The one with the surgery

So, it's been almost 2 months since I had surgery. This means I've had 2 months to heal physically and emotionally. Despite all of the trepidation, stress, and panic that came with surgery - I am relieved to have gotten rid of the boobs that quite literally tried to kill me. Not sad to see the tumor twins gone and a new set of much more docile and calm boobs in place.

Surgery is some scary shit. I don't care how "routine" the procedure or how long you are (or aren't) under the knife - it's scary. I can't lie to you, I was fairly terrified about my surgery. I had a port removal, double-mastectomy, sentinel node removal, and reconstructive surgery all in one procedure. That was roughly 3 and a half hours on the operating table. But, before I get ahead of myself...let's back up and I'll tell you how I got from point A to point 34C.

One of the very first things I did was make individual appointments to speak with a general surgeon, plastic surgeon, and a radiation oncologist before I made any official decisions. I was 99.9% sure that I would need to undergo radiation and I wanted to make sure that whatever surgical procedure(s) I chose would make the most sense for optimal radiation treatment and healing in both the short term and long term. After discussing quite a few possible options, I decided to go with a one-step reconstruction process. This is when the general surgeon comes in and performs the mastectomy, then when that procedure is finished, the plastic surgeon comes in and performs reconstruction. This means one time under anesthesia, one surgery, and one healing process. No need for tissue expanders, multiple visits to plastic surgeon to fill the expanders, and no second surgery to replace expanders with implants. My radiation oncologist said that he could radiate with the implants in place. The one real risk is that the radiation could cause some internal scarring and "globs" of scar tissue that might push on the implants. This would require some fixing from a plastic surgeon. But, there is a chance that everything will go along just fine and when I'm done with radiation, I'm just simply done. That's the hope. Every woman and every case is different and I would highly recommend that women are sure to talk with all medical professionals involved and determine the best plan for herself - - but I think it is most definitely worth it to see if one-step reconstruction is an option.

After I gathered all of this information and had some long and intense conversations with my husband, we went ahead and scheduled surgery. They gave me about three weeks to get my affairs in order. I had to make sure that everything was all squared away at work (I would need to miss about 4 weeks) and make sure that I had everything all situated at home, literally. (I would have limited range of motion - so I needed to make sure things that were up high in cabinets was down low where I could reach them.)

One day at work, I received a call from a nurse navigator with the hospital who suggested I come and take a breast surgery education class. I cannot stress to you how grateful I am that they do this for women. If you know anyone who is having a mastectomy and their hospital offers a class like this - - TELL THEM TO ATTEND!! I learned so much during that 90 minutes. I was of clear and sound mind, too, so this meant that I was able to retain the many details that would prove helpful when I went home after surgery. The nurse stepped me through every single thing that would happen from the moment I checked in to hospital on the day of surgery through the moment I checked out. She taught me everything I would need to know about managing my drain tubes, some simple exercises for stretching my banged up muscles, how to get in and out of chairs, how to sit up in bed, and so on. She also told me about lymphedema and the importance of finding a physical therapist who is also a lymphedema specialist before surgery. That way they can take measurements of your arms in order to track any possible swelling to be addressed post surgery. SO IMPORTANT. But I'll talk more about that later.

Okay. Surgery day. A few things.
1. They definitely put the I.V. in my foot. Terrible.
Because I was having lymph nodes removed on both sides of my body, they did not want to put an I.V. in my arm to reduce the risk of lymphedema. Considering my horrendous fear of needles, this was no small feat. (Oh, god. It was awful.)

2. They gave me pain balls. This means that the anesthesiologist laid me on my stomach, located pain receptors in my upper back that control my chest and side muscles, then they stuck wires down there that are attached to little tubes that are able to administer local anesthetic (kind of like mini-epidurals) over the course of 72 hours. This means that I did not have to take narcotic pain meds every few hours. (That meant no fuzzy head, no upset belly, and so on.) The down side is that I had to haul around two fanny packs containing plastic donuts full of "the good stuff".

This is just one of the pain balls. You can see the little tube inside there filled with "the good stuff".

Here you can see the wires that came out of my back, taped to my neck, that connected to the above pain ball. I had one of these on each side for about 3 days. 

Here's another shot of what those wires looked like coming out of my back. To be honest, it hurt worse trying to get the tape off of my skin than pulling those wires out. 

3. Surgery went like clockwork and there were no hiccups. Thank goodness. I woke up knowing that they had removed my real breasts, but when I looked down, I still had my feminine form and felt like the Jenn I was about 4 hours prior. For me, that was important. This is not the case for every woman. Some ladies opt to not have reconstruction and some do. One is not better than the other. Like I said, for me, it was important to maintain a feminine form and come out of this looking like I did when I started. It was one less thing for me to stress out about and one less thing to mess with my mind and emotions. I came out of this major surgery and felt emotionally whole. This allowed me to focus on healing physically.

4. The nurses definitely had me up and walking the same day. It was rough, but I did it. (I only almost barfed. No actual barfing.)

5. I absolutely got up the next morning and showered. (That was a debacle and a half and thank God my husband has nerves of steel because I was a hot mess.) Showering while you try to manage two pain balls and those wires as well as two drain tubes is a lot to manage. It's do-able, but the first time was definitely a learning experience.

6. I was discharged from the hospital the next day. At first this seems absolutely crazy, right? I just had major surgery, I have these pain ball things and wires coming out of my neck, oh, and I have two drain tubes sticking out of my body. BUT, I can tell you that it was so much better being uncomfortable at home in my own chair and my own bed than at the hospital.

This is a Jackson Pratt drain tube. The top tube section is what is stuck in your body (it's like almost 10 inches of tube in there) and then the rest just dangles out. The tubes are sutured to your skin. It's pretty gross. You have these plastic grenade things dangling at the bottom and they need to be emptied multiple times a day. Then you have to measure the "output". Again, thank God for my husband. The guy was a rock. 

7. Both of my surgeons were wonderful. They came to see me the next morning and were full of smiles and jokes and well wishes.

8. The nurses who took care of me were the best. They were kind and helpful and just plain wonderful. They even sent a "hope you're feeling better" card after I went home. How great is that?

I feel like I was one of the lucky ones in that I was able to get both of my drain tubes removed at the same time, after just one week. It can sometimes take up to 2 or 3 weeks, and not every woman gets both out simultaneously. My plastic surgeon and his nurse tag teamed it - they each snipped the sutures around the tubes and then 1...2...3... PULLED. Out the tubes came. Was it the worst thing in the world? Probably not. Did it feel like it at the time? A little bit.

So, week one after surgery, I just hung out at home trying not to laugh, cough, sneeze, or jerk in any way. Holy shitballs. You don't realize just how often you use your chest muscles and side muscles up through your armpits (they removed lymph nodes from up in my arm pits - they went through the incisions they made for the mastectomy and up into the 'pits). If you know someone who is going to have a mastectomy, tell them that it is smart to invest in button up shirts to wear for the first week or so. Trying to get in and out of a t-shirt just isn't gonna happen for a while.

Week two I met with my physical therapist, who is also a lymphedema specialist. She was able to make sure that I got my range of motion back, strength back, and monitor me for signs of lymphedema. She was also able to take care of any little cords that developed. (Imagine those little glow stick bracelets and how you  have to crinkle them to get 'em to glow - - she massages the cords that develop until they crinkle and snap and go away. Those cords are made up of hardened lymph fluid.) Again, if you know of someone who is going to have breast surgery, you might mention to them that they should get squared away with a physical therapist who is a lymphedema specialist. IT'S SO VERY VERY IMPORTANT.

By week three I was cleared to drive and the pain was mostly gone and my PT sessions had been going really well. I was wearing tshirts again and doing laundry and going stir crazy (read: too much Pinterest and YouTube.)

Now, I am leaving out quite a few gory details, but to be honest - you don't really want to know about those things.

I had surgery on September 9, 2015. I was back at work, full time, by October 5, 2015. This is all due to my amazing and fantastic doctors, my superman of a husband, and the love and support of my family and friends. I was definitely scared about surgery. I was scared about losing parts of my body. I was scared of the pain. I was scared of the drain tubes. I was scared of the scarring. But you know what. It's all okay. The surgery went great and while yes, they did take parts of my body, they only took the bad stuff. The parts that made me sick. Those surgeons left the good things. They left all of the parts and pieces that make up me. I still have my heart, my humor, and my ability to love.

It was about one month after my surgery when my physical therapist encouraged me to join her Making Strides Against Breast Cancer walk team. I was a bit tentative at first because I really didn't know anyone else on her team, but something about doing this walk felt right. In hindsight, raising money and awareness for breast cancer by participating in such an uplifting event was the perfect way to finish my fight (Thanks, Tracy!). It was pretty dang inspiring to thousands people the day of the walk supporting their survivors and hoping to make a difference. I gotta tell you, it felt really good to know that I was out there just one month after surgery, able to put on my own t-shirt, walking a full 5k, and laughing with my friends and family. It felt really good to know that I got through the scary and can call myself a survivor.