Explanation!!

I thought I would take a few minutes today because I think I have been too vague on what this round of surgeries is.  I have talked to a few friends and noone seems to fully understand what is happening (plus I haven't been too sure about how much to explain about breast reconstruction, I mean we are talking about boobs and sometimes it gets a little uncomfortable for some) but this is my blog and I want it recorded so here goes:

When I had my mastectomy done in Sept. 2010, I had 2 surgeons working on me, my regular surgeon who took care of the cancer and my reconstructive/plastic surgeon who was there to put me back together and make me look good (as best as is possible:)) In my case they cut me wide open going diagonally starting at my armpit going inward to the bottom of my breast.  They had to take all the tissue, the nipple, 18 lymphnodes and some skin.  That was the first priority, trying to get all the cancer and making sure the margins were good so that none of the little buggers could do any more damage.  When that was all done my reconstructive surgeon cut in to my pectoral/chest muscle (through my left side, I think) to make a pocket and then put in an implant.  He also used acellular dermis (bovine dermis (skin)) to help hold it together.  Not sure how to fully explain that part, but you can look it up if you would like.  He was able to put a silicone implant in that was 450 cc's.  That process is immediate reconstruction. 

Well after that had healed to the point where they felt they could start my next treatment, I headed in to radiation. Which kills any cancer cells that may be lingering but it also damages the skin, heart, lungs, anything that it comes in to contact with.  The implants sometimes become encapsulated with scar tissue, mine did but not too bad.  But what did happen is that it ended up staying up too high and not settling down next to my other breast.  Hence, lopsided! :)  So a year ago this April (2011) he put an implant in on my right side to try and even things out, but it didn't work too well, so we waited for the year mark from when I did my radiation to give the skin enough time to heal to try something else. 

That is when I went in December 5, 2011 to get an expander put in on my left side.  He took out the implant that was there under the muscle (I got to bring it home with me) and put in an expander.  Imagine a thick rubber ball with a metal port on it, deflated.  He put it in there and I don't even know how to describe it other than hard and not fully inflated so just imagine a ball that is starting to go flat and you can push in to it a little bit and move it around.  I know weird, and it hurts.  But to top things off, the whole thing slipped and turned 90 degrees to my left side.  The port is usually at the top, but is now on my left side, so now it looks funny, more up and down than going left to right.  That part is really hard to explain but just know that its awkward but still doing its job which is expanding the muscle to make a bigger pocket.  There is a good thing to it turning, though, the whole left side under my arm is still numb, so when he fills it I don't feel it.  Hooray for that! I had it filled initially and then I have gone in twice more and had it filled with 50 cc's each.  He basically fills a syringe with saline and sticks the needle through my skin to the port and we watch it grow!  At the time there is just a little pressure, but by the time I get home, I am almost in tears.  Thats where the valium and painkillers come in to play and I try really hard not to move for 2 days until it calms down.  Sounds fun doesn't it.  You know I have seen men flex their chest muscles, but to have mine doing it on its own is just not right!! :)

I went in yesterday to get it filled just one more time.  Its hard trying to figure out what size to go, because when he changes it out for a permanent silicone implant it will lay differently and be softer, so therefore you go a little bigger than what you want so there is enough room for the implant to be placed and the muscle will wrap around it.  Well, when he came in and looked at it, my incision (he went in to the same incision as the original surgery, to lessen the scars) was bright red and irritated, meaning it wasn't ready for another fill and could possibly get infected.  I don't like to take chances, especially where it could split open, so we are waiting another 2 weeks.  At that time we will know if this is all my skin can handle of if I will be able to do once last fill.  To date I have a total of 580 cc's in there.  I was trying to get to 6 or 630 cc's, but we'll see.  I am really crossing my fingers, because I have had to deal with so much I would really like to choose my size.  Which in reality is not that big.  I have always been a pear shape and I just want to look proportionate and have a more hourglass shape.

I have scheduled my surgery for April 16th.  Once the expander is filled to where you want it, it has to sit in place for a few months before you exchange it for an implant.  During this surgery he will replace both my expander and right implant for ones that will be symmetrical.  He will also try to lift my right side if needs be, because we have had the problem of lopsided! :)

Now there is one more aspect to this whole thing and that is the radiated skin.  During my surgery in december he took some fat from my belly area through lipo.  The reason for this was to put it just under the skin of my left breast.  Apparently the stem cells from the fat actually help heal the skin from all the damage that has been done. The bad part is, that only part of it actually stays and some gets reabsorbed back in to your body so it usually has to be done multiple times. He told me he will take wherever he needs to take it from (thighs, butt, stomach).  For some this might be a wonderful thing, but for me its just more pain.  So I will probably let him take one more time since I have to go back in anyways, but not sure if I can do more than that.  I am way beyond the point of being done!  If it wasn't for this horrible cancer I would not be doing any of this.  BUT I am grateful that the knowledge and technology is available for me to be able to feel as normal as possible.

Did you know they can reconstruct nipples and they can tatoo nipples??  Well, they can, but at this time I am not going to do that.  I actually have stick on nipples, if I ever feel inclined to wear them!  Come on, you are laughing with me right now, right?? :)  I am actually proud of what I have done and feel no need to have one!  Ok, done with that part! :)

When I am all done, this should last me 20-30 years (I am praying really hard for this).  I am looking at it as only 6 more months of torture then I will be able to heal and move on!!!  Granted I still have the tamoxifin to deal with and menopause, but atleast reconstruction will be over!!

So there you go!  Hopefully you weren't too appalled, but it is what it is!  The human body is amazing! You know I keep thinking that atleast its my breast that was taken and not an arm or leg, or especially my voice!

There is always something to be grateful for!