Thursday, September 17, 2015

Under (re)construction

My big news today is that I finally got my post-surgical drains removed! Those things were awful and a constant reminder that I am a patient. If you've never had the pleasure, basically, during surgery, the surgeon inserts tubes near the surgical site. These tubes connect to a plastic bulb. The bulb is squeezed tight and creates a vacuum to suck all the nasty blood and other fluids out of your body. The patient then has to empty their drains several times a day, measure and record the output. When the output reduces sufficiently, the doctor can remove them. They don't particularly hurt, but there is some tenderness at the insertion point, and they tend to get in the way and make sleeping on your side a challenge. Drains come with the territory regardless of reconstruction. Some tips for those who ever have to live with them.
  • First, I used my running belt to hold the drain bulbs. They fit snugly and securely and provided the most discreet option. 
  • Second, I pinned them to a strand of beads around my neck to take a shower. This was not particularly comfortable, but it helped to keep them from hanging.
Okay, so about the reconstruction. There are many different reconstruction techniques, and I'm learning that it's not one-size-fits-all (get it? ;) ).  There are implants and there are autologous techniques (using your own tissue from elsewhere in the body).

So, if you're wondering about my reconstruction process, I chose to get implants. It's not quite as simple as it sounds, and it barely resembles a breast augmentation. There are two ways to get post-mastectomy implants: the first is direct-to-implant procedure and the second is to have temporary tissue expanders followed by implants. That's what I got. I actually hoped to go directly to implants, but when the plastic surgeon was able to see what he was working with, he was concerned that my skin was too thin to successfully accommodate them. See, during the mastectomy, the breast surgeon has to remove ALL the breast tissue, taking it down to skin and fat and muscle. I'm a pretty thin person, so there wasn't a lot of fat to help the cause. So, he made the game-day decision to use the expanders. They are basically inflatable implants, which are placed under the chest muscle (yes, that's as painful as it sounds) and gradually expanded to size. I go every couple of weeks and he injects more saline into the expander. Once they are a little bigger the final implant size, I'll live with them for a couple of months. Then I will have another surgery when he will exchange the expanders for implants.

I was lucky that I was able to have a skin and nipple-sparing mastectomy, meaning that they left the nipple and as much of the skin as possible in-tact. This will avoid the need for nipple reconstruction (though some opt for no nipples, 3D tattoo nipples, or some very beautiful tattoos). Of course, many women choose not to have reconstruction, which I'm starting to understand more and more.

So, along with the drain removal, I had an expansion today. The expansions put a lot more pressure on my muscles so I'll feel more sore for the next few days. My other complaint is not about reconstruction, but just the mastectomy. As you can imagine, nerves had to be severed, so now as the nerves are trying to regenerate, I have pretty intense hypersensitivity on my chest. It's hard to find any fabric that does not exacerbate it. I must change my clothes at least three times a day, as something that feels comfortable will become unbearable within a few hours. It's also been very hard to sleep between the discomfort and the drains. I'm really hoping that along with the drain removal, I'll get a better night sleep tonight.


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