Friday, August 5, 2011

just another operation

I don't know if it's the effect of advancing age (not that I acknowledge advancing age), or the cumulative effects of anesthesia, but I'm definitely not bouncing back from surgeries as well as I used to. Or maybe it's just that eight surgeries in seventeen months is a few too many!!

Anyway, I'm home from the most recent phase of breast reconstruction. Went in Tuesday morning early, with an 11:15 a.m. date with a table. In typical fash
ion, various dramas cluttered up the surgical units, and I wasn't granted that table until 3:15. That was OK - I read, cover to cover, an entire James Patterson book - a strange one for him, about genetic mutations that created, among other things, a beautiful girl who could fly. Definitely kept me distracted!

When everyone finally started showing up to prep me, things moved a little faster. My doc dropped by for a short visit. I asked him, since he was already cutting me open, if he'd mind cleaning up a little boo-boo from his original surgery. When he got rid of the handful of unsightly skin and scars and stuff under my arm, there was a little 'thing' left over . . . and vanity being what it is, it made me nuts. I called it a little pimple, or an out-of-place nipple - which it wasn't. But it did show thru my clothes on the rare occasion when I actually wear something decent. He had a lovely medical sounding term for it, which I of course can't remember, but he said he'd take care of it.

Then he got out his pen and marked me up to show himself just what he wanted to do.

After that, he autographed my new little tittie. I asked the obvious question, why? Said doctors had been doing that since 1994 (or was it 1974?) when a doctor in Philadelphia took out the wrong lung from some poor guy.

Obviously, that doesn't always work, since we hear stories all the time about folks being operated on the wrong knee, or arm, or kidney, or whatever, but I thought, other than the rather distinctive difference between my right and left boobs, his initials would do the job!

I had given my camera to one of the surgical staff, so she could take a picture of the 'gadget' that he was inserting in to me - the initial implant and skin expander. Somehow that didn't happen, unfortunately. But my doc tells me he has them laying around his office, so I'll be able to get a photo of one next time I'm there.

Woke up promptly, ready to go home to my poor puppy who was probably worried sick, I'd been gone so long. But they were trying to get my pain under control, and not doing well at it at all. I found myself bound up tight in a compression bra, and I hurt like hell!

All my records show that I have a really high pain tolerance, so when I finally admit I'm hurting, I need serious pain meds. The best I could get out of them was hydrocodone, 5-500. I would need about 10 of those to get any effect at all, and of course them wouldn't give me that much. Finally they agreed to give me some Demerol - 12.5 mg. I asked for 50 mg to start, and they just laughed at me. I finally said I was feeling OK, just so I could go home. Where I could take some of my own meds!!

This results of this operation are so odd. He sliced me open along one of my existing scar lines,
and separated the muscle layer from the fat and skin (rather like when we are doing a turkey, and wiggle our fingers under the skin on the breast, separating it so we can squish in a layer of butter and other goodies to keep the breast moist and tasty while cooking). That's where he put the implant gadget and tissue expander. Sounds easy enough!

Somehow they bandaged me up and got me into the compression bra and sent me on my way. I was to leave it in place for 48 hours, then I could remove the bra and bandage and take a shower - yes!!

The bandaging was huge for the little incision. Which was one explanation for why I was so damned uncomfortable!

Underneath all the bandages, the incision is held together with steri-strips, which hang on to my skin for
dear life, ignoring the showers until they are good and ready to let go! I'm supposed to re-bandage the wounds and wear the nasty compression bra until I see the doc again, in about 10 days.

This one should have been easy. Minor pain. And if I'm standing up, or sitting, it's basically fine. I had surgery. It hurts. That's to be expected. And that part doesn't even need pain meds.

But when I bend over (and do you have any idea how many times we bend over
in a day? at least 743!), the pain is excruciating, cry out loud pain, radiating waves of massive pain! I've now learned to do most things around the house without bending over. But when I forget? OMG - the screaming pain. I can't help but cry out from the pain.

That is not me!!!! And I don't have anything in the house that has much effect on it.

I've come up with a pain med cocktail that breaks the worst level of it. Can't ever tell a doctor or pharmacist about it, though! And thankfully, now tha
t I'm into the third day after the surgery, it's finally starting to ease up just a little on its own.

I emailed my doc yesterday and asked if he could tell me why this was happening, what was causing the intense pain. He wrote back promptly and told me not to do anything strenuous with my right arm and it would get better in a few days. Huh? I guess he hasn't heard of anything like this before and doesn't have an answer for me.

Oh well, I'm finally over the worst of it. Which is good for more than just me. My poor little Misha was very upset hearing me cry out in pain, and when she's upset, she throws up. And bending over to clean that up just made me cry out again. A lot of fun. So thankfully that has stopped.

Now she just sits as close to her mommy as she can get on our makeshift hospital bed.

I wasn't able to lay down flat for the first couple nights. Did so last night for a while and it felt great -
slept for several hours without waking up! Of course getting up again wasn't the easiest, but I made it!

I assume, when I see him next, I'll find out what the schedule will be from now on. As I understand it, every couple weeks, I'll go back in to get fluid put in the implant gadget, until we get to a size we like.

I'm still trying to decide if I want to use silicone or saline. Most things I read suggest silicone is best, but most breast cancer patients I've talked to say the saline provides a more normal feeling boob! Not that I anticipate anyone feeling them again, but as I said earlier, vanity is a strong guide. We'll see. It may turn out that I don't have a choice anyway - the insurance company may have its own ideas!

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