134 days of Preparation and My Reconstruction Surgery

April 13

Tomorrow is the day of my implant exchange surgery. It has been 134 days since my double mastectomy. 

I have been living with very uncomfortable tissue expanders under my skin where my breasts used to be. These are not the soft implants you think of when you imagine a breast augmentation or a "boob job." These are very hard plastic medical devices with the sole purpose of keeping your skin tight so that it can be stretched to accommodate the implants. 

As a reminder, this is what they look like:

(The blue tabs are where they suture the expander to your pectoral muscle.)

The best way that I can explain the feeling is this. Imagine that you got a small jagged pebble stuck underneath your skin. What do you think it would feel like if I pressed on your skin on top of where the pebble was?  It feels like that...kinda. Only the pebble is much much bigger. 

When I get bumped, carry things in my arms, use a seat belt, or even give people a hug...they hurt. I can't explain the sensation. I have about 50% feeling on my skin on the outside, but I can totally feel pain underneath my skin. My chest muscles scream at me every day. I hurt all day. I don't only hurt where my expanders are, but my back hurts also. My bicep and tricep muscles hurt from stretching and loss of range of motion. My neck hurts and my shoulders hurt from hunching all day to protect me from being accidentally bumped. If I need to scratch my chest it hurts because the skin is so thin that the slightest scratch sends painful zings throughout my chest. Sleeping is a feat all in itself. I am a side sleeper, and I have slept on my back for the past 134 days. I wake up in the morning and I hurt. I think it is from the weight and the pulling on my skin. Gravity also works against me in the night, seemingly trying to push the expanders through my chest and out of my back for the past 8ish hours. Sitting up in the morning is a very delicate dance between these expanders and I. It takes a good 1/2 hour before they are ready to be in the correct position on the front of my body giving my pectoral muscles a much needed break. 

Understand that "hurt" is different from "pain." Excluding the times I have an itch to scratch (which is painful), my body just hurts. I am not in pain like I need to take a pain killer or live on Advil or Tylenol every day. My hurt is an overall body and muscle soreness. Kind of like I worked out a couple of days ago and the initial pain is gone, but I still have a bit of lingering muscle ache. 

I have learned to live with the hurt. I have been able to do 90% of my daily activities which has been so good! I have been able to go to work, church, school functions for kids, vacations, and pretty much anywhere else I want to go. I make modifications to my daily life where necessary like holding my seatbelt away from my body, or having Kaden dig the laundry out of the bottom of the machine. Sometimes making small modifications are no big deal, but to be honest, sometimes making those modifications just remind me that I am still going through this cancer crap. For example, we got a trampoline for my kids this spring and I have been dying to go jump on it, but that is one thing that has to wait or possibly not be an option for me. Or one of my favorite things is to lay on my stomach where the sun beams in and I haven't been able to do that. It's stupid little things that don't matter. Can I live my life without a trampoline or a good "sunbeam nap?" Of course. But it is frustrating that something that I didn't choose keeps me from doing things I enjoy. 

I don't want this to sound negative or "woe is me," but it is the best way to explain the last 134 days. 

I try to remind myself that I am alive to feel the pain and the hurt.. and that is a good thing. Part of being alive is feeling pain, sorrow, and hurt, but the other part of being alive is feeling your husbands heavenly back massages at the end of the day, hysterically laughing with your kids, an outing with friends, vacations with family, and many many more happy things!

Ruth Bader Ginsberg once said, "I am optimistic in the long run....when the pendulum swings too far in one direction, it always swings back." She was talking about the United States and politics, but I think it applies to the ups and downs of life. :) 

Newtons 3rd law of motion states that, "For every action there is an equal and opposite reaction." It's science. It's the law of motion. It's comforting to know that I am still moving and I am moving because I am alive. 

So here's to the end of the last 134 days. To the end of the rocks on my chest. To hopefully, the beginning of the end of the constant hurt. This has been a crazy pendulum swing, and while I don't feel like I have quite completed the arc, I know I am getting there! Soon the motion will change and I will begin the healing process and that is happy and exciting! 

April 14th- Surgery Day

My surgery check in time was 8:10am.  

There really wasn't anything too eventful or remarkable about this surgery. I went into it with relatively good spirits. I kind of compare it to your 40th week of pregnancy and you are being induced. You really don't want to do it, but you want that thing out of you! You know it is going to be painful and recovery will stink, but you know that it is going to be the outcome you want once you get this part over with. 

As per usual, they had a very tough time trying to place my IV. I have tiny veins that have many branches. Usually, what happens is they can get the needle in, but once they try to get the catheter in it blows my vein. So after 4 attempts, we were finally successful. They literally had to use a baby needle that they use on infants in order for it to work! And, just like last time, the anesthesiologist came in to ask me a bunch of questions while I was being poked and prodded! 

The surgery was to remove my tissue expanders and place silicone implants in their place. The first thing they do is harvest some fat from my abdominal area. This is done using lipo suction. They take out fat they need for later on in the surgery and it goes through some type of cleaning. While they are processing the fat, they cut through the same incision as my mastectomy to remove the tissue expanders. 

After they remove the tissue expanders, they use "sizers" to see what size implant to use. Basically the Dr said that the sizer is just like the implant that they will ultimately use, but not the actual one. (It's kind of like the hospital's "library" of implants.) They place a sizer in you, then sit you up and see how they look. Then lay you back down and try a different size/shape. He said this is usually done 4-10 times until they find the size that looks the best. He said that towards the end it is kind of like an eye exam where it's like "Do you like #1 or #2?" The difference by that point is subtle but they are making sure to get the one that is the most aesthetically pleasing. Once they decide on the size, they open the package that has my implant in it and place it. Then they sew you back up. 

Kaden and I kept laughing that they "Weekend at Bernie's" you while you are naked! 

The thought of it totally made us laugh! (Maybe I should have been more mortified, but after all that I have been through, what is one more crazy experience to add to the list?!)

After they place your implant, they use the fat that they harvested and syringe it back into your body around your implant to help it look more "natural." Just to clarify, in a normal breast augmentation, you have breast tissue that surrounds the implant so you can't see it. With a mastectomy, all that tissue is removed, so the only thing you are left with is a thin layer of skin. If you only had the layer of skin, you would be able to see the implant. Thus the fat grafting. 

The whole process took about 2 hours. I woke up in a bit of pain, but they were able to get that taken care of in a decent amount of time. I remember telling the nurse in the PACU, "Sorry I am moaning. I don't usually do that, but it seams to help with the pain if I can let it out." She assured me that was not a problem, but I bet she was happy when she didn't have to listen to me anymore! ha ha!

When all was said and done I was home by about 3:00pm. I am feeling good. Again, I am not in pain, but I am sore. My stomach and breasts are bound up pretty tight. I feel like I did a bunch of sit ups and the parts I can see of my breasts are black and blue. I haven't looked at my stomach yet, but I told Kaden that if the part where they injected the fat is that bruised, I don't even want to know what my stomach where they took the fat looks like! 

This was me right before I left for the hospital. I posted this pic with some lyrics to a song that has been my anthem for the past 134 days. It's a song from "The Chicks" titled "For Her." I love this song for SO many different reasons. 

https://www.youtube.com/watch?v=bZ6v2JA6kOY&ab_channel=BeatCafe 

Some of the lyrics say:

"Wish I could go back and tell my younger self, you're a fighter, you just don't know it yet"

and

"Cause it takes a lotta hard work, to get a whole lot stronger, cause it's real tough girl!"

and

"Stand up, show up, for her, for her" 

I have loved this song because it talks about the struggle between an "old version" of a woman and the "new version" of the same woman, and how hard it is to get those 2 seemingly different women together. 

It has some powerful lyrics that state that the new version needs to "stand up, show up" -- for her (meaning the older version of herself.) 

I blast it all the time as a sort of pep talk to myself while I have been fighting though all kinds of emotions these last couple of months. Emotions like anger, survivors guilt, grief, feelings of loss of the life I had etc. This song buoys me up and lets me know that I can do this! All I have to do is show up and show love to myself. Give myself a break in those hard times and know that I can get through this! 

The other part of the "For Her" song that I use is to remember my "why" behind this fight. It's for "her." It's not only for my old self and my new self, it's for my 3 daughters. I want them to know that sometimes life gets hard and crazy and sometimes you don't have control over your circumstances, but that you are strong and you do get to choose your attitude. You get to decide how hard you are going to fight for what you want and what you believe in! 

It's also for all the other "hers." For all the women in my life who I love and care about who have gone though hard times and fought like hell through them! Women who have been at their lowest low and deepest pain and somehow found the courage to keep fighting another day. Women who have pulled themselves up from the very depths of despair and said, "I am worth fighting for!" Thank you to all the "hers" in my life that went before, that were my examples, and did it "for me," so I could know how to do it when my time came!