My Final Reconstruction Surgery: Part II **WARNING: GRAPHIC SURGERY PHOTOS**

Mood: Excited πŸ˜„

Soon after my anesthesiologist left me I was greeted by two nurses who were there to take me to the OR. One of them warned me that the OR was going to be cold and she said that she wanted to make sure to let me know because a lot of people are shocked by the temperature. I told her that I was expecting it since this was my 4th surgery in a little over a year. When we got into the OR I immediately saw more signs of the virus affecting the process of surgery. In my past 3 surgeries there were usually around 7 people in the room…my surgeon and the med student shadowing him, the anesthesiologist and sometimes a student shadowing them plus an assistant, and generally two nurses. This time I only saw 4 people before I went to sleep…my surgeon, the anesthesiologist and his assistant, and one nurse. The nurses were chatting with me about things I don’t remember now…🀣 and the next thing I know, I was getting oxygen and then I woke up in the recovery area.

When I woke up I was not doing well. I had a terrible sore throat, I was moaning in pain and I was crying. My recovery nurse was right by my side, but I was very much out of it and I told her that my pain was coming from the area under my breasts, that it was “stinging.” She checked my blood sugar and gave me some more meds for the pain. I kept trying to go to sleep and as soon as that would happen an alarm would go off. The nurse kept telling me to take deep breaths as my oxygen level kept dropping. She asked me what I wanted to drink and eat and she gave me several options for both. It felt amazing to drink some water but trying to eat the crackers was torture, my mouth was so dry that I could barely chew them. She left me for a moment and when she came back she said, “I asked your surgeon what he did to you, because when you woke up you were crying, and he said that he had to put one of the stitches deep into your tissue.” She and I were giggling when she told me about it because it was in a lighthearted way. I didn’t really say anything but I know that he did whatever he needed to do. I trust him with my life without question. Soon after that, I did see my anesthesiologist walk by a few times but he didn’t personally come in to check on me. At first I was surprised to see him but I wasn’t very conscious of the time, so when I didn’t see him again I realized that he was in the last surgery of the day. Another nurse came by a bit later to update the recovery nurse that my surgeon was half way through the last surgery, so I didn’t see my surgeon before I left to go home, but that was OK as I knew I could call or text him any time if I needed to and that I would see him on the following Monday.

Once I was stable I heard my nurse call my husband and tell him that he could come over and see me in recovery. We live close by so it didn’t take him long to get there and even though I was still feeling bad, it was good to have him there with me. I don’t know how long I was in the recovery area but I do remember looking at the clock and noticing that it was 4:30pm at one point. Eventually I was able to get up, go to the restroom and get dressed. I was still feeling a bit queasy and I was still somewhat out of it when my nurse wheeled me downstairs to meet my husband at the front of the building. On the drive home every bump in the road made my stomach upset but we needed to go get my prescriptions filled as I needed to take a pain pill later that night and start my antibiotics the next morning. By the time we got home I was feeling worse and out of nowhere my mouth started to water. I ran to the kitchen sink and got sick, luckily it wasn’t much as I had only consumed a glass of water and two crackers at the surgery center. I went and laid down and a few hours later my husband was starving and wanted dinner. I wasn’t hungry at all but I needed to eat so we had a small dinner and I fell asleep as soon as I laid down on the couch. For the next two days I slept almost constantly, just getting up enough to eat a little something and take my medicine.

Bandages & Drains

My Final Reconstruction Surgery: Part I **WARNING: SURGERY DETAILS**

Mood: Excited 😊

On Tuesday, April 28th I had my final reconstruction surgery. I was scheduled to arrive at 11:30am and go into surgery at 1:00pm. Unfortunately due to the virus, my husband was not allowed to go into the waiting room with me so he had to drop me off. It made me more nervous to not have him with me but there was nothing we could do about it. He ran a few errands, grabbed lunch and then went home to wait for my surgeon to call him with an update on how the surgery went. A little while later the nurse that was caring for me in recovery, called him to let him know that I was awake and that he could come over and sit with me.

Meanwhile I was changing clothes into my gown, putting on compression socks, my surgery cap, and my warm socks to start getting prepped for surgery in the pre-op area. There are 4 bays in pre-op and my surgeon had 3 patients there. Besides me, he had a woman getting a port put in and a woman having a double mastectomy that day. I was 2nd in line after the port surgery and when the lady getting the port surgery left for the OR I knew that my surgery was going to start late which is pretty much the norm.

In pre-op it was obvious that the staff was different due to the virus. I only had one nurse prepping me instead of two nurses, but the nurse I had was very thorough and took her time to make sure all three of her patients were comfortable and well cared for. At one point she even had a little time to sit with me and chat which was much appreciated. I realized while we were talking that she was my pre-op nurse when I had my first reconstruction surgery back in November so it was nice to see a familiar face.

My surgeon eventually came in to see me to take measurements one last time and mark me for surgery. He said that he had thought about my surgery a bit more and thought it would be best to use cadaver tissue instead of having my body create tissue on its own. Because I had gone through 25 radiation treatments I had the risk of my own tissue growing in hard which would deform the look of the implants and cause me pain. So, by using cadaver tissue, my body would be tricked into thinking that there is extra issue in my breast and not an implant that it needs form around. I have to admit that this all sounded fascinating to me and it only confirmed that I am blessed to not only have an excellent surgeon as my doctor but also a breast specialist. I gave him the OK to use the tissue and I signed the consent form. He finished measuring and marking me as we chatted and giggled back and forth and as usual he made me feel completely at ease which was awesome since my husband was not able to be there. I mentioned that it looked like he was pretty busy having three patients in pre-op, to which he replied, “not really, it’s just that we only have one of two OR’s open due to the virus.” Once he was done marking me he said he would see me in a little bit and that my anesthesiologist would be in shortly to talk to me.

My anesthesiologist came in a little bit later talk to me about the surgery and his process for putting me to sleep. We went over my allergies and my past experiences with my other surgeries and he assured me that I would be fine. When we were done talking he said that the nurses would be coming to get me soon and then he went out to the hall and tapped on his neck when he saw my pre-op nurse. As soon as I saw him make that gesture I knew that I was going to get the anti-nausea patch put behind my left ear. I am not convinced that the patch really works well but I wasn’t going to say anything.

**I will post Part II soon**

Oncologist Follow-up Appointment & Tele-health Appointment

Mood: Happy πŸ˜„

So besides seeing my surgeon this past Monday I had appointments with my oncologist and my nurse practitioner as well.

On Tuesday I had my follow-up appointment with my oncologist to talk about how I am doing on Anastrozole and to get my bloodwork done as well. My bloodwork is improving as time goes by. My red blood cell count is still a little low which explains why I am still dealing with fatigue, but it is not at a dangerous level at all, my body just needs more time to continue to heal.

He asked me about any side effects now that I am three months into taking the medication and I explained that I am having some dizziness and hot flashes but nothing that is taking over my life to where I am miserable. Even so, he offered to change my medication as there are a few other options, but I assured him that I am fine and if the side effects get any worse I will call him and let him know.

Overall he said that I look great and that I am continuing to do well. I really appreciated him telling me that since I certainly do not feel that way all of the time. He reminded me to keep taking the Anastrozole every day, which I do. I get the feeling that a lot of patients don’t take it regularly but he knows that I do what ever he asks me to do.

We also discussed the virus and he said that he is very happy that I am not going through chemo right now with the virus continuing to be a major concern. He said that it has been very tough on his patients, the other doctors in the office and nurses. “This virus and chemotherapy treatments do not go well together.” I can only imagine what it is like to go into the treatment room now as there is the issue of having a compromised immune system and not being able to have anyone in the treatment room with you.

I will follow-up with him again in July and hopefully by then my bloodwork will be completely back to normal and my side effects will have eased up a bit.

On Wednesday I had a tele-health appointment with my nurse practitioner. It was so great to not have to go into the office and possibly be exposed to anyone carrying the virus. My NP is pregnant and she said that they had people coming in to have a follow-up appointment to refill prescriptions, only to find that when they went in back and had their temperature taken they had a fever, a cough, etc….and tested positive for the virus. After that happening more than once, her obgyn said that she could not work at the office anymore, so she is home doing most of the tele-health calls. I was both surprised and happy to see her when our call connected as I wasn’t sure who I was going to meet with and if they would know much about my medical history over the last few years.

My NP was the first medical professional that I saw when I found the first tumor that lead me on my journey with breast cancer. She is the one who referred me to my amazing surgeon who has been with me from the beginning, as he was the one who did my first biopsy and diagnosed me with breast cancer over a year ago. So needless to say, my NP holds a special place in my heart!

We talked about the virus and how much it has changed going to appointments at the doctors office. I filled her in on the previous appointments I had with my surgeon and oncologist, and I let her know when my surgery is scheduled for. Because the virus has changed the scope of appointments so much in her office, she actually prescribed my meds as usual for 90 days, but with a refill as well so I don’t have to go back to the office for another 6 months. She said that she knows my numbers are good concerning my diabetes and that she was confident that it was not a problem to go ahead and give me a refill, something under normal circumstances she would not do.

So it was a great week for me and it was so nice to meet with all of my doctors! With everything I have been through with breat cancer I rely on my doctors to continue to care for me and I actually look forward to seeing them, something I never thought would be the case, ever in my life.

My 4th & Final Surgery

Mood: Relived 😌

**Please note, if you are going to judge me for my choices, just go ahead and stop following my blog. It is unfortunate that I have to even mention this here in my blog that has been a huge comfort to me while on this terrible journey. Until you have spent even just one day of my cancer journey in my shoes, you have no right to judge me!**

I decided last Thursday to call my surgeons office to see if it was possible to come in and see him before my August appointment. When I wasn’t able to get a call back in a timely manner, time was not on my side so I needed to speak with someone quickly, I remembered that my surgeon had told me to never hesitate to text him if I needed him for any reason. So I decided to text him knowing that he was most likely going to be in surgery all day so it might be a while before he could respond back to me, but I was shocked when he responded back about 5 minutes later. I explained my situation to him, he answered “probably yes” when I asked him if we could move my surgery up to now and he said to call his office and schedule an appointment for Monday morning. If they said there were no openings, I was to let them know that I had already spoken to him and that he needed to see me on Monday. I was thrilled that he wanted to see me and talk since I was not supposed to see him until a few days after my mammogram in August.

So on Monday I went in to see him and talk with him again about my final surgery. We had previously talked about the surgery back in February at my 3 month check up for my first reconstruction surgery that was back in mid-November. I asked him a lot of questions in February so when I saw him on Monday I had all of the information I needed to make a decision. He examined me again and we talked about the details of the surgery. He wanted to make sure that my husband and I were on the same page with him as far as the results I would get from the surgery and that we didn’t have any unrealistic expectations. We let him know that we understand what the results will be and I told him that I wanted to go ahead and get the surgery done. His surgery schedule has changed quite a bit due to the virus but he was thinking that he could get me in next week because the surgery will only take 45 minutes to an hour. So on Tuesday, April 28th I will have my 4th and final surgery, and it is classified as a second reconstruction surgery due to having breast cancer.

So here is the big question…..what am I asking my surgeon to do and why?

Going through breast cancer was a terrifying and life changing event in my life. No matter how well you appear to be fighting the battle, it forever changes you inside and out. There were many stages that my body went through during the last year…..losing my hair all over my body, losing both of my big toenails, having burns on my chest from my collarbone to underneath my breast, losing feeling from under my arm to half way across my breast from having 18 lymph nodes removed {I am still numb a year later}….the list goes on and on. I will probably never get used to seeing the scars on my chest and yes, the scars will fade eventually, it has helped a lot to use Bio Oil on them, but the scars are big and long in some places and even though they were put there by an amazing, talented and experienced surgeon, they are more than just scars on the surface, they are much deeper than that, they are a constant reminder of the hell I have been through in the last 16 months.

When I had reconstruction surgery in November my surgeon left the side that the cancer was on a little bit bigger because the radiation treatments can shrink the area that is treated. To make me as symmetrical as possible he had to take more tissue out of the right side of my chest than we expected, so it ended up being a pretty big reduction. Once I had healed from the reconstruction surgery it was obvious, to me anyway, that the left side was still bigger than the right as it didn’t shrink as much as expected and I felt out of proportion, plus I had lost a lot of volume, at least a cup size if not a little more. At first it was nice to have a smaller chest, something I have never had before; but as I healed and my chest settled into a natural position, it really began to bother me that after going through two surgeries, I am not happy with how my chest looks. I asked my husband what he thinks but he loves me no matter how I look, so this was not any pressure or comments from him at all, it is all about me and what I see when I am looking in the mirror. I need to feel whole again, feminine, beautiful….and I don’t feel those things at all so I am doing this for me.

So after much thought, research and more than one extensive conversation with my surgeon, I am getting breast implants. There are only a few options to add volume back into the breasts, flap surgery where fat is taken from the stomach and put into the breasts, or implants. My surgeon recommended implants as it is a much simpler surgery for me to heal from, where the flap surgery is very involved and painful. I trust my surgeon without a doubt and I know that he would not do this surgery unless he was absolutely sure that it is safe and my best option. Yes, he wants me to be happy, but he is a very responsible surgeon who actually cares about his patients and not making more money.

Getting breast implants is something that had never, ever, crossed my mind before breast cancer, but I do not think the same way now about myself or the world as I did before cancer….as I said before, fighting cancer forever changes you inside and out.

Final Appointment With My Radiation Oncologist

Mood: Happy 😊

A few days ago I had my final appointment with my radiation oncologist. The last time I saw her was the Friday before my last treatment back in January so this was a 6 week follow up to check on my overall health, my skin where my burn was on my collar bone and on my breast.

The skin on my collar bone got even redder a few days after my last treatment. I had some medicated lotion left over from going through my daily treatments so I kept using that three times a day and the burn eventually peeled completely and then healed up. She said that my breast is still a little swollen and I agreed. The swelling will eventually go away with time, there isn’t much I can do to help it along and it’s not so swollen that I need to be concerned about it.

My fatigue is still in the mid range, about 4 or 5 out of 10. She wasn’t surprised that I am still dealing with the fatigue as my body has been through so much in the last year +. I told her that I am taking things day by day, some days are better than others, but overall I am slowly improving.

She asked me if I have had any appointments with my other oncologist and surgeon since finishing radiation treatment and I updated her on those appointments. I also told her about the dermatologist that is removing my radiation tattoos and showed her the progress from my first appointment with him. She asked if her office has the contact information for the dermatologist and I let her know that I gave it to the front desk. Now if she has any other patients ask her about getting the radiation tattoos removed, she can give them his information and let them know that he removes them for free.

We ended my appointment with a big hug and she made me promise that my husband and I will stop by after our trip in May and show her the pictures from our trip and especially our ceremony….we are renewing our vows in Jamaica. 😁

So now my most excellent team of three doctors is down to two. I am sad, but also happy that I am completely done with a third of my journey. My oncologist and surgeon will be with me for quite a while to come as I am on medication for 10 years and I may possibly have one more surgery in September.