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.

The Boobie Blues

I'm gonna skip ahead a little bit....my last post was all about my breast reconstruction surgery. I am still going to write about the big "unveiling" but I need to talk a little bit about my personal meltdown that occurred this week.

This is my current facebook status:
Dear boobies: I know you're new in town, I'm really trying to be your friend, but you're a lot bigger than my previous set. It's taking me a while to warm up to you. I hope you enjoy the Donna Karan bras and forgive me for hating you yesterday.

So you're probably wondering what happened- right? I have no idea, but I'm slowly processing this wave of emotion which took over my life on Wednesday. At some point during the day I starting obsessing about everything listed below:

1. I don't know how I thought I'd look, but this is not it.
2. what happened to my perfectly round and full "Tori Spelling boobs" that I had when the tissue expanders were in.
3. these boobs do not belong to me...they belong to some fatty-bo-batty woman...not me.
4. why are these implants so wide and flat...I think they might be in sideways.
5. I am a gigantic blob of silicone uni-boob.
6. sports bras are not pretty - and I like pretty, lacy underwire bras.
7. these implants are permanent!
8. what now? no more chemo, no more expander fills, no more cancer?

So amid my hysterics, I got an e-mail (promptly followed by a phone call) by a good friend, neighbor and fellow breast cancer survivor. I was lucky enough to be able to swing by her house to have a cry-out session with someone who KNOWS EXACTLY HOW I FEEL, who WEARS MY SHOES EVERYDAY, and who could just listen and assure me that what I was feeling is normal. And I realized several things.

1. it's only been 5 days post-op.
2. it's only been 48 hours since the surgical bandages came off!
3. I'm bruised and swollen, and have sutures across my breasts.
4. my perspective of looking "down" is WAY different than the perspective of someone looking at me, or looking in the mirror.
5. my implants are memory silicone which needs to relax and be massaged to get their "normal" shape...which will take 3 months.
6. I went from being a 34A before cancer, to having a double mastectomy, to having no breasts for 16 months, to having perfectly round tissue expanders which changed shape every week for 3 months, to having FULL 34C "naturally shaped breast" implants.
7. my implants were specifically selected to fill in the gaping space on my side where the lymph node tumor was removed.
8. Donna Karan Intimates made my day.
9. I can wear pretty, lacy bras...in 4 weeks.
10. it's ok to feel this way.

So that's kinda where I'm at with things. I will say this- my boobs look so much better today than they did on Wednesday. The shape is starting to round out and I know that once the sutures come out and the skin can "relax" they will be even better. And they will soften, and the swelling will go away and the scars will (once again) fade, and I will start to feel more like the "new me".

I'm Beginning to "C" the Light....

Friday morning was like my own personal Christmas in April. It was the day I had been waiting 17 months for. It was my BOOB DAY. Forget about the months I spent with a concave chest, forget about the chemo, forget about the excruciating tissue expanders. The day of my breast reconstruction day was finally here!

I was lucky enough to see my Plastic Surgeon (PS) the day before my surgery. Long story short..my dad had a last minute procedure to remove a squamous cell carcinoma from his cheek. My dad lives in Florida and was flying up here to help me out, so I got him a follow up appointment with my PS. So it was nice to see my Doctor the day before and be reassured that we're all ready to do this. I asked him to please get a good nights rest and not do anything crazy....

Friday morning- I get up bright and early (ok- it's not so bright outside at 4:30am). I enjoy an nice LOOONG shower (because I know it's going to be a few days before I can enjoy a shower again). Mike gets up and we get ready to leave at 5:30am. I feel excitement...I feel - relief. I feel like I'm "graduating". This is my first procedure at the Outpatient Surgery Center so I'm not sure exactly what to expect, but I've been through enough surgeries to have a general idea of what's going to happen. I basically get checked in, changed and prepped. My PS comes in and marks me up with a black sharpie. We talk about a few last minute things. He marks off where the other surgeon (Dr. Bob) is going to do his procedure (the Mediport removal). Come to think of it- I didn't even see Dr. Bob before my surgery. And, of course, the nurse can not get an IV going, so the Anesthesiologist actually hooks me up and wheels me to the OR. On the way, the IV pole is too tall for one of the doorways and - clunk- the IV bag goes flying off and onto the floor. I grabbed the IV tube hoping it doesn't rip out of my hand. Yeesh. We get into the OR and I move onto the operating table and I feel my arms being strapped down...and then - I wake up in recovery.

Recovery must be like what it feels like to die, but you "come to" as opposed to "fade away". First you hear muffled sounds of someone calling your name. Over and over. Then you can usually open one eye and you just see light and a blur. Then you feel people around you, moving, talking, checking on you. Eventually you come to and it takes you a minute to realize where you are. You're constantly asked- Are you in pain, are you hot, are you in pain, are you cold, are you in pain, are you thirsty, are you in pain? I remember NOT being in pain, but being really cold- so cold that they had to put the heater blanket on me. My mouth/throat was raw and my lip had been I guess caught between my tooth and the intubation tube, so it was swollen and numb. I had no concept of what time it was. My surgery started at 7am and was scheduled for 2 1/2 hours. What I did know- is that I had to pee.

My nurses were great- we were all chatting about something, but I have no idea what about. I swear- they must hear some Ca-Ra-zay stuff. I usually try to explain The Diaper Bag Wrangler to them, which I'm sure never comes out the way it's intended. I asked to get out of bed to use the bathroom and I was so proud of myself that I could walk unassisted (yep- it's the little things). My nurse brought me some ice, apple juice and crackers to make sure I could keep food down before they discharged me. I was feeling so good. I really couldn't believe it. I didn't even take pain meds at the surgery center! Dr. Bob decided to make an appearance and told me to come see him in 3 months. Nice.

I think it was around 11am and I was ready to go home. I WALKED to the car (NO wheelchair!!) and we drove home! Lilly wasn't even done pre-school yet! I started examining my bandages. I had gauze taped to my skin- like a shield of gauze. Then I had a surgical bra and a bandage wrapped around me on top of that. Plus two surgical drains (right and left side). My boobs didn't hurt at all. What DID hurt- was the site of my Mediport removal. It hurt pretty bad, so I busted out the ice pack, Percocet and took a nap.

Over the weekend, mother nature decided to unleash her fiery fury- and the temperatures rose to the high 80's- low 90's. Hot + bandaged boobies + menopausal night sweats DO NOT MIX. I think the adhesive from the tape was melting off and bonding with my skin. I was getting SO itchy from the tape, sweat and heat. Luckily I only had to wait 3 days to get my drains and bandages off. While I was counting down the hours/minutes/seconds until my post-op appointment I loafed around the house and ate Rita's Water Ice. I even went with Mike on Sunday night to stockpile- got a quart of Lemon and a quart of Florida Orange.

And then something strange happened. Around 8:30pm on Sunday night, the phone rings. It comes up "wireless caller" and Mike answers the phone. The caller asks for "Karyn" (that's my "real name" but no one calls me Karyn unless they work for the DMV, Government or Insurance Company). Mike hands me the phone and I say "hello....who's this????" And - it's my Plastic Surgeon! He's calling to check up on me....but he sounds entirely distracted...like he's hiding in the bathroom making secret phone calls to his patients.

Coming up next- the unveiling!

Full Foobies

Today was the day I had been dreading. The day of my FINAL tissue expander fill. You might be saying- whaaa? Wouldn't you be HAPPY to get the last fill- it is, after all, the LAST fill. Nope.

Fill = Pain.

Pain that is unexplainable. Pain that does not subside. Pain that wraps from my sides to shoulder blades. Pain that radiates down my triceps, abdominals and back. Pain that does not respond to Percocet, Vicodin or Valium. Pain that prevents me from sleeping. Pain that prevents me from picking up my daughter.

So in preparation for the inevitable pain, (and the pain in the a** that I subsequently become) I made arrangements for Lilly to have a playdate and sleepover at Uncle Andy's house. Yep- on a "school" night. How many kids get to have a sleepover at the "fun aunt and uncle's house" on a Monday??? After preschool today, I took Lilly right over to my brother's house. From there I rushed to my dr. appointment. But the universe must have been telling me something because I hit every single red light. No joke. It was like the night I went into labor with Lilly- March 3, 2006 and at 11:50pm, on a Friday night, we hit EVERY SINGLE RED LIGHT getting to the Emergency Room.

Anyway, I was just a few minutes late to my appointment, but no worries- my surgeon is only 30 minutes behind today! Woo-Hoo! So as I'm sitting in the waiting room, fearful that my "foobs" are going to rip open as soon as the pending expansion occurs, my name is called. I go back to the procedure room, get dressed in my jacket gown, and wait. I'm thinking...hmmm... you think he'll notice if I drain out 20cc from the prepared needles before he gets here? Too late, my Plastic Surgeon walks in.

I start out by saying I want a new Rx for Percocet because it seems to help the "most". And by "most" I mean- gets me feeling good so I don't notice the pain as much. (It's also enjoyable to watch LOST while on Percocet). He takes a look at my "foobs" and says..."hmmm. How do you feel about this size". I tell him I love it and I'm beyond thrilled with the results so far. He continues to express concern for my over stretched skin and the fact the the incision skin is so thinned out he'd prefer not to do another expansion and just call it quits. Whaaat???? I'm DONE!!??

Basically, he doesn't want to mess up what I have going on, OR put me through more pain. I totally respect that. So we agree to meet again next week to go over the implants and sign all the consent forms. He says that on Monday he'll take a look at my skin and see if we can "maybe" do 1/2 a fill...but at this point I really don't care! I am up to 420cc on each side! Holy C Cup!!


After fill #6 (360cc)



And finally - after fill #7 (420cc)

300cc = 1.5 Cups

Never in a million years did I EVER think I'd have breast implants. Although my implants will be reconstructive and not cosmetic, it's still strange to me. But a good strange. I postponed my reconstruction for like 15 months and was really getting used to my flat chest. I didn't necessarily LIKE it, but I was used to it. But there were times when it was a nightmare- basically anytime swimsuits or dresses were involved. But now - oh my- clothing is like a whole new experience for me.

So far I've had 5 saline fills in my tissue expanders for a total of 300 cc in each side. For the metric deprived 300cc = 1.5 cups, so I have 3 cups total of saline in my chest right now. I'm kinda starting to feel like a keg... minus the beer and the tap. My surgeon feels 2 more fills will give the "perfect proportion"....whatever that may be.

Here's the pics from after fill #4 and #5:



Here's a quick recap of the 5 fills:
Fill 1- pain
Fill 2 - no pain, but discomfort
Fill 3 - excruciating pain and back spasms
Fill 4- no pain
Fill 5 - no pain

I don't know if I'm lucky the last 2 fills have been "easy" or if the worst is yet to come. I mean- the last 2 fills were not entirely pain free, there's been some major soreness on my sides and in my back, but it hasn't required painkillers or kept me from doing my everyday routine. Regardless- I'm always preparing for the worst and hoping for the best. I was able to schedule my surgery yesterday, so on April 30 I'll have the tissue expanders removed and silicone implants put in, plus I'm having my mediport taken out. I also have decided to have nipple reconstruction which will happen at least a month after the permanent implants go in. That is simply fascinating to me....

The Expanders

A lot of people have been asking about my tissue expanders. I have to explain over an over that they are NOT like regular soft and squishy breast implants. The expanders are hard and look like this:



But the best real world comparison is to this:

Ooohhh We're Halfway The-re

That's about as Bon Jovi as I get.

Today was expander saline Fill #3. Not only did I have an appointment with the Plastic Surgeon (PS), but before that I had an appointment at my Oncologists (Onc) for a port flush. Yep- I still have the Power Port in my chest. And every 6 weeks I have to get it flushed to prevent blood clots. It's amazing that today was my first port flush since my LAST chemo. Anyway- a flush is a little more complex than it seems. They have to clean the skin and then use the chemo "claw" needle:

and then they inject the Heparin and a saline flush through the tubing. It's not like a flu shot where they just stick it in your skin and you're done. Of course, there was some "miscommunication" at my Onc office and I had to wait about 25 minutes....with Lilly...who spilled water (from their water cooler) all over the carpet.

Ok- so because my Onc visit ran long, I was now LATE for the Plastic Surgeon. So I drove as quickly (and safely) as you can when there's 20" of snow surrounding you, with a 3 year old in tow, to the PS office down the road. I apologized for being late, and I knew- of course- my PS was running late too. He was 1 1/2 hours behind. So Lilly and I sat in the waiting room for well over an hour, spelling silly words on her Doodle-Pad. Then it was finally our turn to go into the procedure room, where we waited another 30 minutes or so.

My fill today - it hurt. It hurt so bad it felt like razors were ripping through my chest. It felt like a barbell was wrapped under my armpits and across my chest and back. It hurt to move, breathe, reach. Everything. It hurt- bad. And- I have about 3 or 4 more to go. I KNOW it's going to hurt, but man does it SUCK. My back is in spasm now because the muscle on my side that wraps around to the back is being stretched. And the cherry on top- the isosceles triangle left boob, is still there. It's not as bad, but it still feels like a baby's foot kicking into my armpit. It's just bigger now.

So here's my process so far. From my post-surgical deflated expanders to today - 180cc on each side. Keep in mind- I'm a small gal. About 5' 3" and 120lbs. A little bit goes a long way on me. I measure a lumpy/bumpy (but full) 34A right now. It seems bigger because the expanders are more broad across my chest. I plan to be a full B, so I'm about 1/2 way there.

post surgery - deflated expanders:



after fill #1, 60cc total:



after fill #2 , 120cc total:



after fill #3, 180cc total:


A lot of people ask why I am taking pictures and posting such a personal journey. The bottom line is this- my breast reconstruction is a part of breast cancer, and breast cancer is a part of me. There's nothing to be ashamed or afraid of. And it is empowering for me to look back and see the winding path of this journey. This is my life. I live this every day. I am a mom, I am a wife, and I am 31, and I am a survivor.

There's an Alien in my Boob.

Seriously- there is something bizarre going on in my left "foobie". The best way to describe it is this: if my left boob were a pregnant belly, there would be a 8 month old fetus growing inside, kicking it's foot into my armpit and making weird pointy shapes where it SHOULD be round. The right boob apparently got the memo and is a nice round-ish shape. The left one is like an isosceles triangle:
Today was expander fill #2. It was, uh, interesting.

1. Lilly came with me. Those that know her will understand without further explanation. For those of you who don't know her- she's 3. She will be 4 in a month. She doesn't listen, touches everything and doesn't stop saying mommy- look at this, mommy - what is that, mommy- do they have a potty, mommy- do you have a tissue, mommy - do you have candy, mommy, mommy, mommy. So the waiting room wait consisted of her climbing underneath chairs and hiding a rubber door stop. The exam room wait consisted of me showing her pictures on my Blackberry.

2. I took a picture of the needle that goes into my boobs. For size comparison- on the far right is the cap of a bold Sharpie marker.


3. While I was laying on the procedure table and my surgeon was injecting me with 60cc of saline with the gigantic needle, Lilly was holding my hand, being so caring and loving. She was saying "it's ok mommy, you hold my hand, don't be scared. THEN- she "accidentally" put her foot on the "up/down" pedal and UP went the table. The scene from Pulp Fiction where Uma Thurman gets the adrenaline shot in the heart flashed before me. Needless to say, everything was fine, after all my Plastic Surgeon IS a professional. Lilly on the other hand got yelled at. Big time.

All in all, it was pretty pain-free today. Just a little sore, mostly because I keep poking the "triangle" trying to "pop" it out of this funky form. I'm thinking maybe I can jiggle it around or do some jumping jacks and move the saline to the side and fix it. Otherwise I'll just have to wait until next week for fill #3.

Something REALLY funny did happen today. When Lilly and I got back from the PS, I let the dog outside. While I was doing this, Lilly went into to the bathroom. I knocked on the door and asked if I could come in. (note to parents- any time a 3 year old is in the bathroom and the door is shut, beware of what you might see on the other side.) Anyway- Lilly said I could come in, so as I crack the door, I see her sitting on the toilet, pooping, and flipping through a Bass Pro catalog.

Free Refills - 60cc's on pump #1

If I were like 12 years old, I'd definitely be getting my first bra. I think I'm like an AAA. But I have good news, REALLY good news.

My tissue expander surgery was exactly 2 weeks ago. I had my drains and sutures removed 3 days ago and today I had my first saline fill. I'm still recovering from the surgery, with twangs, and pangs here and there, but my surgeon is gung-ho about moving this process along. I did after all, delay my breast reconstruction for 17 months. So here's the good news. Originally when I had the surgical consult he told me we'd fill the expanders every 2 weeks. But today- he said we're going to do it EVERY WEEK!!!! The plan is to do 6 or 7 fills at 60cc's each side, each week. That should make me a nice full B. Oh the EXCITEMENT!!!! Then, as long as everything goes to schedule I'll get my permanent implants in May. It would have been April but I teach sewing classes at our High School as part of their Community Education Curriculum. And, of course I am scheduled for 3 weeks in April.

Today I headed down to the Plastic Surgeon's office, it's crazy there. My surgeon only sees patients on Monday and Friday afternoons. He's in surgery all other times. So he has to fit a ba-zillion patients into like 8 hours of office time a week. I get it- he's the man. He does tons of reconstructive and microvascular surgeries. But the wait time to see him is borderline crazy. It's always like this so I am slowing accepting it is what it is. Today was especially drawn out. My appointment was at 2:15pm, I arrived about 5-10 minutes early, I sat in the waiting room until 3pm, and then was brought back to the exam room - where I waited another 30 minutes. Just sitting on the paper lined table, in a jacket gown, in the freezing cold exam room, with lots of weird sterile things surrounding me.

Finally- he came in and was like AMPED to fill my "boobs" with saline. THAT'S how you know you have an awesome surgeon. So here's how it works: The tissue expanders are like silicone pancakes with a round 1" valve towards one side. The pancake is folded in 1/2 so it's like a semi-circle and placed in my chest pocket. As the expander is filled over time, it will unfurl and become circular. Then it will start to balloon. So for the first 2 fills, it's still folded up. The 3rd fill it will pop it open. My Dr. uses a "valve finder" which is a lot like a stud finder. Then he marks the spot with a Sharpie and then injects me with a MASSIVE NEEDLE. It doesn't hurt, but it can be a little drippy- I'll get 60cc in each side for each fill. It's a slow push to inject the saline. And then- that's it.

It was amazing- there was instant shape and definition to my once concave chest. The expanders alone made it look like there was SOMETHING there. But this was awesome. And here's the highlight of my appointment:

Me: Will the saline slosh around?
Dr: Oh yea- especially if you "do the boogie".

My Doc is awesome.

My husband is awesome too. Today is our 8th Wedding Anniversary. Yea- we were youngins' when we got married but some things are meant to be. So here's our favorite wedding picture, in front of the slot machines in Vegas.

we can rebuild her (part 3 - pains, drains and automobiles)

Yea, I know, I'm a little behind on posting about my surgical recovery. I've been totally unmotivated and honestly- in pain.

I spent 2 nights in the hospital, and I wasn't discharged until well after lunch on the 3rd day, so there was a lot of time for quiet recovery before I came home to my husband, a 3 year old, a dog, and my mom who traveled 1200 miles to help take care of all of us. I knew (kinda) what to expect recovery-wise from going through a double mastectomy 16 months ago, but this surgery was much more painful. Maybe because I did 2 major surgeries at once??? Surprisingly, there was minimal pain from the laporoscopic procedure of having my ovaries and Fallopian tubes removed. I have 3 incisions from that- a big one in my belly button and two smaller ones on each side of my lower abdomen. Each abdominal incision was simply glued shut- not sutured. Interesting......

The pain I had in my chest went from sore discomfort, to throbbing, to stabbing white knuckle pain. It constantly moved from my back, to sides, to front. I was taking Percocet every 6 hours 24/7, and it just barely took the edge off. It was truly some of the most intense localized pain that I have ever experienced. And I have been through some serious pain.

In case you forgot (or are new to my blog) I'll give you a quick recap about my previous mastectomy and this tissue expander procedure. August 29, 2008, I had a radical double mastectomy where my surgeon took 100% of my breast skin and tissue. I had a small amount of muscle spared, but I was left with an extremely concave chest (or pigeon chest as my doctor calls it). January 11, 2010, I began my breast reconstruction. My plastic surgeon made incisions through part of the mastectomy incision scars and then separated my pectoral muscle from my ribcage. He then made a pocket for an implantable tissue expander on each side. The expanders are like super fancy silicone balloons, they go in deflated and then over time, my surgeon will inject saline through a valve beneath the skin. The saline will slowly inflate the balloon and stretch the muscle and skin. Once I am happy with the volume, the expanders will come out and new, permanent silicone implants will go in.

Allright- back to my pain. I came home on a Wednesday, and spent the first few days resting in bed and moving about the house when I felt I could. At some moments I couldn't move, the pain was so severe. I'd clench my fist and my hand would turn white. Then minutes later, the pain would be gone. By Sunday I was feeling slightly better. My mood was better, my mobility was better...things were improving. I also had 2 surgical drains to deal with, one on each side which look like grenades with tubes that go into my sides. Three times I day I'd have to empty the drains and measure the output. Sleeping was a nightmare. I had horrid back pain and muscle spasms from my body trying to figure out what was going on. I started taking Valium at night time to help my muscles relax.

On Monday, my mom flew home, and I went to see my surgeon for a post-op follow up and to have my surgical drains removed. Unfortunately, when my surgeon saw my drainage output records, he was forced to send me home. The drains were not ready to be removed. NOOOOOO!!!!!!! And since he only sees patients in the office on Mondays and Fridays, I'd have to wait 4 more days to have these things taken out! And wouldn't you know- after I left his office that Monday, my drains hardly had any output for the remainder of the week. Figures.

From Monday until Friday I kept trying to keep a positive attitude. There were definitely some tears shed out of frustration, but every day kept getting better. I still had some general discomfort and pain through most of the day and night, but I had to stop taking the Percocet so I could start driving again. My mom was not there anymore to chauffeur us around, Mike was back at work and it was up to me to start up our regular routine...or at least be able to drive Lilly to/from preschool (which thank goodness is LITERALLY in our backyard).

Friday finally came. Lilly went to school, we came home and had lunch, and then hit the road for my 2nd follow up appointment. Lilly insisted on bringing an entourage of toys and dolls to occupy her at the appointment. My surgeon is insanely busy, and the wait tends to be on the long side, so I go prepared. Lilly and I spent almost an hour drawing, including this masterpiece:
Yea, I went to Art School, and I have mad doodle pad skillz ..... pictured is Dr. Bob (my breast surgeon, not my plastic surgeon, go figure), Lilly -walking our dog Caesar, a fishbowl, a swaddled baby and me.

Anyway, I finally got called back to the exam room, got checked out, and everything looks good. First my sutures came out- and believe it or not- I actually felt a pinch in some spots! That means I may be getting some sensation back. Then the incisions were immediately covered with stero-strips. Yea- like 16 of them. Then...the drains. The drains are sutured to the skin, so they first have to be cut and then pulled out- which SUCKS. Lilly thought it was so cool to watch. She ACTUALLY counted alongside the nurse and watched everything. Oh- I may have a Doogie Howser on my hands.

It is such a sense of freedom to be rid of those drains. Sure, it's great that they help prevent infection and get that nasty fluid out of me, but man are they gross. Unfortunatley, the left drain site got a little irritated and was turning red. It hurt- bad, but wasn't infected so that's good. I also got to take off my surgical bra. That thing was big- it zippered up the front and had 2 separate sets of hooks in the back. It was covered in iodine, sweat, bloody drain splatter and 11 days worth of who knows what.

I got to take a shower, which was heavenly. No bra, bandages, drains, tubing or anything in my way. Well, I still had to steer clear of my drain holes which are kinda oozy, and a chest covered with stero-strips, a belly button glued together and 2 abdominal incisions- other than that it was great.

Tomorrow- the reconstruction process will move to the next phase. I go for my first saline fill. I'm excited to document this experience over then next few months. I expect it will take about 8 saline fills over 16 weeks to get to a B cup. Math is not my strong point so I may a little off there.

Coming up next: Fill 'Er Up!!!

we can rebuild her (part 2 - The Big Lebowsk-pee)

The first 24 hours after surgery are the worst. This recovery ranks #2 on my all time worst surgery/recovery list. (#1 is my gallbladder surgery which was a nightmare). After I was moved from Recovery into my room, I actually felt pretty good. I was still having a hard time waking up completely from the anesthesia, so I would nap on and off. The pain was manageable, I was getting Dilaudid, which is like morphine, but it sucks and it gave me a headache. Mike was continuously feeding me ice chips, which was sweet relief because my lip was injured during my intubation- I guess the tube push against my lip, which pushed against my tooth and then my lip got all mangled.

I have no idea what time it was- maybe 2 pm, but I was super hungry, and my nurse ordered some food for me. So my "clear liquids" tray came up and Mike lovingly spoon fed me some lemon jell-o, orange sherbet ice cream and I sipped grape juice. Ahhh, sweet relief. Now I am not sure of the exact timeline, but I believe after I ate, I decided to try and use the bathroom. And ANYONE who has had surgery knows the importance of "the first pee". So as I was attempting to walk to the bathroom, my Oncology Surgeon decided to pop in. Ugh- worst timing ever!! I was intent on peeing so I told him to come back in a little bit. So I sat on the potty, and sat, and sat, and sat. This was exactly what I DID NOT WANT to happen. I guess since my surgery was so long I was catheterized, so that plus the anesthesia made my pee not want to cooperate. During my frustration in the bathroom, my Surgeon kept coming into the room, and I basically yelled at him (see Mike's blog post below) and he went away. The pee drama went on all day, and night, and into the next day. But eventually everything got back to normal.

While I was attempting to pee all day, I would get lightheaded and nauseous from the anesthesia every time I'd get out of bed. Like pukey nauseous. So I would be trying to pee, then get the heaves and have to hold a puke bin. Lovely- right. I think Mike was still there when I actually started puking. The good thing about the pukes, was I'd actually pee, but then I felt like my chest and stomach was going to rip open and they'd have to take me back to the OR. But that never happened. I just continued to pee and puke all night, For my nausea I got a drug called Zofran which I actually took during chemo. It's like a melt-away wafer that you just put in your mouth. It (usually) works, but it also gives me a headache, The Zofran did nothing for me this time, so I had to ride out the nausea. Mike had to leave somewhere around 9pm, so the nurses were left to deal with me when I'd push the "call nurse" button- every 2 hours- all night long.

Tuesday morning I was still a little nauseous but I knew that I needed to get some (bland) food in me. My Hospital actually has- ROOM SERVICE. There's a menu with breakfast 24/7 and lunch/dinner from 11:30am-6:30pm. With my nurses' help she got me the menu and the telephone so I could call in my order. Bonus- the food is actually good, like really good (better than my cooking). I ordered Special K (dry- no milk), a corn muffin and apple juice. I kinda snacked on that, napped and had nurses in/out of the room for most of the day.

Mike had to pick up Lilly from my brothers, and then get my mom from the airport so I knew not to expect him until the afternoon. It was really great when he got there, just to keep me company and help me out when I needed to get up or reach something. Around dinner time, my nurse said I could switch from Dilauded to Percocet but I had to eat something first. So I ordered a hearty dinner of chicken noodle soup, rice pilaf, fresh fruit and panko breaded chicken. Mike went out for Peace A Pizza which was his go-to meal for the entire 3 days I was there. I think he's got like 5 stamps on his frequent pizza card from those 3 days alone. While he was gone, my plastic surgeon came in to check on me before he left for the day and said everything was perfect. My pain and discomfort was going to last for a few days, but eventually subside. After he got back we watched tv until visiting hours were over at 9pm.

I think that I slept A LOT from Tuesday night into Wednesday Morning. That Percocet makes me drowsy! I had an overall good night and was looking forward to going home in the morning.

Coming up next : Part 3- going home and white knuckle pain.

My View From the Waiting Room

So it's Mike, K.C.'s loving husband - she asked me to write a post about my view of her recent surgery. I'll be honest, most of the day involved waiting, and waiting, and waiting...but here's three observations.

1. The new wing of the Paoli Hospital is really nice. There's a beautiful new atrium and all kinds of high tech stuff. Being on the outside, it was kinda neat to be able to "follow" the progress of K.C.'s surgery at a computer terminal. I can best describe it as a ticker, sort of like the one at the bottom of all sports programming (constantly showing scores). Instead of scores, it displayed things like "in surgery," "in recovery," etc... So even though the one douchebag surgeon didn't come out after he was done to let me know how K.C. was doing, at the very least I knew her 2nd surgery was over and she was in recovery.

One note to Paoli Hospital - get some TVs in the waiting area. The old waiting area at least had a small TV so I could distract myself by keeping down the vomit caused from watching "The View" or "Ellen." Unfortunately, as big and beautiful this new wing of the hospital was, no TV (or magazines) in the waiting room. What's the deal? Thank god I had a BlackBerry to keep me busy or I would have lost it.

2. K.C.'s surgeons couldn't have been more different. The first surgeon was really personable, came in to visit K.C. before her procedure, they swapped some jokes, and seemed to put her at ease. After the surgery, he came out and personally told me how it went, what to expect, and answered any questions I had. The second guy...he might be a talented surgeon, but he really came off as an assclown. Not only did he not acknowledge K.C.'s presence in the room prior to her surgery (just a quick pop-in to sign some forms), but he didn't even come out following to let me know (or the ladies at the surgical desk) how it went. Surgeon #2, did make an appearance later in the day when K.C. was up in her room. Unfortunately she was trying to pee (which I guess can be very difficult after you've had a catheter), and was on the toilet. He basically hollered his instructions to K.C. from across the room while she was on the throne, tried to crack some ill timed jokes, and then scurried out when K.C. screamed "I just want to pee!" Oh, and he was wearing some sort of size medium brown velvet looking track jacket. I don't care if I ever see the guy again.

3. As if it's any revelation - my wife further established the fact that she is one amazing woman. I couldn't believe how well she handled everything despite the tremendous pain, extreme nausea, medically induced constipation, and multiple contraptions hooked up to her chest. It's incredible how she's shown great strength and humility while balancing the needs of a 3 year old daughter (& a husband that at times is just as needy). As cheesy as it sounds my love, admiration, and respect for her continues to grow with each step in her journey, and I realize more and more how incredibly lucky I am to have her in my life.

we can rebuild her (part 1 - a little nip, not so much tuck)

I feel a lot like the six million dollar man....or woman.

On Monday I checked into the hospital to start the next phase of my breast cancer treatment and recovery. I chose to postpone my breast reconstruction until after I finished all the chemo treatments. So 2 weeks after my last chemo, I was ready to move full steam ahead into reclaiming my body.

Mike and I arrived at the hospital at 6am, I registered and then we were brought into the new surgical annex of the hospital. I was assigned a room, which was more like a typical OR staging area with a curtain divider where I had to pee in a cup for a pregnancy test and then get changed into one of those Bair Paws surgical warming gowns. They are actually pretty cool. They're a one time use gown made of like a flannel-y paper-ish material that has ports in it that warming air tubes hook into. The nurse got my iv flowing and we just kind waited for my 2 surgeons to swing by and sign off on the surgical consent forms. The anesthesiologist came by and got my meds all set up. After that, my plastic surgeon (PS) came by and marked me up with a sharpie. It was like my own nip/tuck moment...kinda. So a little bit after that the nurse anesthetists who were assigned to my case came in and we were just waiting....waiting for my Oncology Surgeon (OS) to show up and sign his paperwork. We're all just waiting, and waiting, and FINALLY the OS shows up. He does not even acknowledge me or Mike, he signs the forms and says - yep, gonna take your ovaries out, and then left- never even LOOKING at me. I just laid there, my jaw dropped to the floor and the nurses, Mike and I just looked at each other in total disbelief. Could my OS really be THAT much of a jerk? After the drama, we started wheeling away, and well- I don't remember anything. Not even entering the OR. I was O-U-T. I think Mike will write a guest post about what happened since his perspective and level of lucidity was quite different than mine...

ANYWAY- several hours later I woke up in the recovery room. I have been through this before. Sometimes it's bad, sometimes it's not so bad, and sometimes it's really bad. This time was not so bad, except I could not open my eyes. I could hear everything and answer questions but I was having the worst time totally waking up. I'm not sure what kind of conversations occurred in recovery, but I remember hearing bits and pieces about my pain level, my post-surgical bra, checking incisions, etc. I think a recovery room nurse could write a book about the crazy stuff they must hear during any given shift. I hope she didn't tell me anything important because I remember pretty much nothing.

Coming up next: Mike's commentary and the first 24 hours

I'm on my way

I have to report to the hospital tomorrow morning at 6am. Wow - that's gonna be an early wake up call. Especially because I have been sleeping a ridiculous amount these past few months. I guess the Herceptin has finally caught up with me.

So with all the preparations made, especially mentally, I feel pretty good about surgery tomorrow. I spent this week pre-making dinners so there will be some easy things to heat up during my recovery. A lot of people have offered to make us food but there is a huge difference between 'now' and 'then'.

Now: My surgery has been discussed, planned and scheduled well in advance. I know what to expect and once I recover, well, I'm recovered.

Then: I was diagnosed with cancer on August 18. I had a double mastectomy 11 days later. I had no time to prepare and by the time I was healing from the surgery, I was getting chemo every other week.

So you can see, things are a lot better this time. Unfortunately, in true K.C. style, there's been some little blips. #1 - Lilly is in a full arm cast for another week. She is doing really well, but she needs help getting in/out of the car, eating, going to the bathroom, and bathing. #2 - I broke my pinky toe yesterday. I walked right into our bedroom door and my toe immediately swelled and turned a horrid shade of purple/black. It also hurts- a lot. AND- I can't take any OTC meds within 7 days of my surgery, so no Aleve for me. Just ice, elevation and a bandage.

Despite my gimpy toe, I spent the majority of the weekend, cleaning and getting everything ready for this week. Our house has been cleaned from top top bottom. My mom will be here to help out with Lilly. Mike will be running all over, making numerous trips between the hospital, our house, my brother's house, the airport, work...it's going to be a rough few days for him.

As far as tomorrow goes,. people have been asking me all week (or really for the past month) how I feel about it- nervous, excited, scared? Honestly I feel nothing. I knew in my mind this day would come. Believe it or not- it actually took me a while to finally get the courage to make the initial consult appointments. But once I got in to see the docs, and we went over everything I was excited to move forward. Since my surgery tomorrow is two-fold, it comes with some very mixed emotions.

On one hand, I am starting the breast reconstruction process. That is exciting. To finally get put back together and to have such a caring and compassionate plastic surgeon to help me get back what I lost. On the other hand, I am losing my ovaries. I know in my heart that our little family of 3 was complete when Lilly was born. I didn't have the yearning or desire for another baby. I had a difficult time getting pregnant, I had a miscarriage, and my pregnancy with Lilly was full of morning-noon-and-night sickness....for the entire 41 weeks and 1 day. All of those thoughts and feelings came racing back when I was diagnosed with cancer and the doctors told me that if I thought we MIGHT want another baby, that I should have my eggs harvested. I don't even think Mike and I discussed it, not even for a second. I thought of all the emotional pain and frustration of just trying to get pregnant, the physical discomfort and the constant puking that there was no doubt in my mind we were not having any more children. Plus the fact that if I wanted to have another baby, I'd have to wait at least 5 years until I was off the hormone therapy from my cancer treatment. That would make me almost 36 years old. And if I were to get pregnant right away, I'd be 37 when baby #2 came around....and Lilly would be 10! TEN!!!! I couldn't imagine having a 10 year old and a newborn. No way- not for me. PLUS, knowing I have the BRCA gene, could I pass that onto another child? And what if the cancer came back, could I go though this again. I mean- taking care of a 2 year old while going through chemo is no walk in the park.

Allright- back to my case in point. The ovaries. This decision has been made for me. There's too much of a risk to keep them. I don't need them. But I am losing yet ANOTHER chunk of my womanhood. It's just kinda depressing. And emotional. And final.

Well, it's getting late, and the 5am alarm buzzer will be here quicker than I'd like. I have a few lists to make still and a hospital bag to pack. I'm excited for this new phase. Not excited about the pain.

What happens when people don't do what they say they will do.

I don't even know where to begin.

I am scheduled to have surgery in 6 days. I have coordinated 2 surgeons to do their totally separate procedures on me at the same time so I can have 1 less general anesthesia/recovery/hospital stay over the next 6 months.

A little over a month ago, I started the process of scheduling consults with 2 different surgeons 1) a Plastic Surgeon to do my breast reconstruction and 2) a Gynecology Oncologist to do my Oophorectomy. Both are in my little network of doctors, at the same hospital in the same office building- and I felt great after we initially met and went over the procedures. I was very eager to move forward with things but the Gyn Onc (to be referred to as GO) thought I was being a little too ambitious and wanted to wait until I finished my Herceptin chemo to do the Oophorectomy (removal of my ovaries and fallopian tubes). I told him that I was also meeting with the Plastic Surgeon (to be referred to as PS) and asked if we could combine the 2 procedures. He told me- sure, as long as the PS is ok with it, I'm ok with it.

A few days later I met with the PS and told him about the procedure with the GO. He said- sure thing, might as well do them both together. So after we met, I sat down with the PS surgical scheduling coordinator and we picked a day- a day that I KNEW would work with the GO, who had told me 2 days prior that he could operate ANY MONDAY IN JANUARY. (do you get where I'm going with this?).

After we picked the day I said-
You will coordinate with the GO office and get everything set up with them- RIGHT?

Answer- Yes.

Fast forward to last week- I had to schedule my pre-op appointments with both doctors, so I called and got them both lined up. Yesterday, I met with the PS to go over all the last minute details. TODAY, I met with the GO....and here's pretty much what went down.

I made the appt with the GO for a pre-op exam and to sign the consent forms. I told them this when I made the appt. I also told them that I was scheduled for surgery on the 11th, so I needed to see the GO prior to surgery (duh). I walk into my GO office and he looks at me and says, how did everything go with the PS, do you have the tissue expanders put in? I say- no, we're doing that on Monday when you DO YOUR PROCEDURE. Hmmm. He then goes on to say that NO ONE FROM THE PS OFFICE HAS NOTIFIED HIM OF THE SURGERY!!!!!!!!!!!!! AUGGGH- this can SERIOUSLY only happen to me.

So we go over things, he looks at his surgical schedule and *thinks* he can work it out for Monday - in 6 days. So he does what I can not believe he did. He personally calls the PS office *ON SPEAKERPHONE*, and gets the scheduling coordinator on the phone, while I am sitting at his desk. Allright- I'm gonna say it, since I'm not naming names or anything- my GO is kinda a jerk. There's just something about ANY Oncologist- they're a little cocky. So he basically ummm.... expressed his frustration..... that he was not notified about the procedure. I wanted to melt into the carpet. It was the most horrid, awkward moment of my life. Then he started talking some surgical doctor talk about "cases" and "procedure codes" and "start times", and then basically left it as- "if you don't hear back from me, then a 7:30 start time is fine".

So we're on????

I felt so bad. I knew that I had inadvertently put him on the spot and NO Doctor wants to look like a fool. I know that my PS office dropped the ball, which they admitted to, and thank goodness the stars aligned and everything worked out. I kept apologizing (like that helps) and he said- it's not your job to take care of things like this. Whew.

Now, had the GO not been able to fit me it, it wouldn't have been the end of the world. It makes no difference if I have the Oophorectomy on Monday, or in 5 months, or 2 in years. The reconstructive surgery to insert bi-lateral tissue expanders is my main procedure. It will take about 1.5 hours and I will be in a lot of pain. The Oophorectomy is only 30 minutes and is actually an outpatient procedure with minimal pain. All I can say- bring on the Percocet!