I got the last two surgical drains removed this morning. Victory! Well, as small as it may seem, every hurdle I pass on the road to recovery gives me just the little boost that I need to keep the forward momentum and optimism. The doctor said that I am healing very well. If it weren't for my severe allergic reaction to the surgical glue and adhesives I'd be looking pretty good for someone only one week post bi-lateral mastectomy. I feel lighter and more free without the tubes and bottles hanging from my body. Doctors orders: no lifting arms above shoulder height, continue to sleep slightly elevated on back, no more prescription pain pills (tylenol only), continue with nitrobid cream 4 times per day, and anti-itch creams as needed. The pathology report from surgery came back in to indicate that no cancer was found in the sentinel lymph node and all of the margins came back clear. In other words, the cancer was contained and removed during surgery. Great news! The better scenario would have been if the tumors were hormone receptor positive because there are drugs that can be given to provide additional measures to keep the recurrence rate very low. Because I have TNBC (triple negative), the hormone receptors are negative and the drugs are not an option for me. We have to rely only on the chemo to try to ensure that there are no other cancer cells lingering around.
So, here comes the TMI part. If I'm going to help aid others going through this to know what to expect, I must divulge some of the gory details (boys, feel free to stop reading now :). Today's mastectomy with reconstruction options is so much different than the mastectomy that one might expect. When you think of having your breasts completely removed, you think about a flat, smooth chest with no trace of breasts remaining. With my decision to have mastectomy with immediate reconstruction what I see are two hard, swollen small breasts that actually look like real breasts. Not so shocking. They did skin/nipple sparing mastectomy on me and because there was no cancer in or too close to the nipples, they were able to leave them. The one on the right looks normal, the left one is very dark, purple. The doctor has us applying nitroglycerin cream 4 times a day to keep blood supply going to the nipple in order to keep it alive and healing well. So far, so good - I think it will turn out just fine. The first step of the reconstruction was for the plastic surgeon to create a muscle/tissue base with a tissue matrix product called Alloderm and to place expanders (implant place holders) under this material. The expanders are filled with a small amount of saline to keep the skin stretched and ready to accept implants further down the road. I will go in for my first saline expansion in about 3 weeks from now to increase the volume in the expander. We may only need to do one or two of these sessions. Chemo will begin in about 2-3 weeks from now as well and the procedure to take out the expanders and put in the implants will take place at some point when chemo has completed. There will also be some fat transfer to the breasts at some point to complete the process for a more natural look.
Quite a process, but we have come so far with the options for women who need to have mastectomies. The main thing is to be cancer free and healthy, but after that, it is wonderful that women have the opportunity to make a choice as to whether or not they want to reconstruct. The decision is very individual and there really are many options and variables.
So, all around good news today. Feeling more human each day. Now, for a trip to the kitchen to pursue my quest to put some more meat on my bones (doctor's orders)!
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