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Healing post-lumpectomy – 3 months later

13 Jan

November 16, 2011

Surgery takes its toll, as I’m sure anyone who has gone under the knife will tell you.  With a lumpectomy, it’s not so much the outer scars  which feel like an issue right now as the stitches inside my body.  I can monitor the external scars and address them as I see fit, but I can’t visualize the inner wounds/stitches/scarring.  These are the ones I worry about a bit.

This past weekend I did a really long drive and near the end of it I was worried because my breasts were hurting quite a bit.  I thought there was a good chance the pain was caused by a combination of more heavy lifting than usual accompanied by wearing a bra that wasn’t sufficiently supportive, but I was still concerned enough to finally call my surgeon’s office and leave a message.

On Monday I got a return call from the physician’s assistant.  I learned something new.  I had had “twinges” of pain that I would feel from time to time.  They were intermittent but concerning.  She informed me these were normal and could be expected for up to a year.  They are indicative of the healing of damaged nerves.

What a relief.  Too bad they didn’t tell me that earlier so I wouldn’t worry.  Don’t you think that would have been helpful to know?

I do wish there had been more information given about what to expect post-surgery.  I mentioned this to the P.A.  She told me that they did give quite a bit of info to those who have had mastectomies, but apparently not to those who’ve only had lumpectomies.  And that’s why I’m glad I’m doing this blog!  So you all can learn through my experiences!

I went online to see what I could discover about healing following lumpectomies, and the truth is there really isn’t much information out there.  I looked both online and in the books I have about breast cancer and nowhere yet have I discovered anyone talking in detail about recovery from lumpectomy surgery after the first couple of weeks.  Everyone in the clinical field seems to think recovery will be pretty quick and easy.  But looking at discussions on the breastcancer.org site, it appears there are many women who have swelling and discomfort for several months after the surgery.

For instance, they suggest only that one refrain from heavy lifting or jogging for a couple weeks.  That’s absurd!  Especially for women with larger breasts.  Even with a good support bra, I’d be extremely afraid of jogging.  My breasts still feel way too fragile for that.  My goodness, I still can’t even give good bear hugs without hurting a teeny bit.

What I have discovered is that a sports bra or the surgical bra they put on me in the hospital gave support to the breast tissue, but also created a lot of sensitivity in the nipple area.  Nipples are obviously sensitive areas anyway, but when they’ve been impacted by surgery, they are even more so.  Thus, supportive bras will feel good to the breast itself (especially for larger-breasted women) but may not feel good to the nipple.  My nipples didn’t stop being hyper-sensitive until about two months after the surgery.

As far as lifting and heavy physical activity, I think we need to tune into our intuition.  Among other things, I am a massage therapist, and I was very wary of doing massage again because my right arm/hand is dominant and deeper work most definitely uses muscles in my chest!  The site of my incision is pretty much directly lateral to my right nipple, therefore it is a little lower than most of the pectoral muscles.  However it would most definitely impact the serratus anterior muscles which are involved with a pushing kind of motion.  I was also aware the lifting and pulling motions would impact my breast tissue.

This intuition was born out a few times recently.  I moved at the end of September and into the early part of October.  I tried not to do too much hugely heavy lifting, but I certainly lifted my share of boxes and smaller furniture.  I tried to remember to keep my arm close to my chest so as to not overly stress the chest and underarm muscles, but occasionally I would be caught up in doing things and would be less conscious.  In addition I moved to a place in the country and my landlord asked me to assist with the raking and some other activities that did put some stress on my arm/chest/breast area.   After these activities I started feeling more shooting pains in the underarm area, as well as fatigue/discomfort in various places in my breast.

Apparently any “shooting” or tingly intermittent pains are related to the regrowth of the nerves.  It’s called neuropathic pain.  It makes sense that there would be odd sensations during the regrowth and healing of nerves.  But again, couldn’t they have freakin’ warned me of this so it wouldn’t be a surprise?  What’s up with that???

Other aches in my underarm area I believe are more muscular in nature as my body adjusts to using muscles that I’d been resting for a few months.  I read about one woman who obtained a prescription for physical therapy.  She said the physical therapists were extremely helpful and knowledgeable and spent quality time with her answering questions and making suggestions.  So for any of you larger-breasted women who have physically active or strenuous lives (including things like looking after toddlers or working on a farm), you may want to ask about physical therapy.

All in all, I’d say I’m healing well.  The lumpectomy scar is lighter now and the hardness of the tissue underneath the scar has diminished significantly.  As far as my left breast (where they had removed a milk duct as well as the nodule inside it), the scar is barely noticeable, as the color of the areola disguises it perfectly.  There is a very slight indentation where the milk duct was removed, and the nipple lists ever so slightly toward the scar, but unless you were looking for it, I doubt you would notice these things.

I am really grateful to have had such a skilled and conscientious surgeon.  And once again, I am so grateful to have my breasts, scars and all.

And, oh yes, I’m glad also that I appear to be cancer-free.  Let’s not forget that!  I guess sometimes I’m afraid to count that chicken.  (Is that the right metaphor?)  I don’t want to let my guard down and become complacent.  But for now, oh am I grateful.  May I use this experience to get healthier and healthier and healthier.  There is a lot of life yet to be lived!

Be well, my friends.

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45-days Post-breast-surgery

15 Nov

The Breast Blog #17

October 13, 2011

It’s been one and a half months since my breast surgery and I thought I would update you on how things have been. The good news is that the anxiety has largely passed.  I now “believe” the pathology reports.  I believe that the lumpectomy was successful in removing the cancer in the right breast and that there is nothing cancerous in the left one. However, having said that, I must admit that once one has received a cancer diagnosis, I don’t think it’s completely possible to not worry about it a little bit.  Will it recur?  Will it manifest on the other side?

We don’t live in an environmentally pure world, and though my diet is vastly improved, it is not perfect.  There are yet risks.  However the fear has gone farther below the surface.  I can now focus on other things in my life.  I have more energy for more things than I once did.  I am ready to be more of service again and not so focused on my own navel (read: breasts, mortality, etc.)  This is a great relief.

My breasts feel much better now.  For several weeks I was unable to go for more than a half hour without a bra on.  I could feel the pulling (mostly on the internal stitches) and it felt physically uncomfortable and emotionally stressful worrying about whether or not I was impeding the healing.  I have been blessed with slightly larger breasts and I imagine my healing process is a tiny bit more involved than that of someone with a smaller cup size.

My surgeon had  told me not only would I need to wear a sports bra during the healing process but that it would be unwise for me to go without a bra ever.  This was somewhat distressing to hear as I had always found it uncomfortable to wear a bra during all my waking hours.  Many is the day that when I got home from work one of the first things I would do is take off my bra.  For larger breasted women, NOT wearing a bra all day is not comfortable, but wearing one all day is not comfortable either!  So imagine wearing one 24 hours a day!  Ick!

Recently I passed a milestone.  I was able to go all night without a bra on.  YEA!!!!  Freedom!!!

The first night with my lover sans bra, I could feel his delight in having the opportunity to once again “look and touch.”  We had had to be so careful for so long.  It was so wonderful to not feel so fragile.  It was so wonderful to be touched again.  He had been so reluctant to touch my breasts before because he was afraid he’d hurt me.  And I’d also been afraid of feeling pain because my breasts were truly super sensitive for a while.  I was also afraid of causing distress to my healing tissues.  Truthfully the latter worry has still not disappeared.

As we were lying there together, I felt myself welling up with gratitude that I still had breasts at all.  I truly had not wanted to lose them.  I love being a woman.  And I really was and am fond of my breasts.  My breasts are one part of this changed and changing middle-aged body that I am not embarrassed about.  As I let myself feel the emotion of gratitude for still being a breasted woman, I began to feel great sadness for all the women who lose their breasts due to breast cancer.

During this tearful episode of gratitude, I had a startling image come to my mind of a great crowd of women without breasts, or perhaps with only one, and off to the side I saw this big trash heap filled with discarded breasts.  What a disturbing painting that would be.  I know women choose mastectomies in order to increase their longevity on the planet.  Given the choice of living without breasts or not living at all, almost everyone would choose the former, right?  However, isn’t it sad that this is necessary?  Can you even begin to imagine the loss these women feel?  This culture equates breasts with physical beauty and sexual attractiveness.  Imagine what a struggle it must be to continue to feel attractive without breasts.  Imagine also if the option of breastfeeding a newborn were no longer an option.  (This is, after all, what breasts are really for.)

Of course many women choose to get implants, and thankfully insurance now covers this. But that has its own share of problems and emotional and physical adjustments as many women who have had reconstruction will tell you.

One dear girlfriend had a double mastectomy a few years ago.  She now has gorgeous looking pert round model-like breasts, but she said her husband doesn’t even touch her breasts anymore.  Her breasts feel cold and lifeless to him and there is no sensation to her so he figures what’s the point?  She said her breasts often feel disconnected from the rest of her body. Without someone to touch them, there is little opportunity to help incorporate them.  (“Incorporate” means literally “bring into the body.”)  As her massage therapist as well as her friend, she has asked me to please touch them/include them in the massage and help to integrate them energetically with the rest of her body.  (I have never before or since touched a woman’s breasts so much!)

Anyway, suffice it to say I am MORE than grateful to still have my breasts, scars and all.  As one social worker friend said, those scars mark me as a warrior.  I have, thus far, survived the battle against breast cancer.  I guess I am now a veteran of this war.  But it’s not a fight that will ever truly be over.  It’s not a war from which one can retire or go AWOL.  One must remain continually vigilant.

And for those of you who are reading this now who have been blessedly healthy and free from cancer, please don’t become complacent.  Do everything at your disposal to live a healthy lifestyle.  Each person I can help to get well or keep well will make this a worthwhile experience.  (And actually, it already has been worthwhile in many, many ways.  As are most of the experiences in my life.)

Be well, everyone!  Be vibrantly exuberantly WELL!!!!  Celebrate each day!  Life is good!

GOOD NEWS!!!!!!

29 Aug

August 29, 2011

The Breast Blog #15

I HAVE GOOD NEWS!!!!!!!!

I called the doctor’s office on Friday and they still didn’t have the Pathology report.  I called again today and someone called back.  My heart was in my throat until I heard the words, “We have good news for you.”  (They must love saying those words.)    Apparently the “margins are clear” on the right, which I believe means there are no cancer cells left following the lumpectomy.  And on the left breast, the nodule was diagnosed as a papilloma, a benign condition.

I cannot express the relief I feel.  After that call, I felt immediately so much lighter.  I had thought I was, by and large, doing okay with everything.  I really thought I was handling things.  But when I compare how I felt this afternoon to how I’ve been feeling the last three months, I can tell you, it is clear now I was carrying a huge weight for these last few months.

I gave the news to a few of the more significant people in my life.  The first several times, I spoke the words, I cried.  I cried more sharing this good news than I did sharing the scary news!  Tears of relief and joy.

How do I adequately express my joy and gratitude????  Picture me doing a HAPPY HAPPY HAPPY HAPPY DANCE!  Picture me giving each of you who has prayed for me, sent me love, sent me Reiki, or given me any kind of healing session or comfort or food or money or any kind of kindness, being hugged with the most heartfelt of hugs.

You all have been my gift.  There have been many gifts, actually, but feeling your kindness and love, and getting back in communication with friends I haven’t seen or talked to in a long time, has been an enormous blessing.

I only received that short summary from one of the office people.  I don’t really know a lot of details.  I’m really curious to read the actual report.  To be honest, I’m kind of curious if the papilloma/nodule shrunk a bit from when it was first discovered.  So many prayers were sent on my behalf that I can’t help thinking SOMETHING changed as a result.

Well, I certainly have changed.   I know that I will be a significantly healthier person as a result of this.  I have already changed my diet in a good direction.  I have learned a lot – on both a medical and metaphysical level.  I have certainly processed a lot of emotions.  I hope to never take life for granted again, but I know that it’s hard to retain this level of euphoria and commitment over the long haul.  Let me just say I pray I will be very conscious of my choices from now on.  Life is indeed sacred.

I have a follow-up appointment with the surgeon on Thursday.  I’m sure I will learn more and have more to report after that.

Meanwhile, all I can say is THANK YOU.   Thank you, thank you, thank you.  And thank You, thank You, thank You, Mother/Father God.

Blessed be, one and all.

The Lumpectomy

26 Aug

The Breast Blog #13

August 24 and 25, 2011

Truth time.

So the truth is, in spite of all my loving and supportive friends, I am feeling a bit lonely.  The truth is that even though I “need” to worry about income, I don’t have a lot of energy for anything that “mundane” at the moment.  The truth is I feel a bit sad when I look at the scars on my breasts.  I know I’m lucky that I still have them.  And I still feel a bit sad.

The truth is I’m sleeping a lot.  The truth is I’m watching more movies than usual.  The truth is I’m “tuning out” a lot.  I find I don’t want to talk very much and I’m finding it increasingly hard to listen.  I’m sure all this will pass, but it’s where I am at this time.

The truth is I hate wearing a sports bra 24 hours a day.  I know I need the support while I’m healing (and yes, I caught the double meaning of those words as I wrote them) but I don’t like feeling continuously smushed.  (I am rebelling right now.  I’m giving my breasts a literal breather for a few minutes.)

The truth is I’ve been eating a vegetarian diet since my diagnosis, and generally I’ve been feeling better as a result of that change.  And boy, some ice cream would taste good about now!!! (Maybe I’ll get some Tofutti.  I need to do another shopping trip.)

The truth is I’m worried that my left nipple area is warm to the touch.  It could mean it’s “only” an infection or that it’s healing from the surgery.  But I thought I noticed warmth there before the surgery.  (My lover confirmed it.)  What does this mean?  I must remember to mention it to the doctor.  (Oh dear.  I just looked it up and found this: “A breast that always feels warm, sometimes hot to the touch is a symptom of inflammatory breast cancer, a dangerous and rare type of the disease.”) http://cancer.about.com/od/breastcancer/p/6symptoms.htm

The bad news is that inflammatory breast cancer is aggressive.  The good news is that I don’t seem to have any of the other symptoms.  I think I will choose not to do too much more research on it at the moment as it will just cause worry.  Tomorrow the results from the biopsy should be in and I can find out what’s going on for real.

Okay.  I am going to change gears now.  I want to tell you about the surgery so that I can document the process.  If I don’t write this stuff down, I’ll forget it.  And you won’t learn anything.   (I want to warn you that this may be a more boring entry than usual.  My heart’s not really into it, but I’m doing it anyway.)

Monday was the day I had bilateral surgery.  For those who are late to the party: a lumpectomy was performed on my right breast and an excisional biopsy of a dilated milk duct and small nodule was performed on my left breast.

A dear friend drove me to the hospital and sat with me as I got my first ever IV.  The nurses and technicians I met before the surgery were all great.  My surgeon came in to give me a hug and answer a few questions.  (Where would the incision be?  How long would it be?  Would I have a drain?  Will they know anything right then and if so, will they do any more aggressive removing of tissue while I’m under anesthesia?)  (Answers: Right breast – incision curved and kind of near the armpit – two to three inches long.  Left breast – incision along the edge of the areola.  No drain.  No, they won’t know anything until pathology examines the tissue samples.  We’ll have results in about four days.  And no, I had already signed a form saying I was not agreeing to a mastectomy at this time.)

As I was being wheeled on a stretcher to the OR, my doctor came to help guide us down the hall.  She introduced me to the OR nurses.  When I was in place, she guided me in a visualization of somewhere I wanted to be (I chose St. John’s) and then did some Reiki on me.  (Wish all doctors did this.)  Then the anesthesia was administered.

The next thing I remember is being extremely disoriented.  I was waking up and I couldn’t figure out where I was.  It felt surreal.  (It was very much like coming to after the first and only time I ever fainted, after a small motorcycle spill.)  The nurse who came to me at that point was very nice and attentive.  After a few short minutes, I was taken from the recovery room to the room I had been in originally.

Apparently I’d been in the OR for about two hours and in the recovery room for about two hours.

To be honest, from this point on, I felt disappointed in the care.  I felt like they were rushing to get me out of there.  I didn’t feel ready.  I was still feeling very groggy and tired.  The nurse assigned to me at this point was definitely not as compassionate or attentive as the others had been.  She gave me discharge instructions while I was not yet very alert.  I was brought something to drink and some crackers.  I had NO interest in eating.

Because the anesthesiologist had told me prior to surgery that I could get pain meds afterwards and that I shouldn’t hesitate if I felt the need, I did realize I was in discomfort and I asked.  (I had not been asked about my level of pain by the nurse.)  The surgeon had prescribed Dilaudid, and so I was given my first ever heavy-duty drug.  (I don’t take any prescription medicines.  I usually stay away from them.)

The nurse removed my IV and I was told to get dressed.  My friend returned to sit with me.  Shortly thereafter he was instructed to go get the car.  Right about when they brought me a wheelchair so I could be discharged, I developed extreme shivering and chattering of the teeth.  I asked if this was normal and was told it was probably a side effect of the anesthesia.  It was alarming to me, but no one else seemed concerned.

Before being wheeled to the car I said I better go to the restroom, as it was at least a 45-minute drive to my house.  The nurse pointed the restroom out to me but did not accompany me.  I thought that was unwise on their part.  I did not feel that steady on my feet.  They needed to wheel me out but could not take the time to be sure I could walk safely before sending me off to the bathroom?  I thought they were nuts.  I was disappointed in them.

I returned to the wheelchair.  My teeth continued to chatter all the way down to the car and for the next several minutes.  On the drive home, my friend was alarmed by how cold I felt.  It sure would have been nice to have someone be a bit more reassuring.  It sure would have been nice to have someone say, ‘This is perfectly normal.  It will pass.  You don’t have to worry.’  It would have been nice to have someone say, ‘If you have any questions or concerns, please call.  Don’t forget to take it easy and rest well.  Best wishes to you.’

I slept in the car.  We stopped at a drug store to get more pain meds, an expense I neglected to anticipate.  Fortunately there is a generic substitute – hydromorphone.  By 4:00 I was home and went immediately to bed and fell immediately to sleep.  By about 6pm, I was awake enough to very briefly and groggily call my parents and one other friend.  I took another dose of the medication, applied ice packs and fell back asleep for another three hours or so.  I realized my sister had called and I briefly called her to tell her my status.  Then I slept for the rest of the night – zonked out, only waking to go to the bathroom and take my third dose of pain medicine.

I was wearing a surgical bra, which they’d apparently placed on me after the surgery.  It’s a bit like a combo sports bra/corset/straight jacket.  It provides support, but it also like being constantly smushed in multiple directions – not as bad as a mammogram, but definitely not pleasant.  It was NOT comfortable to wear while lying in bed.  If I hadn’t had the hydromorphone, I would have been much more uncomfortable.  But that drug basically knocked me out.  As soon as I would lie back on the bed, I would be in another zone.

By 9:00 the next morning, I felt really good.  I was surprised how good I felt.  It is miraculous how much rest can help!  I’m sure the ice packs helped as well.  I was still uncomfortable, but I wasn’t in serious pain.   It also really helped to have a companion with me, to have someone caring in such a tangible physical way. It was also a good distraction.

I spent the next day sitting outside on a rocker, drinking fluids (including pineapple juice, which has bromelain and works to reduce swelling), making a couple calls when I felt like it, napping (taking one more dose of medication), icing my breasts, and – because it was such a stunning day, lying outside on a blanket under the trees.  It was a wonderful day, actually.  By 4:00, I was ready for my first meal.  We made a wonderful salad – with lots of veggies, hard-boiled free range eggs, and toasted almonds, and I had some leftover fried zucchini sticks.  (Yeah, I know that wasn’t the healthiest of choices, but at least it was vegetarian.)

I do feel better each day, physically, and I am also definitely feeling a bit withdrawn and lackluster.  I could probably use some more distraction.  Does anyone want to take me out to a movie or for lunch or something???

And there you have it.  You are now officially updated.  Tomorrow hopefully I will hear from the doctor.  I will keep you posted.

May you be blessed.