Thursday, April 26, 2012

Buyer's Remorse, or 2% Rule

Photo by Cindy R.

This is a photo of the beautiful Spring Flowers that were naturally on display at the Hell's Hill's Trail Run at Rocky Hill Ranch on Saturday, April 7th.  Funny how that seems SO long ago now, despite it being less than 3 weeks passing.  I was fortunate enough to be able to squeeze in this one last trail race in before my Reconstruction Surgery.  I had a great day overall.  It was a beautiful day, as you can see, less humid than expected, which is great for me, and what a great time I had with my friend Cindy who took me out there and ran her FIRST trail race ever!! Yay Cindy!! We both ran the 25k race.  I took out easy, then picked it up about mile 3.  I was flying from mile 3 until about mile 6 when I fell down FAST and HARD.   It was quite a jolt that banged both my knees up pretty good.  It took me a few minutes to that get back on my feet and moving.  I did get moving again, but never re-gained the previous "high" I had been feeling.  Oh well, it was a beautiful day and I was actually enjoying a trail I had previously disliked.  I ended up 13th female of 79, and would have been 1st in my age group of 40-45 had this race had that as category. I was happy with this outcome overall.  I was later inspired by finding out that my running friend, Jeanette, from my trail group (Tejas Trails) who is 47 years old and who fought and beat colon cancer with 2 years with Chemo and Multiple surgeries, had re-gained the running "speed"  that she had professed to have lossed due to cancer treatment, and beat me for the 12th place finish!! (1st in her age category, as well 45-50).  I couldn't be more proud,  or more inspired, to have been beaten by anyone else!  You know this gives me hope for full recovery and continued gains in running with age, and despite Cancer.
  Thanks Jeanette for being so Awesome and such and inspiration!

After the race, I had 4 days to prepare for surgery.  The days blew by.  I got in one last 8 mile Tuesday Morning run and coffee with some good friends, then a day of mental and household preparation for being in the hospital for 4 days and being basically out of comission for 2-3 weeks. 

Then, suddenly, it was Thursday, April 12th and my alarm was ringing at 4:30.
Richie drove me to the hospital.  There was a small amount of surgical prep, then I was being wheeled down the hall on a stretcher. Even though I was actually more afraid of fatal mistakes during this surgery than with either of my C-sections, or my last Mastectomy, I was comparatively calm.  Usually in situations such as these, my body begins to involuntarily shake.  This time there was an unexpected calm.  Possibly a denial, even.   Then the next thing I knew I was struggling to wake up.  With one eye open, I could see that I was in the recovery room, and yes,  I asked what time it was. 4:40 pm.  Wow, pretty much the time they had told me I would be out.  When I woke up a bit more, I was in the Intermediate Care room in a bed and looked up and saw my mother.  She had driven down that day, so I was glad to see that she had made it.  I saw Richie and was glad to see him too.  I also took note at that point that I WAS alive, and I felt good about that. I remember looking down at my chest, and seeing 2 breasts.  I kept forgetting that I had looked,  thinking it was a dream, and kept re-checking.  I remember making note that one seemed a bit larger than the other.   That night basically went downhill for me from there.  I remember asking the new nurse at the shift change if she had ever cared for someone with my diagnosis and she said she had not.  OMG.  Not a good answer for me.  The anxiety rose, as did my confusion with the pain meds and anesthesia on board.  I felt very stiff all over, and my left arm hurt all over.  Even now, days later, there is severe bruising on the anterior and lateral wrist and knots in the superior medial aspect of the cubital fossa,  (the bend of my left elbow.)  What they explained to me at the time was that they had tried multiple times to place an  Arterial Line on my left wrist and failed.  (There are still 8 visible holes in one area and 2 in another).  Obviously no expert available.  Have You seen the veins/arteries in my arms?  It seems that one could not miss. Anyway, no arterial line.  This arterial line was supposed to be intended to take blood pressure measurements throughout the suregery without having to use a blood pressure cuff.  They did however manage to place 2 IVs.  One on the back side of my left hand and one in the lateral side of my left cubital fossa.  There existed an obvious IV botch attempt on my medial elbow that was painful and knotted up.   So then the rest of the night they were taking my blood pressure on this painful left arm, initially evere 15 minutes, then every 30 minutes.  The cuff was being left on my arm and it felt too tight, so I began to remove it.  This caused a problem with my nurse who kept explaining that the BP was on an automatic machine and it needed to remain in place.  Well, in my mind, she was not the one who would have to deal with a life of Upper Extremety Lymphedema due to repeatedly restricting flow in an arm that was battered and had just had a mastectomy which included one lymph node removal (this was not planned....apparently it was too closely involved with the breast tissue to leave it.)  Needless to say, I was not getting along well with this nurse.  Then after the blood pressure cuff argument, she came in and drew blood from this same poor left might be asking why the poor left arm again...? well, it's because my right arm is not supposed to be pricked or squeezed due to having had 2/3 of my lymph nodes removed in the last surgery (R mastectomy with Stage II lymph node removal). This blood draw which included a tight rubber band around my upper arm was extremely painful... About 30 minutes later the nurse came back in and informed me that "I know you are not going to like this, but, I am going to have to do another blood draw because your Hemoglobin and Hematocrit levels are in the 'Critical' range at 5.2.   A  blood count this low could indicate internal bleeding."  She encouraged me not to get too worried because the test was probably thrown off due to taking blood from the left arm which was currently getting Saline.  She turned off the saline IV and said she'd re-take the blood in 2 minutes.  This freaked me out.  I could not understand why we would re-take the blood from the same arm that had potentially just diluted the last lab.  So we got in another sort of spat when I asked her to take the blood from my foot.  She said she'd rather do the arm because the foot is often painful.  Really? I'd been complaining all night about how much pain my left arm was in, so that argument did not make sense.  Anyway, she ended up taking the blood from the foot, and it was relatively not painful.  The labs came back at 8.9. Low, but not critical.  Indicative of having just had a surgery like the one I'd had.  During these "horrific" overnight hours, I do remember thinking that this is the stupidest thing I've ever done.  Why would I have subject myself to something this dangerous, potentially life threatening, and this painful.  Why would I put my family out, and put my life on "hold" for 2-3 months?

The morning finally came and with it a bit less confusion, and my buddy Ned.  ( Plastic Surgeon ). I told Ned about my night and he agreed that we could have taken BPs from my leg.  I mentioned my doubts and we discussed what his P.A, Jenn,  had earlier termed my "Buyer's Remorse".  He agreed that this was a very common feeling, and that I will likely feel differently in 3 months.  He said that my abdomen would be extremely tight, and I would have difficulty standing up straight because they basically had to fold me in half in order to get enought skin and fat to build the breast.  (He wasn't kidding).   Here is a link to some post op photos of a Bilateral DIEP procedure.  Please do not link to it if  you have ANY psychological issues at all, or if there are children present.   And if you do look, please understand that this is not the finished product. There are 3 small steps left.

  DIEP: Deep Inferior Epigastric Perforator Flap

That first day I had a good appetite and was eating well.  The second night was not that great physically, with one medication error on my part leading to some severe pain, mostly in the abdomen.  It was Extremely Tight and painful.  I remember at one point Richie saying that I needed to "Power" through this, which did help because, this, as you might expect, is one of my favorite sayings.  With the 3rd night came the Nausea and Vomiting.  Pain is bad.  Nausea might very well be worse.  The next day, was followed by more nausea and severe fatigue.  I had a few good hours in the morning when they reminded me to use the Dilauded pump, and got to take a shower.   Then, the pump was Discharged, and within a few hours I was back to nausea and vomiting.  The rest of that day, I was basically gorked out with Richie sitting there petting my leg.  After a few hours of that, I remember him shoving a Schlotsky's Turkey Original no Mayo,  no Onion, Sandwich into my mouth, and I chewed and chewed, and then felt slightly better! Yay Richie!

I mostly slept thru the third night and most of Monday morning.  I remember the nurses being concerned that I might not be able to go home due to how tired I looked.  I told them I could make it home in the afternoon, but just needed to rest in the morning. 

I made it home on Monday around 1:00 and took 2 naps in my rental recliner :) (Thanks Mom and Derek).  By the time Ace got home from school, I was able to rally and sit outside with him and the neighbor kids.  What a beautiful day!

Since I've been home, I've been doing a LOT of resting.  Managing my recovery, working on getting things moving....

It has been absolutely beautiful here.  Unseasonably cool and dry and Sunny!
Thanks Jenn for an awesome morning!
Beautiful Adaline

Things are going well overall.  I had my follow up appointment with the Plastic Surgeon this Monday, and I got all 4 drains taken out.  (There was one on each Breast and one on each hip near the ends of the huge abdominal incision).  This was a huge relief, and was then able to wear some more normal clothing.

Since I've been  home I've corresponded with a friend of mine who was having a  hysterectomy with ovarian removal for Ovarian Cancer on the SAME day as my surgery.  She told a mutual friend of ours that her doctor said that she should expect to feel 2% recovery each day.  WOW 2%! For some reason that just sounded really funny to me.  So, in 50 days, I should feel 100%.  Well, Maybe that is right.  Or maybe, 50 days, then 4 months of Marathon Training!  Yes, I said it....More to come on that!

Thank You to: Richie (even if it was included in...for sickness and in health) Mom and Derek, Jenn, and my neighbors (specifically Edy) for helping with the kids to allow me rest and recovery time. And...Thank You to all of my friends and family for well wishes, visits, flowers, dusters to last a lifetime, food/coffe deliveries, and more! 



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  2. Grrr! Stupid auto correct. Take two: I love that when I scroll through the surgery pics it ends up with a Disneyland map. It's been a wild ride for sure. I'm glad we're voluntary family!

  3. I can't even imagine. The drains alone are enough to keep me away. You have such a wonderful attitude. I hope you can keep it up and that you gain more than 2% each day!