Wednesday, December 14, 2011

Should this post be rated???

Just as an FYI, if you are a guy or just a casual acquaintance of mine, the following post may contain more information that you want. Just thought I'd warn you in advance. For myself, I'm beyond caring who knows the details.

Last Friday I had my first follow up with my plastic surgeon.  I had my surgeons do a skin and nipple/areola sparing surgery. This is when they make a small incision, remove all the breast tissue from inside the breast, but leave all the old skin, including the nipple and areola.What is probably more common is for them to remove the nipple and areola and all the breast tissue, but save the skin and at a later date, reconstruct the nipple and areola using skin taken from another part of your body.

Anyway, I probably shouldn't have asked them to save the nipple and areola. I don't think my plastic surgeon and/or my general surgeon had quite the experience or skill level necessary to do it sucessfully because I don't think they have done many of them before. When I was in the hospital, a couple of the nurses said that this was one of the first ones they'd seen. So... shame on me. I should have asked more questions, but oh well it's done. So now, the issue is that the nipple and portions of the skin around it have died because the circulation was compromised during surgery. So I have to goop on this cream three times a day to protect the wound until we know if there is going to be good skin that grows up underneath the dead skin or if I am going to need a skin graft. It's kind of nasty. I'm planning on a skin graft, probably some time in January.

Some good news is that of the four drains I had coming out of my body, we were able to remove two of them. They were longer than I expected. I only thought the tube extended an inch or so inside my body. Turns out, it was closer to about 6 to 8 inches and was curved up by my collar bone and around the top of each breast, ending around the sternum area. Of course, the two she removed were not the ones in the most uncomfortable locations, but it is still nicer to have half as many tubes and containers hanging from me constantly. The other two have just dropped to the maximum output of fluid in a 24 hour period (30 milliliters), so they should come out this Friday at my next appointment. (Unless I can find someone to take them out earlier.) I hate them. I have seriously considered taking them out myself. I watched her do the first two. It didn't look that difficult. Just snip the stitches and pull...  I think I'll feel tons better once they're gone. Not so much like an invalid. I should even be able to drive since I'm off the narcotics too. I'll have to win the battle with Neil on that one first though.

So that is the latest. A little closer to what I hope will be a little calmer life. I've had three crappy Thanksgivings, three crappy Christmases, and three crappy wedding anniversaries. I'm looking forward to being able to celebrate the holidays next year without having to deal with a horrific autoimmune disease, chemotherapy, or having just been taken apart and put back together.

Saturday, December 10, 2011

Surgery story

We got to the hospital (IMC) on Wednesday morning at 5:30, bright and early--and then sat in the waiting room for about an hour, waiting for our turn. (I will never understand this.) Once they actually let us back I got in my fashionable little hospital gown and they wheeled me into a little room where I met with everyone that was going to be attending my little party over the next 12 hours: general surgeon, plastic surgeon, anethstesiologist, surgical nurse, and someone else I've forgotten. We all talked about exactly what we were doing so everyone was on the same page. It was probably a good thing since the general surgeon was under the impression that we were only doing a single mastectomy when the plan was to do both.

After we got that clear, my plastic surgeon got out the sharpie and started marking me up. The fun part was when she drew the incision on my belly where they would be removing the tissue to build the new breasts. It went from hip to hip and it took it ALL.  I was quite excited about that part.

The next 12 hours are a little fuzzy. I don't even remember them taking me into the operating room or saying goodbye to Neil. I'll see if I can get Neil to fill in the blanks in a different post. The next thing I remember is someone calling my name and a stabbing pain in my right calf. I vaguely remember  being confused at the location of the pain and yelling, "Why does my leg hurt?" Apparently my leg had been lying on top of a small cord for 12 hours and had developed a huge knot in the calf muscle that was about 4 inches long. That was a little unexpected. So Neil spent the next little while trying to work the knot out of my leg.

The first 24 hours after I came out of surgery were spent in the Intensive Care Unit. They had to carefully monitor the transplanted tissue to make sure that circulation was well established. The plastic surgeon had to connect the dissected blood vessels in the tissue from my belly to the dissected blood vessels in the tissues in my chest. If the circulation wasn't good, then the tissue would die and we'd have to start all over again.

They checked the circulation by monitoring the color of the skin and poking me a lot. When you poke yourself, you normally see a white spot the size of your finger tip where you have pushed the blood out of the veins. After a second, it turns pink as the heart fills the veins with blood again. That shows good circulation. So I was constantly getting poked.

I also had four tubes coming from my body that were draining blood and body fluid from the surgical sites. Two were in my upper abdomen and two were in the lower abdomen. The nurses were constantly emptying these out. The fluids need to get below 30 ml per day before they can be removed.

After 24 hours, they moved me from ICU to a regular hospital room. I was hooked up to an drug pump that would give me a shot of some sort of narcotic once my pain level got too high. Over the last couple of years, I've learned to be a lot more tolerant of pain, but that doesn't mean that I won't do everything I can to avoid it, so I made sure to push that little button every time I thought of it. Fortunately for me, the machine is set so patients can't self administer too much drugs, but I still just thought I should make sure I was getting my money's worth.

I spent four nights in the hospital and as miserable as I was most of the time, I did notice that my pain levels were improving each day. Even that early on. The first time they had to move me to a different bed (when I left the ICU), I thought I was going to die. I had two nurses on either side of me and they just lifted me up in the sheet that I was lying on and slid me over to a different bed. That one hurt. I felt like someone had tried to cut me in half. Well, I guess with an incision from hip to hip, that wasn't too far from the truth. I wasn't feeling much from the chest area. Nerve endings had been severed so there wasn't a whole lot of sensation from that area. It was the tummy tuck that felt like it was going to kill me. But the next time they had to move me from the bed--when I got up to take a shower--it wasn't nearly as bad, so it got a little better each day.

So three more nights in the hospital and I was feeling well enough to come home. We left the hospital around 7 pm on Saturday night. One of my angel neices had taken my kids for the weekend so the house was quiet. It was nice. Neil, the genius that he is, set up the bed we just bought Lily so it bent just like a hospital bed. I had to have both upper body and legs elevated. It was quite the task to figure out how to make me comfortable while wearing a super, hot surgical bra--something that literally held me together from neck to belly button, a binder that was 8 inches wide and cinched around my hips as tight as they could get it to protect the incision on my belly, and 4 tubes protruding from some very inconvenient parts of my body, but he did it. I doped myself up with my old friend, Percocet, and slept like the dead.

Sunday, December 4, 2011

Doing the granny shuffle...

A couple of days before I went into surgery, I went to the store to find me a house coat. I knew I would have a few cords coming out of my body for a couple of weeks after surgery, so I needed something that I could either zip or button up in front. I came home, put it on, and showed Neil and then burst out laughing. It is exactly what my grandmother used to wear every day whenever I saw her. I have my very own "granny coat."

Neil found another one for me the next day that is a little more hip because it has a hoodie and little matching socks with a fur cuff. That's right. I'm one stylyin' little granny. But that's not all. I now have an incision about four times the width of my C-section scars. It is from hip to hip. Because I am not supposed to put any stress at all on that incision, my surgeon has told me that I need to walk hunched over for a few weeks.  Well, that causes some lower back pain issues, so we were able to borrow a walker from a friend of a friend (thank you, thank you!), and now the granny shuffle is complete. Granny house coat, furry socks, a hunched posture and a walker. Add the little shuffle and I am one sexy little granny librarian girl. I'm supposed to get out and do some laps around the cul-de-sac, so who knows, maybe some of you will be lucky enough to see me in action this week. If not, my mother has requested pictures. What the heck. I'll post them here once I get some taken.

More details about the surgery and hospital experience in a couple of days. For now, I am recovering somewhat comfortably at home. Thanks to everyone for all the prayers, support, food, babysitting, and healthy, happy vibes that have been sent my way. I'll keep you posted

Monday, November 28, 2011

Two days and counting...

Two days to surgery. I'm glad to finally be there. It won't happen exactly as I had planned, but this situation is a close second and I just want to get it done.

My surgery is on Wednesday, all day (12 hour surgery) at the Intermountain Medical Center in Murray, Utah. Their general number is 801.507.7000. I should be on the patient directory if anyone wants to check in. Or you can just call Neil's cell. That would probaby be better actually. I don't plan on being conscious for most of my stay there. (Finally, a decent nap!) I'll check in early Wednesday morning and probably be home by Saturday afternoon sometime.  Woohoo!

Sunday, November 6, 2011

It can only get better from here.

I went and saw my new surgeon on Friday. Her name is June Chen. She is really nice. It almost seemed like a formality. I've spent so much time in the last year reading about the procedure and talking with other doctors and cancer patients that I really didn't have any questions for her. I'm sure I just gave her the impression that I was more than just a little clueless, because after a while she looked at me and said, "Do you need some time to think all this over." I think she was a little surprised when I immediately answered back.  "No. I want this done by the end of the year. In fact, your assistant already has me pencilled in for a surgery date of November 30th."

At some point during the consultation she asked me why I wasn't going to stick with the surgeons at the Huntsman Cancer Hospital where I've received all my other treatment. I just said, "Because I've heard very good things about you." I have. When I started looking into surgeons, I came up with a list of top three. Massey was number one, she was number two, and I still have one backup. Though I'm really hoping I don't have to go there. I'm so tired of all this.

I did reach a new low that day though. I thought I lost all sense of dignity that day of my first breast MRI when I walked into the room and saw three big guys waiting for me. Well, when you compare that with standing in a small room in front of a total stranger with no clothes on, in my post-chemo, post-steroids, post-second worst year of my life body, while she snaps about 30 pictures with her digital camera... Well, let's just say, it wasn't the most ego boosting moment of my life.

Tuesday, November 1, 2011

Change of plans. Again.

Since last February I've been planning on having my surgery done by Dr. Marga Massey. She works out of the St. Charles Surgical Center in New Orleans. It has the only clinic in the world dedicated entirely to breast reconstruction. She and her colleagues are, I believe, the very best in the country at what they do. (Not to mention that I think she is an amazingly kind and compassionate individual. I absolutely adore her.) I would have flown out next week, on the 8th, had my surgery on the 10th, stayed in the hospital for 4 nights and flew home on the 18th. Everything was arranged. Then I guess things were just a little too organized and that I needed a little more anxiety and stress in my life so I decided to change everything.

I think it was just a little more than I could handle right now. I wasn't nervous about the surgery. That little, dark broom closet in the back of my head has worked beautifully once again and I haven't had a  moment's anxiety about the surgery itself. My anxiety was stemmed from all the arrangements that had to be made in order for me and my husband to take off and leave my children for 10 days. I probably could have managed it if it weren't for the fact that we haven't been able to keep them both well for more than 3 days in a row, and the recent death of our furnace, necesitating a complete reconstruction of the ducts in our home and installation of new furnace and water heater just seemed to push my nerves over the edge. As soon as I decided to cancel everything and find a surgeon locally, I felt much less anxious about life. My new surgeon will probably not have 20 years of experience in microsurgical breast reconstruction and she is probably not as insanely obsessed with building the absolute perfect breast, but when it all comes right down to it, I think I'm okay with just a little less than perfection if it means keeping my sanity intact.

Neil wasn't too thrilled about my deciding to throw a big ole' wrench into everything. He wanted me to see the best. When he was sick, I made him fly out to New York so he could be cared for the best surgeons in the world for his condition. He wanted to do the same for me, I think. I tried to point out that I didn't think you could fairly compare brain surgery with a boob job (an extremely complicated boob job, but a boob job nonetheless), but he didn't really go for it.

So that's the latest. My tentative surgery date is now November 30th. I'll be sure to keep everyone posted on what I hope is the last phase of my little adventure with breast cancer.

Sunday, August 28, 2011

I am a librarian on a mission.

So after I'd waded around in my self-imposed depression for about a month, I came across a book called Not Just a Pretty Face: The Ugly Side of the Beauty Industry by Stacy Malkan. This book was just as jarring as the previous one I'd read, but the difference was that it gave me an idea of what to do about it.

Here is the book description I swiped off Amazon:


Lead in lipstick? 1,4 dioxane in baby soap? Coal tar in shampoo? How is this possible? Simple. The $35 billion cosmetics industry is so powerful they’ve kept themselves unregulated for decades. Not Just a Pretty Face chronicles the quest that led a group of health and environmental activists to the world’s largest cosmetics companies to ask some tough questions:
  • Why do companies market themselves as pink ribbon leaders in the fight against breast cancer, yet use hormone-disrupting and carcinogenic chemicals that may contribute to that very disease?
  • Why do products used by men and women of childbearing age contain chemicals linked to birth defects and infertility?
As doors slammed in their faces and the beauty myth peeled away, the industry’s toxic secrets began to emerge. This scathing investigation peels away less-than-lovely layers to expose an industry in dire need of an extreme makeover. The good news is that while the major multinational companies fight for their right to use hazardous chemicals, entrepreneurs are developing safer non-toxic technologies and building businesses on the values of health, justice and personal empowerment.

 As I learned about the carcinogenic and toxic chemicals in everyday products I was slathering all over my scalp, skin and face every day, I was absolutely stunned. And remember ladies, "cosmetics" are not just limited to lipstick and mascara. Think deoderant, hand lotion, toothpaste, baby shampoo.  These are chemicals that are directly linked to cancer, ADHD, autism and a number of other disorders and birth defects. And yet there they are, right in my facial moisturizer.

WHY HADN'T ANYONE TOLD ME THAT???? Why hadn't anyone told me that the "extra-sensitive" baby lotion that I had been rubbing all over my 8 month old baby every night, almost since the day she was born was filled with endocrine disruptors that would act as synthetic estrogen in her blood stream, significantly increasing her chances for cancer 20 or 25 years down the road? Why hadn't anyone told me that most of the major sunscreens contain ingredients that increase the risk of and/or speed the development of cancer? (Click here for more info about that little tidbit.) And here I thought I was being a good little mom by gooping both my kids up with that stuff every time they went out in the sun. Why was the FDA allowing that stuff to be sold in the stores? What happened to the public's right to know? What federal agency was supposed to be protecting us from this kind of thing? Why weren't the products sporting labels letting people know that some of the ingredients used were carcinogenic?

I should mention here that I was seriously tempted to type this all up in all caps, because just writing this, I'm getting all worked up over it again. But I thought that would be a bit much. Just know that I am pretty stinking mad and am screaming at the top of my lungs in my head.

Well, shortly after finishing that book, I got online and started working my way through the Environmental Working Group's Skin Deep Cosmetics Database. Just as an FYI, should you choose to actually continue reading this blog, you will hear a lot about the Environmental Working Group. Their site is http://www.ewg.org/ They are simply amazing. Anyway, EWG developed a database where they did independent testing of cosmetics products. They list all the individual ingredients, along with the various diseases/disorders each ingredient may be linked to. Then, they rate the product on a scale of 0 to 10. Zero being a safe, natural score and 10 being toxic/carcinogenic.

I was horrified to see how many of my products were in the 8-10 range. So, I started cleaning house. I dumped out lotions, and lip balms, and mascara. I tossed toothpaste, suncreen, foundation, diaper cream, baby lotion, and baby shampoo. Then I slowly started replenishing with things that I was more certain wouldn't make my family, and especially my children, sick in the future.

I hope you'll read the book. There is a lot that society as a whole needs to understand about the cosmetics industry in the United States. Like, for example, that it is one of the least regulated industries in the country. That means that there is no federal agency standing over their shoulder making sure they conform to some list of preestablished safety guidelines. They are self regulated. This basically means they can put whatever they want into your favorite lotion or lipstick and they don't answer to anyone for it. The European Union has banned approximately 1300 ingredients from all cosmetics. The United States has banned a fraction of that. You see, Europe has a very different approach with the various chemical industries. They say that chemicals may only be used after they are proven safe. Makes sense, right? But the American government takes a slightly different approach. They say that various industries may use whatever chemicals they wish in their products until they are proven unsafe." It's basically this "show me the bodies" mentality that has me completely baffled. Our government won't ban a chemical until it has been proven that people are getting sick or dying because of exposure to it. Nice.

There is one chapter in the book on green chemistry. It's not something I was familiar with. It was fascinating. It talked about a small, but growing movement of green chemists that are trying to develop substances and products that are needed by our society by mimicing nature. For example, when cabinets are made, it is necessary to use a very strong adhesive. The glue is toxic. So some green chemists looked to nature to find a safer alternative. Have you ever seen mussells cling to a rock? You can't pry them off. They looked at the chemical makeup of the substance that the mussells produce to adhere to the rock and replicated it creating a perfectly natural, non-toxic alternative to the glue that was making people sick.

I have a friend with a son that is currently getting his degree in chemistry. I sent him an email and asked him to read that one chapter in the book. As a future chemist, I was interested in his opinion. I guess I was hoping that he would be someone that wanted to make a difference. Someone that would see the importance of looking beyond the blather that he was being fed by the very industries that were doing us so much damage. I was looking for a champion of sorts. I was really surprised by his response. I don't have the email anymore, so I'm defintely going to have to paraphrase, but he said something like this:

As a chemist, I don't think I will be that concerned about developing better lipstick and mascara for a bunch of anorexic supermodels. It is true that some ingredients in cosmetics have carcinogenic properties, but they are really in such tiny amounts, that there is no danger in it. And the whole idea of green chemistry, though an interesting one, is not all that realistic. It is just way too expensive.

I think I read the email two or three times before I let out a modest string of obsenities and deleted the email. Though, I can tell you that I fumed over it for days, if not weeks. I never wrote him back. I adore his family and didn't want to hurt feelings, but I must have written my response at least 50 times in my head. This is what it said: (I'm sorry, but the all caps is a must for this one.)

DAVID!!!!! (Names have been changed to protect the guilty)
THAT HAD TO BE THE MOST IGNORANT AND ARROGANT THING I HAVE EVER HEARD! YOU SHOULD BE ASHAMED OF YOURSELF! I FEEL IT NECESSARY TO REMIND YOU THAT THE COSMETICS INDUSTRY PRODUCES PRODUCTS THAT ARE USED BY A MUCH WIDER AUDIENCE THAN THE ANOREXIC SUPERMODEL! HOW ABOUT THAT TOOTHPASTE THAT YOU USED THIS MORNING? OR THE DIAPER CREAM THAT YOUR MOTHER USES ON YOUR BABY SISTER? OR THE SHAMPOO AND DEODERANT THAT YOUR SIBLINGS USE EVERY SINGLE DAY?? AND AS TO YOUR ARGUEMENT THAT THE CARCINOGENIC PROPERTIES ARE AT SUCH LOW LEVELS AS NOT TO DO ANY HARM, ARE YOU AWARE THAT YOU ARE SPOUTING OFF THE VERY SAME BLATHER THAT THE CHEMICAL INDUSTRIES USE? CANCER STARTS WITH ONE CELL, DAVID. ONE CELL THAT MUTATES. ARE THE LEVELS SO LOW THAT IT IS IMPOSSIBLE FOR THEM TO CHANGE ONE CELL?  DO YOU KNOW THAT FOR SURE? DOES ANYONE? ARE THE LIVES OF THE PEOPLE YOU LOVE WORTH THE GAMBLE? BESIDES, WHEN YOU ADD UP ALL THOSE "TINY AMOUNTS" IN TOOTHPASTE, SHAMPOO, CONDITIONER, PERFUME, HAIR GEL BODY LOTION, FACIAL MOISTURIZER, LIPSTICK, AFTERSHAVE, ETC. IT'S NOT SUCH A TINY AMOUNT ANYMORE, IS IT?!? I AM PAYING $20+ DOLLARS A BOTTLE FOR SHAMPOO TO USE ON MY CHILDREN, AND WOULD PAY TEN TIMES THAT AMOUNT BECAUSE I AM NOT WILLING TO TAKE THE RISK. IF OTHERS KNEW WHAT I KNOW, THEY WOULD TOO SO DON'T GIVE ME THAT CRAP ABOUT GREEN CHEMISTRY NOT BEING COST EFFECTIVE BECAUSE IT WOULD BE TOO EXPENSIVE!!!

Hope all is going well at school and the family is healthy and happy.
Love,
Marie

Whew! That felt really good. So, you can probably see why I never actually sent the email. In all fairness, I should have had him just read the whole book. Just reading the one chapter out of context probably did not give him enough information to form a sensible, non-irritating opinion.

So, to sum up. This was really the turning point in my journey. This was when I decided there was something I could do to protect myself, my family, and other people that I loved. (Assuming I could explain it to them without them thinking I had turned into a paranoid, hippie, cancer survivor.) I was determined to find a way to make a difference. I was a was a librarian on a mission.