Saturday, July 16, 2011

Interesting times in the Old Pueblo (one of Tucson's nicknames)!

We are now into a more typical summer - monsoons have arrived, which means great lightning and thunder storms with big winds and big downpours (and usually damage to trees and homes!)! And humidity, which comes as a shock to our systems!

After three wild storms over my little neighborhood, and several more in other areas around town, we're now back into 'summer', where it's dry and hot and the humidity is gone. The thing that makes the monsoons so fun is that you can get two inches of rain on your house and down the street, they won't get a drop! You can see a huge curtain of rain down the road, and no amount of begging the rain gods will bring it to your house!

What the monsoon storms and their humidity did bring was relief for the troubles I've been having with my thumb! For the week that the humidity was through the roof, my thumb was absolutely normal. But now that we're back to our more normal 8% humidity, the thumb is back to clicking and locking and popping things across the room. Almost (note, I said 'almost') makes me wish for high humidity.

But to make up for the brief respite from thumb trauma, I've developed a new lymphedema problem. I've been seeing my lymphedema therapists for my annual 'tune-up' and to get fitted for a new compression sleeve, so we've been talking about it. I now have a big 'puddle' of lymph fluid accumulating on the right side of my rib cage, just below my new little boob.

The 'educated guess' is that it's caused probably by my TRAM-flap surgery that sliced through skin
and muscle and fat from hip to hip, thereby severing the regular paths of the lymph channels. There is no sewing them back together, and they do not regenerate. So I'm getting this growing puddle of fluid that can't find a way to escape. I'd like to stick a knife in and put in a spigot to drain it. Probably not practical.

What I see when I look straight down over my new little boob is this:

On the advice of the lymphedema therapists, I put in a call to my reconstruction doctor to see if I could get an appointment to talk about my new protruberance. I sent him an email with this picture of it. Amazingly, I got in to see him first thing the next day.

Doc gently poked and prodded and manipulated the bloody puddle, and agreed it does feel like a congestion of lymph. He's never heard of or seen anything like it before, 'but there's always a first time'.

That protuberance is trouble. If I bump it or lean on it, it feels like a big fresh bruise. The lymph just can't get out of there. This fucking lymphedema is going to be the straw that…

Anyway, the therapists wanted me to constrict the rib area, with something like the belly support I wore for 12 weeks after the surgery, including putting something like a piece of an oven mitt or something with lots of bumps and ridges directly over the puddle. My doctor absolutely forbids me doing that, for the very understandable reason that the basic blood flow and whatnot to the new boob comes up right thru that same area, and if it's constricted, the fat/muscle (boob) will die. "Besides, you'd be horribly uncomfortable wearing that 24/7" - no shit Sherlock!

He is confident that further surgery will not affect the area, but has no suggestions, as the therapists do not, of how to deal with it. He believes the swelling in the rib area will continue to reduce in the coming months as everything continues to heal from that traumatic surgery, which might help a little.

So, as we speak, I'm still scheduled for the surgery in two weeks, assuming the insurance company gets off its ass and responds.

I asked for details of this phase, and it's not at all what I expected. He says they'll go in thru one of the many existing scar lines near the underarm area. The new fat boob is laying on top of the chest muscle which is on top of the chest wall. They'll gently separate the area between the muscle and the chest wall (kind of like when we squish our fingers under chicken/turkey skin on top of the breast to insert a buttery seasoned baste) and he'll insert a 'gadget' (I commented on his use of explicit medical terms and he just smiled - I'm not sure he has a sense of humor, but I still like him). A couple weeks later, we go back in and start putting fluid in the gadget, and increase it every couple weeks until we get a size 'we' like. Then he removes the gadget (it has some metal parts and 'doesn't feel very breast-like', and insert in its place, the implant of the appropriate size.

I'm still vacillating daily on whether I even want to go ahead with this next phase. I'm so tired of pain, of being exhausted. Since all the chemo is out of my system, all my old pain has returned - both hips, both knees, my ruined right ankle. After years of trying, we've not been able to find anything that gives me any relief from my pain.

Now, with this dumb thumb, 'they' are looking at 7 or 8 more surgeries for me - four or five for the reconstruction, my thumb/hand, my left knee, and something for the disgusting cyctocele. Eight more surgeries? Talk about 'quality of life' - I'm thinking it's just too much. I'm just so tired. The warrior is faltering.

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