Pain in my a…xilla

WARNING: NSFW / graphic content below.

No, it wasn’t all a bad dream; yes, I did get a tissue expander  :(

During my follow up appointment with Dr. M we discussed the reason for this: with nothing separating the pec muscle and my ribs, the tissue on my left breast adhered to them. This wasn’t a surprise, but Dr. M had to do some extra work to prep the pocket again. He went in through my armpit to avoid messing with the incision site that gave us necrosis and later the breakdown that caused an infection. He shared photos he took during the procedure illustrating the adhesion and how he separated and cauterized it:

cauterizedadhesion

TESSAincisionThis helps explain why my left side hurts so darn much! In addition to the internal sculpting, I also have a large incision and the drain tube in my armpit. Doing my best to not move my left arm! I’m still Norco-ing it up every six hours and the drain has been kicking out close to 100mL/day. I went in on Friday with the expectation that I’d be leaving it behind, but at this rate, I’m not sure we’ll be able to remove it when I go back on Monday.

Next steps?

So now what? Well, the right side looks great! The pocket closure and bump in size to 450ccs seems to have done the trick. The other side needs a lot of work to catch up, though. We must wait a few weeks for things to heal before we begin the expansion process. The tissue expander has 300ccs of saline and our goal is 550ccs (Dr. M over-expands). Last year’s expansions were in increments of 50ccs, every other week. Then we wait four weeks until the exchange, which puts us out to sometime in August. Here’s to another awkward summer!

prepostop

Now some good news …

I have been downing Sunsweet Prune Juice, oatmeal with flax, and lots of water in an effort to avoid that dreaded post-op constipation. I also tried Smooth Move tea for the first time. I am happy to report: I pooped today! :D

pooping

 

FORCE jewelry fundraiser

FacingOurRisk.orgEXCITING NEWS: I have launched yet another fun fundraiser to benefit FORCE: Facing Our Risk of Cancer Empowered!

This time I am making and selling cancer awareness themed jewelry. Started with bracelets in many different styles, sizes, and colors (not just pink and teal). Now that I have some free time on my hands while I recover, this is a great way to keep busy! Other products coming soon. I am taking custom orders too!

Jewelry banner

I am really excited about this fun project and supporting such a great organization, which has helped me and many others facing hereditary breast and ovarian cancer. These bracelets are great for previvors, survivors .. those undergoing treatment .. families and caretakers! Buy and wear (or gift) this hand made cancer awareness jewelry to show your your love, support, and warrior spirit.

Sample bracelets

I hope you love these as much as I love making them. I donate all proceeds from this fundraiser to FORCE: Facing Our Risk of Cancer Empowered (www.FacingOurRisk.org). FORCE is a nonprofit organization dedicated to improving the lives of individuals and families affected by hereditary breast and ovarian cancer. People like me and many of you.

Etsy logoPlease visit my Etsy shop to see more styles and place an order. Mother’s Day is coming up! These bracelets make great gifts! As I mentioned, I am taking custom orders too, so if you’d like to purchase one, but don’t see something you like. Send me a note!

P.S. Recovery update coming soon. Going to my follow up appointment later this afternoon.

Yup, tissue expander

Tard on drainsDarn it! Yes, it’s a tissue expander. There was too much scar tissue in there, so we are playing it safe. I’m OK with that … I like safe. Also, yes, I do have a drain and yes, I still hate them!

On my right side, we were able to go up to 450ccs and alter the pocket. From what I can see so far, things are looking OK. I will take photos tomorrow after my dressings are off and this pesky drain is out.

Tiddy BearThe procedure took about four hours and I only stuck around for a little bit after. The Tiddy Bear came in handy for the ride home. I <3 these things! My throat is sore and my chest does hurt, especially on the left side where I have the tissue expander. No surprise there. No showering until tomorrow after I see Dr. M for my follow up. Until then I look as if I was choked by an Oompa Loompa, because of the pre-surgery scrub on my neck :).

Thank you all for the massive amount of positive energy and prayers sent my way. <3 <3 <3

Hubby has been taking really great care of me. I just took delivery of a green smoothie to drink with my Norco. He keeps reminding me to stay on my ass and take it easy. We don’t want a repeat of last year. Nope! My two kitties have not left my side since we got home. You can’t see the other one, because she is under the blanket, spooning my leg. LOL

Recovery buddy

Box o’ recovery crap

Counting down the hours! My surgery is scheduled for 8:30am on Thursday and should last about three hours. We are doing reconstruction on my left/flat side and pocket revision plus implant swap on the right side. I’m excited to finally get here after the six-month wait, but I’m also very nervous. Not knowing what is waiting for me is uncomfortable.

My bedside box o’ recovery crap is ready! I used my PBM checklist to gather the essentials:

  • Recovery aidsWater
  • Back scratcher
  • Tissues
  • Tiara (of course!)
  • Digital thermometer
  • Scissors
  • Tape
  • Measuring cup
  • Alcohol swabs
  • Chap stick
  • Phone and charger
  • Rubber gloves
  • Snacks
  • Medications
  • Camera
  • Lanyard (I will very likely have a drain or two)
  • Hand sanitizer
  • Lotion
  • Cough drops
  • Note pad and pen
  • Kindle

I think I’ve got it covered. Don’t you? Now I just need to pack my hospital bag. I expect to be home in the afternoon, so this should be quick. Wish me luck! Talk to you later ‘gaters.

Fighter

No whining

WhambulanceIt looks like it will be a tissue expander after all. Waaah! Not what I wanted to hear. Somebody call the whaaambulance, STAT!

Dr. M and I discussed this yesterday during my pre-op appointment and unfortunately, he will likely be inserting an expander rather than an implant. There is a chance that one will not be needed, but as I mentioned, that is unknown until he goes in there, so planning on an expander. What a disappointment! I am hoping this won’t happen, but definitely not counting on it. Major bummer.

kikDeflated = this is how I felt when I left Dr. M’s office. It means surgery #5 is in my future and probably not until some time in August. Another summer with a tissue expander, more appointments, many more uncomfortable moments :(. BUT I got over it after reading the text my husband sent me in reply to my rant. I took a deep breath and exhaled all those thoughts out of my system. Expander fills suck and can be very uncomfortable, BUT chemotherapy side effects are much more uncomfortable. Doing this, all of this, is worth it.

So NO MORE WHINING! It is what it is and I trust Dr. M will make the best decision after assessing the state of my tissue and skin. And yes, it will be over before I know it. What I know I don’t want is more complications as a result of trying to rush things.

In addition to talking about this, we discussed the low pocket and implant size. During the procedure the pocket will be closed up a bit and I will get a larger implant on my right side – we are shooting for 450ccs. There’s a chance of fat grafting around the implant. Not sure where the donor site will be, but I know this means lots of bruising and more pain.

Less than two weeks to go! I leave you with a short video of me playing with a busted cohesive silicone gel implant while waiting for my appointment. Even if ruptured, the gel stays within the silicone capsule, unless pressure is applied. It returns to the capsule when released:

Here we go again

Got the pre-registration call from the hospital today. Here we go again. I am two weeks away from going under the knife for the fourth (and hopefully last) surgery in this process. Almost six months have passed since I had the last surgery during which one of my implants was removed due to an infection (see: Houston, we have a problem).

Pre-op

My pre-op appointment is on Monday, March 31. I’ll be doing standard lab work and discussing the plan for my upcoming surgery, including:

  • QuestionNipple symmetry – the left nipple became necrotic and I lost just the tip when the scabs came off. I want to snip the tip of the right one to match. What’s worse than two erect, awkward nipples? ONE!
  • Pocket closure – the pocket on my right side is too low, so during this procedure I’d like it surgically closed up a bit at the bottom.
  • Increase in size – since we are going in there on both sides anyway, I’d like to achieve what I originally declared as the right size for me, which is 450ccs (350ccs now).
  • An implant, not a tissue expander – this! More than anything, I just want to be done.

I have my fingers and toes crossed that I will wake up with an implant and not another expander! Obviously, I don’t want any more issues, so if an expander it is, I’ll suck it up and just deal with it. I’m pretty sure I will have at least one drain. <sarcasm>Yipeee.</sarcasm>. Time to whip out the good ol’ checklist and start getting ready.

BRCA mutations and me

BRCAaskmeAfter a couple of recent messages from readers, I realized that I don’t talk about my genetic status much … you have to do some digging to figure that out. Well, I’ve updated my About page and here I am clarifying: I am a BRCA uninformed negative. If you’re already confused, scroll down for an explanation of BRCA and its significance in the cancer world.

What is an uninformed negative?

There is a distinction between a positive genetic test result and a negative one, obviously, but there is a further separation between true negative and uninformed negative. The former diagnosis is made when a mutation has already been identified in the family line, but the person tested does not carry that mutation. The latter applies to individuals like me, whose family tree DNA does not present any known mutations associated with the increased occurrences of cancer. It is still a mystery and we remain uninformed.

Aside from the most commonly tested BRCA1 and BRCA2 genes, there are many others that impact risk of breast and ovarian cancer, such as PTEN, CHEK2, ATM, TP53. The clinical significance of mutations on those genes varies from that of BRCA mutations, however. My genetic counselor and I are discussing testing for these. I am aware that it is possible my sister and mother, who both died from gynecologic cancers, carried some gene mutation their limited testing did not uncover and I did not inherit it, so we are considering importing my mother’s blood sample from Europe to be thoroughly tested in the US. To find out how to assess your risk, learn more about counseling, or find a certified counselor, visit FORCE.

Also, if you are a fellow uninformed negative, there’s a Facebook group for that! Join us.

Now, for the nuts and bolts of this …

What is BRCA?

Everyone has four BRCA (BReast CAncer) genes: one copy of BRCA1 inherited from mom, one from dad and same of BRCA2. They produce tumor suppressor proteins, which help repair damaged DNA. Mutations present in these genes result in production of defective proteins unable to do their job, which can result in genetic alterations and ultimately lead to cancer.

Together, BRCA1 and BRCA2 mutations account for about 20 to 25 percent of hereditary breast cancers and about 5 to 10 percent of all breast cancers. In addition, mutations in BRCA1 and BRCA2 account for around 15 percent of ovarian cancers overall. Breast cancers associated with BRCA1 and BRCA2 mutations tend to develop at younger ages than sporadic breast cancers. – National Cancer Insitute

An important thing to note: as long as an individual has one properly functioning gene, they are producing those DNA-repairing proteins and remain protected. Not until the second copy of the gene is mutated does their chance of developing cancer skyrocket. Somatic mutations can occur due to exposure to carcinogens, such as certain chemicals found in prepared foods (I’m looking at you, hot dog), cigarette smoke, asbestos, radiation, alcohol, etc. Eat healthy, live clean, wear sunblock, lay off the booze!

This is a really great video shared by Andrea on her blog Brave Bosom. It explains mutations, how they relate to cancer, and how treatment affects cells.

Genetic testing can determine whether an individual is a carrier of a known BRCA mutation. There are well over three thousand BRCA mutations that have been identified, however not all of them are clinically significant, which means they either don’t increase risk of these cancers or we don’t yet have enough data to comfortably say so. Here is the break down according to another blogger’s analysis of data available from the National Human Genome Research Institute’s Breast Cancer Information Core database (say that three times fast!). Although this database contains a wealth of data, this analysis is from a specific point in time. New mutations are discovered every day! If you’re a data nerd, hop over to Jessica’s blog to read the full post and her story: Breaking BRCA.

BRCA mutation counts

*Please note that I am not a genetic counselor or a healthcare professional and am only presenting my experience and what I leaned from doing my own research. Please consult a doctor or certified genetic counselor if you have questions or concerns about your own genetic status and associated health.

Previous posts on the topic: