Thursday, August 28, 2014

Love this!

http://bertalippert.com/never-ashamed-scar/

She explains drains and tissue expanders:

http://bertalippert.com/my-breast-reconstruction-journey-phase-one-tissue-expanders/

http://bertalippert.com/my-breast-reconstruction-journey-phase-one-tissue-expanders/

On a more positive note...

No more venting...

I slept fairly well with only one drain. Nice day so I walked. I've been trying to get out and walk everyday.
I did laundry, cleaned part of my bathroom, & washed the screen from my window. Oh and I walked the dog. Now it's quiet time with reading followed by a nap.

Cancer IS NOT a positive experience!

http://blog.thebreastcancersite.com/giulianarancic/?utm_source=social&utm_medium=wearpr&utm_campaign=giulianarancic&utm_term=20140828

As far as I know, she never had chemo so no hair loss; never had radiation...so it irks me to hear her talking about hair & makeup & looking like herself again. It's great if she's "cured" and has no evidence of disease (NED). Having stage IV myself I find her "advice" to be a bit frivolous. But that's just my opinion...

Wednesday, August 27, 2014

Two drains removed!

First pic is drain hole.
I wasn't able to take pic of the drain but this is what it looks like (second pic). The white part is inside the body. Notice how it's larger than the tubing. It's also about 12 inches long. I asked the nurse if I could see it. She laughed and said most people don't want to see it. I told her I'm a science geek and like gross things! I watched her pull the second one out.

Sunday, August 24, 2014

Bored

I feel like all I do is sleep, eat, read, eat, nap, eat...
Can't wait for these drains to come out! Number 3 is getting close!
I did complete a couple of required courses for Search and Rescue today. Along with some work on my fingerprint identification & classification course. Printed out a job application for a 911 dispatcher in Park County, Colorado and searched job websites.
So I guess the day wasn't wasted.

Thursday, August 21, 2014

Amusing tidbit...

I found out today that my feline "nurses" both like barbeque potato chips and string cheese. Of course, they only had a small taste. Wonder what else they like? Maybe I'll find out since it seems like all I do is eat, read, and sleep. And the kitties are usually with me. 🐱

Update: They also like Goldfish crackers.

Wide awake and angry

I just finished writing 3 1/2 pages in a notebook about that hospitalist. I already marked his survey questions as "poor" and "very poor". I am very happy that my next surgery to have the implants put in will be outpatient.
I found out today that there are prosthetic nipples! I thought yeah, I'll do that instead of having one reconstructed! Uh, no, one price I saw was $288! WHAT??? I'll put that $288 towards that hibiscus tattoo I want. Who needs more than one nipple? Am I right? I already have one original one!

Gross coming up so beware!

The skin on my real nipple and areola was kind of crusty and dark. The PS told me that would peel off and there would be healthy tissue underneath. Well, she was right! I "helped" it along a bit because I'm a scab picker but... looks as good as new ( or looks as good as it used to).

Wednesday, August 20, 2014

Expander fill...

HURTS a few hours after. I was very sore right before bed so I took ibuprofen and that helped along with my heart pillows. Much better today! The skin must stretch quickly. Now it just feels like I'm wearing a bra (I'm not, just the camisole). I gave up cutting the little gauze squares to fit around the drainage tubes and just slapped a giant bandaid on 'em. :-)

Tuesday, August 19, 2014

Third post-op with PS

PS said everything looks good. She said my radiated skin is doing well with the blood supply from the lat flap. I had 70ml injected into the left expander and 80 into the right. She told me to try a bra and tight T-shirt to see how I feel about the size. She doesn't want to add much more because it will make my skin too thin. I see her again in 2 weeks. The drains weren't ready to leave me yet. They are at 35ml, 35, & 45. When they are at 25ml for 2 consecutive days I can call & have them removed. Maybe Friday...
It didn't hurt when she filled the expanders but my sides ache now like last time and it feels tight on the right side.

Waiting for PS in my paper half-gown

Saturday, August 16, 2014

Whoa!

I thought I posted this but don't see it. Sorry if this is a repeat. I got a letter from my insurance company. "Explanation of Benefit Payments. THIS IS NOT A BILL."
Apparently my surgery cost $66,064.15! Holy cow! At least I didn't have a panic attack like I did after opening my first bill for chemo: over $10,000 for one treatment! I'm thankful for insurance and medicaid because my balance is $186.29. Whew!

Friday, August 15, 2014

The "hat"

There was one "special" item I encountered during my hospital stay after my urinary (Foley) catheter was removed. The nurses called it the hat. It's a plastic measuring cup thing that fits on the toilet to measure urine output. So I'd pee in the thing and leave it for the nurse or PCA to check. I felt bad that they had to empty my pee. I broke the "rules" and emptied it myself a couple of times.
Tried to post pics on here but I wouldn't work so pics will be in separate posts.

Hat pic

Hat pic

Drains: the good, the bad, and...the gross

I've been irritated the past few days. These drains are annoying me and I'm not sure the volume will go down enough to have them removed on Tuesday. The good thing is that they are preventing fluid build up in my surgical areas. I'm all for not having to deal with that! The bad thing is they hurt! The tubes are stitched in place but they still move around a bit and that's painful. I accidentally bumped one today and YEEOUCH! The tubes are a little smaller than a straw and are flexible but you don't want to accidentally pull on one! The gross things are clots and other floaty things that come out of the drain. Enough said about that.

Anyway, I'm still crazy happy that I'm on the road to finally finishing up the surgeries and reconstruction! Woohoo!

Fabulous pillows!

After my mastectomies a bag of goodies was delivered to my room. In the bag was a camisole with pockets for drains and for padding for the missing breast. There is also a paper to sign stating the cost of the camisole is your responsibility if insurance won't cover it. Those suckers are not cheap: $59! I could buy a $5 tank top and add Velcro but whatever...
The bag also contains one of the coolest items ever! A heart shaped pillow! The thing is great for helping keep pressure off certain areas or as I've been using it lately, to put under my side where the rib hurts. I also used it to protect my side from the cat (er, sorry, the nurse) from walking on my drains. Whoever makes them to give away is wonderful!

Thursday, August 14, 2014

Funny!

Hospitalist

I received a survey today about the hospitalist who "cared" for me while I was in the hospital. A hospitalist is "a doctor who is not your primary care physician".
My hospitalist is the one who asked if my left eye " normally looks like that" early in the morning after turning all the lights on. I had been flat on my back in bed for hours. He also had the padding put on the sides of my bed because my heart rate went up (because of the pain of trying to sit up) in case I had a seizure. Instead of treating me for what I was there for he made me feel like a mental patient. He will not be getting high scores on the survey.

Wednesday, August 13, 2014

Tissue expander discomfort

OK, so the nurse at my appointment yesterday told me to take pain meds for any pain from the fill of my expanders. Nothing was bothering me at the time but at 3 am it woke me up. Kinda sore and uncomfortable especially on the sides. I think I'm less numb on the sides of my breasts. Now I'm reading until the meds kick in. Itchy, irritated, and sore but happy! :-)

Tuesday, August 12, 2014

Alloderm

The PS used an acellular dermal matrix (i.e. cadaver skin) on my right side. This article explains how it's used and reassures about the "ick" factor...

AlloDerm® in Breast Reconstruction

Released September 2007

AlloDerm® is a patented tissue matrix that was originally developed in 1994 by LifeCell as a graft for burn patients. Since that time, AlloDerm®'s remarkable versatility has led to its use in a host of other reconstructive applications, including facial reconstruction, abdominal wall reconstruction, and more recently, breast reconstruction. AlloDerm® allows surgeons to restore many type of tissue damaged through radiation, injury and disease using the regenerative power of their patients' own body.

AlloDerm® is created from donated human skin. LifeCell’s patented process removes all of the cells from the donated skin, while retaining all of the important biochemical and structural components. This makes AlloDerm® an acellular tissue product which will not result in rejection. Since AlloDerm® is derived from human tissue, there may be a concern that it might harbor disease carrying viruses. However, with more than one-million implants and grafts to date, the safety of AlloDerm® has been proven, as there has never been any evidence of viral disease transmission to any patients. Tissue donors are screened and tested for transmissible diseases, and a comprehensive review of each donor is completed by a medical director before allowing the tissue to be processed.

When placed in the human body, AlloDerm® repairs damaged tissue by providing a foundation for new tissue regeneration. Blood will flow into the preserved vascular channels in AlloDerm® allowing it to be incorporated into the body. As cells move into AlloDerm®, the process of tissue regeneration begins. With progression of the healing process, AlloDerm® is transformed into living tissue that not only resembles your own but also functions like your own.

For patients undergoing mastectomy, AlloDerm® is primarily used in the setting of tissue expander and implant breast reconstruction. In the first stage of reconstruction, AlloDerm® helps to provide coverage of a tissue expander and can help to decrease the number of times expansion is needed. The AlloDerm® serves as an extension of the surrounding soft tissue on the chest, allowing for a more immediate breast contour. In fact, for the right patient, direct-to-implant reconstruction, without the need for a tissue expander, may be made possible with the use of AlloDerm®.

In addition to first stage breast reconstruction, AlloDerm® has been used for numerous applications in secondary reconstruction. For example, AlloDerm® may be used in revision reconstruction to help camouflage implant rippling and to help correct implant malposition. Also, AlloDerm® can be utilized to help in nipple reconstruction.

http://www.breastreconstruction.org/InTheNews/AlloDerminBreastReconstruction.html

Second post-op, first fill

The plastic surgeon said things are looking good! She did my first tissue expander fill today. She used a magnet over my skin to locate the port on the expander. Since I'm numb there I didn't feel the needle at all! She filled my right side with 100 mls of saline and the left with 50 mls. She had put some saline in at the time of surgery so the total in my left is 100 and right is 250. It's pretty awesome to not be flat on the left side anymore!
She said my back pain was just the rib because it has no protection from that muscle. I suspect the drain tube is lurking in that area also because I think I can feel it under the skin.
I left home with all 3 drains and I came home with...all 3 drains. Darn! Oh well, I go back next Tues. She told me not to worry about the irritation around the drain sites.
So, a very good appointment!

Tissue expanders



Here's what they look like:

Since I had my chest muscle removed with the first mastectomy they used the lat flap for coverage. 



The yellow thing is the magnet that the surgeon moves over the skin to find the injection port.
Below shows a needle in the port. Skin is numb so it doesn't hurt.


Lat flap incision/scar

Took the tape off my back. Tried to get a pic showing the length of the incision.

The tape on my side is where the drains are.



Monday, August 11, 2014

Foobs


Hopefully this link works:

http://www.huffingtonpost.com/joannamontgomery/post-mastectomy-my-new-foobs_b_3886195.html

Tried to link it so it would go right to the article...didn't work.

Lat dorsi flap

Along with the lat dorsi muscle that was tunneled under my skin and around to my chest the surgeon also took an area of skin from my back. This was for added coverage because my skin was so thin on my chest. It's a small area in the middle where my nipple would be normally. Almost a triangular piece of skin. I took the paper tape off the incision two days ago and there's a area that hasn't healed well yet. I'm worried about that so I'm glad I see the PS again tomorrow so she can take a look. They like using the lat flap because of the ability to keep the blood supply intact. I don't really have any pain under my arm where the muscle was tunneled to the front (sounds ickier than it actually is!).

My other side had a skin & nipple sparing mastectomy so at least I got to keep something! :-)

Showering with drains

I usually don't take long to get ready in the morning...usually. With 3 drains it becomes more of an ordeal. Here are the steps I take:
1. Take all 3 out of pockets attached to camisole & make sure all tubes are going out the front.
2. Put lanyard around neck and thru camisole; attach safety pins on drains to lanyard so they don't fall & pull out (OUCH!).
3. Step out of camisole.
4. Take off gauze/tape around drain insertion sites & spray with Bactine to numb them a bit. Pulling the paper tape off hurts in the areas where I'm not numb.
5. Strip drain tubes and empty bulbs. Record amount.
6. Take all 3 "passengers" (drains) into the shower & be careful while reaching for shampoo.
7. Step out and pat incision areas dry. Dry off "passengers".
8. Pull up camisole; take off dripping wet lanyard; insert drains back into their respective pockets.
9. Cut slit in small gauze square and apply antibiotic ointment to gauze. This fits around drain tube and covers painful irritated area. More paper tape. I do this for all 3 drain sites.
10. Pull camisole up over shoulders, put on another shirt over it. Ready to go! ( Ha ha! Ready to go take a nap...).

It is much easier than last time because my range of motion is so much better. I think I pinned the drains to my shirt last time and that works fine also.

Saturday, August 9, 2014

Feeling good!

I've been feeling pretty good the past few days. I hurt a rib while sitting in a chair on the deck last night. No idea what happened. Ha ha! That's still painful...but that's what I've got Norco for!
I'm a pro at stripping and emptying my drains. The are called JP (Jackson-Pratt) drains and work by suction. The bulb on the end fills with fluid and I have to strip the plastic tube to prevent clots from forming. Then I open the bulb to pour the fluid into a measuring cup; squeeze the bulb and plug it to create the suction vacuum. I then record the amount. I do this for each of the 3 drains.
I cannot wait to have them removed! The total 24 hr volume has to get to 25ml or less. Today's was still over 85mls.

Friday, August 8, 2014

Awesome blog!

http://thetracinator.com

She has gone thru the lat dorsi flap, tissue expanders, implants, nipple reconstruction...

She also has the BRCA 1 gene mutation and that is why she elected to have surgery.

First post-op

I saw the plastic surgeon on Aug. 5 for a post-op appointment. The nurse removed my dressings and chatted with me. She is a 13 year breast cancer survivor and had some very encouraging things to say to me. Plus she hugged me as I was leaving. My drain sites are irritated and the drains still had enough volume that they needed to stay in. I have another appt on Tues.
The doctor said things look great, better than she expected! She only injected a small amount of saline into the expanders during surgery and elected to wait until the next appt to inject more. I can feel it sloshing around in the right expander. Weird feeling!

Thursday, August 7, 2014

Nurses: human and feline

I had some wonderful nurses taking care of me while I was in the hospital. It takes a very special person to be a nurse! I hope that I wasn't too much trouble for them.

I also had my cat nurses caring for me at home. Callie prefers the night shift and there were some disputes when Fiona showed up early. Callie is especially cuddly when she knows I don't feel well and she checks on me throughout the night (she did the same during chemo).

Surgery day

So last Wed., July 30, was my right mastectomy, left lat dorsi flap and tissue expander implants.
I arrived at the hospital the night before so my IV fluids could be started at midnight. I had to pee in a cup so they could make sure I wasn't pregnant. Uh, seemed ridiculous since i did have my ovaries removed in that very same hospital...
All was good until I rolled over and pulled the catheter out of my wrist. I then had to endure a very painful poking around in the same area with no luck.
Around 8 am I was wheeled in my hospital bed down to pre-op. There I was hooked up to the "bear hugger" warming blanket; a new IV was started (she used
Lidocaine); I was injected with heparin in my belly; met the anesthesiologist and he assured me he'd do what he could to prevent nausea. My breast surgeon popped in to say hi then the nurse gave me some "happy" drugs.
Wheeled into OR and this time I was awake enough to help them position me on the table. Next thing I knew I was dreaming about animals and someone told me not to rub my eyes. Then a searing pain on my left side but, hey, wait a minute...no nausea!
Recovery room memories: dry throat; pain; intact sense of humor but difficult to crack jokes with a throat like the Sahara; crazy chapped lips; asking for ice chips.

Back in room to be awakened all night by nurses and PCA's. Blood pressure cuff on my lower left leg because of the IV in right arm and lymphedema in left arm. Things squeezing my legs to prevent blood clots; bed adjusting and readjusting itself constantly.
Pushing the call button to ask for more pain meds ("What's your level of pain, 1-10?").
Then at 4 am people rushed in to put protector things on the sides of my bed because they were afraid I'd have seizures because my heart rate went high. Um, of course that couldn't be because I had just tried to sit up and it was crazy painful. Look at my chart for 2 seconds and you'd see I have a normally high heart rate you stupid man! All of the sudden an internal medicine doctor had jumped in. "Does your eye normally look like that?" I got pissed! It was the middle of he night and he had just turned the lights on. I had been lying in bed for hours and hours. How the hell was I supposed to know what my eye looked like????!!!!
" Why are you shaking so bad?" Uh, possibly from the PAIN!