Post-surgery, day 2

I sure would like to say that today is a lot better than yesterday, but I’d be lying. I’m still very, very sore, and moving around is pretty uncomfortable. I can’t see how bruised I am on my legs because I’m snugly encased in a compression garment. I joked with my doc yesterday that he and I know each other on a whole new level now, with the pre-op business. He looked slightly confused and I was greatly comforted to think that the “new depths of indignities” as Trevor put it, didn’t seem to register with the good doctor. I know now that when he sees a body, splayed out and nekkid, he’s seeing just that — a body. Not mine or yours or anyone’s specifically, just a body.

Whew. That’s a good thing, because he saw every bit of mine. Up close and in his face. Yikes. I thought we had plumbed the depths of indignities before, with the “grab the fat” games and the up-close examinations of the fattiest regions to determine where best to cull from in the reallocation surgery. Ha. That was amateur night compared to the real deal on the big day. Anyone who’s been thinking I am lucky to get “free lipo” may well reconsider after reading this. Do I need to deliver my lecture on opportunity cost, again?

Getting marked up for surgery is not new to me. Baring my chest for the doctors is old hat, as is the alcohol-y smell of the Sharpie markers they use to draw the roadmap for cutting and stitching, as well as the feel of the Sharpie sliding over bare skin. Lest this sounds like a Nora Roberts novel’s love scene, let me assure you there’s nothing sexy or sensual about it — if a doctor is drawing on your bare skin with a Sharpie, it means you’re in trouble. The kind of trouble that can only be fixed by scalpels and sutures. There’s nothing romantic about that.

So getting marked up Wednesday for my revision surgery should have been no big deal; been there, done that. Except this time it wasn’t just my upper body that needed to be bared, it was the whole thing. Since my doc was going to be extracting fat & skin from my hips and legs, he had to well, mark up my hips and legs.

Did I mention that the surgery center is under construction, and that as I went from my suite–where I changed into the gown, compression hose, and shower cap–to the triage room–where I would get my pulse and blood pressure taken and get a needle shoved into a vein in my hand to start an IV–that I had to walk down a hallway with my surgical gown tied not so securely in the back, with construction workers all up and down the hallway? I’m pretty sure part of my backside was hanging out, but really, at this point in my “cancer journey,” I can’t be bothered with such an insignificant concern.

I can, however, be very bothered by the utter horror of standing buck-naked in front of my good friend and beloved surgeon while he maps out his surgery plan via Sharpie. Always the jokester, I tried to keep the mood light and make jokes, but if I had access to an open bottle of vodka I would have chugged like a girl in the desert. Anything to ease the embarrassment of that moment.

After I stood up for the Sharpie fest, my doc wanted me to lie down so he and Katie the surgical nurse could check that the lines were even or whatever they check for. They did their checking and calculating, and my doc left me to go scrub in. The surgery was about to begin. Katie covered my nakedness with a gown and a blanket and went to scrub in herself.

Note I have not yet mentioned the “cocktail” that the anesthesiologist provides to relax the patient before administering the hard-core anesthesia to knock one out for hours at a time. I had of course inquired about my “cocktail,” multiple times during the Sharpie fest, in fact, and was told that I would get it in the OR because they needed to prep me for surgery standing up.

Pardon me?

Prep me standing up? As in, I’ll be awake for that part? I’ve envisioned the prepping required for all my surgeries, and before too many thoughts of my leaden, sleeping body being manipulated and scrubbed down enter my head, I quickly chase those thoughts off with thoughts of puppies and bunny rabbits instead.

This time, I was to be stone-cold sober and awake for that particular horror show.

Oh, the depths of indignities just keep on getting deeper.

Once everyone was scrubbed in, someone came to collect me. I walked from my cozy suite to the OR, probably with my ass hanging out for all the construction workers to see, and entered the last level of humiliation. In Dante’s Inferno, there is no mention of the level of hell that is being prepped for surgery while wide awake, but there certainly should be. There should also be some sort of extra prize for someone with a reconstructed body — full of scars and mess and reminders of the impossibly hard road that’s been traveled — who has to display that body in the presence of strangers in order to try and reclaim some semblance of normalcy. The two males in the room, besides my doc, did a good job of averting their eyes from the trainwreck that is my body while they counted scalpels and readied surgery supplies.

I was instructed to drop my gown and stand — buck naked — with arms and legs spread wide. Not sure what the yoga pose is but I’m going to call it shamefaced patient. Two nurses, Katie & Mary, and my doc himself, scrubbed me down with betadine swabs. Katie was nice enough to warm them first, and that small kindness went a long way toward soothing my jangled nerves. My favorite doc was on high-alert against any possibility of infection. Much discussion ensued between the 3 health-care providers about who was swabbing which area of my body, and let me tell you they were quite thorough in getting all the nooks & crannies. Once I’m finally allowed to take a shower I may be scrubbing for days. There were a few commands of “turn this way,” “raise your arm higher,” and ahem, “spread your legs a bit wider, please” as they doused me with the foul-smelling but surprisingly tan-enhancing liquid. I may be splayed out like a deboned chicken (again) for all the room to see, but at least I was golden brown.

Once they had slathered me in the betadine, it was time to get on the OR table. For every one of my previous surgeries, I’ve already been in la-la land when it was time to get on the table. I don’t know how they got me onto the table in the past, but I expect someone lifted me, because the anesthesiologist had mixed and administered the “cocktail”and I was out like a light. This time, I had to be wide awake and fully cognizant of the humiliation that had ensued.

That OR table is narrow, people, and the last thing I needed after my abject embarrassment was to slip off it, all goopy with betadine. My doc was very, very specific about the sterility of the room, the people, and the table, and insisted that Mary and Katie hold my hands as I got onto the table so I didn’t touch anything. The table is high and I am, well, not tall, so we had to use a stool.  I managed to haul my carcass onto that high table without touching anything or falling off and was quite pleased with my effort when the anesthesiologist said I needed to scooch down closer to her, at the head of the table. Egads. More maneuvering and cussing on my part, then I was able to settle.

At last, the sweet relief from this latest horror show came in the form of the anesthesiologist finally giving me some Versed. I asked her to also give me something to make me forget all that had just transpired. Whatever form of mind-altering, memory-erasing drug will work, just give me plenty of it.

The Versed worked swiftly and completely, and I don’t recall a single thing beyond that point. I woke up in the recovery room, somehow stuffed into a compression garment but blissfully unaware of how that happened. I was released from the surgery center and delivered home, to bed, where I could pretend that this was all a bad dream.


Good fat

Another thing to add to the long list of things to love about me: I have “good fat.”

googleimages.com

So sayeth Dr Spiegel, who recognized the high quality of my fat at first glance. So skilled in assessing fat is she that a physical exam wasn’t necessary. No need to grab the fat; she could tell the caliber of my chunky-monkey-ness just by looking.

That’s good, because I need that fat for my upcoming revision. While the Drs S did an outstanding, better-than-expected job at reconstructing my sunken, mastectomied chest, there are a few little tweaks needed before I am “done.”

One big lesson about breast cancer and reconstruction: you’re never really done, and it’s never really over.

Much like the plight of an at-home mom in a house full of busy, messy kids, there’s always something else that needs to be done. In this case, rather than errands, laundry, and getting people to & from activities, what needs to be done is correcting asymmetry, changing shape from oblong to rounded, and filling out a few collapsed areas. The best way to do this? Suck out some of that good fat from my hips and inject it up top. 

Remember the “dog ears” left on my hips after closing my 17-inch belly incision during reconstruction? Those pesky globs of fat have tormented me the last 4 months, since surgery. They’ve gotten a bit smaller as I’ve counted calories and gotten back into the gym and onto the tennis court, but they’re still there. At last they will serve their purpose.

I wanted to get Dr Spiegel’s opinion on the best way to go about this before I went under the knife with Dr S. Since the 2 Drs S worked so well together on The Big Dig, I coveted her advice on the revision. I also knew I’d get very clear answers to my questions, as she is very good at communicating and explaining options.

She had the same ideas as Dr S for how to handle this revision. That’s all the confirmation I need. While I’m not looking forward to it (more anesthesia, pain, and downtime), it’s one more step closer to being done. Or as done as a cancer patient ever gets.

Here’s the plan: I go on vacation to Salisbury Beach for 2 weeks, to forget all about the trials & tribulations of the last year. I soak up every second of my favorite beach in an effort to make up for missing it last year. I say yes to every adult beverage offered me, regardless of time of day, food consumed, or number of beverages preceding. I revel in the balmy weather, listen to the sound of the ocean, and relish my friends’ company. I eat lobster in some form each day. I savor the traditions this trip provides my family. I thank my lucky stars that I’m present for this tradition.

Then I come home–tanned, relaxed, refreshed & slightly worried about the state of my liver–and have 2 days before my revision procedure.

I know, I know — having fat sucked out of an area you don’t want it and relocated into an area you do want it sounds like a dream come true. In theory, anyway. I would find it a lot more dreamy if it didn’t involve tools that look like this

and this

and this

Thank you, Google images, for helping me visualize the method of extraction. I’ve been looking forward to bidding adieu to the dog ears since they became a part of my body and to finally having some symmetry to my newly constructed chest, but like everything in this “cancer journey,” it comes at a cost.