Archives for posts with tag: TRAM breast reconstruction

I’m cold. I mean that literally. It is winter and I am cold.

Obvious, huh?

Not so obvious, actually. Through the miracle of insta-menopause, which was part of my cancer treatment, I was hot for a long time. I would find myself stripping down to a sports bra in February during an outdoor walk. I stopped wearing tights with my dresses and went bare-legged through many winters.

Last year, I started wearing footless leggings under my dresses. This year, I notice that my workout clothes are not warm enough. I also noticed that I have a shortage of long-sleeved dresses.

I am longing for the two sweater dresses that I gave away to charity a few years ago because I could never wear them. I always overheated.

Yes, my friends, my body continues to heal from the effects of cancer treatment and the natural hormonal changes that come with middle age. My personal thermostat is much more like it was before the years leading up to cancer when I was in peri-menopause.

Sensation continues to return to my torso, the areas of my surgeries. Although not fully restored, I no longer feel numbness when I am upright. It is odd how a lack of sensation feels very much like something, like carrying around a weight.

After nearly 7 years of survivorship, I am still healing. Perhaps, if I knew this would be the case back in 2012, I would be fearful. But today I find this to be a gentle miracle, an aging body that is better able to sense cold, pressure, and gravity.

May 2019 bring you peace and healing, dear friends.

-Elizabeth

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After a couple of recent inquiries about my physical health, I realized that I have not provided an update for some time. So I will take out a bit of time from my concentration on my emotional and cognitive health (a post about my challenges with attention, organization, and memory is forthcoming) and focus on my medical status.

Medications

I started taking Lupron injections last summer. I now get one every three months and will continue to do so for a total of two years. Lupron “shut down” my ovaries by disrupting the signal between my pituitary gland and my ovaries. So my ovaries think my days of monthly cycles are over and done with. I am currently infertile and functionally in menopause. However, Lupron induced menopause is reversible. Once I stop taking Lupron, I may start my cycles again and go back to being peri-menopausal.

In October, I started taking tamoxifen, another hormone blocker. I will take that for a long time. At the time of my diagnosis, the usual treatment protocol was to take it for 5 years. Subsequent research suggests that 10 years might be better. I’m not going to worry about it because we’ll have more information by the time that decision needs to be made.

Other than those stupid hot flashes, occasional foot cramps, and having to work out harder to maintain a healthy weight, I have been very lucky and tolerated these medications very well. Knock on wood.

Scans

I have an annual diagnostic mammogram and an annual MRI, staggered by six months. I had a “clear” mammogram last January. I will have my next MRI in September, six months after my TRAM surgery. (Recent surgery makes it harder to read the images for MRI.) Both diagnostic mammography and MRI missed three of my four invasive tumors as well as a 6cm area of DCIS. A disadvantage of being “young” (under 50) in the breast cancer world is that our breast tissue tends to be denser because there is  higher water content. The water shows up as white on imaging as does cancer. So it’s hard to know. I have also read measurement research on the sensitivity and specificity of breast imaging techniques. Imaging should get considerably more sensitive as I age. However, the specificity of mammography in particular is not great. As you know, there is a high rate of false positives. But that was not my problem. My problem was of false negatives.

Surgeries and recuperation:

As many of you know, I had seven surgeries between 6/27/12 and 3/11/13. I know I mention this a lot. I also know that it is not a race as in she who gets the most surgeries wins! Let’s just say that one of the reasons I keep mentioning it is because I am still trying to believe it. And I kept my sanity that whole time. And I know that many of you out there have been through similar and even rougher treatment protocols. Let’s pause a second to reflect on our resilience. It’s really rather incredible.

Back to me, sorry, I told you that I was going to write a post about my ever-changing cognitive functioning. I had an appointment with Dr. Welk, my plastic surgeon last Friday. Even though I was feeling good and nothing appeared to be amiss with my healing, I was kind of nervous about the appointment as I had not seen him since April. I am happy to report that nothing appears to be amiss.

I am still slightly swollen from my TRAM surgery, which was 4 1/2 months ago. A significant portion of my sensation has returned to my abdominal area. There are no areas that are totally “dead” to heat, pressure, etc. I intermittently feel those little electrical shock sensations associated with nerve regeneration, especially right after my acupuncture appointments. And then after several hours of on and off shocks, I notice that I have more feeling. I just now read a plastic surgery abstract from a very small study of women post TRAM surgery. A good number of them had at least some sensation return. (Yes, it would be better to read the entire article but the journal was charging $30 for the privilege.) I had not expected any sensation to return and so had not mentioned this issue to Dr. Wang. I will talk to her about it next week when I see her. Perhaps there could be some welcome improvement in the “being able to feel stuff” department.

An unexpected positive is the fact that my abdominal strength is much better than I expected it to be. I had a pedicle TRAM procedure which means that one of my rectus abdominus muscles was sacrificed to create a blood source for the transplanted tissue. Microsurgical procedures can be used to prevent this but I was not enamored with the higher rate of complications and failed surgeries. There is a little bit of controversy regarding the pluses and minuses of these procedures but I am happy with the choice I made.

I am seeing Dr. Welk again in October after my follow-up MRI. I may have another set of plastic surgeries, which Dr. Welk said could be done in one office visit. (Dr. Welk’s time estimates are like dog years so this means two office visits.) The purpose of the procedures would be to improve symmetry between lefty and righty. But at this point, I don’t have to do a thing and Dr. Welk was very clear that this was a perfectly reasonable option. He provided a range of possibilities including doing breast enhancements on each side, which would involve getting a set of implants. For me, this is a big “no, thank you”. He was fine with that.

Healthcare visit schedule:

Currently, I see my breast surgeon every six months, my medical oncologist every three months, my naturopathic oncologist every 4 months, my Chinese medicine physician every two weeks for acupuncture, and my psychologist every two weeks. And I continue to get a full body massage every three weeks, something I have done for nearly 13 years now for stress and chronic pain management. (I had chronic neck pain for twelve years during my 20’s and early 30’s. It went away after two months of massage.) I typically have 1-3 healthcare visits a week, about half of which are across town or in another city. I am very lucky to have such wonderful care. The logistics, however, contribute to a frequently interrupted life and work flow especially on top of parenting duties.

So that’s the state of the union as of today. I will keep you posted and thanks to all for your continued support and concern.

I was looking through the photos on my phone when I ran across this one:

Ollie, enjoying a sunny spring day, out on the deck.

Ollie, enjoying a sunny spring day, out on the deck.

 

This photo was taken just a couple of weeks before he became very obviously ill. He was greatly enjoying the new deck. He his tail does look narrower toward the base. Ollie had been pulling out his own fur, something he’d never done before. I don’t know if this was related to the metastatic cancer or whether it was coincidental.

Ollie was an indoor cat up until last April. We live near a major street and I was afraid that he would be run over by a car. The rest of my family felt differently. We loved him but he had a lot of anxiety problems, which resulted in his spraying all over our house for years. And no, our house does not smell like cat pee but it has taken a lot of work  to keep it from getting that way. He was also aggressive to visitors though the sweetest cat to us. Ollie had a lot of personality but I know that other families may have taken him on a long drive to the country or euthanized him. I am not a person who always wants to have a pet. I had held off for years before meeting Ollie in Eastern Washington. He was a stray, adorable, and I didn’t want him to be coyote food. My stance is that once we committed to having a pet, we committed all of the way. When someone rather pointedly asked why we didn’t get rid of him, I said, “We don’t kick members of our family out for mental illness.” Little did the person who made the comment know that this policy was also working in his/her favor.

While I was home from TRAM surgery, I must admit that the first time Ollie pooped on our bed, it was less than charming. He did it again only a few days later. I remember letting go of the fear of trying to protect him from everything at all costs. I relented, “Okay, we can let Ollie go outside,” I told my husband. Being an old cat, Ollie stayed pretty close to home. He mostly stayed on the deck or sat on the stair railing on the front of the house.

Miraculously, as my husband had predicted all of these years, Ollie stopped spraying. He acted much less anxious. My husband was right. I was wrong. (I figured that once he got a whiff of all of those other cat smells out there, he would get even more paranoid.)

However, as I described in a recent post, Ollie was killed by a car. And this was only two months after I’d agreed that he could start going outside of the house. So I was right, too.

But when I look at this picture of our beloved pet sunning himself, I can help but think we did the right thing. We didn’t know it at the time, but his body was full of cancer and he would soon stop eating and fall over every time he tried to jump up onto a table, because he no longer had the strength that he had had only a couple of weeks before.

We were both right. Yes, that can actually happen in a marriage.

This post is inspired by Mogatos, the author of the excellent blog, Saying Nope to Breast Cancer.  She is in her early 30’s and had a prophylatic bilateral mastectomy due to her high genetic risk of breast cancer. Mogatos is a very courageous person who is helping lots of women. She has created a photo diary of her physical transformation since her mastectomy surgery in January. If you are interested in the two stage tissue expander/implant reconstruction process, I particularly recommend the site to you. Mogatos even painstakingly lists the costs of her medical care. Once I’m done with one of my medical bills, I don’t ever want to see it again.

I have had a request or two to see my reconstruction. I’m sorry to say that I am not evolved enough to share more than a photo of my belly button to the blogisphere. However, I have put together a visual showing my surgical process. Although breast cancer isn’t funny, using humor to cope with its threat is serious business.

smiley3

 

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My recovery continues, though at a slower pace. Nonetheless, I’ve passed a few milestones in the last week:

1) I tried on the swim suit I bought awhile back and not only does it fit, but I look normal in the chest area. Woo hoo!

2) The miracle lounger went back to the medical supply company this morning. I still need to spend a lot of time sleeping as well as most of the day off of my feet but sleeping in bed has gotten comfortable again and our couch is again comfy. I miss my tray table, though. My laptop computer is warm and although it is comfortably resting on my legs right now, I expect it will cause some hot flashes later in the day.

3) I averaged 3 miles a day of walking, for seven days straight! Yesterday I was beat so I stayed in. I didn’t make myself feel guilty about it but instead reminded myself that walking every day is above my health goals. I started walking every day instead of 5 times a week because it felt good and I wanted to do it. So yesterday I was mindful that my body was not up to doing a “bonus round” of exercising.

4) On Sunday, I cooked for the first time since the surgery. I wanted to bring something to my brother and sister-in-law’s for Easter dinner. I roasted some asparagus. It took me 15 minutes, including washing, trimming, and cooking. They were delicious.

 

John and I went for a beautiful walk this morning. I am back to walking 3 miles a day, just a lot more slowly than usual. It’s my favorite part of the day, which more than makes up for the fact that I end up spending the rest of the day sitting because I wore out my feet. Actually, it’s my abdomen that is bothered by standing. There’s a lot of muscle work that goes into supporting my gut even though there’s a lot less of it than there was before surgery.

For those of you who celebrate it, I wish you a very Happy Easter. For those of you who don’t, I wish you a very Happy Sunday. For my blog buddies in Australia and New Zealand, I wish you a Happy Monday!

A scene from our walk, the Olympic Mountains, Puget Sound, and islands.

A scene from our walk, the Olympic Mountains, Puget Sound, the Olympic Peninsula, and assorted islands. The mountains are not this blurry in real life. This is why a smart phone is not the camera of choice for a professional photographer.

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