10.24.09
Debridement
It sounds scary. I was terrified when the HIQ said that at the next appointment he was going to “remove the dead tissue”. I anticipated pain. I even had a panic attack. As if I wasn’t enough of a basket case as it was. I didn’t even get an explanation as to how it would be done.
By this time I was crying at least once a day. It had finally sunken in that things were really bad. I had lost both nipples and areolae. The tissue was completely dead. The tissue itself was blackened and rubbery. In some places it crackled when I pushed down on it. So it had to be removed.
Dead tissue is a breeding ground for infection and if it wasn’t removed, it would have caused infection that would have gone systemic and eventually killed me. So debriding, even though it sounds terrifying, is actually a good thing.
When we came back for the next appointment, the HiQ STILL didn’t explain exactly what would be going on. Thankfully his nurse did. She explained that this wouldn’t hurt because the tissue he would be removing was dead so the nerve endings were dead too. Because the nerves were dead, there wouldn’t be any sensation except for a pulling sensation.
I sat down and kept my eyes closed the entire time. I do know that he cut the tissue off with surgical scissors because I saw the instruments before the procedure. All I felt was pressure and tugging. No pain aside from the emotional grieving of having lost an intimate part of myself. I grieved for the loss the same way an amputee or breast cancer survivor would.
It still freaks me out some that he was cutting tissue off my body. It sounds like something out of a horror movie, doesn’t it? Just the concept was enough to freak me out. Yet through all of this I explained calmly and in clinical terms to Hubby what was going to happen. He was, again, not allowed in. I refused to expose him to it and I was determined that I would do my best to maintain a facade of normalcy.
I failed about half the time by this point. But I tried, by damn. I tried.
The most important thing to take away from this post is that if you have to endure debridment, it is NOT painful. It sounds scary but what’s scarier is what will happen if you do NOT have it done. So have it done and do something really nice for yourself afterward.
09.09.09
The First Check-Up
The afternoon after the initial surgery I had my first check up. So we headed over to the office of the HiQ. It wasn’t a very fun trip. I could feel every pebble and bump in the road.
Regardless of the pain meds I was still something of a hurting unit. I was probably a 2-3 on the pain scale until the meds kicked in. Because of that I just stayed in my PJs and robe. I figured ’screw it’. It was a little unnerving being in the waiting room like that but I was SO sore and tender that I didn’t actually care how I presented myself at that point.
Ken came with me when I was called back into the exam room. I was told to take off my robe and PJ top and they would take care of the rest. It took me a minute or so because the meds may not have kicked in completely yet.
The HiQ’s PA came in and she was very gentle as she removed the bandages. Once everything was off I could finally see. I must admit right then I was happy with what I was seeing as far as size went. Now that I have some distance and a little more perspective I can say this: It looked like someone took two small Nerf footballs and shoved them under my skin. In retrospect, it was disappointing. Sure they were bigger but the shape was awful.
I was also VERY deeply bruised from my collar bone to my waist. This includes my breasts, although the initial bruising was splotchy. There were dark spots on my nipples and areolae and it looked like there was a little separation around the areolae where it was supposed to meet up with the rest of the breast.
In places the bruising actually looked like hand prints. That was also disconcerting that people manhandled me so badly that I was black and blue.
Much later I posted the situation on another forum and I was contacted by a nurse specializing in plastic surgery. She thinks that something went really, really wrong during the surgery and THAT was the reason that I had so much bruising. I wish now that I had taken more photos earlier.
With all the bruising I was quite obviously concerned. When I brought it up the HiQ he said that bruising was normal. I figured he knew what he was talking about so I let it go. I chalk it up to ignorance.
I would also like to point out that I noticed that the HiQ did not put in drains to drain off the serous fluid. This will come into play later so remember that point.
08.19.09
Right After Surgery
We got back to the hotel around 6:30 pm. After I made my way VERY slowly into the room, Ken got me set up in bed, propped up and surrounded with pillows. I was still pretty groggy from the anesthetic so I was sort of in and out of sleep for a little while.
I woke up a little while later and found Ken sitting in bed watching TV with a pizza box in his lap. The smell made me ravenous. So he made me some soup.
As part of my after care instructions I was told that I should walk as much as I could. While he was puttering around in the kitchenette, I got up SLOWLY and walked a couple laps around the coffee table.I was more capable of moving after this surgery than the reconstruction.
The HiQ had given Ken a couple of prescriptions for after the surgery. The pharmacy was closed by the time we got back to the room and Ken didn’t want to leave me alone the first evening so the nurse sent along enough pain pills for me to get through until my one day check up.
After Ken made soup I actually sat at the kitchenette table and ate some of it. Even though I thought I was ravenous, my body didn’t seem to want that much food. So I ate what i wanted and then went to the bathroom.
I was really curious about what I looked like so I gingerly took off the pajama top. My chest and torso were wrapped in a compression bandage over other bandages so all I could see was that I had bigger boobs. I wouldn’t be able to actually see them until my one day check up the following afternoon. Although I did try to peek, it would have been too complicated and painful for me to completely unwrap myself.
I remember falling asleep pretty early after taking a slow walk down the hall. I think I slept through the night. I was still pretty dopey from the anesthetic after all.
I’m going to apologize in advance because this is difficult and painful for me to remember so I won’t be very consistent on my posting. I can only deal with remembering for a little while before I have to stop and take a break.
On top of that, Ken and I are leaving the country for a few days on the 24th and won’t be back until the 28th. I’ll talk about this in another post.
08.04.09
Progressively Moving Backward
I am incredibly frustrated at how slowly I seem to be healing. Is this my body’s way of saying “Sit down and shut up!”? I had a couple days of higher level activity and last night I ended up taking half a Darvocet because I was spiking a 3-4 on the Oh-My-God-It-Really-Fucking-Hurts o’meter. Today I was a little sore but no big deal so I sorted piles of old mail. Now I’m at about a three again. I feel like I did two weeks out of surgery. I am ready and raring to go but my body itself keeps planting a metaphorical hand in my chest and shoving me back into the chair. I can almost hear some big tough guy from the Bent Nose Brigade telling me “Siddown an Shaddap”.
What’s sad is that in the back of my mind I feel like I’m being lazy. I feel like I should be doing SOMETHING. Yes I understand on a logical level that writing this blog helps people and that’s doing something. With our finances the way they are though and this being our business slow season I feel like I should be doing something to contribute economically to our household.
People tell me, and I’ve passed this advice on to others, my job is to heal. But for how LONG? Someone emailed me a few days ago saying she wants her life back.
So do I sweetie. So do I.
07.29.09
Under-Do??
I found this old draft and thought I would revisit some of the more pertinent issues I dealt with during my process. This post was originally started on 4/27/09, 11 days after my latissimus flap breast reconstruction surgery.
It seems as though practically over night, the color of the drainage has gone from Ruby Grapefruit to Apple Juice. I’m taking that as an encouraging sign. Although when I wake up, my back still feels like there are rocks under my skin.
Moving definitely helps. Though I’m not sure how much is too much. I don’t want to over do and hurt myself that way. But it seems that under-doing is just as bad and has the potential for lengthening my recovery. So I’m doing something I hate to do. I’ve told Ken that when he sees fit, if I’m not in pain, he’s to take me for a walk.
Poor Ken has to do so much. Not only is he taking care of me but he’s also keeping up with the household needs and the business. I’ve been so out of it, I’ve actually had to ask him on numerous occasions WHEN I need to take my meds.
The pain meds are really helpful but they’re draining me of the ability to think. It takes me about 30 minutes to write one of these daily entries. Granted, I am a lightweight when it comes to intoxication of any sort. But it’s still frustrating. I feel disjointed and I have no memory.
Eleven days after surgery I’m guessing that’s to be expected. It’s just really frustrating not being able to remember things that are really important. Like how long ago I took meds that could REALLY mess me up if I forget and take a double dosage. If I wait TOO long though, then there’s real trouble with the pain. Once the meds start wearing off, my options are 1) Take more or 2) Sit very, very still until I CAN take more.
The bad part is that if I wait, the it takes longer for the meds to kick in and they’re not as effective because they have more pain to battle. So I’m walking a very fine line here. And this is a line that my dear Hubby is in charge of because my brain is about as useful as cottage cheese.
07.21.09
The X Rated Episode
***THIS IS MATURE SUBJECT MATTER. ANYONE UNDER 18 MUST VACATE THIS BLOG NOW. YOU HAVE BEEN WARNED!!***
In previous episodes I’ve briefly covered sex and good positions to use while recovering. Now that I’ve recovered more, I’m going to be talking about the one thing that I think every man looks forward to when his partner has a gigantic set of knockers like mine.
Titty Fucking.
See? THIS is why I called this the X Rated episode. If you’re under 18 and still reading this, GO AWAY! Your Mommy’s calling. Imagine what your sweet little grandma would think about you reading this kind of thing. Go on now! Git!
Are they all gone? Good.
It’s been 13 weeks today since the surgery. A couple nights ago, after having talked about this for quite a while, we decided to try titty fucking. Sorry gang. I don’t know a more polite way of saying it. “Breast sex” just doesn’t cover what happens.
Hubby has been looking forward to this since before I had the initial surgery that went horribly wrong in October of 2007. Yes, he is a patient one. So I thought it was time he got his payoff.
It turns out that laying on my back while he straddled my chest really didn’t work very well. My back is apparently still very sensitive to pressure and all that weight on top of me was just too much. So we tried something a little different from the standard.
He lay on his back and I knelt between his legs, knees slightly under his thighs. Lube was applied to both his penis and my cleavage. Then I leaned over a bit and wrapped my breasts around his penis. He was the one who did all the moving. It sounds uncomfortable but it really wasn’t. From my vantage point I had the pleasure of watching his face as he moved.
Admittedly, watching him was the most pleasure I had from that particular escapade. But HE certainly enjoyed himself immensely. So much so he suggested we do it again SOON.
07.02.09
Nipples Or Not
For my regular readers, do you remember when I was vacillating about surgeons or even whether or not to HAVE another surgery? Well it’s that time again. This time I’m starting to research and contemplate nipple reconstruction.
I read some older articles that indicated that up to 40% of all nipple reconstructions fail. Most flatten out within 6 to 18 months. There is also a higher incident of infection and necrosis according to those older statistics.
THEN I talked to Dr. Elliott. He explained that those complications are not as frequent anymore. In the last two years or so surgical techniques have been greatly improved. He reassured me that usually those complications are due to poor blood supply. My tissue is healthy, according to him. He also went to lengths to reassure me that recovery time is going to be greatly reduced since this is an out patient procedure only dealing with topical tissue.
He also suggested that I research the Star Flap Nipple Reconstruction. The link shows the basic steps starting at Media 7 http://emedicine.medscape.com/article/1274411-media – star flap That’s the nipple flap reconstruction he wants to ue for me. He believes that specific type of flap reconstruction will work the best.
I really don’t want to have ANOTHER surgery so soon. I’d rather wait until this winter. So in the interrim, I’m going to get prosthetic nipples. Dr. Elliott is having his PA, Patti Bergley, look into it and see what she can find out for me. I’m expecting her to call today.
Talking to Dr. Elliott made me feel more comfortable about my outcome. I’m still tempted to get a second opinion when I go back to see Dr. Guy’s people in another week about the tissue growth isue on my back. I’d like to see what she has to say too.
The problem is now really the cost. Nipple reconstruction and any tweaking that needs to be done for aesthetics will cost us an additional $7000 on top of the $18000 we have already paid AND the $6000+ we still owe the hospital and the anesthesiologist. Nipple prosthetics on the other hand are only around $200 per pair for the really good silicone ones.
Really, I don’t think that it’s so much a matter of “if”. It is now a matter of “when”.
06.23.09
9 1/2 Weeks
From the title of the post, it’s pretty obvious what today’s topic is.
Medical updates.
The spot on my back is still troublesome. It’s not really getting any better. I’m still not too worried about it though as no one else at Dr. Elliott’s office is overly concerned. Last night Ken said he thinks I should “be seen” by Dr. Elliott’s contemporary down here, Dr. Roxanne Guy. I have an appointment for Thursday.
Honestly, I am SICK of “being seen”. I am SO over all of this medical crap. I just want to get ON with my life. I think that’s part of the reason I’ve started doing Ta Ta Tuesday. Even though I may not be completely done with all of this, I want to start enjoying the completion of the major stage.
The nurse at Dr. Elliott’s office had suggested that I wait another month to take the tape off the suture line. I got tired of waiting so I went ahead and took the tapes off four days early. Really I could have taken the tapes off at 6 weeks but I tend to be overly cautious as far as suture lines go.
I haven’t taken any acetaminophen for pain in a few days. I’m happy about that. It’s definitely a few steps ahead of where I was. My endurance, however, is another matter all together. I used to be able to be at Disney for anywhere from 12 to 14 hours. Now I can’t walk around for more than a couple hours without getting worn out. It’s possible that the heat could be exacerbating the issue, but I just don’t think so.
Mobility is another issue. I can raise my left arm all the way up next to my head. The skin in my armpit is still a little tight. My right arm is another matter. I can only raise it at a 55 or 60 degree angle without tightness and pain. It HAS improved since surgery. It’s just improving more slowly.
Emotionally I’m doing better, as the idea of TaTa Tuesday shows. I’m still trying to decide if I want to take a chance on nipple reconstruction. Some articles say that in experienced hands the failure rate is less than 2%. On other websites I’ve read women’s stories of how their nipples flattened out between six months to 2 years. There was also a fairly high incident of infection.
I have emailed Dr. Elliott and asked him to suggest someone who makes custom silicone nipples and write a letter of request. Every prosthetics maker I have found that does really good hand painted nipples requires a letter from a physician. Even if I decide to have the surgery later, I will still have the prosthetics in the mean time.
06.15.09
It’s More Complicated Than That
Something that isn’t really mentioned much is that eventually many breast implants may need to be replaced. An article released in 2005 by the New York Times reports that up to 93% of silicone implants fail within the first 10 years. http://www.nytimes.com/2005/04/07/politics/07breast.html .Those implants need to be removed and possibly replaced as soon as possible. This is another surgical expense that you will have to cover. Usually these costs must be paid out of pocket. In one study by the New England Journal of Medicine, the complication rate for augmentation was as high as nearly 25% http://content.nejm.org/cgi/content/abstract/336/10/677.
Other things surgeons are unlikely to tell you are that sometimes the skin thins and wrinkles and the silicone shell of the implant become visible. With saline implants, if you push on your breasts, you can hear the implant sloshing around. Ever fondle a breast with a saline implant? It feels like you’re fondling a water bottle. When it comes down to it, saline breast implants are really only good for looks. The other option is silicone implants. Although there is not a conclusive group of studies, it is widely believed that leaked silicone is responsible for, or at the very least, contributes to, autoimmune conditions such as fibromyalgia.
Sex may not be the same either. You have water bottles sloshing around in your chest that feel totally different from your natural breast tissue. Many women also report numbness or reduced feeling in their breasts and especially the nipples after augmentation. Sometimes it’s temporary. Sometimes it isn’t. This is surgery and it can cause permanent nerve damage just as with any other surgery.
Before you sign your paperwork for the surgery, someone in the doctor’s office will go over the list of possible complications. In my case the person stressed repeatedly that these complications were extremely rare. I’m sure that there are women out there who have gone through the procedure with no complications and no issues at all. I would LOVE to talk to one of these women.
The list of possible complications is as follows:
Seroma (pooling of serous fluid)
Hematoma (pooling of clotted blood; risk is 3-4%)
Symmastia
Double Bubble (also known as “double fold”, “snoopy effect”, or “snoopy breast”)
Mondor’s Cord
Bottoming Out
Deflation Photos (approximately 7%)
Capsule Contracture
Traction Rippling & Rippling Photos
Photos of these complications can be found here: http://tinyurl.com/5gz6mc
Other lesser complications include:
Asymmetry
Bleeding
Breast droop
Displacement
Implant leak
Infection (risk is less than 1%; always involves removal of implant)
Interference with mammography
Keloid (heavy scar)
Nerve Damage
Nipple numbness
Pain
Permanent numbness (risk is 15%)
Reactions to medications
Rippling
Rupture of the implant (often due to injury)
Skin irregularities
Sloshing
Slow healing
Swelling
Visible scar
The above are relatively MINOR complications, however. Seroma and hematoma can lead to necrosis because of the pressure on the small blood vessels reducing blood flow to the affected tissues.
Necrosis is the death of tissue. When necrosis occurs, the area must be debrided. This means that the dead tissue has to be clipped out and the remaining, new tissue cleaned. Debridement doesn’t hurt. That tissue is dead which mean there are no living nerve endings. To leave dead tissue is to invite infection. So even though the thought is terrifying (and believe me, it was TOTALLY terrifying when I went through it), it’s better to get it done and over with. Then the body has a clean bed of underlying tissue to grow from.
The complication percentages listed above are reported to be low. Most are under 10 percent according to the statistics I have found. This does NOT mean that surgery of any kind is completely safe. Do not believe that just because your friend had a boob job that went perfectly that you would have the same experience.
Your surgeon and his or her skill level play a big part. So does your body and how it heals. Even though I got a clean bill of health from my pre-surgical physical and blood test, I developed several complications. I had seroma and hematoma that were NOT addressed by my surgeon. I believe those contributed to the development of necrosis. I also talked to a nurse about a year after my complications. From the description of my waist to collarbone bruising, the nurse was completely convinced that something had gone wrong during the surgery that led to the development of the necrosis.
I’d like to stress again that you should be educated about your choice of surgeons. He or she MUST be board certified by a plastic surgery association. ANY doctors can call themselves a plastic surgeon but the ones who are actually educated for that specialty are board certified.
Do NOT try to find a deal. Trust me when I say that cheaper is NOT better. I learned this lesson the hard way. It cost me more than money to learn this.
If something does go wrong, you may not be able to sue. In the state of Florida a plastic surgeon is only required to carry $100000 in malpractice insurance unless they are affiliated with a hospital. By the time your lawyer proves malpractice, most of that $100K will be gone to lawyer’s fees. You will, in all likelihood have little to nothing left for any repair procedures.
Use my story as a cautionary tale. Know your body, know your family medical history, know your surgeon, and know the risks.
06.12.09
Frustration
I am ready to beat my head against the nearest blunt object. I woke up this morning, rolled out of bed and realized ‘Hey! That didn’t hurt!’. So I proceeded to pack up some stuff I needed to send back, make food for myself, run to Home Despot to get an answer to a question and do a bunch of measuring for another project I’m planning.
I wanted to replace the crappy plastic handles on our bathroom faucets. Unfortunately I have to replace the entire faucet. Since everything needs to match I also had to pick up matching shower handles. BUT they only come as a set SO I bought the entire set. But I got all the matching hardware for just a little over $200. Not bad for three faucets and two bathrooms, eh?
I spent 20 min on the Net looking for the new bathroom faucets and shower trims. Now my back and chest are seizing up! AUGH!! <headdesk headdesk headdesk>. I am SO frustrated with not being able to get things done without pain!
I know. I know. It’s only been 8 weeks. I’m still healing. Blah. Blah. Blah. I am SO SICK of sitting on my ass doing what amounts to NOTHING!! AUGH! But when I DO get more active, then I get knocked back on my ass. It’s just driving me NUTS!!
When the faucets and new shower trims get here, I’m going to be doing the work myself. Unless of course we can find a plumber on barter to do it. I really don’t want to wait though. I’ve been waiting for the last three months to do this and get it done.
I WAS going to paint the kitchen cabinets to update them, too. Fortunately I read that dark woods are coming back for kitchen cabinets. So all that needs to be done there is to replace the one door that’s cracked. If we were going to be staying I’d be saving up for an Induction cooktop or stove.
In the mean time I’ll just do the best that I can. I’m resting on a heating pad, sipping a decent Zinfindel and waiting for things to improve further.
