The Big Dig

Yesterday was yet another trip to the medical center, for one last pre-op visit to Dr Spiegel before reconstruction. I really need to think of a catchy title for the surgery, something like Boston’s big construction project, the Big Dig. Come to think of it, there are some similarities between the Big Dig and my surgery: both relate to the Central Artery and Tunneling (in fact, the official name of the Big Dig is the CA/T Project). Both are complicated, involve lots of people, and take a mighty long time to complete. But unlike the Big Dig, which replaced the 6-lane elevated Central Artery (I-93) with  a 3.5-mile long underground tunnel, my surgery won’t cost $22 billion. Hopefully. My insurance company, which has been mighty nice so far, might just stroke out about that figure. 

The Big Dig sounded like a great idea and was intended to be a tremendous boon to an already kick-ass city. But mismanagement, scandal, and skyrocketing costs quickly dominated headlines, and my second-favorite city had a big mess on its hands. Congressman Barney Frank quipped, “Wouldn’t it be cheaper to raise the city than depress the artery?”

Say what you will about Barney, but that’s a good line.

But back to the update on the doctor visit. This was Trevor’s day to meet the lovely Dr Spiegel, her ultra-energetic PA, Jen, and her trusty nurse Sonia. My friend Laura, who is a nurse practitioner in the liver transplant unit at Methodist, met us there, too. Dr Spiegel wanted to brief my caregivers on what to expect post-surgery, and Laura kindly offered to help out. In her white coat and super-stylish glasses, she brought a nice element of professional gravitas to the occasion. She told Dr Spiegel that she’s done some match-making for me and picked out an anesthesiologist she likes and trusts, and Dr Spiegel agrees that Dr Ashmore is the guy for me. Laura and Sonia recognized each other right away, then she and Jen hugged and high-fived, happy to be collaborating on my case. It’s good to have connections.

The visit itself was pretty uneventful. I like uneventful at the doctor’s office. Dr Spiegel  went over a few basics with us but since we were pretty much up to speed on everything, there weren’t any new developments. I’m finished with all the pre-op testing (bloodwork, blood donation, x-rays, EKG, CT-scan), and just need to watch the video consultation on Dr Spiegel’s website to get a more detailed overview of the procedure. I’m not saying I’m scared to do that, but after watching a video on youtube of an actual surgery, on an actual person, I’m not in a big hurry. Ick.

The one topic we did need to cover, though, was the infection. I wanted to bring it up in a way that seemed breezy and conversational, as opposed to, “How the sam hell are you going to keep this bloody nightmare from recurring, lady?” I was pretty sure that wouldn’t go over too well.

I’m not the most diplomatic person, and I tend to say what I really think, even if it’s not pretty or may be hard to hear. It’s a blessing and a curse. Believe it or not, I actually do put a lot of thought into what I say and how I say things, but because I’m pretty direct, sometimes things come out a bit, um, harsher than I intend.

Sorta like, “Are you outta your mind??? You’re not really going to wear that are you?” or “Clearly that person has neither friends nor a mirror; why else would one go out in public looking like that???” as opposed to “Have you thought about what to wear?” Those kinds of niceties take a bit of work on my part. My instinct is to just blurt out whatever needs to be said, and let the chips fall where they may. We’re all grown-ups, right?

Right. Except I really don’t want to tick off the nice lady with the very sharp scalpels. That would be bad. So I fumbled around and probably sounded idiotic by saying, Um, so, uh, like, how worried do we need to be about the um, you know, infection? You know, like, um, during the uh, reconstruction?

She smiled knowingly, and if she’d been sitting closer might have patted my hand and said, there there.  She reminded me that my case isn’t exactly normal, and I tried not to tell her that “normal” is pejorative and listened to what she had to say.

She has a plan, of course, and it sounds like a good one. Usually, in cases of infection, she would wait to do reconstruction, to be sure the infection is truly gone. But in my case, which again is not normal, we need to get in there sooner rather than later and clean up the mess,  i.e., excise the damaged tissue and replace it with some new, fresh meat. And by meat I mean my own flesh. Fresh flesh. Yum.

The plan is to work on the infected side last, and she promised to take her time and wash it all out thoroughly with 6 liters of antibacterial solution. That’s way more than usual. She’ll have separate fields of instruments, and once the instruments touch the infected area, they’ll be classified as contaminated. Remember the scene in the movie ET at the end, when the little guy was dying, and the family home was a warren of plastic sheeting populated by feds in Haz-mat gear? I’m having visions of the Haz-mat suits. But hopefully no aliens. Although I do kinda like the polka-dotted kiddie pools in this scene.

So we’re on track, on schedule, and presumably ready to go. She estimates the surgery will last 8 hours, not 12-15 like I’d originally heard. Of course, we won’t know what we’re dealing with until she actually gets in there and starts cutting and scraping away, but I’m going to be optimistic.

Meanwhile, I’ll be thinking of a name for my own personal Big Dig (if you have ideas, send them em!), and can’t wait to post before and after pictures like this:

Except, I won’t make you look at the before pics, because they’re pretty gross, and that would just be mean.

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38 Comments on “The Big Dig”

  1. Lisa says:

    good luck, nancy!

  2. Ed says:

    Never thought I’d see Barney Frank tagged on a blog about breast cancer (although Barney is probably aT least a c-cup himself!). Mountains out of molehills? The ressurrection? Breasturrection? Return of the girls? Twin peaks (the sequel)?

  3. [...] this letter in the mail while I was in the hospital for the Big Dig, aka reconstruction. I don’t even know what to [...]

  4. [...] through the port instead of an IV in the crook of my arm. However, the port was in the way during the Big Dig, and so the Drs S decided not to use it during surgery, even though it had been accessed, and they [...]

  5. [...] of open interpretation, Dr Grimes gave me a copy of my pathology consultation report from the Big Dig. Fascinating stuff. I think it warrants a separate post. Don’t want anyone to get behind in [...]

  6. [...] been 30 days since my reconstruction surgery, aka the Big Dig. I’ve had some inquiries regarding my health, happiness, and healing at this stage, and [...]

  7. [...] pan of homemade macaroni & cheese (thank you, Leanne!). Between the abdominal swelling from the Big Dig and the constant influx of simple carbs, I don’t have a thing to wear. But given the choice [...]

  8. [...] I did something I haven’t been able to do since The Big Dig. I’m very excited about it. It’s been 5 weeks since the excavation that gutted me like [...]

  9. [...] feel all that great. Again, me & my stupid assumptions. Because it has been 6 weeks since The Big Dig, I stupidly assumed that on day 42 post-op I would magically be back to normal. [...]

  10. [...] the day how long I’ve been on oral antibiotics (251 days), and how long it’s been since The Big Dig (49 days). More likely, it’s because I’m focused on the destination and not the [...]

  11. [...] look like a normal suburbanite going about her daily business. I’m pretty much recovered from The Big Dig, other than some lingering soreness in my belly incision and the annoying fatigue that I [...]

  12. [...] Year came and went, and before I knew it was time to start making preparations for reconstruction. The Big Dig was a big step, and I had hoped it would signal the end to my “cancer journey” and [...]

  13. [...] Year came and went, and before I knew it was time to start making preparations for reconstruction. The Big Dig was a big step, and I had hoped it would signal the end to my “cancer journey” and [...]

  14. [...] and he delivered the most-excellent news. He is my new best friend. All of the cultures run during The Big Dig came back negative, which means we can safely assume the post-mastectomy infection is gone. Yes, at [...]

  15. [...] beloved lymphedema specialist, to continue breaking up the scar tissue under my belly incision from The Big Dig. I have several spots that are about the size of a marble under my skin, and they must be [...]

  16. [...] my cancer-versary, about a revelation, about week-old recollections after The Big Dig, aka my reconstruction, and returning to the tennis court after a long absence full of [...]

  17. [...] is a great cook (she’s from Louisiana, after all), and she fed my dad when he was here for The Big Dig. When he told her that I ususally put some leftovers in the freezer for him along the way so I can [...]

  18. [...] Dr S lifting the tennis ban, I realized that I haven’t so much as picked up a racquet since The Big Dig, nearly 3 months ago. In fact, I had to dig around in the garage for my tennis bag. Sadly, it had [...]

  19. [...] I’ve iced and elevated and slept in a splint. I had high hopes that while recovering from The Big Dig and taking several months off from tennis and most of my daily activities beyond laying in bed [...]

  20. [...] normal life back to finally getting around to reconstruction, to the long recovery process after The Big Dig. Quite a circuitous route I took, with very little [...]

  21. [...] and the beginning of the elusive pursuit of getting back to “normal.” When I endured The Big Dig in March, I knew that as gee-gantic as that surgery was, it wasn’t the end of reconstruction [...]

  22. [...] also did the one things I really should not have done, and that I also did the night before The Big Dig, aka reconstruction: I watched the surgery on [...]

  23. [...] over a few points. The main scuffle is an ongoing one in which the good doctor claims that before The Big Dig, i.e., my DIEP surgery for reconstruction, I did not have a waist. This has always struck me as [...]

  24. [...] I think my surgeons did a good job with my newly reconstructed chest? Yes. A fantastic job. Does it look 1,000 times better than it did pre-reconstruction? Way. But am [...]

  25. [...] post-mastectomy infection and a much-more-complicated-than-expected reconstruction known as The Big Dig, the prize at the finish line of my cancer “journey” isn’t much of a prize at [...]

  26. [...] indeed able to fix my messed-up chest, and his artistry certainly prevailed. I never expected the DIEP surgery to result in one-and-done results; I knew that revisions, plural, would be necessary. But I had [...]

  27. [...] and not-nearly-as-exciting-but equally-dramatic-as-Eclipse saga that is my life, we commenced with The Big Dig and relocated blood vessels from my belly to my chest. After a long-ass surgery and a Hades-esque [...]

  28. [...] Going toe-to-toe with the worst that nature dishes out is an epic journey, much like the cancer “journey.” Cancer has dished out some nastiness, and my body has struggled mightily in an effort to right the listing ship and get back to “normal.” This week has been far off of normal as I’ve encountered some trouble in getting to the next surgery, the oophorectomy. The surgery has always been in the plan, it was just a matter of when to do it. The time is upon me, but the OB-GYN I met with Monday left me with more questions than answers in what should be a settled matter. In addition to being hell-bent on reiterating the risks and espousing the wide-ranging unpleasantries of surgical menopause on a “young” woman such as myself, she introduced a new fly in the ointment by decreeing that a laparoscopic oophrectomy was not an option for me because of the existing abdominal scar from The Big Dig. [...]

  29. [...] oophorectomy wasn’t an option for me because of the abdominal incision on my belly from The Big Dig. This was something I hadn’t even considered and is another example of how much of what one [...]

  30. [...] I thought I was nearing the end of my “journey,” with what could be my last revision to reconstruction, the game became more intense and complicated  and pretty  much blew up in my [...]

  31. seo says:

    Hmm it seems like your site ate my first comment (it was extremely long) so I guess I’ll just sum it up what I submitted and say, I’m thoroughly enjoying your blog. I as well am an aspiring blog writer but I’m still new to everything. Do you have any helpful hints for novice blog writers? I’d really appreciate it.

  32. [...] came the harrowing process known as reconstruction. Thanks to the infection, nothing was simple, and what should be the final stage of the BC [...]

  33. [...] I’m taking his advice and am going to write it on my heart: being one year out, exactly, from The Big Dig makes this day the best day in the year. This time last year, I was once again in a hospital gown [...]

  34. [...] Surgeon #2 last week about the next step in revising The Big Dig. Didn’t want to talk about it or blog about it at the time. I’m not sure why, but I [...]

  35. [...] suffer. I’d like to lament the fact that that damned infection caused me to undergo a heinous reconstruction that will likely never achieve the results I want and deserve, despite everyone’s best [...]

  36. [...] and needed to shore up the sunken, excavated chest wall with some healthy, vascularized tissue, aka The Big Dig. I showed up with a hot mess of a post-mastectomy chest wall that went from bad to worse to even [...]

  37. Have been trying to think of an appropriate comment…and would just like to say: I Wuv You:) Appropriate or not….I love how you tell it like it is.

  38. Kanyinulia says:

    Great idea. My friend is discussing this with me, he used 2 live in boston. Wonder when we’ll have something like this in my country.


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