And Never, Ever Feed Them After Midnight

The next step in the tram flap reconstruction process is nipples, and four weeks and a day after my original surgery, it was time for that step.

This surgery was done in the surgery center connected to the plastic surgeon's office, under a local anesthetic. Dr. Geter almost need not have bothered with that, since I still have basically no feeling in my boobies.

That leads me to a digression of sorts, called "Things No One Told Me Before This Surgery." 

1. I was told I was going to be given blood thinners in the hospital, to prevent blood clots. But no one told me they were going to be in the form of a shot administered into my stomach.

2. No one told me I would have utter and complete numbness around both incision sites. My stomach is numb from about three inches below the incision to three inches above it, starting at my sides. When I put my hand on my belly, I feel pressure, but that's it. It's as though there is a thick, leather pad over my stomach. Except that it's warm to the touch. The breasts are numb starting just below the chest. And here's the kicker: I've now been told that it will most likely always be that way. I knew it wasn't going to be the SAME, but I was not expecting this.

3. No one told me that having your arms stretched out Jesus-on-the-cross style for a 12 hour period during surgery would have such a lasting effect. While I was still in the hospital, the nerves in my left hand would cause my index finger to jump around and tremble. Both arms trembled for over a week after the surgery, and even after four weeks, my handwriting still isn't quite right.

4. No one told me that insomnia is a side effect of anesthesia. Up until a week ago, I was only getting about 3 or 4 hours of sleep a night and not even napping during the day.

5. No one told me that the process of the tummy tuck, a by-product of the reconstruction, itself had a by-product. It wasn't until my hair started growing back in (and I had been shaved from my chest to my crotch, so you know what I mean when I say "hair") that I realized that the top edge of my pubic hair was higher than it used to be. Apparently, when Dr. Geter yanked the skin on my tummy tighter, he pulled it from both directions, nearly giving me a beard. I always thought the danger of wearing really low-rise jeans was that your butt crack might show, but that is now the least of my worries....

Back to the nipple surgery, which was a very casual affair. The doctor, two nurses and I chatted while the radio played in the background (Alice 95.5, music to make nipples by). Dr. Geter DID warn me that the new nipples would be bigger than I expected but not to be alarmed, because they would shrink down to a normal size over the next three months. It took him about half an hour to do whatever it is he did to make a nipple on the right side, then he moved to the left. While he was working on my left side, I tried looking in his glasses to see if I could see a little of what he was doing in the reflection. I couldn't, but the nurse saw what I was doing and told me I could look at the completed right side. She threw back the drape and what I saw made me blurt out, "It's hideous!" The new nipple was HUGE and had little black threads sticking out all over, making it look like a cocklebur. Dr. Geter looked a little crushed, but he continued and, hopefully, at least made them match.

When the surgery was complete, Dr. Geter snipped holes in the middle of multiple squares of gauze and threaded them down over the new, gargantuan cocklebur nipples, finishing with plain gauze squares and taping the whole thing down with wickedly strong paper tape, telling me not to get them wet and to leave them on for an entire WEEK. It reminded me of the movie Gremlins ("never get them wet and never, ever feed them after midnight").  God knows, I don't want them to multiply, so every measure will be taken to keep them dry.

Watch out, Jennifer Aniston. I'm halfway there! 

Move Over, Wonder Woman

Move over, Wonder Woman, there's a new sheriff in town....

From the little research I did before my bilateral mastectomy with tram flap reconstruction, I thought I was really in for it. Much pain, MONTHS of recovery. And this I got from women who were having the surgery prophylactically and didn't have breast cancer. They stayed in the hospital for at least six days, were on heavy pain medications, and each time they stood or walked, it was a tremendous ordeal.

Apparently, I have a pretty high pain tolerance. I'm not saying the first couple of days of getting up out of the hospital bed were a walk in the park, although maybe having had two c-sections helped prepare me for the searing pain that accompanies sitting up and walking after abdominal surgery. But the c-section incision is only about six inches long. My new abdominal incision is 26 inches long, starting at the back of one hip bone and going across my tummy under my (new) bellybutton, ending at the back of the other hip bone. 

(Now, if you've been privy to my volleyball injury of early February, you may think my pain tolerance is, in fact, quite low. But I was hit on the thumb joint by a volleyball going about 60 m.p.h. from only about 30 feet away. My thumb was swollen for several weeks and it STILL hurts when I bend it. I thought it was finally completely CURED when I was in the hospital and my thumb didn't hurt one tiny bit. That is, until the narcotics wore off....)

I quit taking the pain meds a little over a week after my surgery. The only real pain I had was when I transitioned from sitting to standing or lying down (and vice versa), and pain meds weren't really going to help that. They also weren't going to make it any easier to endure the drains. And they weren't helping me sleep, so what was the point?

Easter Sunday,
11 days post-op

I made my first journey into the real world by taking a walk down the street, one day with Nicole when she came to see me and the next day with my husband. The walk with my husband netted us a ham from a neighbor who saw me walking hunched over, drain tubes hanging out of my clothes. He thought maybe he should trot me around the whole neighborhood to see what else we could score, but I declined.

I had a follow up appointment with Dr. Geter 2 weeks after my surgery, and by that time, I was feeling great. I still had some pain from the tummy incision, but I was walking much straighter and feeling much more like my old self. Dr. Geter and his staff were very impressed with my progress, although when I asked him when I could return to Zumba class, he gave me a benign smile and said he wouldn't want me messing up all those stitches he had made in me and to wait 4-6 weeks. But at least now I could DRIVE!

It was at this appointment that the hated drains were removed. A nurse took all the dressings off and then told me she would count to three, at which time I was to take a deep breath and blow out. She snipped the sutures holding the first drain in place, and as soon as she got to three, as I began to take in the deep breath, YANK! The drain tube was pulled out. I said, "I didn't have time to take a deep breath yet!" She said, "I know. That way it catches you by surprise and you're not anticipating it so much." Which would be a great technique if she didn't have THREE MORE TUBES to pull out. The process didn't get any easier as we went along, and the last one felt as though the end of the tube were tucked in between my ribs. (In fact, I am holding true that that is exactly where it was, as tender as the area still is.) In spite of the process, I was now drain free and ready to move on.

My follow up with Dr. Dorian Gray was the next week. He carefully felt the new titties and said they were doing great and gave me the good news that my right breast did not have any cancer, the sentinel node was clear and my margins were clear. 

I also got to ask him the burning question of whether or not I could safely shave under my left arm. I had been told by several people that I could no longer shave under the arm where the lymph node was removed with anything but an electric razor, nor could I have blood drawn from that arm or have my blood pressure taken there because of risk of lymphedema, caused by bacteria entering the body through a cut. The blood draw and blood pressure I could work around, but the shaving thing was completely stressing me out. I shave under my arms every day and I don't believe I have ever cut myself. (My legs are another story. I have cut them to ribbons over the years.) Dr. Bumberry said that that advice was basically old school, from the days of radical mastectomies, and that he felt there was no reason for me not to shave. Problem averted. 

With the approval of both doctors, I was now free to return to work as soon as I felt like it. I set the date for April 24, four weeks after my surgery, another step closer to "normal."

There's No Place Like Home

I wasn't entirely sure I was ready to leave the safety of the hospital for life back in the real world, but Dr. Geter thought I was. I had this weird fear of falling down, of all things. Not pain. Not infection. Not bleeding. Falling. 

I was not leaving the hospital without a shower. I discovered I really didn't give a rat's ass how hairy my legs were, but the hair and body needed to be washed. I was sure I looked (and smelled) like a DK. 

The nursing staff wasn't terribly interested in getting me clean. I asked several times for help taking a shower, and finally, around noon, the nurse stuck these clear, plastic sheets over the four drains to protect them from water.  That was the end of that. It became up to my husband to give me the shower, if I were going to have one.

While I dissed my husband on Facebook as being a lousy, whiny nurse in comparison to Kristin and Cindy, he actually was very good in the long run. The shower was just the beginning. Not that he gets any gold stars for technique. I sat on a shower chair and he sprayed me with the hand-held shower like I was a dog outside in a washtub. I had shampoo running down my face and into my eyes, and a good portion of it remained in my hair when it was over, but I was cleaner than I was when I went in. 

I put on real clothes, where I discovered the drains were EXACTLY where the waistband of my yoga pants would go. Hadn't allowed for the drains, not having had a CLUE what they were going to be all about when I packed what to wear home. Mid-afternoon, I finally got my walking papers and was ready to get the hell out of there. 

I stayed at my parents' house in Branson for a few days after leaving the hospital, slowly gaining the ability to walk upright. The tummy tuck portion of the surgery left my stomach tight as a drum; so tight, in fact, that I couldn't completely straighten up. It was almost as if I had atrophied into one side of a parenthesis. The drains made sleeping miserable. I devised a method of sleeping where I put my drains and tubing (in the fashionable little black bags) next to me on the bed and covered them with pillows so I had a place for my arms to lay. I was propped up with many pillows as well. Every trip to the bathroom or to go sit outside on the deck required that I unload all my pillows onto the floor, hang my little bags around my neck and carefully swing my legs over the edge of the bed without catching anything on the drain tubes. Then I had to do it all in reverse when I got back to bed. 

Sitting on the deck, soaking up sunshine.

Another lovely thing about the drains was they had to be stripped twice a day. The nurses taught my husband how to do it (thank God - I couldn't have done it myself if I could have even REACHED them). It was a disgusting little exercise where the fluid inside the tubes had to be scooted down into the drain reservoir, where it was then poured into a cup, measured and the output duly recorded. Each drain reservoir looked like a clear hand grenade. The four drain  tubes were stitched into place, so if the tube stripper (i.e., the husband) pulled a little too hard when stripping the drain, it pulled on the tubes and stitches and hurt like a sonofabitch. Then once a day, the gauze pads over the openings where the drains were inserted had to be changed. That meant the tape had to be pulled off each one, some kind of gooey medicine had to be applied around the wound, and then the whole thing re-bandaged. The whole process made me a little woozy. In fact, the only time I cried in the hospital was the day I was leaving and the nurse was pulling off the tape while I was standing up instead of lying down. I started feeling light-headed, sat down on the bed and started to cry. Couldn't begin to explain exactly WHAT I was crying about. It just all got to be too much.

The days spent at the lake were a delightful transition from hospital to home. I got a lot of rest and got to watch mindless tv shows like "Dance Moms" without anyone whining about wanting to watch something else. But just as I was ready to leave the hospital, I was also ready to leave Branson and try to get back to some kind of routine at home. I imagined my family there, happy to see me, joyfully taking on the household duties of doing laundry, scooping the cat box, cooking, doing dishes. What a lovely fantasy....

You Know You Want To See Them, Derik

On the third day in the hospital, the nurses make you get out of bed, those bitches. 

My friend Cindy came Friday morning to relieve Kristin, bringing me a box full of goodies and Diet Coke. I got my iv taken out, the oxygen taken away, the pain meds switched from iv to pills. I got my catheter removed, which is a mixed blessing, because it is kind of nice not to have to go to the trouble of getting up to go to the bathroom. I had visitors. Quite a few, in fact, but thanks to the pain meds, I couldn't begin to say exactly who came and when. (If you were one of them, I appreciate your visit, even if I can't remember it.)

With much searing pain, I was forced to move from my bed (which was entirely too short, by the way) to the recliner. And it was there that I experienced the absolute highlight of my stay: I got my effing period. I won't go into gruesome details, but I will say that if Cindy and Deanna don't unfriend me, it will be a miracle. (@Dr. Lacey: I suggest you run and run fast. Because after the D&C and endometrial ablation you performed on me a six weeks earlier, this was a cruel, cruel surprise. I'm giving you a head start. You might want to take advantage of my generosity in doing that. Because I WILL catch you....)

I was able to go pee pee on the big girl potty twice that day before my bladder clammed up and refused to cooperate further. Back in goes the Foley catheter. I was secretly happy, because I no longer had to endure the trip to the bathroom. 

Drunk as a runaway bicycle on  pain meds

The Everyday Heroes event finally ended, and my husband was able to return to the hospital late that afternoon. I'm sure Cindy was relieved to see him, after what I'd put her through earlier. The pain meds were making my eyes cross and I couldn't focus on anything.  They also made me nod off, but every time my eyes closed, my mouth dropped open. I was lucid enough to be aware of this and vain enough to pop awake each time and shut my mouth so I didn't look like a drooling idiot. 



On Saturday morning, I was scheduled for another surgery with Dr. Geter. Now, here's an interesting tidbit: my husband had been telling me what Dr. Geter said to him about the reconstruction after my first surgery (while I was in the recovery room). I looked at him and said, "I heard him say that to someone during the surgery." So when Dr. Geter came in my room that morning, I told him that I had heard that conversation. He kept smiling, but his eyes got a little big, and he asked if I heard him tell any dirty jokes. I said no, but I heard that one conversation and was able to recall details of it. WHAT THE HELL?



Around 9:00, a woman came to wheel me to surgery.  My bed was the equivalent of a grocery store cart with a crazy-ass wheel, so my trip was like Mr. Toad's Wild Ride at Disneyland. We careened off walls, doorways, and people. Yes, PEOPLE. 

I don't know if it's a Cover Your Ass thing or a spot-check to see if I have all my mental faculties about me, but every time someone would introduce themselves to me and tell me what part they were playing in my morning, they would ask me what procedure I was there for, and I had to honestly answer, "Beats me." I finally said, "Dr. Geter is tweaking something." (I didn't know there was going to be a TEST.) One of the nurses asked me if I had any metal anywhere in my body. I first answered, "Yes, all those little clips from my biopsies," then let out a hoot and said, "Never mind! They cut my boobies off and now the little clips are all gone!" 

What was supposed to be an hour or so procedure turned into three hours, and I STILL have no idea what was done, but back to the room for a little rest and then a very raucous visit by my Girls Night Out peeps, who were later joined by Melinda, Derik and Maddie. I think my pain meds did most of the talking....

My grand finale for the day was a walk down the hallway. My legs felt like jelly, but it wasn't painful. I was, however, rather fearful that I would run into my iv stand with my big ol' foot and send it, and me, flying, but it turned out to be an uneventful trip. I crept back into bed, hoping against all hope that I wouldn't wake up in the night and need to pee....

Day 2: It Only Hurts When I Move

pain meds... yesss.....

Being hospitalized wouldn't be so bad, if it weren't for the surgery part. Friends come to see you. You get flowers and presents. Push a button, and a nurse comes to see you. With a wave of your finger from your hospital bed throne, someone will adjust the covers, the thermostat, bring you fresh ice water.  And if I laid reallllly still, I could even forget that I had had surgery....

Thanks to the narcotics, even though I couldn't focus my eyes, I had a great day with Kristin. We took lots of pictures, and she approved all of my facebook posts. It's nice having a nurse be your babysitter. Every time I bent my left elbow, I set off an alarm for squishing my IV, and she was able to push the reset button and make it stop. A valuable skill, because I did it often. 

I got a breakfast tray that morning. Chicken broth, coffee (me, really?), grape juice, red jello, and this little cup of frozen, pink Italian dessert. I ate a few bites of jello and tried the Italian dessert. It was a non-descript pink flavor. Very sweet. Very mediocre. I passed. Lunch was the same thing, only they shook it up with beef broth and orange jello and yellow Italian dessert. I sipped a little broth, but it was so salty that I felt like I'd been brined. A bite or two of jello. I had high hopes for the Italian dessert this time, because I thought it would taste like the frozen lemonade you can get at amusement parks. Instead, it tasted like frozen Formula 409. I was sorry I had dissed the pink Italian dessert that morning. Dinner was the exact same thing. Bleh. Fortunately, I wasn't hungry. And THAT's a good thing, because Kristin decided to forego hospital food for dinner and ordered a Domino's pizza and ate it in front of me. VERY fortunate that I wasn't hungry. I will admit that it smelled divine.

My in-laws brought the kids to see me that evening. My son sat in the corner and chewed on his fingers the entire time. My daughter sat on my bed and talked the entire time. They are such polar opposites.  There was a sweet tea fiasco that I won't go into, because it makes me look shallow and unappreciative, and we can't have THAT. 

Kristin seemed to take to sleeping in the recliner rather well. I hadn't taken to sleeping on my back in a hospital bed, so I was awake. A lot. At one point, while watching helicopters go over, I realized that if I needed the nurse, I was screwed, because Kristin fell asleep with the tv remote, which meant she also had the call button. I scrutinized my tray table, trying to decide what I would throw at her if I needed to get her attention.

Both of my doctors are early risers and freakishly cheerful in the mornings. Dr. Bumberry came in first, mostly just patted my leg and asked if I were doing okay. He had a cute little Mizzou scrub hat on that, sadly, covered the lovely red hair. When he left, Kristin looked at me and said, "Is he, like, 26?" Doogie. Doogie Bumberry. Personally, I think he has a painting of himself in his attic that ages for him.

As gently as Dr. Bumberry came in that morning, Dr. Geter was just the opposite. He threw on the overhead light, and with a big smile, began pulling the bandages off of me. He assured me I had been shaved before the surgery, but I hadn't been skinned, so the tape removal hurt like a sonofabitch. I looked down when he was done. I had a happy face-shaped incision that began around my side at one hipbone and ended at the other, falling a little over an inch below my belly button. Well, not MY belly button but A belly button. Mine had looked nothing like the one I now had. I don't know whether or not that's an improvement, but I do know that Dr. Geter was very proud of the way it turned out. He pulled off the bandages on my chest next, and lo and behold, there were BOOBIES there. There was an incision across the equator of each one that ended where a nipple would be. The nipple area was inset with a piece of skin from somewhere. My stomach? Gave me a peculiar patchwork look. Dr. Geter was proud of these as well. He said, "They're the same size as the old ones. Actually, they're a little bigger. There was more to work with than I thought." WHAT? I thought I was pretty distinct when I said I wanted them to look small and perky like Jennifer Aniston's. Kristin later told me she saw my face fall when he said they were bigger than expected. 

No backsies....

The Shortest 12 Hours of My Life

Narcotics are a wonderful thing (when used RESPONSIBLY, kiddies). I remember practically nothing about my surgery on March 28. 

5:15 a.m.

Dr. Geter did, indeed, come in and draw on me with a marker. Only it was no Sharpie. It was purple and very permanent. Very. He also used a tape measure, which concerned me. I was afraid he was trying to measure the droopage so he could replicate it, which is precisely what I DIDN'T want. Dear husband pointed out that Dr. Geter wouldn't do that, as he "would be sued for malpractice if he gave you the same ones you had." (That's true love, isn't it?) I did ask him if he could tighten up my turkey neck while he was at it, and he gave me a big smile and said no. Worth a shot....

The nurse started the happy juice before I left my room, so I don't remember the trip to the OR. I don't even remember the awkward maneuver of hauling myself from the cot to the operating table. And why is it that you have to do this yourself? When the surgery is over, they seem to be able to manage getting you from the table onto the cot. Personally, I think it's done just for the amusement of the OR workers.

In the blink of an eye, it was over. In the blink of MY eye, anyway. My family, in the waiting room, blinked several times during the nearly 12 hour surgery. I remember hearing someone tell me it was all over.  I remember someone telling me the sentinel node was clear. I remember hearing my parents' voices. I remember trying very hard to open my eyes and smile. I remember feeling like I had been held and loved by all the people praying for me. I remember wanting a drink and getting ice chips instead.

My husband spent the night with me and slept like a log all night. I know this because I DIDN'T sleep like a log. My vitals were checked every hour, and although I tried to sleep between, it was mostly impossible. I kept getting distracted by sirens and thinking, wow, this neighborhood has a lot of police activity. There were also helicopters going over periodically. SWAT team? Military? Try EMERGENCY ROOM. 


My sister in law, Kristin, arrived around 8 a.m. to babysit me so my husband could go back to Joplin and finalize his Everyday Heroes luncheon, scheduled for the next day. And she brought Diet Coke! Let the healing begin!