So, You Had a Mastectomy…

Also titled, “I will not pee the bed.”

Today is the first day post surgery that I have been able to focus and type, two things I had taken for granted previously.  The pain has been excruciating, not enough drugs and there isn’t a single position I can sit in or rest in that provides any comfort or relief.  I spent yesterday counting the hours until I could take another pain pill and trying to sit as still as possible; every breath hurts.  With the lumpectomy, my chest was comfortably numb after but with this surgery, I can feel everything.  Something wasn’t just removed during my mastectomy but for reconstruction, something was added.  And no, it didn’t end up being just a nice soft comfortable gel implant. We had to take the extra-pain-extra-surgeries route.  I shall explain soon enough.

We flew to Oahu on Tuesday morning, arriving at the hospital at 10:15 am for surgery at 12:30 pm.  The day before I was feeling sorry for myself, resigned to fate, relieved to be taking the next step.  Life is often about perspective.  My perspective at that point was, why do I have to deal with this, all of this, when so many of my peers get to worry about work, weddings and babies?  This is based on the general consensus and not everyone’s own personal goings-on, so again, as the blog rules go, do not be offended.  I know we all have our shit.  But I get to feel bad for myself here and there and Monday was a good day for that.  I want to be spending my stress and worry hours on my career and relationships and normal 20-something life, not on my health, not on dealing with cancer and healing.  I’m a classic multi-tasker and I’m bored with this one step at a time health crap.

The resigned and relieved feelings were welcome after that.  To think I could go in to surgery and potentially cut off the cancer and be done with it was lifting.  But I was also resigned to the fact that this is really my only option, if I wanted to have a strong quality of life.  If I had opted for another lumpectomy, there would be a good chance we wouldn’t get all the cancer cells and there would be a good chance it would come back.  And there wouldn’t be much boob left and it would look weird.  I live in Maui!  I’m a marine biologist!  I live in a swimsuit!  I cannot have that aesthetic discrepancy on my mind.  And thank God I have insurance and that it covers all of this.  (Yeah, if you don’t have insurance, you might want to rethink some things).

So I had finally accepted that I would be amputating my breast.  To me, boobs have always represented two very important things: femininity and motherhood.  Now, to me, they have come to represent pain, sadness, loss, suffering, anguish, fear.  But also, life.  If I accept that one has to go, I may get to keep the other (so far it’s still healthy) and, more importantly, my life.  I am not any less able to be feminine or a mother because of the loss of my breast.  But it’s always hard to sacrifice a bit of body–of who I am, of what the bit represents–even if the result is survival.  Man, I really hope the pathology reports come back saying that we got it all.  If they don’t then I would probably have to have radiation (that would mean the cancer went deep enough to reach my pectoral muscle tissue).  There’s still never going to be a guarantee that my left breast will stay healthy.  But I’m hopeful that it will, and with lots of follow-up imaging and testing, I want it to stay that way for a few babies in my future.  Natural options are important to me.

Pre-op was very different than Maui.  In Maui, I had a private room; in Oahu, I had a private curtained section and could hear what the three patients next to me were going in for and when they had last peed and whether or not they had a living will.  Hmm, I have given up my tight grip on privacy a lot these last few weeks but I think this is a good instance when privacy should be striven for and granted.  I just wanted the drugs, the sleep, the shit to get done!  I went through the changing, stowing belongings, answering lots of questions, a quick IV stab with lidocaine this time, hanging with parents and finally I was whisked away to surgery and I remember little.

Mom and dad and Sean told me it took about three hours (they had thought one hour would be all) and recovery took another several hours (oh, I do remember waking up to the pain and asking for lots more morphine).  Dr. Gambhir performed the mastectomy, removing all of my breast tissue and nipple on the right side (all drains lead to the ocean?  all mammary ducts lead to the nipple and since cancer hangs out in the ducts, the end of the trail had to go to).  Then Dr. Nishikawa came in to “begin” the reconstruction (remember, many surgeries in my future).  He placed something evil known as a “tissue expander” in the space.  Oh, yes, it’s the horrible gruesomeness I referred to in previous blogs.  It was placed under part of my pec muscle at the top and then cadaver tissue with the DNA removed was placed around the base.  This creates a pocket and extra padding for the future implant and allows for the space to be expanded over time to fit the implant; since the nipple and some skin was removed, I don’t have enough space to fit a implant right now.  Yeah, not quite the easy out, easy in I had hoped for.  I think this is where I get to say FML (fuck my life).  This is gross just thinking about it.  And it’s in my body.  Note to all: don’t get cancer, it sucks.

I woke up in recovery and they wanted to know my pain level from 1 to 10.  And what’s my comfort number?  I don’t need drugs if I’m at five.  But I think I was at 8 or 9 and so I got a lot of drugs.  And it went like that for many cycles of waking up and sleeping, which to me was about fifteen minutes in all but was actually many hours of time.  It hurt so bad I couldn’t breath right.  Inflating my lungs hurt.  Finally around 7 or 8 pm I was stable enough to go to my room.  My parents found me (communication was not great in the nurses letting my family know what was going on) and off we went.  I proceeded to get lots more drugs in my IV, antibiotics, saline, etc and some dinner (that part not in my IV).  Most importantly, I got to watch TV!  I haven’t had cable for years so I watched all the trash I could: E!, Kardashians, Price is Right.  The good stuff.

My personal goal was to not pee in my bed!  Even though I was allowed to.  Hell no I did not want a catheter and I couldn’t fathom trying to pee in a bed pan (seriously, how would that even work?!).  But I had to pee.  So the nurses helped me get up and walk to the toilet (3 feet away!) and I peed all by myself!  Ah, the joy of accomplishing a goal.  Not quite the same feeling as scuba diving the Great Barrier Reef in Australia but, it’s all that perspective.  And my nurse wrote my other goals: “pain control, no nausea or vomiting.”  Good!  Technically, I am allowed to puke on someone.  Or rather, they can’t get too mad at me if I puke on them.  But I’ve worked on boats for years and dealt with my fair share of seasickness (and general crabby people) so I did not want to continue that horrible scenario (I didn’t want to pay the vomit forward if you will) if I could help it.  I wanted someone to enjoy a vomit-free day, or at least a vomit-free patient.  I vowed not to vomit and I succeeded!  As I was leaving the next day, they termed me the independent patient because I insisted on peeing in a toilet.  It’s kind of like a gold medal at the Olympics.

My parents left around nine and not too long after, I got a roommate.  This lady was a character.  She was constipated (the reason she was in the hospital) and had cancer too.  She would say nice things to nurses and then call them all the time, saying “ooch ooch ooch” in loud rapid succession.  It was a constant procession to her side of the room, plus that no privacy thing.  I found myself trying to figure out her life.  What was her ethnicity?  She had an interesting accent.  How old was she?  She looks old but I know she has a ten year old daughter… Hmmm.  What does she have?  Who is she?

The night passed uneventfully for me, exciting for the bed next door.  Staying overnight in a hospital is like having a sleepover.  No one really goes to bed.  We all sleep for a few hours at a time.  But there are always nurses coming and going.  Vitals are taken every few hours and drugs are administered every few hours in between.  The doors stay open so I could hear other patients.  At one point, the person in the room next door was yelling “help” and since no one came, I pressed my nurse button and sent the message on.  New perspective: OK, life isn’t that bad, I can still press my call button but look at all these other people in recovery, they probably have it worse.  Leave it to being in a hospital to change my perspective, at least for the time being.  I couldn’t read because it hurt too much to move and my brain was too spacey.  More TV and peeing to pass the time.

I could have stayed another night in the hospital but I just wanted to be home, to see Sean and the dog, to be in my own comfort zone.  Traveling home was painful as was the first night back, but it’s getting better.  I got the premier treatment via wheelchairs but any bumping and/or movement hurts.  I like to sleep on my side but I cannot.  I’m learning to use ab muscles and they hate me.  I move like an old lady.  Yesterday I had to switch books from something semi-educational to a mindless novel because I cannot concentrate or process a lot of info (brainless is making me feel smart again!).  I glare at the phone when it requests my attention (sorry, friends, I’m almost there).  I have a very fashionable right side pony tail because I cannot lift my right arm all the way.  I am learning to be ambidextrous because it hurts to use my right arm too much; I’m also learning to balance my food on the fork as I slowly bring it to my mouth.  I am forever thankful to my caregivers, mom, dad, Sean, puppy.  I wanted to write but couldn’t until today.  And we’re sticking with the facts for now, maybe I can put one song in here for some fun.  I just wanted to get you all up to speed.  And I need some more drugs (trying just Advil!).

And I’m still trying to suss out all the good in this and focus on the humor in this, where applicable and when possible.  Believe it or not, one boob the less, I still cannot believe this is happening.  I mean, it’s happening, yeah, I know.  But, really?

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The Devil’s in the Details

“Courage doesn’t always roar.  Sometimes courage is the quiet voice at the end of the day saying, ‘I will try again tomorrow.'”

~Mary Anne Radmacher

One of those details being: I still have cancer.  That’s right, I tried to wish it away but it just wont go!  Seems as though there are still some cancer cells attempting to corrupt more pre-cancerous cells lingering in my right breastal region (perhaps you prefer boobal region?  I believe in the American right to make up words.  It is ginormously important!  It may even be in the first amendmant…).  That’s the scary truth of it: I’ve been through so much shit and I still have cancer.  Can’t you tell you’re not wanted, evil C cells?!  Theoretically, a mastectomy will get it all and we’ll be in the clear.  Ideally, hopefully, fingers-crossed-ly.

Another detail, why did Kenny Loggins “I’m Alright” from Caddyshack get thrown in here in one of the first blogs?  Danielle told me Beyonce’s “Survivor” went through her head when she heard/read the news, and I can’t help but admit, it traveled into mine too!  But then I had to quickly mute it because we’re just not there yet.  Driving around town in a state of shock, disbelief, anger and doom, the universal powers that be gave me a little Loggins time and sent “I’m Alright” to the radio.  Listening to it was a nice step back in time–ah, memories, family, friends, life–and a reminder that I’m not the kind of person that stays curled up in a ball of doom and gloom (sure, I curl into the ball sometimes, but only temporarily).  I’d rather go at this aggressively, seize cancer by the throat and chuck it out into the streets, ASAP!  I got shit to do and cancer was not on my list of life-long goals.  But here it is, already over-staying its un-welcome.

“I love to see a young girl go out and grab the world by the lapels.  Life’s a bitch.  You’ve got to go out and kick ass.”  ~Maya Angelou (If she can swear, why can’t we?!)

And, Nik, thanks for the home-made CD!  Listening to it now, and mellowing.  Kari, yours in up next!

“One good thing about music, when it hits, you feel no pain.”  ~Marley

One more, little tiny teensy weensy detail: the armpit numbness I’ve mentioned may last anywhere from nine months (Dr. Gambhir’s estimate) to one year (my plastic surgeon, Dr. Nishikawa).  Or rather, that’s the amount of time it may take for my arm to be back to normal.  This is because of the removal of and damage to my lymph nodes.  F.  Bomb.  Ugh.  Do you know what it feels like to put on deodorant on when there’s no feeling there?!  I can’t tell if the deodorant went on!  (Which, by the way, as cousin Nicole mentioned, Aluminum-free deodorants don’t work so great; still looking for a good one.  Ash, which one did you try and like?  I didn’t like the Crystal, never thought it worked, I need something that smells good.  Should I just rub some aluminum chunks under there?  Is that the secret ingredient?  I know it’s potentially carcinogenic but, hey, I already got cancer!  I’d rather not be the smelly kid at this point.)  To explain what my upper arm and arm pit area feel like, it’s just this: chaffing.  Constant relief-less chaffing.  I see men cringing.  Ladies, it feels like a bra edge folded under a tight tank top and rubbing only I can’t just adjust it.  It’s tight and stiff and sore to move and lift my arm.  Nine months of this?!  Fuuuuuuuhhhh.

Yesterday was the Oahu day trip (I live on the neighboring island of Maui in Hawaii and not all of Kaiser’s doctors and facilities are here) to the plastic surgeon to discuss reconstructive surgery.  Folks, I’m here to be honest.  I’m not going to sugarcoat this.  You may need to remove small children from the room.  The details of a mastectomy and reconstruction, are in one word, BARBARIC (boobaric?!  Hahaha.  I may be loosing my mind, finally).  I was horrified as we talked through the process.  Cancer is obviously here in my life to show me that there-are-no-shortcuts-we-can’t-get-through-this-fast-I-need-to-slow-down-stop-and-smell-the-roses-stop-worrying-about-work-and-anything-else-but-getting-healthy-shut-the-hell-up-and-deal-with-it.  Something like that.  At least that’s what I got out of it.  I will spare you the details for this blog because there was something deeper at the heart of the Oahu trip.

I finally had my meltdown; I went and sat at rock bottom and had a brief pity party.  Obviously, the last blog represented a terrible day and the descent into no-man’s land.  I thought it was the bottom and that I climbed back up.  But I was wrong.  I got through the Oahu trip and then got home, went to a lovely movie with my man and then started telling Sean about the horrors of the reconstructive surgery, the time it will take to go through the three surgeries and six plus appointments that make up the reconstructive process.  By re-telling what I had heard earlier that day, the reality came in fully and sat like an elephant on my chest and a storm cloud over my head.  Cue giant fat rolling tears on the car ride home, pause to get ready for bed, and cue more tears in bed.  Sean chose the tough love method in the car as I whined and pitied myself and this sucky path of life I got put on and then, at home, I “yelled” (spoke strongly sounds more accurate, “voiced my opinion”) at him that he needed to baby me (as a stubborn man to my stubborn lady-ness, he finally relented and  chose to alternate between supportive things and being quiet while I got it out; we are quite a match of stubborn-ity!).  But the whole magic of it all, is that once I gave in a cried it out, I was over it.  I was lighter.  It took maybe ten minutes and then I could let it all go.  All that shit just floated off in the breeze and I slept.  Don’t think for a minute I’m telling you that I’m emotionally balanced but that chunk, that situation, has been processed away and put to rest.  I’m better today than I was yesterday.  And guess what mastectomy with reconstruction?  I’m still coming at ya.  You.  Me.  Tuesday.  See you (in part) in the OR.  (Stronger drugs, please).

“Anyone can give up, it’s the easiest thing in the world to do.  But to hold it together when everyone else would understand if you fell apart, that’s true strength.”  ~Unknown.

How are you all doing?  I’ve gotten some feedback that you experienced many emotions from reading this, but what exactly?  I know I promised you a poll in the Results are In blog but I couldn’t have your opinions weighing on my decision; it just had to be my decision or as an independent young lady, I would second guess myself.  So let’s try the polling feature below.  The Unknown/Other category are for those of you that say, “Serena, I don’t know how I feel.  My girlfriend made me read this.”  Or perhaps, “Serena, I don’t know what emotions are.”  Or even, “Serena, I’m cry/laughing so hard I don’t know what I’m clicking.”  Or the usual, “Serena, I’m not good at multiple choice, is this a test?  Is there a right answer?  A wrong answer?  WHY IS THIS SO STRESSFUL?!”  Just, shhhhh, click it, breath, take a walk and come back when you’re ready.  Stop channeling college nightmares.

Another detail: To Bob and Maryellen, I have changed the tag line to reflect your witty input!  We are no longer here for therapy but “Tumor Humor and Cathartic Carcinoma Quips.”  Much more attractive and far less scary.  Therapy is scary sometimes.  I did a little dictionary-dot-com-ing to make sure I was using “cathartic” properly (Darlene Wilt, I almost always check my work!) and I found some interesting definitions.

The first was “a purging medication; stimulates evacuation of the bowels.”  Well, according to that definition, we are going to shit all over this blog!  Go for it, purge away: shit on it, I dare you!  Life is shitty.  We often get stuck in shitty situations.  Shit will hit the fan at some point.  This is shit and this is shine-ola (The Jerk, a classic family and Lake Winnipesaukee Labor Day Party movie).  We are never too hold to deal with shit and have fun with shit; some of you are even cleaning up shitty diapers (even from adorable Sellier girls, Cami and Cossette!).  Ah, shit.

The second definition was far more accurate and exactly what I was looking for: “emotionally purging.”  Yup, in the case of shit hitting the fan, we’re usually experiencing a lot of emotions (ideally, the fan will whisk those emotions away and just a hint of a poo smell will remain as a humbling reminder of what we went through, the shit).  I am using this blog to emotionally purge.  I’m kind of shitting on you.  In some species, that is special.  Maybe not in Homo sapiens.  But a bird shitting on you is lucky, right?  Or did a parent somewhere make that one up so console a shat-upon child somewhere?  Hmm, I digress.  Where were we?  Oh, yes, I shit on you with emotions.  But I leave the door open for you to shit back!  That’s what the comments section is all about!  Shit away (the overuse of this word is leading to it’s loss of intensity; granted, it’s a bit more acceptable in society and culture than the F word; kids reading this, I’m just referencing Fudge or Fruit or something else Fantastic).  We’re emotionally purging our way through a very difficult matter with equal bits of reality and crap and humor and fun; like a fine life recipe, huh, mum?

Can you find the shit in this picture?  Guess what?  It’s from the brown BOOBie bird!  Life is ironic!

And this leads me to one of our last devilish details: the amazingness of all of your [unshitty] support!  And my extreme inability to call you back.  I’m still Serena, I still have a hard time with the phone.  I have received so much love and support from you and I haven’t been able to keep up with it.  But the cancer books say I don’t have to and the cancer books say (because you probably haven’t had as much time as our household to read them so I did for you) that you should not be offended that I didn’t call or write or email or text you back!  Yay!  Cancer, the scapegoat, strikes again!  You can blame it too!  I got flowers from mom and dad, Erik and Lisa, Michael and Craig, the Pacific Whale Foundation Lahaina-side family.  Care packages and thinking of you gifts from godparents Carol and Craig, Nik, Kari, Mike and Laura and Reno dog (and Scupper even got a doggy care package from them!), Aleta and Gary, Steph and Linds, Jac and Andrew, Sierra and Drew, Uncle Dennis and Mary Lou, the McClellands.  Cards from all over the place from all areas of my life, phone calls and texts all up in my phone, emails filled my in box.  It has all been overwhelmingly amazing and continues to be so!  I write this as a huge thank you.  I cannot always get back to you.  Sometimes I’m busy, sometimes I’m just too tired with all this stuff.  And I do feel guilty about even though I know you understand and the books say I don’t have to.  But your love and support and respect and care do not go unnoticed.  You all want to do something and you have; just reading this and sharing this is enough but you’ve gone above and beyond.  Mahalo cannot be expressed enough and I know I’ve said it a lot in here; I’m shooting for overkill anyway!  I love you kids!

“Being deeply loved by someone gives you strength, while loving someone deeply gives you courage.”  ~Lao Tzu

Our final detail: did you feel yourself up yet?!  Woah, WOAH!  Let’s not get carried away!  Get your mind out of and away from the gutter!  I just want to make sure you did your boob check.  It can take 6-10 years for cancer to develop into a notable lump.  Ain’t that a mind trip?  All this reading and learning about cancer and I’ve maybe possible potentially had it for a long time.  But, dear, cancer, you are still not an old friend!  You are still not welcomed with open arms.  I still plan to find you.  And kill you!  Don’t put up a fight anymore.  Let’s just make this quick–and since we can’t say painless, and hardly even quick for that matter and my mind set; just go peacefully.  And never ever come back.