Post-Surgery, Part Two

In my last post, I talked about one of the results of having a mastectomy: the drains. They’re (not-so) fun.

But wait, there’s more!

I was going to make a part three, but I decided to combine these because honestly wasn’t sure I would be able to get 5-600 words out of each of these next two parts. Ha!

The first is the Nerve Block. The anesthesiologist gave me a lot of information about how they were going to numb me for the longer procedure; including information about a nerve block which would block pain in the surgical area for a longer period of time. This one would last up to 72 hours, but I honestly didn’t pay too much attention to all the details.

When I woke up I was in a little pain, especially at the site of the drains, but it wasn’t too bad. I slept most of the day I came home, but the next day was Sunday and I was in a lot of pain, so took the allotted amount of pain medication. Monday the pain was better. But Tuesday, the pain got worse. Much worse. I couldn’t figure it out. Why three days after surgery was I starting to hurt worse? Then I remembered that conversation with the anesthesiologist… the nerve block would last 72 hours. 72 hours = 3 days. Tuesday was the fourth day and I was in pain. So I had to up the pain medication that I had been weening the day before. Sigh…

I think they should invent a nerve block that lasts long enough for the area operated on to heal. That would help stem the opioid addictions, right? But I guess then people would start moving around too soon, thinking they were healed, when, in fact, they weren’t. So maybe that’s not a good idea…

The other part is the expander. Now, not everyone who has a mastectomy gets an expander. And some people will get one, just not in the same surgery. I chose to have reconstruction done. I didn’t want to go around being lopsided if I had the choice to fix it. So I’ve opted to have another breast rebuilt where my diseased one used to be. And my team decided it was best to begin the reconstruction on the same day. So my plastic surgeon took over the surgery after my oncology surgeon was finished removing the cancer and the lymph nodes. The type of surgery I had was a skin-sparing mastectomy; which means that they were able to save most of my skin to help rebuild my breast. Unfortunately, they were unable to save my nipple and areola because the cancer had taken them and pulled them in.

[SIDE NOTE] Ladies, if you notice that your nipple has turned in, or become inverted, you need to see your doctor right away. It’s not always cancer, but it is one of the signs they take seriously. Please do not ignore this sign!

So the plastic surgeon is able to insert, sometimes over the muscle and sometimes under the muscle, what’s called an expander into the space that was once my breast. I will have weekly appointments to inject saline into the expander to get & keep my skin stretched in the appropriate shape and size of my former breast. They will not do reconstruction until any necessary treatments like radiation or chemo are complete.

Now here’s where the silver lining comes in; because you always have to look for the silver lining and the blessings in all situations, right? Because I’m a cancer patient, I get to choose my size! And augmenting the other breast to match my newly constructed one is no longer considered cosmetic! Apparently the law requires insurance companies to pay for reconstruction so don’t let them tell you otherwise.

But here’s the thing about the expander: it’s weird. It’s square. And I didn’t realize it until one day when I was scratching an itch below my collar bone and I felt it. I felt this hard, straight line under my skin. I can honestly say it freaked me out a little. But I conferred with my plastic surgeon, that it would, indeed, be removed when my implant is put in… Whew!

One more thing I want to say about reconstruction before I sign off; ok, two things. First, you don’t have to have reconstruction. It doesn’t make you any less a female if you choose to stay flat. The choice is yours and it’s personal. You can – and should – seek opinions of those you love and trust; and maybe others who have ‘been-there, done-that.’ But no one should make that decision for you.

The other thing is that reconstruction can be done another way. They can take tissue from your abdomen or back and rebuild a breast from your own tissue. There are advantages and disadvantage to this. For me, the disadvantages of a longer surgical and recovery time, at least two places that would have to heal and could possibly get infected out-weighed the advantages. If you are reading this as someone deciding about reconstruction, please make sure you get a good explanation about both the advantages and disadvantages of all of your options. And then, armed with the facts about each, make your own decision. Don’t be pressured into one or the other; you have to live with the decision, they don’t.

See all posts on my breast cancer journey here.

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