Keeping abreast of it - Part 2

I've been to the hospital today for a filling. But not of the tooth variety. I've had my implant inflated - or expanded. I also had a large amount of fluid drained from around the scar under my arm where my lymph nodes were taken out. The relief after this was done was amazing. Kind of like when you've been desperate for a pee for ages and you finally manage to find a toilet. I no longer feel like I've got a rolled up towel under my arm and it's a lot less painful.

The expander implant I have in has what is referred to as a port. I can actually feel this under my skin. This is where they put the needle in to inject to saline in to the implant to fill it up. The plastic surgeon used a magnet to locate the port and then inserted a needle in preparation for injecting the saline. However, in the process she found another pocket of fluid like the one under my arm, and so drained this one as well. Turns out that this fluid (stuff that actually wasn't supposed to be there) was what was giving my new breast a lot of its shape and after draining it, it looked rather like this:

Well, kind of. You get the picture.

However, after the injection of the saline, it looks decidedly more round again. Neither of the needles hurt. In fact, the skin on my breast is totally numb and I've been told will always remain so. I have to be careful about applying any sort of heat to that area as I won't actually feel it if it burns. In fact, you could probably set fire to it and I wouldn't actually notice. 

Back at the hospital next week for another session of boob inflation.....

Keeping abreast of it

Just a quick update on the surgery situation.

On Thursday I had my last drain removed. The drain was basically a bottle on a long tube, the end of which was inserted in to my body and the operation site just at the side of my rib cage. It took a little while to get used to it not being there as I'd grown accustomed to carting the thing around with me everywhere. I'd also been watching in grim fascination as the 'tissue worms' (basically long pieces of tissue from the wound site) made their way down the tube in to the bottle at the bottom. Here is how the bottle looked the night before the drain was removed:

A bottle of blood, tissue and lymphatic fluid. Perfect for distracting zombies whilst you make your escape, if such a situation were ever to arise.

I've managed to get out and about a few times since my operation, including meeting with some of the girls from the Younger Breast Cancer Network. I've been carrying the bottle about with me in a bag like this:

However, as less blood and more fluid began draining from the op site, I realised that it did indeed look like I was carrying a bag of piss around with me. Nice.

Thursday was also when the dressings came off and was the first time that I've seen the results of my surgery. I have a large scar under my arm below my armpit from my axillary node clearance. They went through the scar that they made when they took out the few nodes for my sentinel node biopsy back in August last year. There is one huge lump of scar tissue there now, which makes me feel like I am constantly carrying a book under my arm and is pretty uncomfortable. My armpit looks like a banjo with the amount of cording underneath there, including one thick painful one that almost runs down the entire length of my arm and prevents me from fully extending it. Here is a lovely little piccy of the mess that is now my armpit:

When lymph nodes are removed, the nerves running in to the arm get a good bashing about. As a consequence of this, I've been left with a pretty sore bingo wing - the back of my arm down to my elbow constantly feels as if it's burnt and my elbow permanently feels like I've just banged my funny bone. Ironically, this is not funny. It's in fact very painful. And annoying.

Now on to what is my new breast for the time being. Its an incredibly odd feeling. When I lay down it feels as though I have a small animal sitting on my chest. Its completely numb to the touch and as the implant is only half full at present, when prodded it feels very strange. The only thing I can liken it to is when a football or tennis ball gets a puncture and it has that plasticy, empty feeling. I also have another scar of about 10 centimetres in length running across it. Regrettably however, I am not going to share this one with you!

I'm also currently not able to lift anything heavier than a quarter filled kettle or to use my right arm for anything at all strenuous so any offers of help with the housework would be much appreciated!

Visually, the outcome of the surgery is better than I expected and I often feel like I want to proudly show it off to people like some gruesome Blue Peter project - "and here is one we made earlier!". I am of course having to curb this urge as not everyone will want to be bombarded with unsolicited photos of my Frankenboob. But as happy as I am with the results so far, ultimately this is something I would never have chosen to do unless essentially my life depended on it. I'm still coming to terms with how my body is now irreversibly altered, and will be even more so when I undergo further risk reducing surgery to remove my other breast. So please, please save the 'at least you get a nice new pair of boobs out of it' comments. As it goes, I was pretty happy with the ones I had before. I'd really rather that this wasn't happening and that I could have hung on to those ones, thanks all the same!

Plastic fantastic

I have a date for surgery! I went to see the plastic surgeon today and also had my pre-op. I have to say that the highlight of my day today (and yes I am joking) was standing topless in the middle of a room having photos taken of my boobs. I think the last of my dignity got up and walked out the room, waving as it went!

I lose my boob (and more importantly the tumour) on the 5th of February. As the results of my genetic testing for BRCA mutations were negative, they won't be removing the other one at the same time. However, because I still have a 25% risk of another breast cancer (as calculated by the genetic counsellor) I am opting to have the other one removed as soon as possible to reduce that risk. It won't be done at the same time as the bad one, as the priority is treating the cancer and the more surgery I have, the greater the risk of infection, which would delay my radiotherapy.

I will be having what is called a skin sparing mastectomy with immediate reconstruction with an expander implant. An expander is essentially an empty implant which gets pumped up gradually to stretch what skin is left after the mastectomy, until there is enough skin to put in an implant equal to the other side. So instead of a titty squash, I'll now be having a titty stretch!

As my sentinel node biopsy showed one out of five nodes as having cancer in, I'll also be having what is called a level two node clearance - all the lymph nodes removed from my armpit and chest. To be honest, I'm more worried about this than having my tit cut off. The node clearance will leave me with a number of possible side effects, including nerve damage, cording and permanent lymphoedema or the risk of developing it.

Because the inside of my breast will be essentially scooped out (like a jacket potato  - eew) the expander will need to go behind my pectoral muscle and be held in by what is called a 'strattice mesh'. It's basically a sling made of pig skin, but with the 'pig' taken out.

It's very likely that the radiotherapy will muck up the reconstruction and that things are going to need tweaking and fixing. Worst case scenario I could lose the expander and /or the strattice. But it's a risk I'm willing to take. The surgeon told me to look at the expander as a temporary fix until treatment is done, something that will slightly less traumatic for me than seeing a flat scar in the mirror every day where my breast used to be.

I'll probably be in hospital for three to four nights. I'm hoping I'll get a side room where my hairless cancer face and head won't be on show to the whole ward and their families! I'll also be doing my best impression of a boiler, what with the three drains that will be hanging out of my boob and armpit. Two these will come out before I leave hospital, but unfortunately one will be staying in and I'll have to carry it round with me for two weeks like an additional body part - "we've taken your boob but here's a bottle of bodily fluid instead!".

The surgeon will start filling the expander once I have completely healed, gradually filling it with saline at weekly or two weekly intervals. Once this is complete (and it shouldn't take that long - I'm not exactly Katie Price) then radiotherapy will begin.

This is very basic account of the next stage in my treatment. As you will hopefully see, it is not quite as simple as 'getting a new boob'. It's major surgery and a long drawn out process with it's own risks. But onwards and upwards as they say - bring on that scalpel (and the morphine!)