Tag Archives: Exchange Surgery

Happy ending?

WARNING: NSFW / graphic content below.

One week after exchange surgery, during which my right tissue expander was replaced with an implant, I am feeling fantastic! My recovery has been going very well and I like what I see. The surgery took a few hours; I was home by 2pm. I left the hospital in a bra and with a drain exiting my right armpit. I suspected I would have one, so while still a big bummer, it was not a surprise. The pain level was low overall (maybe a 3). The following days were uneventful. I spent the weekend home alone, mostly reading and sleeping.

Pain Scale

Drain tubeAlthough my level of activity was low, drain output was 80mL for the first couple of days, so it had to stay in a bit longer. During my second follow up appointment, on Monday, the drain was removed. About a foot of tubing, which was placed in the pocket around the implant, was pulled out (see pic on right: from the black stitch just under the hand, all the way down!). This is usually not painful, just weird. Good riddance! Feeling so much better with that thing out of me. Dr. M declared that things were looking good and ordered a follow up a week later.

So, how are things looking? You tell me!

2015_7_30

Mentor round, smooth, high profile, silicone in 450ccs. Left in pic: 1 week, right: 10 months.

IMG_3901I am still swollen and bruised (Arnica helped), but the result is pretty darn good, considering the circumstances. I’m hesitant to celebrate, however. With my history, I have a few more weeks to go until I can breathe a little easier. The issues I experienced after my last two exchange surgeries (see: Houston, we have a problem and Déjà vu) both happened about a month out. So, fingers crossed that this is my happy ending! I can’t wait to move on with my life.

T-minus

WARNING: NSFW / graphic content below.

The final countdown has begun. T minus seven days until my exchange surgery! That’s right, just one week left. This will be surgery #8 in the mastectomy and breast reconstruction process, which started January 22, 2013. The goal is to replace the tissue expander on my right with a squishy implant. On one hand, I am very excited about this surgery, as it should be my last one. However, I am also incredibly anxious. This process was supposed to take about eight months and two surgeries. Here we are 2.5 years later with #8 on the horizon. I’ve experienced a few complications that have drawn it out and caused me a lot of grief. In any case, this time next week I will be home and it will be behind me. I can focus on healing and moving on with my life!

Surgery prep

As I prepare for next week, I think about what supplies I need to gather. I’m dusting off the good ol’ Checklist that has helped me get my stuff together each time. I’ll be using the abbreviated version from my Box o’ recovery crap post, which lists the things I keep on the night stand:

  • MedicationsRecovery aids
  • Lanyard (I will very likely have a drain)
  • Measuring cup
  • Rubber gloves
  • Alcohol swabs
  • Scissors
  • Tape
  • Digital thermometer
  • Back scratcher
  • Tiara (of course!)
  • Tissues
  • Chap stick
  • Cough drops
  • Water
  • Snacks
  • Hand sanitizer
  • Lotion
  • Note pad and pen (to track meds and temperature)
  • Camera
  • Kindle
  • Phone and charger

That should do it.

Status update

Yoda fucksI haven’t posted a photo since the tissue expander placement, six months ago. Slacker! My expansions went OK. That side is a different shape and size than my implant, of course, but not too bad. We stopped expansions at 450ccs, which is the volume of the implant on my left. There are a few things off at this point, like my nipples not being “level” and some weird divot in my cleavage, but honestly, at this point, I’m almost all out of fucks to give about these details.

So here I am, On the left in photo I am sporting a tissue expander in 450ccs. On the right I have a Mentor round, smooth, high profile, silicone implant in 450ccs (10 months after exchange).

IMG_3801

A few months after surgery I’ll evaluate the state of things and decide how much the details are bothering me and if there is anything else to be done. Maybe that divot will fill out (it’s OK in a bra) and the nipple-level thing won’t be as bad. Things will be different with an implant and maybe they’ll be symmetrical and just right.

One thing I know will definitely follow is a tattoo by Amy Black. I still haven’t decided if it will be just a 3D nipple fill or something artsy fartsy and covering more of my chest wall. We shall see!

The day after

IMG_2641Yesterday was the seventh surgery of my breast reconstruction. I was a little worried, because of the snow, but it was just a dusting for us, so it still happened.

After three months uniboobin’ it again, I got a tissue expander on the right side. I don’t know yet how many ccs were put in with it. I will find out at my follow up appointment with Dr. M on Friday. The procedure took a little over two hours, as there was some scar tissue that also needed to be cleared away. I got a drain :(. Boo! This time it is not coming right out of the middle of my armpit, but rather on the side. Not complaining about that one. Armpit drains are no fun at all!!!

Yes, I am in pain today. It’s not as bad as initial TE placement after the PBM, but it’s not far from it. Staying on top of the pain by setting alarms on my phone and sticking to a schedule. Also popping Arnica Montana to minimize the swelling and bruising.

I tried to get ahead of the post-op constipation and started downing prune juice Monday. Have been eating lots of fruit, veggies, granola. Also drinking a lot of water, green smoothies, and Smooth Move tea. Fingers crossed that I go soon. No a fan of the bloating and discomfort. Got another pair of compression knee highs as well as the tread socks as hospital souvenirs. I’m sexy and I know it! Today I’m just lounging in bed, reading, Facebooking, and loving my BFF, the backscratcher.

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What’s next?

We wait six weeks for the body to heal and then start the expansion process. Once I find out how much was put in, I’ll have a better idea of how long this is going to take. I typically do 50cc expansions every two weeks. When we hit 550ccs I wait another four weeks before exchange surgery. Right now that is  scheduled for July 23, but I may be able to go sooner again. We shall see!

Déjà vu

WARNING: NSFW / graphic content below.I can't even

A month after my last surgery, during which we swapped the tissue expander on left and adjusted pocket on right, I am again uniboobin‘ it. Déjà vu? Twilight Zone? Groundhog Year?

Yes, that is right, I have lost another implant. This time it is the right one. Everybody together now: WTF?!? DARN IT! I am really feeling dejected. I literally can’t even … (not me~>)

So what happened this time?

This was different than last year, but the outcome is the same, unfortunately. Sunday during my typical post-shower wound inspection, I noticed that there was a tiny inflamed spot on my right breast on old, already healed incision. It got a bit bigger by end of day. Monday morning I went in to see Dr. M. Both him and one of the nurses suspected it was an internal stitch trying to make its way out.

That’s not so bad, right? Just a little stitch. Dr. M advised me to do a warm compress three times per day and keep a very close eye on it. A couple of days later the area started bulging out and I could see yellow puss inside. Thursday morning I sent an email to Dr. M, with an update but I knew he was in surgery. Early afternoon I did the compress, which made the abscess open. After all the goo drained and the stitch knot came out, I was left with another hole. I knew what was coming :(. Went to see the nurse right away. She took cultures and started making calls to coordinate my surgery for the next day, during which I had the right implant removed, pocket cleaned out, and closed back up without inserting another implant.

So … here I am with one breast again AND I got another drain. Fun fun! I go in for follow up on Monday to find out what is next. This is like a rerun nobody wants to watch. Especially not me. Last year I had exchange 9/3, implant taken out 10/15, expander placed 4/10, exchange surgery 9/11, and this implant out 10/10. At this pace, it will take another year.

Enjoy the visual (kind of gross):

Abscess

Bra shopping

WARNING: NSFW / graphic content below.

My exchange surgery was on September 11. We swapped out the tissue expander on my left and made a pocket revision to correct the implant bottoming out on the right. The follow up appointment was two weeks later. Everything feels and looks relatively good. Some twinges of pain here and there, but that is to be expected. As far as my results: small issue, but it’s still early as things will change and settle for a while. My next follow up is at six weeks.

Compression braI have been wearing this sexy little hospital-issued number almost 24/7 and was hoping to hear that I could ditch it. Well, I can burn that one, but I do need to continue wearing something. It should be wire-free, but have a tight band. I set out bra shopping this weekend and quickly became frustrated! The first two stores didn’t even carry a 32. I ended at Victoria’s Secret, where I should have started, but that was tiring too. It seems that out of the 23049814 bras VS carries, only a few are wire-free.

First tried on the Perfect Comfort Demi Push-Up in 32DD. Too much padding, I’m still spilling out (no DDD), and the VS girl didn’t know her shit – it has an underwire. I went home with two of the Sexy Tee Wireless Bra in 32D. It truly is wire-free and has no extra padding.

VS bras

photoUpdate: I also went to Nordstrom Monday. My location does not work with United Healthcare, but they offered to provide the paperwork and I can file it myself for UHC to review and decide on.

I didn’t mention this option originally, but should have. As Joyce wrote in the post comments, Nordstrom has fitters and works with most insurance companies for post-mastectomy bra needs. They will find the right bra and file paperwork for the insurance company to cover the expense. Appointment required.

I bought How Perfect by Wacoal in 32D. It is super soft! Love it.

The results

As I mentioned things are looking pretty good, but I do see a small issue: asymmetry. Prior to this surgery my right implant had bottomed out and was lower than the left. Now I am seeing the opposite, although not as much of a difference. I also have a sneaking suspicion that my right side is getting tighter, which may be a sign of capsular contracture, but I don’t want to panic just yet and continue to massage like Dr. M advised.

It is still early and things will continue changing. This may be a non-issue in a few months or it may be worse .. we shall see. In any case, I am just pointing out what I see now. I have not lost sight of the big picture and reason for all of this: I said NOPE to breast cancer! In the words of the wise Casey Eischen: “Prevention, not perfection.” 🙂 ❤

These things really don’t look like a D naked, but you know bras are like jeans: there are multiple ways to measure and it seems like every brand does it their own way. The bras I bought will serve for the next month. After that I hope I can go bra-free.

Reminder: Mentor round, smooth, high profile silicone implants in 450ccs.

2014_9_27 front

 

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Updates galore

WARNING: NSFW / graphic content below.

Mother’s Day sucked

This was the first US Mother’s Day without my mom, who had ovarian cancer and died in November. Last week was rough. May 8th was World Ovarian Cancer Day and May 11th US Mother’s Day. Seeing everyone posting photos of celebrations with mom was really difficult. I know many of you reading this understand, because you have also lost your mom.

nope2BC is a success!

I spent the weekend doing my best to occupy myself with other things, such as painting, moving furniture, and shopping. I finally did something with the spare room that has been empty since we moved into this house seven years ago: it is now my crafting room.

Etsy logoDid I tell you the FORCE jewelry fundraiser lead me to start my own business? Yup .. nope2BC – Saying NOPE to Breast Cancer. Come see and Like on Facebook. I am making and selling cancer awareness themed jewelry and donating all proceeds to FORCE. I opened an Etsy shop and have also participated in a few local craft fairs and art expos. Over $1,000 has already been raised, which is way more than I expected to make in such a short period of time. I am ecstatic that it has done so well! I have another event tonight and many more coming later this year. I have lost count!

Recap of my reconstruction journey

Moving on to an update of where I am in the breast reconstruction process. First, I’d like to recap my journey for those of you who recently started reading this blog:

  • 01/2013 – Prophylactic bilateral mastectomy with tissue expander placement
    100ccs @ PBM, necrosis on left breast, hyperbaric oxygen therapy, fills delayed for two months, lost left nipple tip, expanded up to 550ccs
  • 09/2013 – Exchange surgery
    550cc expanders > 350cc Mentor round, smooth, high profile, silicone implants
  • 10/2013 – Infection and left implant removal
    Necrosis scar tissue broke down, hole developed, infection followed, implant had to go
  • 04/2014 – Revision surgery
    300cc tissue expander on left, swap to 450cc implant on right
  • 08/2014 – Planned exchange surgery

Expansions are a go

Five weeks after my most recent surgery I finally had my first expansion. We added 50ccs to the expander on my left, for a total of 350ccs. Our goal is 550ccs, so four more expansions to go. My exchange surgery is scheduled for August 19. We are going to be cutting it close with only about four weeks between last expansion and exchange. If I wuss out again and need to lower the expansion volume, I will have to push the surgery into September. Just two days after the fill, I am sore, but it is no surprise. Next expansion: May 30.

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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

One month post-exchange

WARNING: NSFW / graphic content below.

It has been a month since my exchange surgery and over eight months since my prophylactic bilateral mastectomy. I went from about 184ccs of breast tissue pre-PBM, to 550ccs of saline in overfilled tissue expanders, to 350ccs of silicone gel in my Mentor round, smooth, high profile implants.

2013_10_5 FrontNot much has changed in the last month. I was hoping that the pocket on righty would close up a bit on the bottom, but that has not happened. This means I will most likely have a revision procedure this year to do that surgically. The new girls look fine in clothing, but I am not 100% happy when looking in the mirror. In addition to pocket revision, I am still planning on addressing the nipple asymmetry by removing the tip of the right nipple. I hope to wrap this all up by the end of this calendar year.

My scars are not pretty, but I already know I develop “two year” hypertrophic scars, so I am not surprised. I just started using Kelocote on the incision spots; hopefully this will help speed up their softening.

In other news, I just returned from a two week Europe vacation visiting Venice and my family; I’m excited to be participating in the local 2013 Race for the Cure on October 12th as part of Team FORCE (Facing Our Risk of Cancer Empowered – www.FacingOurRisk.org); and I was also recently featured in another article in the Fall 2013 edition of a local cancer magazine. Here’s my excerpt (changing names, because I want to continue to keep this blog anonymous):

“Mogatos says she never thought much about cancer until about ten years ago, when her 28-year old sister was diagnosed with breast cancer. In the intervening years, she’s had a great deal of time to think about it: she lost her sister to the disease, her mother was diagnosed with ovarian cancer, and another sister is undergoing breast biopsy.

Mogatos began having alternating ultrasounds and mammograms every six months to monitor her own breast health. She also had the BRCA test, which was negative. Once in a while she’d have an MRI, just to make sure everything was OK. Her doctor explained some women with breast cancer in their families choose to have a mastectomy, so she knew that was an option. But she was only in her early 20s, and “I was going along the lines of if it ain’t broke, don’t fix it,” she says.

In March of 2012, the time came to fix it. Mogatos picks up the story: “An ultrasound spotted some issues. Three separate masses were present. They had developed in the six months since the last mammogram. The oncologist recommended an MRI screening. Waiting for test results was hell, but when they eventually arrived, they were good – no cancer.

“In June, I felt something unusual during one of my monthly self-exams. The lump was in one of the three spots where the ultrasound found issues.” Another ultrasound confirmed that two of the three spots had increased in size and were now palpable. Mogatos had biopsies done, and again endured the terrible wait for results. There were some abnormal cells but no frank cancer. She was told to continue her self-exams and keep regular screening appointments. “The inconsistency of the messages I was getting was very hard psychologically,” she says. “I didn’t want to go through this again, having to wait for test results, feeling anxiety, then being relieved, and then ‘oops, maybe we made a mistake.’ I just couldn’t go through that again.” She began considering preventive mastectomy.

She was referred to Dr. M. “When I met him, we really clicked,” Mogatos says. “He brought up things no other surgeon mentioned. I talked to some of his other patients. I felt he’d be a great partner to get me through it.”

When the time came for surgery, she was ready. “I’d researched, I’d read, and I knew what to expect.” She was too lean for the DIEP procedure, so Dr. M placed tissue expanders, and a recent surgery replaced those with Cohesive Gel implants. “I’m ready to be done with the reconstruction,” she says. “It’s been sometimes painful, sometimes frustrating, but I’m so happy I did it. When I look at the big picture, the possibility of getting breast cancer and not making it through, like my sister, I have no regrets. It’s totally worth it. I never have to think about breast cancer again.”

From the other side

Thank you to everyone who sent their love, support, and best wishes for today! The exchange surgery was a piece of cake! Nom nom. 🙂

2013_9_3 post-exchangeWe started just after 9am and I was on my way home by 2pm. Dr. M removed my tissue expanders and replaced them with silicone implants. I didn’t see him post-op, so don’t know yet what projection and volume I ended up with. They are definitely smaller than the expanders and are not all the way up to my collar bones. Woo hoo! I haven’t messed much with the dressings and plan on leaving this up to Dr. M.

On the pain scale, I’m at about 2. Really feeling good. I took Norco, stinky antibiotics, and some Arnica Montana to help fight inflammation and bruising as soon as I got home and ate something. This time around the nurse gave me an anti-nausea, behind-the-ear patch. I do have terrible dry mouth, though, so I’m drinking lots of water and eating cough drops like candy. This also means frequent trips to the potty.

Drain reservoir

I am sporting a sexy hospital-issue bra and an ACE bandage as you can see above and dealing with two drains. Yes, this happened. The tubes exit my armpits causing me more discomfort than the chest pains! Once again they are the giant hemovac type reservoirs. I have a follow up appointment Wednesday afternoon, during which the drains are supposed to be removed. Less than 24 hours to go!

Squishy time

Mario finishWell, the day is almost here. Exchange surgery is less than 12 hours away! I’m so happy to finally be here. All that’s left is a good night’s sleep. I feel like Mario when he finally reaches those stairs at the end of the level. 😀

Following the handy-dandy checklist I put together for my prophylactic mastectomy back in January, I have gotten everything ready. Based on all the feedback from the Ladies that have gone through the exchange surgery before me, I expect this to be a breeze. The exchange surgery will only take about two hours and will be an outpatient procedure. I should be home by about 4pm.

Prep for surgery

I didn’t borrow a recliner this time, so I built myself a pillow-fort-kind-of-thing on the bed. I prepped a basket of essentials to keep by my bedside. It will travel with me between the bed upstairs and the couch, as needed. The hospital bag is packed with a few essentials like the tablet, hand wipes, chapstick, cough drops, lanyard (for those stinkin’ drains), medications, and my awesome My Destiny Foundation tiara.

I have been downing prune juice for the past couple of days to get ahead of the constipation. Also bought some snacks and food items that will be easy to prep while I’m home alone this week. I took the rest of the week off and expect to be doing absolutely nothing.

Later gaters. Write to ya from the other side!