Thursday, April 17, 2014

Too Much Information



Day Forty-Nine – Thursday

Randy and I spent a good deal of the day speaking with surgeons. We learned more about breast surgery and reconstruction than we ever wanted to know. Who thought that keeping the patient well informed was a good idea? I mean really. Tell me I need this operation, do it, and when I wake up, tell me how to take care of it. My head is so full, it’s going to explode.

First we went to see the Plastic Surgeon. Nice person who loves what he does and comes highly recommended. And yet, I was crying when I left the office. It all became so very real.

Here’s what we learned:

1.       I won’t be ready for a reconstruction immediately after my mastectomy. I will have to wait 2 to 3 months. As of today, I’d be willing to wait for a while. Not looking forward to additional surgeries. I honestly don’t know what I was thinking, but it wasn’t any of this.
2.       There are two kinds of reconstruction. One is the traditional which goes something like this (in laymen’s terms) – I have surgery to insert an expander. The expander requires several visits to the surgeon so he can poke a needle with solution into my now removed breasts and expand them until they have reached the proper size. Then I go back into surgery and have these removed and the silicone implants put in. Then he may want to tweek them so they are perfect. On the short end – two more surgeries. On the long end, implants may form scar tissue and may become hard and the whole process starts again. The second form of reconstruction takes more time in surgery, only one doctor in Tucson does it, and recovery time is longer. It’s called a flap and here’s how it works – they take the fat and tissue from my abdomen and move it up to form my breasts. A tummy tuck and breast reconstruction all in one. Surgery time is 8 to 10 hours, 3 to 4 days in the hospital, and 6 to 8 weeks of recovery time.

Then we had pie at Village Inn.

Next stop, the surgeon who is doing the Double Mastectomy, where we both learned that I will lose not only my breasts, but my nipples. It’s all breast tissue and the reason for a Mastectomy is to get rid of breast tissue so breast cancer won’t come back again. Plus, if he left them there, they wouldn’t have any sensation anyway and may be all catty wompus so that the plastic surgeon will remove them anyway. We also learned so many new and very unfun things like….

1.       Well, the nipple thing. Randy asked what they do about the look of nipples. I think the doc said something about a tattoo, so Randy said I could be rather creative with that – Like flowers or pink ribbons or something – but I really don’t think that’s what he meant. I think the surgeon does it so it looks like an ariola. Something to talk with the plastic surgeon about later.
2.       I will have drains to get rid of fluid that will form. I will need to take care of these drains for about 10-14 days or until I stop draining. Anyone who knows me knows that things like cleaning up vomit or a broken egg makes me very sick. So, this should be all kinds of fun.
3.       There will be no external stitches only internal ones. Who knew? I thought staples or stitches that need to be removed, but no. The only stitches I will have are those holding in the tubes.
4.       They will send me home with one – just one – camisole. I will have to buy more. They have pouches to hold the tubes so no one can see them and so they are not just dangling around. Nice to know that if you invite me over, you won’t have to see them and if I never mentioned it, you wouldn’t even know.
5.       The surgeon says he is leaving more skin so they can reconstruct later. This means I will be all lumpy instead of smooth.
6.       The doctor wants to do this at a Surgery Center and I will go home after the surgery. He says patients recover better in their own environment. Okie dokie. For some reason, that little piece of news made me very nervous. But the surgeon prefers it because he gets to chose his own team and he has worked with them thousands of times and he feels more comfortable in that environment. So, I’m reading the website about the surgical center and they want my co-pay up front when I check in. I need to call them.
7.       I have to have an injection before the surgery so that the doctor can trace from my lump to my lymph nodes so he can cut out the closest lymph nodes to have them looked at. And chemo is still a possibility if the cancer has spread, but the lymph nodes are not palpable now and that is a good sign.

I can still change my mind and do a single mastectomy, but with my cancer history, it may only be delaying the inevitable. Plus, the plastic surgeon said that every single patient who had a double mastectomy was more happy with the reconstruction results over a woman who had a single.

So that’s what we know. The surgery will probably be in two to three weeks. I just want this cancer out of my body. I just wish it could be done without removing yet another part of me. On the other hand, surgery is quicker than chemo (something I know too well).

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