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Thursday, August 12, 2010

Hopeful, confident, and Revived!

I am two weeks post prophylactic bilateral mastectomy!!! And to all of you who have read my past posts and to all of you reading for the first time, I have made it through my surgery amazingly. I went into surgery with so many fears, apprehensions, anxiety, and confusion; I have come out of surgery feeling revived, strong, confident, relieved, hopeful and HAPPY! I have not felt hopeful, happy or excited for a long time.

So lets walk through my last week...
My surgery was July 28th. My last day of work was friday before that so I had a few days to let all the anxiety sink in even more. I literally felt like all the air was getting sucked out of me. My emotions had exhausted me. My husband and I however managed to celebrate our 6 year wedding anniversary in the North End of Boston on Saturday and I truly had one of the best nights with him. I woke up the next day with that empty feeling again however and continued to count the days to surgery. Tuesday I had to go to nuclear medicine at the hospital and meet the surgical nurse practitioner to inject the dye into both my breasts for the sentinel node biopsy. I have to say I was so nervous and anxious about his "procedure". I could not imagine getting something injected with a needle into my breast/nipples. Let me say, I hardly felt a thing. I left there feeling like I had expended so much energy on this freaking injection and I felt nothing. It did burn a bit, but painful is not a word I would use. That night my husband brought my kids to his mom's and I cried my eyes out and felt so bad for myself. Basically had a pity party!

The next morning July 28th, we woke up at 4:45 am to head into Boston for surgery. I medicated myself with a little Ativan, which let me tell you prevented me from going over the emotional edge. My sister and mother met us at the hospital, which was comforting as well. My family has a way of just relaxing each other in times of difficulty. We laughed, we joked, and it guided me into the OR that morning.

I have to say every single nurse I encountered was unbelievable. I am proud to be a nurse after the care I recieved from these people that never knew me. Even the physicians were great. The second I checked into the extremely busy surgical area at 6 am, he process began. I was greeted by the nurse who held my hand and felt my emotional pain and concern and just made me feel so secure. I was introduced to the anesthesia team and they explained to me the paravertebral nerve block that they have been now routinely doing pre mastectomy. This involves me lying on my stomach and the anesthesiologist injecting a "numbing" medication into the nerve area surrounding the spine. The medication is injected in the vertebral area near the scapulas. This medication then follows the nerve pathway along the back and front of the chest. Research at MGH has shown to dramatically decrease post operative pain after a bilateral mastectomy within the first 12-48 hours. The level of pain is blocked from this medication so the intensity is not so severe. I was so scared to have this done because in my head, any needles going near or in my spine scare the shit out of me. I did not want and epidural with my first born out of fear of long term damage. This is my crazy nurse brain taking over! I of course am so grateful I went through with this procedure.

The injection into my vertebral space did not hurt at all, a little stings here and there, but honestly, again, worried over nothing. They did however give me a little medication to relax before hand, but I was completely awake for the procedure. It was after this that the rest is foggy. I remember saying good bye to my family and husband, but really did not feel much emotion at that time, which I am so grateful for. I thought saying goodbye would be hard, thank God for medication. I then was wheeled away calmly, peacfully, and surrounded by supportive, caring people.

I woke up 7 hours later to my husband and parents. It is all still foggy, but I really just remember feeling good. It is not really the physical discomfort I think of, it is the emotional aspect. I just felt happy, relieved, like a huge weight was lifted. It was all behind me. I was at that moment looking ahead from the moment I woke up. I was of course uncomfortable and groggy, nothing that morphine can not fix. I was in recovery for a few hours, resting, visiting with my family and being evaluated. I have to say I had the most amazing care and nurses. I know they knew I was a nurse, but they just treated me with such relaxed, sincere and humorous care. Which is what I prefer. Laughter goes a long way in difficult times.

I then was brought to my room where I was settled in. I stayed for two nights. I felt really good, the pain was there, but well controlled with medications. I was placed in a cotton bra, with a 3 inch binder that went above my breasts. I had four drains, two in each axilla area. My chest felt heavy and sore. The day after surgery they started me on percocet for pain, and off the IV morphine. The pain was well controlled with the transition, but I did have some nausea and vomited a few times. This is what happens when you do not eat and take pain meds. So I quickly found that out. I was up and walked a short distance the night of surgery, and then the hallways the day after. I was a little dizzy the first time, and then realized I just have to keep doing it.

I went home two days later, and was certainly ready. I was not ready to go the day after surgery, which I know some people do. I spent the first week just resting, napping and letting people care for me and my kids. This of course has been the hardest. The day my kids got home was hard. Hard b/c my my husband and I were tired, it was alot of responsibility for him to care for all of us and the kids wanted there mommy, and I just could not hold them. I was able to have snuggle time with my son, who is 4, as long as I had a pillow in front of my chest, I let my daughter, whose one, sit on my lap, but that was a bit scary at times b/c she just moves and crawls all over you. But overall, I felt good. Pain was not holding me back. I think it was more the restriction of lifting and range of motion of my arms and the drains. I did have noticeable nerve discomfort. The skin under my arms and bicep area was very sensitive for about a week. That has gotten better of the last week and 1/2 though.

I did experience constipation, so take your stool softeners!

I gradually was coming off my percocets day by day and even doing probably more than I should around the house. Tripping over kids toys and crumbs on the counter are what makes me crazy. So ten days after surgery I had my first follow up appointment with the nurse practitioner and she removed two of the four drains. I did take two pain pills before I left because I of course was nervous about this and thought it would be painful. It was NOT! Having the stitch removed was more uncomfortable. Having the tape removed actually felt good to me, b/c I was so freaking itchy in that area. It just really felt strange having the drain removed, it is about 6 inches in you. I felt a huge difference in my armpit area after just the two were removed, my range of motion was better, and discomfort was better.

So I felt like everything was looking up, until sunday night I developed a sharp, stabbing, burning pain around my drain site on the right. It came sharp and fast. Stopped me in my tracks. I took pain meds, and went to bed. Assumed I had done a bit too much that day. I woke up the next day with the same pain. It was truly the worst pain I have ever had. If I moved a certain way or took deep breath or just unpredictable movement, the pain came on. I cried and yelled b/c of this pain. And that is not me! I called the doctors office and they felt it was the drain hitting a nerve in that area, and then some muscle spasms on top of it. As the swelling and drainage decreases the drain moves a bit and can change positions, changing it's purpose. I also had the visiting nurse at my house at the time, and thankfully she calmed me and advised I request the drains to be removed b/c my drainage was low enough for this to happen. The nurse practitioner called in some valium for me, which did work! Thankfully! She said sometimes it will not help, b/c nerve pain is tough to treat, but the spasms should be relieved. I spent that day feeling pretty annoyed and set back. I knew I was going to go to the doc the next day and request the drains be out. Could not deal with that pain again.

Woke up the next day, had to take a valium for the pain, drove into Boston and within 5 minutes, last two drains were removed without any discomfort and I had no more nerve pain. My armpit areas felt less tight and I felt like my range of motion was better. I was told I am still restricted from lifting until I see my surgeon friday, but usually 4 weeks of no lifting. This is so hard with my daughter, but I certainly do not want my implants to move. I also realized after having the drains removed where I was feeling the most discomfort and from what . I felt more aware of the actually surgery and implants.

As far as my cosmetic results, I feel so blessed and happy with my decision and the amazing hands of my oncologist and plastic surgeon. My foobs, look like my old boobs. They are fuller and do move, but they are the same size, symmetrical, and smooth. I am noticing as my swelling goes down I can see more chest muscle then breasts. But honestly I can not even complain, I am so happy with how they look. I feel a lot of tightness in the armpit area, and think I am having more discomfort from the nerves being cut. My skin is very sensitive to touch under both my arms and on areas on foobs. I also feel bruised if I press on my upper chest wall muscle, to be expected. I can not feel my foobs or the nipples, they are numb. It feels as if I am wearing a tight sports bra all the time, even if I have nothing on. I can not feel change in temperature, but I do feel like my nipples respond to touch, I don't feel it, but they change in appearance a little. I am two weeks out of surgery and I take two percocet in the am and two at night, and feel pretty good. I did take tylenol in between and assume it helped me.

I think fatigue is the one thing that I have noticed also. Fatigue is something that personally gets me frustrated and down a bit. I am a go go go person. So napping during the day or resting is tough. Don't get me wrong I enjoy my TV time and time alone, but I wonder how my strength will increase and how prepared I will be for going back to work. However, I know with each day I get stronger.

So emotionally I woke up from surgery feeling strong, happy, confident, and hopeful. I did not think or work on these thoughts or emotions, they are just present. I did not think about my pain, or my scars, I thought about my strength, my courage, my life, my kids, my husband, my family, my new niece that I will soon meet. I felt hopeful for the first time in my life. I thought about Christmas with my kids, and running around with them, and watching them grow and just be! These feelings have not left me yet either, of course I feel tired and frustrated, but that is because I am anxious and excited to live. And that is why we make this decision.

My visiting nurse whom I met once, entered my bedroom as I was hysterically crying about the nerve pain. She calmly talked me down, made me feel like me again, saw my husband, my kids, my new breasts, my weakness and her last words to me was that I was so brave and she admired my courage and my decision. She made me feel proud and confident in my choice, and made me believe her words.

So to all of you who are in my shoes, we are admirable, strong, selfless women. We were given what can be an unfortunate opportunity to see our future, and we have decided to change it, take it on, and not let it take us. We will have ups and downs, perhaps doubt ourselves sometimes, but we are strong!

Stay strong my friends, and thanks to all who have sent me well wishes and strength. It is your stories that have lifted me and guided me! How lucky are we all!!!

Kim

2 comments:

  1. Hi Kim,
    Just checked back in and read your update. I am so happy that you are healing well. I applaud your courage! Hang in there; it does get better each and every day.
    Hugs,
    Elizabeth

    ReplyDelete
  2. Thanks Elizabeth! I am doing well. Day by day!

    ReplyDelete

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