Surprises

There were many things that I thought I knew going into this having already had a mastectomy and reconstruction once and having read like everything out there on DIEP. But here are something that surprised me.

1. The bruising. My breasts are bruised all over. My arms and legs am have bruises from the shots from the blood thinners. My abdominal scar has bruising at the ends of it. They are all at varying points of healing so I am a beautiful mash up of purple, pink, and yellow.

2. Diet restrictions. I was given a strict no caffeine and no chocolate diet in the hospital. I’m not a coffee or caffeine drinker so it wasn’t a big deal, but chocolate! My heavenly hunks had to wait until I got home.

3. Rib pain. A small portion of a rib connected to the sternum was removed to have a blood vessel to connect the flap to. This area was more sore than expected.

4. Drains. I was completely mentally prepared to have 6 drains. I came home with only 2. It was quite a bonus. However, my predictions of what I would wear to manage these was so off. Last time, I loved my drain camisole. This time I struggle with it because I don’t like to have anything on my breasts initially and that zip, even though it’s not tight, still feels like too much. Also the spot where the drains are held is too high and feels like it actually hits where the drains are stuck in me. I also did not have drains in my abdomen, which was a total bonus for me!

5. Penrose drains. I was surprised to have penrose drains while in the hospital. I hadn’t heard of this before. The best way to describe them is a silicone straw stuck halfway in your body and half out. I also pictured these (because I couldn't actually turn my body or lift my arms enough to see them) similar to the spigot that Katniss was gifted in The Hunger Games: Catching Fire to get water from a tree, except drilled into my body. THEY HURT! These drains resulted in a lot of goo just coming right out and soiling the hospital gown, sheets, pillows, that I had anywhere near my sides. Thus, the clothes that I thought I might wear in the hospital were useless.

6. Occupational Therapist visit while in the hospital. Maybe this was because of my length of hospital stay, but it was awesome. She came in each day and helped me learn exercises to do for PT but also how to get out of bed, tips for how to shower safely, how to get clothes that aren't button up on safely while having T-Rex arms. This was another great surprise.

Surgery Recap

I'm almost 1 week out from explant and DIEP reconstruction and I'm finally feeling ready to think back about the week.

It started on Sunday with a drive down to Madison. We dropped the kids and dog off at my parents and made the 140 mile drive in a snowstorm. It usually takes us about 2 and half hours, but because of the snow it took closer to 4 hours. There were several areas where we were either completely stopped or down to 5 mph on the highway. At one point it felt reassuring that there were two UW Health Ambulances following us for a portion. Mitch, who never takes a break while driving this route, suggested we stop at a gas station for a little stretch break, so you know it was rough. Eventually we made it and checked into the hotel that is right across from the hospital. We ate a good meal out at a restaurant fittingly called "BRAsseire V." We enjoyed dinner and spent the night watching The Office on the hotel TV. The first episode on was the one in which Jan gets implants. Fitting on two regards...implants obviously but second because there is a student at school who insists that I look just like Jan from the office. I don't see it. I think it's just because I'm the only female she sees that wears a blazer like Jan. Oh well. I did the Hibiclens shower and tried to sleep. Sleep didn't work very well. I had a drink with dinner, I listened to peloton sleep meditation, I prayed the rosary in my head, I did 4-7-8 breathing, all thing that usually help. But sleep really didn't happen the night before surgery. I forced myself to lay there until 4 am.

  

At that point, I got up and did my second Hibiclens shower following the directions from the pre-op appointment. I boxer braided my hair and double checked my bags to make sure that I left Mitch with all the things I thought he could take home and I had packed all the things I thought I'd need in the hospital. We took the brief drive to the hospital.

We were told to arrive at 5:30. We pulled in at 5:13. Valet parking wasn't open yet. Mitch dropped me off because it was still quite a snow storm and I wanted to leave my jacket in the car and found a spot to park. We quickly found our way to "First Day Surgery" which was also not open yet at the time that we arrived.


Surgery Day 1-Monday

The First Day Surgery department handled everything for my check in. I got dressed in Bear Paws gown, vitals taken, and pryed my wedding ring off my finger to leave with Mitch. At 7:00 all the action started. They started my IV putting it in the vein in my wrist because the front of my hand wasn't cooperating. Dr. Afifi came in and drew all over me. The Anesthetists came in and explained all their part as well. Throughout all this the nurses kept apologizing that I had to wait so long and that it was so rushed. They explained that they prioritize the order of people based on who they think is going to take the most time and I was someone they thought would be very simple, which is true...other than these BRCA related surgeries, I'm really a very healthy person. The wait also didn't bother me because it was nothing compared to what I experienced during my mastectomy.

My surgery was scheduled for 7:30, I said goodbye to Mitch and was rolled into the operating room. The last thing that I remember is the surgery team doing the check in thing where it felt like they were all standing around me and one leader was naming off the different responsibilities and each person would respond.

The next thing I know, I woke up in the recovery room. I spent some time in and out of it in there. I remember taking breath and feeling so surprised at how it felt. Now, I'm sure I was on significant pain meds, but I remember thinking it was so much easier to breathe. I took like three breaths and couldn't believe it. The nurse thought something was wrong and came over to ask me about it and I tried to explain but clearly didn't do it well. Then was rolled into the room I stayed in for my time in the hospital in the F6/6 section. Sometimes after DIEP surgery, hospitals require a stay in the ICU. UW Healthy University Hospital has this section designated for higher risk surgeries like this so I didn't have to move from ICU to normal room at any point. Mitch met us in the hallway, squeezed my hand and gave me a kiss. The first thing I said to him was "It feels so good to breathe." Apparently, I was trying to explain what breathing felt like. He didn't quite get it either. I think that I was so used to breathing with my implants which felt like rocks attached to my chest that I didn't realize how their weight felt or how restricting it felt until they were gone.

While I was in surgery, Mitch found the waiting area at the hospital. He was given a buzzer that provided him general updates every 2 hours. According to him, the waiting area was a really big open area. He left once to eat a breakfast burrito from the cafeteria. He read a book, dozed off, watched American Pickers because that was what was on TV and he didn't want to change it. He was intrigued to learn that the former ESPN anchor George Smith was now an anchor on a Madison station. At 4:45, Dr. Afifi came out to meet with Mitch. He let him know that they were able to get all of the capsule that surrounded my implant out and that everything went well.

I remember the staff coming in checking my vitals and using the doppler to listen to the flaps. At first it was every half an hour, then moved up to every hour. The room had to be 74 degrees to help the flaps adjust. They monitored the color and temperature of them as well. I dozed off a couple more times and by 8:30 Mitch decided he would go back to the hotel.

Post op day 2-Tuesday
I was in and out all night. It felt like day 2 started when Mitch came back to the hospital at 5am. They told him that the med students do rounds at about 5:30, so he wanted to be there to hear what they had to say. They had nothing new or earth shattering to share, but it was my first experience in a hospital with med students and it was a chance each day to see scenes from Grey's Anatomy or Scrubs in real life.

Feeling good

Later that morning they determined it was time for me to get up and moving around. They pulled my catheter and had me start to sit up. I had to be able to roll onto my side, put my feet down and get my body up without using my abs or arms to push against anything. That was horrible and painful and the only thing that was worse was when they said I need to stand up. Holy hell. That was awful. I had to do that three times while they monitored my blood pressure to make sure that it was steady before they would let me walk. I didn't want to walk. I cried it hurt so bad and I sat back down and quit.

I drank a ton of water because of the sore throat and dry mouth. They provided a little cup with a straw and a mini pitcher full of extra. I remember thinking how on earth am I supposed to be able to refill this water cup--I don't have the strength to pick up that pitcher, but eventually I was able to do that and it was good exercise for me. Because of all this water though, it was only 20 minutes before I really needed to go. I pushed through the awful pain. Did the blood pressure checks again and waddles to the bathroom. I figured out that if I relied upon my leg strength getting up was much better. I couldn't stand up right because of how tight by stomach skin has been pulled, so picture an old lady hunched over a walker, minus the walker, and that's what I look like walking anywhere.

The Good Pizza vs. The Original Cheeseless

I learned how to order my hospital meals. I took the meds, which was a variety of the big pain meds, tylenol, aspirin, stool softeners, miralax, potassium, shots for blood thinning... it felt like every 2 hours they had something for me. I watched some tv and dozed off. I moved from the bed to the chair several times. I managed the drains with the help of the nurses.That afternoon Dr. Afifi came by to check on me and I was allowed to shower. Mitch eventually headed back home because we agreed that it was a waste of time for him to be off work and it'd be better for the kids if they had the normalcy of him home.


Post op day 3-Wednesday

I continued with the routine of meds, drains, and flap checks, sleeping and small amounts of walking. Flap checks moved from every hour to every 2 hours then to every 4 hours overnight. The nurses began asking about passing gas or bowel movements. This was the last task that needed to occur before I could be considered ready to be released from the hospital. UW Health has these awesome posters to help you describe poop so that when it happens you can accurately let them know. I understand that I'd been given twice daily stool softeners and miralax because of concerns about the anesthesia and narcotic pain meds having an impact on everything down there. They may have overdone it though because imagine this situation, someone who doesn't move very well or very fast, experiencing the sudden urgency of these meds. It wasn't pretty. Nurses and Nursing assistants are saints. Due to how hard it was to move around, I decided to ask Mitch to order the recliner rental and he got right on that. It was a little bit lonely at the hospital that day. Between my digestive issues and being by there by myself and pain, there were some tears. That afternoon the Occupational Therapist visited and gave me plenty of exercises to do to regain range of motion in my arms and shoulders. That afternoon, they started talking about when I could go home. We had planned with Dr. Afifi to do Friday because of the distance to the hospital in case something came up. I let the resident know this plan for Friday despite how lonely and homesick I was feeling because I thought it would be better incase something happened with the flaps and because I needed to feel reasonably sure I could make it throughout the drive without needing to use the bathroom.

Feeling Awful and Homesick

Post op Day 4-Thursday
Same old, same old with the flap check and vitals. I started to slow down the pain meds and they promised they wouldn't make me take any more stool softeners or Miralax. They were able to turn the temperature down in my room. During rounds, they declared me allowable to be discharged whenever I was ready. I stuck with the idea of waiting until Friday, but by lunch time I was again feeling homesick and my stomach had settled, so I asked Mitch what he thought about this. He made some re-arrangements to cover the kids and was on his way. By 5:00, I was discharged from the hospital and on my way home. I used a pillow placed between my and the seat belt to help feel comfortable on the ride. By 7:30, we were home! It felt so good to be home and to hug the girls and sleep in my own bed! I used a wedge pillow to keep myself at about 45 degrees in bed with more pillows under my knees and by my arms. It was such a comfortable nest!

Post op Day 5 Friday AT HOME
I was able to sleep through the night with just one wake up for more pain meds. Mitch helped with the drains and dressings before heading to work. I got to spend the day with the girls because they had the day off of school. They took good care of me, making me breakfast, refilling my water, picking up whatever I dropped and couldn't pick back up. We watched a movie together, they played while I napped. Mitch came home for lunch with us and then again at dinner time. Pain wasn't horrible and I was walking a bit more upright.

Post op Days 6 and 7 Saturday & Sunday AT HOME
Each day felt a little bit better. I continued to wean off the pain meds switching to only tylenol. I am progressively standing more upright. Days are spent in the recliner with several slow walks around the house. I've had some great afternoon naps and then crawl into my nest at bedtime. My drains are putting out less each day. My penrose drains have scabbed over so they don't need dressing anymore. I even attempted putting on the abdominal binder for a few hours today. My incisions look good and I've almost got the adhesive goo off most places. Hopefully this continues with feeling better everyday!

I like lists

I like lists.

Here’s a list of things I did to get prepared for this surgery (no semblance of order here.)

-Deep cleaned the house...like ridiculously. Every room, every closet. I even moved the oven and fridge and vacuumed behind them.
-Bought a few more button front, zip up, or super soft shirts to be extra cozy.
-Moved all of my leggings, sweats, and shirts to a spot in my closet where I won't have to reach or open a drawer for them.
-Made soup...lots of soup. Every week I made a big pot of soup, we ate it for our meal and then I froze the rest in small containers that I should be able to each for lunches at home.
-Prepared a stack of books to potentially read. Some are work related; some are pleasure reading. Last time, I remember thinking I'd read a ton but not actually doing it because I'd fall asleep too easily. We will see how it goes this time.
-Asked friends for recommendations of what to watch on Netflix, Prime, Hulu, etc. So far my plan is to finish Parks and Rec (already started season 7) and the 8 episodes of This is Us from this season that we haven't watched yet. I need to do season 2 of Big Little Lies and season 3 of Handmaids Tale. After that maybe Ms. Maisel, Schitt's Creek, One Child Nation, Imagineering, or You.
- Overthought the need for a recliner and whether to purchase or rent. I still didn't buy one. Worst case scenario, I rent one from home medical supply company and they deliver it.
- Increased my protein intake and added collagen as well. You should see my nails!
- Hydrated--water, water, water!
- Prepared for a substitute taking on my role at work. I thought planning for a long term sub for my classroom during maternity leave was hard..prepping for someone to stand in as Assistant Principal was even more of a challenge!
- Moved all of the kitchen supplies that I will need to use into a basket on the counter so that I don't have to reach up or open doors.
- Worked out focusing on leg and core strength. I was NOT supposed to lose any weight before this surgery, so for the first time, pretty much ever, working out took on a new meaning. I worked solely on heart and lung health instead of trying to burn calories.
- Purchased a ton of food to stock the pantry and freezer so that I don't have to grocery shop for awhile.
- Prepped everything I could possibly take care of that I will or could miss out on while recovery. Taxes done. Swim meet info ready for Mitch to write on the kids arms. Carpool organized.
- Made a list of the simple things that I can do during medical leave that meet my movement restrictions...wash my makeup brushes, use that little wood colored marker to color in the scratches in the woodwork, catch up on podcasts. I have big goals!

I'm ready

I am ready!

My bags are packed. The house is clean. My inbox is cleaned out and my away message is set. I have a list of books to read and things to watch while on leave. I don't want to jinx myself, but I think that I made it to surgery day without getting a cold, flu, or fever at the last minute that would keep me from being able to

On Sunday, Mitch and I will drop the girls and dog off at my parents and make our way to Madison. There's a predicted snow storm, so it may be a slow drive. We have plans for dinner out Sunday night--a good meal and a glass of wine to hopefully help me sleep. Then I hit the shower to wash my body with half a bottle of Hibiclens. I get to do that shower scrub again early Monday morning before our 5:30 am arrival at the hospital. 7:30 Surgery time.

I am nervous. But I am also ready for this. I'm confident in my doctors. I'm happy that this could mean that I don't have to have maintenance that I would have and with implant reconstruction. I'm 100% sure this is the right decision. I'm curious what everything will look like in the end. It's hard for me to predict what the pain will be like and what things will be like during the recovery. I'm very much a planner, so this unknown is hard for me.

I was struggling more with this before Christmas, just feeling overwhelmed by the unknown. I started writing though again, journaling for myself. I really loaded on the workouts to keep my sanity. I have a 11 week streak on Peloton that I plan on keeping up through recovery by using the Peloton meditations.

On surgery day, Mitch will be in charge of my phone. It's a long surgery and I've been doing my best to convince him NOT to stay at the hospital the entire time, but we'll see what he chooses. He'll be handling the texts to update. I've also heard that I should let him keep it for a bit after as you never know what will happen on those pain meds and I don't want to come home to a million Amazon boxes.