Friday, May 18, 2012

The Morphine Diet is Over

               Two weeks have passed since my mastectomy and I am doing rather well.  I owe a large part of this to my aunts, friends, and family who came to sit and take care of me for the first week after surgery.  One aunt needs particular thanking as she actually moved in to take care of me even though the morphine frequently made me rather ill.  I only took it for a week and decided that the pain was easier to deal with than the whole being ill part (at least I get to keep my figure?).  I am much happier these days and far more lucid (yay for being able to remember things!).   I also want to thank all of the lovely people who sent me flowers and cards.  I love waking up surrounded by flowers and encouraging words.  Thank you. 
                Mastectomy is a scary concept, but to be honest it is not nearly as bad as I thought it was going to be.  Sure, I now have a large numb section under my arm that I have been assured will shrink down to just my armpit (so yay for numb armpits!) and a permanently damaged and rather painful nerve that again, I have been told will heal but never be completely normal (at least the shooting pains down my arm will stop!), but other than that and the fact that it is very difficult to lift my arm above my head it is not that bad.  On the bright side surgery was a complete success.  They ended up leaving almost all of the skin on my breast (deep sigh of relief because that’s oddly enough not numb and very normal) and except for the GIANT scar across my breast and the missing areolar complex and everything that was once inside that skin, my breast is sort of still there.  Even my two little moles!  Hopefully when all is said and done I will feel sexy again and maybe, just maybe, have a little of that thing called sex appeal. 
                I guess success is a relative term depending on your perspective; loss of a beautiful breast versus the complete removal of cancer.  As far as I am concerned success means that the cancer is gone.  The incredibly sweet and nationally renowned breast specialist removed the tumor (Sven was a whopping 4.5 centimeters) and all the tissue around it, also known as “margins” in the medical world as well as seven of my lymph nodes.  The margins all came back as negative meaning no cancer.  The lymph nodes, which are way more painful to have removed (literally nerve wracking), technically all came back as negative too.  I use the term “technically” because one out of the seven did have some isolated, but non-metastasizing, single cancer cells.  In other words the cancer had started to spread to one lymph node (if you will recall Minerva from an earlier post), but my doctor guesses that the Adriamycin Cytoxan chemotherapy cocktail that they gave me for my first eight rounds of chemo did its job and stopped the party.  These single cancer cells still count as negative which is freaking awesome and damn lucky.  My doctor was also relieved.  He told me that this improves my prognosis significantly and lessons the chance of recurrence, which hopefully will not happen.  I will do my best from now on to keep it from happening[i].  His assistant also came out and gave me a hug, which was touching.  Especially after not being sure what would happen if they were unable to get all of the cancer and it had spread.  If it had spread I would probably be panicking as I only responded to the one chemo cocktail and you can only be on that one for so long before it causes other problems such as heart and kidney failure.  However, we don’t need to think about that because the surgery was successful. 
                In addition to the mastectomy I also had reconstructive surgery.  That’s right, three different surgical procedures in one day.  I think I deserve some sort of prize.  Oh , wait, I get to live, never mind. I could tell you that it was all a piece of cake, but reconstructive surgery hurts and morphine and I do not get along.  On the one hand I did not have to wake up completely without my breast because they were able to save more skin and therefore the plastic surgeon was able to pump up my tissue expander a bit (one A-sized breast and one C-sized).  Potentially this is far less scarring than waking up with absolutely no breast. 
                On the other hand, reconstruction really hurts.  Imagine have a large almost flat object like a small, oval plate placed under your pectoralis major muscle while wearing a bra with the most uncomfortable underwire in the world.  Then imagine that large, hard object rubbing around against your ribs like a bad attempt at playing a washboard.  However, it gets much better and that feeling goes away.   A tissue expander is essentially a large balloon that starts out flat (note the plate analogy above).  The plastic surgeon gets to fill it up with saline solution every couple of weeks and the flat bottom curves to shape around your ribs.  I had this done on Tuesday and it helped the washboard feeling immensely.  It’s much better when things contour to your body than work against it.  However, the washboard feeling was quickly replaced by a very full feeling.  The balloon pushes forcefully up against my pectoral muscle in order to expand it.  It also presses against my ribcage and lung, making it very hard to breathe.  Do you know what happens when you try not to breathe or try to take short, shallow breaths?  You yawn.  I never thought that yawning could be painful.  This feeling eventually goes away because your body forces you to breathe and therefore, stretch your muscle.  Except for a very tight I-just-spent-too-much-time-at-the-bench-press- feeling, everything is okay.  That, I have been assured, also goes away in just a few days or so.  So now my mission is to be able to lift my very sore arm above my head and return to my yoga like ability to grasp my hands in the center of my back or put on a hoodie.  I’ll settle for whichever comes first.  I also need to make it through a couple more bumps of saline and a summer of radiation therapy.  In another year or so I get to complete my reconstruction with brand new breasts!  Which, I have to wait a year for because they want the skin on my right breast to heal and recover as much as possible.  So one year of balloon boob is not so bad.  There is definitely a light at the end of the tunnel. 
                Although I see a light at the end of the tunnel, I still feel uncomfortable.  Technically I am still a cancer patient and have about two months of treatment and two or three more surgeries left.   However, I also no longer have metastasizing cancer inside of me.  It feels so strange.  I do not feel cancer free.  I’m not sure if I ever really will.  I am currently still in chemo-induced menopause and therefore an infertile twenty-three year old and might be infertile forever.  They also do not want me to have kids for at least five more years.  However, most women in my age group are able to have children within two-to-three years after treatment.  Not that I want to have kids any time in the near future, but I would like to have the option.  Also, for the next year or so I am still undergoing treatment and waiting to be operated on and for the next five years I will be taking pills to suppress my hormones.  I will also have to have blood tests and checks for tumors by my doctors for the rest of my life.  To say “I don’t have cancer anymore” just feels wrong.  So technically, I do not have cancer, but I am a cancer patient.  I am in remission and I am recovering.  My hair is growing back (I look like a fledgling bird) and my breast is in the process of reconstruction.  The surgery was successful and at the moment I am okay and desperately hoping that I will stay that way.    

[i] For further information on how to prevent cancer through personal habits please read Anticancer, A New Way of Life by David Servan-Schreiber MD PhD.  It is a fast read, I promise.  

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