Tuesday, March 2, 2010

REMOVE THE OLD - INFLATE THE NEW

Men -- you've got it easy!!

I am fast learning what the words "determination" and "perseverence" really mean. As I progress through my unexpected encounter with breast cancer, I have acquired a profound respect for those who have traveled the road to recovery before me. Without determination to get it over and stay healthy in mind at the end, and without perseverance in achieving that goal, the journey would be nearly impossible.

On February 3, 2010, I woke at 5 a.m., showered, and readied myself for the ten minute ride to West Hills Hospital. My cousin Susan has been my chauffeur for these many early morning trips to WHH. I was directed to my room on the 6th floor, where I waited for the trip down to the operating room. At 7:30, I took that ride on the OR gurney, and was placed in the OR "hold" area until my surgeons and anesthesiologist arrived. I had become very familiar with that "hold" area over the past several months -- this was my 6th surgery since July 2009!

I had a great team - one general/oncological surgeon (who had been there with me for the 3 lumpectomies), two plastic surgeons (brothers who operate in tandem - one boob each), and a wonderful anesthesiologist who had been with me on two prior surgeries. Each of them greeted me, tried to make me feel at ease - fat chance! - and then the circus started. The general surgeon performed a double mastectomy, assisted by the two reconstructive surgeons -- first he removed the breast tissue in one breast, assisted by one of the plastic surgeons, and then he moved to the other, assisted by the other brother. While they were carving up breast #2, the first PS started reconstruction work on the first breast. The two surgeons working on the 2nd breast then switched roles, and started reconstruction. That included insertion of a silcone "spacer" with a port, which would eventually be filled, periodically over several weeks, with saline to expand the muscle and skin until I was as "big as I wanted to be". Oh Joy!!

I am lucky because my cousin Roger is on staff at WHH -- I am known as "Dr. Amerian's cousin" at the facility - that entitled me to incredibly supportive "VIP" treatment in every respect. After 5 hours of surgery, and some unknown period of time in recovery (I'm told it was around 2 hours or more) I was rolled back to my room -- which was a semi-private room. I was very lucky that I had the room to myself for what turned out to be an extended stay.

Take my word for it -- having a double M is not fun. But, by Friday morning I was beginning to feel a little better - thanks to a self-directed morphine pain pump, regular pain IV shots, and an automatic pain med pump in the incision areas. But, I don't do anything the easy way -- nope, not I!

Friday I learned that the doctors (all three of them) were not happy with the way the skin looked around the sutures. Necrosis (dying tissue) was setting in thanks to poor circulation. At 4 that afternoon, one of the brothers called me and told me that the surgeons had all agreed that I had to return to the OR and have a 2nd surgery to remove the dying tissue. My alternative was to "wait and see" and most likely come back in a week for another surgery. No way -- I'm there, let's get it done. Of course, that meant trying to get one of my preferred anesthesiologists, and beefing up my resistance for the next surgery. Needless to say, I was not a happy camper.

But, the team came through for me. My anesthesiologist of choice cancelled plans for Saturday and came in for me; the surgeons were there too. And, there I went again, at 9:30 a.m. Saturday, into the operating room, for what turned out to be another 5-hour long surgery. Without going into gory details -- this one involved turning me onto my stomach (thank goodness they did that while I was OUT!!), taking muscle, skin and fat from both sides of my upper back, rolling me onto my back, and grafting that tissue to create two new breasts.

I can honestly say - that second surgery was the "bar exam" of this entire battle -- I woke up in recovery and eventually back in my room feeling like I had a fully inflated inner tube around my upper torso. And, three weeks later, it feels the same!!

Three more days in the hospital, and then I was released to recuperate at my mom and dad's house for the next 10 days. How lucky I was to have my parents there for me, even while Dad was going through his own medical challenges. A few days later, both brothers and my niece Melia joined the crowd, and we spent President's Day weekend as a family. I think this was the first time in at least 25 years that we were all back together as a family in the home we grew up in.

The highlight of that weekend was a duplicate treat -- Dad turned 88 years old, an event we celebrated with a nice dinner and a great chocolate cake! And, Dad's 800+ page book on the history of the Armenian Patriarchate of Jerusalem - 10 years in the making -- was finished and he received the first copy on that Friday. That was a fantastic afternoon - he was so excited!

The birthday kids!


Dad and his publisher, Nahabed

The fog of cumulative anesthesia wore off early the following week. I was able to convince my mom to let me return to my home by mid-week, promising that I wouldn't do anything strenous. Fat chance -- I was lucky to be able to get out of bed and walk to and from the kitchen!

The next few weeks were tough -- lots of pain and swelling, 5 drains that needed measuring and emptying twice a day, extraordinary fatigue, too much TV, lots of sleep, no exercise, and prayers that this torture would eventually go away! Truly -- NOT FUN.

But, I have now passed the 3 week mark, the pain is easing up, the inner tube is still there, I have more stamina (appetite was never an issue), and my surgeons have promised that by 6 weeks I will feel A LOT better. I'm holding them to that promise. And, of course, it will be temporary, because in May or June I'm back in the OR for surgery #7, to replace the spacers with permanent implants. That happens after the spacers are filled up to stretch the muscle under which they are now inserted.

A year from now, all of this will be a memory -- I'll have two beautiful, symmetrical artificial breasts - or so I'm told - and I will be cancer free. That's the pot of gold at the end of the rainbow.

For now, it's one day at a time. Hour by hour, day by day ... just keep focusing on the prize.

And, as a preview of the prize -- my hair started growing back while I was in the hospital. I still look like a partially bald porcupine, but my hair is coming back - black, white, straight, curly -- it really doesn't matter what it looks like -- it's hair! Wahoo!!!!