiated side would be slow to heal for any reason, for the rest of my life. GREAT.

I now, for the most part, really regret even going down this reconstruction road. But I’ve come this far, I pretty much have to see it through – unless I just say “Screw it!” and have the doc reverse it and take the implants out altogether. I’m not to that point yet, considering all of the pain and soreness that I have endured….but I am SO ready for all of it to just be over.

** Added segment 9/12/2014 **

Fast forward to today. Over the course of this week, the pain has been steadily increasing in my left implant, while the wounds are still draining (over a week now) and not looking any better. I went back in for the doc to look at it, with pain so intense that it hurt to breathe. As soon as he took a look at it, he said, “Oh damn. That doesn’t look good.” He examined it, touched all around it, got a Q-tip and dug around in it (not pleasant, by the way), and confirmed that it is infected – probably with staph. Wait, WHAT?? Staph?? Um, are you going to put me in the hospital right now and take it out, and stick an IV in my arm to pump antibiotics in?? He was very calm, telling me not to freak out or be afraid, because staph is just the type of infection that takes place in this area when it happens. He said that he wants to try to save it if possible until we are ready to swap it out in November for the larger ones. I am to spend today and the weekend taking lots of antibiotics orally, along with pain meds, and report back to them on Monday morning. If it is not significantly better, then he will put me in on Thursday and remove the implants. This basically will mean that all of this pain and limitation will all be for nothing, and IF I decide to start over, we will do so with expanders once the tissue is completely healed. Again. And all of that means that there will be surgery next week, then another to insert the expanders, then another to take the expanders out and add implants. Ugh. breast-reconstruction-jo-400x400

This makes me extremely grumpy.

The Radiation

Chemotherapy finally ended in mid-October, and soon plans were being discussed about starting radiation.  I had another surgery that I was waiting to have approved, one that would, for all intents and purposes, be my version of reconstruction.  The surgeon needed to go back in and remove more skin and fat, as I remained a bit deformed and misshapen after the double mastectomy in April.  Once the second surgery was approved, I spoke with my Oncologist, and he said to proceed with it before starting radiation – otherwise I would have to wait a while, until my skin had completely healed from treatments.  And I did NOT want to wait any longer.

Surgery was performed December 2nd, with an overnight stay at the hospital, and then it was back home and back to doctor appointments, follow-up appointments, lab work, and consultations to plan for the next round of treatments.  Once I consulted with Dr. Ilahi, my Radiation Oncologist, it was decided that I could get through the holidays and begin radiation on January 7th.  I was beyond thrilled!  During the interim, I had gotten a follow-up PET scan, and on November 14th was given the report that there was no evidence of previous tumors in any of the areas where it had been given.  In other words – the chemo had worked and I was cancer free!  This made me really question why I absolutely needed to continue on and put myself through radiation; but Dr. Ilahi said that it was an extra measure to help prevent it from coming back – like, by a large percentage.  So with that information, I knew that it was something that I needed to do, as much as I did not want to do it.  For myself.  For my wife.  For my children.  If it increased my odds of STAYING cancer free, then hell yes I would be doing it.  

Thanksgiving and Christmas came and went, and I began to slowly start feeling better after chemo life.  Dragging my feet, I went in and started the routine:

  • Treatments would be every day, Monday through Friday, at 3:30 PM, for six and a half weeks

  • Dr. Ilahi would see me every Wednesday to check my skin

  • There would be 33 treatments, of a particular dose, and none could be skipped

  • Since it is like sun damage, the negative effects would build, each week getting a little worse (and would end up like a bad sunburn…so they said)

  • Fatigue would be a side effect, but it wouldn’t get too noticeable until around week four

    Anna (one of my radiation techs) showing the machine of my torture...LOL
    Anna (one of my radiation techs) showing the machine of my torture…LOL

Me, on the table, about to begin treatment
Me, on the table, about to begin treatment

By week three, my skin was already a ruddy red color, all across my chest on the left side (where they were radiating).  I battled with nausea, which boggled the doctor and techs’ minds, because supposedly nausea is not a common side effect when getting radiation in the chest area.  But then again, EVERYTHING makes me nauseous.  By week four, I started getting tired.  And I started noticing, for the first time, that my left armpit was getting really dark.  They were blasting me in the armpit, too??  I had no idea.  By week five, I was getting really tired, really easily.  My chest became blistered, but no skin had opened up.  I developed itchy, little, red bumps on my upper back from exit radiation.  My armpit got darker red, and started to hurt.  By week six, I was tired.  Like, bone dragging, dawg ass TIRED.  I was using up to four lotions/creams at a time, multiple times per day, on my chest and armpit areas.  They both hurt and itched all the time.  By the final week, which would only be three days, I was beyond ready to be finished.  I could barely stay awake during the day or evenings, and couldn’t wait until kids went to bed at night so that I could retire to our bed as well.  I had prescription hydrocortisone for the itchiness, and was using it rapidly.  And with three days left, my second degree burns under my arm had opened up, now requiring Silvadene cream twice a day.   

It got to the point that I was in tears.  

Shot of part of the chest burn, just a few days from the end
Shot of part of the chest burn, just a few days from the end

Three days from the end, and it finally got the best of me.  

The 2nd degree burns under my arm (and yes, they got worse than this)
The 2nd degree burns under my arm (and yes, they got worse than this)

But the end was in sight…