Exchange Surgery - Final Phase of Reconstruction

February 4, 2015 - 1st Exchange Surgery 

Prior, I had a small chest.  I was a 34B on a good day and the plan was for me to become a very full C. The morning of my Exchange Surgery (replacing the chest expanders with silicone implants) I was not nervous at all.  I was more amped about getting the hard rock-stupidly uncomfortable expanders out of my body.  The lack of sleep alone, after 3 months of living with these bad boys, was enough to drive any woman crazy.  My surgeon had told me that this will be the "easiest surgery yet" and she was right!   

Recovery 

Was beyond a breeze.  I was back to work within 72 hours and doing just fine with zero pain pills.  I was not given any drainage tubes which was a huge plus.  My 1 week post-op came and I was sitting in the exam room waiting for my Surgeon.  Now, she did an unbelievable job taking me from chest expanders to implants, however I was not pleased with the size at all.  Even more so, because of the smaller implant, my mastectomy on each breast looked very concaved at the top and unnatural.  The Surgeon came in to check me out and asked how I felt with the outcome so far (please always be honest, speak up and give your total opinion regardless of how nervous you may be) I told her that "I wish I had gone bigger".  She completely understood and told me that I am the one who will live with this chest for the rest of my life, not her.  Within 30 minutes my next surgery was booked for the following month.  I went from 425CC to 550CC and cannot tell you how grateful I am - to myself - for speaking up!  I can honestly say that I don't believe any other Surgeon could have done a better job!!! 

Here it is.  Now, to be effective in showing what I had gone through during the entire reconstructive process, I needed to start at the beginning.  It is unbelievable what my surgeon has created and I am forever grateful to her, in taking such pride in her work and making sure that every woman who is on her table feels whole again.    

I was dead set on having my nipples re-created, but I have chosen NOT to have this surgery and there is a very solid reason for this!  I no longer, for the rest of my entire life, HAVE to wear a bra.  These suckers stay up real nice and don't budge worth a damn.  Grant it, they are ridiculously heavy compared to my real breasts and wearing a sports bra is at times a saving grace.  I have have opted for "3D Nipple Tattooing" but unfortunately I have to wait until my scars have lightened in color.  It has been a solid 6 months since I had my last surgery and the scars have only lightened a little.  

My state of mind involving my chest has COMPLETELY changed.  I no longer feel like I have breasts.  I have what "looks" like breasts, but after 4 surgeries on my chest - they are just that - a visual.  I am completely numb in this entire area within the victorian tabs.  (I had minimal "stickers" to work with here) 

6 Months Post Final Surgery
I have yet to gain any feeling from where my armpits start, down to below my breasts.  This has been the most emotional mind-screw for me, to know that I will never have any feeling again in my entire chest. I have taught myself rather quickly to "chuck this in the fuck-it bucket and move on..." 

  

Tamoxifen - Blocking the Actions of Estrogen

Note: 

This is solely MY opinion on Tamoxifen and the research I had found on it to make my decision. 

I was given the prescription to Tamoxifen by my Oncologist in July of 2014.  She had told me that when I felt that I was in good physical health after ending chemo and going through my 1st mastectomy, that I needed to start taking 1 pill daily.  I fought this tooth and nail.  I had even gone on the drug for 1 month then off of it for 2 months because I did not want to have anything to do with popping this pill for the next 5 years of my life.  Here is why...

Before I started on Tamoxifen I, of coarse, googled it as well as read through the pamphlet that was sent home with me.  All I could think about is that this pill-popping distributer was making a killing off women who have survived Breast Cancer - Irony.  Every single woman is recommended (because the "statistics say") that this decreases our chances of recurrence.

My diagnosis has a lot to do with WHY I have to take this pill.  I was diagnosed with Invasive Ductal Carcinoma - HER2 Neu Positive.  Women carry a HER2 gene and if your cancer is HER2 positive, this means that your HER2 gene has overexpressed itself, thus feeding your cancer. 

"Breast cancers with HER2 gene amplification or HER2 protein overexpression are called HER2-positive in the pathology report. HER2-positive breast cancers tend to grow faster and are more likely to spread and come back compared to HER2-negative breast cancers. But there are medicines specifically for HER2-positive breast cancers." breastcancer.org

With that said, Tamoxifen has over 100 common/less common side effects.  Guess what one of them is?   Increased chance of cancer in the uterus.  I just went through breast cancer and now I'm on a pill that has an increased risk for UTERINE CANCER?  Seriously. The struggle is real, people. Here is a good informational read on the drug, from The American College of Obstetricians and Gynecologists - Tamoxifen & Uterine Cancer

Throughout this process and even beyond, women are faced with several life-changing choices.  If you don't go mentally insane from trying to wrap your head around each and every one, I applaud you.  But be your own advocate.  Research.  Talk to other women who have gone through or are going through the same thing.  Finding the opinions of others on brestcancer.org or talking to women locally or on the phone in other states, did not waver my choices - It opened my eyes to options.   At the end of the day, every woman I have been in contact with that was HER2 Neu positive, through their own research, opted to be ON Tamoxifen.

- Tightness, almost like a fatigued ache, in the back of my calves.  
My doctor said that this is due to blood clotting which is one of the major side effects.  I now take a  low dose aspirin (per my Oncologists orders) and this has taken care of the issue.

-  Cloudiness in my Right Eye.  
Tamoxifen can cause cataracts.  This is the most common cause of blindness.  This side effect started within 2 weeks of being on Tamoxifen.  My oncologist thought that I had symptoms of dry eye, but after 1 year it has increasingly gotten worse and probably my most uncomfortable side effect yet.  I am going to see a 2nd Opthamologist next month, as the first doc couldn't find anything wrong. If this issue increases and if going off Tamoxifen will halt the progression, I will be making a choice at that time to stop taking this pill.  I do not want to lose my vision in either eye and deal with that for the rest of my life.  

- Eyebrows and Eyelashes are thin and fragile. 
I can not use an eyelash curler or it will (no joke) pull out a dozen eyelashes with it.  My eyebrows I dare not pluck, as nothing will grow in its place.  Im not sure if this is a residual effect from Chemo (I've been off Taxotere for over a year now) but noticed that within a month of starting Tamoxifen, my eyelashes fall out even when I simply wash my face.

- What I have heard from other women who are on this drug. 
Weight Gain / I have not experienced this at all.  Hot Flashes / Maybe 1 a month but nothing compared to chemo hot flashes. Vaginal Dryness / Nope! Mood Swings & Depression / Not even the slightest.  Low Libido / Nope! Nausea / None at all. 

So why am I taking this drug?  
The answer I keep coming back to is the fact that I want to do EVERYTHING I can to decrease recurrence.  I dont ever want to go through chemotherapy again.  The statistics show that taking Tamoxifen for 5 Years decreases recurrence by 25% and being on it for 10 Years, decreases by 50%.  Now if the percentages were significantly less, then I would look into other alternatives in order to suppress my estrogen.  

Do. Your. Research. 

Another Side Note: 

This is not an expensive drug.  Its free on my Insurance, but without Insurance (here in Idaho) I would only pay $25 each prescription - which is 30 pills. 

Growing Boobs - Tissue Expander Process

November 1, 2014 - February 4, 2015 

3 Months... Yup - That's how long it took to grow a pair of boobs!  

When I was told that Tissue Expanders would be placed underneath my muscle and that my surgeon would insert saline every week via a port on top of the expander (through my skin mind you) in order to stretch out the connective tissues, you can only imagine one's facial expression.  

Of course I had googled the crud 

out of this process :) 

I have been stuck with so many needles at this point, meh, what's another one in my breast every week for 3 months?!  I went into my first appointment to have the saline injected into the expander and was pleasantly surprised at how easy and quick the process was!  

My doctor had bags of saline laying out on a table along with a VERY large needle to inject with.  She grabbed this small magnet-finder device and found the port to my implant at the top of my chest. She then popped the needle into the port and started to inject saline into each one.

This process really depends on the person. I had started to feel pressure in my chest and had her stop at 75 CC's because it was getting a little hard to breathe through the tightness.   After this first experience I had learned very quickly that taking in less at a time and more often was the way to go, unless you're on a mission!  

I had started to go in every week for about a month then tapered off to every 2-3 weeks.   I would have her put anywhere from 50-100 CC's each visit depending on how much ache and pain I was willing to go through during the days after.  There was definitely pain involved and with skin and muscle stretching, I expected nothing less at this point.

What I wasn't prepared for:

My chest looked like an alien was growing inside of me. There is nothing PERFECT about this process and you really have to wrap your head around the fact that this is prepping your chest for the final outcome.  It was impossible to wear any type of top and not look like I was completely lopsided. The saving grace throughout those 3 months was to wear the sports bras I was given when I had only 1 breast over the summer.  These bra's had come with contouring pads.  With the left breast that was seemingly up in my face, I had to manipulate the pads in the bra to create more thickness to match my right side.  

Everything was disproportionate and the idea that I could have a "normal" looking chest after this was beyond my imagination.  My surgeon said this had a lot to do with the fact that my Right Breast was an immediate mastectomy - to - expander swap out.  My Left Breast was not, and I had gotten it removed 4 months prior to the expander surgery.  

This photo was taken the morning of my Exchange Surgery (Expander - to -Implant swap) I was at 400 CC's and all of my trust was in the surgeon's hands, in making me look and feel like I had breasts again. 

Talk about Faith. 

 

My First Hair Cut

November 22, 2014

How many adult women can say they are having a "First Haircut & Color?"  Not many.  I had been anticipating this moment for a long time and growing your hair out from a buzz cut is NOT all it's cracked up to be.  No one tells you that when your hair starts to touch the tops of your ears and the nape of your neck for the first time in almost a year, that it can drive you CRAAAAAAAAZY.  Yes, truly crazy.  I had dreamt about having my long blonde hair back... but at this point all I wanted to do was find a pair of scissors and CHOP.  

During the grow out process I felt like a boy.  As my hair grew it would faux hawk out at the top, sometimes it would get a little wavy (my hair was wavy before chemo) and don't get me started on the ever evolving mullet that was happening in the back. For lack of a better term, I did not feel "pretty." Instead I felt guilt, for disliking the hair on my head.  I should have been appreciative but instead I was miserable.

Exactly 10 months, almost to the day, after my last appointment at the Salon (where I had chopped off 8 inches of hair the day of my 1st Oncology appointment) I was back in the chair and this was the result...  

I felt like a 

WOMAN again! 

I thought that there was no way she could make any sort of impact on what little hair I had - but she did! My hairdresser lopped off my lovely mullet and shaped the back and the sides around my ears.  I did not have her touch the top of my hair at all.  She highlighted heavily in the front and ombre'd down the back.  She did an unbelievable job. That whole 2 hours in the chair completely changed my attitude and I started to really appreciate what I had.  

17 Days Post Tissue Expander Surgery

November 18th, 2014

I am going to be extremely honest about what I went through during the Chest Expander process. It was, absolutely, the most painful and emotionally draining surgery that I had gone through - And at the end of this process, I had 5 surgeries (this was my 3rd)  

This face right here - is hopped up on meds.  At this point the pain in my chest was so unbearable I had literally cried every day for 2 weeks straight after the surgery.  Nothing I did, how I slept, the amount of pain pills I had taken and anything in between gave me relief.  The only reason I was smiling was because of the news I had received that day from my Oncologist right before my Herceptin Infusion:

"Only 3 more mother-effing needles left! Then this woman gets 1 LAST surgery & her life BACK in the New Year"
- Facebook Post that day -

(I did end up having 2 more surgeries)

One night my Dad had called me after hearing about the amount of pain I was in.  He asked if there was anything he could do to help.  My biggest issue was lack of sleep and after a few weeks it had been taking a toll on me mentally.  I thought maybe a recliner would help and asked if he could drop off their recliner for me to borrow.  The next day he dropped that bad boy off and I had high hopes - only to be sorely disappointed.  I slept in that thing twice and just the process of getting in and out of the recliner was enough to punch something. HUGE donut hole. 

The problem was not just the pain, it was the laying flat on my back part that threw me into agony.  The pressure from the expanders was truly too much to bare.  I remember one night I had gotten out of bed and gone to the couch to sit Indian style with my back up against the wonderful couch pillows that were my only saving grace during this time.  I sat there and I sobbed.  I cried and prayed to God to please give me some type of relief.  That was a pivotal point for me because I realized that night, there was no choice but to be in pain and to just get through it.  I wanted relief but I could not see past the pain - and that was my mental block. I dwelled on it.  This was the 2nd time throughout the entire year process, that I completely broke down emotionally and I needed it.  Sometimes you have to ALLOW yourself to indulge in a shitty moment.  This was my shitty moment and I owned it.