Category Archives: Complication City

Anti ode to the surgical drain

A week after my revision surgery, I am happy to say that the drain is finally gone! Out of eight drains that I’ve had to endure, only two have caused me pain when being pulled out. This one was brutal. Tears-in-my-eyes, screaming-on-the-inside, get-this-thing-out-of-me type of pain. I felt every inch of it coming out. The pain was about an 11. Good riddance!

Pain Scale

Things are healing well and looking great. I am very happy with my right side and the volume we ended up with. Also glad to say that there is no necrosis in sight and bruising is at a minimum. I will keep an eye out for a seroma, now that the drain is gone, but don’t expect an issue. Antibiotics have been refilled for another week and my first expansion appointment is scheduled for May 14. I leave you today with my anti ode to the drain:

Surgical drain, o surgical drain
You are a necessary evil
But you cause much pain
Like a device that’s primeval

Waking up with you attached
Is more than a disappointment
You truly were a nuisance
Your level of awkwardness unmatched
I hated all the discomfort
I felt like a mutant

Your home was my armpit
You stayed way too long
You were my hate’s target
You really just din’t belong

You caused me much anger
And a lot of disgust
Anxious to rid of you
You felt like a dagger
You, I have freely cussed
Very happy to say adieu

Pain in my a…xilla

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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:

This 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!

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! 😀

pooping

Yup, tissue expander

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Darn 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.

The 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 ❤ 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. ❤ ❤ ❤

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

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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:

Water
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.

No whining

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Whambulance It 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.

kik Deflated = 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

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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:

Nipple 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.

Breast Prosthesis

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Guess who has two thumbs and the same number of foobs? This .. gal. No, I haven’t had my reconstruction surgery yet, but I did acquire a new breast prosthesis to compensate for the flatness on my left side. I recently said that if somebody is uncomfortable with my lack of bosom, that’s their problem. Well, my thoughts on that haven’t changed, BUT I did realize that I would soon be in a situation where I’d prefer to avoid having these conversations altogether.

Vacay

Hubby and I are going to visit his family in the Caribbean. It’ll be up-close-and-personal and about 85° Fahrenheit, which means my state will be unavoidable and questioned. If I spoke fluent Spanish, I’d say bring it on, but I don’t, so that leaves all the conversating and explaining to my hubby. I just don’t feel it necessary to do this to him. I’m very much looking forward to spending time with his family and enjoying getting away from everything.

How to acquire a foob

So, where do you even start? I remembered that the awesome Miss Casey Eischen – who is a rock star fitness expert, nutrition guru, and herself had a mastectomy with some complications – recently shared that she had a breast prosthesis in need of a home. I reached out and got the package just a couple of days later. I was excited and couldn’t wait to get it opened! Unfortunately, it wasn’t meant to be: the size and shape just weren’t right.

I dug up the name and number a friend shared with me shortly after my removal surgery for a local boutique that specializes in the needs of breast cancer survivors and individuals in need of image consulting. We scheduled a fitting and I obtained the necessary referral from my plastic surgeon. It took a couple of visits and an overnight shipment for us to get the piece just right, but we did it. Here it is, my new friend. Can you tell? The prosthesis is on the right side of the photo. It looks great in the pocketed bra and even better in clothing! I won’t fool the TSA agent reading the images produced by that airport body scanner thing, but I’m confident that I won’t be fielding and attempting to answer uniboob-related questions in Spanish. Yo no hablo mucho español.

I got the prosthesis and two bras. All of the pieces are covered by insurance, but standard deductibles and out-of-pocket maximums apply. Since my insurance plan year just restarted on January 1st, I have not yet met my deductible, so had to cover the total myself. Not a huge issue, as I will have additional expenses with the April surgery and will have to exhaust my deductible and out-of-pocket maximum then anyway. The damage? Around $400. Not too bad. Breast prosthesis: $300, two new bras: $98, consultation fee: $20, not having to answer awkward questions from distant in-laws about your missing boob: priceless.

Just some “fluffing”

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WARNING: NSFW / graphic content below.

Well, it has been a month since I posted my last status update, because there really isn’t anything terribly exciting going on. I do have a photo for you to show you some “fluffing” I’ve noticed in my right implant, though.

I saw Dr. M for another follow up visit a couple of days ago and we agreed that the infection is no more. I have been redness-free for over a month, so I seem to be in the clear. My next appointment with him is at the end of March, which will be my pre-op visit, with the surgery to follow on April 10, 2014. During that procedure my PS will attempt to replace the implant via a small incision in my armpit, using the TESSA technique (right). If he observes that too much scar tissue has accumulated in that space, he will have to place a tissue expander instead. We won’t know until he gets in there. It’s a log way away, but it’s not too early to start crossing fingers and banking those positive thoughts. Get on it! 🙂

As of today, it has been over three months since my exchange surgery and two months since the infection claimed my left implant (see: Houston we have a problem). The implant on my right does seem to be “fluffling,” meaning there has been a slight change in the perceived shape and size of the implant. What is actually happening is my body is changing around the implant forcing it into a different configuration, thus making it seem like the implant itself is actually changing. It is a gradual redistribution of the volume from top to bottom of the implant. The completion of this process may take from three months to a year. Here is the difference in just one month: left = November 13; right = December 13.

The waiting game

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WARNING: NSFW / graphic content below.

It has been over ten weeks since my exchange surgery and a month since the infection that lead to removal of my left implant. I originally thought that I may have the next surgery just three months after the deconstruction, however some issues linger.

While I was across the pond, spending time with family after my mother’s passing, I experienced a lot of redness on the left side. I emailed photos to Dr. M and was told that the combination of stress, emotional and physical exhaustion, as well as a possible infection were the very likely cause of the inflammation. He instructed me to finish the antibiotic I proactively picked up on my way to the airport. After a few days, the redness went down and hasn’t resurfaced since. This Wednesday I saw Dr. M for a follow up. He did an ultrasound and discovered a couple of small fluid-filled cavities. I am to finish the antibiotic and keep a very close eye on the area, while the serous fluid is reabsorbed and addressed by my body. If the redness returns, the fluid will be aspirated for a culture and a decision on following treatment. I’m 48 hours drug-free and things are looking good.

In any case, my next surgery is scheduled for April 10, 2014. At this point, it is unknown whether a tissue expander will be needed. Nothing to do now, but sit and wait. This is what things look like now. I am not wearing a prosthesis or going out of my way to camouflage my lack of bosom. I’ve come to the conclusion that other people’s discomfort is their problem.

Attitude is everything

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Attitude

Yes, THIS. I have hit a pretty huge speed bump on my road to being finished. A major setback that’ll add at least three more months to this process. When I had my prophylactic bilateral mastectomy in January, I expected to be finished by mid-summer. HA! It’s almost January again! Yes, I’m devastated and angry, but there really isn’t anything I can do about it now except focus on recovery and what’s ahead of me.

Attitude really is everything. While you cannot always control what happens to you or around you, you have complete control over your reaction to it. I have chosen to continue to be positive, because the alternative won’t help anyone or improve my situation.

Good news x 3

I saw Dr. M for a follow up on Friday.

The Lone Drainger is out! Whoop whoop! I was producing less than 15 mL/day.
Culture results are good and show no signs of infection. This doesn’t mean I didn’t have one, it means that the antibiotics I have been on since Monday are working.
I might not have to have a tissue expander!!! Dr. M thinks the tissue won’t retract so much that I would have to start all over. If all looks good in a few months, he will place the implant via a small hole in my armpit using the TESSA technique (Transaxillary Endoscopic Subpectoral Smooth Augmentation). This was the best news! It also means that we will NOT have to mess with the incision/scar again.