Mid-February put me 3 months post-surgery after my double-mastectomies and first portion of breast re-construction. I had a meeting with my plastic surgeon to check on how everything had settled and begin talking about the next (and hopefully final) phase -- exchange surgery, which has been scheduled for this Monday, March 1st.*
*It's worth noting there, that my initial ultrasound and mammogram was March 2nd, 2020, so this final step will happen *just* under a full year from the time we first started this process. This ain't no boob job...
The next surgery is called an "exchange" surgery because they will be exchanging the strange-feeling and looking, hard as rocks tissue expanders with silicone implants that they assure me will look and feel much more natural.
In addition to the implant exchange, my surgeon will be removing my port (YAY--while I was glad to have it, I won't miss looking at that bizzare contraption!) and doing something called fat graphting. He calls the fat graphting "photoshopping", but as a regular user of Photoshop, I KNOW that digitally photoshopping is NOT the same as having fat sucked out of one portion of your body and inserted into another. Photoshopping doesn't hurt. But, I get his point, and it does help explain WHY he's doing it. Since I won't have breast tissue above my implants, they can take fat from another area of my body (my lower back "love handles", in my case) and insert it into the layers of skin above the implants to soften the edges of the implants under my skin and make my constructed breasts look more natural and less like they're just two half softballs stuck to my chest.
I'm skeptical about the benefits of fat graphting vs. the pain in recovery and bruising and compression gear required for several weeks afterward, especially since I've been told it may take several separate attempts at the fat grafting for it to "stick". A large percentage of the fat moved often doesn't "take" and re-absorbes into your body. But, for this surgery, since I'll already be put under and have forced recovery time, I figured it was worth an effort if he thinks that will help it have a better finished result. I gotta trust him. He's the pro.
I was very glad he didn't ask me to gain a bunch of weight before the surgery. I was just hitting my stride with 5 good HIIT workouts a week. I did eat plenty of Edgars orange rolls though over the past couple of weeks, because why not?
Over the past 3 months, I have VERY much enjoyed getting back to full functionality, and I'm not looking forward to another 4-6 weeks of sitting still and recovering. But I am VERY thankful to be knocking out the next, and hopefully last, big step in this cancer treatment journey.
I've spent the last week getting ready to be out of commission again for a while, and while I definitely have some anxiety about going through another surgery and recovery, this is a WHOLE different ballgame. At the end of this surgery's recovery, I should look better, not worse (which was definitely the feeling after my port insertion and double-mastecomy surgeries.) There's not a fear of what the pathology will say, and it doesn't even feel that "cancer-related." It's also the last step in a LONG list of steps that I've been going through one at a time over the past year, which feels pretty good.
The way I see it, I've made it through all of that, so I can surely get through this too. Here we go...
My work life has been severely interrupted in the past year, by cancer treatment, COVID, virtual school, my father passing away, my mom being hospitalized for two months in another state, and then my own surgery and recovery.
Over the past month, I have thoroughly enjoyed getting to (again) work with some of my closest friends and having the opportunity to combine my interests and talents to promote health and confidence to women in our city. We have a VERY talented team (not all pictured below) and it's an honor to be able to work alongside them. This past month we launched the new gym in Homewood, and even in the midst of the struggles that come with running a business in the pandemic, it has been a raging success in it's first month, largely due to the talent and diligence of this team.
For me, it's been a wonderful (and welcome) return to socialization and working on a team, and thinking about OTHER women and their health instead of just my own!
And, while it has taken me a little longer than I expected it to, this past week I have finally felt ready to return to painting signs. I painted my first round of the year this week, and it felt very good to create something with my hands again!
Whether or not the feeling lasts (because I've learned not to count on anything until it happens), it finally feels like I'm gaining my footing back and feeling like ME. I'm looking forward to fun things in 2021...as long as it continues to cooperate!
Today is about 9 and a half weeks post-surgery. Thought I should give a little update, and show off my curly pixie haircut (which is about 6 months of growth from completely bald in July 2020)!
Cancer Treatment. I saw my oncologist, who was very pleased with my surgery pathology -- no evidence of cancer! Clearly the chemo was successful. Because my initial tumor was slightly estrogen positive, as one last attack and prevention method, he recommended I take Tamoxifen, an oral estrogen receptor modulator, probably for 5 years, as long as the side effects of it don't radically affect my day-to-day. I had thought it would be 100% required for me to take it, and I expected to be taking it for 10 years. I was also very nervous about the horrible side effects I've heard and read about. But, his "try it, and if you don't have severe side effects, take it for 5 years just to be sure we did ALL that we could" prescription sounded good to me! I'm going on almost two weeks on it, and so far haven't noticed a thing as far as side effects. He said it could take a month or two to see how it affects me though. So, stay tuned on that front...
Reconstruction. As far as my breast reconstruction process, the saline fills in my tissue expanders were pretty easy. I ended up with three fills, and am currently as large as I care to be at 300cc per breast. These tissue expanders are still really strange feeling and hard as rocks, with little air pockets in a couple of places. I'm extremely thankful these aren't the final product, but at this point they are tolerable, and not painful, and to be honest, I'm enjoying the rest of my body feeling GOOD enough that I can happily hold off a few months before facing a second surgery. The implant exchange surgery will be a nice finale to this treatment plan though. I'm currently very happy with my decision to reconstruct and though my breasts won't be the "same" again, they'll be just fine once it's all said and done.
Physically. My last post was written at 5 weeks post-surgery, and I had just started to do some really low-impact exercises and stretching and walking. My body has steadily improved week over week and now has returned to what I consider to be normal--not quite as strong or as fast as I was back in March, but plenty sufficient for a 41-year-old who has had the year I've had! I do have some sore tendons or something under my left armpit that seem to be surgery-related, but it's minor. And my left hip cracks and pops every time I do a squat. I wish I could inject some padding or lubricant into my hip-joints to make that stop. It doesn't hurt. But it's loud.
(7-weeks post-surgery, not at real-time speed of course, but feeling pretty strong!)
I spent week 6, 7, and 8 slowly increasing my workout length and intensity and working on flexibility, and this week was able to do all five of the Burn workouts for the week with just a few modifications--mainly to accomodate my bum elbow* that still hurts from an injury a year and a half ago. My endurance and strength otherwise feels pretty good.
*Clearly the plasma-rich platelet injection from last winter did not magically fix my elbow. Perhaps that's because right as it started to feel like it was really healing, I was diagnosed with cancer and COVID shut our world down, and I pretty much quit all physical therapy exercises for it. I had other things on my mind...
Mentally. While I still don't feel like my brain works as quickly as it used to, I haven't felt nearly as foggy or uncertain as I initially did as I was healing from surgery and chemo, and all the stress from 2020. I just seem to need more time to think, more time to process, more time to plan, and more time to do every task. But in a way, that's been kind of nice--to allow myself to do less, and expect less of myself each day. My pace has slowed down, I feel more focused, and am more willing to stop and sit and look around a little bit instead of just moving full speed ahead. I did a lot of puzzles over the Christmas break.
Emotionally. As my physical body has improved, my emotions have followed. I've been happy. Content. Downright pleasant. I still have bouts of anxiousness, especially in any kind of decision-making for the future situation (which feels wobbly at best). But, even though many circumstances haven't changed, or have gotten harder or more complicated, everything doesn't feel so sad and hopeless and tragic. I'm able to see the bright side a little more often, have a positive attitude again, and tackle problems a little bit at a time instead of being completely overwhelmed by them.
Socially. COVID is still a real drag on my social life, but we were able to pre-quarantine and see Ben's family over the Christmas holidays, which was blissfully almost-normal. I've started working with a couple of my closest friends on a project, so I've been able to see them some (who have all already had COVID) and interact with them on a more regular basis, so that has definitely helped. COVID seems to be *everywhere* right now in our area, so our family is staying to ourselves most of the time, and wearing masks more regularly. It would be really great NOT to get it...so I'm doing my best to avoid it.
But otherwise, we are trucking along pretty well, cautiously looking around the corner to see what 2021 has in store...
The first few days were rocky though. As I started to cautiously ease back into more normal activities (like driving and laundry and dishes and cleaning and cooking and other REALLY basic everyday activities), I found myself second-guessing every request, every commitment, and every task. "I want to do it, but am I capable? I think I can now, but will I be able when the time comes? Will I have enough time? Enough energy? Enough mental capacity to handle it?"
Normally, I'm extemely confident and sure of what my capabilities are. If I say I can or will do something, I will--end of story. But suddenly, I found that while I'm not completely incapable of everything, I definitely am not able to keep up with my old pace of life. So I don't intuitively know how much to commit to or how much time to reserve for every task, and it's hard to account for my mood changes...of which there are many.
It's a very odd feeling not to trust myself. I don't trust that the "right now" Andrea will feel the same as the Andrea three days from now (or even three hours from now). Everything takes a little longer than it used to (sometimes a lot longer) and depletes a little more mental and physical energy than I expect it to. So that has taken some adjusting, and some trial and error, to see just what the current version of me is able to do everyday. Needless to say, I've had to go very slow so I don't get myself in a pickle and become completely overwhelmed.
I've found though, as the week progressed, my physical and mental state and confidence has improved every day as I've found "success" in various activities.
Physically, I'm definitely improving. I'm stiff and still a little sore and uncomfortable, but I'm not hurting anymore. I've spent a good portion of each day focusing on stretching and physical therapy exercises to increase my flexibility and mobility. I've needed that particularly in my shoulders and arms after surgery, but my legs have done nothing for a month too, so they're pretty tight these days as well. I've been able to do some some low impact bodyweight exercises and walking to slowly ease back into working out. I'm focusing on taking small, slow steps forward so that I don't hurt myself. I've been able to see progress pretty quickly, particularly in flexibility, which has been very encouraging.
I'm not there yet, but maybe in a couple of weeks I'll be back to doing my 4-5 day a week Burn workouts (modified though, for sure). For now, I'm thankful for modified 15 to 20 minute BenderFitness.com workouts, SaraBethYoga YouTube stretching videos and the walking path around the park behind our house.
Mentally, I've started trying to exercise the creative and business side of my brain again, while doing some work at my computer. While it feels a little like I'm stumbling around to remember what I'm doing, it's been a good way to slowly transition back to work-mode before I have to hit the ground running. I'm saving any physical sign-painting work until after the new year, just to give my body plenty of time to heal and to see what kind of energy levels I have each day.
Multi-tasking and thinking about more than one thing at a time is much more difficult for me right now than it used to be. Maybe that's long-term effects from chemo? Maybe it's just from the stress of the year. Hard to say. The more I do though, the more confident I feel about being able to manage my workload. Most days. Some days I fall apart and am overwhelmed...
...which takes me to...
Emotionally, I'm slowly doing better each day, and I'm starting to stack up some good days finally. But still, I never know when or why I might just burst into tears or have a sudden pang of anxiety or dread. I had a complete fall apart about a Christmas tree I ordered from Amazon (after hours of research) arriving WITHOUT A WAY TO PLUG IT IN and said "Christmas is cancelled. We aren't decorating." And I would have stuck to that too...but Ben saved Christmas and found a better looking, less expensive, more fabulous tree at Home Depot and brought it home by the time I had dragged my defeated and angry and depressed self out of bed and downstairs the next day. True story. And yes, Amazon accepted the return. And we did end up decorating for Christmas (cheerfully). The point of that story is that any little thing has the potential to set me spiraling. I can't always control it, though I do try to throttle it from destroying everyone in my path.
...which is a good segue to...
Socially, I'm REALLY struggling with how to be social (which I need) and see my friends and family again in the middle of the COVID-19 pandemic situation we have found ourselves in. While I'm trying to go back to "normal" -- normal isn't there to go back to! I can't just get together with a group of friends or our family for dinner or to hang out at their house, or meet up for coffee or a project without thinking about ALL THE COVID crap.
While I'm pretty sure my family are all very low risk for serious side effects from getting Covid, I have inconvenienced them enough this year and would feel terrible to be the one to bring it home and force our whole household to strictly quarantine right now. But, I also really dislike the feeling of trying to interact with people I know and love while wearing a mask. You miss so much of the experience of being with someone when you can't see their face or expressions. Instead of being uplifting to see them, it depresses me--and so I avoid those kinds of interactions as a protective coping mechanism. After all the depressing stuff I've been through this year, every little thing feels so much heavier than it should. I need to be putting together a lot more non-depressing experiences to rebuild my resilience. So (in cases where a mask is not required or specifically requested), I either say "no" to the get-together and avoid seeing anyone in person, or I say "oh forget it" and risk the interaction mask-free, which is wonderfully rejuvenating. But then I feel guilty or like I'm doing something "wrong" if I hug a friend or have a maskless meeting or get-together. I'm inconsistent at best, and I admit that. And I know I'm not alone in that constant back-and-forth struggle.
For me personally, I think it boils down to this: Sometimes, the risk of mental, emotional and social harm done by staying isolated is higher and more emergent than the risk of physically contracting or spreading COVID. So I guess that's my personal measuring stick. It's not perfect, and it's a sliding scale depending on the day and the circumstance and even the minute. Frankly, it's an exhausting decision-making process that happens multiple times a day, with every single request, event, outing, and interaction that we're faced with. I'm aware that sometimes how I behave may look careless or inconsistent from the outside looking in. But before you judge, please know that I'm doing the best I can to stay sane and survive--just like you are, just like everyone is in this insane world that we have to navigate.
So, that's the 5 week post-surgery, after cancer treatment, trying-to-put-my-life-back-together update. Clearly, I'm a work in progress in ALL the areas of my life. I guess that's nothing out of the ordinary for anyone...
This morning was the next step in my breast reconstruction after my mastectomies -- switching from air to saline in both tissue expanders.
The surgeon initially filled each tissue expander with air during surgery to give them shape, but keeping them lightweight while the incisions healed properly and fluid drained from around the expanders. Once the fluid had been drained sufficiently, the drains were removed (Monday) and then today (Friday), I went in to switch from air to saline.
To do that, they would deflate each side, and then inject the same amount of saline as air that was removed, which for me was 200cc on the left side and 150cc on the right. Which is a LOT of syringes of saline.
I was pretty nervous about this process. I knew after I'd done it once, I'd be ok to go back for fills on my own, but I asked Ben to come with me for this appointment. Turns out, I needed some hand-holding.
Here's a look at the type of expanders I have and how they work:
The nurse found the port for each expander with a little magnet, and then injected a giant butterfly needle to first remove the air with an empty syringe (I peeked, deflation was WAY weird) and then to insert the saline, 50ccs at a time. The needle hurt, but not any worse than having blood drawn, and just for a second. I couldn't really feel the deflating and saline injection at all though, so that was relieving. I did feel a little lightheaded and my stomach flipped a little bit, but I'm sure that was from nerves.
On the left side, where I've been way more bruised and had the drain in for two weeks longer than the other one, she also used the second port on the expander (explained in the video above) to remove some extra fluid from a seroma that had collected since the drain was removed earlier this week. That meant another big needle stick, but interestingly, that port was underneath one of the numb sections of my breast, so I didn't feel that one at all. Watching her remove that rusty-colored fluid into the syringe was pretty gross though--but after 4 weeks of draining fluid from my drains twice a day, it didn't bother me too much to see.
When it was all said and done, the expanders felt much better and softer and more "normal" with fluid inside them instead of air. They look a little rounder, which I imagine will continue to improve with each fill. And though I've been sore and tender throughout the day today, it was overall a pretty easy process--and more bizarre than anything else.
I'll have a couple more saline fills to get them to the right size over the next couple of weeks, but then the reconstruction process will be on hold for a few months while everything settles and continues to heal. I won't have my exchange to implants surgery until sometime this spring (likely).
It feels good to be moving forward.
There's really very little to report about the past week (which was also Thanksgiving week) as far as progress or recovery.
I still had my left drain, which sloooowwly decreased in volume and turned more of a rusty dark brown from the dark maroon shade it had been. All the annoyances of having a drain continued throughout the week--sore drain site, poor mobility in my left arm, having to hook (and hide) a tube and bulb to my clothes, sleeping on my back with a wedge pillow, taking regular tylenol, ibuprophen, muscle relaxers and pain meds, etc.
The bruising and tenderness on my left side has subsided significanly (though not completely). The nerve pain and skin sensitivity continued through most of the week as well, although that has been less pronounced in the last couple of days. Unless I get the chills. Or yawn. Then ZING!
I kept my activity levels way down all week, per my breast surgeon's instructions hoping to keep that drain from producing any extra fluid. I spent most of everyday sitting or laying down, doing very little walking, and no lifting anything more than a couple of pounds.
We took a family trip to the beach for a few nights over Thanksgiving with Ben's parents, which is about a 4 hour drive from us. In full honesty -- I did NOT want to go. I was in a horrible mood leading up to the trip, physically uncomfortable, wasn't excited about dealing with a drain on the road and not in my own home, didn't want to make small talk, wasn't sure how to pack or what I'd be comfortable wearing, and was worried about the drive down being painful. But, I knew the kids and Ben needed the trip and the change of scenery might help me break out of my funk, at least a little bit. So I went -- but I'm sad to admit--not cheerfully. And I was definitely dead weight and completely unhelpful when it came to packing, preparing, planning, and parenting on this trip. Ben and his parents get ALL the credit for that!
While I did put my toes in the sand for a short period of time each day, I spent most of my time on the couch wrapped up in a blanket, and stayed medicated each evening to try and remain pleasant(ish) to be around.
Besides being physically uncomfortable, it was far too depressing for me to sit on the beach and see everyone around me in swimsuits getting tan and sandy, exercising and moving their bodies, when I was restricted to full-coverage bulky clothes, hiding a surgical drain and rock hard expanders and allowed little-to-no exercise. Many of my favorite beach activities were prohibited or awkward or uncomfortable. That (and the ever-presence of breasts in bikinis all around me) made it very difficult to temporarily forget my struggles.
I would say my mood was *slightly* lifted by the sand, the sun, a change in scenery and some holiday time with family. But boy was I in a rough spot when it took all of that to lift my spirits just a little bit. Yikes!
When we returned home, I was determined not to return to the dark dungeon of my bedroom recliner and Netflix and made myself get up, get dressed, and move around the house more over the weekend. Then, this morning at my appointment, my left drain was finally removed and I was (re)cleared to begin increasing my activity. Sweet relief!
My surgeons both said around 4 weeks most people "turn a corner" after the double mastectomy and expander reconstruction surgery I just had. Today marks 4 weeks, so I'm hoping that's true. Getting that last drain out will be a HUGE help in that, I'm sure.
The past week had some ups and downs. After three days of walking for 25 to 35 minutes a day and beginning to push myself to become more active, that regimen was shut right back down by my breast surgeon on Wednesday, who said I was doing way too much. So, I spent the rest of the week sulking and sitting and doing more resting.
She was right, and I know it. But it sucks.
Having my right drain out since last Monday has definitely been an improvement. It allows me greater mobility with my right arm. I can reach above my head with that arm (to about 60 degrees before it starts to pull and hurt). I haven't had to worry about accidentally yanking on that drain tube, and the drain site incision has been slowly healing. It's still very tender to the touch, but is much better than having a tube coming out of it!
The left drain continues to be an annoyance, limits my arm mobility, and protecting it from getting pulled makes me hunch my shoulders forward way more than I should, which makes my back hurt. Unfortunately, it's still producing a decent amount of fluid and hasn't changed colors like it should, so it's sticking around until after Thanksgiving. That means I have another week to carry it with me.
Showering and getting dressed continues to be very difficult. Not impossible, and I'm able to do it myself, but I have to be very slow and methodical about it, and make sure I don't reach too far or pull on the drain tube. Generally, once I'm dressed, I'm in better shape, but the process of getting there is pretty exhausting and uncomfortable.
While my incisions are healing well, I'm still very bruised and tender across my entire chest and down my left side, so even the slightest touch can be painful and sensitive. Some people talk about their entire chest being numb after a mastectomy -- not the case for me. I have spots that are numb, but the rest of it is constantly tingling, burning, throbbing and extremely sensitive to touch or fabric, almost like the thin skin that is raw and sensitive after a burn. That seems to be getting more prominent, not less, and is probably the most uncomfortable and painful feeling so far. When it's constant, it's just so difficult to focus on anything else. Medications haven't seemed to help much to make it go away. Mindless distraction seems to be the best medicine for that ailment. I asked the nurse about it, and she said, unfortunately, it's common. I was afraid to ask if it's temporary or permanent...I'm not sure I want to know the answer. Maybe it means I will have feeling in most of my chest when this is all over, and it's ultimately a good thing.
I am still spending a lot of my time sitting in a recliner or laying in bed on my wedge pillow so that the pressure on my chest is slightly lessened. I want to wear the softest, stretchiest, most comfortable clothes I can find, because my skin is so extremely sensitive to anything that touches it. I'm still taking tylenol or ibuprophen a couple of times a day and a muscle relaxer and pain pill most evenings to release the tension and muscle tightness that has built up from protecting it all day long, and to help me fall asleep. Thankfully, I'm still sleeping well.
I usually have a couple hours of energy in the mornings (after two cups of coffee) where I can think pretty clearly, feel mostly ok, and am able to do something productive (but not physical). Sometimes that's a little bit of work, or catching up with emails or text messages, or reading or writing. Usually it's sitting at my desk or in the dining room or outside for some variety. But, by about 1pm, I'm fading fast, and spend the rest of the day in a recliner, on the couch or in bed.
I did start driving to run short errands in the middle of last week, and that has gone okay, but my limit is two stops on any outing, and nothing that takes very long to do. Parking lot spaces are a little hard for me to twist and turn and get out of safely. I went got my nails done on Friday, but being out for over an hour and sitting straight up in a chair was pretty taxing.
Mainly I'm waiting. Waiting for the drain to slow down so it can come out. Waiting for the bruising to go down so it hopefully doesn't hurt so badly. Waiting to be allowed to increase my activity. Waiting to switch from air-filled foobs to saline-filled foobs and see what kind of challenges that brings. Waiting to have enough mental and physical energy to go back to work. Waiting....
I had really hoped to be in better shape this week than I am. I'm still trying to stay the course and allow my body to heal properly, but it's been extremely tough mentally when I'm physically so uncomfortable. I kind of want to just sleep until I can wake up and feel better.
Honestly, I'm tired of hearing myself complain!
Ben has been a saint, taking care of EVERYTHING around the house and with the kids, and empathizing with all my sad sack whining. If he's complained about it, it hasn't been louder than me, so I couldn't hear it...
Hopefully by 4 weeks out, I'll have more progress to report.
On Wednesday afternoon, Ben and I went for my 2 week follow-up appointment with my breast surgeon. She was double checking to make sure everything was physically healing well, and then giving us the pathology report, which tells us what the cancer cells have been doing for the past 8 months since I was originally diagnosed with breast cancer.
Physically, she was mostly happy with how everything looked and how it is healing. She acted a little concerned about my left side still being very visibly bruised and beat-up looking, and speculated that perhaps something extra had happened on that side during the reconstruction portion of the surgery. From some additional research, it looks like I had a hematoma that caused all that extra bruising and blood. She checked my remaining drain (which is on the left side) and said it looked like there was still a lot of healing left to do on that side and recommended I keep the drain through after Thanksgiving (another week and a half).
When I told her my plastic surgeon's nurse had suggested and approved of me doing some walking for exercise to speed up the drain removal process, she shook her head and completely disagreed. "You're doing too much. You need to be lazy. You had major surgery and it needs more time to heal. You should not be walking until that drain comes out, and it needs to stay in until after Thanksgiving." That was a major buzzkill--but also my own fault for jumping the gun. I should have waited to get the ok from my plastic surgeon AND my breast surgeon before starting to increase my activity. So, instead of walking the rest of the week and increasing my activity, I've been back in my recliner. Boo.
But...she did have other great news. The pathology report on all of the breast tissue removed during surgery showed no evidence of cancer cells whatsoever, which means that chemo killed it all before I ever made it to surgery. We had an inkling that might be the case, since back in June, after finishing AC chemo, both an ultrasound and a mammogram showed no sign of abnormalities. But this report was a clinical, lab-tested, confirmation of success. That's the best response we could have hoped to get.
When I first started sharing that news with family and friends, I did it with an expectation that the response would be cheering and smiling and jumping and excitement, and thrilled celebration. So I sent the news safely in a text message, with an exclamation point at the end, to show that I understand that it is good news. I didn't want to give the news face-to-face though, because then I knew everyone would visibly see that I am clearly not in a celebratory mood. I didn't want to disappoint them, or to take the opportunity away from them to celebrate, if that's how they felt.
My response to this news is not celebration. Why not? I think I personally equate "celebrating" with feeling happy and whole and accomplished and satisfied--and I don't feel any of those things.
Cancer (and really, I've only experienced the turmoil from cancer treatment, not even the effects of cancer itself) is an uninvited, unexpected invasion. It's a real pain in the ass, an enormous disruption and a pretty severe physical and emotional beating. Sitting here trying to recover from a permanent, body-changing surgery that will take several months to complete, I'm a LONG way from "done" and feeling "normal", and I'm pretty sure I'll never be quite the same because of all of it.
After I initially read my family and friends' responses in a super-cheery, happy, excited, "aren't you glad that's over?" voice and tone, I went back and read their words again. It turns out, no one dismissed the difficulty in my current situation or acted like now everything is fine and the whole ordeal is over. They were just geniuinely happy I received good news in the midst of this long struggle.
What I had to realize is that being happy that I received good news is NOT THE SAME as expecting my life to magically go back to normal, and that I will be my old self again immediately. No one has actually asked that of me. That's an unrealistic expectation I've put on myself.
So, here's my response to my "cancer free" news:
I hoped the treatment would work, and thankfully, it did. Hopefully, it worked well enough that it won't come back again.
Strong nod. Step forward.
I'm thankful the cancer is gone. But I'd be lying if I didn't also admit a strong feeling of bitterness that it was ever there to begin with. I don't really know what the other side of this ordeal looks like for me, and am still in the middle of physically suffering the pain and setbacks from all of it. So, I'm just not ready to celebrate (yet).
Week 1 was a physical struggle.
Week 2 was definitely more mental and emotional, with some slow physical progress. About day eleven post-op, I started trying to make some efforts toward feeling more normal. I put on (stretchy, soft) jeans instead of sweats. I wore dangly earrings. I spent more of the day downstairs than in my bed or in the recliner in our bedroom. I rode in the car with Ben to pick Paxton up from school at the edge of our neighborhood (which was the first time I even left the house!) I even put on a TINY bit of makeup--which is how I realized my eyebrows and eyelashes have thinned again.
That seems to be the pattern about 4-6 weeks after chemo ends, but since I didn't lose my hair during Taxol, I wasn't expecting to lose my eyebrows and eyelashes again. I took that kind of hard. They'll grow back quickly and plenty thick on their own, but let's be clear, I did NOT need another reason to be frustrated with my reflection -- or to see 1,000 ads for lash boosting serums, magic mascara, magnetic eyelashes, etc. which honestly just makes me feel worse about them -- BACK THE FRICK OFF Facebook!
Otherwise, I continued to take it very easy. Lots of rest. My biggest activity in each day was taking a shower and getting dressed, and then changing clothes again that night for bed. That's it. That was the only physical goal--and it was plenty, considering how slow and methodical I had to be to do those tasks.
I started to notice my arm and shoulder mobility improving. While I still am not able to move quickly or hold/push/pull anything heavier than a couple of pounds, I have a little better range of motion before it starts to pull on my incisions or become uncomfortable. So, that's encouraging. I also found that I can wear normal shirts (not just button-downs) as long as they are stretchy enough, which makes me glad I didn't buy a bunch of special clothes for post-surgery. But I am still sporting a fanny pack or an apron to hold my drains, which are extremely annoying.
When I found out I didn't have to wear that awful compression bra after week 1, I tried a couple of days with no bra at all, thinking that would be great, and found that it was just as awkward and uncomfortable. Although I wasn't wearing a bra, the under-my-skin tissue expanders and the surgical tape all still made me feel like I was wearing an iron bra that was too tight, without anything on at all, which was very disorienting. I found that wearing a soft cotton bra was much more "normal" feeling. At least then that wearing-a-bra feeling made sense.
In the meantime, I continued to monitor the output on those drains in the hopes that I could have them both removed at my 2 week post-op appointment. One seemed to be slowing down and changing colors as it should. The other stayed stubbornly about the same, but slightly less each day. The goal is less than 30ml per 24 hours.
Today, was my 2 week post-op appointment with my plastic surgeon (well, technically with his nurse). I was instructed to take the tape off of all the incisions this morning in the shower, which was a fairly nerve-wrecking exercise. You certainly don't want to "rip the bandaid off" in this moment. I took my time, but without a mirror, and without knowing what I'd find underneath the gauze, each pull of tape felt like tiny scary torture. It both hurt (any tape that stays put for two weeks through daily showers is pretty strong) and was terrifying to wonder what was beneath the tape. I did it though, and the incision scars (aka battle scars) aren't too terrible or Frankenstein-y. I think (hope) they'll fade over time. At the moment, it doesn't really matter what they do (as long as they heal), because they'll cut them back open again when I have my exchange surgery in a few months.
I had a LOT of anxiety going into this appointment. I had no idea if I would get my drains out, if everything looked like it should, if I had been healing properly, if I had been moving enough and making enough physical progress, if I'd get a "fill" or saline replacement of the air pumped inside those expanders, if any of it would hurt, if I'd be given permission to start walking or exercising, etc. etc. Also, I hadn't left the house in two weeks (well, neighborhood, technically, since I did take that one little joy-ride to the edge of the neighborhood on day 11). Isolation does something nasty to a person's mental state--it's fear and anxiety inducing, especially in the middle of a pandemic. Ben drove me to my appointment and did his best to calm me down without dismissing my anxiety. I'm not sure I really calmed down until hours afterward though.
The appointment was quick. The nurse checked out my incisions, looked at my drain log, decided to remove one drain, told me I could definitely start walking (and that it might help progress the other drain along), and sent me on my way with a new appointment for Friday to (fingers crossed) take out that other drain. Taking the drain out was not a big deal and did not hurt. That doesn't mean I wasn't extremely nervous about it. Next time, I'll be much more calm. Essentially, she cut the suture, which was slightly uncomfortable, but not painful, and told me to take a deep breath. While I was breathing out, she pulled all of the drain tubing out and I didn't feel anything remarkable. It was over fast. I did NOT look, and in fact, I told Ben to move to another chair so I could look at him and not be able to see myself or the nurse in the mirror next to him. He said (with a grimace and a shudder) that it looked like a very long tapeworm that she pulled and pulled and pulled out. I think I'm glad I didn't watch.
So that's it. Now I'm home and gearing up to walk a lap or two up at the park behind our house. I know the "ok" to walk and get a little exercise and fresh air will help my mood, and probably restore some energy and life back into me.
We'll try again on Friday to see if my other drain is ready to come out. If it is, I'll be able to start the switch over from air-filled to saline as early as next Monday. If it's not...we just keep waiting. While most don't, some people have their drains for up to 6-8 weeks! I'm hopeful that won't be me, but trying not to set any expectations. In the meantime, I'm going to start trying to add back some regular activities to my day to relieve Ben--like making coffee and washing dishes, paying a little better attention to what the kids are (or aren't) doing, and hopefully driving (at least in the neighborhood).
This is a slowwwww process to get back to "normal". I'm trying to stay patient and positive and be accepting of a much much slower pace and output than I am accustomed to. The doctors say around 4 weeks most people feel like they turn a corner. Some who have gone through it say it takes 6-8 weeks. Some say their energy levels don't come back for months. I'll keep you posted...
The first few days after my surgery were kind of a sweet relief. No work. No need to be attached to my phone. No reason to feel guilty about not being productive. I could wear sweats and not put on makeup and sleep all day if I wanted to (and I did).
I've had a stressful year. I deserved a break and some rest.
But here's the thing I was warned about, but didn't pay enough attention to -- As soon as there was a true pause, then it ALL caught up to me. And there was nothing around to distract me from the gut punch and pain of each and every thing that has been stolen from me this year.
Perhaps this is all a little overly dramatic--but allow me a (few) moment(s) of wallowing, will you?
Suddenly I am in physical pain with limited mobility from a glorified amputation that I didn't want. I have foreign objects implanted under my skin that make me feel like a cyborg. I look in the mirror and I have a super-short, very gray haircut with thinning eyebrows and eyelashes, that ages me at least 10 years and isn't the "me" I recognize (although it probably matches the way I feel this week).
And that's just the physical.
Working from home and being self-employed is both a blessing and a curse. Yes, I have the flexibility to do my job and have kids at home all day, and have cancer treatments, and take care of my mom in the hospital, and be in Chicago with my family when my dad passed away. But what have the costs been? I had to quit a job that I loved to devote my time and mental and physical energy to cancer treatments. I largely ignored my kids and husband and sacrificed time spent with friends to use the energy I do have to push myself to work and try and earn as much of an income as I'm able in the midst of one tragedy and setback after another. Or, I had to shut down my business completely for weeks or months at a time to drop everything and tend to my own health, my father's death or my mom's health.
Everything COVID is infuriating and infiltrating every aspect of our lives in this already difficult year, making everything that used to be uplifting and fun and regulating and grounding, now a depressing struggle. We have not had a "normal" week since March (nor has anyone, I'm aware). Everything that used to be a go-to pick-me-up has been poisoned with mask requirements and social distancing and fear-inducing restrictions. Instead of feeling refreshed and uplifted and grounded by things like shopping and hanging out with friends, and going to church or school, or traveling and concerts and sporting events--all of those things have been poisoned with the stamp of COVID. Some of them we can still do, but that COVID stamp just puts a bitter taste all over everything, leaving me sad and more depressed, not uplifted and encouraged.
And then there's the cancer factor. My treatment has been successful, and that's good. But potential recurrence will hang over my head forever. It will be a filter over everything in my life moving forward, whether it ever returns or not. Unfortunately, recovering from surgery isn't the "last step" -- not for us anyway. Other people will move on (and they should), but Ben and I and the kids will be forever changed and affected by the trauma of this year. There are too many stories of people we know well who had great and promising results from their cancer treatments, but then a few short months or years later, it took their life.
It's no wonder we're exhausted and feel defeated.
I've been told I have a hard time expressing (or even acknowledging) my feelings. For me, it's easier and "more efficient" to shrug things off, let things go, focus on the positive, and do what I CAN instead of brooding about what I can't. But when everything stopped in the past two weeks, and I had time to sit and reflect on all that has happened this year, the feelings I normally refuse to allow began crawling their way up to the surface. So, I'm acknowledging them and expressing them while they are making themselves known.
I'm angry that I have to go through any of this.
I'm discouraged that there never seems to be an ending.
I'm scared that the cancer will come back and I won't be prepared for it.
I'm annoyed when my double mastectomy and reconstruction is compared to a breast augmentation.
I'm grieving that I can't call my dad anymore.
I'm worried that irrepairable damage has been done to some of my relationships.
I'm mourning the loss of my youth and innocence (or perhaps more accurately, ignorance).
I'm frustrated at the reflection I see in the mirror.
I'm resentful toward all of the things that took time away from me when I felt good this year.
I feel inadequate as a parent with no real way to help my kids navigate through all the worry and disappointment from this year.
I'm resigned to constant disappointment.
Honestly, I'm not sure I know what to DO with any of these feelings, other than trying to be transparent and authentic as I record this journey and process. It's uncomfortable for me, and feels like complaining and whining about things that can't be changed, which feels pointless and wasteful. Truthfully, my instinct is to ignore them and look at the bright side, be positive, and press forward--and most days I will. The past week though, I've been grumpy and depressed and self-loathing and wallowing, and I wanted to be honest about why.