April 2014 Surgery Sisters

Pnak,

I know, drains suck, but they are a good thing.  Better than fluid building up inside, I think.  Mine were in for 16 days, and one came out easy peasy, the other was a bitch, sort of tore out, they say sometimes they start to develop roots.  So, it's a balancing act, don't take them out too soon so you have to suffer from swelling, don't take them out too late that they start to attach.  It sounds like you're getting close in terms of out put.  I also found that one day I had a lot of output and the next very little so it can change quickly.  Keep track and keep your surgeon updated.

Good luck, Nina

Hope everyone is doing well!

I am now 2 1/2 weeks out and definitely think I will be back at work at end of 4 weeks now, though I had booked 6 just in case. I feel good (ibuprofen only, and I only get a bit sore at end of day) and I am already starting to get pretty bored at home. I distracted myself doing some baking today, but given I still can't do much housework...except to slowly empty and fill the dishwasher with lighter dishes...I don't know what I will do tomorrow! I can and do go to the gym everyday to walk, spin, and/or do some leg work but even that only takes up a couple of hours, and I am getting much more efficient at bathing so that does not even take as much time. Funny now that I have all this time to relax and watch movies/TV and read I feel less inclined to do so. Work is stressful, but my brain kind of thrives on the challenge. I am going to try driving by the end of the week, so hopefully I am able drive myself to my PS appointment in Calgary the following week and my husband does not need to take more time off work...especially as I want to go back to work the next week. My cat enjoys the company though!

My new breasts are still healing. My left blister injury should be totally healed over in a couple more days, and my nipple is looking great. I have been doing moist wound management on both. My left breast implant is still riding higher than the right....I can feel the top of implant is at least 1/2" higher on that side, but my PS also said there is still lots of dropping for both to do into their pockets. I am not surprised the right dropped more so far though, as that was my naturally larger breast and there was more of my skin flap there even right after surgery. The left side was a bit smaller and tighter. Ultimately I know they were, and will be, sisters and not twins, and revisions are always an option.

On another note, my mum had her CT scans on Friday, and has an appointment with her oncologist this coming Friday for the result, so this week is both going to be long...and way too short (sometimes it would be nice to delay more bad news, you know?)

Shew, I'm back. I have read every post since I disappeared into the surgical suite on April 29th. It has been a long journey leading up to today. I have struggled with fatigue, but today I feel alive again. I had so much post surgical pain and spasms the first 24-36 hours after surgery, I wasn't sure I was going to get through it. A word of advice for anyone nearing surgery.... muscle spasms are tough and if one medication doesn't help ask the surgeon to change meds. I was started on flexaril with no relief. My surgeon said, flexaril never worked for him either and switched me to valium. I could take a deep breath finally. Speaking of deep breathing, this is a must. You don't want pneumonia!! 

I also have the tightness all of you comment on- (tissue expanders with 350cc at surgery, 50cc each breast a week ago and planned another injection tomorrow). I thought it was my clothing and would stretch and pull and tug, finally realized the "band of tightness" was not something I could do much about. I still have 2 of 4 drains in place and soooo look forward to these last two coming out, hopefully this week!

We are all different, yet so much the same. I spent a good amount of my time sleeping, with no pain meds. others enjoy walking and some need pain medications. I just decided when the fatigue took over I would just go with it, and slept. 

I am so relieved and so "cancer free". I do not need chemo or radiation. I may need some medication as I am 100% ER, PR positive, but it's all good. So thankful for my relationship with the Lord and for all of you. I can not imagine this journey without Him or without all of you. Thank you for sharing!

Geosomin,

I only had drains for a week and while I would have a "spot of drainage" daily at my incision sites until they healed over, which took a few days, I did not have much else. But I was under 20ml by time drains came out.

I don't think your drains came out too early if you were under 30ml. Many people do get drains removed within 7-10 days, though many also end up with them for 2-3+ weeks as they keep draining high. 

But...some people do experience more drainage/fluid buildup with activity. This was not my experience, but I have seen enough comment on it here that I think it is very normal. My nurse, when she removed the drains, also said it was not unusual for them to drain for a few days.

Check with your PS, but I think you should just keep doing what you are. Keep the area clean and dry, and change dressings as needed. I would worry less about infection with them OUT than in as long as you keep the area clean. Keep up with your exercises. They will close up and your body will reabsorb fluid (as long as it is a reasonable amount) in time. 

teachermom:

Good luck on your first fill! What is the final "goal" for fill amount? Starting at 500cc's is a lot - I still think the highest fill at surgery I have seen - but I guess puts you closer to whatever the goal is I guess. I am a direct to implant who had 435ccs put in right at time of MX. I know I have heard those who go direct to implant (I am assuming here they mean with larger implants) often have a harder "front end" in their recovery due to the muscle stretching so much off the bat, and I would imagine it would be the same for someone who gets a 500cc fill off the bat too. 

3 weeks post-op today and tried driving for the first time today. Not far, just basically up the block. Definitely found I needed to do more smaller movements turning wheel over one big movement...or else my pecs ached!

I am feeling more random pings and pangs...I assume them to be nerve pains, though they are not really painful as much as just...there. Now that the numbness from swelling has eased up a bit too, I also totally feel that cold/hot drink thing I read about here before. I was in car with my husband the first time I felt it as I drank some cold water, and laughed, then had to explain to him that I now have the questionable talent of being able to feel what I drink in my breasts. So weird. 

Hi to all my April sisters.  I haven't posted in a few days, but have been reading all your updates and you're all in my thoughts.

I spent the better part of my day yesterday on the phone between my insurance company, Genomic Health, and my oncologist office.  I have an appointment Monday to find out my Oncotype results, but my insurance was holding up approving the test, which was already complete, so Genomic couldn't release the results to the oncologist office or I would have to pay for it ($4,000).  The insurance company  told them it would be another 14 days, so I took on the round robin of calls to make sure the insurance company had everything they needed and pushed to get the review and approval done that day so the results could be released for my Monday appointment.  Luckily, I did get a good person on the phone with my insurance company who was very helpful and after a number of hours, we were successful.  I was a little afraid that in the process, I would be told the score, and is really don't want the results without the support of my husband, but I didn't get them.  Just another bump in this road.  Now I'm just hoping for a good low score and no chemo.

Radical2squared, so sorry for what you're going through.  It all definitely sucks, in varying degrees on different days, but this is the place to whine, cry, and share your stories with women who will listen, understand, and support you.  We're all in this together.  Hugs.

@Janet-

At my four week mark I was feeling better overall.  The vice grip sensation had diminished to a feeling that I was aware of it, but not bothered by it.  The spasms in the middle area of the chest are far less frequent and severe.  However, I went back to work last week for 3 days.  I teach, and the first day back I did not have my normal instructional routine, and no issues that day.  The following day carrying my normal instructional load, I could barely lift my left arm by the time I made it home.  Went to bed super sore, and woke up to find a huge amount of fluid build up on the left side rib cage area under the armpit.  It just plain hurt.  Decided to try wrapping an ace bandage around the chest for compression and picked up a sling for my left arm, as it hurt to let it my arm hang down in the normal position.  By the evening the arm was feeling better, and the next morning the fluid had dissapated for the most part.  But just 2 full days of instruction and I am terribly sore now, and still can't use my left arm.  I am feeling like it is too early to go back to work since the pain level has increased to the same as about week 2.  It just can't be good for the healing process.  I have a doc appointment with the BS Monday, so I will see what they say about all of this. 

The tissue expanders are still very uncomfortable for me, and I am still having a lot of difficulty sleeping because of them.  They are not so painful that I can't imagine having them for 3 months, but damn.  I had originally decided that if the exchange could be done until the beginning of the next school year I would just put it off until the next break, but not now.  No way.  These damn things are coming out just as soon as possible. 

happyteacher, thanks for the TE info. By the way, I am also a teacher. My BS said I needed six weeks to recover which luckily meant I will not go back to school this year (our last day of school is May 29). I think I would really be struggling if I were trying to teach now. I believe the soreness and tightness have let up a little, but sometimes I'm not so sure. I see from an earlier post that your surgery was on the 15th (I assume that's April). Mine was on the 16th, and I don't see how you are teaching now, especially with the fluid and pain issues you have had!

Like you, I want these TEs out as soon as possible. I will see my PS this week, and I'm hoping to schedule exchange surgery for late July. That would give me about two weeks to recover before school starts back up in August.

Regarding fills, he put in 500 cc at the time of surgery. That seemed like a lot when I read this thread, but I went back to the March thread to see how people are doing who are two to four weeks ahead of me. At least a couple of people over there said they started with 650 cc! I definitely had pain the first week, but somewhere between week one and two I would say it is soreness and tightness, not pain. Aleve seems to work as well as the Rx pain meds.

Welcome busymama!

I am sorry to hear about your infection/healing/wound issues.  Hang in there....you can still end up with a great result on that side as well though it is a different road than expected to get there. Did they need to remove the TE as well?

I am a bit older than you (34, but much nearer the end of 34 than the start of it!) but also had my surgery for prophylactic reasons due to a very strong family history, with unfortunate outcomes for those diagnosed. Only a few days after my surgery I also found out my mother had a distant recurrence of her own cancer, she was first diagnosed at 47/48. We are not a BRCA+ family so have no idea "why" breast cancer has (or will) end the lives of at least three generations of women that preceded me but I know I did not feel right being the canary in the coal mine for my generation. Not knowing that none have survived their cancer. Maybe the whys will come later, but I had to work with what I did know. 

Again welcome, and I wish you no more complications in your healing. 

Zeeba,

My fingers are crossed for you!

I am sorry to hear you are still feeling so exhausted. Everyone reacts different to the surgery/anaesthesia, and I have seen some say that it takes about a week for every hour you are under. Sometimes the medications you are an can contribute to the problem. I fortunately have really had no exhaustion, but I really think it was luck of the draw. 

Hopefully you turn the corner very soon! I think having the drains removed will help.

I've been back to work for two weeks now. I don't feel physically exhausted, but most days I'm mentally exhausted. I don't feel I'm working or thinking as fast as I normally do. I also feel somewhat apathetic toward things at work! I brought home my computer this weekend so I could get caught up on emails after a two day staff retreat.  I haven't touched that computer because I don't care! Those emails can wait until tomorrow!

If I were a teacher, I would have taken the whole six weeks of leave. I can't imagine standing in front of a classroom teaching when you're still somewhat physically miserable. So to you teachers, my admiration goes out to you!

How do you know if you need genetic testing? The BS wants me to see a genetics counselor. The counselor called me once and left a message, but it was right before my surgery. I haven't called her back. My maternal aunt and great grandmother died of BC. The BS said that wasn't enough family history, but she's concerned because my BC was bilateral. 

Thoughts?

Thanks scubalady! I've never been good at whining and crying, but I'm learning...and finding it does help when done appropriately!

Sodie1017:  See the genetics specialist! There was not a single woman in my family who had ever had breast cancer. All lived into 80's and 90's! The genetics councillor wanted me tested because I am only 36 and had desperate cancers in each breast. I also have Ashkenazi Jewish ancestry. 

Guess what...even with NO HISTORY I am BRCA1 positive!

Sodie, 

The GC will be best to assess you, and your family tree, and determine if genetic testing (and what kind) is recommended. You still have the option to do so or not. Meeting with the GC does not mean you will, or need to choose, to get testing. But it can be very, very beneficial.

Factors that increase risk of, say, BRCA mutations (note that the GC may look at your family history and thing another genetic mutation is also possible, like CHEK2, and recommend testing for that, but I am just going through BRCA+ as that is where most people think first)

Diagnosis under 50 

2 or more first degree relatives with pre-menopausal BC

3 or more close (1st, 2nd) relatives with BC (some say any age)

Strong family history of pancreatic, ovarian, breast...some also add colon, and prostrate cancers

Close relatives who had both ovarian and breast cancer or personal history of breast and ovarian cancer.

Bilateral BC (different primaries), either personal or in a close relative. 

Ashekenazi Jewish ancestry (commonly for these men and women, it will be 1 or more of 3 mutations, often run as a panel where someone has AJ ancestry)...in general population about 1 in 400+ may have a BRCA-mutation, in Ashekenazi Jewish persons it is 1 in 40.

Triple negative BC (though note this is is because TN is more rare in general population but is more common (75%) in BRCA1+, in BRCA2+ ER+ is more common than TN (pretty much the reverse)

Family history of male breast cancer (as it is so rare in eye real population)

While BRCA-mutations cannot skip generations, the presentation of disease can. Sometimes the mutations get hidden in male dominated families for example (men with BRCA+ are at higher risk of BC, but still it remains rather rare; those with BRCA2+ are also at higher risk of pancreatic! prostrate, etc). It can pass down through generations of men without any sign of disease. Also, being BRCA+ does not mean one is guaranteed to get cancer. Risk estimates range from 40-85% for BC, and from 11-60% for OC....it varies depending on family, on mutation, etc. There are families where no disease presents until it does...who knows why, could be bad luck, or different environmental exposures, or other genes at play that added protective factors. So, it can remain hidden just for that reason. 

BRCA mutations only account for about 5% of all BCs, and about 25% of all hereditary BCs, but I imagine your doc is looking at your age, the bilateral cancer, and the fact there is some family history there, to at least see a need to refer you to a GC who can do a more detailed review.

Even being referred for testing/qualifying does not mean you will be positive. In my family, my 2 great grandmothers on my mother's side had BC (one died of metastatic BC in her 60s, the other lived after a Halsted MX and died in her 80s of colon cancer), my maternal grandmother had 2 dx's, one before 50, and died of metastatic BC at 59, my mother was dx'd at 47/48, and has mets at 56. I have no aunts or great-aunts, and the woman before that died younger but we do not know of what. My family is BRCA-, but it is suspected there are other genetic factors at play, be it an unknown mutation or a combination of genetic variations.