Homework

Posted: January 7, 2011 | Author: | Filed under: breast cancer, drugs, infection | Tags: , , , , , , , , , , , , , , , , , , , , | 5 Comments

I’ve been reading up on and researching reconstruction. Oh, to return to the days in which the only context I had for reconstruction involved the South rising again.

Alas, that’s not to be, and the horse is out of the barn, the worms are out of the can, and we can’t unring that bell. So now reconstruction means something entirely different.

It was supposed to be a pretty simple affair: tissue expanders put in at the time of my mastectomy, which would be filled with saline slowly and gradually, over a period of a few months, to allow my skin to stretch and accommodate a set of perky but modest implants (male readers, go ahead and groan at the mention of modest implants.) Why does one need her skin stretched for implants, when millions of women get the orbs jammed into their chests in a single step? Because those millions of women haven’t had their flesh scooped out down to the ribs. (Hope you weren’t planning on eating BBQ anytime soon.)

Back to the implants: my simple affair turned in an epic fail when the right tissue expander exercised some really bad judgement in allowing a mycobacterium to share its space. Ah yes, the infection. That dadgum bug turned my world upside down, and fast-tracked me from post-surgery superstar to sick, sick, sick. My recovery was going so well. I was convinced I’d be back on the tennis court in a month. Sigh.

Moving along to option B: the TRAM flap. It’s a big surgery (8-12 hours average) with a week’s stay in the hospital and 3-to-6-month recovery. Youch. I didn’t really get how they accomplish this surgical feat, so in the course of my research I watched a youtube video of an actual TRAM flap procedure. “Ewww, gross” doesn’t even begin to cover it.

In laymen’s terms, the surgeon cuts a football-shaped piece from your tummy, with the incision going from hip to hip. He or she (for this purpose, we’ll say “he” since Dr S will be the surgeon, but y’all know I’m all about equal opportunity so I must digress) then cuts the rectus abdominal muscle, in its entirety or partially, and  uses that muscle as the blood supply (e.g., blood vessels and small arteries) in the newly created breasts. Then he tunnels his way from the tummy incision up to the breast area, shoving tummy fat upward to create the new breasts.

After recovering from the grossed-outed-ness of watching this, I marveled at the ingenuity of the technique. Pretty cool stuff. But I admit it unnerved me for a few days. You may recall from previous posts way back when this all started that I HATE hospitals. I detest the smell, the noise, the lack of privacy, the parade of people in & out of the room, the clanking of carts up & down the hall, the cafeteria-style food, the machines beeping, the cords snaking everywhere, and the omnipresence of needles and IVs. I do like the morphine, though.

In addition to my extreme and unconditional hatred of all things hospital, I now fear them greatly and mightily because of the infection. I’m really, really scared. Like “want yo mama scared.” The risk of infection in any surgical procedure is estimated to be 3 percent. That’s pretty low, right? When you think about all the different surgeries done in all the different hospitals in all the different cities every day, that’s pretty low. But leave it to me to be the one person who gets it. Sheesh.

And leave it to me to get a rare infection that is not only hard to classify but hard to kill. Hence the never-ending 12-hour cycle of oral antibiotics. A quick back-of-the-envelope calculation tells me I’ve been taking those two oral abx for about 140 days. And there’s no end in sight.

So you can see why I’m not exactly rushing back into the OR for my reconstruction.

However, the compelling reason to get in there and get ‘er done is the complications still arising from said infection. Dr Grimes, my infectious disease doc, thinks that undergoing the surgery sooner rather than later will help clear up some of those complications by way of cleaning out the unhealthy tissue and replacing it with fresh new tissue with a brand-new blood supply. Sort of like replacing your old, threadbare socks with a nice new pair.

That’s why I was doing my homework and scaring myself half to death, so that I can go into my appointment with Dr S armed with knowledge and ready to proceed. I took a lot of notes and tried to keep up with all the different kinds of flap procedures: pediculed vs non-pediculed vs perforated, etc. Then there are variations on the procedure called DIEP and SIEA flaps (Deep Inferior Epigastic Perforator and Superficial Inferior Epigastic Artery, respectively). Prior to my research, I had no idea what TRAM stood for but speculated, based on my limited knowledge, that it was “That’s Rough on your Abs, Ma’am.” Turns out it’s actually Transverse Rectus Abdominis Myocutaneius. Good to know.

I didn’t pay much attention to the DIEP and SIEA flaps, because the TRAM flap was the only procedure Dr S had ever mentioned. I assumed that’s what I’d be getting. We all know what happens when you assume…

Dr Dempsey pointed out, however, that the DIEP flap is the one for me because it spares the ab muscle, something I will want and need as I go forward in my long, active, tennis-filled life. The DIEP flap is a more complicated surgery (12-15 hours), though, and there’s not nearly as much info available on it as there is on the TRAM flap.

Here’s why: the DIEP involves a lot of microsurgery. Instead of transferring the ab muscle and its blood vessels to the breast area, Dr S will make that big incision on my tummy, but leave the muscle there, removing the blood vessels and arteries entirely and reconnecting them in the new breasts. Apparently he will have to cut a piece of a rib, too, to make this all come together. I choose to skip over that part and not even think about it. Yikes.

The DIEP is considered the gold standard of flaps. And the reason there’s not as much info available is that it is a more technically complicated surgery, and not many surgeons do it. But if you’ve read any of my posts about Dr S, you know that he is the gold standard of surgeons, so I’m in good hands.

Stay tuned.

Crazy lady on aisle 3

Posted: January 6, 2011 | Author: | Filed under: Uncategorized | Tags: , , , , , , , , , , , , , | 5 Comments

I went into Randalls yesterday, a grocery store at which I rarely shop, and came across the strangest, angriest, kookiest lady I’ve ever seen.  I’m still wondering if this really happened, or was a crazy-train dream.

Here’s how it went down: I was behind Ms. Crazy in the checkout line. Her roast or whatever cut of red meat had dripped bloody juice all over the floor where I needed to walk, and was also all over the conveyer belt of the checkout area. I didn’t say anything even though, as a non-meat-eater I was sicked out big time.

Ms. Crazy noticed it on the conveyer belt and griped at the sweet elderly cashier to clean it up. Hearing how she talked to this service provider was the first clue that Ms. Crazy is, well, crazy.

When Pat the sweet elderly cashier rang up Ms. Crazy’s assorted box of individually wrapped cookies, Ms. Crazy complained in a loud & ugly way that the store flyer advertises that product for $2.99 but it rang up for $3.99. Ok, mistakes happen, and I’m pretty sure sweet Pat isn’t the one responsible for programming the sale prices into the cash register, so back off Crazy Lady.

Pat consulted the flyer and found that yes, that product is on sale but Ms. Crazy got the wrong variety or wrong size or something. Ms. Crazy’s response was to bark at Thomas, the bag boy, to go get her the right kind of cookies.

Yes, ma’am.

He came back with what he thought was the right variety, but it wasn’t the assorted box, it was all Chips Ahoy, and Ms. Crazy and her family need the variety and excitement that only Chips Ahoy, Nutter Butter, AND Mini Oreos can bring. Did I say they need the variety? Pardon me, they deserve it. She didn’t say that, but I could totally tell that’s the kind of person she is.

So Ms. Crazy sent poor Thomas back to the cookie aisle to do her bidding. While he was gone, she looked at me, waiting ever so patiently behind her hot mess self. I was making an effort to be patient, for once, and didn’t huff or look at my watch or otherwise complain. But when Ms. Crazy rolled her eyes at me, as if to suggest the Randalls employees were disappointing her high expectation of — and God-given right to — exemplary service, my patience quickly evaporated.

That was when Ms. Crazy noticed the bloody juice all over the floor. She asked me, Is that blood? I said, I don’t think it’s blood but juice from the meat you’re buying. Again, I didn’t say one word about how disgusting that is, or what a potential health hazard it is, or inquire about her feelings toward the innocent cow that gave its life to appear in her shopping cart or lecture her in any way about all manner of evil represented by that styrofoam tray full of flesh & muscle.

Not one word.

Fat lot of good all my restraint did me.

When Thomas had yet to appear with the holy grail of cookies, I jokingly told Ms. Crazy that I would give her a dollar if it would help speed up her checkout. She didn’t think I was one bit funny, and told me to, and I quote, “Shut the F*%# up.”

Yes, you read that right. She told me to shut up AND used the F word. In the grocery store.

Wow.

That is some serious insanity.

I was stunned, for sure. I kept my cool and told her that she had no right to speak to me, or anyone else, like that. She replied in a nasty sneering way, “Oh  no! Did I offend you? I doubt it.”

Ok. Right. I’m not even sure how to respond to that, so I took a step back and said, ok, back off, I was just joking anyway. She yelled something about how Randalls needs to fix the computer and correct the price right because what’s going to happen when the next person comes along and has the same problem? I told her I’m not real concerned about the next person, because hopefully by then I’ll be home and have my groceries unloaded and be on to the next task.

Well, Ms. Crazy didn’t like my answer one bit. Not one bit. She screeched at me (yes, she really screeched), “You’re in your Sugar Land bubble and just want everyone to hurry up, get out of your way because you’re next.”

I’ve often joked about the Sugar Land bubble, where all the kids are above-average thinkers, the moms all have perfect figures and keep a perfect house, the dads all have high-paying jobs and coach Little League and everyone drives a gas-guzzling SUV. God Bless Sugar Land.

But I’ve never suggested that the “Sugar Land bubble” entitles me to preferential treatment.  So there, Crazy Lady.

After she screeched at me, I held up my hands as if to say, Ok, whatever, and to signal my official disengagement. Thomas had returned with the offending cookies by this time, and it was time for Ms. Crazy to pay for her cartload of processed, trans-fat-laden crap. And she didn’t even have her credit card out, ready to swipe.

I swear, some people. Sure lady, hold up the entire line so you can get your cookies and be unprepared to transact business. Egads.

But that’s not all — when Ms. Crazy finally got around to digging her credit card out of her wallet, she suggested my shopping cart was in her way. And she said, “Move your cart or I will move it for you.” Wow, again. I asked her if she was threatening me, and she said it sure sounded like it. So I decided to treat her like the child whose behavior she was modeling and said, “As soon as you ask nicely, I will happily move my cart.”

Ms. Crazy clearly doesn’t like people who establish boundaries. She told me to move my f-ing cart and then she shoved the cart a little bit. Pathetic.

I really wondered about the right parting shot. I chose to let it lie and didn’t say anything, but I kinda wish I would have told her how sad it must be to be her. Or that it’s not nice to talk to people that way. Or that there’s lots of good mental help available, even without comprehensive insurance.

After she left, Pat the cashier apologized to me, and Thomas said the Ms. Crazy comes in there all the time and is always like that. I joked to them both that if she was waiting for me in the parking lot, I was going to call the police. They took me seriously, though, and Pat made sure I had my cell phone and asked Thomas to walk me to my car!

And people say nothing exciting ever happens in the suburbs.

The power of a great book

Posted: January 5, 2011 | Author: | Filed under: breast cancer, kids, literature | Tags: , , , , , , , , , , , | 8 Comments

I’m completely entranced by my latest book club book, a super fun story that has me itching to find out what happens next. Not in a suspenseful, dramatic sort of way, but more in the way of great character development that makes the characters seem like real people.

I thought I might get some reading time in while sitting with my aunt at the hospital today, but we chattered and blabbed the whole time instead. After running my errands and doing a few chores, I had about 20 minutes before Macy came home from school, so I raced to the car to fetch my Kindle and get to reading.

I was engrossed enough that when Macy barreled through the door it startled me a little. She wanted to run to the mailbox to see if her latest order from amazon.com had arrived. She too has been bitten by the reading bug and has devoured a new series of books. Her eager anticipation paid off and she was rewarded by the sight of a cardboard box in the mailbox.

Before long Payton was home, too, and barely got his backpack off his shoulder before announcing he was going straight to his room to stretch out on his bed and read. He started a new series just after Christmas, and I am thrilled that it’s something other than Diary of a Wimpy Kid. Nothing against the Wimpy Kid or author Jeff Kinney — I think he has a cute product — but I like to see Payton reading something a bit more substantial. 

Both of my kids are sucked into great books, and I couldn’t be happier. My mom, the former English teacher, would be equally tickled to see her progeny so captivated by literature.

My house is so quiet it’s a little unnerving — no thumping feet up and down the stairs, no phone ringing, no door slamming, no Nickelodeon laughtrack or video game sound effects. It’s pretty great.

Cheers to 2011

Posted: January 3, 2011 | Author: | Filed under: Uncategorized | Tags: , , , , , , , , | 3 Comments

“The Old Year has gone.  Let the dead past bury its own dead.  The New Year has taken possession of the clock of time.  All hail the duties and possibilities of the coming twelve months!” ~Edward Payson Powell

I have to admit, I didn’t know who Mr. Powell is, but I sure like his sentiment. About the New Year. About the past being just that — the past. About the ripe possibilities contained in a brand new year.

(BTW, Powell was a journalist and author in the late 1800s and early 1900s who died at age 83 while on a fishing trip with his daughter.)

Every January, the dawn of a new year is exciting and full of potential. Many people make (and quickly break!) resolutions in an effort to shrug off bad habits and assume good ones. Personally, I abstain from resolutions. I’m more of list-maker and goal-setter year-round. Not that there aren’t things I’d like to improve upon, for schizzle. But I’m wise enough in my advancing age to know that a promise made at the tail-end of one year for sweeping change in the next is an unrealistic proposition.

January is one of my favorite months, as it signals the end of the hectic holiday season– which typically is not my favorite time of year– and it ushers in the celebration of the entrance of Macy into the world. (I feel the same way about May, and the celebration of all things Payton.) 

This year, this fresh new year, of all years, I’m not looking for sweeping change. The last 6 months notwithstanding, I have to say my life is pretty sweet. And even when I factor in the calamity that ensued since May, I would have to give myself an above-average grade in coping, managing, and reinventing.

Not to toot my own horn, but I think I handled it all just fine. There was a decent amount of bloodshed, but all of it was mine and I didn’t cause it to happen to anyone else (namely Dr S, who could have suffered at my hands more than once!), so that’s a good start. I made some new friends, always a good thing, and learned an entirely new vocabulary. I like to think I passed the “Eleanor Roosevelt test” in which a woman is like a tea bag: you never know how strong she is until she gets into hot water.

So I won’t make any resolutions for this newly minted year. I will resolve, however, to keep on keeping on. To not let the turkeys get me down. To keep on truckin’. To mind the gap. To live free or die. To do unto others. To keep calm and carry on.

And my new favorite platitude: 

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