Nearing the End: Reconstructive Surgery

Last spring I began weaning myself off of caffeine. Less and less coffee, until I didn’t drink any. If you’ve ever lived with me or stayed at my house or me at yours, you know that coffee is a big part of my morning routine. My brother-in-law calls me the coffee monster in the morning. It’s true. It wasn’t fun, but it was part of the healing process because after the surgery, no caffeine for 6 weeks.

At the same time, Nathan and I started on the app “Couch to 5K” and I joined a gym that had classes you signed up to attend. I was building up my body 5-6 days a week, jogging in the morning and classes at night, with the hope that my body would heal faster after surgery. I had gained quite a bit of weight over the past year and it was exciting seeing the pounds go away.

The procedure we decided to go with is the DIEP flap that would take my belly fat and rebuild my breast tissue. This was supposed to be the surgery of surgeries. Belly fat tissue would be taken as well as a blood vessel and moved to my chest and the blood vessel would be resewn into a vein.

It was going to be a long surgery, estimated around 12 hours. For my mastectomies, I had been in the hospital about 24 hours. This time I was going to be in the hospital for 5-7 days to make sure that the transplanted tissue flaps weren’t rejected which would render the DIEP a failure. I was told I wouldn’t be able to stand up straight for a month and that I would have to use a walker. It seemed unreal. I was in perhaps the best shape of my life and the surgery was going to knock me flat to the start. It was maddening. But it did make me train harder.

The reality was that it was an incredibly difficult time. My time at the hospital is a haze of pain, medication, medical staff checking the flaps every 2 hours for the 1st 36 hours (the most likely time the body would reject the tissue), I couldn’t stand the smell of food, and time moved so slowly.

If you are ever in the hospital, let me know, if I am in town or near you, I will come visit you. PSA: Visit people in the hospital, tell them jokes, just sit and read a book, or bring them smoothies. I don’t know what I would have done without the crew of people that stopped by.

Once we were home, it was such a relief. We had had such a hard time adjusting after the 1st surgery with gross surgical drains and my amount of pain was very high. This time we had twice as many drains, but most of the fluid had drained during my 5 day hospital stay. I was getting up and around with my walker. We were more than treading water this time. It was just slow. Slow getting up, laying down, eating, sitting, standing, moving anything was just slow and sometimes painful. Soon the drains came out, we started walking in our neighborhood, going back to church, or to a restaurant. It was just slow healing, but not painful like before.

And then… 6 weeks were done and I could drink caffeine and eat chocolate and I was very happy. We drove up to North Carolina and stayed the night with Aunt Marcia in her beautiful home and neighborhood. We continued on to reunite with our conference friends at Bridges Math-Art this year in Baltimore. It was a time of celebration. On our way back down we stayed in DC with Cousin Tamsen and had an incredible time. And then we made our way back to Florida and stopped in with Adam and Casey and had good talks late into the night. Eight weeks out from surgery, I was back at pre-planning ready to start school again.

Tissue Expanders: Exactly as Pleasant as it Sounds

About a month after radiation, early 2015, I started the process of having the tissue expanders in my chest filled.

So here’s how that worked: mastectomy removed the breast tissue, plastic surgeon put the tissue expanders underneath my pectoral muscle. Super weird feeling. It felt like my body was in a permanent push up.

In a normal female body it’s: chest wall, pectoral muscle, breast tissue, skin. But it’d look super weird to have tissue expanders right next to your skin. This might be obvious, but I didn’t understand what the heck a tissue expander was before they put them in. They are designed to help your body prepare for reconstructive surgery so that that area of your body and skin done contract and make later surgery incredibly painful or nearly impossible. All I know is that they hurt and feel super weird.

So in January of 2015, I go in and have the expanders “filled up” with saline. The expanders have a magnet at the opening, so the nurses would use a magnet to find the opening and mark it and take giant needles and fill up the expanders, usually 100 mg to 150 mg in each expander.

We’d do this every few weeks until March to gradually have the skin expand. This was my least favorite part of the entire process. Though, the nurses at “Fill-up Fridays” (yes, that’s what they called it) were super awesome and hilarious (and they laughed at my jokes).

Radiation: The Nicest People Who Burn Your Skin

I started radiation 3 weeks after my mastectomies and in order to radiate the correct area I had to be able to lift my arms significantly above my head.

This absolutely seemed impossible and was incredibly painful.

I started physical therapy a few days after surgery and had to stretch again and again. I was able to get my arms into the arm holds above my head, but it still hurt.

Radiation was my favorite part of cancer. Yes, let me say it again, my favorite. Not because radiation was fun; it actually seemed like nothing was happening until 4 1/2 weeks in when my skin became raw.

No, it was my favorite because I saw the same team 5 days a week for 6 weeks. We built a bond at 7:30 am every day. They laughed at my jokes, asked what my students were learning about that day, and just were so encouraging. They felt my pain when my skin changed, they got me the right kind of aloe, and celebrated with me when I was finished.

It was so different from chemo: it was a different nurse every time, 3-4 other patients in the room with me, so it was really difficult to build up a rapport. Don’t get me wrong, the chemo people were awesome and “high tea” (yes, like the British) was served every Thursday (when most people get chemo), but it was a different nice person every week or every two weeks.

Double Mastectomy: Boobies be Gone!

I don’t remember a lot about this time period. Other than I was in a lot of pain and it was hard to move and the tissue expanders hurt a lot. I had started school with the kids and 4 weeks in I had the surgery and the substitutes took over. They did lesson plans and graded and were wonderful. After 6 weeks, I was back. Weaker, sitting down more, but back in the place I love.

Chemo

It’s a marathon. 5 months of being in the doldrums, not an epic movie.

I think being scared of chemo is normal.  In the movies, the person is puking their guts out again and again.  Not me.  They had me on strong anti-nausea meds.  I didn’t feel good, but it wasn’t the stuff of movies.

You know the malaise of the flu?  You just don’t feel well.  Your body aches, you’re tired, you can’t focus, you’re sort of asleep and awake, you don’t feel hungry.  That was chemo.

During the 1st round of chemo (4 treatments every two weeks, for two months) it was like this:

  • Day 1: chemo injection, sleepy and weak
  • Day 2: injection of fluids, sleepy and weak
  • Days 3-8, sleepy and weak
  • Days 9-14 normal
  • Repeat 3 more times.

Round 2 (chemo every week) was much different:

  • Day 1-2 feel pretty good
  • Day 3 less good
  • Day 4-6 not good
  • Day 7 O.K.
  • Repeat 11 more times.

The normal thing of losing your hair happened about three weeks into my 1st round of chemo.  I have always wanted to shave my head.  Always.  GI Jane.  But in that scenario I didn’t picture my eyebrows and lashes being absent as well.

People said that I should just draw in my eyebrows.  Personally, I felt that was a lot of responsibility. So many different styles I could do: permanently surprised, super villain, the Frida Kalho, Marx brothers, a lot of options.  I chose not to mess with it at all.

Halfway through the 2nd round of chemo my hair started to grow back.  It was so soft like a little baby bird.  So did my eyebrows and that was a nice change.  As time went on my hair became thicker and thicker and curlier and curlier.  Curls are very different than my hair before chemo; surprisingly, this happens to many people who’ve gone through it.