Today’s update is going to be difficult to write. I’ve been avoiding it for a couple of reasons. One reason is because I had a bit of a breakdown following the news. The other is because the news is not all that good and writing about it or talking about it is difficult.
On the 4th of September, I had my follow-up appointments with my two surgeons. The first was with my plastic surgeon who told me I was healing nicely and then removed the tube for the drain which though it didn’t hurt it did make me feel light headed. He made me lie down for a while and then came back to check on me. He was going to start adding fluid to the expander but because of the amount of pain I was still experiencing and how I was during this appointment he decided to hold off for another week, so I scheduled an appointment for the 11th of September, then left for my appointment with the general surgeon.
The first thing my general surgeon said is that she had good news and bad news. Then she told me I needed more surgery. I need to have more lymph nodes removed because the two they removed during the mastectomy both had cancer and the cancer had grown out of the outer shell of the lymph node. So more lymph nodes need to be taken to see if any more are infected with cancer. The good news was there were good margins around the cancer that did not have any cancer so she feels good that they got all the cancer that was in the breast. So their focus now is on the lymph nodes. She asked me if it would be easier for me to have the general surgeon in my town do the surgery. I told her it would take a lot of stress off of me if he could because trying to get someone to take me to my appointments an hour and fifteen minutes away was very difficult and put a lot of stress on me to try and coordinate. She called the local surgeon right then and talked to him about it. I couldn’t hear everything she said because the nurse in the room kept talking to me and distracting me. I wanted to tell her to shut up so I could hear what the doctor was saying. I felt like she was distracting me on purpose when in fact I’m sure she was just trying to find a way to comfort me because I had started crying as soon as the doctor had told me I needed more surgery. What most people do not understand about me is how facts and knowledge sooth me and how the unknown terrifies me. The nurse I am sure didn’t realize that her distraction was putting me more on edge than listening to the doctors talk would have. I left with the understanding that I was to call the surgeon’s office to make an appointment.
My appointment with the local surgeon was on 10 September. He had an intern with him learning and as he examined me he explained to the intern what he was seeing and why things were as they were. When he told the intern I had an expander, the intern asked what the expander was for. The surgeon didn’t say anything so I answered for him and told him how liquid would be added to it over several weeks to stretch the skin in preparation for the implant. The surgeon thanked me for explaining it to the intern. I think he purposefully didn’t say anything to see if I would answer and if I did then he would know if I really understood its use. I think he was pleasantly surprised by my answer.
After the examination we sat in his office and he told me what he would do. How he would make an incision below the hairline in my armpit and pull the skin back to remove the lymph nodes in my armpit and then also pull back the pectoral muscle to get to the lymph nodes underneath the muscle. Those would be the only lymph nodes he will remove. He mentioned a couple times how this surgery would be more, in his opinion, than the previous surgery I had and I would be staying in the hospital overnight. I told him that the other surgeon said it would be outpatient surgery. He told me he would feel better if I stayed in the hospital overnight because if there ended up being any bleeding problems that if it occurred at home it was often very traumatic for the patients and he would rather if it were to happen that it happen in the hospital. I agreed with him on this and it also put me at ease since I had no idea if it would be just me and my daughter at home immediately after the surgery this time and I didn’t want my daughter to have to deal with any emergencies. By the time I left his office I had a surgery date of 30September.
The next day 11September I had another appointment with my plastic surgeon. I considered canceling it since the general surgeon said he didn’t want them to do anything with the expander until after the surgery but with the continued pain I was feeling I decided to keep the appointment to discuss this with him and to also see how I would do on the drive. I had a driver for this appointment as well as a driver for the previous follow-up appointments. The previous appointments had left me drained and in more pain than when I’m just lying around at home. This trip had been better. The discussion with the plastic surgeon finally revealed the reason for the extended period of pain was because he had to cut through muscle in order to tuck the expander underneath the muscle. He also reassured me that the pain I would feel whenever they added fluid to the expander would last only about 24 hours and he said some patients didn’t experience any pain at all. We setup our next appointment to be in mid October so I would have time to heal from the next surgery. He also told me I could change the date if I was ready before that or if I wasn’t ready then I could move it out. He would be fine with any decision I made. He said I was still healing nicely and soon the pain would go away. He also agreed with the general surgeon about not doing anything with the expander until after the surgery.
It has been about four days since that last appointment and the pain has significantly decreased.
The breakdown I had occurred between the follow-up appointments and just a couple days before the appointment with the local general surgeon. I was concerned about still being on Tramadol/acet for the pain and was trying to see if Tylenol and Advil would be enough to deal with the pain. After a day and a half on just Tylenol and Advil, I was so much on edge I ended up collapsing in my bedroom and crying my eyes out. My concern being whether I could take care of my daughter through all of this because that night with the pain I was in I didn’t feel like cooking and told her she would need to fix her own dinner. The dishes were piled up and she hadn’t put away the clean dishes in the dishwasher, so I started doing it. When she finally got up and started helping and told me she would rinse the dirty dishes and put them in the dishwasher, I went to my room and collapsed. Later she asked me if I was sick with her cold and I told her no that I was just hurting and that I went back on my pain medicine. She told me I should take it if I need it and I agreed and decided to stay on it until there was no doubt I didn’t need it any more.
Pain does terrible things to people. And for me it not only puts me on edge but I also can’t eat. I get nauseated. Since my surgery I lost about ten pounds and I know my breast didn’t weigh that much. Today, the pain is a lot less but I’m remaining on the pain medicine for a couple more days at least.
I also went to see my family doctor on the morning of the 11th. This was to get something for my nerves. There are times this situation overwhelms me and I find it difficult to deal with, so I asked him for something to help. Something I could take just when I need it and I would still be functional. He prescribed me diazepam for my nerves and zopiclone to help me sleep. Generally I don’t need either one but at least I have them in case other things like Rescue Remedy, Pharma Gabba or Valerian Root don’t help.
The next steps after surgery will depend upon what is detected in the lymph nodes they remove. I made my Naturopath aware of the results of the first surgery and now I’m taking Modified Citrus Pectin along with all the supplements I’m taking. The past few weeks after surgery have been hard, mostly because of the pain I’m experiencing. In other ways it hasn’t been as difficult as I thought it would be. My energy levels are good when just staying around the house doing a little cooking and knitting and from time to time sleeping and watching movies. I’ve gone a couple times to the grocery store with my neighbor and have done well but definitely ready for rest once I get home. I’m not yet missing work. In some ways I see this as good but in other ways not so good, my not missing work sometimes makes me realize just how much this surgery has affected me, while on the other hand it makes me realize how I would enjoy not working but unless I won the lottery, that just isn’t possible.
I’ve been knitting socks. Just finished knitting some knee socks for my daughter and started another pair for a friend. Sitting in front of the computer isn’t comfortable for me right now, so writing this is a major feat. I generally check my email and posts in the mornings and don’t return to my computer until the next morning. Some emails I’ll reply to from my phone but for long ones I wait until the next day. I’ve been allowed to shower since they removed the drain. I’ll have another drain from the next surgery so I’m enjoying my showers while I can. The incision is looking a lot better and I’ll have my daughter take another picture after my shower today and I’ll post it in the next day or two.