Plastic Surgery “PS”

PHOTO NOTE:  The photo to the left was taken on a Fox River boat tour with my friend “Cappy,” David Anderson as the guide, along with my husband and friends Grant and Kathy.  A great day with friends and wonderful memory to keep.

PROCEDURE #4: May 31, 2011 it was off to the hospital for my first plastic surgery experience. Dr. Ferlmann was to place an ‘expander’ in my left breast.  It isn’t quite as easy as slice, place and sew.  Since all the breast tissue is gone, the PS has to build a ‘shelf’ to hold up the expander.  This is made of ‘newskin,’ a very clever name for treated cadaver skin that is used during surgery. The expander is placed under the pectoralis muscle and put in the newly fashioned sling.  Closure is a special type of glue that minimizes scar tissue and is also waterproof.  My favorite part, the drain, included only one drain this time and the hole exiting my body was nicely placed mid bra strap area.  Since nobody in my support group had reconstruction months after their mastectomy, I did not have any idea how long recovery would be compared to my mastectomy. Minutes before surgery, my PS had me stand up to take measurements. Dr. Ferlmann then took a Sharpe marker and drew on my breastless chest the angles needed to create my new breast. I asked him (only half kidding) if he got an A in geometry and he said he did.  Filling the awkward silence, I also asked him if he got an A in trigonometry just to be sure (he did).  I guess a bit of nervousness made me talk and that is what came out, but it was also the bit of comic relief I needed before going under the knife for the third time in six months. Steve looked the other way while the doc sketched me out a new breast; Dr. Ferlmann said not being able to watch was typical for most husbands.

When I awoke from surgery, I was in recovery with a noticeable ‘mound’ on my chest.  My new ‘breast’ felt more like a foreign object was placed in my chest. The morphine pump was welcome pain relief and I watched the clock tick by until I could press the magic button that would take away the edge of surgical side affects.  All went well until later that afternoon when I started getting the sweats and feeling nauseous. Note to self, “Don’t drink grape juice until you know you can keep it down.”  No explanation needed there, you have the visual I’m sure. My stay at the hospital that day went downhill with nurses understaffed, a broken phone in my room and a couple bad episodes of nausea. There is positively nothing worse than throwing up after chest or abdominal surgery (I’ve had both).  Enough said about that.  The endless hospital night finally passed and I was looking forward to getting some solid food in me.  As a former competitive swimmer, I have always had a healthy appetite.  Food and I are soul mates and I was looking for some warm comfort food to brighten my spirits. This hospital lets you order a la carte anytime the kitchen is open.  That is a great concept.  Order food when you are hungry instead of getting a tray full of food at a time that is convenient for the hospital to deliver it to you.

Around Noon the net day I was getting a bit antsy for Dr. Ferlmann to come on his rounds so I could be released.  When I inquired to a nurse what his routine was, she explained it was either very early or later in the day.  I found out later that he had kept tabs on me and I was not passing his list of “the five things you have to do to go home.”  I had failed on the “keeping your food down” category, so he was giving me time to be able to tolerate solid foods and regain my strength. My inlaws arrived just after lunch to drive me home, but we had to wait until close to 5 to be released. One thing I didn’t think about what the car ride home. I opted to sit in the back seat to avoid the seat belt, but then endured the bumps and jostling for what seemed like an eternity before we pulled up in my driveway.  What I learned was you’ll want to make sure the car that drives you home has a smooth ride. You feel every bump in the road and I found myself cradling my new chest addition to prevent pain.  What I learned at my next support group was to bring a pillow to put under your seatbelt and use it to hug yourself and brace for bumps.  I’ll add that to my Top 10 Tips.  Nothing looks better than home after being in the hospital.

As it turns out, my upper abdominals were more affected by this surgery than the mastectomy and getting out of bed required help for the first few days at home. I slowly learned how to leverage my good arm to push off the bed and even devised a way to grasp the underside of my bent knee to create a lever, which worked the best.  Again, I was very glad to have one good arm to assist me.  Technology is also a great thing as I would text my helper when I needed something and seconds later someone would appear.

I had pre-planned help at home and assigned a caregiver for the first five days.  Being proactive and knowing I had someone around to assist me and pass the time was both physically and mentally reassuring. I scheduled my nephew Andrew for Thursday, my son Kyle on Friday and my husband, Steve on the weekend.  The best laid plans… Steve came down with the flu and cloistered himself in our basement all weekend on a History channel-a-thon.  I happily brought him crackers and water and was comforted by just knowing he was around if I needed him. This is a good time to remind you that friends and family truly want to help, but don’t really know what to do for you. Help them out by asking them for specific things and arranging as much as you can before your surgery.  I saved leftovers from dinners and froze them in individual portions for the second week when I was on my own at home.  It was an easy thing to put in the microwave and I also tried to prepare healthy meals that were not high in fat as I wasn’t burning many calories re-cooperating on the sofa or front porch.  I emailed four friends to get two rides and within one hour had both rides set up.  Just ask, really, it is not a sign a weakness, it is letting people help you.

RESTRICTIONS: The rule of thumb is to avoid lifting more than ten pounds for the first four weeks.  I mostly complied with that and did ask for help from my sons and husband.  One thing I could do was walk, just not get my pulse over 120. Dr. Ferlmann didn’t want my blood pressure elevated creating fluid build up again.  So, I started with walking to the end of my block with my nephew my first day home from the hospital.  We got ‘stopped’ by a neighbor boy who posted a toy size stop sign.  We obliged and paid our imaginary ten cents to pass on the sidewalk. His imagination triggered my childhood memories of building forts and playing ‘Miss America’ in my St. Anthony, MN backyard.  Back when things were simple and I just had to be home before it was ‘dark in the trees.’  Each day I added another block to my walk and was up to a mile at the end of week one, two miles at two weeks and three miles at three weeks.

CATTYWOMPUS: The time right after surgery I was pretty ‘balanced.’  My newly fashioned breast was roughly the same size as my ‘God given’ one, but after my first ‘fill’ things started to get off balance, or as my husband says, ‘Cattywompus.’ Two weeks after surgery I visited my PS for my first fill episode of ‘pump me up.’  First, he inspected his handiwork and then had me lay down for the procedure.  His assistant held up a very large syringe as I got swabbed and sterile for the procedure.  Once you have a mastectomy, you don’t feel anything around your entire breast, so no numbing agent was necessary.  In plunged the needle and 40 cc’s of saline was slowly pushed into my expander.  The problem was that I had swelling and the doc ended up taking out 60 cc’s of body fluid.  I’m not the best at math, but 40 cc’s in and 60cc’s out is a net loss of 20.  Not exactly the fast track to perky ta tas, but, I did feel better as the pressure inside my chest cavity was relieved.  I remember thinking, ‘at this rate building a new breast will take a really long time.’

Pause. Fast forward to week three. I hopped up on the table and knew the routine.  But this time, the syringe plunged in 40 cc’s and nothing came out…progress!  I looked in the mirror and at that moment felt the definition of ‘cattywompus.’  For those of you not familiar with the term, it is a word my husband uses for off kilter or unbalanced. I had to explain this to Dr. Ferlmann too, so you are not alone if you haven’t heard it before.

Fast forward again and it is September and I’m ‘the right size.”  I’m thinking that if I get any bigger my friends won’t recognize me. I happily place the prosthetic “puff” I used to wear over my breast less chest and moved it over to my right side and wallah – the ta tas are now in balance. Next it is time to decide whether I’m going to have saline or silicone implants and wait until my November 18 surgery. I blog about this decision and even after scheduling an appointment to discuss it with Dr. Ferlmann haven’t yet come to a definite decision.  Weigh in if you have an opinion either way as surgery is now less than a month away.

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