Tag Archives: recovery

Fitness

I can’t wait for this surgery to be behind me! Only a few days left. At 1½ years, this process has taken much longer than I expected and I’m so ready for it to be a distant memory.

One of the things that I have stayed away from during this adventure has been my regular workout routine. I miss it and am eagerly awaiting to be cleared by my plastic surgeon to get back to it. After my last exchange in September ’13, I got that clearance a month out. About the same time I began using the silicone scar-reducing gel and we all know what came next. Ever since then I have been scared to overdo it, so I just haven’t done anything.

I’m not planning on seeing my good ol’ buddy Tony Horton the day after surgery, but I do plan on seeing Casey! Casey Eischen is a fitness expert and nutrition coach that is certified in training women who are recovering from breast cancer related treatment or surgery. She created a great post-mastectomy exercise program that I did after each one of my surgeries (see below). Casey also founded Foobie Fitness as a guide to help women not only prepare and recover from treatment or surgery, but also to educate us on how we can all make small improvements to help live a cancer-free lifestyle. Today I got my Foobie Fitness tank. I am ready!

Foobie Fitness tank


As with starting any diet or exercise program, always consult with your doctor.

FoobieFitness.com

You’ve seen me mention the amazing Casey Eischen and her post-mastectomy exercise program, I’m sure. I’ve done it more than a couple of times. Foobie Fitness, which started with Casey’s YouTube channel and a community page on Facebook, recently became an official non-profit! Today Casey and her team launched FoobieFitness.com aiming to help not only women navigating breast cancer-related journeys, but anyone interested in disease prevention, nutrition, yoga, and the overall cancer-free lifestyle. Who isn’t interested in saying NOPE to cancer?!? Make sure to visit this awesome resource!

FoobieFitness.com

 

My feedback featured as a Success Story on FoobieFitness.com:

 “The Coach Casey post-mastectomy exercise program is was what really helped me make a speedy and successful recovery after my prophylactic mastectomy and tissue expander reconstruction over a year ago. I knew that my range of motion and mobility were going to be severely impacted by the traumatic procedure, so I began searching for the right program that I could begin right away and would help me in my recovery. I found just that in Casey’s videos.

I started doing wrist bends while still in my hospital bed and I slowly progressed through additional exercises in the following days. Each time I played that YouTube video I was doing better than the day before and I attribute that to this program!  I talk about and recommend it whenever the opportunity presents itself. I still do it as of the day I write this, having had additional reconstructive surgery just four weeks ago! Casey has always been positive, encouraging, and willing to offer additional advice and tips. She even created a clean and simple nutrition plan to supplement the exercise regimen. Thank you Coach Casey for helping me and countless other women get through this!” – Nope2BC.com

On a side note: I had my second fill today bringing the expander to 400ccs. I have also moved my exchange surgery out a few weeks to September 11. The story continues.

They’re growing – first expansion

WARNING: NSFW / graphic content below.

Goodbye ugly scab, hello first fill!

The scab that has been living on my left boob has finally fallen off! Can I get a “woo hoo”? It has been two full months since my prophylactic mastectomy on January 22 and the start of my adventure with resulting skin/nipple necrosis. Today I had my first fill. 50ccs of saline were injected into each tissue expander, bringing the total to 150ccs/side.

Tissue expanderWhat are tissue expanders, you ask? The type of breast reconstruction I chose is two-staged: tissue expanders first, followed by silicone breast implants. The tissue expanders, which were implanted underneath my pectoralis major muscle during the mastectomy, get filled with saline on a regular basis to stretch said muscle and the skin that covers it, until the desired volume is reached. They are like “pre-implants.” Similar shape, but more rigid, unnatural, and uncomfortable. They have a round magnetic port in the top half, which allows for insertion of a needle, without compromising the expander.

Breast Reconstruction Guidebook Figure 7.1

The process of filling the tissue expanders is pretty quick and uneventful. First the nurse uses a little plastic contraption with a metal pin at the end to find the magnetic port in the tissue expander. Once the center of the port is identified, the nurse sanitizes the area and injects the needle attached to a syringe holding the saline. She then slowly pushes the plunger until all 50ccs of fluid have been injected into the expander. This takes less than one minute. After completing the fill, she places a little round band-aid over the injection site. Same story on the other side.

This procedure is overall painless (based on just the first fill). The only sensation was a brief sting as the needle was inserted into the port through the skin.Three hours later, I feel a little bit of that now-familiar pressure on the muscle and skin stretched over the expanders. As soon as I got home, I popped an ibuprofen, did some stretches, and smeared my chest with Palmer’s cocoa butter oil.

As I look down at my chest, I can see that my foobs are bigger. It is a small difference, but it’s there. It will be interesting to watch these things grow. I can already tell that it won’t be pretty. The expanders didn’t settle exactly the same way: one sits higher and the other one is a bit twisted. The asymmetry seems to be normal based on my plastic surgeon’s feedback and the photos other women have shared. Enjoy the visual!

Fills 2013_3_29

100 + 50 = 150ccs

The fills will continue every two weeks at 50ccs/side. At this point, I have not yet decided how big I want to go (one of my friends joked: “go big or go home!”). However, I did find out that my breast surgeon removed 184 grams of breast tissue/side, which translates to roughly 184ccs, so one more fill and I will be back to pre-op size. Next appointment: April 12.

Source of Figure 7.1: Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.

Back to work

So it has been over six weeks since my prophylactic mastectomy and I feel great. My recovery has gone relatively smoothly and I am enjoying the return of full range of motion, exercising, lifting the kitties, scratching the middle of my back, vacuuming (maybe “enjoying” is a bit too strong of a word for this one), and I’m finally back to work.

slouchingI have a desk job, so it isn’t very physically demanding, but I did feel completely pooped after my second day back. Sitting in one spot for most of eight hours is much different than lounging on the couch and it caught up with me. I find that the tightness across my chest, while not painful, is uncomfortable, so my shoulders droop to relieve the pressure and I slouch. Although I’m more comfortable that way, it makes my whole body ache at the end of the day. It’s just awkward. I must admit that I was getting kind of bored at home, though, so the return to work was good for me. I missed the face-to-face interaction with my friends and co-workers.

heartsOn the healing end of things: I still have a scab on lefty (about the size of a dime). Expander fills have been delayed until all is well and the scab falls off on its own. My next appointment with the plastic surgeon is scheduled for March 29th, so I am hoping healing will be complete by then and we can begin the expansion process.

Not much else going on in post-mastectomy land.

Hyperbaric oxygen therapy

WARNING: NSFW / graphic content below.

Tissue or skin necrosis is one of the risks associated with a mastectomy (or any surgery), which is typically a result of loss/interruption of blood vessels feeding the tissue. Read more about it in my previous post: Tissue necrosis.

Hyperbaric oxygen therapy, most commonly known to treat decompression sickness related to deep diving, is sometimes used for treatment of wounds or necrosis. I was not familiar with this type of treatment before entering this community and even now, being completely engrossed in it, I don’t see it mentioned often.

In a nutshell

Hyperbaric chamberHyperbaric oxygen therapy (HBOT) involves the breathing of pure oxygen while in a sealed chamber that has been pressurized at 1-1/2 to 3 times normal atmospheric pressure. – American Cancer Society

What that means is: you get into a clear plastic tube that is sealed, the air pressure is raised (while your ears constantly “pop”), pure oxygen is pumped into the tube, and you get to watch two hours of TV while the oxygen works its magic. I renewed my Netflix subscription just for the occasion!

Why do it?

The main benefit to hyperbaric oxygen therapy for wounds is esentially faster healing. Here are some key points from WoldWideWounds.com:

  • Oxygen used under pressure can assist wound healing
  • It can be used successfully in wounds such as failing flaps and necrotising soft tissue
  • HBO therapy provides oxygen needed to stimulate and support wound healing where there may be insufficient supply
  • It combats clinical infection
  • It is a relatively safe non-invasive therapy

Does it work?

I had 14 treatments total and can definitely see changes in the necrotic area. I am unsure, however, how much of it can be attributed to the hyperbaric oxygen therapy versus regular rate of healing, diet, exercise, etc. Both my plastic surgeon and the wound care doctor agree that I will still have scarring and “discoloration” of the tissue underneath the necrotic skin, but will not need any skin grafting or other forms of treatment. My breast surgeon thinks that HBOT saved my nipple. So discoloration I can deal with, as long as I can avoid additional surgery and get to keep Dusky, the rebel left nipple!

These are earlier pics of changes in the wound over the first two weeks post-op, pre-HBOT:

Necrosis progress

This is what Dusky looked like after ten HBO treatments and four weeks post prophylactic bilateral mastectomy:

Necrosis four weeks

This is after the scab fell off two months post-op. Unfortunately, I did lose the tip of my nipple. Yup, just the tip. It took another couple of months for the pigment to return.

2013_7_12 Pigment

Recovery photos

I have finally added some photos! Check out the MY PHOTOS page.

CameraA couple of days before my prophylactic nipple-sparing bilateral mastectomy I took a “before” photo of the girls. Since then, I have been taking daily pictures to document my journey. Take a peek to see how I’ve been doing during my recovery thus far. The pics are of my nude torso, so NSFW/graphic.

Snot delivery

Low healthHaving a cold within a week of a bilateral mastectomy is not fun or pretty. I started coming down with something a few days post-op and knew it was going to be trouble. Today, two weeks out, I am still stuffed up and hacking up stuff. I’ve gotten to the point where I feel nauseous from the amount of mucus I have ingested. Did someone order some snot? My nose is raw from trying to avoid that by blowing out whatever post-nasal drip has decided to make an appearance. That’s the “not pretty” part.

The “not fun” part is even worse. Blowing my nose, coughing, and especially sneezing are extremely painful. Each one of those actions causes abrupt movement in the chest/rib cage and is just brutal. My first sneeze took me completely by surprise. Immediately after it came, I screamed out in agony. My husband insists that the coughing and sneezing is good for me, because it forces a stretch. I think he’s talking out his butt and just trying to make me feel better.

Remedies

I got some great advice from the ladies in the FaceBook support groups (see: #1 on my list of Resources). Here’s what I have been doing to make it a bit easier on myself:

  • Carry a pillow, always. When I feel a cough or sneeze coming on, I gently hug it against my chest to soften the blow.
  • Passion orange guava juiceWater, water, water. I drink plenty of water. Guava juice is also good and tasty! Bolthouse Farms Passion Orange Guava juice is my drink of choice.
  • I drink a lot of hot tea and eat chicken soup. Although I maintain a whole foods, plant based diet, I put it on hold for the sake of getting some relief. Chicken soup helps!
  • I take hot, steaming showers.
  • Use a humidifier.
  • Get plenty of rest.