Post Exchange Pictures added and post op update.

I've posted new pictures on the pictures page, I added pictures from just before the surgery and from yesterday after I got the bandages removed.

I have to say I am pretty happy with the results so far.  They are closer together, though I worry about whether they'll drift apart If I don't keep them strapped.  He said I didn't need to wear anything special, just a comfy soft bra, but after just one night of that I felt like they were drifting to the sides.  So we'll see....

I also didn't know until the bandages came off that he didn't reopen the entire scar!  He only needed to open the area of the scar that goes under the nipple and out to the side, so the portion of the scars on each side that go in to the center of my chest remained closed and so are still fairly nicely healed.  You'll see in the picture they're hardly noticiable (atleast compared to all the other gore going on there).

He said the bruising and discoloration is normal (especially considering my haircolor - and he called me a red head, I'm not sure if thats some kind of joke or not, but I didn't take it as one), and the swelling is normal as well.  He seemed a little concerned about some of the redness, but then we discussed that I did get a little red with just the stretching, so he figures the redness is from the swelling and putting in a bigger implant, and he's not thinking anything looks infected, so I'm to watch them like a hawk to keep an eye out for infection and I'm on antibiotics this time, so we're being extra safe.  But so far it all looks good.

The other thing I didn't know, was that we didn't end up with any of the implants I thought we were talking about.  I thought we were going to go with smooth implants, but when I got my info cards on them it turns out they are textured.

From http://www.justbreastimplants.com/breast_implants/natrelle120.htm

Allergan Natrelle™ Biocell® Style 120
Textured Round High Profile Silicone Gel Breast Implant

The BIOCELL® Round Silicone Matrix enables you to select an implant that uniquely meets the requirements of your preoperative plan with our patented BIOCELL® surface texture designed to provide mild tissue adherence and reduce the risk of capsular contracture.

I got the 400cc implants, with a diameter of 12.1 and projection of 4.5.  So not what I expected, and not sure where they even came from, but I'm happy with them!  Ha I just had a thought - I hope they were actually for ME, that would be uncool if I stole the implants from the next patient.  LOL.  I'm sure thats not the case!

So now I'm able to to shower which is nice.  Yesterday before my appointment I got a haircut with a very nice hairwash.  It's a pretty drastic cut too for those of you who know me - its ALOT shorter (ATLEAST 6 inches fell on the floor).  It's shorter than I really wanted, but I like it.  I think it will be easier for me to pull off a highly professional look.  I think it looks more mature (my moms word - I said "older").

I'm staying on top of the pain meds, so i'm staying pretty comfortable though I'm having issues with feeling too hot and getting itchy (mostly on my back where I can't reach).  

I'm going in to the PS on friday so he can check that all is good before we go into the weekend, then I'll probably see him again the following Friday to remove the tape.  So now I'm just resting, watching daytime tv, trying to not eat too many oreos. 

Exchange surgery complete!

I had my exchange surgery on Friday morning.  The exchange surgery is removing the expander implants and exchanging them for the actual implants, in my case - silicone. 

My mom took me in because my husband was out of town (for a work related seminar).  We had to be there at 7, so she picked me up at about 6:15 so we'd have plenty of time to drop off my daughter, who got to be the first kid at daycare and got to be the teachers helper (she gets excited about that sort of thing).

We ended up getting there about 15 minutes early, so we sat in the car and chatted until exactly 7, when we went in.  The nurse who greeted us asked if I remembered her from my last surgery, which I didn't so I felt kind of bad, but then later realized she must have been the nurse I saw AFTER surgery when my memory was still messed up from the drugs.

I went in and changed and they had me pee in a cup to ensure I wasn't pregnant.  Now I was very sure I wasn't pregnant, but I have to admit I had a little trepidation waiting for that to come back negative.  That would have been horrible timing for a positive pregnancy test!!  Of course I wasn't pregnant.

The doctor came in and drew on me.  We discussed again what he planned to do, and he said he thought we'd probably end up with the 360 cc implant, and I said - but we'll try for the 400 right? and He said yes, but we might not be able to to do that, and I acknowledged that I was aware and agreeable to whatever ended up happening.  Then somewhere along the line (it's hazy now) I fell asleep and woke up done!  I think one of my first questions was "did we get the 400?" and the answer was yes.  I don't remember talking to him, but my mom said he said I would probably be pretty happy with the results.

One thing I was TOTALLY happy with was that I did not have on the dreaded breast binder.  WOOHOO.  As much as I would have liked to add another to my collection (or not).... I was put into a white front closure bra wrapped with what I'm pretty sure he called a bandoo (compression strap) and then covered by what appears to be basically a giant ace bandage.

Then the thing I was NOT happy with - being told I can't shower until after my follow up appointment on Monday.   I feel sooooo gross when I don't shower daily, waiting 3 days is like torture.

My mom then took me home.  We stopped somewhere for lunch, I don't remember now for sure but I think it was taco bell, then I sat in the car while my mom grabbed stuff at the grocery store for dinner and looked for a twin size sheet that I wanted for the recliner. 

Then we hung out at the house (reclined in the recliner) until it was time to pick up my daughter from daycare.  I went along and we got snowcones, then came back to the house where my dad joined us for dinner.  By the end of the day I was pretty worn out and committed to relaxing more.

But overall I felt really good!  The next day (yesterday) I was really sore, and I spent most of the day resting.  I'm about ready to return to the recliner, but I wanted to post an update.  I'll post more later or tomorrow.  Here are a couple pictures though.  One is of my arm where it apparently put up a fight with the blood pressure cuff, there are little pinch bruises about an inch long circling my arm. not sure what that is about.  and my bandaged bust. note the staple holes.  I will be happy if I never get stapled again!

Blood Pressure Cuff attacked me.

Right now I'm pretty tired and sore, and battling a fairly bad headache, so I'm probably going to spend the rest of the day napping/resting, while my husband takes my daughter out for fathers day. 

Just when I was starting to feel normal...

Good news!  My autoimmune issue seems to be under control... or not bothering me.  I have alot more energy and I don't feel sore all over all the time.   It's nice.  The last couple of days my right boob has started feeling a little odd.  It kept me up night before last.  It kind of felt like the implant was rotating or something.  Maybe like the magnetic port was trying to get out through the top of my breast... It was fairly uncomfortable.  I will ask the PS about it today, at my pre-op appointment.

Yes that is right - Pre-op appointment!!!  June 15th is the date for my exchange surgery.  Two weeks and two days away.  The week before hand my husband will be out of town, so I'm a little concerned about how I'm going to get everything ready (at work and at home) without having his help.  He also won't be back until really really late the night of my surgery.  My mom has very kindly offered to spend the day/night with me and shuttle the 5 year old around until he gets back.

I have somewhat mixed feelings about the surgery.  I mean I'm excited about being that much closer to being done with this part of my BRCA journey, it will be nice to have the surgeries behind me, but now that i'm feeling so much better, I kind of hate to go into surgery again!  Feels like it will be a set back, back to lifting restrictions, and resting alot and fear of infection, and concern about wound healing, and what if it like sets off my autoimmune thing again, BLEH. 

So I'll just try to look at the positives.  I really do like napping and resting.  I read other blogs with people who are so eager to get back to exercising and being active.  And I can admit lately now that I've been feeling well, it's been nice to go on bike rides (got a bike for mother's day!!) and it felt good to walk the 5k Komen Race for the Cure with my daughter and co-workers.  But seriously, I could be very content if I was allowed a nap every afternoon..

Ok, so speaking of feeling normal.  I had to take my older daughter to the aiport this morning because she is spending the summer overseas with her father.  It didn't even cross my mind until last night around 7:15 on my way home from work (long day) that I might have an issue going through security with magnetic ports on my breast implants!!!  I researched online and asked on the FORCE message boards (while trying to ensure my daughter was set to go)  All I could really find was that I should carry an info card.  well... too late for that!  I don't have one and there wasn't a way to get one from the PS between last night and 7 am this morning when I needed to be at the airport.

So I told the lady TSA agent checking IDs and passes (I get an escort pass since she's a minor so I can see her off at the gate), that I had tissue expanding implants for breast reconstruction with magnetic ports and asked what her recommendation was when I got up to the checkpoint, she said she knew what I was talking about and that the body screener would be more likely to detect them, but it would limit the secondary screening to that general area of my body, where if I went through the metal detector and set it off I would potentially have a more thorough secondary screening (full body pat down?)

I decided to go through the body screener, and sure enough it caught them, so they pulled me aside, and another female TSA agent came over, I explained to her about the implants and she agreed that was likely what it was, asked if I was sore any where and said she'd be gentle and quick.  Then she just very lightly patted around the top sides and did a quick swipe under the breasts, and that was it.  I can see how someone could feel embarrassed by it being out in the open like that, but I didn't have a problem with it.  It was quick and painless and assured the airport I was I wasn't smuggling a bomb in my bra.    HA.  just realized the irony in that.. BRCA + people sometimes refer to their breasts as time bombs before mastectomy.  I got rid of my time bombs and now I'm suspicious at the airport. 

I took the day off work today.  I'm glad I did, I'm super emotional.  No way I could have gone to work.  I remember last time I took her to the airport I got a little teary but it wasn't like it was a new experience... seeing her off like that.  It just hit me really hard this time.   So now I'm going to fix myself up and try to look like I haven't been crying all morning to go to my preop appointment.  HOPEFULLY I'll hear what I want to hear about the implants!

6 Months Post Mastectomy!

So 6 Months ago I was in the hospital my first night after my mastectomy dealing with my horrible arm pain, with no clue what was to come. 

Now that pain is competely gone luckily.  But geez this last 6 months has truly been unpleasant.  It could be worse though, and thats the important thing to remember, though it is hard for me to not think of how much happier I might have been with my results had I not had an infection. 

But really, who knows?  It wasn't like I ws particularly happy with them before I got the infection, but I still had hope of them being what I wanted them to be.

I had a happy surprise for my 6 month mark though!  I had an appointment with the plastic surgeon today, and he seemed really happy with how I was doing, and I got a fill!  WOOHOO!  Last appointment he had left me with very little hope, but now my hope is renewed... I know I'm still not getting the size I wanted originally, but atleast I might get a little bigger than I am now. 

We discussed how they're kind of like half filled bags of water... well exactly thats what they are he said.  When I lay on my side they do this weird wrinkle thing.  So that is partly because they're not full, and partly because my skin has kind of naturally stretched, so we weren't really filling to stretch my skin this time, but to fill the area thats there.  I asked if maybe between now and my surgery, my skin might stretch more "naturally" and be able to accomodate a bigger implant.  He thought that was unlikely, but he'll still TRY for the 350 cc implant (versus the 300). 

I also talked to him about how my left one is off center.  Its more towards the outside of my body than my right one, and I asked him if we could fix that in the exchange surgery.  He said we could TRY.  Good enough for me.  I know he doesn't want to build my expectations too high, as they tend to be very high to begin with.

New pictures posted of where I'm at and one showing the off center thing.

Funny (?)  thing, Its kind of hard to tell how numb something is by touching it yourself.  Because you can feel it with your fingers, but my nipples are TOTALLY numb.  My husband poked them today to see if I could feel. and NOTHING, if I hadn't been looking I would have no idea he was touching them at all. 

I've determined the discomfort I feel when getting a fill (which is very minor) must be the muscle reacting as the needle goes through it, because the skin does not feel the needle pierce it.

Anyway, these are all things I've been getting used to for the last 6 months, and really I feel the worst of it is is over and where I am at is not all that bad.  The pain is mostly gone.. I just get some pain on my sides (just below my armpits) when I do alot of work with my arms.  I can sleep on my sides and even on my stomach if I position the pillow/blankets right.  (I guess we'll see if thats any more difficult after this fill).  And even though I'm dealing with this autoimmune thing and scared about whats going on with that, the weight of the fear of breast cancer is off my shoulders. 

1st fill! (in round 2)

I got my first post surgical fill in these expanders on Friday.

I'm sure the surgeon thought I was totally paranoid about infection, but he assured me it was understandable considering what I've been through. I had lots of questions about the probability of getting an infection from the fills and how long I should keep the band aids on and should I wash the area in any special way, and was he SURE I shouldn't take antibiotics just to be safe??...

There is a risk of infection from the fill since the port is under the nipple, and if you didn't know this - every natural nipple contains staph bacteria.  So everytime they have to inject through the area around the nipple (the areola).. there is a risk of that bacteria getting into the breast and causing an infection. 

He did do a double swipe of the alcohol on each site to try to make me feel a little better.

He still doesn't want to have me take antibiotics because he feels like when I"m already so limited on what I can take, we should reserve those for when we really need them.

I meant to take a picture of these needles.  They're CRAZY.  And it's even crazier that I can't feel it at all!

We injected 50ccs into each side, so with the 100 injected at the time of surgery and the implant counting for about 50, it is equal to a 200cc implant on each side. 

Due to the extra trauma it's been subjected to, the skin on my left breast is MUCH tighter than the right.  Strangely the left one is currently nicer looking than the right.  But so if you can imagine they're both the same size technically, but they look different.  The right one is kind of spreadout and oddly shaped, and due to the tightness of skin the left one is a nice little dome.    I'll get a new picture up soon!

I definitely was set back a little in my level of discomfort.  I was/am more achey and have had trouble sleeping. 

Today I worked from home (I'm working from home this week and going back onsite next week).  I woke up at about 330 and struggled to fall back to sleep until about 5, when I got up, and decided to start working, and then couldn't because I had to wait to receive my new IT access info.  Once I got it I locked myself out of my laptop trying the password (long story...) I was finally able to log in on my desktop computer about 11 am.  and about 1 I was sooo tired, I desparately wanted a nap but then only had half an hour until I needed to get dressed again to pick up my daughter from school for a meeting.  Then I came back and worked while she prepared for the meeting, then the meeting took over 2 hours and I had to stop on my home to drop off my laptop to get unlocked, so I got home shortly before 7  at which point I really needed to take some pain medication and then spent almost 2 hours preparing valentines for my younger daughter to take to school and then got her to bed and THEN realized that I forgot to wash her Valentines day outfit - which is why I am still awake (waiting to put clothes in the dryer)  

I'm working from home again tomorrow, and I need to do my valentines day shopping (on valentines day... urgh) and pick up my laptop... but I hope it will be a little more restful than today!!!

Preop Appointment Today

I had my preop appointment today!  Two weeks from tomorrow I will be having my expanders put back in!   It was pretty straightforward, nothing new or exciting really.  I got to peak at the waiting room and recovery room in what I will call the "surgical suite".  There are 2 beds in the recovery area and I have been informed I am the second surgery.  Since I'm the second surgery and I'm supposed to be there at 9 and there is only one operating room, I will almost definitely share the recovery room with someone else for atleast some portion of the time.  This is probably more normal than I'm feeling about it.  I would guess they set up the curtains in such a way that you probably never even see the other person and it probably is infact much like the initial recovery area at a hospital before going to "your room". 

I pointed out the two little weird spots that I have that he confirmed are loose sutures, so if he can readily access them while he's in there, he'll get them out, otherwise they'll still be okay, they'll disolve over time.  He also said I'd have the smaller drains this time, technically "Medium" drains, but they're small compared to the ones I had after the infection, so that will be nice!  And he said I will very likely have them for a much shorter time period.  YAY.

When I asked the nurse whether I should bring something like a breast binder, or a front closing sports bra, she said no, they would be putting something on me.. she's pretty sure a breast binder.  My husband asked if they had something other than pink or blue... (since we currently have 2 blue and 1 pink...)  she laughed and said no.. just pink or blue.. with flowers.   Another pink one would be nice I guess,   I (semi) joked with her that it would be nice to have white, or black.. you know something more neutral..  She didn't like the idea of white because of staining.. but thought black would be cool.  Oh well, maybe someday she'll find herself in charge of ordering them and someone in the future will get a cool black breast binder!  Seriously though.. who needs 4 breast binders?!  And I'm guessing now that I'll end up with a 5th before I'm completely finished.

It really is somewhat of a pain to be allergic to 2 major groups of antibiotics.  It is apparently quite limiting.  So I'm hoping all goes well and there are no infections!

So, back to the time frame.  I will go in at 9 am.  I can't eat or drink past midnight, and have to do the special cleaning the night before and morning of, just like last time.  I will probably be dying of thirst by time I reach the office (that's how it goes, when you're not allowed to drink.. suddenly your more thirsty than you've ever been in your life!  Thats how it is for me anyway)

He said he will probably be operating a total of an hour and a half or so, but there is time on both sides for getting me in there and under general anesthesia and then finishing things up and getting me awake again.   He estimated I would probably leave the office around 1:30 or 2.  I'm a little nervous about this.. I've only had one outpatient surgery before and it was a seemingly much simpler breast biopsy... But if for some reason something doesn't' go right, the actual hospital is just right there... practically across the parking lot.

Nothing will go wrong though.  I am confident.   This will be as easy as we could hope for!

New Countdown! Surgery Scheduled!

I now have a new countdown on my page.  21 days until my surgery for getting my expanders put back in.  YAY!  That is Friday, January 27st.  I thought I'd have to wait atleast a few weeks longer, but this is just in 3 weeks!  The appointment today with the plastic surgeon went well obviously..  He said I looked healthy and he checked things out and said considering what we've gone through things look really good and he didn't see a reason why we couldn't go ahead with surgery as soon as I wanted and we could get it scheduled!  They even offered me January 13th which is only a week from tomorrow!  But the surgeon then pointed out that it is Friday the 13th and he's superstitious so he'd prefer not to do that day (he may have been joking) but that was a little too soon anyway!  I have to get things prepared at work and we have a big "thing" going on in 2 weeks, so I need to stay atleast through that.  It won't be too bad this time since it won't be nearly as long of a leave. 

We discussed the alloderm again and he really doesn't think it's worth the risk.  He's only used it one case of delayed reconstruction (which is what mine is considered now) and it was a different situation all together than what I'm thinking I'd want it for.  He thinks we can still achieve a reasonable size for me (and I'm pretty sure he knows what I want), and if we feel like there is a coverage issue (like need more tissue covering the implant) we can look into fat grafting... he told me to eat more icecream!  I explained that I'm already actually on the heavier side of where I've been weight wise in my life..  So we'll see. 

He said I'd have the drains again for about a week (bleh) and then at some point... maybe a couple weeks (?) we'll start doing the fills and fill for about 6 weeks, then they'll need to sit for a few months.  He's not going to have me take any antibiotics preemptively.  He was saying there some merrit in doing a long course of a particular antibiotic followed by a sulfa antibiotic, but we can't do that because I'm allergic to the sulfa.  But he doesn't think at this point that we really need to do anything differently than he would with someone without history.

This was good news.  I'm excited to get on to the next step towards being done with all this!  And I'll have boobs!!

3 Months Post PBM - Update

I was just responding to a post in a message board, and realized that tomorrow it will be 3 months since the PBM!  Whoa.  And it has been over 2 months since my surgery to remove the expanders which left me entirely boobless.  That is crazy!  I still have probably at least 6 weeks to go until my next surgery to get expanders put back in... I'll start scheduling that at my appointment on Thursday (day after tomorrow).  It's good to know that I'm on the downhill side of the boobless time.

So here is an update of how I am doing with this right now:

My arms are pretty much better.  They tire easily, and feel really weird if I hold them up for long periods of time.

My arm strength is improving.. I can carry my 4 year old.. though it takes more effort than it used to.

I have mostly the generally achy feeling I had before all this from the autoimmune inflammation, I do feel it more sometimes around my would be breast area, like little twinges from the skin and tissue that was affected.

I can sleep on my stomach!!! Yay!  I still mostly sleep on my sleep on my sides, but occasionally will slip onto my stomach..  I'm going to really enjoy this for the next 6 weeks, because I know I'll be stuck on my back once I get the expanders.

I still don't feel sexy... 

I imagine that once I have boobs, even weird expander boobs.. I'll probably feel totally sexy, like "look at me! I have boobs!"

The majority of the day I don't worry about my booblessness.  I've found a system that works for keeping the breast forms securely in place and most days (in most clothes) I don't even worry them.  There are some outfits I try to wear some days that cause me a little more concern.. I have to pull up my tank top once in a while to make sure there is no gap, though I've been assured that someone would have to be creepy to be peering down a tiny gap in my tank top (and they would deserve the unpleasant surprise of nothing there...).

The numbness under my arms seems to be decreasing.. it's still fairly substantial but definitely less than it was.

I tire easily, but I don't know if that is more related to the autoimmune thing, or the surgery... or the combination of both. 

I wore mascara today.  Success!!

Big Red Squishy Boob

Argh.  So I apparently have an infection of some sorts.  Yesterday I noticed my right boob looked a little red, so I was keeping an eye on it.  Then both of them started feeling a little squishy compared to how they're normally fairly hard (I never quite understood the hard boob thing until I had hard boobs) 

This morning I woke feeling rather crappy, which isn't so unusual these days.  Figured it might be more than usual because I kept waking up (numerous times) thinking I heard footsteps in the house (which really had me freaked out), so I was pretty tired, but then I had a lightheaded moment in the shower, and then was feeling a little clammy as I watched The Tudors with my mom. 

It was after my mom had left and I got to thinking - It's friday, and going into the weekend, I should probably just give my surgeon a call to see if the squishy boob was a concern.  The nurse recommended I come in and just have the surgeon look at it.  My sister inlaw just happened to stop by and I asked her to take me into the surgeons office.

After examining both of the breasts, SQUISHING them (because they're squishy not hard), he had me lay back on the chair and asked the nurse to recline it so that I was laying at a slant with my head towards the ground (it really felt like I was going to slide off - he laughed and said the nurse would catch me if I did, but he hasn't yet had that happen).  I don't know what all the different feeling from different angles really told him, but he determined I have an infection, and that it looks like I got in early, and so we're going to jump on it and hopefully get it under control with  the antibiotics.  Then he wants to see me again Monday (instead of waiting until my next appointment on Thursday).  He also said that if I end up with an emergency situation over the weekend he would be available.

He said worst case scenario is that we do surgery and I lose the expander and cant replace it right away...(delayed reconstruction) which really seems pretty terrible...  He said there are other potential scenarios between the antibiotics and the worst case, so for now I'm going to just really focus on the antibiotics working.

So right now my left boob is squishy and red and bigger than the other and I have a fever and my back hurts, and I'm a little clammy, and I'm really just not too happy about it all.  Blah.

Drain Free and Filled!

Today is one day after the two week mark.  I got the drains removed today.  It was rather unpleasant.  I think I described previously how these drains were wrapped around the outer edges of my breast under the skin... well as they were pulled out I could feel it moving through that space, and I think my tissues had probably started trying to attach to it, which is probably what caused pain as it was torn away (thats just my theory). 

Prior to that though I got my first fill.  I was a little nervous about that because it seems like my breasts were still sensitive.  I explained to my plastic surgeon that it seemed like I still had painful sensation and that my incisions sometimes had twinges of pain.  And he said that its just the nerves trying to make sense of what we've done to them, but that in reality I shouldn't have any actual feeling.  He had me lay back and suggested that I close my eyes (unless I really wanted to see him come at me with the big needle).  So I closed my eyes and he said, okay here we go, and I braced myself, and... I felt nothing.  He proceeded to inject my breast (the expander implant) with 50ccs of fluid. and then went on to the next.  Same thing.

It was kind of funny to look down and see bigger boobs!  My husband who was in the room was equally amused.  He called them bionic boobies.

The plastic surgeon is comfortable with where my nipples are at in healing, so now that my drains are out he wants me to compress the boobs with either a tight sports bra or my breast binder from the hospital.  Right now I have both, since I'm not sure that either of them are adequately tight (or comfortable) on their own.  We also went to the store and bought a couple bras that I hope will be more comfortable than what I have currently.

I found what he said about wearing a bra interesting.. I asked if I still needed to wear one and he said that yes, considering that what I had before was the equivenlent of 500ccs and what I have now is essentially 300ccs - I have boobs, and they need support.   ok.   I'm learning that I actually had um... not small.. breasts naturally.  I've always been a bra wearer anyway, so no big deal.  I was just a little curious about this world of non bra wearing I read about on the message boards with women who for some reason aren't required to wear them.

I also mentioned early in the blog that he had said I might not even be able to get them the size they were when I had actually wanted them a bit bigger.  Now it seems that as long as we go slow, we'll see how it goes and might be able to get there (or even a bit bigger!)  YAY!

Anyway.. I am worn out today.  Off to bed I go!