Flat-Chested

   It's almost been two weeks since my surgery, and I'm feeling a lot better. I haven't needed any painkillers the past few days (even for the chest pain!). The surgery went well and I got out of the hospital Wednesday afternoon. There was some strange swelling on the left side, so I saw the doctor Friday to get it checked out, but they said it was just the tubing inside from the drain (gross). I saw the doctor again Wednesday to get the two drains taken out. Everything's kind of numb in my chest area, and I didn't have those terrible shooting pains from the lymph node surgery this time, so the drains were much easier to manage, but I was still glad to have them out. I ditched the uncomfortable hospital/surgical bra as soon as I could and I've been wearing the As Seen On TV Genie Bra because they had an extra-small that actually fits. It's almost just as hard to find bras now. I'm somewhere between the little girls and the juniors, but most of them come built-in pockets with padding. Our society's obsession with big boobs and oversexualization of pre-teens are working in my favor. Walmart even has $5 "water pads" next to the Buty Pant butt-enhancing panties. While I opted to skip the padded underwear, those cheap bra pads are good enough to make me look a little less like a flat-chested twelve year old.
   I saw Dr. K today for a follow-up. She ripped the steri-strips off both sides, but thankfully I couldn't really feel it. That swelling never really went away, so she just sucked it out with a syringe. Again, happily still numb! It's definitely flatter now, but I forgot to ask about the other swollen part at the top. Hopefully that's not just leftover skin... Everything else looks really good, completely flat and the incisions are very thin, even though each one goes from the middle of my chest up into my armpit. I think she did a great job.
   She gave me a copy of the pathology report, and said everything was fine with the surgery. The chemo obviously worked because the tumor went down from 2 cm to 0.6 cm. When I got home and looked over the report, I realized I don't know what any of it means, but Wikipedia's super helpful. Overall, I had a grade of 1 which is the lowest (and best). Tubular differentiation had a score of 3, which isn't good, but nuclear pleomorphism was only 1 and mitotic count was only 1. Nothing was found on the left side, except that fibroadenoma. While Kyle jokingly said it was a waste of a good boob, I feel better knowing I have almost no breast tissue left to form new cancer cells. Plus, they're a pair anyway; I'd rather be flat-chested on both sides than lopsided.
   Dr. K also went over some massages for my arm when I asked for a new referral for a lymphedema physical therapist. I mentioned the arm pain to the oncologist a few months ago, and they said it was lymphedema, which is why I thought it was a lymphedema... And my right hand is noticeably swollen compared to my left. She said lymphedema doesn't hurt though, it's just the swelling. She thinks it's just the muscles in my arm and I must've overused or underused that arm after the first surgery. She said to keep it elevated above my heart whenever I have a chance, and showed me the massages for both the lymphedema and for my muscle aches. If I'm still having issues in two weeks and want to see a physical therapist, she said to call. Otherwise, I'll see her in six weeks to make sure everything's doing okay. She also asked when I wanted to get the port out, but considering this is my THIRD one now, I'm going to hold onto it for as long as possible. Once I'm done with treatments with the oncologist, it'll need to be flushed every three months to keep it functional. She said they could take it right out in their office instead of dealing with all the hospital stuff. Very different from the last two ports...
   I have an appointment with Dr. B from radiation oncology tomorrow for another consultation. My chest pain finally went away (after seven weeks), but I really don't want to get radiation if it's going to aggravate it in the future. I guess we'll see what she says tomorrow.
   As for the official weight for my boobs: the right one was 439 grams and the left was 427 grams. Less than a pound each! I was expecting heavier.

Skipped Herceptin

   Now that I only have regular appointments every three weeks, I'm probably going to be lazy and update a lot less. I had a MUGA scan last week, but Dr. C called the next day to tell me the number was lower than he wanted, so I didn't get the Herceptin today. It was only 52, and my first two were 65 and 55. He said it's still normal, but I'm at a certain threshold where they want to wait and see if it gets better before giving me any more Herceptin. I have another MUGA scan scheduled for April 4th and see the doctor again April 11th.  I asked for a copy of my counts as I was leaving and apparently they still had me in the system as male. My hemoglobin was 8.7, my platelets went down to 112, but my white counts are good. Hopefully that won't mess up my surgery date next Tuesday. I'm also supposed to start the Tamoxifen when I get home from the hospital. The hot flashes stopped a few weeks ago thankfully, but this medication will probably start them up again. And I'm supposed to be on it for the next five years. Oh what fun. Besides the typical menopausal symptoms, it also has rare side effects of blood clots and uterine cancer (just can't win).

   My chest still hurts (four weeks now?). He said it's a good thing that it hurts when I push on my ribs because it sounds like a cartilage issue and not something to order a bone scan for. He even said it sounded like costochondritis, which I thought I had told him before? But either way, at least he's familiar with it. I realized I've been dealing with this on and off for almost seven years now. The only thing I can do for it is pop ibuprofen and slap a heating pad on my chest. I just hope it gets better before surgery next week.

   I saw Dr. K for a pre-op appointment last Thursday for the list of questions I've been making. She said the surgery might make my chest pain worse because it'll feel tight, but that it's fine to keep taking the ibuprofen, as long as I don't drink anything the night before surgery. And yes that crazy thing in my chest IS a power port, that's all they use apparently. I was supposed to get a booklet and a card when I was in the hospital, but she's going to try to get me another one. I should only be in the hospital for one night and the surgery should take less than three hours. I asked her not to leave any extra skin, and she said it'll be completely flat with the scars slanted with the way the muscles underneath naturally stretch. I'll have drains again, but I won't have that terrible nerve pain since they're not messing with any more lymph nodes. She said I could drive once the drains are out and I'm not drugged up on painkillers. 

   I tried to make an appointment with the radiation oncologist, but they told me to call back after my surgery. Dr. K said they can start radiation two to four weeks after surgery, but that seems too soon and I don't see how my skin would have time to heal before then? We're going to SC for a week in May so they're going to have to work around that anyway. I'm more concerned about what the heck radiation is going to do to my chest in the long run, especially with this ongoing chest pain and my swollen arm. The radiation oncologist was unsure at first whether to do it or not (September and October entries). Maybe whatever they find during surgery will influence it. Either way I'm screwed.

Five Weeks Left of Chemo

   Taxol #6 was last week. For some reason, my fingers suddenly stopped feeling all tingly, and the numbness seemed to have leveled off, so I might end up doing all/most of the Taxol treatments after all. My platelets were pretty low last week though, around 60, so Dr. C was a little worried about that.
   I met with the breast surgeon for a pre-op appointment last Wednesday. All she wanted me to do was sign a paper basically. She went over all my options again. I told her the plastic surgeon said I couldn't get an implant on the right side since I'll be doing radiation, but she says that's not true. Okay? ...But the plastic surgeon she referred me to, who shares her office, refuses to do it. She also said that moving the fat alone from my stomach into boobs wouldn't work because you need the blood supply provided by a muscle. Otherwise you just have "dead fat" hanging there. Good mental image. Either way, I told her I don't like the ideas of sacrificing muscles for boobs, having foreign objects in my chest for the rest of my life, or, more importantly, extra and unnecessary surgeries at this point. She pointed out that having a mastectomy on the left side could be considered "unnecessary". Except let's remember that my breast tissue is potentially deadly and leaving any of it attached to my body does not seem like a good idea. And that's really the best argument she could come up with to try to convince me to get immediate reconstruction? I can personally live with my decision (and will probably live longer because of it), it's the rest of the society that seems to have a problem with me going boobless. As of now, my surgery's scheduled for April 10th if everything goes according to plan (ha).
   I had Taxol #7 yesterday. My platelets and hemoglobin are looking better. Dr. C said he can't even feel the tumor at this point, just some "thickening" from the biopsy. He asked if the breast surgeon examined me and was surprised she didn't. So I took the opportunity to ask him if my ribs would be sticking out once my boobs are gone. Apparently they won't because they leave the muscle intact in today's modified radical mastectomy. Good to know. Kind of wish the surgeon had gone over some of this, except I was at a blank when she asked if I had any questions.
   My mom came up to visit last week and cleaned the house for us (thanks Mommy!), even though she might have been trying to kill the dogs by using toxic chemicals to scrub the floors. I almost killed them myself earlier when they escaped out the front door, which was the fault of the HVAC guys who just stood there like idiots with the door wide open as the dogs took off. Luckily Kyle came home for lunch right as Zeus was taking a dump in the neighbor's yard and snatched him up mid-poop. When the guys were leaving, I asked what we could do to make the downstairs warmer, and they gave me another stupid look and asked if I'd gotten a letter from housing saying when the maintenance guys were coming. I thought THEY were the maintenance guys! I have no clue who these men were that I let into my house and the real maintenance people never even showed up. And I'm pretty sure the heat's broken now because the house is freezing.
   Very frustrating day. And to top it off, the numbness/tingling in my fingers seems to be coming back, making it painful and irritating to do schoolwork. And the new hair that's been growing on my head since I finished the Cytoxan is starting to fall out. It's about an inch long all over, so this is pretty depressing. I should've seen this coming though since my eyebrows are still pretty sparse and I mysteriously haven't needed to shave my armpits for weeks. Thankfully only five more weeks of chemo.

Plastic Surgeon

   I saw a plastic surgeon yesterday (now conveniently located at Dr. K's office). All these older women were there waiting, so excited about having their new boobs installed. It kind of creeped me out. And I've kind of already decided to not have reconstruction done the same time as my mastectomy, especially since I'm only two months into chemo and I have another four to go. I don't want to deal with anything "extra" by the time I get to surgery. Not to mention the five weeks of radiation to follow. But I figured it wouldn't hurt to see the plastic surgeon to see what my options are.
   Since we're planning to do radiation, he said I'm not a candidate for an implant, at least not on the right side. I don't really like the idea of having a foreign object in my body for the rest of my life anyway, especially if it can cause extra complications. The tissue on that side won't heal very well after radiation, so it can't be expanded for an implant. He then squeezed the fat on my stomach (awesome), but said even though there's "some" fat there (thanks), it wouldn't be enough to do both boobs. So they start salvaging other parts of your body. In my case, he said he could use tissue from my back. Four large incisions in three different areas of my body all at once?? No thanks! Plus they'd be taking muscle from my back too. I can't really see the justification of sacrificing (any) muscle on my body for a boob. I'm already so weak from the chemo and the lymphedema in my dominant arm, I'd rather not make it any worse in the long run. Plus I googled some pictures of the stomach scar (pretty sure it's the DIEP flap procedure he was talking about), and it does not look like a fun recovery time.
   I mentioned that if I did get reconstruction, I wouldn't want the same size. Whenever I say that, people always seem to assume I want bigger boobs for some reason. I'm five feet tall, I'd like, for the first time in my life, to have boobs that are appropriately sized for my body. So smaller. Much smaller. It's a nightmare finding bras to fit, and that 32 band size? Pretty sure it should be a 30 but they don't make those. I don't think the doctor took me seriously though, because he kept saying "for the same size" when he was mentioning all the parts he'd have to scrape together from the rest of me.
   He said insurance should cover reconstruction, no matter when I have it done, so that shouldn't be an issue. However, for the best looking results, I should do it the same time as the mastectomy. After another four months of chemo, I can't imagine I'm going to feel well enough to change my mind about it. Plus there's that more important question of why get reconstruction at all? Maybe so clothes fit a little better, or so people don't mistake me for a 10-year-old year girl, or worse, a 10-year-old boy. My husband said he just wants me alive either way. Plus, I'd never be able to feel them. The numbness in my arm still feels weird, and the mastectomy scars should be numb too, I don't want extra tissue hanging off me that I can't even feel. Why pretend to make it seem normal?
    He also kept mentioning how important it is to get back to a good "quality of life". Maybe I'm just a little dazed from chemo brain, but the way he kept saying it made it seem like I would never have a decent quality of life if I didn't get new boobs. If anything, not having extra, unnecessary surgery right now will give me a better quality of life, considering I'll be able to return to normal activities much sooner. I asked if I could just wait until my stomach inevitably gets fatter and THEN have them rip it out to make new boobs. He said that's fine, but geez, he kept trying to emphasize how much better they'll look if I do it right away. Boobs have never been that important to me. If anything, they've caused me a lot of extra stress in my short lifetime and now I'd like for them and any semblance of them to go away for a while.

Yay I Can Shower Again!

   Finally got my drain taken out today. Dr. K ripped all the tape off from my other bandages first, so I barely noticed when she pulled the drain out of my side. The hole will "leak" a little for a few days, but should heal up fine. She showed me some exercises to do to keep my arm and shoulder flexible. (I also pointed out my double jointed elbows, and she told me to let the genetics counselor know.) I'm scheduled to see Dr. K again August 25th to make sure my exercises or working or else I'll go see a physical therapist. I'm also penciled in for January 10th or 17th for the bilateral mastectomy, which means I have to get in touch with the plastic surgeon before then to find out about reconstruction. Dr. K said the results of the lymph node surgery showed that 3 of the 10 she removed were cancerous. Good thing they're gone.
   Now I'm going to go take my first shower in 9 days. Goodbye armpit odors!

Update post-shower:
   I don't know what was scarier: seeing the four inch incision under my arm for the first time, or the small forest that has taken root in my armpit. Omg.