Sometimes, Things Don't Go Exactly as Planned....

My apologies for the length of my last blog post.  Sometimes I feel like I have so much to say and it’s hard to edit down without losing the flavor of the story.  Thank you for sticking with me through that, and for coming back to continue with me on this journey.  Hopefully this won’t be quite as difficult to get through.

Now that surgery’s out of the way, I’m on my way to healing and putting this Stupid Cancer behind me once and for all.  The focus right now is on resting and eating well to aid healing.  For the first few days home I move through simple daily tasks aided by Ken – showering, dressing, getting up and down the stairs.  Slowly I regain some range of motion and confidence and am able to start doing things for myself, but for a time it’s agonizing to be so dependent on someone else.  I have a new perspective and appreciation for the anxiety and challenges my parents face each and every day, as their need for assistance continues to grow.  I apologize to them a thousand times a day in my head for all the times I’ve been impatient and less-than-kind with them and their aging bodies.

Three times a day, Ken and I “strip” the JP drains and record their values.  The drains are large, clear rubber bulbs about the size of your fist, attached to clear plastic tubing about two feet long.  The ends of the tubes are nestled inside my abdomen at each end of my tummy incision, with another drain sutured inside my left breast.  These bulbs help suction blood and other bodily fluids from the incisions, preventing seromas (closed pockets of body fluid) and hematomas (closed pockets of blood).  Small amounts can be absorbed by the body over time, but larger amounts not removed can lead to infection and other complications, and these drains facilitate that process.

With one hand we stabilize the plastic tube to prevent pulling it out, and with the other use an alcohol pad to clamp and “wipe” the fluid away from the body into the bulb.  We then open the valve at the top of the bulb and pour the fluid into a small container to measure the output.  We squeeze the bulb to expel extra air then close the valve at the top, and we’re done.

It can be kind of gross (and yet weirdly fascinating, I’m not gonna lie).  Having been a paramedic, Ken is incredibly helpful with this process as no amount of body fluid bothers him in the least (it’s one of the weird things I love about him).

I wear the drains in a super-sexy VS-worthy camisole, resplendent with a lace-covered velcro front closure and internal pockets to hold drains and breast forms.  When showering, I hang the drains from large safety pins on a lanyard around my neck.  I’m a jumble of bulbs and tubing, and not only do they easily get tangled, but it’s equally easy to accidentally yank on them when changing clothing or pulling down pants.  The easiest way to avoid this unfortunate (and painful) experience (at least at night, when lights are low and a bathroom run is inevitable) is to go commando and wear a gown.

Ken offers to pick up something that will button or snap or zip up the front, is big enough to cover the super-sexy cami, and is cool enough to sleep in.

Which is how I ended up modeling My Grandmother’s Mumu:

It is totally the icing on the super-sexy cake of breast reconstruction and recovery.

Damn, I’m hot.

Once a drain puts out less than 30 mL total for two days in a row it can be removed.  By Thursday all three are on track to be removed at the same time and we decide to wait until my follow-up appointment the following Tuesday instead of making an extra trip to Ann Arbor. On Friday, though, the breast drain output increases.  On Saturday it’s higher still, but by Sunday it’s decreasing once again.  On Monday it’s below 30mL for the day, but since we don’t have two days’ of consistency the PA won’t allow it to be pulled on Tuesday.

I whine.  I cajole.  I think I even beg a little.  No go.  I decide to be super-happy that I’m losing the abdominal drains, which have been more of a challenge that I could have anticipated (and I can put my panties back on).

We make the return trip to Ann Arbor on Friday afternoon, and much to my delight the final ball-and-chain is removed.  It’s hard to describe how good it feels to be completely free of the very last of these surgical tethers; it’s been a long two weeks at this point and I’m looking forward to resting and healing unconstrained by body fluids and bandages.

After our appointment Ken and I enjoy a mid-day “old people’s dinner” at Zingerman’s Roadhouse.  The benefit of having a surgically reduce tummy is I’ve lost my “overeater’s pooch” that used to allow me eat in excess and sport a food baby for several hours.  Now, as soon as I start to feel full I’m unable to eat anymore.  This means I rarely eat an entire meal – and I’ve already dropped a couple of pounds.  I nibble on my enormous patty melt and ask for a box after just a few bites.  We decide to catch a matinee of the new Bourne installment on the way home, and as Ken drives I settle back in to my seat to relax and enjoy feeling free.

I doze on and off on the drive home – something I never do.  I hate sleeping in a car, and as we approach Jackson I realize I’m not feeling very well.  Ken and I decide to see the movie later in the weekend, and when I get home I lay down to take a nap so I get over what I assume is just a lack of sleep.

After a two-hour nap I wake long enough to grab a quick snack, chat with my dear husband, and fall back asleep for the night.  I sleep fitfully, odd dreams waking me as I alternating between hot flashes and chills.  The next morning I wake and realize something’s not quite right.  In fact, I feel “sideways”, the word Stephanie used as a child to describe how she felt when she had a bad fever.  Ken checks my forehead which seems cool enough, but I notice my left breast is a little tender which I attribute to removing the drain the day before.  Still, I take two Tylenol just in case.

At 11:00 I take my temperature – 99.8 – not unreasonable.  At 11:30 I take it again, butnow it’s 101.7.  I call the plastic surgeon on duty as directed in my discharge instructions (“any fever over 100.5”)  By the time she calls me back an hour later my breast is much more painful and swollen, but my temp has come down to 101.4.  She asks if my breast is red to which I reply that it’s not – I had checked it a few hours prior when I was cleaning the drain site and don’t remember seeing any redness.  She attributes the fever to something other than my breast, but suggests I come into the ER at UofM to be seen.

An hour later we’re in the ER chatting the Nurse Mike who doesn’t hesitate to see my port as the best access (finally – someone who agrees with me!!).  The on-call PS stops by and a quick check of my left breast reveals some redness and swelling underneath the breast.

She snaps a pic of my breast with her iPhone and sends it off to my surgeon.  Half an hour later I’m being admitted for IV antibiotics.  The PS believes I have cellulitis, and a couple of days of IV antibiotics should help clear it up.

Everyone we come into contact with has the same question:

“Weren’t you just here a couple of weeks ago?”

To which I reply every time:

“I missed the pudding.  I was looking for a reason to come back.”

But deep down, I’m a little concerned.  I understood the risk for infection with this type of surgery, but 24 hours ago I was feeling pretty good and normal.  I packed a bag on the off-chance that I’d be admitted, so I decided to use this opportunity to read a little more Harry Potter, work on my newest afghan project, and finish my last blog post (obviously fueled by hospital pudding and pain meds).

Ta-da!

I’m escorted upstairs….to the very same room from which I had been discharged two weeks prior.  I pass my former nurse and aid in the hall, and we had the pudding-and-cellulitis conversation.  We settle in to our time-share condo and chat with the nurses regarding treatment.  By now it’s evening and I send Ken home with the promise to visit me on Sunday, with the assumption I’ll be released.

Despite strong IV antibiotics, the infection continues to progress, causing serious pain in my breast, and fear in my heart that the flap will fail.  The PS tells me that having a tissue transplant is actually preferable; an infection with an implant or tissue expander requires removal of the “foreign body” until the infection is under control.  On Sunday evening I’m switched to a strong oral antibiotic and another 24-hour watch period.

On Monday morning there is, again, no improvement.  By now my breast is fiery red, rock-hard, and feels like a half-ton weight on my chest.  I’m living on pain meds and naps at this point, hoping and praying for relief soon.

The PS sends me down to ultrasound to look deeper into the breast tissue and determine the cause of the swelling and pain.  They suspect something bigger and deeper than cellulitis – potentially seromas or hematomas.  The ultrasound reveals four “pockets of fluid” – two rather large, and two much smaller.  After consultation with Dr. M, the radiologist drains three of the four pockets of fluid (the remaining pocket is in the area of vasculature for the flap, and he wants to leave that one alone for now).  The first pocket is large – 50cc’s, or about a quarter cup of fluid – and appears to be seroma fluid.  The second pocket is much smaller – 5cc’s – and is a little more red but thin and not cloudy.  The third pocket is the same size, but this fluid is brown, thick, and unpleasant – an obvious infection.  These are sent off to cytology for culturing, and I’m sent back to my room.

I’m switched to a third antibiotic, and on Tuesday morning the PS residents visit me briefly.  They feel my breast is less red than the previous evening, and they encourage me to go home to continue the antibiotics and rest in an environment with fewer infectious risks.  By 11:00 Ken and I are once again back on the way home, and I plan to rest and wait for improvement over the next few days.

When I get home I realize the front of my shirt is lightly wet, and when I check the mirror I see a pinhole-sized opening in the flap scar, and drops of fluid draining out.  My breast is so swollen and painful I’ve wondered if something like this would happen eventually.  A quick call to the surgeon’s office and I have instructions for care (“cover it gentle with a sterile 4x4, but if it starts to leak a lot of fluid you can always use a maxi pad.  And we’ll see you on Friday for a follow-up.”)

I spend Wednesday morning resting quietly, then visit with my friend K who brings me the most delicious home-baked lavender shortbread, two beautiful healing crystals, a loaf of European bakery bread to soothe my tender tummy, and a thoughtful bracelet with an Om charm.  We chat about her recent family vacation and though I’m tired, it’s nice to be up and around and feeling kinda-sorta normal.  Stephanie and Josh stop by, too, just to check in, and Michael and Tori pop in later to help with a lawn-mowing project.

I get a call from the PS office to let me know they’ve discovered the bacterial infection in my breast – a superbug called klebsiella.  In addition, they tell me mine has an enzyme that makes it resistant to but a few antibiotics.  They call in a new prescription for me to start taking that very evening, hoping that by Friday we’ll see some improvement.

Thursday I sleep most of the day; my tummy is upset and my appetite is completely gone.  I decide to take this opportunity to simply listen to my body and do what it needs me to do to aid this healing process.  In between long naps I try to nibble on something but my stomach wants to reject anything I put into it, except water.  My fever spikes to 101.7, but the pain meds have Tylenol in them, and I find that helps bring it down.

I’m not feeling confident about improvement at this point.  Lucy is angry – as in very red, hot, and ugly looking.  Her skin is so full of fluid she’s “denty” – push on her and the imprint will remain for several minutes.  The weight is almost unbearable, so when I walk I gently cradle her in my hand to lessen the stress and movement.  And I know there’s still a great deal of fluid inside the tissue somewhere, as every time I move positions I feel rumblings and tumblings.  My frustration and fear starts to boil over and I find myself in a weeping heap in the recliner.

Friday morning my breast is no better, but possibly no worse.  It’s hard to tell as it’s just overall so awful.  Ken and I make our way to the follow-up appointment with the surgeon’s PA.  I express my concern about the lack of improvement, and she agrees that more might need to be done.  The medical photographer comes in to take a highly-detailed and properly-exposed photo to accurately document the color and texture of the breast.  After sharing this information with Dr. M, the PA returns and gives me the option of returning to the hospital for further testing and observation.

As much as I don’t want to go back, I am happy to have this option, and once again we make our way back down the well-travelled path to UofM.

Late Friday I have another ultrasound; more pockets of fluid are discovered.  Today, we meet with the Infectious Disease doctors who recommend a new, broad-spectrum antibiotic to hit any other infections that might not have cultured, but may be lurking.  They also recommend replacing several drains into the pockets of fluid, but leave that decision up to Dr. M.  Later on the PS resident stops by and very quickly and painlessly makes larger the small opening in the nipple incision, drains the fluid that’s been leaking, and packs my cavity with gauze.  He doesn’t seem to think Dr. M will want to do the drains, but will discuss it with him further.

So here I am, again.  I feel as though there’s been a little positive progress.  Lucy’s not feeling quite a heavy and full today, although she’s still pretty red and angry.  My hope is that tomorrow will bring more evidence of good things happening, and I’ll be able to get out of here quickly, but only once we know we’re on the right path.

Besides – pudding.

I Loved Lucy

Surgery is behind us, and I’m well into my recovery.  I’ve been instructed to take it easy and do very little during this time off, and have multiple restrictions on lifting, moving, and physical activity.  Now, “time off” sounds wonderful, and eight weeks recovery time off sounds a little like heaven, right?  Except you can only nap, read, watch bad TV, nap, walk the block, nap, grab a snack, nap some more, then take another nap just so many times before you start to lose your mind.  Anyone who knows me even a little bit also knows that the hardest part of this recovery is “taking it easy.”

(My apologies in advance for the length of this blog post.  Brevity was never my strong suit).

The surgery itself went smoothly, and was a rousing success.  Surgery day starts early – 4:30 a.m. to be exact, so we can be at U of M by 6:30 am.  We check in with a smiling, chipper (and highly caffeinated, I suspect) admin.  She sees my doctor’s name and smiles coyly.  “He’s a great surgeon,” she says, “And, you know – a man knows what we need when it comes to this kind of surgery.  You’re in great hands.”

Good thing I have a man to tell me what I need to do with my breasts…....  Ugh.  I realize my non-caffeinated, nerve-wracked, sleepless and unhappy ass just isn’t in the mood for crap this morning, but I don’t want to go into this with negative energy so I take a deep breath, appreciate her comment in my heart, and smile.  I’m feeling sensitive and tender, and a whole range of emotions I’m not certain of, and I’m trying not to become the ticking time bomb on the verge of explosion.

Ken and I are escorted back to pre-surgery holding, and someone later sneaks Stephanie back to be with us (the rule is only one visitor pre-surgery, but she’s charming and beautiful and someone is kind this scary morning).  Eventually the nurse comes in to start my IV.  She seems gentle and patient (as every nurse who starts an IV should be) as I point out the one vein in my right arm that works best.  She taps it several times, then asks the magical question:

“Are you a hard stick?”

I let her know that yes, starting IVs can be a challenge, and we can only use my right arm.  “But hey,” I say, “I do have my power port – can we use that?”

She’s pleased with the idea of the port and doesn’t hesitate to consider that the best option, so in an instant my port is accessed with an IV line, and no hunt had to take place in my arm to find a vein.

Little did I know that this convenience for me would be the catalyst for blame and questioning.

A few minutes later the anesthesiologist stops by to introduce herself and her team, and after a few medical history questions she turns my arm over to see the IV.

Except it’s not there, and the quizzical look on her face is priceless.

I point to the port and she says, “Why did they start your IV in your port?”

The question felt a little accusatory, as though I demanded my port be used.  She didn’t seem necessarily pleased but said, “Well, we’ll get you started with this but because you’re having surgery on your chest it’ll be in the way.  We’ll have to move it to another location so don’t be surprised if you wake up with something in your foot.”

Thank goodness they can knock me out before THAT excitement begins!

Next the oncological surgeon stops by to chat briefly.  “Come on in,” I tell him, “Join the party!”
“I think we have different ideas of ‘party’,” he deadpans.

Just trying to keep it light in the face of life-changing surgery.  Much of a buzzkill, doc?

He immediately hones in on the port IV and asks the same question:  “Why is this here?  We’re going to have to move this.”  Again – accusatory.  Really?  Whatever.  He doesn’t ask if I have questions, just lets me know the pathology will take five days and they’ll call me with the results.  He’s in and out in less than 2 minutes, and I put him out of my mind.  Definitely not inviting him to any more of my pre-surgical parties.

Next comes The Team – my plastic surgeon and five of his minions.  Two are fellows, and three are residents.  One resident named John has a large green stain on his white coat…oh, wait, that’s a Spartan on his pocket.  He’s a brave man to have wandered into Wolverine territory.

Dr. M and I chat briefly about the surgery, a routine conversation we’ve already had.  The oncological surgeon will start by completing the mastectomy on my left breast, then Dr. M and his team will move in and begin the reconstruction process.  The surgery will take several hours and they don’t expect complications.

He then pulls out the medical-grade Sharpie, and has me open my gown so he can mark me for surgery.  With my family and his team watching he creates abstract art on my body, leaving purple marks from my sternal notch to my pubic bone.  I have a large open-mouth smile on my abdomen:  a long straight line from hip-to-hip above my belly button, opening to a large dip down to my pubic bone.  Like one eye winking, my left nipple is circled in purple, and a lone tooth created by drawing a purple circle around my belly button.

My torso resembles a living Picasso.

Kneeling down, eyes belly-level, he again does the squish-the-tummy, squish-the-breast dance – back and forth a couple of times, determining how much tissue in my tummy he has to work with, and how much he’ll need based on what he needs to recreate.  He, too, is obviously and vocally unhappy about the port IV, and even though I tell him it’ll be moved after surgery starts, he’s not pleased.  With that he’s done, and the herd of doctors moves along.

Within a few minutes I’m kissing Ken and Stephanie and moving down the hall to the OR.  I’ve already had a quick injection of joy juice and I remember very little of this period except that there are many people in the OR, calling out their teams and positions.  A flurry of activity is swirling around me – instruments clinking in trays, conversations about last night’s baseball game, shuffling bodies bumping into me as I lay on the narrow table.  I try to bear witness this activity as part of the surgical experience but my brain is confused and my eyes won’t focus and I feel my anxiety level rising and I think I’ve changed my mind.  I can’t do this.  I can’t.

It suddenly becomes all to real, what’s about to happen.  I thought I was prepared.  It still isn’t enough, and I’m suddenly overwhelmingly sad down to the depths of my heart and soul.  My right hand cradles my left breast and my left hand gently rubs my tummy as a tear rolls down my cheek.  Over her mask the anesthesiologist peers into my eyes and asks if I’m okay, and all I can do it nod.  I am.  But I’m not.  And I sense that she gets that as she nods slightly and her eyes close momentarily in understanding.

That’s the last thing I remember.

Bits and pieces of recovery come back to me.  I remember being warm and cozy, Ken’s face above mine, smiling.  Very nice nurses asking my pain level (zero, thank goodness), reminding me to wake up.  I close my eyes and listen to the noises around me until I’m reminded again to wake up.  It’s 5:00…5:15…what time is it exactly?  I’m hot, this blanket needs to go, I try to push it off and the nurse tells me no, you need to keep the warming blanket on, and I close my eyes again…

It takes three nurses to move me to my room – one to push the bed, the other two to lug all of the equipment I’m hooked up to.  Once we arrive and I’m settled I take an inventory of all the balls and chains lined up around my bed:  compression sleeves on each leg, electronically hugging one calf, then the other; a Foley catheter hanging off the side of my bed; and the IV pole with my new BFF, the PCA pump with a little green-light button that, when pressed by myself, delivered a gentle dose of morphine to my now-aching body.  From neck to knees I’m covered in a warming blanket called a Bair Hugger.  Attached to a noisy compressor the size of a suitcase, warm air is forced through a flexible hose reminiscent of the home hair-dryer of my childhood.  The hose plugs into the “blanket” which is more like a blow-up pool raft, the underside of which has small holes through which the warm air (approximately 116 degrees) flows out against my skin.  This is designed to improve circulation by keeping the blood vessels in my chest open and flowing.

The nurse tells me I’ll wear this “for a few hours.”  She doesn’t tell me a “few” is actually 48.  I’m pretty sure that’s more like “many”.  Not only does it keep me warm but it sets off multiple hot flashes that make me whine like a baby.

I dub thee my own “personal summer”.

There is also a wire running from my breast to a small machine called a ViOPtix, which measures the venous and arterial blood flow in the flap.  The first 48 hours are the most critical for flap failure, so every hour the nurse will come in to check the ViOPtix.  If we make it through the first 48 hours, the next 48 hours are the next critical period, but checks will be every two hours.  The nurse also uses a tiny Doppler wand to listen for blood flow in the flap.  It sounds like a baby heartbeat, and reminds me of the ultrasounds I had when pregnant.

The head and knees of my bed are raised to keep my midsection bent at an angle, while I am forced to lay on my back.  I’ll lay in this position for the first three or four weeks as it supports the integrity of the sutures across my belly as they heal.  Long-term, I’ll be sleeping in a recliner when I get home, and won’t be able to stand straight up for several weeks.

Before letting my family in to visit, the nurses pull back the warming blanket and my gown, and I get the first glimpse of the end result of the pre-surgical Picasso drawing.  My incisions are closed with internal sutures and covered with glue to help protect from infection.  There are red incision lines criss-crossing my body, and three JP drains coming out of each side of my abdominal incision and my left breast.

It’s a little more than I can bear at this moment.  I push my PCA button just to dull the emotional pain for a while

I’m allowed to suck on ice chips and Ken is kind enough to keep me supplied.  He sleeps at my side, waking up every hour when the nurse comes in to check me out.  That first night there is no real sleep; the air compressor is loud and annoying, the IV alarm keeps going off, I’m being poked and prodded every hour.  I’m not a back sleeper and this weird head/knee angle thing is making me crazy.  Eventually I’m able to nod off for a few minutes in between visits.

On Friday morning I’m told I won’t be able to eat until the next day, in case I need to be whisked back into surgery.  By now I’m having constant “personal summers” under the Bair Hugger and am getting pissed off about the heat.  I pull back the blanket momentarily, just for a bit of relief in the middle of an extraordinarily bad hot flash, when one of the surgeons comes in to check on me.  He admonishes me for removing the blanket as though I were a child.  I can do great things for short periods of time, and since I’m still under the illusion that it’ll only be a “few” hours of misery, I fold it back over my chest.

Shortly after, the IV alarm goes off.  I buzz for the nurse and she comes and fiddles with it and it stops.  Five minutes later, it goes off again and once again she fiddles with it.  The error message indicates the IV is occluded, and she moves the tubing from the top all the way to my hand (ouch!!)  The alarm stops but as she leaves the room, it goes off again.  This time, no amount of moving the tubing shuts it down.

“I hate to be the bearer of bad news,” she says, “but I think we’re going to have to pull this IV.  And start another one.”

We both laugh in that weird, uncomfortable way of knowing that this is not a good idea.  When I first arrived in my room we discovered I had been repeatedly poked for IVs during surgery, apparently with little success.  I have bandages on the crook of my inner right arm, an obvious stick mark in the vein next to the one where my current IV is located, another bandaid on the top of my left foot, and also on the outside of my left knee.  Success was finally found in the top of my right foot, which was quickly removed after surgery, leaving behind yet another bandaid.

I mention my power port and ask if we can use that instead (I’m feeling more confident about this suggestion now, than after the pre-surgical fiasco of the day before).  The nurse agrees this is a good idea and calls Vascular to access the port.  In the meantime, she says, we’ll just remove the IV and check your ViOPtix.

In one swift movement the IV is out and covered with a wad of gauze and tape.  She moves to my left side and we listen for the little whooshing sound of the heartbeat coming from my breast.  I’m commenting about how beautiful and remarkable that sound is, when I feel something wet on my leg and look…

…to see my IV spot is bleeding profusely.  The wad of gauze is completely soaked through, the blanket is blooming with a red moonflower, and my gown is drenched.  She changes the dressing and I apply pressure to hold in whatever blood is left in my body.  Seems like a good time to get a sponge bath and change the linens. 

A few minutes later Vascular arrives and in moments, my port has been accessed yet again.  Shortly thereafter my IV and PCA are reconnected, I’ve had a lovely sponge bath and am feeling clean and happy (albeit still hot).

During the day my blood pressure falls precariously, eventually bottoming out in the low 80s/ low 40s, and my fever spikes to 101.  Luckily the port allows them to very quickly push IV fluids which, after a couple of bags, brings my BP back into a more normal range, and my temperature eventually comes back down as well.

Too much excitement for one day.  *pushes my green button*  Time for a nap.

I sleep fitfully that night, as my back is starting to hurt intensely from laying in one position for so long.  On Saturday morning at 6:00 the nurse and assistant come in to check my vitals. I am completely and utterly over this whole experience.  I’m frickin’ burning up under this stupid hot blanket, my back is screaming at me to MOVE TO A NEW POSITION, and if my legs get hugged one more time I’m going to throw a fit.  

“I need out of this bed,” I say in a fairly-snotty voice.  This makes them very happy as I should have been up and walking yesterday, but my lowered BP wasn’t supportive to walking the halls.

I’m advised to “push the green button” because this move is likely to be painful.  Within a few minutes I’m slowly, careful, and fearfully rolling over to one side and with a great deal of support, I’m sitting on the edge of the bed.  I’m tangled in a jumble of wires and tubing so all the machines are moved to the other side of the bed.  I stand and take a few slow step towards the recliner, and gently sit down.

Ta-da!!  *pushes the green button again*

Getting out of bed is a pivotal moment, and almost everything changes.  The Foley is removed, and my BFF takes a hike.  My saline drip is disconnected, but the port access remains.  The leg huggers come off in anticipation of my first walk down the hall.  In the end, the only things I remain tied to are the Bair Hugger and the ViOPtix.

This is my chance to break free of that stupid warming blanket, so I ask Ken to help me take a quick sponge bath, after which I take my first walk down the hall.  It’s surprisingly hard and exhausting, and after 100 feet or so I have to turn around and come back to the room.  I climb into bed to rest for a few minutes, and am informed I can eat again.  FOOD, GLORIOUS FOOD!!!  I’m presented with the menu and see it’s a liquid-only diet.  

“You can have anything on that menu.  Except no coffee.  Or chocolate.  No caffeine, sorry.”

What fresh hell is this?  Excuse me?  I must have misheard you.  No caffeine?  Um, yeah, I need some answers here.

Caffeine is a vasoconstrictor, which would be counter-productive to all the work we’re doing to keep the blood flowing while I’m burning up under the Warm-Air Blanket from Hell.  Unfortunately, this restriction will continue for 6 weeks as we continue to work to preserve circulation to the flap.  

I haven’t eaten in two days, and I’m on enough paid meds that the caffeine headaches are controlled.  I just don’t frickin’ care at this point.  

I order chicken consumme, which tastes like diamonds dipped in gold and rolled in glitter.  I think I might have cried just a little as the clear liquid passes over my dry throat and warms my insides all the way down to my belly.  Heaven!!

The next couple of days move quickly and I continue my journey towards normalcy.  Saturday evening I'm finally freed from the hellish warming blanket.  On Sunday I’m allowed to eat REAL FOOD, and I get up and walk three times, each a little farther than before.  Always at my side, Ken walks with me, encouraging me to be gentle and patient with myself.  My mind is ready to run a marathon, although my body is screaming to sit down.  On Monday I’m released, and we’re on the way home!!  The fresh air feels like love and I turn my face towards the sun like a sunflower seeking out the warming rays.

The next day I take a quick shower, which is far from quick but rather a lesson in patience and restraint.  I can’t twist or bend so as I sit on the shower stool Ken helps wash my back, my feet – pretty much most areas because I just can’t reach anything.  

He stands me up and helps me out of the shower, and I face the mirror for the first time, completely naked.

My body is a battle zone of cuts, scars, bruises, tubes, redness, surgical markers, tape marks.  There is a red line across my lower stomach – the smile has closed – as well as a bloody scab where my belly button has been recreated.  At the end of the abdominal incision are more JP drains.  My tummy is incredibly, shockingly flat, and I run my hand gently over my midsection.  I feel nothing.  All the nerves have been cut so I’m numb from the bottom of my ribs to just below the incision.  Over time, some of the nerve may regenerate and sensation may return, but there is no guarantee.

Lucy bears the worst of this war, two lumpectomy scars still present, other small scars from needle placements.  My nipple is gone.  It’s just – not there, even though the rest of my breast looks exactly the same.  In its place, a thin red line circles a very white piece of flesh from my lower belly.  This breast is incredibly swollen, having endured an unprecedented assault, and I’ve been assured the swelling will decrease in the next few weeks.  Comparatively, Ethel looks small and sad, as though she wasn’t invited to the party.  The long, flexible tubing of the JP drain emerges from Lucy, just under my arm, and is sutured to the tender skin.

My breast doesn’t feel any different than before surgery.  I don’t feel as though there’s something on my chest or in the breast tissue.  I reach up to cup the underside of my breast and it’s warm and firm.  It’s so surprising to me that it feels normal.

Lucy is gone, yet she’s still here.  She’s not quite the same, but that’s the nature of cancer – nothing’s ever really “the same”.   The external scars are a visual reminder of the internal battle that I’ve waged for almost five years, and I’m both horrified and pleased with what I see in the mirror.  I know that this is the beginning of the healing process, but seeing so much damage spread across my body makes me sad.

It’ll just take some getting used to.

I lay my right hand gently across Lucy, and my left hand delicately across my belly, and send them both positive energy and healing light.  They've been through hell and back to help make me feel whole again, and I am ever gratful for their sacrifices.  

No matter how you look, girl, you'll always be Lucy to me.