Stop the ride: I want off!

Posted: March 25, 2011 | Author: | Filed under: breast cancer, infection | Tags: , , , , , , , , , , , , , , , , , , , , , | 17 Comments

Was it really just yesterday that I blogged about how I rarely have trouble coming up with a topic about which to blog because my medical life is such an extreme cluster? Yes, I believe it was. Is it weird to quote yourself? Hope not, ’cause here goes:  “…the topic du jour is dictated by the most recent medical flare-up, break-down, or blow-out. Sometimes there’s an embarrassment of riches in the complication department.”

Really??? Ya think? I especially like the “flare-up, break-down, or blow-out” part. I really appreciate a good turn of phrase, even when it’s describing my own hot mess.

Although I would love to parlay this instance into a new career as Madame Z, the all-knowing and all-seeing teller of fortunes, I know I’m not prescient. Oh how I wish I were, and I could see how this complicated tale would end.

I got some news yesterday that well, for lack of a better word, sucks. Just sucks. This week has not been good. I could blab on about all the reasons it’s not been good, first and foremost my own deranged impression that by this point, 3 weeks post-reconstruction, that I’d be on the mend and getting back to my normal life. Hahahahahahahahahahahahahaha. So funny. So deranged. So sad.

I won’t keep you in suspense, although the childish side of me thinks if I wait a little longer to spill this bad news, it won’t be entirely real. There is a moment of suspending the two worlds, the wished-upon-a-star-for-best-case-scenario and the hard-core, cold reality of bad news crashing through some already pitifully low reserves of cheer and optimism. That moment before speaking or publishing the reality of the latest bad news is precious, as it allows me to believe for just a moment that in this 50-50 shot, the odds may finally turn out to be in my favor. I’ve had some statistically unlikely things happen (cancer diagnosis at age 40, no family history, post-mastectomy infection), and I’d like to think that the great karma wheel is spinning my way.

But alas, it is not.

The news of my latest pathology report tells me that the giant karma wheel is not only refusing to spin my way, it’s come unhinged and is crashing toward me.

Smoosh me now, great wheel. Just get it over with.

The week began with a needle aspiration and the culturing of fluid to confirm or deny my suspicion that the infection was presenting itself. Dr Spiegel held out hope that these symptoms were just part of the normal healing process after a long, complicated reconstruction surgery. She wasn’t around this past summer for the infection saga.

The pathology confirms that I have a MRSA staph infection. In addition to the mycobacterium that is my ongoing nemesis. If you feel so inclined to learn a bit more about these bugs that make me want to cuss nonstop and invent new ways in which to curse and rant, just click on one of the handy links. If the text is a color other than black in this workspace, you can click it and get all the info you can hold on whatever fascinating topic is at hand. Today the topic is bacteria, followed closely by cussing and sticking one’s head in the oven.

A staph infection is sucky enough, but an MRSA is worse. It’s drug-resistant and hard to treat. The mycobacterium is very drug-positive (like me) and not hard to treat, but hard to kill. It moves slowly and reproduces slowly, so it doesn’t often avail itself to the stream of antibiotics entering its domain every 12 hours. The drugs keep coming, but don’t break through very often. Hence the need for the long-term antibiotic regime. 225 days long and counting. It’s also hard to tell if it’s cured. The best way to tell seems to be stopping the antibiotics and waiting to see if the symptoms appear.

I’m still waiting to hear what my infectious disease team plans to do about this latest development, but suspect it will involve adding either vancomycin or zyvox to my minocycline & bactrim habit.

No, we don’t know where this staph infection came from, if it was contracted during surgery or was already there. I think it was already there. Way back in July, when the post-mastectomy infection hit the fan, before the mycobacterium was diagnosed, many cultures were run. Myco is very hard to diagnose because it’s so slow-growing; it can take 6 weeks to present in a culture. By the time it’s diagnosed, you can be all better or really sick. I was really sick.  I did have a staph infection at some point this summer, so it’s possible that this is the same one and it’s been lurking around waiting for a good opportunity to become more of a nuisance. Statistically speaking, it would be crazy rare for one person to have contracted not one but two infections during surgeries, but stranger things have happened. I don’t know enough about infections to know what the relationship is between the staph and the mycobacterium: do they travel together or is one opportunistic, presenting itself when its predecessor has already set up shop?

What I do know is that the new infection is a coagulase-negative piece of junk that not only makes me feel bad physically but also worries me. A lot. I try hard not to borrow trouble and to keep the “what ifs” at bay, but adding a new infection to an already crowded field makes me worry. And the fact that the new infection is creating physical symptoms in my newly created breast is very worrisome. Dr Spiegel spoke on Monday of worst-case scenario being the need for a simple outpatient procedure to excise infected tissue, clean and debride, and stitch it up neatly. She said the biggest downfall there is that it creates another scar.

Uh huh. Yeah. As if I’m worried about another scar. Rand McNally would love a chance to copy the lines and tracks and planes that the scars have created on my chest. Any my belly. And even my poor little belly button. Sweet little belly button was just minding its own business when it was callously sliced off and stitched back on in a new location. Poor baby.

So suffice to say, another scar is the least of my worries. And having been down this road before, I know that there’s nothing simple about excising and debriding infected tissue. Especially when that tissue has already been sliced & diced, carved and stretched and pulled practically into nonexistence.

I really hope I don’t have to do that again.

Last summer, in the heart of the infection mess, I’d had it. I was done. I didn’t think I could take any more. A cancer diagnosis and a bilateral mastectomy 3 weeks later followed by a nosocomial infection was too much. 23 days in the hospital, 3 additional excision surgeries, and more missed opportunities of summer fun and precious memories that I care to recount here.

This latest surgery, the reconstruction, was supposed to be the end of all that. It was supposed to be a symbol, a port in the storm, a beacon of hope. I’m not a big believer in panaceas, but this was supposed to be it for me. One last excision and debridement of the infected tissue, exactly 6.2 liters of antibacterial wash, healthy tissue transplanted from my belly, AND a brand new blood supply, a la microsurgically transplanted blood vessels was supposed to fix all my troubles and get me from victim to survivor.

What a load of hooey.

I’m gonna have to invent some new cuss words.

Just another day in paradise

Posted: March 22, 2011 | Author: | Filed under: baseball, breast cancer | Tags: , , , , , , | 8 Comments

To me, paradise looks something like this: 

Insert a comfy chaise lounge and a pitcher of perfectly mixed margaritas or a bottle of Vueve Cliquot, and I’m good. Add a compelling novel I’m really good.

I can’t conjure up a photo that shows the opposite of my version of paradise, but whatever it is, I’m smack-dab in the middle. Instead of sitting beachside on the chaise, staring out at a peaceful blue sea and feeling the warm rays of the sun on my skin, I’m still in my jammies, back in bed, feeling rotten with no end in sight. Not complaining, just explaining.

This is the portion of the program in which I make a quick mental run-down of all the things that are going right these days. The list is shorter than I’d like, but my expectations are high, and it’s good to have a little perspective.

Sadly, once my blessings have been counted and perspective delivered, the realization of my situation sinks in. Sure, it’s one more week of convalescence out of my entire life. One week isn’t much, right? But the days are long, and the frustrations grow with all the things I still can’t do. Add to that the fact that I still have the drains, when I really, really, really thought I’d get at least one of them pulled yesterday, and I’m blue. Knowing that I will have the drains for yet another week makes me bluer still.

It’s my own damn fault for setting the bar so high, for having the audacity to expect to be nearly well by the 3rd week. I was fully prepared to dedicate two full weeks to feeling crummy, walking hunched-over, aching all over, and feeling like a full-blown invalid. I could give up my independence and my car keys for two weeks, no problem. Those expectations were reasonable. The DIEP surgery was intense, but I was ok with that.

But then I snuck my Super Girl cape on over my hospital gown. After the agony of getting in and out of bed the first few times passed, I spread that cape across my shoulders and pulled it tight around the 17-inch-long scar on my belly (yes, I measured it and no I’m not exaggerating it. Those of you who have seen it know. And I apologize if your retinas were burned by the reality of my gutting).

My cape and I powered through the requisite hospital stay, and I got home a few days early. Once home, the progress rolled on and I was on the mend. This was do-able. This wasn’t so bad. Recovery was within my grasp. Every day got a little bit better, and I began to think the worst of it was behind me.

I packed up my cape, thinking I no longer needed superpowers and that I could return to “normal.”

Super Girl is not known for her brains.

That fast-tracked recovery came to a screeching halt with the appearance of the divot in the newly created right breast. This was troublesome because it was in the same spot as the post-mastectomy infection, aka my arch nemesis, mycobacterium fortuitum. Oh how I despise that bacteria. The only good thing about it has been the education it has forced me to undergo, and the addition of words like nosocomial and gram-positive will surely help my Scrabble game. The divot was followed by a fever, then hardening in the previously soft newly created right breast, and rounded out by some intense pain in the area around the remaining right drain.

In other words, paradise lost.

It has been widely reported that I’m a very impatient patient. These reports are true. I’m no good at convalescing and have no patience for the slow pace and endless days of non-productivity. The list of things I’m not getting done is long, very long. I try not to think about the process of digging out from under this period of doing nothing; that’s way too depressing. I don’t even look at the calendar anymore because there’s nothing on it but doctor’s appointments, and I don’t need the reminder of all the things I’m missing. My tennis team and Payton’s Little League team both forge on through their seasons without me. I haven’t seen a baseball game yet, and even though my poor boy is wearing the dreaded Yankees uniform this season, I’d still like to see him take the field, step up to the plate, and grace my favorite spectator sport with his presence. I would really like to be just another parent at just another game, bum aching from the metal bleachers. I miss the sights and sounds of the ballpark, and in my current state, there’s no telling when I’ll make it there. Opening Day ceremonies are Saturday, and my little boy gets to march with his All Star team from this past summer, with their Sectional and District champion banners. I missed the entire summer of baseball because of the post-mastectomy infection, and here we are in the midst of another season, and I’m still on the DL.

One step forward, two steps back.

Maybe I’d better unpack that cape. I think I’m going to need it. 

$82,996.75 later…

Posted: March 18, 2011 | Author: | Filed under: breast cancer, Surgery | Tags: , , , , , , , , , | 11 Comments

According to the latest hospital bill, that’s how much my reconstruction cost. Well, at least phase 1 of reconstruction. More phases to come, but let’s not even think about that now; I would hate to stroke out this close to happy hour on the last Friday of spring break.

Here’s the breakdown, in case you’re curious; please note the absence of any fees for the surgeons. I can’t even begin to imagine how massive those costs are, so let’s say for now that the Drs S did an amazing job and I couldn’t put a price on their services if I tried.

ICU Surgical: $9,312.00

Radiology (don’t recall any of that; must have been asleep): $359.00

Medical Surgical Supplies (nice & vague, huh?): $18,117.00

Laboratory: $12,785.00

Pharmacy: $4,306.50

OR Services: $22,550.50

Anesthesia: $9,220.25

Intermediate Care: $2,586.00

Respiratory Services: $147.50

Pathology Lab: $3,607.00

And finally, the most puzzling charge of all:

Patient Convenience: $5.50

WTH?? If anyone knows what “patient convenience” is, and why it costs $5.50, please do tell. I can assure you there were precious few things about that procedure that were actually convenient.

I would have expected my pharmacy fee to be much higher. Maybe as a repeat customer, I get a discount on morphine.

Milestones

Posted: March 15, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , , , , , , , , , , , | 8 Comments

I just realized that Sunday was 10 months exactly since my mastectomy. And tomorrow will be 2 weeks exactly since reconstruction. I’m trying hard not to think about the fact that exactly 3 weeks after the mastectomy came the infection, which landed me back in the hospital just as I was getting my life back, and ended up costing me 23 days of incarceration (hospitalization); 3 vacations (Duke girls’ trip to Lake Tahoe, to Tyler for Payton’s All Star team’s state championship, and our annual visit to Boston and Salisbury Beach); 3 more surgeries; 10 days of twice-daily IV antibiotic infusions at home; and introduction to and hatred of Sucky, the wound vacuum. All in one summer. I’m sure that nasty infection cost me more that what’s listed, but those are the highlights.

I’m trying, really trying, not to think that a catastrophe is coming. I’m trying not to wait for the other shoe to drop, for the bottom to fall out, and the walls to cave in on this recovery. It’s a fragile peace. Very fragile.

Two mantras run through my head: It’s Temporary, and Don’t Borrow Trouble.

The first comes from Jenny, my survivor-sister mentor who has walked this walk, and then some. Her kids were 7, 5, and 1 year old when she was diagnosed, and like me, her case was anything but textbook. Hers was way worse than mine, and we veterans do like to compare and contrast. But she not only survived, she thrived, and she’s a shining example for me every single day. Now that I’m getting closer to being “done” with this “cancer journey” I appreciate her example even more, because she’s my tour guide for L.A.C.: Life After Cancer.

The second mantra comes from guest blogger and night nurse Amy Hoover, and along with her charging me $10 for being difficult, she reminds me to avoid looking for the bogeyman. Ignore him, assume he’s moved on. I suspect all survivors have a little bit of pessimism in them, no matter how chipper they seem. Yes, I’m glad to have been one of the lucky ones, who found it early and can bask in the security of single-digit recurrence rates. And yes, I do try to look on the bright side, count my blessings, and walk on the sunny side of the street (as my mama used to say). In general, my side is blindingly bright, my blessings are innumerable, and I need SPF 70 for the powerful rays on my side of the street. But the thoughts are still there. Sometimes.

Sometimes thoughts of “what if?” fight their way to the surface and take giant gulps of pessimistic-filled air. Those gulps sustain those thoughts as they traverse my grey matter and circumvent the rational side of my brain that tells them to hush up, quiet down, and go away. The rational side of my brain fusses at those thoughts to beat it, get outta town, and quit plaguing me with doubt, worry, and fear. And usually, it works.

But sometimes, instead of celebrating the milestones and thinking about how far I’ve come, those thoughts prevail. Instead of holding my head high even though my back still isn’t completely straight from the giant incision on my belly, I cower a little. Just a little, because I absolutely despise cowering. But sometimes my irrational brain takes over and reminds me that there are no guarantees in life, and there certainly is no travel insurance on this “cancer journey.” I’m the poster child, after all, for doing everything right lifestyle-wise yet still being crapped upon by the giant cancer bird in the sky.

You know me, though, and I’m not about to let some giant bird or some niggling thoughts stop me from living my life. And living it out loud. Today I will celebrate being a 10-month survivor.

Cranky, irritable, and just plain bitchy

Posted: March 13, 2011 | Author: | Filed under: breast cancer, cancer fatigue | Tags: , , , , , , , , , , , , , , , , , , , , , , , , | 13 Comments

That’s how I feel today. Don’t say I didn’t warn you.

If you’re not in the mood to read something scathing, if you’re feeling a little frail today, or simply don’t like bitchin’ & moanin’ then I suggest you move on, because I have a powerful need to get it out. Bleeeeeeeeeeeeeh.

Don’t know what set this off, and in my current state of utter bitchiness, I don’t really care. I’m just feeling pissy. Been fighting it since I woke up this morning, and am only 4 hours into it, so it’s gonna be a long day. I’m not too proud to call for help in the way of a bloody mary followed by a bottle of champagne followed by a Shock Top or two followed by an extra-tall vodka tonic with extra lime. Yeah, yeah, yeah, I know that alcohol isn’t the answer, and in many cases actually makes the problem worse, but today I don’t really care, and if you want to lecture me about the dangers of overindulging or how alcohol consumption is tied to increased rates of cancer recurrence, don’t bother. I already know that. But some days it just doesn’t matter.

Today is definitely one of those days.

The straw involved in this particular breaking of camels’ backs came when I decided to spend a little time mindlessly surfing the blog-o-sphere this a.m. in search of humor, inspiration, and distraction from my wickedly bad mood. There are a lot of good blogs out there, and if I ever get out of this funk, I plan to create a blogroll on my blog’s homepage, to share some of the greatness I’ve found. And I will do that. Y’all know me, once I set my mind to something, I do it. ‘Nuff said. But for now, I am waylayed, stymied, stopped in my tracks in my pursuit of a mood-elevating stint on the ‘Net.

Why? Because in the span of 10 minutes I came across 2 blogs that tell me I have to be invited to read before I can even click one single time to see if it’s a blog that appeals to me. WTH??? I have to be invited to access a blog I don’t even know if I’m going to like, much less return to or perhaps follow regularly? WTH???

Ok, on a normal day (whatever the hell that is), I might come across an “invitation only” blog and think, hmmm, that’s interesting, I wonder why it’s configured that way? I’m pretty new to the blogging world, and there’s a lot I don’t know about the wide and wonderful world of blogs. On a normal day, I might wonder: Is this invitation-only blog’s readership so huge that they have to separate the wheat from the chaff? Does the blog’s author feel particularly strong about privacy, as opposed to airing her dirty laundry, the way I do in my little blog? Is she just snotty and isolating in general but in particular toward other BC survivors who are trying to muddle along in this wretched “cancer journey” and seeking solace or answers from those sister souls who’ve been there before?

Maybe that blog author is just a bitch.

This blog author certainly is bitch-y. But I don’t think I’m a bitch. Maybe I am, but today, who cares? I don’t really think that other blog author is, either, although I can’t say for sure since her stupid blog is by invitation only. Screw her, I don’t want to read her stupid blog anyway. I’m gonna pack up my flaming bad mood and leave her holier-than-thou protected blogsite. Bitch.

The post-op instructions that I brought home from the hospital mention something about mood swings and periods of intense emotions. Apparently it’s all part of the “cancer journey” and in particular, the recovery from the major surgery required to try and put the pieces back together after a firestorm of mutated cells banded together to create some bastard tumors that burst through my milk ducts and invaded my system. Rude.

Maybe this is the mood-swing-and-intense-emotion portion of my recovery. Maybe this is the culmination of the hormone frenzy that goes on in my tired, taxed, put-upon body every single day, and today the frenzy got the best of me. Maybe this is totally normal for those of us in the midst of a “cancer journey.” Maybe this is just an ordinary, run-of-the-mill bad day.

Maybe it’s all of the above. One thing I do know for sure is that I am sick, really sick, supremely sick of all of this. I’m not a good patient on a good day, and I’m a hellabad patient on a bad day. Oh how I am sick of all this. Sick of the pain, yet leery of the pain meds. Sick of the drains yet aware of their necessity. Sick of the right drain leaking yet too pissed off to attend to it. Sick of the pile of dirty clothes with patches of bloody spots from the damn drain leaking, yet not at all motivated to start the laundry. Sick of the fact that I need to start the laundry, yet still haven’t been cleared to do any chores. Sick of chores needing to be done while I’m not cleared to do them, yet unwilling to seek help. Sick of having to think so hard about what to wear because of incisions and drains, yet unwilling to stay in my jammies another day. Sick of how hard it currently is to do the basic everyday things (like washing my face), yet not satisfied with the “it’s temporary” mantra that usually calms me. Sick of wondering if raising my arm high enough to reach a glass is the motion that will tear the micro-stitches and disrupt the healing of the micro-surgery, yet thirsty enough to reach anyway. Sick of worrying if I’m doing too much or being too still, yet too lazy to find the answer. And I’m sick–really sick–of sleeping on my back. I’m a side-sleeper but I have to sleep on my back, yet again, because I can’t lay on my incisions. Dammit to hell, I can’t even get comfortable at bedtime.

I’m 11 days into this recovery, and while my rational self knows that 11 days isn’t long enough to heal, I’m impatient and fidgety and ready to move on. But then I realize that when it comes to moving on, I don’t really know what that means. Baby steps aren’t my style. I’m more apt to pitch headlong and headstrong into something and just get ‘er done. Only, in this case, I don’t know how to get ‘er done. Have no clue. I’ve been on this “cancer journey” so long that I don’t exactly remember how to get ‘er done. Don’t even know what it is I’m supposed to be getting done.

All I know is that I’m cranky, irritable, and just plain bitchy today.

1 week ago today…

Posted: March 9, 2011 | Author: | Filed under: breast cancer, drugs, food, infection, Surgery | Tags: , , , , , , , , , , , , , , , , , , , | 11 Comments

I was out cold in the OR, having unspeakably nasty things done to my body to restore the damage wreaked by the post-mastectomy infection. Whew!

The first couple of days of week 1 are pretty hazy, thanks to my BFF morphine. Love that stuff. But my BFF knows its proper place, and we have short but infrequent get-togethers. This time around, my BFF gave me a terrible headache, which was quite rude, so I bid adieu to the pain pump as fast as I could.

Let’s start from the beginning. Or as much of it as I can remember. Readers, feel free to chime in when you notice I’ve left something out. We got to the Medical Center on time (6 a.m.) and I got right into my pre-surgery room. My beautiful gown and compression stockings were waiting for me, but I waited until the very last minute to don them. After some precursory steps, like accessing my port for the administration of the really gooood drugs, a gaggle of white coats entered the room.

Dr Spiegel led the way, with her PA Jenn next, followed by their resident, Dr McNight, then my favorite plastic surgeon. He was the only guy in the room. Yahoo, girl power! He had a cool wooden box in his hand and when I asked if it was a present for me he gave me one of his looks. Someday he’ll appreciate my humor. Inside the box was not a present, but his loupes, which sadly he didn’t offer to model. I’d love to see him in a pair of goofy glasses.

Dr Spiegel and Jenn started marking my belly and I’m so mad I didn’t think to take a photo because it was cool. They used a blue sharpie for arteries, a red sharpie for blood vessels, and a black sharpie for incision lines. Lots of arrows and lines later, there was a roadmap of sorts. Very cool. At one point, Dr Spiegel wasn’t happy with an incision mark so she had Dr McNight scrub it off my belly with alcohol and re-do it with the black marker.

After that it was time to head to the OR, and they must have given me a cocktail in the pre-surgery room, because I don’t recall anything after the sharpie party. When I woke up, some 8 hours later, I felt pretty good…but it was because I was wrapped in the loving embrace of some big-time anesthesia. Dr Ashmore, my hand-picked anesthesiologist, did a fantastic job of putting me to sleep, and more importantly, waking me back up. It was good and restful.

I’m not too sure about whether I was in a recovery room or went straight to the ICU, but once I got to ICU I recall that it was HOT. And I’m a Texas girl, so I know about some heat. The docs had warned me that the room would be warm, to help my newly transplanted blood vessels learn to regulate themselves in their new northern home. But wow, was it hot. Between the high temp, the two heaters, and the squeezing of the compression hose, I was roasting. I tried to be nice about it, and I think I only lost it once, when I begged one of the ICU nurses, probably Carol, to please please please just crack the door and let some AC in. Just for a second. She declined my request.

I spent the night in ICU, but thankfully the flaps, aka former belly skin & fat that were magically transformed into breasts, behaved and there was no drama (other than me begging Carol to crack the door, turn down one heater, turn up the thermostat or bring me a gallon-sized frozen margarita). The flaps had to be checked every hour, yes every hour, with a hand-held doppler. There were (until yesterday) some wires stitched on top of my chest that somehow transmitted audible sound of the blood rushing through my newly transplanted blood vessels through the doppler. It sounded a lot like a fetal heart monitor. And we heard it a lot. My flaps were cooperative, and the nurses were able to hear the blood rushing almost instantly after putting the doppler onto my chest. One nurse told me that sometimes it took 20 minutes to find the sound. I started to panic after a few seconds of not hearing it, so can’t imagine the size margarita I would need if it took 20 minutes to register.

The ICU room had a wall of windows with mini blinds, and the nurse was right outside the door at a desk looking into my room if not attending to her one other patient. Some people might think that would make you feel very safe and catered to, but it made it hard to sneak anything by her because she was always watching. If she wasn’t watching, somebody else was walking by. It was a constant parade of doctors, residents, nurses, PCAs and other people peeping into my room.

I got released from ICU after some really delicious jello and a contraband peanut butter & jelly sandwich (liquid diet…pffft) into a regular room on the 8th floor of Dunn Tower. Lovely view out the window of the heart of the Texas Medical Center, and more importantly, no heaters. It wasn’t exactly chilly in the new room, but so much better than the ICU room. Nevertheless, I did beg to have the tight, scratchy, hot compression stockings removed. Those nurses were not swayed by my shameless begging.

Apparently the docs were pretty pleased with their handiwork, and if you missed Trevor’s and Amy’s guest blogs while I was too loopy to post, go back and take a peek. Long story short, the flaps were cooperating, the morphine headache abated, some regular food arrived, and life rolled on. At some point they moved the flap checks to every two hours instead of hourly, which was mighty nice. It’s amazing how your perspective changes in a situation like that. After umpteen hours with no food, a simple PB&J was a delicacy. After being awake most of the night, a short cat-nap seemed a decadent luxury.

I’m sure I said some goofy stuff and probably offended someone at some point with my off-color humor. Apparently I channeled my mom, too, telling my friend Laura who works at Methodist and who visited me several times a day, “Thanks for dropping by.” Every time she came by. I was just being mannerly and didn’t realize I’d seen her a few hours previous.

There are conflicting reports on how the turf war between the Drs S played out. All parties are being quite cagey on the details of who did what part of the surgery, and like a good murder mystery, we may never know who real killer was. I have my suspicion, but even asking point-blank hasn’t garnered an answer, so we may have to label that information “permanently classified.”

I did get to skate out of the hospital a few days ahead of schedule, and even though I received impeccable care, I couldn’t wait to get out of there. Coming home is always sweet, but never as sweet as when I’m leaving a hospital room.

I have more mobility than I did after the mastectomy, but not as much as I’d like. The first few times I had to get up without using my arms but relying on my legs and abs, the hip-to-hip incision on my tummy protested mightily. But it got better every time, and now I do it almost without thinking about it. Almost. I still can’t walk completely upright because the incision is still very tight, but I’m not quite the Quasimodo I was in the hospital. I get a bit straighter every day.

I came home with 6 JP drains this time, and had to upgrade my VB sling bag to a bigger VB bag that could accommodate the drain party. I knew from last time around that 4 drains fit nicely, with a little extra room for my Blistex, some folding money, and a teeny ziplock bag of pills, should they be necessary. Six drains would have burst my handy little bag right open. Wonder how many drains this lady is toting in her VB bags?

I had my first real shower today, not counting the seated variety the hospital offers. Again, it’s the little things we take for granted. I’m down to just 2 drains and back to my sling bag, thanks to Jenn removing the 4 drains up top yesterday. She gave me a good report; everything looks good and is healing nicely. 

While I feel a whole lot better and am ready to get back to normal, my handlers think one week post-op is a bit premature to jump right back into the day-in, day-out routine. I am trying to take it easy. I’m resigned to the fact that I’m back to one outing a day for a while, and sadly, a doctor’s appointment counts as an outing. Yesterday I had a small entourage escort me to see Jenn, and we had a bite of lunch (sans margaritas) beforehand. The handlers insisted on snapping a photo of this maiden voyage, and there was some talk of me earning a margarita for every device I had removed at the subsequent appointment. Between the two doppler wires and the 4 JP drains, somebody owes me 6 margaritas. No salt.

Although I complain about going to the med center, there’s always something interesting to see along the way. Getting out of the suburbs is a good thing, and there’s a whole ‘nother way of life in this big city of ours. Last time I was at the med center for some testing, I saw this car and had to take a picture, to show Macy. I knew this car would appeal to her:

She loved the polka dots and said she’d like to have that car, then she saw the back and said forget it. Fickle.

Yesterday on the way home from the med center, I saw this:

and had to snap a picture. Yes, it is a zebra car, complete with a long tail. Gotta love the big city.

Seriously???

Posted: March 7, 2011 | Author: | Filed under: breast cancer, Surgery | Tags: , , , , , , , , , , , , , , , , , , , | 4 Comments

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

And that doesn’t happen very often.

As you lovely readers know, I usually have a lot to say, about a variety of topics, and one of my favorite things about blogging is being able to blab away about whatever tickles my fancy at the moment. Sometimes silly, sometimes ticked off royally, sometimes serious, but rarely speechless.

When I saw yet another envelope from the Methodist Hospital, I didn’t think much about it because I get a lot of mail from that fine place. Between the bilateral mastectomy and the post-mastectomy infection, I’ve spent a lot of time at Methodist, both in Sugar Land and at the Medical Center. Getting mail from Methodist is nothing unusual. (If you click on the Sugar Land link above, you’ll see a pic of several doctors on the Methodist SL home page. The dark-headed one on the far right is my oncologist, Doogie Howser. Yes, he is that young, and yes he is that cute in real life.)

But this letter is definitely unusual.

Now I’m not dogging Methodist. I’ve had most excellent care there on all of my visits, and I don’t for one second take for granted the supreme luxury of having such esteemed medical care right around the corner (Sugar Land) and a short hop down the toll road (Med Center). I know that people come from far and wide to seek care at the places that are easy drives for me. So let’s be clear that I’m not dogging Methodist.

One of my favorite things about Methodist SL is this:

Love that. Hell yes, I should get special parking, right up front, at the breast center. Even though until just a few days ago I had no breasts, I still liked the special treatment that Methodist SL affords its breast care patients. Wish the grocery stores and Target would follow suit.

But back to the letter.

I know, I know it’s a terrible picture. The iPhone camera stinks, but it’s convenient, and let’s remember, people, that I am 5 days post-op here, with 6 JP drains sprouting from my body, and today was my first day without any pain pills, so keep your comments about the shoddy photography to yourself. This is not a photography blog, after all. I probably shouldn’t even be typing yet, but I’m dedicated to bringing severe belly laughs to you, my lovely readers, so you’re welcome. 

Since it’s such a shoddy photograph, let me reiterate the juicy parts: The Methodist Sugar Land Hospital Breast Center’s records indicate that based on my US mammo f/U uni performed on March 22, 2010, it is time to schedule a routine screening mammogram.

Oh, you mean the mammogram last March that set off the chain of events, preceded by my annual well-woman exam, that led to me being diagnosed with breast cancer at age 40? That mammogram?

The letter goes on to tell me that I need to be aware that many breast cancers do not produce symptoms. That “early detection requires a combination of monthly breast self-exams, yearly physical exams, and periodic mammography according to your age and physician’s recommendations.”

And that I should contact Methodist Sugar Land Hospital Breast Center at 1-800-HOW-STUPID-IS-THIS to make an appointment, and they thank me for my cooperation.

Wow.

The irony is stifling.

On one hand, it’s nice that the MSLHBC is so on top of things as to remind its patients that it’s time to come in for the good old smoosh & squeeze. Lots of women need reminders, and the hospital certainly should not be tasked with knowing I don’t happen to be one of those women.

On the other hand, it’s pretty hilarious and utterly ridiculous. And scary, too; don’t forget scary: the idea of anyone touching my newly sculpted chest, much less putting it through the greatest flat iron ever, makes me very, very afraid.

Thank you, Methodist, for the reminder. I will get right on it.

Back in the saddle

Posted: March 6, 2011 | Author: | Filed under: breast cancer, Surgery | Tags: , , , , , , , , , , | 7 Comments

Well, sort of. I’m sitting at my computer but feel pretty fuzzy-headed. At this time on a Sunday morning, I would normally be on the tennis court, earning my beers after 3 sets, but there’s a new normal nowadays, and tennis will have to wait.

I figured I’d better get back to blogging before my guest bloggers took over permanently, making me a redundancy. Big thanks to Trevor and Amy for filling in for me while I was unable to think straight or type coherently.

My handlers have established some boundaries for me, which I apparently need. Visiting hours today are 2 to 4 pm, and tomorrow from noon to 1 pm. Bring a brown bag and visit awhile, but don’t get your feelings hurt if you get kicked out. My handlers are determined to make sure I don’t overdo it; I have no idea why they think I need that.

It’s pretty great to be home, and while the nursing care at Methodist was the best I’ve ever had, nothing compares to home sweet home. No one woke me up last night to check the new skin or peek at the incisions or take my temp and blood pressure. I’m pretty mobile but still walk all hunched over. I think Amy compared me to Quasimodo. I’d agree with that characterization, but must note that I don’t have a hump on my back!  

Dr Spiegel said not to push myself to straighten up; the incision on my belly is pretty tight, and if I try to straighten up I run the risk of tearing the incision. I also need to be careful to limit my arm movement and not raise my arms above my head, because the microsurgery requires such tiny stitches that they’re easily ripped.

It sure would be nice to have a non-complicated recovery this time around. Fingers crossed.

Last night was a Good, Good Night….and it was the LAST night…in the hospital

Posted: March 5, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , | 4 Comments

Amy here.

Nancy is a changed woman!  As I type this she is walking around the room brushing her teeth.  Wow!  What a difference a good night’s rest and a little bit of activity can do!  We settled in for the night around 10 PM and she had the Norco to keep a handle on any pain. She had her “flap checks” every two hours and didn’t even need the Ambien, Ativan or the Flexeril!  I think she had peace of mind just knowing they were there at the ready.

Around 6 AM, Nancy was ready to get moving, and get moving she did!  She is able to get out of bed with little assistance (and that’s because the staff insists on that little bit!). She’s taken a long walk in the hospital corridors, had her breakfast and is preferring the chair over the bed.  I would say she is in a chipper mood.

Dr. Spiegel showed up around 7:15 to talk to Nancy about discharge.  Nancy had one main thing to keep her here and one main thing that made her want to go home.  She definitely wanted to go home because that signaled the end of the compression hose wearing!  On the other hand, she knows that she’s a busy body and it is much easier at the hospital to maintain a low profile, resting as needed and staying inactive.  Dr. Spiegel asked what she was planning to do at home and we talked all that through.  So now Nancy wants you to know, “I’m throwing these dumb hose in the trash!”  Yep, homeward bound!  There was even talk about these crazy contraptions that Dr. Spiegel says you wear around your chest called a “bra.”  Nancy didn’t know what in the world she was talking about!

She has one more dose of IV Vancomycin (1.5 hour infusion) so that is what is keeping her from packing out just yet.  She is extremely grateful for the great care that she has received at Methodist Med Center.  We both agree that this is the quietest hospital room that she’s had so far–and she was even right across from the nurses’ station!

Speaking of home.  Trevor and Nancy would like to respectfully request that today and tomorrow morning be a “hospital day” at home.  One of her main concerns about not going home just yet was that she would be tempted to generally NOT get the rest that she would at the hospital, even with those blasted “flap checks” every two hours!  That said, if you are thinking about stopping by for a visit, Nancy would like to post “visiting hours” for tomorrow afternoon, Sunday 3/6 from 2PM to 4PM.  Please feel free to stop by during those times, and even if she tries to get you to stay past 4PM, please don’t listen to her!  We all know she’s a social gal and would love to “take some tea on the veranda” for much longer than is good for her recovery process.

Her plan after discharge is to take it easy, rest often, and walk hunched over at least for 2 weeks.  She will followup with Jennifer in Dr. Spiegel’s office next week and Dr. Spiegel feels that she will unload the majority, if not all, of her drains and wires.

Here’s to a speedy recovery for Nancy.  Thanks to Nancy for allowing me to be her guest blogger and for the added privilege of being able to assist her at the hospital. It has been my great pleasure.

Her nurse is here with the Vancomycin now….

The Morning Report

Posted: March 4, 2011 | Author: | Filed under: breast cancer, Surgery | Tags: , , , , , , , , , , , | 4 Comments

Nancy had a restful night–as restful as being woken every hour can be.  A shout-out to her nurse, Amira, who was extremely capable and attentive.  Nancy did snooze very soundly when she was able. The combination of Norco and more Norco seemed to diminish her headache, although it’s not completely gone.  The pain is still there and is being managed by the Norco also.  This morning a bit of muscle tightness and tenderness in the stomach area reared its ugly head and has taken the forefront in the battle for attention.  While Nancy hasn’t actually called it pain, I think that may be the best word for it, and she did say it was a new sensation that came up today.  I bet the other stuff has diminished enough that this now gets to grab her attention.  She has bruising around the hip to hip “free tummy tuck” incision and Jennifer, Dr. Spiegel’s PA, says that they did have to work hard with her muscle layer there as well as on her chest wall so this is to be expected.  She has been given Flexeril (a muscle relaxer) to help with this and the added benefit is that it makes you VEEEERRRYYY sleepy.  So, even though at 5:15 AM, Nancy was confident that she was up for the day and we did the teeth brushing and face washing that comes with a new day, she was within minutes back to sawing logs.  Good Girl!  She has been dreaming out loud and woke asking me, “Is that due tomorrow?”  You can take the Mom out of the home but you can’t take the Home out of the Mom!

The fever is no longer an issue.  Nancy did a great job with her breathing exercises and coughing so those nurses must have been right about the phlegm.

Today is a going to be a busy day.  It started with a flurry of people in and out at shift change.  Dr. Spiegel specifically trains the nursing staff that takes care of her patients so there is only a handful of nurses who are qualified to be Nancy’s caregivers.  Her new nurse is Karina. There are promises of getting rid of her IV and a few other constant companions since she’s had the surgery.  Once that is done, she will get a shower and be expected to walk the halls at least 3 times today.  Nancy is looking forward to that since the compression stockings can be taken off during this time.

Mr. Morphine Pump has become just an extra appendage.  Nancy last summoned his prowess on yesterday’s second and final “sitting trial.”  She’s planning to shed him when she sheds the other hangers on.

It’s going to be a good day.  The staff is quite certain that the shower and ambulation will bring strong feelings of rejuvenation.  It has been mentioned twice already that she may be ready to be discharged tomorrow.  We’ll see how she feels later today and as Laura mentioned when she popped in for a quick Hi this morning, “Knowing Nancy, it might be better for her to stay until Sunday, just to keep her from doing too much.”  Yep, Laura, you are probably right about that!

We’ll keep you posted.

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