Tag Archives: Reconstructive Surgeon

by

What Looked Like “Better” Turned Out to be PMS and a Full Moon


full_moon_wallpaper_3-t2

In the days following this blog post, I started to feel better – almost as if acknowledging the Bad allowed me to release it and move on.

Or so I thought.

It was a weird few days –

It was a short work week, with Monday and Tuesday off to celebrate Christmas (and that previous weekend effectively being 4 days long – nice).

The full moon was Friday night (which always affects me, amps me up just a bit with that increased pull on the liquid in my body).

Then Saturday, I had already planned to go see my Dad’s house – for the last time it would look anything like it did when I lived there in my teens.  Dad is moving from the apartment he’s lived in for 35 years.  The apartment I lived in several different times during my teens when I was bouncing between parents, trying to find my way.  Dad’s apartment building was sold and he’s being thrown out.  We figured this would be the best time for me to go say my goodbyes to the house before it didn’t look like Dad’s anymore (we were able to wait until I was out of radiation for a bit).  It also turns out to be almost a year to the day that we lost Grandma (Dad’s mother) (see “I Missed You Last Night Grandma – Single Malt Scotch and Election Returns“).

Add to that, we have Grandma’s unveiling coming up in about a month.  Just thinking about her and saying goodbye to Dad’s place reminded me that I had to do the same to Grandma’s house already last year in May (the Only house she and Grandpa had had during my entire life and so where our whole relationship took place), a mere two months before being diagnosed with breast cancer.

It was an emotionally-charged day, to say the least.

I had also not seen Mom since my last week of radiation, and had managed to procure and wrap gifts for Mom and Dad, so, as long as I was heading out to the Westside, I might as well deliver the last of the gifts.

Had lunch @ Mom’s – gave her her Holiday Gift.

Went over to Dad’s place – took pictures.

Went over to Dad’s new place – it’s really beautiful actually and I think he’ll be really happy there.

Headed home by way of a couple of knitting shops – acquired what I was looking for and fell in love with a new yarn (look for upcoming knitting posts – yep, I’m a multi-talented, or just maybe undecided, blogger).

Got home just about when Hubby did (he’d gone out doing his own errands) – we shared our various purchases and decided to head back out together to make an adjustment to something.

Had dinner and went to sleep.

Woke up Sunday morning, coffee in bed, hanging out – waking up, had No motivation.

The energy of the last few days was gone.  Did my morning cleaning up and realized the hormones had crested.  Hm, didn’t even pay attention to that one coming.  But all the energy of the last few days was gone.

Turns out those few days of energy were just PMS and a full moon (plus emotionality about Dad’s move).  Now we’re back to desperately seeking naps.

I am seeing small improvements I think I can rely on – I’m feeling like doing more at home, and I’m more okay with doing an errand on the way home from time to time now.  I think the last time I cried from sheer exhaustion was actually my last week of radiation therapy – a whole 3 weeks ago!

I figure at this rate, I’ll start to really reliably feel like myself about the time my Reconstructive Surgeon runs me over again.  Let me explain – she is beautiful, sexy, extremely talented, experienced, has a great eye and great hands, is amazingly good at what she does . . . and that bitch is a Mack Truck in surgery!

She’s also my way of making lemonade (with vodka, thank you very much!) out of this bushel of lemons raining down on my head.

And as Scarlett said “Tomorrow Is Another Day.”

by

Radiation Therapy Journal – Day 24 – Monday December 3, 2012

Treatment Notes:

– They needed to do new films today, and have the doctor come in while I’m positioned on the table because I was swollen and she needed to confirm application of cell-destroying radiation – um, okay.  So my guys could see that on the films (that I was swollen from the treatment – if you’ve been reading me you know it actually happened Treatment Day 1 or 2), and I’m imagining the CT scans taken last week to plan the boost Did Not exactly match the CT scans taken a week before I started treatment because treatment made me swell damn near immediately!  But could she have believed me when I told her this 4 weeks ago?!  Apparently Not – she must be a fan of Dr. House (who gets the reference – 1st section?)!  But other than it taking a bit longer than normal – nothing much to see here, move along.

Doctor’s Visit:

– I’m inclined to believe that my ROnc actually did talk to my RSurg last week as she claims she did, for two reasons:

1) Mom pointed out that she said she did in my medical records and she couldn’t/wouldn’t do that if it weren’t true ‘cuz of this little thing called Medical Ethics.  Count on Mom for reminding me of the logical side of things.  But even more than that, I believe they talked because . . .

2) ROnc did Not try to push me into what she thinks I should do.  She walked into the room with printouts (as I had asked her to do) of the boost plan.  She explained them to me.  She then hands me and explains to me several study abstracts backing up her claim of the benefit the boost will provide to me And shows me the fairly good cosmetic results also covered in the studies.

She then tells me that she’ll do her visit notes with me and when we’re both happy, Then (electronically) sign them and print me a copy (to avoid having to void and reissue the notes as I had her do last week regarding my use of painkillers to get through the pain caused by the swelling (that she actually now believes exists) caused by the treatment itself.

She reads the notes right up until the last sentence, which I happen to see as she’s printing and closing that screen: “Patient will be given discharge instruction on last day of treatment.”  I repeat this to her and ask her to get them to me earlier (I don’t need things like that to be last minute in case I end up having questions, but she says they basically say “Call me if you have any questions or problems.”) and then she says she’ll have them printed and I need to bring them back to her, signed, on Friday, which will be my last day of treatment if I decide not to have the boost.

No further pressure – just giving me the information and letting it be my decision.  This is actually why I quit smoking (98 days CFT, BTW!) – because my RSurg Did NOT tell me to quit – she just told me what would happen to my body if I didn’t and I decided all by myself, just like a big girl who doesn’t have to be told, that my boobs and what I was going through to keep them, were more important to me than smoking.  I have to come around to things in my own time.  Forcing me there does not get me there sooner, it Delays Me Getting There.  Christ Almighty, she could have saved me so much angst if she had figured this out sooner!

Side Effects:

– lightheadedness, again – intermittently throughout the day

– So, interestingly totally normal blood pressure (107/62) this morning during my morning activities & the weekly installment of putting my doctor in her place.  Okay, so I seemed all calm this morning.  I figured I’d go with it.  Then midday I get nauseous and start to hurt, badly.  It’s actually my back that hurts, but I know it’s coming from stomach upset – this is a fairly familiar GERD pain pattern.  So maybe my Monday Morning Stuff manifested this way instead of as higher than normal blood pressure.  Okay, so I take a Zofran for the nausea.  30 minutes later the nausea was gone.  The pain wasn’t.  Took a pain pill.  45 minutes later no nausea And no pain!  Yay!  Time for lunch – soup, just to be on the safe side.  All’s well with the tummy for the rest of the day.

Copyright Ridingthebcrollercoaster.com 2012 All Rights Reserved.

by

Radiation Therapy Journal – Day 19 – Monday November 26, 2012

Treatment Notes:

– really nothing to report, except for slipping by one of my guys at the front of the suite on my way back to the machine – being Perfectly on time and having him scramble to catch up with me today – hehehe (well, I’d take credit, but I think we’re maybe headed into that amorphous time of half-holiday-light traffic as we gear up for schools to start letting out for Christmas Break (yeah, I’m Jewish, I celebrate Chanukah, I’ve been known to have a Christmas tree, not a Chanukah Bush, get over the ultra-political-correctness already, will ya?)

Doctor’s Visit:

– Yeah, long story short:

She said she called my RSurg, had a discussion with her, and that my RSurg was okay with a “regular boost,” but was concerned that I was getting a “super boost,” and therefore was comfortable with the boost plan in place for me

. . . which claims, all of them, will be checked out by me, hopefully telephonically, with my RSurg, since I trust her, but do Not trust my ROnc to have the Whole Me in her best interest.  I wish I did, but I don’t.  Oh well.

. . . which boost plan has not been drawn up – What?  Yes, the boost plan (the last week or so of treatment where they take the daily amount of radiation currently spread over the whole boob, and concentrate that amount of radiation in the tumor bed only) has Not Yet been planned.

As I was writing the last sentence, my ROnc called me – she wants to get new CT readings (since I’m having some swelling – or she finally believes I am – she never got to see me before I started rad therapy and I swelled almost immediately) but using my existing tattoos – to make sure the boost plan is completely accurate (since my body has changed with the swelling since beginning this treatment, the CT scans done a week before I began treatment may not be accurate to my anatomy today).  Then she will take Thursday and Friday to do the boost plan.  She will print it out for me (like I asked her to do today with the regular plan) so we can discuss it next Monday at our visit.

Then I’ll have all of next week, still on the original and unchanged first part of the plan to decide if I want to do the boost or not (which, if I do it, will start the following Monday) without getting me into a situation where I don’t have enough time to consider boost or no boost before we’re forced to consider an unintended break in treatment.

So, that’s the plan for the moment, so to speak.]

Side Effects:

– Um, other than blood pressure of 140/75 this morning (WAY high for me – I’m usually – well, BC as in Before Cancer anyways – around 110/60 normally), but since I was planning to follow my “new normal” Monday schedule of 1) get my radiation treatment, 2) put my doctor in her place, 3) go to work – I was okay with that reading (this too shall pass) – the good old “white-coat syndrome” magnified and all that.

Update: This early evening before acupuncture, Mo took my blood pressure again – 110/70.  Not surprising at all.  I was having the Pavlovian relaxation reaction just being there knowing what we were about to do was going to make me feel better, immediately and for days to come.

In fact, when I left I shared the elevator down with another cancer patient I had met at acupuncture and we both had that ever so slightly sleepy, very relaxed ‘I just had acupuncture’ look on both our faces and shared that moment together in the elevator on the way downstairs.

– less pain today.  I’m inside the week that my acupuncture treatment effects seem to last (I managed to get another appt with Mo tonight – yay!), and the past 4 days of not having to wear a bra, and being able to rest and/or sleep Whenever I Want have helped too – a much needed break indeed.

Copyright Ridingthebcrollercoaster.com 2012 All Rights Reserved.

by

Radiation Therapy Journal – Day 16 – Monday November 19, 2012

Treatment Notes:

– some warmth during the up-from-under portion of today’s program, otherwise not much, kinda in-zap-out

– I laid myself down on the table this morning Without taking my dress down – they had to remind me (and they were so good about it too)!  Oops!

Doctor’s Visit:

– there’s a first time for everything – I’ve never been treated like an addict before.  I finally realized that is the POV that Dr. Sanghani is coming from.  (Yep, naming names.)  I told her that I haven’t had a pain-free day in 14 weeks (since my first surgery).  My intention was to convey the fact that when one’s been in pain that continuously, one’s pain-tolerance may drop.  My dad had a different interpretation – one which never occurred to me: that I’ve been on pain meds every day for the last 14 weeks.  Which I have actually.

What she did not seem to hear and/or take into account is that what pain meds I’ve been taking have changed with my needs over that time.  The highest I was taking was Norco 10 (10 mg hydrocodone/325 mg acetaminophen) right after my 2nd surgery – for about a week or so.  Then something miraculous happened…I stopped taking it because I didn’t need that much pain relief anymore!  :-O  Oh my gosh, I have the ability to self-regulate my intake of pain meds according to actual need – just like a real non-addicted adult!  Can you imagine such a thing?  As it happens, when I first started radiation, I was down to two Aleves twice a day and that was doing the deal.

But let’s be real – the object of my radiation treatment is to destroy cells.  Sorry, well actually I’m not sorry if that makes some people uncomfortable, using those words.  I’ve left my sugar-coating this stuff behind a while ago.  The object of the treatment is to cause damage (a measured amount, more or less, to be sure, but still damage) in my body.  Causing damage to the human body nearly always results in pain.  This treatment causes skin damage – irritated skin can be painful.  This treatment causes swelling in the radiated area.  Swollen tissue presses on nerves – often causing pain.

It is not nearly in the neighborhood of crazy that I should be experiencing pain (increasing pain, as more deliberate and intended damage is done to my body over the course of the treatments), and desire some relief from that pain.  Also, I have recent experience with some pain relievers, and you know that disclaimer they put on narcotic Rx’s: “May cause drowsiness – Take care while driving or operating machinery until you know this medication affects you?”  Guess what, I actually know how these medications affect me, from recent, personal experience!  I actually know I can function, work and drive on 2.5mg hydrocodone.  It’s when I take 5mg that things get a little weirder.

The funny thing is this: I realized that the very fact that she is treating me like an addict (by doling out the bare amount needed to get me through to our next scheduled visit on the amount I’m telling her I’m taking now – not thinking that my pain may increase with more treatments – two more to go this week – and if I have to take more than we planned on, I’ll be stranded right in the middle of a 4-day streak when I can’t easily get to her – nice) – is actually making me act like one!  In order to get my needs met, I’m gonna get my pain meds from another doctor (because I don’t need to have this begging, bullshit conversation every week until the end of my radiation therapy)!  So, because she assumes I’m an addict and therefore is treating me like one, I am actually displaying doctor-jumping drug-seeking behavior…too fucking funny!

Of course, it’s not really funny, because that was one prong of a two-pronged visit wherein Dr. Sanghani completely lost my respect and trust.  She has now given me the strong impression that she really does not care what happens to me after she’s done with me.  And that’s fine, for her.  Not so much for me, since I actually get to live in my body (hopefully for another 40-50 years – yep, not a typo – if this treatment business does its job).  Part of that for me is what the girls look like and how I feel about them specifically, and me generally.

To that end, my RSurg has recommended against me getting a boost because it causes more damage, that she will be having to fix.  But Dr. Sanghani is focused on (and Only on) eradicating the cancer as best she knows how – side effects, temporary and permanent, be damned.  Don’t get me wrong, I want the cancer to be completely gone.  I”m not stupid, and I get what this is about.

And…

I also expect 40 more years of living after this treatment course is over.  I’m currently 46 years old.  That means I expect to live almost as long as I have already been here.  That’s a Long Time to deal with physical defects that could be avoided.  And, if I don’t come out of the other side of this feeling good about myself, healthy And sexy, then really, that’s not a successful outcome – it’s the classic quantity vs. quality of life question.  I want both.  Am I greedy?  Yes.  But wouldn’t you be too in my situation, if you thought you could have both?

So my problem with Dr. Sanghani is that the quality of life issue is not at all important to her.  She doesn’t have the same overall gameplan for my recovery as a complete person that I do.  She’s too focused on the tumor and/or the disease and forgets both of those are attached to an actual human being.

Whereas, my RSurg sees my outcome as a whole person.  She has been involved with this since almost the beginning – certainly before my first surgery.  Her opinion has been dismissed by other saying “of course she cares about how you look when this is done – she’s a plastic surgeon.”  What they don’t know is that that perspective comes from an understanding of breast cancer recovery as a unique blend of mind, body and soul, in a different way than almost any other cancer because of the physical disfigurement attendant to it.

Why do I believe she has my best interests at heart and I don’t trust Dr. Sanghani?  When I met my RSurg, it was the very first time since my diagnosis almost a month before, that I actually felt calm – I could take a deep breath.  I have re-experienced that ‘safe haven’ moment in each of my subsequent visits with her.

I knew also that she had pioneered a one-step mastectomy/implant procedure for breast cancer patients.  She is experienced not just with cosmetic procedures, but with reconstruction after cancer.  She called me (as did my CSurg seprately) to explain why she was not comfortable with and therefore could not do my reconstruction at the same time as my excision surgery – namely that if my CSurg did Not get clean margins the first time and my RSurg had already used my own tissue to do the repair, then my CSurg would have to go in and re-excavate the tumor bed in order to Get clean margins, thereby wasting all of my own adjacent tissue (it would have to be removed along with more edges of the tumor bed) and that tissue would be forever gone for reconstructive purposes.

Why is reconstruction such a big deal for me?  Please see “A Lesson in Volume.”  Let’s take a divet this size out of the front of your body and see what you think, eh?

Anyway, this made sense to me.  I understood it.  Although I would rather have had only one surgery (that would have been ideal, wouldn’t it?), I went into it accepting that I would have two or three (if my CSurg did not get clean margins the first time) and that I couldn’t even Schedule reconstruction until pathology on the tissue confirmed clean margins.  And I accepted it because I Trusted that both my CSurg and my RSurg had my best possible outcome – physically, mentally And emotionally – in mind when charting my treatment.  I trusted (and still trust) this about them because they had instilled this trust in me by how they interact (still) with me.  Dr. Sanghani hasn’t really done this in the same way – my calm last week was (apparently) a temporary reduction of defending myself against doctors who mistakenly think their relationship is about them and not about the patient.  <shakes head>

Side Effects:

– pain – more of it every week.  These days it can hit anywhere from the left side of my sternum where my ribs attach, all the way to past the midline of my body under my arm – and from almost up by my collarbone down to the inframammary fold – including my chest wall under Lefty and Lefty itself being just generally tender.  Lovely.

Copyright Ridingthebcrollercoaster.com 2012 All Rights Reserved.