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Thanks for the Mammaries

In the four weeks since surgery I've had some time to perfect my response to the question which has been foremost on the minds of others: "What's it like to be down one breast?" (in actuality, the question posed has been the safer, more tactful, "How are you?")

Although my response is sure to morph with time, I think it can best be summed up as follows:  Cancer got my breast, but it didn't get the breast of me.  Sure, my rogue breast took a hit for the rest of my body, but I am still here, I am still me, and I am still (in my own mind, anyway) a healthy woman in her late thirties.  Ok, very late thirties.  Oh, stop it! 

You may be surprised to learn that my grieving happened long ago, just prior to and around the time of diagnosis, when all of the initial breast changes had already occurred.  Since that time, I have simply accepted that the tumour was too big to allow the breast to be salvaged.  Removing the breast meant removing the tumour, which was jolly fine by me (and good riddance!).  Mastectomy was just the natural next step in my treatment. So no, I am not saddened by losing the physical breast, as I had already lost it*. 

*Note to self to look back at this post 6 months from now and see if this still rings true

Keeping a Breast of Ellen
In a recent post I mentioned some follow-up tests.  My pre-surgery MRI had a surprise in store for me, and it was not a cool new magnetic imaging sound.  The scan showed a small (5mm) lump in my right breast - the good one.  Although the radiologist felt it was likely fibroadenoma (benign tissue), I was advised to have a mammogram and ultrasound done to confirm.  During the ultrasound, the radiologist was unable to locate the lump at all.  I was told they could not biopsy it at this point because it was too small - there was literally nothing to aim for.  So I'm to have another MRI in 6 months time.  It will show that the lump is indeed benign and that I have nothing further to worry about*.

*Note to self to look back at this post 6 months from now and give cancer the bird

So I am happy to report that for the time being, I will be keeping a breast of Ellen!

Surgery Day
Jitters
I became quite nervous the night before surgery.  Oddly, it was the actual procedure I was worried about, not the end result.  I was most worried about the anaesthesia, which is so silly as it went really well and I had no adverse reaction.  I had to fast the night prior, and was asked to arrive at the hospital by 6:30am to prep for the 8am surgery.  It was murder not being allowed coffee at that ungodly hour, but I'd walked the halls of the Civic Hospital in the wee hours of the morn many a time when my preemie was in the NICU, so I felt oddly at home!   

Prepping
A superhero friend of mine met me there and stayed at the hospital all day.  What an amazing person she is.  I met with each member of the surgical team before we entered the OR.  One of the doctors wrote his initials (YL) on my left arm after confirming with me that it was indeed my left breast they were removing <insert nervous chuckle>.  I do think this is an excellent system they have going.  No waking up with a bandage on my right breast!  And had his middle initial been "S", I would have expected a nice little vial of perfume on my pillow when I got to my ward.  

Pain Management
I knew I would be offered an optional nerve block in addition to the general anaesthesia.  This involved a series of needle pricks in my back to block the sensation of pain following surgery.  After some research and consultation with a trusted source, I opted to take it.  The associated risks were no different than those of the surgery itself, and the benefits highly outweighed the risks.  It was the best decision I ever made.  I  woke up with no pain whatsoever.  I was urged to start taking the prescribed painkillers immediately but was reluctant as I felt so good.  I did accept one of the milder, non-narcotic variety the next morning to ward off any pain that might have set in once the nerve block wore off.  When I was discharged later that day, I took Tylenol out of moral obligation but soon abandoned it too once I realized how unnecessary it was. Amazingly, my mastectomy and axillary dissection were completely pain and narcotic-free.  

Drain
The only discomfort I ever felt was in relation to the drain that had been inserted to collect lymph fluid.  I had to wear this for 5 days, and it was not at all painful but more of a bother.  I had purchased a highly recommended "mastectomy camisole" which had fancy pockets to carry the drain bulb - a nice concept - however the pockets were a little higher than waist level and were velcroed to the inside vs. the outside of the camisole, making it rather uncomfortable to wear.  The camisole in fact was too snug to close while the original dressing was on, so I ditched it and used a tensor bandage instead.  This did the trick, you definitely want something snug on the first two days.  On day 5 when the drain was removed by the home care nurse, it felt unpleasant.  Again, not painful, but not pleasant.  My 5-yr old insisted on watching the removal, and stood wide-eyed, poised with his play stethoscope and a patch of gauze steri-stripped to his nose as a makeshift surgical mask.  This immediately put me at ease, and made me realize there is a reason I am going through this with young kids.  The minute the drain was removed I felt like me again. 

Comic Relief - The Natural Healer
Since then, my chest incision has been healing nicely and I now have an impressive 15cm scar from the mastectomy/axillary dissection.  Any inhibitions I had about showing my scar to my kids went right out the window when my 3-yr old daughter saw the scar and proclaimed, "Hey!  Where'd your breast go?", and proceeded to check around my shirt, it's pockets, etc, to see where it was hiding.  She thinks it's hilarious that it's gone and I like her attitude.    
Where'd your breast go, Mommy?
Let's get Physio!  
A friend of mine in the health field coined it best, I believe - "You have great protoplasm, Ellen!".  My recovery has been a breeze, and I was back to "normal duties" in about two weeks. In the absence of pain, I felt free to dive right in to my prescribed exercise regime  the moment I awoke in recovery (by exercise, I mean, stretches and other range of motion exercises).  Most worrisome to me was the risk of lymphedema (build up of lymph fluid causing swelling), so I have been diligent in carrying out my exercises three to four times per day.   

I attribute the ease of my recovery to the fact that I consulted a physiotherapist prior to surgery.  She explained the lymphatic system to me which helped me better understand the procedure and its effect on me.  Most importantly, she armed me with a bevy of anti-lymphedema exercises and walked me through them until I got them right.  She also took measurements of my arms and hands so we would have a baseline to gauge any suspected swelling. 

To say I was fortunate that my surgeon pointed me to a physiotherapist is an understatement.  Physio was not stressed during the pre-surgery info session I attended at the hospital, and there was certainly no talk about a pre-surgery physio consult (which I can't emphasize enough is so critical).  Somehow, yet again, I landed in the right hands at the right time.

On the right "Path"
Two weeks post surgery I met with my surgeon to review my pathology report, or "path".  It felt like parent-teacher interview night; I was slightly nervous and hopeful for a good review.  Well, I passed.  It was cancer all right!  I won't bore you with the minutiae, but I will tell you that chemo shrunk the tumour's cellularity by about 80-90% and my masterful surgeon was able to obtain clear margins.  Although this is commonplace with a mastectomy, it was surprising to me, given the sheer size of my original tumour (7cmx6cmx4cm).  It had occupied about 70% of my breast.  In the axillary, we knew I was node-positive going in, and boy was I!  I had 21 lymph nodes removed, of which 19 tested positive for cancer, despite having shrunk considerably too.  Needless to say, I was alarmed by these numbers and the threat of cancer potentially migrating through my lymphatic system.  Which brings us to treatment number three...

Radiate me, baby!
With chemo and surgery behind me, the next step in my treatment plan is radiation therapy.  The idea here is, well, burn, baby burn!  We want to radiate the heck out of the remaining tissue in case any cells were missed or have hitched a ride back to the site and set up camp.  I haven't yet attended my "radiation 101" class, but in a nutshell, a ginormous machine will irradiate my chest, axillary and clavicle (around the collarbone) for about 90 seconds.  The radiation itself is not supposed to hurt, and as this is a local treatment, I am not expected to experience any of the systemic side effects associated with chemo.  I will develop a sunburn-like sensation over the area which may or may not be painful/uncomfortable.  I'm guessing it will be, I mean, it's RADIATION, people!  On the plus side, I'm told that my olive complexion will be my saving grace, as I'm likely to heal more quickly. 

Radiation will be given daily (Monday-Friday) for 5 weeks, and I'm expected to start sometime in the next two weeks.  I was worried about Christmas, etc, but thankfully the radiation department is closed on Statutory holidays.  Bad news is I haven't yet convinced them that my 40th birthday should in fact be, a statutory holiday!   

Lingering chemo side effects
I have to close the chapter on the nail debate, i.e., "to chill or not to chill" with freezer booties/mitts during Taxotere infusion.  I may (gasp!) actually be leaning towards "chill".  I ended up keeping the booties on for the duration of the treatment, but frequently removed the mitts to sip my tea, have a snack, chat on the phone, etc.  Well my fingernails are now starting to change, whereas my toenails are intact.  I admit I'd been worried about the dreaded "falling off" but as it turns out, it is really no big deal.  New nails are growing in underneath and only the tips of the old nail peel off (for me anyway), so the change is almost unnoticeable.  I'm keeping my nails painted blue to conceal the white tips underneath (they look not unlike a bad French manicure) as they transition.  Once the nails have undergone the metamorphosis and regenerated, I paint them bubblegum pink.  Presently I am typing with 8 blue fingernails and 2 pink thumbnails.  It's the simple pleasures, remember?

Blessings Report:

Live Laugh Learn Ottawa
This month I attended my first meeting of Live Laugh Learn, a gathering of women under 40 who have been diagnosed with breast cancer.  It's hard to describe how I felt, but it was almost like discovering a new planet of old souls.  Most women were juggling treatment and raising a family, and many had been diagnosed during pregnancy or just following childbirth.  I knew I was not alone in this incredible adventure, but it was enlightening to see the faces of others who were handling it.  The icing on the cake was the event's guest speaker - my absolute favourite professor from University!  This woman had a profound effect on my life 20 years ago, and it was uncanny that she should be facilitating our discussion at my first meeting.  It was a magical evening.

Cleaning for a Reason

If we didn't have time for proper housecleaning when we had one child, then two children, then three children, then oops add cancer treatment, well, it had become a lost cause.  Then suddenly, galloping out in the distance, clad in crisp clean white and hoisting a mop in the air came Cleaning for a Reason, a nonprofit organization partnering with maid services to offer free professional house cleanings to women undergoing cancer treatment!  It took several months to get in on this in-demand service, but this week I finally received the wonderful news that we'd been offered 4 monthly cleanings, free of charge!  Hallelujah!  

Creating Community

My dream of creating community is coming true!  My page views are skyrocketing and the emails are slowly trickling in from amazing women everywhere.  I admit I am finding it challenging to correspond in a timely fashion, but am thrilled to be reaching out to so many.  Please keep writing!  My email address is in the right navigation bar. 

I love that my little blog is providing some much-needed comic relief to those walking in or about to walk in my shoes, and I am touched that you feel I am inspiring hope.  It is really an easy thing to come by, the trick is to not let it pass you by.  Hope is right in front of you if you reach out to it with an open heart and a firm grasp.  Acknowledge, then look past your fears to see what you want to see and where you want to be.  You will find you are already there.


Ellen

Comments

  1. I am the first to comment on this one...and I am honoured! El, having known you for for over 25 years you always make me smile. You are such a positive force, an amazing person and you are, hands-down, the most eloquent writer I have ever read. Like ever (Thank-you Taylor Swift). Thank-you for letting us all go through this with you by writing this phenomenal blog. PS ... I completely agree....40th birthdays should be statutory holidays! xxoo

    ReplyDelete
  2. My dear Ellen... I can't even tell you how honoured I am just to know you. You are so inspiring and I'm so awed by your strength. You are amazing and much loved by all. xo

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