DONE!

Everything is done!  Another successful surgery!

I was more nervous for this one than last time.  I had this sense that something was going to go wrong.  I felt like things would be delayed or forgotten or something just because of it being the day after a holiday being kind of relaxed sort of a day.

As we were entering the hospital doors, my phone rang.  It was Dr. J's nurse. My heart skipped a beat.  I was so afraid the next words were going to be that we had to cancel for some reason or another.  But that was not the case at all!  They were running ahead of schedule and wanted to know if I could get there as soon as possible.

From that point on everything went fabulous! I got a fast pass through everything and was in surgery almost an hour ahead of schedule.  No strange recovery room neighbors, no nausea.  The only negative of the whole morning was that the nurse admitting me was feeling rushed and had very shaky hands.

I am still feeling the anesthesia.  I have been up for a few times this afternoon, but then like drop off to sleep immediately.  I am feeling kind of like motion sick as well (just sitting on the couch watching the girls dance and jump around the living room was making me dizzy).

While I am feeling ok right now and the recovery from it is a breeze in comparison to the others, I can say with certainty that this is absolutely the last time.  I do not want to wear a bear paw gown again for a long time!  I am hoping it will be 10+ years before I'm back to the second floor of St. Mary's hospital again.

 Some family fun the night before.

 The will be my last time in these silly Bear Paw inflatable gowns for a long time.

What happens when one little girl is left to her own devices.  

Someone else looks like me!

A typical night in our house after the kids are tucked into bed, usually involves Mitch watching some DVR'ed shows while I work diligently on school work (or crush some candy, online shop, pin things, etc.).  I catch bits and pieces of what he's watching, but rarely pay much attention because he has a habit of getting into shows that are bound for cancellation.  Just the other night, Revolution caught my attention. Half way though, I interrupted him with, "Did you see that! Rewind it!" I'm sure he was thinking I caught something in the crazy storyline, but I continued "Look at her chest! It's just like me!"

Elizabeth Mitchell. Do you see that shadow to the right of her center cleavage?  She has concave areas on her chest! In other scenes you can see the concave spots in plenty of other areas.  So now this leads me to a ton of questions:  Is she like me?  Does she have implants? For reconstruction or regular purposes?  Or are they giving her shadows and a hollowed look because of the storyline? They are living in a worldwide blackout fighting a revolution nearly dying each day, thus not much access to food or fresh clothing. Either way, I kind of like it!  However hopefully after this final step, I won't look like that anymore.

This is the last one!

I forgot to mention, this is my final reconstruction surgery.  This will be my last attempt.  If after this try, they are not perfect (or maybe just normal looking), then I feel like they don't need to be. I want some time away from the hospital.  I do not have plans to do another BRCA related surgery until I am 40.  :)

"Eat more sausage"

Never have I expected to hear those words come from a doctor, but they honestly came out of Dr. J's mouth at my latest appointment.  I knew I picked the right plastic surgeon!  

I had a quick check on my reconstruction looking particularly at the fat grafting that was done this summer.  It appears that I still need a bit more.  The problem is that all of my fat in this area was removed during my mastectomy (because that is a main component of breast tissue).  This leaves just thin skin and implant in some areas, with more muscle in others.  The skin falls into the open space.  I am not particularly fat in this area anyway; hence, Dr. J telling me to eat more sausage. Luckily I have plenty to spare in my post baby belly (am I still allowed to call it that 3 years later?) and don't need to change my diet at all. He said that it's like painting. Two thin coats are better than one thick coat.  The day after Thanksgiving I will be going for my second layer of fat grafting.  It will be the same procedure as last time.  

This is something that I know and feel totally comfortable with. I have even started thinking about if I can beat my time.  Last time it was 4 hours 50 minutes.  This time with it being the day after Thanksgiving, I am hoping not to burden someone with watching my children for too long forcing them to miss the good sales (or taking away their adult nap time from late night/early morning shopping the day before).  Let's see how fast I can get through that recovery room this time!  

The only thing I am not excited about is more incisions.  I counted up what I have.  From shoulder to pelvis, I have had 23 incisions over the past almost six years.  And 3 of those incision sites have been re-used for repeated procedures.  They are just starting to look better, hopefully a few of them will be re-used again this time.  

5 miles later...

I made it 5 miles today without any pain! Whohoo! It's only 27 days until the Fox Cities Marathon and I have a relay team relying on me for a 5 mile leg of the race.  I took it slower and was on the treadmill, but this is a very promising start! Dr. J recommended that wear the adominal compression binder and layer on the bras again for awhile.  It worked like a charm.  No pain (until I hit the shower and realized the binder cause some chaffing, oh well...more body glide).

My brother posted a picture with a good quote about how so many people don't consider themselves "runners" or feel like they have to meet a certain distance or speed requirement before they can officially call themselves a "runner." Well, my moment came before my last surgery.  I had that pre-op EKG that worried the anesthesiologist so I had to see a cardiologist to make sure that my low heart rate wasn't due to any problems.  During my appointment he asked a ton of questions, one of which was "Are you a runner?"  My response wasn't yes.  I said that I like to run, I've do a hand full of 5K or 10k races and the half marathon earlier this year.  Then he asked "How long have you been doing this?" So I did the calculations quickly in my head: 9 years (minus two pregnancy breaks).  The doctor chuckled and said, "You're a runner."  

I am a runner and I am back at it now.

Recovery is going well! Stitches are out. I am thoroughly compressed and no longer need to wear it 24/7.  I have minimal bruising on my stomach which is not nearly as bad as I expected. The incisions are tiny.  I simply look like I had a whole bunch of bug bites across my breasts.  And in some ways the marks from the stitches are worse than the incision themselves.  I am going to attempt running tomorrow.  My original hope was to jump on the treadmill and simply run until it hurts.  However, I took the stairs at a little bit of a jog today could immediately feel pain.  Combined with the sharp pain of sneezing, I am a bit concerned that it will be slower to get back into that I hoped. Still overall, this has been the easiest surgery recovery I have dealt with so far.

Proof: One day after surgery, I was able to go to a friends wedding reception.  In preparation, I took an afternoon nap, a pain pill, and found a dress that would hide the dressings on my breast and abdominal binder. It turns out a maxi dress can hide a lot of stuff!

Sleeping on my side

Still doing well. My favorite part is that I slept on my side last night already!!  I needed pillows for my arms because they put too much pressure on sore areas.  It feels so much better than being stuck on your back unable to move. My abs are quite tender, but I have them wrapped up tight in a binder.  It feels good to be wrapped up tight.  I tried taking it off and switching the spanx instead, but it didn't feel right.  I need the security of the binder for a bit longer.  All of the incisions on my breasts where the fat was grafted are closed with one little stitch.  I have 7 of these little stitches on each for 14 total.  They have to remain covered for another day, then I can shower and clean up better.  Mitch did a very good job washing my hair for me already this morning.  Now I just have to find more clothes that can hide the dressings and binder for awhile.  It would feel so nice to put on a big hooded sweatshirt, but the weather isn't cooperating with me and is back to 80 degrees again.

World record speed

Everything went great this morning.  I am becoming very good at this.  I knew exactly what to do... like take my contacts and Invisalign right at the last minute, put my glass case on the hospital bed with me so I could have some sight during the recovery room, etc.  The nurses were impressed with how prepare I was for everything.

We were back at hospital #1 for today's procedure.  Everything went so much smoother.  I would definitely try to be the first thing in the morning again.  Everyone we came in contact with was kind and prepared and helpful.  They are back on my good list.  After the snafu with nuclear medicine last year, Mitch received several free meal vouchers.  I tried to throw those things out on several occasions, but he insisted on keeping them. He was quite proud to use them today, while I cringed at his purchase (hospital cafeteria biscuits and gravy).    

I had another interesting recovering room neighbor.  The young man next to me decided that he wanted to find a wife, he was embarrassed that his mom was the only person in the waiting room for him.  He was 25, showed the nurse his tattoo and discussed the importance of it.  He happened to be from the same town as me--not that I mentioned it, I was just a silent observer whereas he was a constant talker.  My nurse pulled my curtain but it did nothing to shut him up.

I was quickly able to go back to outpatient area and home with Mitch.  I was home by 10:50 which I think might just be the new world record.  I had a little bout of nausea when I got home, but I was glad it happened here so that they didn't keep me extra long at the hospital.  I just ate like half a loaf of great harvest bread and drank some Sierra mist and felt better.  I would have been stuck with just saltines at the hospital.  Off to bed now for another nap.

What a difference

Tomorrow is another surgery day.  I feel perfectly fine about it.  My only worry is that I might sleep through  my alarm.  There has been zero nesting before this one.  However now that I mention it I do have a desire to run to Target and pick up school supplies at 9:00 pm.  I will probably post tomorrow during the wait once the nerves kick in.

Summer of surgeries

After that last crabby post, here's a good one after a very good day. I am currently reading Gone Girl and like the style of one character, I am going to set the scene a little for you.

The day started off with the girls and I sitting around the kitchen table eating breakfast.  Aila chats me between spoonfuls, "My tooth is really wiggly today...I can push it...my tongue...this way...or that way..."  Then her eyes got really big, "MY TOOTH!  I PUSHED IT OUT!"  That look of amazement in her eyes was priceless.  Then she says, "I lost my first tooth and it's our recital day at Vacation Bible School...this is the best day ever!"  I think she was onto something.

We made our way to St. Norbert for our last day of Vacation Bible School.  I had been wanting to get involved in some way at our church and I figured that this was a pretty obvious volunteer choice for me as I kind of know what I am doing with kids.  To my surprise (I am being honest here), it was a very enjoyable week and my kids loved it.  While I had a little prep time between groups coming to our craft station, I was hanging out in the bright light of the atrium gathering space when I got a phone call.

Emily from Dr. J's office was calling to tell me that I was approved.  My insurance pre-approved the revision to my breast reconstruction that I have been waiting on.  At first I was waiting for Dr. J to get the newest machine, then I was waiting on the appointment to finalize the plans, and this insurance pre-approval was our final hurdle before scheduling the surgery.  Everything finally came together and right then and there we set a date.

I told her that I was willing to make just about anything work.  Other than the first day of school which I clearly couldn't miss, I would clear my schedule if they were going to be able to get me in yet this year.  My options were August 16th or September 20th.  "Oh that's funny," was my immediate response.  The one day that Mitch requested that I not book this was August 16th on the grounds that I "ruined" Father's Day with the recovery from my first surgery of the summer and he would like to not have to take care of me again on his birthday (which is really just a classic Mitch exaggeration and overstatement).  September 20th the other option is 2 days before I our team runs the Fox Cities Marathon as a relay and a day before my cousin's wedding for which I just sent the reply card in for.  Because this surgery is a two part process that needs to be done three months in between, going with the September date will be pushing it to get the second one in before January 1st and a new deductible (which I know I am going to meet anyway, but it would be nice to not meet it in the first month at least).  So after a quick call to Mitch to seek his opinion, we decided on August 16th.  

I don't know if I can state this enough.  I AM SO EXCITED TO HAVE THIS DONE!  This surgery is purely for vanity.  It may not even be noticeable to anyone one else afterward but to me I am hopeful that this will make a huge difference to me. The first thing I notice in pictures of myself if my neckline is at all showing is shadows of the hollowed points.  I've been working out or in the locker room getting ready for swimming and I catch myself in the middle of an action in the mirror and I see the squished deformed look my breasts get as they ripple and move.  Now this isn't all the time, as long as I remain covered, you would never know.  But I really would like to stand in front of the mirror and like what I see no matter how I move. This surgery could really make a difference in helping me not notice the difference.  It feels like a little bonus that I get to have after dealing with all this stuff.

So this summer is now becoming the summer of surgeries for us.  Thankfully though, as I explained to the girls, I am going to have some more owies in a few weeks on my chest and stomach but once this is done I shouldn't need to have any more owies for a long time.

On a side note, all of the issues that I had on my last post have been resolved through a couple of long phone calls.  I am all healed and ready for the next one.

That may have been the most useless appointment ever

Today's appointment left me feeling pretty grouchy all day.  

First, I had the appointment accurately written on my calendar for months now.  I got a confirmation call yesterday saying that the appointment time was 15 minutes earlier than I had written down.  Instead of looking back at my folder of paper work (which I easily could have done but didn't so I am fully to blame), I just made the necessary adjustments to get childcare a bit earlier and get there for their time.  It turns out this 15 minutes earlier wasn't the actual appointment time, it was just their attempt at making sure patients arrive on time.  Anyone who knows me knows that I am obsessively early for everything, so really 15 minutes early for the 15 minute early time they gave me.  FRUSTRATING!  I sat in the warmth of the full windowed waiting room and read a good book for over 30 minutes.  I was called in for my appointment just 3 minutes after my originally scheduled time.  They would have been getting the highest rating for wait time on my survey if they had just stuck to the regular schedule!

In the appointment I went through the usual with the nurse.  She said I didn't have to get naked or anything which I figured was a plus and the doctor would be in in a few minutes.  Doctor PJ and his med student (Side note: he always has med students--different ones with him each time. They always ask if it is OK for the student to join.  I always say yes, thinking that I am helping contribute to a new generation of knowledge.) came in unusually quickly.  I didn't even get to see his nurse practitioner who usually comes in first.  He asked me how I was doing, asked to see the incisions, and said they look perfect.  He then got up to leave saying everything looks great, we don't have to see you anymore.  WHOAH!  It was like a minute and a half tops.  He didn't even touch my stomach or the incisions.  I had questions to ask that I didn't get to.  He didn't even notice that I had designated on the health update form that I was still experiencing abnormal bleeding.  I stopped him to ask about that and he quickly explained an answer but he was clearly on a mission.  He spent more time giving me referrals to other affiliated doctors who I could go to for a regular doctor from here out than talking about my recovery.  I was so thrown by this that I didn't remember to ask the rest of my questions. I wanted to know about my pathology report.  I wanted to know about my CA125 numbers.  I wanted to know about the knot that I have over one of the incisions or the pulling pain I still get occasionally.  I wanted to tell him that "slight gas discomfort" he described that I'd feel after surgeryis a bigger deal than he made it sound like.  I cannot believe that I ever said that he might be the Dr. Colette of gynecology.  He was nothing like that today! 

Because of this, I will probably end up on the phone quite a bit this week with the nurse practitioner or back there to see him two weeks from now the next time he is in town.  I have decided that he must have had a busy day booked of surgeries that he wanted to make sure he stayed on schedule for just like he did for mine 4 weeks ago and that's why he wasn't able to provide the time he had in the past. 

More than 3 weeks

It's been more than three weeks.  I'm doing more, feeling good.  The bruising is finally almost gone.  One bruise stuck around so much longer than the others.  It was shaped like a crescent moon and reminded me of the Relay for Life symbol.  With the bruising gone, I am now capable of wearing pants with a real waist band.  Even though I am capable of it, you'll still see me quite often in yoga pants.  I have my 4 week check up on Friday to hopefully get the all clear.  My kids are ready for me to start lifting them up on the swings again!

I had an interesting thought today at the dentist.  For those of you like me, how much of this do you share with others?  The dentist asked today if there was anything new I needed to add to my medical history.  I thought about it for a second and then just said no.  Now if I was filling it out in a form, I probably would have updated it.  But I really didn't feel like having the conversation with the hygienist about what I had removed and why.  I don't know why.  I usually have no problem talking about it.  Is it really important that they know I don't have my Fallopian tubes?  I'm hoping it isn't.

I've got a good one

I am so lucky to have a great person to help take care of me through all this.  That's something that I've noticed in the media about Angelina Jolie and Brad Pitt.  Many articles commend Brad Pitt for being by Angelina's side.  Well I have my own good guy.  He has made all of these decisions and surgeries much easier through his support.  Before appointments that he knows I get quite nervous for, he'll arrange for a date.  Here we are at Captian's Walk and Hagemeister Park (in which we found ourselves with a perfect heart shaped onion ring) before my final appointment. The weekend before surgery to keep my mind off things, we went out of town to visit some friends and go to a game. Post surgery he constantly comes to the rescue when I start things and realize that I cannot complete them.  He may over-estimate my ability to take care of our children soon after surgery, but he makes up for that with his cooking meals and cleaning while I "take it easy."  In addition to the time he has taken off of work for these things, he comes home every day at lunch to make sure that I have everything under control.  Thank you, Mitch.  I'm a lucky girl!

1 week later--lessons learned

It has been over a week now since my salpingectomy.  I am feeling good.  I've hit the point where the bruising is going away and the dermabond is getting itchy and falling off.  I love when this happens.  All this time my incisions have been closed with this clear glue.  The look pretty gross all ragged and bloody.  But then the glue starts to peel away from the skin and behind it is this magical little bitty pink line.  What was hideous turns out to be not that bad at all. Only one of the sites is still slightly painful.  It's the largest one right above my belly button where the largest of tools was used and the largest bruise was.

I have learned a lot of lessons from this surgery that I will take with me from now on:

• I will never take another surgery lightly.  I didn't think this one would be a big deal and because of that didn't plan well.  For any future surgery, I will not assume that my body will immediately bounce back. Whether under anethesia for 8 hours or 30 minutes,  my body needs time to get back to normal. 
• Even though I like to think I have a high pain tolerance,  if a doctor prescribes pain meds, it's an obvious sign that there will be pain involved and I should take them.  This was my biggest problem with this surgery.  For my mastectomy, I never woke up in intense pain.  I kept on top of the pain meds taking them round the clock for the first while because I knew the pain would be bad.  I should have done the same thing this time at least for the first day or two.  
• Just because I start feeling better, it doesn't mean you actually are back to normal.  On day 4 I posted that I really started to feel better.  Which led to me thinking that on Day 5 I could do a lot of things that I shouldn't have like vacuum, pull the hose out around the yard to water the flowers, or let the girls bike during our walk which I know leads to trouble when one little girl's legs just get too tired.  I knew that I have a lifting restriction of 8 pounds, but to me I justified it because pushing, pulling, or dragging is not lifting.  Silly me spent Day 6 regretting all the actions of Day 5.  I know better now.  I will be taking it easy more.  This is what happens in my house when I take it easy. One daughter dances and signs with the dog while the other sets up an obstacle course with every basket or box she can find while I read on the couch.  

Getting better now

Today is Day 3 and I think things are getting better now.  I slept much better last night.  When I woke up this morning, I was able to stand upright right away (the last two days that had been a struggle for awhile).  I am just taking tylenol now for pain.  We've taken two walks around the neighbor hood.  Unfortunately, Stella can't come yet because I am afraid she will pull and I won't be able to handle that yet.  I do look like kind of like a mess.  I found that compression on the bruised and swollen areas feels better.  But it doesn't look good, I am pretty much wearing a mumu over my exercise leggings.  If you are interested in checking out some graphic pictures of my incisions, click here.  I like to take pictures often so that I can see that things are getting better even when I feel like it isn't. But I don't want to force those uncomfortable to see them.  Right now, I think things are looking worse even though it's feeling better.  That seems to be the way things go with bruising though.

I think I was just too impatient the last few days and expected to be feeling fine way too soon.

Sleep

Last night was a rough night.  I could not find a way to sleep comfortably.  Some ways I tried I felt like I couldn't breathe because of intense shoulder pain.  If it tried rolling on my side, I felt like my insides were falling all over the place.  My back is sore from only being able to sleep on it. I can't take a deep breathe, laugh, hiccup, or cough without intense pain.  I didn't want to take pain meds, but definitely needed to.  I should have just taken more when I woke up during the night rather than trying to switch to sleeping in the recliner.

Thankfully, I posted on the FORCE page asking for advice and got some great tips.  The pain that I am feeling is most likely gas related.  Some of the CO2 used to inflate me during surgery is still inside causing this pain. I tried to be more active today as walking is said to help this gas dissipate faster.  So to celebrate Father's Day, we went for lunch at Curly's Pub in Lambeau and walked around the atrium a bit.  Mitch enjoyed his gift.  He finally started reading this blog again, so I'll give him a little feature.  He does think that he missed his calling as a competitive eater.

 

Then this afternoon we went for a walk on the DePere River Walk.  The girls loved seeing the pelicans.  I have a new respect for the work of the people on the locks after getting a chance to see it up close during our class field trip there.  They were busy manually turning everything the entire time we were there.  We then spent some time with my family tonight. Hopefully being active today (and not napping at all) will help for a better night of sleep tonight.

My thoughts so far

I will admit that it hasn't been as easy as I thought it was going to be.  There isn't a huge body of work out there on the "tubes only" surgery that I had.  Before my mastectomy, I read and read and read and knew exactly what to expect. For this one though, there are resources about other gynecological surgeries such as hysterectomy or resources about what Fallopian tube removal is like after ectopic pregnancies but nome of these seemed to match my situation. In my mind, I figured that women have their tubes tied in the doctors office, so removal of them can't be that much different. I honestly thought I would feel perfectly fine today and that around maybe grocery shopping or something.  I didn't think pain meds would be involved at all!  I probably should have read more about laparoscopic gynecological surgeries as no matter what you have removed, these robotic surgeries are quite similar.

Here is a recap:

The morning yesterday went well.  I was very impressed with how smoothly everything went at this hospital.  I had great nurses who never made me feel forgotten about like last time.   Right on time at 12:30 I rolled into surgery. I woke up in the recovery room in a lot of pain.  I did not expect that at all, but they quickly helped take care of that.  As I move onto another room I struggled more with nausea, dizziness, and more pain.  It was Friday afternoon and I hadn't eaten anything since Wednesday night., so some of these thing could be attributed to that.  I wanted to eat but could barely get 2 crackers down. I needed to eat something with the pain meds.  I'd feel like I was going to puke but was afraid it would really hurt and couldn't get myself upright without more pain.  They gave me something for the nausea and I was able to start feeling better but I was still so tired I could barely keep my eyes open.  At about 5:30 I was able to be discharged and we went home.  I had this long list of foods that I thought I would want first, but I really just ended up eating applesauce and sleeping th rest of the night.

Still this morning I have significant pain. It is all centralized around the incisions which are about belly button level. It is different than after c-sections because that incision is lower and I felt tugging and pulling whenever I would move. It feels kind of like I was punched or spin kicked in the stomach over and over.  It is tough getting comfortable or taking a deep breath more because of the bruising sort of pain. I don't know why I didn't think of this, it makes logical sense, but I have drainage similar to what it's like after having a baby. It shouldn't last long though they explained. I also have a rash on my back, neck, and chest.  I think I had a start of it yesterday after the miralax diet.  I have shooting pains in my shoulder as well because of the CO2 used to inflate me.

I am eating like normal though and can walk upright rather than hunched over like yesterday.  I will probably take a nap soon.

Today is going to be a good day

Today is going to be a good day because...

• Yesterday the Supreme Court ruled that genes cannot be patented.  For a full article check this link.  This is going to make it so much easier for people to get genetic testing! 
• It's Relay for Life day in Kewaunee and LOTS of family are getting together for it.
• My cousin posted a beautiful picture of her mom on the anniversary of her death 22 years ago yesterday. The girls came by the computer while I was looking at it and it gave me a great opportunity to tell them about her. It helped me explain to why I am going to have more "owies" and helped Aila in particular feel less worried about me going to the hospital today. 
• Bowel prep wasn't as awful as I expected.  It's still in the top three worst medical things I have ever had to do. I am really hungry though and learned that I will never tease my dad again about his post-colonoscopy meal choices.  I have quite a list of foods that I've been thinking about wanting first.  
• Speaking of food, I grabbed a hospital food menu for Mitch while I was in the waiting room last week.  Door County Fish boil is on the menu today.  I find this hilarious because Mitch hated the fish boil that we had for an anniversary dinner at White Gull Inn a few years ago.  He's the only person I've ever heard of who disliked a meal at White Gull.  Fitting that it's on the menu for him today.
• And finally I'm about to take my ovarian cancer risks down a notch. We're off to the hospital now!  I'm excited!

Cheers

Cheers, sort of...

Nothing to eat today except clear liquids and these goodies.

Surgery is on

I was cleared for surgery today.  The cardiologist agreed that my low heart rate is likely just a sign of good health.  At its lowest it was 34, but most other checks have been between 50 and 70.  Running pays off!  All of this monitoring my heart rate though has me very curious and interested in trying out a heart rate monitor to wear while running.  

Day of surgery--much easier this time

This time around the day of surgery will be much easier. We will arrive at the hospital mid morning for surgery prep.  I'll have to have the customary iv antibiotics and sign plenty of forms.  Just after noon I should be headed into surgery.  The procedure itself should take about a half hour.  The plan is to do everything laparoscopically with Dr. P.J. using the da Vinci robot for the surgery. My abdomen will be inflated with carbon dioxide gas so that they have room to work.  The robotic instruments will be inserted into 4-5 different small incisions.  My fallopian tubes along with the blood supply to them will be removed on both sides.  My ovaries will remain.  I will have small internal stitches.  He will do a visual check of my ovaries.  The removed tubes will be sent to pathology to make sure they were healthy.  The instruments will be removed and my abdomen will be allowed to deflate and the incisions will be closed up with a few more stitches.  I will then go into a recovery room where the anesthesia will wear off.  By dinner time we will be ready to head home.  I will not be able to drive for a week and I will have lifting restrictions for four weeks.

However, there are always some what ifs.  First, because I have had 2 c-sections, there is a small chance that I will have too much scar tissue to do this laparoscopically.  That would change the length of the surgery and recovery time after considerably.  Second, there is the chance that Dr. P.J. will see something while in surgery that looks suspicious.  In that case, he will remove whatever it is right away.

And my what if, that is probably the most important right now, is that I have not been cleared for surgery yet.  I thought everything was ready (surgeon, insurance, pre-op labs, work schedule, family schedule) but my pre-op EKG came back abnormal. My heart rate was abnormally low according to the nurse.  The anesthesiologist doesn't feel comfortable proceeding without clearance from a cardiologist first.  I am not at all worried about having heart issues.  I know that I don't.  I just have a low heart rate.  It's always been that way.  I wanted to make some easy money donating plasma in college and I was turned away because of it. I remember during my c-sections, they asked me "Are you all right" because my pulse was so slow.  I remember Dr. Colette coming in one morning after my mastectomy saying "31? What is with that?" So now I am praying that the cardiologists report will be approved by the anesthesiologist so that things can go as planned. I'm ready!

Pre-op appointment

I had my pre-op appoinment Friday. I will be having this surgery at a different hospital with another  doctor who is named Dr. J just like my plastic surgeon.  I think that I'll call this doctor Dr. P.J. so that I don't get them confused.  Mitch came with to hear all the details so that he can do a good job taking care of me afterward and making sure I stick to my post op restrictions.

We met with Dr. P.J. and his staff early on.  They showed us with more detail what the incisions will be like, what the day of surgery will be like, rules for recovery afterward, and answered all of my questions (even the ones about my toe).  I got the disappointing news that I would have to do "Bowel Prep" the day before surgery.  I thought that I was going to sneak through without having to do this, but no luck.  I will be spending June 13th, my first official day of summer vacation, chugging miralax and gatorade eliminating everything possible from my bowels.  YUCK!

Then I had to do all the pre-op tests (EKG, blood tests, and chest x-ray). This part took forever; I was worried for a while that I might not make it back to work on time!  We waited in the same waiting room that I've spent so much time in the past year for the CA125 blood tests that I have every 3 months.  Hopefully, this is the only super long wait we have and surgery day will be a breeze.

Just for fun, here's a picture that I found on my phone during the wait for labs. It was taken the day of the marathon.  It was a long day for her cheering us on, then waiting at the finish line to see my brother finish the full marathon.  She insisted though that she wasn't tired and didn't need to nap.  This is how we found her after she went to play in her room for about ten minutes. Notice the medal still around her neck.

Step 2A

As I eluded to on earlier posts, my mastectomy was just step 1 in reducing my risks for developing cancer because of the BRCA gene mutation I carry.  I am now onto step 2.  On June 14th I will be having a bilateral salpingectomy.  This will be the removal of both fallopian tubes.

All recommendations for women with BRCA mutations suggest the removal of ovaries and fallopian tubes before age 40. The is called salpingo-oopherectomy.  The removal of one's ovaries is not an easy undertaking (I'm not saying the mastectomy was either).  The loss of ovaries means loss of all hormones   This would be a good thing in some regards because most breast cancers are fueled by estrogen and if you don't have the organ in your body producing estrogen that would reduce your risks for developing cancer even further.  It would reduce my breast cancer risk from 5% to less than 1% and my ovarian cancer from 50% to 0%.

However, this puts you into immediate surgical menopause.  Most women slowly go through menopause letting your body adjust to the lack of hormones and those side effects in a somewhat gradual process. After having your ovaries removed your are thrown right into it often with intense side effects which include:

1. Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling 
2. Irregular heart beat
3. Irritability
4. Mood swings, sudden tears
5. Trouble sleeping through the night (with or without night sweats)
6. Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles
7. Loss of libido 
8. Dry vagina 
9. Crashing fatigue
10. Anxiety, feeling ill at ease
11. Feelings of dread, apprehension, doom 
12. Difficulty concentrating, disorientation, mental confusion
13. Disturbing memory lapses
14. Incontinence, especially upon sneezing, laughing; urge incontinence 
15. Itchy, crawly skin 
16. Aching, sore joints, muscles and tendons 
17. Increased tension in muscles
18. Breast tenderness
19. Headache change: increase or decrease
20. Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
21. Sudden bouts of bloat
22. Depression 
23. Exacerbation of existing conditions
24. Increase in allergies
25. Weight gain 
26. Hair loss or thinning, head, pubic, or whole body; increase in facial hair
27. Dizziness, light-headedness, episodes of loss of balance
28. Changes in body odor
29. Electric shock sensation under the skin and in the head
30. Tingling in the extremities 
31. Gum problems, increased bleeding
32. Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor
33. Osteoporosis (after several years)
34. Changes in fingernails: softer, crack or break easier
35. Tinnitus: ringing in ears, bells, 'whooshing,' buzzing etc.  (source http://www.project-aware.org/Experience/symptoms.shtml

These are things that I am just not willing to put myself through yet at age 30.  Instead I've been watching some new research that is showing ovarian cancer is really starting in fallopian tubes and moving to the ovaries before it is diagnosed.  So this means removing fallopian tubes could prevent ovarian cancer.  This is not something widely accepted yet, but one doctor in the area agrees with the new research and has begun recommending this for women in my situation...not ready for oopherectomy yet, but worried about doing nothing.  

On June 14th, I will have my fallopian tubes removed (Step 2a) leaving my ovaries behind.  I will then join a registry of women through the University of Washington being monitored for the long term outcomes of a prophylactic salpingectomy.  The plan is to then remove my ovaries when I feel ready (Step 2b) later down the road. 

Half Marathon

It was tough, but I did it.  I ran the Cellcom Green Bay Half Marathon.  It feels like a huge accomplishment.

With all that time spent training, by the last two weeks before the race, I began thinking what did I sign up for?  I remember telling Mitch during one of our last long training runs "I don't even like running right now" and named one of our maps on mapmyrun "My horrible idea."  I was a bit negative before the race; I think it was just nerves.

Race weekend came and I turned it around.  We went to the WPS kids run.  The girls LOVED the chance to run in their first race.  They cherish the medals and wore them all weekend long.  It was hard for Aila to understand why she couldn't wear it to school on Monday morning.  It calmed my nerves a lot to see the finish line and run a small portion (0.62 miles) the day before.  We enjoyed our free tickets to the pasta dinner at Lambeau Saturday night and were all set for race day.

On race day we made it there in the morning with plenty of time, did zero warm up or stretching (why do you need to add on a mile warm up before you run 13 or 26 miles?), and made our way to the start.  For some reason we had "preferred start" bibs.  I'm not that fast.  I didn't deserve one.  I have a feeling the person who registered lied to say that I ran at the same pace that he did.  It was intimidating for me to be in there with runners who are much better than me.  I would rather start at the back of the pack with people my own pace or slower and work my way up instead of being passed by thousands of people.  Despite this, the first 5 miles were good.  I kept a 9 minute mile pace.  It went down hill from there.  I knew a lot of people who would be in the crowds from mile 5-9, so I was a bit distracted and combined with some inclines, slowed down.  Knowing that these people were there cheering kept me going though!  Thankfully what goes up must come down and the last few miles were down hill or level.

As we made it into the Lambeau parking lot, we got passed by a wheel chair racer and then inside Lambeau was passed by the winning marathoner completing his full marathon.  We finished in 2:19.  This was about 4 minutes off of my goal for finishing in 2:15, but I was able to accomplish my main goal of running the entire thing.

Unfortunately, we have almost no pictures of ourselves before, during, or after the marathon.  We didn't think about it before because I ran with my ipod shuffle rather than my phone.  During the race pictures didn't quite turn out (however, I have a lot of pictures of my daughters cheering people on).  And then after the race, we had a hard time meeting up with my parents so when we finally did, taking a picture didn't cross my mind.  Hopefully I can find some online so that I don't have to pay for the official ones just for a little evidence.

I will admit that I was quite sore for the next few days.  It was the worst whenever I went down steps.  Mitch said that the noise was too loud during the entire thing so that he didn't have to hear my squeak.  I am left with a pretty disgusting toe that has a huge blood blister at the top of it and a nail that really needed to just fall off.

One of my biggest concerns prior to surgery was what it would feel like to have an implant in me.  Would I ever feel so comfortable with it that I forget that it is there?  Yes, at 10 miles in forcing my legs to keep going, my fake boobs didn't cross my mind at all.  

Movie Star, Me, and Marathon

Moviestar
Many have asked me this week.what do I think of Angelina Jolie?  So here are my thoughts:

Am I surprised she has the mutation?  No. She has a family history.  She chose to adopt so many kids.  Many women with BRCA mutations struggle with the decision to have kids and potential pass the gene onto them. There are several other celebrities who have the mutation--Christina Applegate, Sharon Osbourne, Kara DioGuardi.

What do I think of her choice?  She's obviously a smart woman! Here's a link to here actual article.  Her explanation sounds like she went through the same thought process that I did.

Do you think it was a good choice to share?  ABSOLUTELY!  She was incredibly brave to publish that article.  Her publicity will make so many more women consider this as an option.  That doesn't mean that everyone needs to go out and get the genetic test or have a mastectomy.  But it will help people think about their family histories and just consider their options

What do you think of the media's response?  I don't know how I would feel to be her and have my choice be headline news. But I think that the media response to it has only helped the cause.  Many people didn't know what a BRCA mutation was or didn't understand the long hard thought process that went into my decision to have a mastectomy.  Many people probably didn't know that there is a Supreme Court case against Myriad Genetics, makes of the genetic test that made all this possible, for claiming to patent their discovery which is really our genes not an invention.  All of the reputable media outlets that I have read have portrayed accurate accounts and correct facts about this.  What I don't like are the ignorant articles or responses that have been posted online saying she's crazy, over-reacting, or just seeking attention.  If she wanted to do that she would have posed nude showing off the scars to share this decision rather through a well written article. All of the judging responses are really bothersome. It is a very personal decision that nobody else needs to understand.  I found this comic for those who still say her decision is too drastic:

Now onto me

Just like Angelina stated in her article, mastectomy was the first step.  I am inching closer to my second step.  My next step is going to be the removal of my fallopian tubes on June 14th.  I have checked out several doctors opinions as to what I should do to reduce my ovarian cancers risks.  All doctors, including one particular "Hot Doctor," have said that I need to have my ovaries removed.  Unfortunately this surgery has major side effects that I am just not willing to undertake right now.  There is new research that is showing that ovarian cancer may actually start in fallopian tubs and then move to the ovaries before it is detected.  Because of this and my refusal to remove ovaries yet, one doctor recommended removing my fallopian tubes instead. This allows me to have some protection for now, and then when I am ready I will remove my ovaries and be able to have complete protection.  The surgery should be very quick with an easy recovery and within a few weeks, I'll be back to enjoying summer vacation with the girls.

Finally, the marathon

It's finally time.  Mitch and I are running in the half marathon this weekend.  I've been training for what feels like forever.  I'm ready. I'm excited. I'm nervous. I originally had a time goal in mind, but now I just want to run it all.  I still have my squeak.  It used to only happen after a long run; now it's squeaking during runs usually starting around mile 2 and going right up until the end. I just turn my music up louder.  Sorry if you end up running next to me. After the marathon, my running partner wants me to get it checked out. We'll just see :)

1 year, all clear

I had my official 1 year check up today.  All is clear! My MRI looked great (and was just fine despite my mid-MRI stomach issues.)  The nurse showed me what my own images look like. It was interesting compared to what I found for my previous post through a google image search.   Dr. Colette confirmed that I still have a piece of alloderm that was used to form my pocket that is taking longer for my body to take over completely.  This side feels like a super thick underwire part of a bra just under my skin.  This exactly what Dr. J told me at 6 months, but Dr. Colette just explains things so much better.  

Now post-mastectomy, Dr. Colette's recommendations are to keep up with the preventative measures to stay healthy--vitamins, diet, exercise, watch alcohol consumption, the usual.  For surveillance now, I need just need to have annual clinical breast exams like everyone else at a yearly physical.  I will also continue to see Dr. Colette once a year following an MRI to make sure I remain cancer free.  

The best part of the appointment was getting to see this.  Check me out!  I'm September! Pick up a copy of the 2013 Calendar of Hope for a $5 donation.  

A Year Later (My own words)

As I crossed off more days on the calendar moving closer to February 27th a this year, and even as I hit other smaller milestones earlier this year, I made sure that I looked upon these dates with a positive attitude. I don't look at it as though it's been a year since I lost my breasts; I think of it as being one year of being healthy.  It's been one full year since I changed my life and freed myself from the heavy burden of my genetics.

Mitch embraced this philosophy.  He arranged for the girls to go Grandparents and took me out to celebrate this new anniversary. We had a delicious multiple course dinner that included a dessert combination of ice cream, scotch, and bacon.  We reminisced a little and relaxed.  It was great!

In some ways in feels like I cannot believe it's been a year already, but then again it in other ways it feels like the day of surgery was soooooo long ago.  In the same, some memories of the day are crystal clear ingrained in my memory forever.  Other events even in the week following are still a mystery to me.  It's strange how the brain works.

I have no memory of leaving the girls that morning.  I don't know if we left while they were still sleeping or if I purposely tried to sneak out so that it wouldn't be a big deal, but thankfully that moment doesn't haunt me.  I remember how I cried as we dropped off Aila on the way to the hospital to have Adrienne, but nothing like that happened a year ago for this. 

I remember arriving at the hospital and being surprised that I had to check in at the outpatient surgery department.  For insurance reasons, apparently they cannot plan on a mastectomy being an overnight stay.  Instead, they anticipate 24 hour hospital stay and then the doctor must provide a reason for additional stay. I had all this stuff, my red bag of necessities and pillow that I had to cram into this little locker that they use for people with outpatient surgeries.  Then I was brought to this obscure little corner area that where I was forgotten.  But I'm not going to go back to that painful wait.

The strongest memory I have of the morning was when I finally moved to get the nuclear injections  before surgery.  They insisted that I be moved by hospital bed when at that point I felt perfectly capable of walking.  I thought that there was no way that my gigantic bed would fit through the doorways, but of course it did.  The man, while he looked like the cute Indian character from the show Heroes, was horribly awkward while he did the injections.  The pain was the sharpest, strongest shot pain I have ever experienced despite the useless numbing spray he would put on first. I had remained strong the entire morning, but it was at this point that I lost it.  I was alone in this room with intense pain and broke down.  I remember sobbing to the nurse that earlier today they offered me some anti anxiety drugs and I turned them down but I am really regretting that now and I'm sure it's too late now to do anything about that and...sob...sob...sob.  The kind nurse tried to comfort me and reconnected me with my family.

Finally from there, I only remember bits and pieces.  I find that I was totally disoriented as to where I was in the hospital.  I thought they moved me up several floors and around lots of corners, when Mitch says no, it was all on the same floor just around one turn.  I remember how nice the waiting area was in the second pre-op area in comparison to the area we were tucked in earlier in the day.  I remember clearly one specific nurse in this area who really knew his stuff and finally got things taken care of.  My sense of the elapsed time in this area was totally off in comparison to what it actually was according to Mitch.  We'll have to take his word for it because at this point I was already given drugs.  I remember that nurse saying that from this point on you're going to have amnesia right after I swallowed the little cup.  I remember saying good bye to my parents and the look that Mitch gave me, the love and worry behind that smile.  I remember Dr. Colette holding my  hand when we were in the operating room as the anesthesiologist starting working.

And then there is nothing. Nothing until the recovery room and even from there things are very patchy for the rest of the first week.  I am glad that I wrote things down or I would have no idea!

The first thing I remember was hearing things.  I heard this moaning. "Ughhhhh....ahhhhhghhh....arhhhhh"  I remember thinking "Oh no, is that me?"  Then I realized no, that it was coming from a few feet away.  As they kept saying "Sister, SISTER, you are OK" trying to calm her down.  Apparently she was a nun.  I remember asking my nurse, "Is she ok?" because the painful moaning was so bad.  Then I remember hearing the slide of the curtain being pulled closed as though that were going to solve the sound problems.  I cannot tell you a single thing about how this recovery area looked, every things was very dark. My memory is so blank that I don't even know if my eyes were open at this time.

The only other memories I have of being at the hospital are my mom feeding my ice-chips during the night, waking up at what was like 3:30 or 4 am the next day and feeling like I needed to brush my teeth. Everything else over the days is very vague other than the sense of fear when they said it was time to go home.  Even with all the preparing I had done I still felt like I couldn't possibly be ready to take care of myself at home.

Even that first week home, my memories are pretty patchy due to the pain meds, so if keep that in mind if you visited me and I said or did something strange :)

Just a few days after surgery, I insisted that I was going to go to Aila's dance recital.  They let me sneak in early, giving me preferential seating so that I wouldn't have to fight the masses when the doors opened.  I know that I was there, but I don't remember any of it.  Thankfully we have the pictures and videos.  We watched the video of it just the other night to get the girls excited for this year's recital.  There was a hilarious moment by another 3 year old that I had no idea even happened.  But at least I was there.

Now one year later, I am thankful.  First of all I am thankful that I had the opportunity to do this surgery. Just the medical discoveries and health care battles, I am lucky to have this opportunity. I have been so blessed that I've been supported by such amazing family and friends.  And most of all, with the uncertainty surrounding my suspicious lumps discovered in December, I am so thankful that I can say this is the one year anniversary of me taking control rather than it being the anniversary of when my life took a very different turn.  One year later, I am thankful and happy.

A year later

I wanted to put together a great post about my feelings one year later...but I've been knocked out by this cold and I plan to be in bed by 8:00.  So I am going to let someone else do the talking for me.  I found this fantastic writer, Lizzie Stark, and thoroughly enjoyed her post called "A Year Later".  She has a lot of unique views of her mastectomy that made me laugh.  I specifically like how she calls her reconstructed breast "zombie boobs."  I really connected with this post at the beginning, but as the she continues further I don't have the disdain for my reconstructed breasts the way that she does. Unlike Ms. Stark, I am very happy with the aesthetic results but I just love the way she describes some of the unique post mastectomy experiences like the bra salesady and moving around in a crowd.  Maybe later this week I'll be able to put down my own thoughts, enjoy this for now!

"A year ago today, I cut off my healthy breasts to reduce my astronomical chances of developing breast cancer. The months leading up to the operation were brutal, to say the least. It was the hardest thing I’ve ever done, but I’m really glad I did it.

I have the BRCA 1 genetic mutation, which carries with it a 40-85% lifetime chance of developing breast cancer. While breast cancer in the general population generally strikes after menopause, for BRCA 1 women, the age of diagnosis can be much younger. Many women in my family developed breast cancer in their 30s, but my mother holds the record for youngest diagnosis — she learned she had cancer just a few weeks before her 31st birthday.

I didn’t want to cut off my breasts, but it’s what I had to do to feel safe. While it’s amazing that science could pinpoint my risk of cancer, it didn’t leave me many options. My choices were to expose myself to an emotionally draining barrage of tests a couple times a year, tests that began coming back with assurances like, “that thing we found on your scan is probably not cancer,” tests that don’t prevent cancer, simply catch it early. After watching my mother struggle with cancer, I decided I couldn’t play chicken with my life like that. I could have taken estrogen blockers that would have reduced my risk as long as I took them. Of course, taking estrogen blockers means undergoing temporary menopause, and as a BRCA 1 carrier my lifetime risk of ovarian cancer is 40-60%, with most doctors recommending an oopherectomy after child-bearing is done. So I already was and still am facing early, surgical menopause. My final option was to take the breasts off entirely, permanently reducing my risk to less than 5 %. I chose certainty.

My new breasts are cosmetically appealing, or so I have been told by doctors and bra saleswomen, but I still miss my old ones. Because taking out the breast tissue cuts through nerves, I’ve lost a lot of skin sensation. This winter I noticed that my breasts can’t get cold, for example, because there is no feeling. Sometimes it’s awkward to slither past a stranger in a crowded room, only to realize later that my senseless boobs must have bumped against him or her. From time to time I get an itch I can’t scratch because there are no sensation receptors left in my skin. This permanent numbness, reminiscent of a dentist’s shot of Novocaine into an inappropriate body part is the worst thing about the surgery.

Without my breasts, my real breasts, I mean, I felt strangely incomplete, deformed, ugly. As if I were faking an identity I no longer had claim to. In response, I became excessively girly. Jeans left my wardrobe, to be replaced with a strict diet of leggings and dresses, preferably in funereal black. I never let anyone see me without makeup or in sweatpants. I felt dishonest about my new body, as if my personal appearance, my faked cleavage, was presenting a lie to the world that belied who I really was. I was pretending to be a normal, natural female, when in fact, I consisted of medical-grade silicone held into place by a donated collagen matrix (read: skin harvested from the backs of corpses and stripped of DNA).

While I was glad the surgery was over, the months that followed were dark, bleak ones for me as I wrestled with these emotions, emotions that I even felt a little guilty for having — I mean after all, it’s not like I had cancer or anything.

Still, the best thing about the surgery is that the threat of breast cancer no longer hangs over my head. It’s hard to overstate that, since I have no conscious memory of being without that worry. After all, my mom first developed cancer when I was 18 months old. In some ways, I share the fate of my mother and grandmother (and aunts, great-aunts, first cousins once removed) — I’m going to my grave without my real boobs — but I do feel I’ve dodged the bullet. I don’t have to have chemo. I won’t lose my hair. I won’t have to spend years living with the shattering uncertainty that the cancer might recur. And I’m so glad I don’t have to.

Want to read more about my zombie boobs?"  Lizzie Starks http://lizziestark.com/2011/03/04/a-year-later/

Once a puke-er, always a puke-er

Today I went for my (what seems to becoming a tradition) day after the Superbowl MRI.  Prior to my mastectomy, MRI was a much better surveillance method because mammography isn't as reliable on younger breast tissue.  Now after, it is the only available method (picture me doing a cheer about never having to have a mammogram again!!).  I will continue to have this scan annually.  They are looking to see that there is no cancer growth in the remaining skin.  Also because of my choice of reconstruction, they use this scan as a way of checking on my implants to make sure they are in good shape with no leaks or punctures.

You may recall my post last year about my breast MRI experience entitled "I'm a puker."  Well...I don't know why I thought it would be different.  I really had high hopes for this one.  I actually completely forgot that this was scheduled until I opened my calendar at 6:00 this morning.  I feel like this is a good sign though because if I can forget about it, it means that I'm not obsessively nervous about these appointments anymore.  I quickly added a pair of warm socks and a book to read in the waiting room to my bag figuring I was all set for the day.  As I was driving to work, I thought about it a little more and realized I didn't do the research that I wanted to since last time about the IV.  I figured, "Oh well, I'll just try to tough it out this time...I'll be fine." I did not want to puke this time; I wanted to bring something small to eat before the appointment. So at our meeting this afternoon, I grabbed a small deliciously gooey brownie and enjoyed it.

The MRI process began as normal.  I had no trouble getting the IV and I have no problem with the small space.  My music was cranked up and I was positioned very quickly and easily into the machine. The first scans were short ones...20 seconds, 1 minute, 2 minutes, 5 minutes.  Then they injected the dye.  Just like last time, it went like this:
1.  Dye injected
2.  Immediate metallic taste in my mouth
3.  The strange feeling like I just peed my pants (but I didn't)
4.  Then uncontrollable puking for ten seconds

Then it's all over and I need to try to lie still for another 7 1/2 minutes because this dye scan is of course the longest one at 8 minutes.  Those feelings come on so fast and so strong and no amount of self talk, breathing, or imagery can keep me from vomiting.  However, last time I didn't eat anything before the appointment.  This time, I did actually puke.  I felt really bad that I messed up their little table.  I'll feel worse when the doctor gets the images and says that I have to take them over because I moved too much.  So...lesson learned this year: Do not eat before an MRI.  Also, maybe next year I'll ask if I can bring my own music.


This is what a breast MRI image looks like.  This is not mine!

First post of 2013

I haven't posted in awhile, but that's good because things have calmed down quite a bit since last year at this time. It is hard to think back to all of the uncertainty that I was feeling just a year ago.  What's going on now, you wonder?  Just good things.

First off, I do plan on having a little bit of revision surgery, but we are waiting on the plastic surgeon to be able to get the newest machine.  The method of reconstruction I had is called "one-step direct to implant."  Theoretically it is supposed to get everything done in just one step as opposed to having to insert an expander under the muscle, stretch the muscle, then have a second step surgery to replace the expander with a permanent implant.  However, going directly to implant doesn't give the surgeon the opportunity to fine tune things later in the process the way they do with expanders.  With direct to implant, the surgeon has just one chance to put the implant in and hope that it's looks right in the long run.  Now, don't get me wrong, I am very happy to have done direct to implant method.  I am WAY too impatient to have gone through the expanding process and my results overall look very good.  However, alone standing in front of the mirror, I have things that bother me.  There are concave areas and ripples.  Because all of the breast tissue was scraped away from my skin, I am left with just thin skin in any area that doesn't have implant or muscle right under it.  So this skin just kind of falls in between my rib bones causing some concave areas.  A good way to picture it is by looking at your hand.  You can you can see the bones of your hand coming down from your knuckles through the thin skin on the top of it.  This is kind of like what I see when I'm looking at my chest in some areas.  I personally am not crazy about the ribs sticking out look.  This thin skin also causes a bit of rippling too as the muscle stretches over the implant.  So both of these things will be taken care of by using my own fat to fill in the concave areas and ripples.  I will have a small amount of fat removed from a donor site.  Unfortunately it won't be enough removal to really notice any benefit at the donor site--just like a tablespoon worth of it will be removed.  We are waiting so that Dr. J. can use the newest machine available to do something to this special with fat (I am not quite sure what exactly) that will make it more likely to stick.  Then the fat will be injected into those unsightly areas.

So this leaves me waiting to hear from Dr. J's office to find out exactly when this can be done.  It will either be very soon (they expected it after the first of the year) or after May 19th. Why May 19th?  Because Mitch and I officially committed to running the Cellcom Green Bay 1/2 Marathon.  Even though Dr. J. assures me it is going to be an easy surgery with a very quick recovery time, I am not willing to let it throw off my training. I'm warning those around me already that I am probably going to be a bit crazy training for it.  I've only ever done a VERY slow 9 miles in my running career and I am only currently up to 7 miles.  I did however have my first long run today in which I actually had negative splits, exciting step for me!  I'm thinking about doing the "Run for a Reason" to raise some money for Unity Hospice through this.  I will post more about that when we get it figured out.

I have had some problems in the last few months with pain again. This wasn't something that I've had for a long time, so it was pretty strange and had me worried for awhile.  It varies from sharp shooting pains to aching and soreness all day long.  There was no sign of infection, no obvious reason for a bit of swelling that came with it.  So as of now we think that I just did a bit too much working out.  It's possible that my nerves are beginning to reconnect and I am starting to get feeling back.  Suddenly I am now feeling the push ups and other things that I had felt ok doing for so long.  Unfortunately, I don't usually realize that I've done too much until the next day when I'm feeling the crazy pain whenever I move.  So I'm now just a lot more careful about what I do working out and with other lifting things around the house and at work.  I don't want to have one breast swollen again any time soon especially since I'm waiting to hear from Dr. J and wouldn't want have to delay revision because of it.  I look at this as a good thing because it means that I have an excuse not to  shovel snow anytime soon, workouts are more enjoyable with out push ups, and the girls are completely capable of getting in and out of the car by themselves without me lifting them in. Ironically, after a full month push up free I have less rippling than I have had for a long time.

I also am closer to making a decision about the surgery to reduce risks for ovarian cancer.  I met with another specialist to get another opinion and hear more options.  I really liked the office, the staff, and doctor but it didn't make the decision making process any easier.  I think that I will continue surveillance this spring and make a final decision by this summer which route to take.

So welcome to 2013 and all of the good things that it will bring!