Saturday, September 25, 2010

It's a tad nippy here....

FINALLY. I am 100% finished my breast reconstruction surgery.

It all started in January when I had my tissue expander implantation surgery. Then I had saline injections to stretch my skin over the course of 3 months. In April I had the implant exchange and got my NEW silicone boobs. Then 12 days ago I went in for the last step. Nipple reconstruction.

When I originally met with my plastic surgeon, I expressed my indifference towards having nipple reconstruction. I truly didn't care whatsoever if I had nipples or did not have nipples. I was definitely leaning more towards NOT having nipples. I was thinking about all the tank tops and dresses that I could wear with no "nippage". Then a few things happened that changed my mind.

1. I realized that my daughter and I would not look the same if I did not have nipples and she did. I never want her to think that SHE'S the different one. It's hard enough trying to explain what I have gone through to a 4 year old. We always tried to minimize my treatment and surgeries. But Lilly is getting older, and more inquisitive, and more demanding with wanting answers. So in essence, I decided to have nipple reconstruction for my daughter.

2. What sealed the deal was this- after my implants I went to Nordstrom to get my first new bra. The lovely girl assisting me brought a handful of bras, and like any professional bra fitter, they really assist you in the dressing room. I felt OBLIGATED to warn her that I did not have nipples. She wasn't weirded out, and I'm sure I was not the first nipple-less customer, but I didn't want to feel like I had to forewarn anyone for the rest of my life. After my mastectomy, I always told the x-ray tech, or a nurse who I didn't know that I had a mastectomy. I'm not sure why I did, I guess so they were prepared or to make it more comfortable for the both of us. But now I had "normal looking" boobs, but no nipples.

So I told my plastic surgeon that I was on board to have nipple reconstruction. He was GIDDY. Yes- giddy. I made his day. Seriously. You see, my surgeon is so incredibly passionate about his craft that it was almost INSULTING to him that I did not want to "get the whole package". He was very happy that I changed my mind. He told me that we could schedule the surgery whenever I wanted to do it. I decided to enjoy the summer- hang out at the pool and go to the beach, and not worry about surgery or recovery.

You're probably curious about HOW nipples are reconstructed. Well, you know me- I'll tell you. Let me just preface with this. Not all plastic surgeons use the same technique. So I will tell you how MY nipples are reconstructed. Skin is grafted from the "groin fold" - that's a classy name for the skin of your upper inner thigh, waaaaay upper inner thigh. You know where your underwear elastic is- THAT'S your groin fold. So on both "groin folds" skin will be taken and then magically transformed into areola. Then more skin will be taken and magically transformed into nipples. Then then new areola and nipples will be attached to my boobs.

September 14th rolled around and it was MY SURGERY DAY. I was feeling very indifferent about it. It was the final step, and if anything I was more worried about the "what now?" feelings. It had been 25 months since my initial diagnosis. Was I ready to LET GO? I was never the type of person who was obsessive with my cancer. It was there, treated and gone. Well, not that simple, but I didn't let it consume me. BUT- it was a HUGE part of my life. And now this was the last thing to do.

My surgery was scheduled for 11:30am. We had to be at the Outpatient Surgery Center at 10:15am. I checked in and was called back to the "holding area". One of the few upsides to having so many surgeries- you get to know the staff- the nurses, surgeons, anesthesiologists. So it was nice to see the same staff was working today that was there my last visit. I was given a tote bag with my "gear"- gown, booties and cap. I got changed and settled in my little gurney area.

All the nurses and doctors came by to get me prepped. The nurse was unable to get my IV going, so the anesthesiologist was brought in and worked his magic. My surgeon was running late (WOW- BIG surprise there!) and about 12:30pm he came in to talk to me and mark me up. I was pretty adamant that Mike give his input to the nipples/placement. I actually got a set of silicone stick on nipples that I spent 2 hours playing with the night before, attempting to find the right placement. With the aid of my family, I think the best spot was determined so I left them on for my surgeon to see.
He got a little kick out of it. But it was more for me than for him. I wanted to have a *little* control. For so long everything was out of my hands. I just went with the flow and allowed people to poke me, inject me with poison, remove my breasts and ovaries. Everything was done to LIVE. So something as minuscule as nipples- I wanted to try and have some control. My surgeon marked around the silicone areola with his black sharpie, measured me with his handy little tape measure and then- the marking REALLY began.

In addition to my nipple reconstruction, I was getting a fat graft. AKA- Liposuction. You see, I had a major indentation in my right armpit from my lymph node dissection. The original plan was to do lipo when I did my implant exchange in April, but my plastic surgeon did a "game day switch" and said- "hey, let's just put in a bigger implant". So we did, and he released all the skin in the armpit area but it really made no difference. Basically the plan was to take fat from either my hips or stomach and inject it into my armpit. There were no promises that it would work 100% but he felt confidant that it would make some improvement. When he started marking me for lipo,he did me the BIGGEST solid ever- he marked BOTH my hips and stomach. I would just like to point out right now that this was a MEDICAL procedure not a COSMETIC procedure. There was not a lot of fat sucking to be done- just enough to suck out and inject.

After I was all marked up and ready to go, I had a mild freak out. Just about the finality of everything. It had been such a long journey, and for it to be ending.... it's just a lot of emotion to face. My surgeon was very patient and comforting. He stayed with me and Mike and held my hand. When I finally stopped crying I said- ok, I'm ready- let's do this. I gave Mike a big kiss and got wheeled to the OR.

And then I woke up in the recovery room.

Ahh- all the delights of post-anesthesia. Torn up throat, itching from head to toe, can't keep my eyes open, nausea, puking, can't pee. And the crazy thing- they pretty much walk you out the door and send you on your way. I really don't remember anything. I was so completely out of it. The pain and discomfort was in full force. My nurse told me to "keep my legs together so I didn't rip my stitches". I had a girdle on from below my boobs to my hips. I couldn't move! I "slept" the entire ride home, and once we got back home I went straight to bed. Mike came in around 9pm and told me that my surgeon had called and yelled at me to get out of bed. So I did.

I had a chance to evaluate my procedure. My "groin fold" looked like a c-section had occurred, 4" incisions on both sides, sutured up and then covered in steri-strips. My boobs were covered in gauze tape, but there were little "windows" cut out for my nipples. I can't really see anything- it just looks like bloody skin. My stomach and hips are throbbing, bruised and hmmmm....dare I say - flat. My armpit looks- WONDERFUL.

I have been wearing spanx, anti-embolism thigh high circulation stockings, a compression girdle and my bandages 24/7. It would take me 15 minutes to go to the bathroom- just trying to pull the spanx on and off, daintily as possible so I didn't irritate my stomach, hips or groin. And then I find out the worst news- my surgeon is going on VACATION! What- I have to wait 2 weeks to get THIS STUFF OFF! Well, it's not that bad.... I was able to take off the circulation stockings by Thursday. On Friday I took off the compression girdle. I was probably not supposed to but the spanx seemed to be doing a really good job and were much more flexible. Each day got better. I was still uncomfortable from the lipo. That was the most painful. My boobs have no feeling so I was lucky not to have any pain there. My "groin fold" was healing and by the weekend I felt much better. I actually drove on Sunday.

Now it's about 12 days post surgery. I'm still bruised but it's finally fading. My "groin fold" steri-strips have peeled off. My boob bandages are FUNKY. The top layer has lost all adhesive tackiness and are starting to fall off. I tried to put a layer of medical tape across the top today but it's so gross that the tape isn't even sticking very well to the gauze bandages. The bottom layer has permanently bonded with my skin and I'm terrified to have it peeled off. Mike told me that I smell. Yea- no kidding. I wash my hair leaning over the bathtub and wipe off my arms with a washcloth. I can use the sprayer on my legs, but I couldn't get my incision site wet until just a few days ago. It ROYALLY sucks.

I still have 2 more days to go until I see my surgeon for the follow up. I'm curious to see how my new nipples look. I'm sure I'll have another "freak out" but I need to remember that I'm still healing and I need to just give it time.

1 comment:

Dennis Pyritz, RN said...

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