October 31 - Spooky

Here are a few weird things going on right now: phantom nipples and sloshy chest.

I love the crisp, pungent air this time of year. The temperature has dropped, the leaves are falling, the humidity is gone. The mornings are dark and frosty. My chest is one of the first indicators of the seasonal change. True, I have holes where nipples are supposed to be, but apparently my brain still reads chilly exposure as nippin' weather.

And apparently the skin has stretched a little, because when I leaned over to get the wet clothes out of the washer this weekend, I could hear and feel the gurgling in my chest. The doctor says the barely-filled balloons are folded over inside me. They tend to gather in my armpit. I sound like I've had 4 big glasses of water, sloshing around every time I bend over or roll. Eeeeww.

Happy Halloween!

October 24 - BCA II

I got great news today. Well, actually awful news, but something I've been waiting to hear. A friend of mine named Karen found out about my current journey from her son, read the blog and thought she should get checked. She has Stage 2 breast cancer and, in a whirlwind of tests and suggestions over the past three weeks, she has already started chemo.

Whenever something traumatic happens, people are inspired to look for deeper meaning in life or a silver lining. I sort of thought I should be doing this as well: getting in touch spiritually or treasuring my time on Earth or something profound. But that's not really in my nature.

Mostly, the last three months have been just uncomfortable and inconvenient.

So, I've been waiting to hear that at least the people I know are learning something from my experience. Beyond the pink billboards and smiley commercials, people should know that cancer is real and scary and much more common than we think. Something like one in five women will get breast cancer. Men with breast cancer in their family have an 8% increased chance of getting it too.

Karen is a nurse, around my mom's age, and she totally knows better. However, she admitted to only doing self-exams about twice in her life and having mammograms...(quantity unknown).

Breast cancer is one of the "lucky" ones that is actually treatable, especially if you catch it early. If it runs in your family, you should do monthly self-checks, annual breast exams, and mammograms 10 years before the onset of cancer in your family. (Which I found out after I was diagnosed.) If it doesn't run in your family, you should do monthly self-checks, annual breast exams and mammograms yearly from age 40 on. I don't think all the pretty pink ribbon hype is clear on this.

So, while it sucks that I know someone else going through the trials of cancer treatment and recovery, I'm glad she caught it and is able to move forward from here.

And that's what I have to say about Breast Cancer Awareness.

October 23 - Surgery scars

Thought everyone might be getting tired of the word "wounds", although the surgery areas aren't really closed yet. However, I wanted to write down a few thoughts since this is still the major medical concern.

Most importantly, things are healing up nicely considering the depth and yuckiness from two weeks ago. My P.T., Christine, estimates it will still probably be a couple months before we have full re-epitheliazation (new closed skin) and real scars. I am so thankful for my co-worker and friend, Rose, who took her day off and a debridement kit to come assess the situation initially at my home on October 12th. She helped really get things on the right track.

I continue to be very pleased with my care team. Dr. Shulman messes up some of my pre-conceived ideas about plastic surgeons. First of all, they're not all in it for the big bucks. (Although I'm sure she's doing well supporting her stay-at-home husband and young child.) She is committed to providing practical and compassionate care. Also, they don't all look like Barbie or McSteamy. Check out this link for a quick peek and her references: http://www.plasticsurgerycenter.net/credentials_shulman.html.
I'd recommend her to anyone.

I continue to be thankful for all my co-workers. They are making the transition back to regular working hours - i.e. no naps - easier by bringing in family dinners to take home on work days. Last week Ame made a full Thanksgiving feast, Judy made the best chicken soup ever and brownies, and last night Sharon G. made a yummy steak and potatoes supper complete with homemade apple pie and ice cream.

The best part of being back to work is feeling a little more productive. The worst part is how tired and achy I still am. Even with frequent task and position changes, I was never cut out for office work.

But today is my day off. So I think I'll take that afternoon nap.

October 22, 2007 - Wound Care

What's wrong with me? I know it's all in my mind. I should be able to tunnel through this mental wall that springs up in front of me when I see an open wound. Logically, I should be able to look without my head becoming a helium-filled latex orb while my legs remain cemented to the floor with lead.

It must be that I know it's on a person and it's not natural. Kind of like some of those pictures in National Geographic. The guy pulling a loaded wagon using hooks stuck in his back, or the lady who looks like a duck-billed platypus with the metal plate in her lip. I can't look at those either. Don't even get me started on House.

Maybe it's because of what it represents. Pain. I hate to see someone hurting. Especially when there's such an obvious physical manifestation of the pain. When Mel has a migraine, my eyes don't roll up into my skull and I don't collapse, jerking with spasms. Probably because I can't see the head ache.

Maybe it's a skin thing. What is it about skin? I like skin. Skin is good. But for some reason, when skin is split open, it triggers a switch that opens the dam holding back this reservoir of chunks waiting on the other side.

Having shared that, I'm happy to say Melisa has been going to the Wound Care Center at Memorial for the past week. Last Tuesday she saw Dr. Shulman who suggested we hold off filling the tissue expanders until the wounds have healed for a couple of weeks. She sent Mel to the Wound Care Center, claiming they have all the good gizmos and voo-doo to speed up the healing process.

It's been a relief for Mel (and me) not to be burdened with changing the wound dressings twice a day. Now she's supposed to have the dressings changed a few times a week by the PT at the hospital. In a couple of weeks we'll see how she's healing, and probably start expansion again.

Other than dealing with open wounds, Melisa has been doing fantastic. She started back to work last Tuesday. They've been so good to her there. I'm amazed at how supportive, understanding and giving they are. In my opinion she couldn't work for a better place.

They've been keeping her busy in the office, making sure she doesn't over do it. Telling her to take it slow and heal. It shows how much they value her. She's not just a number. Large corporations are typically selfish and make decisions based SOLELY on the bottom line. I understand you need to make a profit to stay in business. But I also understand, like Memorial, that if you treat your people right they'll stay. That's a lot cheaper in the long run than having a high turnover rate.

When we saw Dr. S last week, she prescribed some more Percocet for Mel. She'd been having trouble sleeping just using over the counter pain killers. The Percocet did the trick. She's actually to the point now where she's made it through the last two nights without prescription pain meds. Either the tunnel's getting shorter, or the light at the end is brighter. Regardless, we can now see the light there and we're moving towards it. Slowly.

I'll keep you posted.

October 17 - "Vacation" is Over

I guess my first clue should have been when Naomi came straight downstairs at 5 in the morning to "snuggle with Mommy" two days in a row last week. Skyler was next, coming straight to me for help going to the bathroom at 6AM. For those who don't know my home layout, I have been sleeping on a spare bed crammed in an unfinished storage room in the basement since surgery. I normally sleep with Scott in a second floor loft room, and the kids share a room on the main floor. I moved downstairs because of the multiple nightly visits we get from small people with sharp elbows and wiggly knees. Scott's a heavy sleeper, so I'm usually the nighttime/early morning parent.

I also had my first day back to work yesterday after a long morning at the doctor. Actually, Dr. Shulman's visit was pretty short. She took one look at my chest and wrote an order to be seen that morning by the wound care team at the hospital. Then I spent the next 25 minutes trying to complete my legal medical leave paper work correctly with her staff. The wound care physical therapist was very kind, using local lidocaine to decrease the pain before digging. She also switched the types of dressings to poly-mem foam and gauze, which she is scheduled to change 2-3xwk. Yea! No more twice daily blubbering sessions in front of the mirror with a butter knife.
This does set the healing process back quite a bit, because it may be a month or more before the wounds close, and we don't want to put more stress on the area by adding any more saline till after that. So I'm looking at probably 4 more months of light duty (office work vs. physical therapy) and at least weekly doctors visits. Sigh...

I'm disappointed in the delayed healing and how I didn't get anything productive or amazingly fun done at home in the five weeks I've been off. Seems like such a waste of paid time off! I would have rather gone to Hawaii. It would have been cheaper too. (I'm not even getting started on the medical bills rolling in daily!)

Well, back to the old grind.

October 14, 2007 - BCA

Everyone seems to be jumping on the Breast Cancer Awareness wagon. Ford has a BCA Mustang advertised with Kelly Clarkson's BCA line of clothing (which is refreshingly not dorky). I was smacked in the face by a complete display of pink ribbony things in Bed Bath & Beyond. You can buy gobs of things that donate money to the awareness of breast cancer. The weird thing is that people seem to be aware of Breast Cancer Awareness, but not so aware of the actual threat of breast cancer.

You had breast cancer? Oh, wow. That is just terrible. My dog once had an ingrown toenail. Let me tell you all about it BLAH . . . And they proceed to barf their story all over you.

I think many people consider breast cancer to be one of those easy cancers. Like CliffsNotes cancer, diet cancer or 1/2 the cancer with 0% trans fat. You're so lucky it isn't REAL cancer. Oh, let's bip in there and skip-a-dee-doo-da-day all those naughty little cancers. We'll sing about marshmallows and sunshine and wish the little evils away. Then we'll hocus pocus some Care Bear band-aids on the ouchies and tomorrow you'll be new. Yea!

I'm sad to say, that was also me. But I'm not clueless anymore. Neither is Mel. She thought after a month she'd at least have B cups and be PTing the heck out of everyone. In contrast, she's spreading Silvadene like mayo over her wounds, spending infinity in the shower and waking up with her new boobs in her armpits.

It's been a month since surgery. Only a month, but let's review. A mastectomy is essentially a complete AMPUTATION of the breast. If you have it done to both breasts, that's obviously two mastectomies. And it's not just that. When cancer's involved it entails a scooping out of the insides. In my opinion, you should scoop ice cream. You should scoop a story. You should never scoop things from your body. It's painful, it's weird, and it sucks. Mel will back me up on that.

Fortunately, because of how early the cancer was discovered, she doesn't have to face the additional trauma of chemo or radiation therapy. As unaware as we were about the seriousness of breast cancer and the agony of recovery, we were at least aware enough to get immediate medical attention.

No one should have to go through what she's battling. But if you're aware and prepared, it's a battle you can win. There are throngs of women with the scars to prove it. Tonight as I was holding my wife and struggling with the reality of our life, I couldn't help but wonder. Why her? It's not fair. She's suffering. She's in emotional and physical anguish. She doesn't deserve this.

But then I thank God because she's alive. And she's recovering. And I know a year from now the pain won't be completely gone and her wounds won't be completely healed, but every day she'll be a little bit better. And she does deserve that.

Shout out to the peeps

OK, I think Scott is falling behind with the multitude of thank you's and funny updates. So, I've compiled a brief, non-descriptive, uninteresting list. I'm sure I've forgotten several someone's... please don't be offended. I'm really grateful and continually overwhelmed (even when I'm not hormonally off-balance) for what you all do!

Thanks to Kathryn for the taco stuff, that was ingenious. Thanks to Judy for the groceries and all the household chores; my mums survive because of you. Thanks to Harry for the awesome crock pot stew which miraculously arrived (via Ame) while I was napping. Thanks especially to Shelly for all the support and picking up and feeding Naomi after preschool. Thanks to Grammy for the great bakery goods - eclairs are our favorite. Thanks to Carrie for the pizza/macaroni. Thanks to Stacy for the full fledged meal - very creative and the cookies were gone the next day. Thanks to Sharon G. and Tom for their kind words and continued offers of help. Thanks to Minu and Dad for the bean dip and cards - we're happy to win at Rook anytime. Thanks to the Michaels and Meyers and our new friends the Jakes for a great evening and the funniest spring break story of all time. Thanks to whoever sent all the paper plates and plastic ware - brilliant! Thank you to whoever sent the beef noodles and the yummy cake tonight. Thank you for the new scented lotions - I'm reserving their use until the wound issues clear up, mostly because of the whole associated-smells thing. I'll have to change shampoos, soap and deodorant, too.

Ame deserves her own paragraph because not only has she coordinated meals for the family and deliveries over the last month from work, but she also spent several hours around the house tonight. She brought extra dressings so the Kotex are on hold for now. She made my house look festive and Halloweeny despite my paltry decorations and actually got Scott to wash the sheets. That girl is amazing!

See, we've been pretty busy, and despite what my doctor thinks, I am eating quite well.

Thanks.

October 9 - Today

Today started much like yesterday ended - tired, sore, and more tears. I think I hid it better from the kids, though. Helps that the bus comes before the sun comes up.

Went to see Dr. Shulman, the plastic surgeon, first thing as scheduled. I almost made the medical assistant teary too since I couldn't stop blubbing. So after my sob story, we all decided to wait another week to "pump up the volume". They removed the tapes and stitches (hallelujah!), and have changed the wound care regime. Now I have 2x daily Silvadene goop to put on both sides, and Dr. Shulman said I could cover it with sterile pantiliners. Weird. I'm sticking with regular medical dressings till I run out. She also gave me a rx for Percocet, the stronger pain medicine, because that's the only thing that seems to work at night. During the day I get away with occasional Tylenol or Advil, so I'm really feeling much better overall. I did get a limited work release, so as soon as the medical leave people approve it, I'll be back at the office at least a few hours at a time, probably Tuesdays and Thursdays.

After picking up the prescriptions and a few groceries, I was pretty much worn out and gloomy again. I slept half the afternoon. Thank you to all for your continued comments on the blog, calls, cards and all the great food and supplies. Scott has a whole list of specific "thank you's" and his humorous narrative on the last week's activities, so look for more info soon.

Tomorrow will be better...

October 9 - Yesterday

Yesterday was a great day! I drove for the first time. Granted it was with a huge pillow between my chest and the seat belt, and probably at granny speed. Parking is still a little tricky, involving 6 point turns. Anyway, I took my 3 year old to preschool, which is big in the me-doing-something-functional department and the yea-Scott-doesn't-have-to-do-everything arena. I went for a little walk, then had the afternoon to rest when Scott took the kids to the lot.


I took a shower, which is still a tiring, weird-feeling contortionist activity because of the nerve damage on my chest, back and arm pits. Then started the daily wound cleaning. I thought things looked a little gushier than usual, so I used an extra sponge and looked close in the mirror to check for signs of infection - and promptly lost it. As in heaving, uncontrollable sobs in a heap on the floor. For half an hour - I'm not exaggerating.

What would trigger such a gut emotional reaction in my otherwise rational and practical self? Stretch marks. Yep, silly little scars that indicate rapid skin stretching. Harmless, faded pink tiger stripes. And on the lower half, so not even in the cleavage area. Still.

Oddly, for me, I needed to talk to someone about it, and didn't want anyone to tell me rationally how petty I was being. You know, "at least the cancer's gone and you're not going to die", or anything. I called my aunt, who also had breast cancer in her 30's and happens to be a women's psychologist. So I cried for another hour and she said all the right stuff. I was better for a minute, but called Scott to warn him about the hormonal emotion zone at home just in case. Then I took 2 antihistamines and tried to sleep it off.

Well, the short nap did not even out the hormonal tears every time I opened my mouth, but we got through kid bed time. Then I cried through a re-run of House and an admittedly sad chapter of the book I'm reading (History of Love). Over the course of the next 4 hours I took Valium, Tylenol, Benadryl, Vicodin and Ambien to try to sleep. I was so incredibly sore - probably from all the sobbing - that I was up all night anyway.

Yesterday may have been the day the machine broke down. I'm sending it back for robotic repairs emergently!

October 6 - Occupational advantages

Why working in a rehab profession helps recovering from major surgery make more sense:

1. I only pick my own doctors based on if they are supportive of therapy and have responded to my professional requests within a reasonable time in the past.

2. I already know the anatomy and physiology - although I had forgotten how closely tied the tummy muscles and chest muscles work together to, say, get out of bed.

3. I already know that if it hurts if you don't move and it hurts if you do move, you might as well move it sista!

4. Working with occupational therapists has given me cool toys like a long-handled pink scrubby thing. It's the only way to reach my own back in the shower at this point, which still involves some awkward yoga-like positioning.

5. I know the difference between staples and stitches. Although at the moment I'm not thrilled with the 3 inches of thick, poky, blue fishing line sticking out of either end of the incisions.

6. I also know that, while it makes me a little queasy to think about, next Tuesday when they yank those pull-cords out, my chest will not flop open like sushi souffle.

7. Painting your nails becomes a functional activity, including sustained stretching of nerves and muscles (Ouch!), an endurance test (who has time for this on a regular basis?!) and energy conservation training (I think I need a nap now).

8. I work in a caring profession, with lots of wonderful, empathetic and supportive people. They've watched people recovering for years, and are good at reminding what to expect and when to slow down. Thanks all!

I'm going to lie down now... Mel

Is it October already?

We thought that you may have missed our more regular postings, so Scott and I are catching up today. Scott felt that my last note (Sept 22 - What Surgery Feels Like) may have been a little raw and negative, so I'm hoping to keep my attitude in check this time. No promises. Sometimes I'm a bit sarcastic - it's genetic.

Physically, I've made a lot of improvements. I'm weaning off the heavier prescription meds, using them mostly to get more comfortable rest at night. I still have a tight band of numbness around my chest that makes deep breathing difficult, and occasional sharp stabs especially along the left side where the lung drain was and along the sternal borders on both sides. It is uncomfortable to rest my arms at their sides because my armpits are numb. I hunch up and walk around like a football player with a shortened left arm. Weird. The back of my left arm feels like the funny bone keeps getting bumped. Ha-ha-ha-ha-ow!

The toughest part is emotional. I'm not comfortable being emotional - more of a get up, get it done, suck-it-up-and-move-on kind of person. (That's why I'm such a great encouragement to therapy patients, right?) I'm good with empathy and patience for a couple days max. Soooo... I'm stuck. This is taking WAY longer than I planned. I adore all the help and support we're getting - we couldn't function as a family without it (and sometimes it's still sketchy, like Skyler's homework not getting done and none of the three school fundraisers being even acknowledged). But I feel guilty, and weak, and so incredibly tired.

My kind friend Tammy reminded me yesterday of the spiel I give post-surgical patients all the time. "Your body's been through a major trauma, it often takes 4-8 weeks to get your energy back. You'll find swelling and odd sore places off and on for several months and may even have times of fatigue 6 to 12 months later. This is all typical of the process... yada yada yada." But most of those people are at least over 70. Shouldn't I sail through in at least half-time? I'm only 33! (Of course, my mom says I've been this age since I was 3... maybe that's having some effect.) Sometimes, in darker teary moments, I envy those patients. They're often retired, living in a paid-for home with a supportive retired spouse, worrying about getting back to the library book club or golf course. Ah, the golden years... (anyone in geriatrics knows I'm kidding.)

Enough about me. I'm too tired for any more whining. Hope all is fantastic with all our family and friends. Mel

October 2, 2007 - Gory Details

This past week has been a blur of activity. I was going to touch some of the highlights, but opted for gently massaging them instead . . .

WARNING - NASTY DETAILS ALERT: On Monday last week Mel decided I should be her wound care specialist. Hello. That's a recipe for disaster. I've seen what the surgery sites look like, and it doesn't bother me. But last week she started worrying about a couple of spots and talking about eschar (that's Greek for "yuck") and debridement. I wish I had a picture of my face when she first showed me. I think I covered my eyes. It was a gut reaction and I felt bad afterwards because I was worried she thought I couldn't look at her. It wasn't that at all. Luckily she knows me and knows my aversion to anything involving blood/guts/puss/needles/etc. so she wasn't offended by my reaction. I think she giggled, but she may have been high from the meds and the position she had to hold her head to point out the problem areas.

The first spot she was worried about was ringed in red and had a nice milky center. Hold on. I'm hyperventilating just thinking about it. She was asking me to remove the whitish-yellow center using a pair of sterilized tweezers, while I was trying not to faint. I did my best. Unfortunately, my best debridement is worse than no debridement at all. I couldn't get any of it off and decided the proper solution for all parties involved would be to defer this job to the nurse. There was another much bigger area that had blistered up and was filled with juice that looked like root beer without the fizz. I had developed my sea legs by now, so I popped that thing like I would any blister - eyes closed and chomping with the tweezers. That time Mel was the one who almost fainted.

Just to be safe, Melisa called the doctor and we went to see her last Tuesday morning. She said everything looked as expected and was healing nicely considering there wasn't really enough skin on the left (cancer) side to start with. I also got her to prescribe Mel some "Knock It Off" and a bottle of "Quit Trying To Do Everything". She's been terrible at taking those for the last several days. But don't worry. I'm on it.

This past weekend was awesome for me because my brother, Jeremy, was visiting from Washington. We got in some good quality brother time playing Halo 3 and Wii. We also spent a lot of time at my Dad's with the kids, so Mel got some good rest after over-doing it a bit last week.

This morning, we had another appointment with Dr. Shulman. It was the much anticipated and historic visit where she started filling the tissue expanders. Instant boobies. The Right Side has healed more since the surgery, so it got the full 60cc and triumphed with today's Best in Show. The Left Side is the one with the afformentioned wounds. It received 30cc and still came in with an Honorable Mention. Don't give up on the Left Side yet. It's a fighter and this battle isn't over. I'm confident it will give Righty a run for it's money. Mel's just hoping for an even tie.

October 2, 2007 - Melons

Last week Melisa got a surprise care package from Lara (her sis) and Josh (her sister's new husband) with Aunt Beanie's help. It was crammed full of assorted chocolate goodies, reading materials and wierd things to do like potato bonsai. However, the prize of this treasure chest was the miniature water melon and cantaloupe. Really. They sent her a brand new set of "melons". Apparently the "Milk Jugs" were too heavy. Thanks guys for that. You made us laugh!

On Sunday last week, Mel's friends from book club sent her home with a plethora (yes, I said plethora) of meals, goodies, gift cards and cake! Thank you Arin, Corrine, Michelle, Summer, Tania and Theresa!! Our next-door neighbors from Hungary also sent over a load of homemade applesauce and unique peach preserves. Interesting.

During the week, we enjoyed some killer blueberry coffee cake (among other delicious things like chicken pasta) from Cheryl. On Tuesday, Ame brought macaroni and ham with a cute card from Jenny. Sunday we had Papa John's pizza, apples, gourmet cookies, flowers and other goodies from Kim.

Already this week Adrian has sent over fruit and chili, and Judy bought soy milk. Sarah sacrificed her afternoon off to feed and care for our two youngest most energetic challenges, Skyler (4) and Naomi (3). She has one of her own and was kind enough to brave the chaos and give Mel some much needed rest. On top of that, she brought lunch she'd made. Thank you so much! You have no idea what a blessing you all are. The meals have been devoured with much cheering and celebration. My family sends their love and thanksgiving because they know that the alternative would have been an eternity of PB&Js and cereal. Oh, and toaster waffles. I make a mean toaster waffle now. Mel taught me.

By the way, Melisa wants everyone to know that she works for the best company in the world. No. She's not just saying that. The people who work for Memorial Home Care live out the vision and values of an incredible organization in the care they give for each other as much as their patients. She has had a choice as a physical therapist where to work, and has always "just felt" that MHC was the right place. Everyone has been so kind, understanding, helpful and concerned. Above and beyond what we could have ever hoped for. Thank you.

I thought people would start forgetting about us a week or two after Mel's surgery, and moving on with their lives. It's been exactly the opposite. You've blessed us more than we could have imagined or even asked for. And you won't stop! We love you for that. Thank you for taking care of us, and especially caring for Mel. She needs it and she deserves it, and she's lucky to have you.