Four Months Post-Op & October

Four months today, I'm doing great.  I still have pain, I still have this awkward relationship with my breasts because of how they feel, not because of how they look, and I still thank God and my doctor that I had this amazing gift of life given to me.  But on this anniversary, I focus not on my healing process, but on a greater cause...awareness and action.

In an ideal world, I'd like to think that everyone, all over the world, would have access to understanding their genetics and risks without heavy co-pays.  I'd wish that every woman had access to mammograms when needed, treatment if necessary and education at her fingertips.  My hope would be that every human would already know so much about breast cancer awareness, so that all of the money spent on producing pink items could just go directly to helping women and men get the help they need.  My dream would be that all this money we raise year after year would have found a cure by now, and more importantly, that a majority of the money made it into research/grants/and reduced or free access to care.  In an ideal world.

© Nevit Dilmen [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) via Wikimedia Commons

Every year till now, October approached and I would go into it with a pit in my stomach.  Inevitably, every October, I'd have those who were reminded that I lost my mother at a young age to breast cancer and felt badly, I had those who didn't understand what it was like to be  BRCA1+ for 10 years and not do anything about it and I had those who would just send the "I'm thinking of you" message during the month to let me know they cared.  All perfectly fine in their own ways, but I would get upset inside because I was so conflicted about this month in question.  I had a love/hate relationship with October.  I hated the Facebook secret messages that were hoping to spread awareness because I didn't think it should be secretive, I stayed away from purchasing anything breast cancer pink because it reminded me of pain not happiness, I hated seeing the statistics that so little of funds raised actually made it to where it should go and I wished the month would be over so that I could go on living and sharing my story in my own way, with just as much passion, throughout the whole year, not just in "Pinktober".

I sit here today, four months after my preventive surgery, taking a new turn on life and my own understanding of October.  I've decided it is what you make of it.  Some people love the pink aspect of October, seeking comfort in all of the support and sharing in a larger community beyond themselves.  I'll admit, I love the smiles I see on people's faces in the photos from events, I love my friends who are genuinely fighting for something they are passionate about and I love that the general public pays a little extra attention to an important cause for a month.  I love that voices are heard...or are they?  There are those who still hate October, like I once did, for the commercialism of it all, wondering why we can't just be proactive all year long without the bells and whistles and extra effort during one month of the year.  I have decided that I sit on the wall between both sides now, not really in one court or the other, and here's why.

October Can Be Great...

I lost my mother to breast cancer, and I didn't handle it well.  After her passing, I felt like I had failed as a daughter, as a supporter.  That is when I threw myself into the yearly Susan G. Komen walks and the American Cancer Society's Relays for Life as a way to try and heal.  My friends would join me and I felt like I was doing as much as I could, coming to terms my own way.  I was the one asking for donations each year, putting the sign on my back as a symbol for who I was walking for and feeling like I was making up for time I'd spent in the wrong way.  I'd wear the pink ribbon given to me because I was proud to represent my mother and grandmother in any way that I could.  I'd cry at some point in each event, missing them terribly, and feel comforted that others around me were feeling the same.  But there were always things missing.

While I thought I was doing good for others and trying to love the community spirit that these events brought, I was at the same time ignoring myself.  Never once during those years did I stop and ask about my own health and risks.  Yes, I knew there was something going on in my family that made my future look questionable, but during the ages of 13-25, I never pursued any of the many services offered to someone like me, because I didn't know I had a gene I had to worry about.  Here I was, supporting breast cancer "awareness", but it wasn't hitting home because there wasn't specific information to me, to my situation.  Where was my action?  A month dedicated to helping people gain access, information and support, and I was solely looking at it as a way to deal with my mother's passing.  I then began to think...if there's so much awareness, year after year, then why was my mother passed up for an elective mastectomy and reconstruction when she asked?  Where's the actual education?  October needs to change...we can't isolate Breast Cancer into October.

But So Can the Rest of the Year!

On the flip side, four months ago I had my surgery and I blogged my way through it all.  I never realized how powerful my voice could be.  Here I thought Angelina had taken care of all the hard work, bringing awareness of BRCA to the masses, but I quickly realized...MANY never even heard her story.  Was MY little voice helping to  bring awareness to someone via my blog, my book and now, in the month of October, my article for Parenting.com?  Yes, it was.  I meet people weekly who have never heard of BRCA and I'm shocked.  I realize that not everyone attends an October event, nor follows Hollywood news, especially in different parts of the world.  A woman, just this last week, made a comment about all the pink around and I told her it was for breast cancer awareness month...she had no clue.  For the past year leading up to my surgery, I was the one educating people around me without the pink accessories and fundraisers.  I enjoy telling my story, helping other women understand their genetics, their options and especially how to deal with it all as a mother.  During eleven other months, people still need to be educated.  There will always be someone who just doesn't know, and I'm so happy when they cross my path.

So, here I am, coming to terms with my own understanding of the month of October.  I appreciate those who love it, share in it and find hope through the communities and organizations spreading the word.  I also appreciate those who don't like it for whatever their reasons are.  I now realize that my October doesn't have to be filled with sadness, anger and resentment.  My October is now a time to reflect on my journey and how I decided to change my life's path.  My October is now a time to be there for anyone who needs an ear or a shoulder or some guiding information.  My October will be for advocating about testing, breast reconstruction options and pushing people to listen.  But the rest of the year will also be the same, filled with the same passion as my now October.

Three Months Post-Op

You're a pain in the...

Boob!

No, I'm not talking about my husband, I'm talking about the actual recovery I'm still going through.  Today marks three months since my surgery.  Here's what's happening at this point, but if you need to refresh what was happening at two months, read here.

Follow Up and Physical Therapy...or Not

Yep, the twinges of pain, sore muscles and tightness are still with me...although MUCH less.  This is due to the fact that I can only do so much on my own with the exercises given to me, but I really need physical therapy to work on the scar tissue and muscles.  Having had the surgery overseas and leaving behind my amazing surgical doctor and nurse, I'm left to pickup the pieces back here in Singapore and its not going as well as I had hoped.  

I came back to Singapore and had an immediate follow up appointment with a doctor here.  A doctor who was amazed that I was up and about and feeling/looking so great a month out.  A doctor who knew nothing about Alloderm, and was so intrigued, that he did an ultrasound just to see inside.  A doctor...who I cannot seem to get an appointment with any time soon.  All I need is a referral.

I've been feeling pretty great since my return to Singapore two months ago.  I've been working, I've been completely off any medications (even Advil) for a month and I'm even able to shave my legs with less pain from repetitive motion of the lateral muscles on the sides of the breasts.  However, I do experience tightness that radiates from the lateral muscles on the side of my left breast into my armpit, which not only causes some twinges of pain, it limits my range of motion.  I need this looked at by a physical therapist.  Sounds simple, right?  I'm at my wit's end trying to get a referral from above mentioned doctor to see a physical therapist.  Surely there has to be an easier way.  As of now, there's a 2-3 week wait to get into the doctor.  Let's hope this happens sooner by some act of goodness, and I can start therapy sooner.

Nipples

Wow, I don't even know what to say here.  They still hurt.  They are quite tender, which I didn't expect this far out from surgery (or is three months not considered "far out" for a surgery like this?).  I'm beginning to wonder if maybe the soreness I feel is from tight muscles and scar tissue pulling at that area?  

Aesthetics

My scars are still rocking on their recovery.  I'm using my InviCible every day and watching them fade more and more.  As for my breasts, they are WAY softer.  I didn't think they could get softer than a month ago, but here we are, another month gone by, and they are even better.  My right breast still looks fantastic, while the left breast is having a little bit of a "tugging" issue due to scar tissue.  Again, physical therapy needed now.  Because of the scar tissue, there's an area under my nipple which is almost pulling inward.  It's slight, not even my husband notices unless I point it out, but I see it.  I say this just so women are aware of things that CAN happen after surgery.  To me...I'm just happy I lessened my chances of getting breast cancer.  I can deal with this slight imperfection.

The strangest thing, and maybe too much information for some, is the way the breast moves when the muscles are tightened.  Imagine pulling/lifting or doing anything that would contract the chest muscles.  Then picture the breast trying to move, like a natural breast, but it doesn't.  The implant stays where it is and the muscle tries to go in the direction forced, so you're left with this indenting, rippling and what not.  Thankfully I'm usually always wearing a bra or shirt so that no one can witness this strange occurrence, but again, I'm here to be truthful.

Emotions

I think I'm beyond the emotional roller coaster that is related to the overall surgery preparation and immediate recovery.  I'm back to all my daily routines and I don't break down in tears at random.  However, if I'm being real and totally transparent here, this is something I posted on August 28th:

Some days I wish my boobs were removable and I could just take a break from them. A break from the soreness, the twinges and itches I can't quite get to and the overall weirdness of them.

It's true, I can't help but feel what I feel.  They are foreign. They are strange.  And they take getting used to.  I do wish, some days, that I didn't have the surgery.  But I'm quickly reminded of my WHY.  I saved my life and really, if faced with it again, I'd do it.  This is just a new me I have to get used to, but I don't doubt that the strangeness of it will every go away.  They'll always be a daily reminder of what I did and why.  And maybe that's ok.  If I never did it, I'd never have this story to tell, I'd never have written a book, and I'd never have met so many wonderful people to add to my life.

By Nevit Dilmen (talk · contribs) (Own work) [GFDL (http://www.gnu.org/copyleft/fdl.html)
via Wikimedia Commons

Two Months Post Op and Back to Work

I've just made it to being two months post op.  Another milestone in my journey, which is still unfolding.  Looking back, it seems like so long ago that I was planning for it and waiting for insurance approval.  While doing great, I still have some daily reminders that I'm well in the middle of the healing process.

I hear stories of women jogging at six weeks out after having the same type of surgery, and I'm amazed.  More power to you!  I'm not there.  LOL!  I did, however, go back to work full time.  That is what sent me into examining how I really feel at two months out.  I'm lifting, pushing, walking, and everything in between...I'm an elementary teacher.  I'm testing my body and my body doesn't like it, for now.  I'm coming home, popping pain relievers such as Advil, and finding myself in bed by 8pm.

Pain/Tenderness/Tightness

In order to explain the pain I feel these days, its important to see a diagram of what I had done.

http://www.tavmd.com/2013/09/08/complicated-breast-augmentation-surgery/

AlloDerm  The AlloDerm is what was used to form a hammock, of sorts, to support the implant.  This is also what will hopefully prevent capsular contracture due to the scar tissue not wanting to bond to it. While AlloDerm is great, you can see the number of stitches needed to hold it in place...all securing it directly to the muscles.  Enter my current pain.

If you look at the high left corner of the AlloDerm in the above image, that's the point at which I have a lot of tenderness and aching right now.  In my right breast, I can actually feel the tiny "bump" at that intersection of AlloDerm and muscle, which may be the stitch and/or scar tissue.  When I press on it, it slightly "pops".  I've been instructed to massage that area as best I can, in order to break up any potential scar tissue which may be building.

Lateral Muscles

In addition to that area, I'm also having overall tenderness and pain in the lateral muscle area on both sides.  This I attribute to several factors.  1)  possible scar tissue forming at drain sites, 2) going back to work and using my muscles more than I have since surgery thus far, and 3) stitches being pulled from the overall activity increase and potential scar tissue.  I am also massaging these areas as much as I can tolerate.  I was allowed to begin side sleeping, at a gentle incline with soft support underneath, but some nights, it's just not comfortable and not worth the aching.

Armpit/Arms

I have tightness in my armpit and leading just into my arm.  While it's not cording, or doesn't seem to be a bad enough case to worry about, it's limiting some of my range of motion.  I am doing my daily stretches and hoping that this is just a time issue.

Nipples

The nipples are still quite tender.  I keep telling myself this is a good thing.  It's sensation.  It's feeling.  It's nerves regenerating.  I was hoping it would have gone away by now, but I'll take it in hopes that I really will retain some feeling after the healing is complete.

Bras

Now is NOT the time to try out the strapless bras as I learned the hard way.  I LOVE my Genie Bra line, ordering four different styles in black, nude and white.  I thought I'd try the strapless one just out of pure excitement.  Well, within hours, I was experiencing a lot of tenderness in my chest muscles above the implants.  I guess it was too much weight to support at this time.

Aesthetics

They look great.  There might be slight imperfections that only I notice from my angle of looking at them, but overall, they are great.  They've settled, they're soft and they look pretty darn natural for being implants.  The positioning couldn't have been better.  It is because of this that I realize what a blessing it was to find a micro surgeon, someone skilled at the teeny tiny details.  The scars in the inframammary fold are looking amazing.  I've been allowed to apply my InviCible scar treatment for the past 3.5 weeks on both the drain sites and the scars.

Medications and Emotions

I have been off all of the major medications for a long time now, as they never really suited me.  However, I found myself popping half a Xanax at work this week, as I felt the heart begin to beat rapidly and the overwhelming sense of nausea took over my body.  The scenario of seeing all of my co-workers again was a bit more emotional than I expected, as the obvious first questions are around the surgery.  Not that I don't like talking about it, it's just that sometimes I feel like my boobs enter the room before I do, if that makes sense.  No one made me feel uncomfortable, it was all my doing, all in my head.  That, coupled with the overall stress of being back to work, just sent me into a tail spin.  That's the only time, in a long time, that I've needed anything more than Advil.

Having said all this, nothing is really limiting me from completing my daily activities.  I'm doing all the normal daily routines I was doing before at both work and home, and perhaps doing too much (like carrying things at work that I shouldn't be), so I think the pain is all just part of the process.  Massaging is just my number one priority right now.  Well, massaging, getting physically and mentally fit again and getting to sleep comfortably on my side are my priorities right now.

PRMA Testimonial

I've given a lot of information about PRMA and Dr. Chrysopoulo via this blog throughout my journey.  Please read and view my complete testimonials, here in one place.  If you have any questions, please don't hesitate to contact myself or Courtney, the PRMA Patient Liaison.  Long distance travel should not be a factor in preventing you from going to the best.

PRMA One-Step Implants with Alloderm

Testimony 

Read my story about coming to terms with BRCA and deciding on prophylactic mastectomy at PRMA.

Traveling 9000 Miles for Breast Reconstruction

 Read this blog post by PRMA patient liaison Courtney Floyd and watch my video testimony.

Contact us via Twitter too! 

Courtney Floyd @diepflapbreast
Dr. Chrysopoulo @mchrysopoulo
Heather @expattravelmom