The A-Team in OR 10

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Yell it from the rooftops: I’m DONEEEEE!!!!

Yesterday was the absolute smoothest, most perfect surgery experience I could have ever hoped for on all counts. Before it’s all a giant blur, here’s my recollection: I was blessed with the magical 10:30 am second slot… So no insane wake up time and a perfectly acceptable 8:30 am arrival time. I got checked in within minutes, and we headed up to the surgery waiting room where the amazing receptionist even remembered me and Mom. Impressive, given how many people she sees a day! We were a little early, and soon Mom’s loyal waiting partner, and my rock of a best friend that hasn’t missed a step of this entire process, Ruthie, got there. Of course the laughter started early, and we have a way of quickly getting people laughing with us!

Not long after they took me back to pre-op, and I was soon gowned up, got my IV started, and I met my fabulous anesthesiologist. Soon after, Dr. Teotia, my most awesome plastic/reconstructive surgeon, came in – right on cue as we had just started taking pictures!

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And then began the true artistry – he redefined “pre-surgical markings!” Literally from my thighs to above my expanders were covered in a strategic rainbow of colors – strategic because of a) my shunt and b) he is impressively cautious about not eliminating the option of flap surgery (years) down the line by messing with blood supply, etc, which I SO appreciate. I know I’ve raved about my plastic surgeon at length before, but he truly is amazing. Especially when he tells you you don’t have much fat to graft! I begged to differ 🙂 But in all seriousness, he just has a complete sense of calmness, and his passion for his work and patients is unheard of.

So we went over the whole plan, and as he walked out he said “I have the A-team in room 10 – they’re all super cool!” And he was SO not exaggerating. My CRNA Tommy and nurse Courtney were the absolute bomb!! In a matter of minutes, Tommy hooked me up with IV margarita (while Ruthie video’d…) and off to the OR we went, not even just on time but early. I remember them getting monitors and things situated and the last thing I said was “hey Tommy what was THAT awesome stuff you just gave me?” And I was out. Sure that got a good laugh!

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I arrived in PACU at 1:50 and my nurse Elizabeth was also total A-team! I ended up hanging out there for awhile to get pain under control and also because they were super busy in day surgery – clearly I wasn’t the only one to strategically plan surgery around Thanksgiving! I was more than okay with this – we were making conversation like old friends, and she let ME call my mom to tell her we were heading out!

But yes, I did wake up in a pretty decent amount of pain. Dr. Teotia did everything planned… Took out the expanders, reinforced the left side (where the expander moved) with Strattice (pig skin) to keep the implant in place, put in 640 cc Natrelle 410 highly cohesive silicone (“gummy bear”), teardrop, moderate height, full projection implants, and did an incredible job with fat grafting (basically lipo but instead of trashing the fat you’re moving it elsewhere, in this case my chest). It’s the last part that’s causing the pain… But it’s SO worth it. I had a lot of breast tissue higher in my chest and under my arms, and my breast surgeon was so meticulous in getting every bit of that dangerous tissue out of there during my mastectomy that it left some noticeable crevices. You could feel wayyyy more ribs than desired. So that was a huge reason for the teardrop shaped implants, and the fat grafting just enhances that and fills in the gaps. But it also means I kind of feel like I got hit by a bus from my thighs to my armpits. My doctor told Mom I’d be really sore and he was, in fact, right. So in addition to the approximately 3 inch each incisions that were reopened on the sides of my breasts, I have 6 tiny incisions from the fat grafting: one in each armpit, one below each breast, and one (I think) on each thigh that was used to get fat from both the saddle bag and love handle areas (I mentioned my surgeon is awesome, yes??). I say “think” because in addition to the mastectomy bra fashion, I have on knees-to-boobs length zip-up compression leggings that put Spanx to shame. Oh and they’re black and crotchless (aka:pee hole!), complete with lace trim. Because if that’s not classy I just don’t know what is!! The Uggs completed the ensemble and I’m sure it will be hitting the runways soon! But in all seriousness, the compression is to help with the swelling and bruising, which I anticipate will be pretty impressive given my affinity to bruise and that it had already started before I left the hospital. I tried to sneak a peak of the thigh sites this morning, but as I can’t so much get them back on myself (did I mention the compression?!) I didn’t get too far before Mom had to help… In a “you just couldn’t leave it alone could you??” kind of way LOL. But anyway, that’s the theory behind the fat grafting – thanks to all that offered to “donate” additional fat!! Haha. Yes the donor site removal of fat is a silver lining, but I’m just so relieved to have a normal boob slope back!

So I was feeling really great in the PACU, and just when I thought I had dodged post-op nausea for the first time in my life, the ride back to day surgery caused a massive quease-fest. With the help of a patient nurse and some wonderful Phenergan, I felt better in an hour or so. I talked with Dr. Teotia for a bit and he explained everything, along with the warning I may feel pretty rough (an overnight stay may have been offered.. Needless to say I vehemently denied!) Mom and Ruthie came back, and after some ginger ale, juice, crackers, and fruit snacks, and the obligatory trip to the bathroom I turned a corner and felt well enough for some walking papers! We were finally out the door a little before 5:30, which was excellent timing before some crazy weather blew in! Made it home amidst the rush hour traffic and my wonderful Dad had food ready and the fireplace on when we walked in. I felt even better with real food on my stomach with a side of pain meds, and snuggled up in my pillow/blanket throne by the fire. Got some mostly decent sleep, just feel like a grandma trying to get up! Ha!

So how am I feeling now? Really pretty good for just the day after. If it wasn’t for the fat grafting I’d probably be 95% back to normal but alas… It’s already so worth it to see the girls looking and feeling so normal. I hesitate to use the word “pain” because it’s more like completely insane soreness for the most part. It’s entirely different from the post-mastectomy pain… Not comparable at all. It’s mostly movement related, yet it feels good to loosen things up in a “hurts so good” kind of way. But it is indeed covering a much larger area than just my chest… And of course it’s the 2 muscle groups (thighs and abdomen) I rely on not to abuse my healing pecs! Oh the irony. But it’s still a thousand times better than back in August – none of those hellacious muscle spasms, no drains, and no muscle stretching! I think it’s going to improve quickly, and I hope to be off of prescription pain medicine in the next 24 hours, but I am certainly glad I have the time off to recover that I do.

Oddly enough, lifting and movement restrictions were more emphasized yesterday than with the first surgery due to the importance of the implants settling in the correct spot, especially because of the teardrop shape (round ones can spin around all they want… Obviously not the case with teardrops). Dr. T particularly emphasized not raising my arms above my head for 72 hours so the implants are able to adhere, so I definitely feel more cautious than before (where I didn’t move for the most part because it hurt!) – I think mainly because with the first one I knew in the back of my head that it was just a “rough draft.” Now with this one I absolutely don’t want to mess up anything!! So yeah… No more than 10 lbs lifting till the New Year. Glad those Christmas trees are up already!! 🙂

Anyhow, I have truly felt enveloped in love and support throughout this whole experience and especially yesterday. It was a long time coming, and the true relief I feel is just amazing. I am so grateful for my incredible medical team, and for the never ending support of my friends and family. It has been quite the journey, but it is definitely the start of a new beginning!

It appears I picked a good time to “hunker down” with the parents for the week given the lovely (not!) weather. So that’s my plan… Take it easy, rest, and heal so I’m ready for the holiday festivities. Will update again soon, and thanks again for all the good thoughts sent my way!

 


Ready

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I’m ready. So ready. So very, very ready for tomorrow.

So ready, I think I’m scaring people with how okay I am with this surgery. I’ve had a lot of genuine “are you okay’s??” this week. But this? This my friends feels like the victory lap. This is just finishing what we started 108 days ago. But really, what started with a consultation 9 months ago. A decision made 13 months ago. And a positive blood test 61 months ago.

I’m not so crazy to call myself excited for tomorrow, because I’m certainly not excited about going through the anesthesia, the pain, the healing again. But I am really freaking excited for what comes AFTER tomorrow.

Sure, the high-risk breast tissue was all removed on August 6th. My risk has been dramatically decreased and the relief that brings is indescribable. But since then, I’ve been in this awkward limbo period. It was necessary, and I wouldn’t change my relatively easy experience for anything. But I’m ready to be done with this in-between period. These last few weeks have been a bit suffocating, both physically and emotionally. Physically, as I’m so tired of the uncomfortable foreign-ness of these expanders. But I’ve elaborated enough on that I won’t bore you again. Emotionally I’m ready to truly have this all behind me. I planned to write more about Pinktober, but honestly after I got home from the incredible walk, the rest of October I felt like I was suffocating in pink, everywhere I turned there it was. It was weird and unexpected, and it’s hard to explain. I realize it’s caused me to be unintentionally short and “on edge” these past couple weeks, so I’m even more grateful than usual to be surrounded my incredible, caring, understanding people that I’ve surrounded myself with to make it to this point. And for distraction. And the mantra of “this too shall pass.”

I’m ready to make plans that aren’t based around surgery dates. I’m ready to not think about this surgery every time I move wrong and get a whack of expander. I’m ready to be able to work out again. To wear clothes without worrying about the unevenness. To order my dress for the wedding I’m in in April that I haven’t been able to not knowing my final size. To not feeling like my life is on hold whole counting down the days to another surgery. To truly get to enjoy every minute of my new, risk-reduced life.

Suffice to say, I’m ready.

I’m truly feeling the love tonight from all of my families… My incredible blood-related family, my sisters I never had, my work family, my newfound yet brilliantly amazing Bright Pink family. This past year has truly shown me the beauty of people, and I am so very grateful. I’ve read stories about women who have lost friends because of the decisions they’ve made to take ownership of their health, and that leaves me heartbroken to think about. I will never take for granted the fact that not only did the people I already knew and loved rally around me like I couldn’t ever have imagined, but that I’ve had the true joy of meeting so many amazing people along the way. My journey would not be the same without each and every one of you… You know who you are!

So needless to say, I’m in such a good place going into tomorrow. I’ve had a lot of people try to not-awkwardly ask what exactly they’re doing, and I apologize I didn’t explain this before. It’s the “exchange” surgery, dubbed that because my plastic surgeon will literally exchange the rock hard expanders for the permanent implants, using the same incisions. Then there’s just some detail work to make sure everything is in the right position, which may involve some other materials in addition to the Alloderm I already have, or some fat grafting where the transfer some fat from somewhere else on your body to fill in gaps, etc. It’s expected to take about 2 hours or so and is under general anesthesia, but I thankfully get to come home after! No drains, no hospital stay, no more muscle stretching… All the women I’ve talked to that have had it say it’s a complete breeze compared to the first one, and that is such a huge relief! I strategically planned this with Thanksgiving so I can take all of next week off work without missing a whole lot of stuff going on. So I’ll crash with my parents again and hopefully get to enjoy some R&R and fabulous Thanksgiving time along with the recovering!

So that’s the plan! I’ve done my “nesting,” got ahead of everything at work, set up my pillow “throne”… Basically done everything I can think of to prepare. Even went against my usual no-decorating-before-Thanksgiving morals and put up my tree and lights at home and work since that kind of reaching is probably not the best idea next week and I don’t want to miss out on the magic of the season!

I have such peace and am so grateful the day is almost here. I’ll be sure to update soon, and once again want to thank you all for the good thoughts, prayers, and juju – I’m truly forever grateful. See you on “the other side” (for reals this time!)


So Close

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I don’t have anything profound to say, just the cliche “how is it already here?” thoughts that keep running through my head. Work has been crazy busy, but it’s my favorite busy of the year, so it’s really been a blessing in disguise. I told a friend the other day I feel a bit like a hamster. Of course that provoked a rather befuddled look until I went on to explain the last couple months have been like I’m on a hamster wheel, just going round and round, faster and faster.

It’s so hard to believe that I’ve reached this point in my journey. I know there’s still months left to be truly finished, but it’s just surreal to think I’ve made it this far. I had dinner with a friend I met through Bright Pink after she had her first consultation with her breast surgeon and replaying back all those thoughts of making the decision, picking a date, and then the dreaded waiting game made me realize just how far I’ve come.

No, the expanders haven’t been fun, and I sure am glad to be saying goodbye to them next week, but overall I found myself telling her this whole process really wasn’t THAT bad. Yes, it has it’s moments, but the accompanying relief is still indescribable. I’m so very grateful.

But now? Now I’m ready to be done with this chapter. I’m in such a positive place right now with my life that mentally I’m ready to just get on with LIVING. I’m tired of things being planned around surgeries and recoveries. I can’t wait to be at the end of this and reach the initial goal: the ability to go on living without worrying. And yes, I know, there will always be worry. But this? This is different now.

It’s funny that this surgery seems so anticlimactic. But in a way, it’s bigger, because it’s the last step in getting on with my life. My “nesting” has not been nearly as severe, but I am looking forward to a low key weekend where I can get mentally and physically prepared for next Friday. I just still can’t believe it’s already here.

I’m hoping the recovery will be as easy as everyone says it is, and that these 10 days off work will be a mix of recovering and enjoying Thanksgiving. I adore the holidays, and am looking forward to a season filled with spending time with the people I love and making memories versus things. I still am dumbfounded at all the support I’ve received throughout this journey, and truly remain in awe and inspired of the human spirit.

So just a week away, I’m in a good place. A great place. Ready to get this show on the road and truly reach my place “on the other side.”


Eviction Notice

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3 months already… Seems so long! It’s really hard to fathom that it’s been a quarter of a year since I drastically reduced my chances of getting breast cancer. And what a 3 months it’s been! So with reaching this milestone, and with the countdown to being DONE winding down, seems like no better time to tell these expanders, once and for all, who’s boss. And so I present you…

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Two Week Notice to Vacate

To: Expanders (also known as: turtle shells, boulder boobs, spacers, coconuts, rocks)

You are hereby notified that your tenancy of the premises (formally known as Diana’s chest) will be terminated on 11/22/13 and on that day you will be required to surrender your position to new tenants (hereby known as Gummy Bears or “squishies.”)

I have chosen to terminate your tenancy for the following six reasons:

1. Foul Appearance

Your attempt to minimize the appearance of major surgery is much appreciated, don’t get me wrong, but the unevenness and accompanying requiring of scarves to circumvent awkward stares and comments, is out of control. Also you’re slightly pornographic looking and not the least bit natural looking. Lastly, the crevice created above you is just plan weird.

2. Poor Form

I realize your attempt to be “breast like” was minimal at best. And you are intended to be temporary. But the hard plastic, particularly in the fill port area, is just poor form. You hurt people when they try to hug. You don’t move in any way natural. And you even hurt when your fellow neighbors (arms) come by.

3. Unruly Behavior

Your unruly behavior began early in your tenancy, but has been tolerated due to your previous necessity. However, you on the left side? And your desire to slide laterally? Totally uncalled for. Uncomfortable, awkward, and just plain weird, this behavior is not appreciated and therefore must end. Also, the landlord would like to be able to go without a bra for more than the length of a shower per day. But your rogue behavior has not allowed this and thus will no longer be tolerated.

In addition, your ability to feel like an elephant on one’s chest first thing in the morning should be commended for accuracy, but is less than appreciated. One would think this would improve as your tenancy continued, but alas, has only gotten worse and more disruptive.

4. Interference with Activities

I realize you may not think your personal activities have such a drastic effect on all facets of life, but your unabated determination to make sleep difficult will no longer be tolerated. The landlord demands to have the option of “stomach sleeping,” and as you refuse to make this is a viable option, you must vacate. Numerous attempts were made to rectify this situation (pillows, Benadryl, recliners, etc) with minimal to no effect.

Also, the landlord misses exercising. And as you are too high risk (after the landlord adopted borderline paranoia from one too many horror stories/pictures) of causing complications, you must go. Endorphins are much more wanted and welcome than you.

5. Excess Noise

Don’t think I don’t appreciate a good burp, because trust me, I do. But breasts should not make such noises without apology. Nor should they slosh with movement. Ain’t nobody got time for that. Hence your replacement with “gummy bear” silicone.

And last but not least, the latest development that prompted this notice:

6. Harassment of Fellow Tenants

We get that you’re heavy. 2.5 pounds of (blue) saline. And that muscle generally does NOT like to be separated from chest wall, but the neck/back pain? Really? Wrecking havoc on fellow tenants is just unnecessary. And gnawing pain causes subconscious but overt snappiness, which is without a doubt unappreciated by all individuals around, and the landlord herself. Suffice to say, the tenant looks forward to decreased soreness, dependence on relaxation techniques, heating pads, and accompanying frustration.

Now, because I really do try to find the best in everything, and in the interest of full disclosure, I will say that I have appreciated your tenancy in one capacity: you did the job you were set out to do, and I have faith that my pecs appreciate you more than I do. Fills went seamlessly and I am the predicted, intended size. My skin looks great. Healing went fabulously. Oh. And you rocked in my Halloween costume – I appreciate your willingness to not require additional support (see: straps).

So I’ve been a trooper and really tried not to complain excessively. And you have done your job without complication (which I am forever grateful for) but your time is up. Sooooo up.

Your cooperation in vacating in this time frame is much appreciated in advance.

Sincerely,
Your landlord since August 6, Diana


BRA Day

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Just when you think you’ve learned the lingo and all the intricacies of the BRCA world, you find out about another important day! That’s right, ladies and gents, it’s National BRA Day. Some seriously creative marketing peeps had to be involved with this one, but in all fairness, it’s a day that truly deserves to be recognized. It’s National Breast Reconstruction Awareness Day.

This is a day to recognize the true art that is breast reconstruction. Like wow. I joke about how I will likely look better than how I did when I started when we’re all finished, but it’s really not an over exaggeration. So in order to appreciate reconstruction, we have to recognize the people behind it: the absolutely incredible plastic surgeons. So here’s my shout out to mine, the one and only Dr. Teotia, and to all of the hardworking men and women who truly put their heart and soul into their work so women can feel like women again. They minimize what could be emotional devastation amidst an already ridiculously emotional process, and truly become like family in the process. I’m so grateful to be blessed with such an amazing surgeon, and wouldn’t do this journey justice without recognizing and him on this day!  He has been such a positive force throughout this journey and has made it as enjoyable as possible.  I would never say I look forward to doctor appointments because that’s just crazy talk, but when you’re always greeted with a positive attitude, smile, and hug, it’s almost hard not to. Plus we always all end up laughing about something or other, so you leave with a smile too. Despite being a brilliant surgeon, he truly cares about his patients as people first, and for that I am forever grateful.

I’m also not exaggerating at all when I say that reconstructive surgery is an art, and particularly in the case of Dr. T – he really is a classically trained artist.  At one of my appointments, I had the great honor of getting to see some of his work, and he gave me permission to share it on here.  I was waiting for just the perfect time, and what’s better than the day that recognizes the artistry that is reconstruction?  These are all his original drawings, and evidence of many hours of hard work (and some aren’t even finished!) So needless to say – you can imagine what his surgery results are like!  Anyhow, a perfect day to share these pictures – enjoy!

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