Code Pink Episode 5: New Boobs Under Construction

*In this series, I will share a very raw personal journey. As you read this blog series, none of the information provided should be considered expert medical advice. What I went through may or may not be the same for the next person. I tried to share common reactions to treatment and how to manage. I am also not paid to advertise certain products. Please follow the direction of your medical doctor. The information in this series should be read with a smile. Please also be aware, I am very honest. I tell it how it is. I don’t sugar coat but I can be sarcastic. For that, I apologize for the occasional profanity. The tips and suggestions are things I’ve learned along the way, helped me, and information I want to share with you.

The end of June finally arrived (a month after I was done with chemo) and I was ready for my double mastectomy. While they want you to wait a couple weeks to flush the chemo out of your system and you’re your counts to come back up so you’re safe (not at risk for bleeding or infection), I didn’t want to wait any longer than I needed to. Before surgery I had a pre-op physical with my primary doctor and I had basic blood work done to make sure my red and white blood cells and liver function tests where within normal limits post chemo. I met with the general surgeon to review his plan and what to expect during and after surgery. I also met with the plastic surgeon and picked out a new set of boobs! That was a great appointment! While I did have to wait to get my real implants, I picked out a size so they knew how big my expanders would be.

            The day of surgery I was nervous and emotional. I took my shower and scrubbed my chest for 8 min (3 extra minutes for good measure) with the required cleanser. I checked into the hospital and my people (my family and dear friend Katie) where there. Looking great in their CANCER SUCKS t-shirts I may add! My husband and I went back right away and I got changed into a gown and little booties. I took the required and mandatory urine pregnancy test. Really? Yup. Hadn’t had a period in six months (thank you chemo) but sure…let’s do it just to be thorough. The nurse started my IV in my hand…I was saying goodbye to my port as well! I got a liter of fluids along with prophylactic antibiotics.

            Before going into the OR, I went over to radiology and they injected blue dye into my areola and around my nipple. Yes, into the nipple. It stung a little like a bee sting but I skipped the local lidocaine anesthetic because I didn’t want another poke. I then went back to my pre-op room and waited an hour. In that hour, the dye moved from the nipple area down through the milk ducts and then drained into the lymph nodes. This is how the surgeon knew what lymph nodes to remove during surgery. The thought was that the main nodes (called the sentinel nodes) were the nodes that likely were positive for cancer and thus a vessel to transport cancer to the rest of my body.

The time ticked away and my anxiety level increased. Thank goodness my dear friend was there to calm ALL of our nerves. Anesthesia came in, and explained the process of going to sleep. They also gave me a little medication to calm my nerves and help fend of nausea (which I knew would be a problem from other surgeries). Just before I went back, the general and plastic surgeons came by to check in one last time, sign consent and we were off.

I kissed my husband and hugged my parents and the nurse anesthetist (CRNA) and I walked backed into the room. I laid down on the OR table and quickly asked for the CRNA to give me something to calm me down and put me to sleep. I remember laying there crying as I was very anxious. I kept my cool all the way up until I got into the room and then I lost it. Even though there were staff in the OR with me, I felt oddly alone. As I drifted off to sleep my fantastic nurse held my hand and then I woke up in recovery.

Both surgeries (removal of tissue and reconstruction) took about five hours. The general surgeon started first and removed my breast tissue, nipples, main/sentinel lymph nodes, and as much skin as they could while allowing enough room to stretch and close. He finished his part and the plastic surgeon came in. She started by separating my pectoral muscles from my rib cage in order to create a pocket for my expanders and future implants to sit in. Once the pocket was created, she placed expanders under the muscles, and secured everything by sewing the muscles to the rib cage. By placing the expanders under the muscle it stretched the muscles and the skin to make space for my permanent implants. Some patients get immediate implants but because I was having radiation, I needed the expanders. Per my radiation oncologist, radiating through a permanent implant isn’t as successful and he wanted me to have the best outcome so I went with expanders.

Unknown to me, the plastics doctor placed 500cc (about 2 cups) of air into each one my expanders at the time of surgery so I didn’t wake up completely flat chested. This was something I was VERY happy about. I knew I was going to be in pain but I was terrified to lose my breasts. They were one body part I really liked about myself. So when I woke up with a little cleavage, life was good!

I got to my room and was told I woke up in recovery, I didn’t remember that. My throat was sore from the breathing tube and my chest hurt. It hurt to breathe but I was encouraged to cough and deep breathe so my lungs continued to expand (and so I wouldn’t get pneumonia). The great part was that the catheter into my bladder had been removed at the end of surgery and I wasn’t nauseated! I was very tired and loopy, to be expected. More entertainment for my family! I took the offered and scheduled pain and nausea medications to stay ahead of the game. I also had constant ice packs on my chest. I had an ace wrap around my chest which added some compression and counteracted the pain. It also kept the incisions and fluid drains secured and safe.

I stayed in the hospital for three days. Being a nurse I was pretty self-sufficient. I stripped my own drains, got up to the bathroom on my own, I walked around with my family. I just needed them to give me my meds and fresh ice packs. On the third day, both surgeons cleared me to go home an off I went. Before leaving the breast center nurses brought me a care package including a stuffed animal to put over my chest under my seatbelt. LIFESAVER. I’m sure I looked ridiculous with a pink puppy dog on my chest but it cushioned all the bumps.

Over the next eight weeks I tried my best to avoid complications. I wasn’t always successful but I did my best to avoid another bump in the road and delay radiation.

*Tips For Surviving:  Stay ahead of your pain. Take your schedule pain and bowel regime medications following surgery and use ice packs! Ice packs are your friend!

This blog covers the basics of my cancer journey. If you're looking to read more or know someone going through breast cancer treatment, check out my book about breast cancer on the home page!