I met with the plastic surgeon…and survived

Today I met with the plastic surgeon. It wasn’t as bad as I anticipated, but it was still weird.

I was the only patient in the waiting room, and I didn’t wait long. After some brief questions and blood pressure check, the nurse went to find the doc. He was in the room within two minutes with his PA.

“I know your story and talked to the other doctors, so there’s no reason to ask a lot of questions about your situation,” he started. “Change into the gown, opening in the front, and we’ll do some measurements and photos.”

Measurements and photos? The doc and PA came back into the room. The doc had a tape measure; the PA handled some papers. “Just stand right here,” he said, unwinding the tape measure.

On both breasts, he measured the distance from my nipple to my collarbone and underside of my breast. He measured the size of my areolas and the distance from the edge of the areola to the nipple. As he measured, he called the numbers to the PA. Turns out, I’m perfectly symmetrical – for now. 🙂

Then we walked down the hall to a locked room across from the nurses’ station. It looked like a photo studio with lights and reflectors and cameras and a computer. There were two blue lines on the floor. “Just put your gown there,” the doc said pointing to a chair.

“Are these blue lines for me?” I asked. (Of course they were.)

“Um,” I said, standing on the blue lines, awkward and topless, while he logged into the computer. “I’ve never taken THESE kind of photos before…”

He laughed and said I’d get used to it. “You’re in a plastic surgeon’s office,” he said. “This is what we do. It’s not your last time…”

He snapped three photos (forward and from each side) and uploaded them to the computer. Then we walked back to the original exam room where I redressed and waited for the doc to reenter the room.

He returned with a three-tiered cart full of stuff. I asked him to walk me through all options – from mastectomy to lumpectomy reconstruction options – and he showed before and after photos of each. We started with implants (which I don’t want). He recommended the “gummy bear” implant, which is fairly new, and from my research, a lot of women like them. (Nicknamed “gummy bear” because they have a thicker consistency than other implants, almost like a gummy candy.) They do look more natural, and the doctor is one of the leading surgeons using this kind of implant. It’s also the “easiest” option – little downtime, quick surgery, little follow-up necessary. No.

We talked about total reconstruction using either a stomach muscle or a back muscle. The stomach option (and the before/after photos he showed) is intriguing. Muscle, fat, and tissue from the belly button to the hipbone is removed and shaped into a breast. Totally natural looking breasts and flat stomach – but an 8-10 week recovery and possibility of necrosis. Additionally, with the stomach, there can be only one breast reconstruction surgery. If I were to get cancer again, the stomach would be off-limits. Awkward moment: I was asking about the exact area on the stomach and the doc asked me to stand and look in the mirror. He lowered the waistband of my pants a bit to show me, then he grabbed a handful of tummy. With the other hand, he grabbed my right breast and squeezed both. “Your tummy isn’t quite as big as your breast, so we’ll have to inject fat from another area,” he said. Um, maybe.

The option using the back muscle is similar, but would require a small implant under the relocated back muscle. No.

For lumpectomy, the plastic surgeon would come into the OR after the breast surgeon removes the area around where the tumors were. Without knowing exactly how much tissue will be removed, he’ll shape, possibly reduce, and lift the breast, making it look as natural and good as possible. Since the lumpectomy will require six weeks of radiation, all other reconstruction must wait. (Radiation can cause skin changes and change in the size and shape of the breast, so it’s best to wait until the skin is healed – anywhere from four to six months after radiation is over, or in my case, right after the spring semester ends.) I’ll have a few follow ups then to make sure I’m satisfied with the size and shape (if not, fat from the tummy, butt, or thighs will be lipo’d and injected in the breast). Once the right breast is satisfactory, he’ll work on the left breast to make them symmetrical – a lift at minimum, reshaping with fat injections at most. All follow ups will be out patient, and just an hour or two each.

I asked about next steps. “Choose what’s best for you and the breast surgeon’s office will schedule with us,” he said.

By the time I got home, I knew the lumpectomy was the best option. Surgery is scheduled: July 21.

Now I’m starting to get nervous.


In other news: I went out of town for the weekend. It was the first trip I’ve taken since… I don’t know. November maybe? Not sure if I could make the drive myself, I took my mom and the kids to stay with family, about half way to my final destination. We toured a dairy farm, and I was completely fine with walking (quickly in the rain) for part of the tour. Oxygen levels seemed fine, no heavy limbs or excessive yawning. The next day, I finished the drive (another few hours) to see friends and attend a concert. It was super awesome that the band members wore breast cancer bracelets through the concert in my honor. (We went to high school with the band’s drummer, and it was coordinated through him.) I spent part of the concert sitting, but I’m okay with that. Oxygen stayed on target, and even without an afternoon nap, I was okay with the late night (although when we got back to my friend’s house, I crashed). It was a long drive back on Sunday, but I survived!

Back on the chemo train

I’m feeling better than I have in weeks! After being released from the hospital on Monday, I took Tuesday to rest, and then I was back at work on Wednesday and Thursday.

Upon returning to class this week, a student gave me this "pocket angel." She carried it around with her for the last four years as she battled leukemia. "I believe these things should be passed on to those who need them," she said. "You should carry this around with you until you're better, then pass it on to someone who needs it more."

Upon returning to class this week, a student gave me this “pocket angel.” She carried this coin around with her for the last four years as she battled leukemia. “I believe these things should be passed on to those who need them,” she said. “You should carry this around with you until you’re better, then pass it on to someone who needs it more.”

The official diagnosis: pneumonia (viral) and hypoxemia (abnormally low blood oxygen level). With that diagnosis, I had my first “insurance sucks” moment when my insurance company denied the doc’s request for at-home oxygen. Low oxygen levels apparently does not mean I qualify for… oxygen? Makes total sense, right?!

I’ve managed without the oxygen just fine. I use an at-home pulseox (little device I put my finger in to determine my blood oxygen level) when I start to feel funny. From there, I can figure out what to do if my levels are too low (inhaler, deep breathing, sit down/relax, etc.) or too high. Since my levels were SO low, the docs think my oxygen levels have been low for a long time (probably since my GI problems last month) and my body has adapted to less-than-normal levels. Not good. So I feel funny when my oxygen is in the low 80s, and I feel just as funny when my oxygen is in the high 90s.

Treatment started again today. It’s the second phase of chemo. This one is supposed to be 12 weeks of “easy.” Since I’m still recovering from the fever and pneumonia, the oncologist only started one of two of the drugs for this phase (taxol), with the second one being added in a future treatment (carboplatin, which is only administered every three weeks). Some people can’t tolerate carboplatin, so it’s not a HUGE deal if I don’t get it. As the oncologist said, “The carbo is just the icing on the cake.”

Goal for this week: STAY OUT OF THE HOSPITAL!

Still in a hospital bubble – and with a list of complaints

I checked into the ER on Friday, and I really thought I’d be home by today (Monday), but I was just informed otherwise. I had a bit of a fever last night (just over 99.5), and while my white blood count is now above 10, they want to keep me until my count is normal AND there’s no fever for at least 24 hours, maybe 48 hours. I get it, but still.. My bubble burst while keeping me within my hospital bubble (prison). (Sad face.)

I feel good today, still have a bit of a stuffy nose and cough. But I’ve completely lost my voice. A side effect of one of the powerful antibiotics is “unusual hoarseness,” and that’s the one I got. I guess it’s better than the “very bad and sometimes deadly problems have happened” side effect listed. (No, that’s it, that’s all it says, no elaboration…so I win?)

Still, I’ve been really productive, this first day of spring break. Grading is half done, well ahead of the schedule I had made for myself. And I’ve started a list of complaints (most of the first world variety) because I really haven’t complained about much and honestly, I just feel like it. May I present:

“Things I won’t miss about spring break 2015”

  • Getting tangled up in my IV cord and having to “walk” my IV pole everywhere, well, everywhere within the confines of my room since I’m discouraged from leaving these four walls. So to the bathroom, to the sink, to the desk, to the recliner, to the garbage can. And sometimes getting so close to something, only to realize I. Just. Can’t. Make. It. without backtracking to unplug the IV and starting my across-the-room trek again. (On the positive side, at least they let me move around on my own.)
  • Falling asleep JUST in time for the IV to start beeping or my vitals needing to be taken or a new nurse starting her shift. On the same thought as sleeping, hospitals have major uncomfortable beds, pillows and linens (I am a linen snob – it’s one of my few splurges, and sleeping on sandpaper-like sheets with paper-thin, way-too-small-for-the-bed blankets has been…not fun. I miss 1,000 thread count – trust me, it’s worth it.)
  • Hospital food – except the mac and cheese. Damn good mac and cheese here (but the portion is WAY too small…) God bless my friend who brought me Panera for lunch today. Panera NEVER tasted so good after days of hospital food! Thanks!!
  • Being asked “did you tinkle in the hat” or some other inane question about my urination or bowel movements. Let’s just be adults and use grown-up words. Similarly, I’m not fond of a shift neglecting to empty the “hat” –  it only forces me to internally debate if I chart my own “output” or if I let the fucker overflow.
  • A remote control that only works if one is lying prone in bed. Sometimes I want to change the channel while walking my IV to the sink – not while lying flat in bed, thankyouverymuch.
  • Having to communicate the stuff I need from home to my mom by phone – only to realize that I didn’t specify WHICH drawer or WHICH nightstand, and worrying that she may have found -ahem- stuff she didn’t need to know about. She knows I’m an adult, right? I guess cleaning my drawers and finding better hiding places for things might be on the agenda after I’m discharged. Or why bother – she probably already found things she didn’t want to think about. (Mortified face.)


Almost 100 percent

I’m back.

Last week was rough. A GI virus that took down my mom and Lauren for about 12 hours spent about 10 days rattling around my body. It didn’t help that it was my “low” week so my body had NOTHING to help the fight.

Day by day, I tried to stay on top of rehydration, but the faster I put fluids in, the faster they were (violently) ejected from my body.

I went to work every day, but I won’t win any awards for my performance – it was all I could do to teach the bare minimum to stay on schedule. Usually my teaching style is very dynamic. I move around a lot, making use of the entire classroom. Last week, I didn’t leave my chair at the front of the room.

I slept. A lot. Because I was up all night, I slept until around 10 a.m., got up, went to work, came home, slept more. I had zero energy.

I was REALLY grouchy, and sometimes dizzy and light headed. I almost passed out after climbing about 40 steps in the parking garage – 40 freaking steps and I had to sit down for 10 minutes on the frozen concrete because I was seeing black spots. Good thing I didn’t park where I normally do or I definitely would have passed out on the walk to my office.

On Thursday, my tolerance reached a low point when I got mad at my thermos for keeping my soup hot and at my scarf for hugging my neck too tight. Getting angry (like, CRAZY mad) at inanimate objects for doing their job? Yeah, that’s not right.

I had been talking to the doctor and his nurses all week. Various tests came back normal. I finally laid it out for the nurse, “If I can’t get in today, I will go to the ER. I desperately need fluids, and I just can’t drink any more.”

I drove straight from work to the cancer center. Two bags of fluid plus magnesium and potassium and instructions for how to manage the GI virus symptoms, and I felt better. I slept through the night on Thursday.

I was still tired and weak and grouchy on Friday. I went shopping with my mom – as a birthday/Mother’s Day present, I wanted to buy her a new oven. She found one she liked and the sale was ending, so we had to go on Friday. It was all I could do to tolerate the appliance salesdude and his incessant repetition of the installation instructions. A trip to Target afterward was cut short because I just wanted to go to sleep.

Reread that – I didn’t want to shop at Target because I was tired. That’s pretty freaking tired, people.

My mom took the kids home with her Friday and Saturday nights so I could rest without interruption. I also decided to ignore the clear liquids/BRAT diet instructions I had been following for the past week. I was going to eat whatever my body told me it wanted. I needed nutrition (and to actually CHEW food) – more than comes from clear broth or jelly toast. Eating felt good.

By Saturday afternoon, I was feeling much better. By Sunday, when the kids came home, I was back to myself. Today, I feel about 95 percent “me.”

Friday will be my last dance with the red devil. I’m doing everything possible to stay on top of my health to get through the next few weeks before “regular” chemo starts. I’m told that will be the easy part.

Change in summer plans and mom guilt

Last fall, my mom came across a great deal for a Bahamas cruise with a few extra/added days at an Orlando hotel. We thought this would be the perfect choice for this summer’s family vacation and we booked it for the four of us. Cruise AND a few days at Orlando parks with the kiddos? Fabulous!

We kept it a secret until Christmas morning, at which time the kids unwrapped an inflatable cruise ship and captains hats to unveil the “big surprise.” It was a hit! Kids were excited and talking non-stop about sleeping on a ship and going to the Bahamas.

Inflatable ship? Check. Captain hats? Check. Christmas cruise surprise.

Inflatable ship? Check. Captain hats? Check. Christmas cruise surprise.

The next day, I received word that I had breast cancer.

I (kinda) knew then that being on a ship this summer was not going to work. I didn’t know my treatment plan yet – hell, hadn’t met with docs yet – but regardless, being on a ship right after surgery or with lowered immunity from chemo was probably not a good idea. Still I couldn’t bring myself to say anything to the kids when they rattled on and on about their big summer vacation. I would change the subject or redirect the conversation to something else, but it killed me that I would eventually have to crush their summer vacation dreams.

This weekend, I just couldn’t keep it up anymore. Ethan started asking really pointed questions: when are we going? How are we getting there? How long on the boat? Can he see pictures of the ship?

“We probably need to talk, buddy,” I said to him over lunch on Sunday as he peppered me with questions. “I can’t be on a ship this summer, so we’re going to have to change things a bit.”

I explained the lower immunity I’ll experience between chemo and surgery this summer, and how being confined on a ship could compromise my health – and could delay the rest of my treatment plans if I get sick.

“But grandma and Mr. B and I have been talking about an alternative,” I said. “What if Mr. B and the girls went on vacation with us? Somewhere else? Not on a ship.”

Ethan seemed to take the news okay. He’s disappointed that he won’t be on a cruise ship this summer, and that he won’t be going to Florida or seeing an ocean. But he also understands that breast cancer isn’t something we signed up for, that we just have to deal with the cards we’re dealt.

So summer plans will be a couple of smaller trips – a roadtrip wth B and the girls (and my mom) to a southern Indiana amusement wonderland, camp for a week, boating on the river with my uncle, maybe a waterpark visit here or there.

It isn’t what I wanted or what I planned, but it is what it is. I hope the following summer to make it up to the kids. I feel a ton of mom guilt with giving them a cruise then taking it away because I’m sick. Hell, these kiddos have been through so much I just hate disappointing them – even if they seem to “get it.”

The last two summer vacations involved a beach front condo on the Gulf Coast. Making memories...

The last two summer vacations involved a beach front condo on the Gulf Coast. Making memories…