Grab a drink. It's a long one.....
I left off here in June. My exchange surgery was scheduled. I also went to a Breast Cancer Yoga Certification course in Long Island... (or is it ON Long Island?). So let me tell you about that first!
Not Long Island, but I was here and it was awesome
Generally speaking, it is not handstands and pretzels and contortions. It's a restorative practice, focusing on gentle stretching and relaxation with full use of props such as blocks or bolsters so as to let your body deeply relax and focus on the breath. It's tremendously beneficial mentally as well, allowing much of the stress and anxiety that often surrounds us during treatments to be relieved.
I have a lot to learn about yoga, which is kind of overwhelming for me. I took this class with 4 other great women who have been practicing and teaching for many years and I felt a little out of place. However, they were welcoming and warm and I learned a lot from them.
The Spartan Super!
I completed the Spartan Super! This was a roughly 8 mile event on a Massachusetts farm. Read: FLAT. So happy. The morning weather was a pouring rain though, which pretty much left the entire 8 miles a path of thick, knee deep mud, and rivers so dirty you couldn't see your footing. Plus a mix of natural "farm product" running off from the cows nearby. So. Even though it was flat, we had to take it so slowly to not break our necks or ankles negotiating the land!
Me and THE OCR Princess, making the photos worth the effort
Surgery. Part I
My exchange surgery was July 10th and was pretty uneventful. The ps swapped out the expander for what was to be the permanent silicone implant. He was pleased with the outcome. I had essentially no pain after! This is an outpatient surgery; got it done in the morning, and went home and had lunch! Feeling good!! Ready to move on!!
The ps advised me to not move my arm above my shoulder for a period of time. And I listened. When he told me I could start increasing activity as long as I felt ok, I did. Treadmill, range of motion, VERY light weights. Like, not struggling at all. Basically something to hold on to while my main intention was range of motion. I felt well, no pains, no problems. Returned for a follow up, and all was looking well.
Houston. We Have a Problem.
This brings us to August 21st. Our anniversary. Long story short - because it is short (but a little gruesome if you want to skip it)..... somehow.... I accidentally rolled over in bed towards face down, shifted myself along the bed with my arm to re-position myself and then felt a weird sense. Like my skin was pinched but not painful- right over B-. I felt over it- and felt a gap. In the dark I pretty much leapt to the bathroom in two steps, took one quick look at my hand, saw blood, and said to Chris, 'we have to go, we have to go'. I grabbed a nearby bath towel to hold over it, and we left for the ER. Thank God the kids were sleeping over at my parents.
I walked into the ER, and the nurse asked, "What seems to be the problem?" And, as you do with BC and you generally end up showing your boobs to everyone freely, I lifted my shirt and she said, "OK then, right over here."
In shifting myself a couple inches across my bed I essentially dragged my full incision apart.
B-'s new grade- F... -
The attending doctor called my ps, who was out of town of course. Because if you're a doctor when does the shit hit the fan with your patients- Friday nights, Christmas Eve, the day you leave for vacation. He advised her to close it with stitches and be at his office Tuesday.
Aww, my first stitches!! I beat my two boys to them. Since I'm still numb over a majority of the area I didn't really feel the numbing shot, or the stitches being done. Very Patrick Swayze Roadhouse of me. (Please don't remake that with Rousey... just, no.)
She stitched me up with 10 stitches, spaced across the wound, though the medial side was still a little open. It looked as sad and as temporary as it was meant to be. An attempt to just hold everything inside till I could see my ps. I proceeded the next day to go to a friends' birthday party and feel like Debbie Downer with news of the prior evening's events. I kept checking (probably not discreetly) to see that I wasn't unraveling.
The next few days were not fun. But I had no pain. None. I thought that was so strange.
So Tuesday comes and I go to the ps. All the feelings of the prior four days- fear, anxiety, failure (like my body failed me; or I failed my body), shame (like I did something to cause this) came to the breaking point. Up to this point I hadn't really cried, not even in the ER.
The ps walked in and says, "What the hell happened?" and I said, "I broke it." and just started to cry.
He assured me that I didn't cause this and that while it was "unusual" (Read: I don't think this has ever happened before.) to have this happen 6 weeks out from the surgery, that working with radiated tissue is hard, it's unpredictable. Radiation essentially mutates the normal healing process of tissue. Scars normally form in a cross linked pattern, but in tissue that's been radiated, the pattern can be only unilateral. This leads to a loss of tensile strength. I had been noticing since the surgery, once the Dermabond glue was gone, that the medial side of the scar was butted together, but the skin didn't seem as well bonded and looking like a scar was forming as it did on the lateral side. There's no way to know how it was healing under the surface either, well, until it blew out.
He noted the good news, it wasn't "as bad" as he was anticipating, and there was no skin loss. However, this would require another surgery. The integrity of the reconstruction was now lost, and he would have to revise the scar. This time he would use a graft to bolster under the scar. "I want staples." I said. Well... before that I said, "Just take the whole thing out." I was just done.
He came back with the paperwork to schedule the surgery and went over the procedure and standard risks involved: infection, seroma, wound healing problems (and we sort of laughed at that one) death etc.. I signed away and was ready to go a week later.
To Trifecta, or Not to Trifecta
But in a few days, the day before the surgery to be exact, was the Spartan Sprint. This was the final literal piece of my pie medal. The three pieces fit together to make one big medal. I at first was all, "Eff this!! I'm going, and I'll skip all the obstacles, and I'll squat instead of burpee, and I'll bandage it real good, and tape plastic wrap around that so nothing gets in!"
But the day before the run, common sense powered through. I had heard the course was more like 5 miles than 3. And I just didn't have the energy to try to go. I also figured my doctor may not be thrilled that less than 24 hours before surgery I was knee-deep in stagnant, muddy, farm fecal, probably necrotizing fasciitis-y mud. So I sent Chris without me, and ate my $45.
This was honestly the lowest I had felt in the whole near-year since my diagnosis. I was just lost. To come back up from activity from last year, to returning to it after the July surgery, only to lose it again. And I was just so angry - the "cancer" part was taken care of a year ago.... all this shit is the "reconstruction". I questioned that I should've just stopped at the mastectomy. I also had already downgraded my upcoming half-marathon to a 5K, and now that was in jeopardy of not happening. When these activities have become an outlet for your stress and anxiety or depression and they just make you feel good and strong and then you can't?? It's shitty.
You don't say. Oh the irony.....
AND what's worse! They didn't even go into it! They gave about 7 seconds to it and just said that treatments such as mastectomies or radiation may not be necessary.
Yeah, you said that.
So I had to Google this up. THIS is a bit of a summary of the study. And even taking away the news drama spin, it's still a little confusing to interpret the information. “The study showed that even though a lumpectomy can reduce the risk of a recurrence developing in the same breast, it does not change the risk of dying from the disease,” said Dr. Kramer. “This suggests that what you do locally to treat DCIS may not affect the risk of dying, which is the most important outcome.” Huh? "In another finding, 517 women diagnosed with DCIS died of breast cancer without ever developing an invasive cancer in the same or other breast prior to death. Some cases of DCIS may have an 'inherent potential' to spread to other parts of the body." What?! I do know this is true of many cancers, but still... in what you read on DCIS, you'll find "Stage 0", "Pre-Cancer", arguments whether its even cancer at all (which kind of pisses me off) and all these seemingly "good" sounding terms.... oh but wait, it can pop up somewhere else and take you out. Awesome.
I had to read this a few times and this is MY general understanding. Treatments today, and the intention of the doctors and patient, are to aim to reduce recurrence and ultimately death, but studies show in the end it seems to lower only the risk of recurrence and not death. Treatment doesn't seem to lower the risk of both. AND because the risk of dying from this type is so low, that there is a question to perform an aggressive treatment in the first place. The study states it provides a case for not rushing a woman from diagnosis to surgery in a short amount of time. These changes have been implemented for men with prostate cancer; while once treated with quick surgery, now are managed with follow-up and regular screening.
While this IS an option in DCIS, treatment plans are determined on many things, including age and family history, among others.
Medicine isn't perfect, it's not textbook. The studies are done on a population of people, and those results are extrapolated to give statistics- risks and percentages. They are not set in stone. They are used to determine the best possible course of care.
So in my case, and in the cases of women who are diagnosed everyday and are thrown into the confusing swarm of information and numbers and percentages, you do what you do with the information you are given. And why wouldn't you want to do everything you could to drop that risk factor, that percentage down as low as possible!
Surgery Part 2 ( Actually 3 )
I showed up at 5:45 a.m. and got all situated. After FOUR failed attempts to start my IV, of which each time resulted in crazy ass swelling around where they tried to start, they called in the big guns. This older woman who looked like she was on the 14th of her 12 hour shift. She flicked her finger 231 times against the little vein between my 1st and 2nd knuckle. So while the other area were bruising after the needle, we were gonna tenderize this spot first, THEN jam a needle in it. This is for my own good, this is for my own good.
Sleepy meds, nighty night, and I was out. Woke up later WAY more sore than the July surgery. Long story short, he secured the shit out of it. One running zipper stitch PLUS thick crusty superglue over it. PLUS 8 little stitches around that. Those are the ones that secured the graft under the incision. He also swapped out my implant for one slightly smaller because he tried to replace the one I had, but since he had to cut away the last scar, I had less tissue to close, and he felt it would be too much tension. So I already have gotten a reduction. Whomp whomp.
B-'s new grade-
Reading operative reports is fun too. I found out the reason I was so friggen sore on the outer edge of B- over to my ribs and up under my collarbone was because he had to scrape the tissue apart due to contraction of the capsule to increase the pocket for the implant. Sort of like when you separate the skin of your turkey from the meat to jam a stick of butter in there? That's what he did, without butter. Holy cow, so sore.
Surftown
I made up my mind to show up to this. I would walk the three miles, and take my medal. The damn environment and crowds suck you in though. I wanted to run. I walked across the starting line and thought, "Damn, this is depressing." And then I walked by the first photographer and thought "Oh hell no, we can't have this." So by the second photographer, I broke into a little trot that may or may not come across like a run, enough for the camera, then I walked again.
Once I got to the 2 mile marker, that was it... one to go. I broke into a jog, holding my left arm against me (amazing form there). I definitely felt it but not awful. With probably a half mile to go, I slowly let the left arm down and gently let the arm go with my movement. I ran that mile and finished. I took my medal, walked over to the side, and again, probably not discreetly, checked down my bra to make sure I was intact. All was good.
When you sort of run and walk for 40 minutes
you risk severe dehydration and therefore
two beers are necessary.
I had a follow up yesterday and he didn't take the stitches out yet because there's still a lot of glue over it. I said I don't mind at all. And he said again, "It's really unusual that this happened 6 weeks after that first surgery." Read: I've never seen this happen, you probably effed it up somehow, but I don't want you to feel bad or cry, so we call this "unusual". I'm technically only 2 weeks and 2 days out from surgery. I ran a mile. I need to get to 6 weeks. Actually I won't be fine until December 17th, a year from when I finished radiation. Because the opinion is out there that the tissue isn't "normal" again till a year after radiation. (PS doesn't agree, and many studies I read on post-radiation reconstruction also disagree) But I'll tell you what. I don't trust it. I'm afraid to move, I won't lift. I quit the damn gym so I wouldn't have anywhere to go and be tempted to try to do something that might eff this up. I am scared. Honest to God over the past 2 weeks when I sneeze I feel it there and I'm convinced I am going to sneeze my boob apart.
Today is September 19th. My mastectomy was 1 year ago today. And as much as I thought and hoped, the ride isn't over yet. I just went to my first pity party, it sucked, and I'm going to ghost outta there, kinda like I do at other parties! Give it the Irish Good-bye.
I'm sorry this is long. You're probably drunk. You're welcome.
