Nip, Tuck

Nip, Tuck

The last words I ever expected to cross my lips were “I just had plastic surgery”. But there it is. I just had plastic surgery. I am not a vain person, I don’t wear make-up or fuss with my hair or clothes or my appearance in general. I had considered not doing reconstruction at all, but I am just self-conscious enough to want something there, so I can change clothes in the locker room without embarrassment. Yet, for me this surgery marks the end of this journey battling cancer, and somewhat of a return to normal.

I arrived at 11:00 on Monday for pre-surgery preparations. Surgery was scheduled for 12:30, but the surgeon was behind schedule so I had extra time to sit, hungry, craving my morning coffee, and worrying about the surgery. My boyfriend, always there to cheer me up, put adorable kitten videos on his phone to help pass the time. It worked, and before long, I was all ready to be rolled off to the operating room.

2014-12-08 11.26.43

Because I had lymph nodes removed on both sides, I am not supposed to have IVs or blood pressure cuffs on my arms. I convinced them to do the blood pressure on my leg, but they would not do the IV in my foot, so I had an IV on the left side, which had fewer nodes involved. It hurt like crazy going in because my chemo-weakened vein tried to run and hide. She eventually got the IV in place, and pre-surgery meds started flowing. As with every surgery, I begged the anesthesiologist not to make me sick. They always give me the works to prevent nausea. Antacids, motion sickness patches, anti-nausea meds, but it never seems to work. I always end up sick to my stomach. So that happened. Again.

The plastic surgeon checked in on me and drew lines all over my chest and stomach while I could still stand up. Apparently, they don’t want to make the lines after you are unconscious, flat on your back. Once that was done, they wheeled me off to the operating room right in my recliner. Entering the OR, I said, “I see the party has started without me, and just as I expected, brightly lit and cold”. There was some lighthearted joking around, then they wanted me to get as comfortable as I could on the operating table before they completely knocked me out. I felt relatively comfortable, with my arms straight out at my sides, airplane-like, so the oxygen mask was placed over my nose and mouth with instructions to take deep breaths. Nighty night….

2014-12-08 20.52.06

Next thing I remember, vaguely, was coming to gradually in the recovery room. I heard Andy’s voice and the nurse telling me something, though I don’t remember any of it. I noticed at that time that my left hand had fallen asleep and was tingly. Apparently, they got me up and dressed. It was late in the day and everyone was anxious to get home. I was the last one on the floor for the day. I was becoming more and more alert, and I wanted to go home. That’s when the nausea hit. I got sick, which made me feel better, but then they took away my crackers.

Feeling better, they got me up to walk to the bathroom. I felt weak and lightheaded, but managed ok. Until I had to try to pull my pants up. My sleeping left arm was not working. This made me panic. I feared the worst-they paralyzed my arm. I would never have traded use of my arm for new breasts. A future without the use of my arm horrified me. I have big plans for my future, and most of them involve physical labor (rehabbing houses) and motorcycles, and a generally active and adventurous lifestyle. What would I do with one arm? And that was my “good” arm, that hadn’t endured multiple surgeries.

This new problem delayed everyone’s departure for the day, but eventually, I was wheeled out to the car and sent on my way to recover at home. I managed to sleep fairly well that night and most of the next day. I did speak to the surgeon and the anesthesiologist about my arm, and they reassured me that it is temporary and I should expect to regain use of my arm over the next two weeks. The specialist they spoke with says it happens sometimes, when the arms are stretched out for an extended time. They think the nerve was over-extended or pinched due to swelling. Maybe the IV in my arm also caused the problem. So, I just have to wait and see. If it isn’t better in two weeks, I’ll have to see a specialist. Now, it is three days later and my arm is still numb and tingly, but I am regaining some movement, which is reassuring.

Besides the arm issue and the nausea, the surgery went well. There was a bit of skin that was so damaged from radiation that it had to be removed, though, so the scar may be bigger than I thought. I am tightly wrapped in gauze, with a tight girdle-like piece wrapped around my abdomen. I have to keep this all wrapped up until next Tuesday, when the plastic surgeon will remove the dressings, and expose the end result for me to see.

Now What?

I realize that it has been nearly two months since I updated my blog. Don’t worry. I am still here. I still have a lot on my mind, and have been meaning to write, but the urgency to write which I felt before has let up some. In the thick of things this past year, I felt a strong pull to put my thoughts to paper. Writing was the only way to sort out the complex jumble of thoughts and fears, and dig for some sense of peace with what I was going through. Now, as I continue to move forward, I don’t feel the same pressing sense of urgency to put my thoughts to paper, so maybe you’ll hear less from me. Maybe….

The completion of radiation in the end of September marked the end of active treatment against cancer for me. For 10 months, this vigorous battle dominated nearly every aspect of my life. The abrupt change from constant doctor’s appointments, major side effects, and a underlying, ever-present focus on whipping cancer, to a return to… “normal” life, left me thinking, “now what?” Where do I go from here? So much has changed.

The important things in life are that much more important now. The unimportant things in life are that much more unimportant now. Facing fears, and pain, and setbacks seems to be a regular part of every day, yet I have new goals. Some are previous goals that have been neglected. Some are new goals. Life is too precious, and there are no guarantees that I’ll be around long enough, to put off the hopes and dreams I have for my life. What all of this means, I am not sure. But I am excited to find out. Excited to move forward.

Though I sometimes feel manic excitement to jump head first into this new chapter, waste not a single moment, I also realize that it will take time. I don’t have the strength or the energy that I used to have. I see glimpses of my old strength at times, but only glimpses. It seems that I can’t complete the tasks that I set for myself in the time I think I should be able to complete them. It frustrates me. I don’t have time for the patience of my younger self. I know that I need to learn, for now, to take on less, slow down, do things at a reasonable pace. Balance.

I have one more major hurdle to clear on this journey. Two weeks from today, I will be undergoing reconstruction surgery, along with the removal of my chemo port. I look forward to getting it done, or, rather, to getting it over with. In fact, I pushed the doctor to let me do it before the end of the year because I want this chapter to close with the end of 2014.  I am not looking forward to another surgery, another recovery, another pause from the things I want to be able to do.  I can say one thing with certainty, though – look out 2015! This New Year has new meaning and I am going to come on strong!

Comedy of Broken Pieces

Enough already! The past week has been one problem after another as my body breaks down from the strain of cancer treatment. It’s like the classic example of the driver, breathing a sigh of relief as they near home after a long drive, and then, minutes from home, they get into a car accident.

I was breathing that sigh of relief near the end of radiation, ready to be at home with a new chance at life. I am more than ready to done with doctors and hospitals and all things cancer. My body tells me otherwise. The effects of treatment keep popping up to remind me that I can’t move forward as if nothing happened. It is going to take more time and effort than that.

Monday I met with a specialist to try to find a solution for recurrent UTIs, which are exacerbated by chemotherapy-induced menopause. Tuesday was my final day of radiation, a milestone worth celebrating, to be sure. I brought a dozen donuts to St. Luke’s radiation oncology department. It was a lovely day, and I was thrilled to be done with the 7 weeks of daily trips to St. Luke’s. There were plenty of hugs and high fives. My skin seemed to be over the worst of the burns, and I was starting to heal, feeling like I was nearing the end of the long road.  I received a wonderful bottle of wine from a friend, so there was further celebration that evening.

2014-09-24 18.10.15

Wednesday I had a follow-up with the medical oncologist. Everything was looking good. Fatigue was my only complaint, yet initial blood work was showing improvements over the dropping numbers caused by chemotherapy. There were more congratulations and hugs. I donated my hats and scarves further symbolizing the end of that chapter. On my way out the door, beaming and ready to ride my motorcycle home on a beautiful fall day, the nurse stopped me and said she needed to talk to me…

Back into an exam room I went. The nurse came in to inform me that my blood work showed an elevated level of troponin, an enzyme that is released when there is damage to the heart. It is found in people who are having heart attacks. It also can occur if radiation stresses or damages the heart. So, having told me this and asking if I had any chest pain or shortness of breath, they sent me on my way with instructions to rush to the ER if I experienced any symptoms of a heart attack. NOT a reassuring thought as I strapped on my helmet and climbed onto my motorcycle for the ride home. I felt every beat of my heart on that trip.

As everything else on this road, the “not knowing” period is the worst part. Left without details, my imagination takes over and fills in the knowledge gap with worst case scenarios. In my mind, I beat cancer but surely would need a heart transplant or other extreme measure to survive the effects of the cancer treatment. The cardiologist called and I was scheduled for a heart echo-cardiogram on Friday. I do not like Friday tests. They usually mean I get stuck, waiting with my imagination, until Monday to hear the results. Thankfully, I got the call Friday afternoon assuring me that my heart was stable. Phew.
NOW, certainly I was done with hospitals and doctors for awhile. I looked forward to the upcoming weekend and a visit from a dear friend, Rania, and her boyfriend. I also was anticipating a possible road trip with my boyfriend with excitement. But (since it wouldn’t be November with orthopedic surgery) on Thursday, I had a recurrence of a sharp pain in my knee. I had already seen the surgeon for the knee pain earlier in the month and had x-rays and an exam. The next step was to have an MRI. I scheduled it and went on with RICE (Rest, Ice, Compression and Elevation), and went forward with fun plans for the weekend.

riding

I spent a wonderful weekend with friends, reminiscing, riding motorcycles, eating out and toasting the end of cancer treatment. Then Sunday night, the neuropathy that was finally almost gone from my left foot, came back with a vengeance. By Monday morning, my left foot was terribly swollen and painful, making it difficult to walk. I scrambled around to try to see the orthopedic surgeon asap and attempted to move the MRI date up. The surgeon didn’t want to see me until he had the MRI results in, but I did eventually get the MRI rescheduled and a new appointment to see the doctor.

2014-09-28 09.57.09  2014-09-27 13.18.11

Now it is Tuesday morning, the day of the MRI. I am able to put a little more weight on my foot, but I’m still limping quite a bit. I called around to make sure nothing implanted in my body contained metal (a no-no in MRI machines). The chemo port checked out MRI safe, the IUD also was okay. Then I spoke with the surgeon’s nurse about the tissue expanders (as I affectionately call them – boob placeholders). Tissue expanders have a metal port in them which the doctor uses a magnetic on to locate the port when injecting saline. NOT MRI safe…

The beautiful weather we had all weekend left with a drastic cold front yesterday, I struggle to walk without pain, I can’t have an MRI to determine the cause of my knee pain, I’m exhausted, disheartened, and my boyfriend is leaving tomorrow for a two week trip that I had hoped to accompany him on. I’ve had better days. I am ready to move forward, get my health back, get in shape, yet, here I sit, looking around at broken pieces.

Super Powers

I suppose you could say I’m settling into the routine of daily radiation, but it is not as easy as I thought it would be. The first three sessions certainly took the longest, and were the most uncomfortable. Now that the measurements are all established, each session does go fairly quickly. The 15 minute sessions are short, but the commute, parking and waiting room time adds up. The radiation department at my hospital is under renovation, so I have to travel to a farther location for radiation. I got spoiled on weekly chemotherapy appointments within 10 minutes of home. Now, I face daily appointments 25 minutes away, along with a bigger hospital with more parking issues, too. So my 15 minute appointment ends up consuming nearly 2 hours each day.

 

Everyone says radiation is a breeze. You aren’t supposed to feel anything and side effects are limited. Maybe this would be true for me, except for the fact that my right arm has been through so much recently. Elbow surgery followed by rotator cuff surgery, followed by a bilateral mastectomy with lymph node involvement makes it REALLY difficult to lay on a hard table with my arm stretched up over my head. Holding that position for even 10 minutes is painful.

 

First, they have a special mold that they set on the table to position my head and arms accurately each time. Then they use the computer to achieve precise measurements to line up the areas targeted for radiation. This usually involves them pulling or pushing or rolling me around on the table with instructions to lay still and let them position me, usually resulting in a very uncomfortable position. Inevitable, that’s when I get an itch on my nose that I have to ignore.  The table moves up or down and pivots this way or that, and the machine moves around me until everything lines up just so. Next, the lights go off, beams of light show where the radiation will go and they use markers on my skin to draw lines along the beams. Then the lights go on, everyone rushes out of the room, leaving me alone as the machine clunks and buzzes with radiation.   Minutes go by, the lights go off again and the technicians come back in, engrossed in their conversations, and pull and arrange me on the table again. Lights on, repeat. Lights off, repeat. Done.

 

Once a week, there are more x-rays and I meet with the doctor to discuss how radiation is going. At this point, there’s not much new to discuss, as we don’t expect to see any side effects until week 3. After session number 5, the doctor said, “5 down already, see how fast it’s going?”. Actually, no. It’s kind of dragging on and on already. And only 28 to go… Small price to pay to achieve super powers.

2014-08-12 10.13.22 superpowers

Respite

Respite

I have spent the last month attempting to keep all things “cancer” out of my mind. Apparently, that included posting to this blog, as I realize it has been over a month since I’ve updated everyone who follows me here. Cancer treatment is a long road and can consume all of one’s time, energy and thoughts. Clearly, it is a road worth taking, but like any long journey, sometimes it is necessary to step back and gain a different perspective before continuing. This month long break between chemo and radiation was just the respite I needed in order to rebuild the strength and determination I need to finish stomping cancer out of my life.

The last round of chemotherapy brought some challenges, but my focus in July was to push through and enjoy as many fun summer activities as possible before the start of radiation, which will impose some limitations on me.

I think I did fairly well during this break in treatment. My returning energy levels and diminishing side effects allowed me to take a couple of camping trips (one by motorcycle), I did some hiking, spent a week at the family lake house, attended state fair (I even went on a couple of rides), and hit some outdoor music festivals. Sadly, I was unable to participate in the Riverwest24 (a great neighborhood 24 hour bike race), but I was able to observe the event as a spectator, which gave me an opportunity to see friends and share the event with my kids. All of this was punctuated by weekly doctor appointments which served to remind me that I’m not over this yet.

2014-07-16 20.46.18

2014-07-22 19.43.52

2014-07-26 17.46.27

By the end of July, I had a final appointment with the medical oncologist, during which she told me that I was doing great and my blood work proved that I was ready to move on to radiation. She passed me on to the Radiation Oncologist, with whom I met on Friday, July 29th. He seemed confident that I would tolerate radiation without problems. He assured me that it would be a breeze compared to chemotherapy. I was told to expect fatigue, and localized damage and burning to the skin at the site of the radiation. I was also told to stay out of the sun and no swimming. This was, perhaps, the hardest pill to swallow, as August is my favorite month specifically because I love hot weather, the feel of the sun and swimming (things that are cruelly limited in Wisconsin). After the meeting with the doctor, I went in for radiation mapping. The mapping involves a CT scan, lots of measurements and small tattoos to mark the precise location where the radiation will be targeted. After this appointment, I was scheduled to start radiation on August 6th, which allowed me one more weekend to escape.

I took the opportunity to combine two of my favorite things for the first time. Motorcycling and camping. Both are also a huge passion of my boyfriend’s – so much so, that he has several books on the topic (traveling250.com for more). We had a campsite reserved north of WI Dells, but a last minute change allowed us to meet up with some of Andy’s friends, an Australian couple traveling the world by motorcycle. Their travels brought them to the EAA fly-in in Oshkosh, so we left Milwaukee a day early so we could join them. It was my first time to the fly-in. I was completely blown away by the magnitude of the event.

2014-08-01 07.16.55

2014-08-01 11.46.25

The ride took us through some significant storms and we arrived, late, to a soggy campground, where we had to set up the tent in the dark. It was worth it, as we got to share some wine and travel stories with some fascinating travelers well into the night. The following day, we walked all over the elaborate grounds of the EAA, attempting to squeeze way too much into too little time, as we wanted to leave early to beat the rain to our next campsite. We didn’t quite make it, and we arrived at Roche-a-Cri state park just as the hail hit. The ranger let us hang out in their shelter until we got a clearing in which to set up camp and cook dinner. The next two days were beautiful and we filled our time with hiking, relaxing and a couple of motorcycle meet ups with a group of friends, which took us through the dells, and a trip on the Merrimack ferry on the way home Sunday.

2014-08-03 09.10.13

2014-08-02 11.07.18

2014-08-02 11.30.08

2014-08-03 13.49.13

Back to my current reality after the camping trip, I went back to the hospital (Andy wouldn’t let me run away and extend our trip indefinitely…). Wednesday, August 6th would be my first day of radiation, which actually involves simulating the treatment with x-rays and further measurements and fine tuning to make sure everything is correct before administering the radiation. It was torture! Still not properly healed from rotator cuff surgery, I found it extremely difficult to lay still with my arms up over my head for such a long time. First, my arm went numb. Then it progressed to pain, then my arm started to shake from the pain, at which time I was reprimanded for moving and told that if I wasn’t completely still we would have to start from square one again. That was enough to make me push through, but I was nearly in tears by the end and not sure I would be able to hold this position 33 more times (yes, 5 days a week for 6 and a half weeks). They told me that the simulation would be the longest one and that subsequent sessions would not be that bad, so I went back again on Thursday to start radiation. Again, there was some fine tuning and double checking, and my arm went numb again, but did not have time to progress to pain by the time it was over. Friday was shorter yet, and my kids were with me, so they got a chance to see what I would be going through, which removed some of the mystery for them. They got to see the machine that gives their mom super-powers. And they got chocolate. What more could you want?