October Update

                            WARNING:  THERE ARE GRAPHIC/NUDE POST-OP PHOTOS IN THIS POST.

Not much post-worthy happening around here but I wanted to touch-base with all of you and give you some photo updates.

It's October 10 and today is in the 60's...actually feels like Fall!!  Won't last but a few days, but we'll enjoy it today. :)

As far as surgical recovery goes, life is pretty okay.  I get a little frustrated sometimes with my decreased endurance and lack of upper body and abdominal strength.  I was working on a DIY project last week and could not have done it without my teenage son to do the heavy lifting.  I used to be able to do so much more in one day, but now I find myself tiring out and needing to take a break.  It's not all bad...I tend to push myself too hard to finish projects, but it is frustrating.   Everything takes time, I know, but having never had major surgery prior to this year, I never realized just how much its affects can linger.  I'm trying to learn to embrace the rest....easier said than done. 

Super excited to report that my final Phase 3 is scheduled!!  My micropigmentation procedure (aka tattoos) will be completed in my PS office by my nurse on Nov. 7th.  Yay!  This should be the last procedure on my breast reconstruction journey.  

As my new nipples/areolas have healed, I am even happier with them!  As promised, the nipples have gone down about 50% and are not as "noticeable" when I am not wearing a bra (not that I do that in public, but I could! ;) ).  To see them with color soon...it's like waiting for Christmas as a kid!  

New nipples built 2.5 months ago...all healed and scars fading.
Just waiting on tattoos for color!!

The breasts themselves are great! The fat grafting made all the difference in shaping for me and they are very symmetrical.  Most of the time, my foobs are soft and natural feeling. When I first wake up in the morning and sometimes after an active day, they will feel a little firm.  This goes away immediately with a quick massage.  Love that they are "perky" even without a bra....its been years since that was the case!! 

My incisions have all healed well and the scars are starting to fade.  I'm not very good about massaging them daily like I should, but I'm working on it.  Right now, I am alternating between Palmer's Cocoa Butter and Mederma Oil as recommended by my PS.  Just recently, I purchased the InviCible Scars cream (made by one of the MD's in my PS office).  I've heard great things about it, so we will see how it works and I'll let y'all know.  

The scars on my chest from the fat grafting in Phase 2 are not as red and noticeable....made me feel like I had the measles or chicken pox before!  :)

Fat grafting scars on chest at 2.5 months post-op

My original abdominal incision looks good...not fading as quickly as my breast incisions, but it is very smooth and flat.

DIEP Flap Abdominal Incision at 7.5 months post-op

My new flank incisions from Phase 2 surgery on 07/25 are a little different.  One is already quite flat and thin.  The other side is "indented" and "tighter"....can't figure out a better way to describe that.  Obviously, these scars are newer so it'll take them awhile to fade like the original.  

New right flank incision...smooth and flat already at 2.5 months post-op

I've gained weight since all of this began but I'm hoping that some of the indentation will smooth out with weight loss and scar massage.

New left flank incision...thin but a little "indented" at 2.5 months post-op

So, that's my update for today.  I've "met" quite a few ladies on this journey and have enjoyed chatting with several this month on Facebook. If you have questions or comments or just want to share your story, please comment below!  

Since October is officially Breast Cancer Awareness Month, please don't forget to do your self-exams and get your mammograms!!  I found this ad amusing:

Have a great week!

GettIn Back to Me: 3 Weeks Post Revision Update

Just a quick 3 minute update:

Checkin' Those Nipples! Two Week Post-op Visit

                                WARNING:  THERE ARE GRAPHIC/NUDE POST-OP PHOTOS IN THIS POST.

This afternoon was my two week post-op visit with my Plastic Surgery Nurse, C.  It was a quick appointment and easy.  C started by just asking about how my recovery had been going and if there were any issues.  Then, the good part....she took off all of that surgical tape from my incisions and removed those annoying little sutures in my chest!!

Remember, I had five of these little holes where he did the fat grafting?  Each one had sutures that were sticking out.  They were a little sore, they scratched if you rubbed past them, and you could see them sticking out through my clothes.  So happy she removed those sutures!  I was instructed to start massaging them this week with Cocoa Butter w/Vitamin E or scar cream to soften and flatten them.

There are a total of 5 "holes" from the fat grafting on my breasts.

Close-up of one of the fat-grafting sites

She also removed all of the sticky surgical tape from my breast incisions.  Again, she was impressed with the healing progress and I can start putting cream on those incisions by the weekend.  

Right abdomen at two weeks post-op Phase 2

Left abdomen at two weeks post-op Phase 2

Abdomen at two weeks post Phase 2 Revision Surgery

The nipples still have the dissolving sutures, so I am to avoid putting anything on them for now.  Hoping those dissolve over the next couple of weeks.  There are a couple of spots on my breast "lollipop" incisions that are thick and raised but I know with time and massage they will go down.  The cool thing is that I see the potential!  They look like breasts with real nipples and once the color tattoos are there....it's going to be something!

Right breast at two weeks post-nipple reconstruction

Left breast at two weeks post-nipple reconstruction

Until then, I must continue to wear the nursing pads (with holes cut out of the center) in my bra.

Each side of my bra has to have 3-4 nursing pads
with a hole cut out of the center in order to keep my
new nipples from being "smushed" down by my bra/clothing.

If you look at the above pics and the one below, you can see that the right breast doesn't really have any bruising, but the left is bruised all over.  It is a green-ish hue so that usually means its healing; however, C wants me to start massaging them both but focusing on the left breast.  She told me to keep an eye on it and let her know if it changes or gets firm....don't want it to turn into a hematoma!

My new breasts and nipples....
5 months post Bilateral Mastectomy w/Immediate DIEP Flap Reconstruction
and 2 weeks post-Nipple Reconstruction and Fat Grafting

Btw, they look huge in this pic but they really aren't that crazy looking in real life!  My nurse told me today that I am most assuredly a "full C" or even a "small D" now!!  That's crazy.  Before I had my son (and then got fat), I was a small B.  Prior to surgery, I was a big B....a C was loose.  I'm actually excited to go bra shopping when this heals!

C said that the liposuction areas will continue to be a little tender for awhile even though the bruising has faded.  The compression garment still needs to be worn 24/7 for another month.  C also commented on how nice the one I purchased was...and it is a lot more comfy than the one they gave me!  I highly recommend it if you are still looking. Since I have to wear it for another month, I stopped at Walmart and picked up another one on my way home for $19.98.

I can start sleeping on my sides again next week...woohoo!  I hate sleeping on my back.  And, being able to massage and put on the cream will make things softer and more comfy too.

Next up will be to get my tattoo session with my nurse scheduled for this Fall!  Insurance requires it to be three months from the last surgery so I'm hoping for end of October or early November!

I head back to work tomorrow and on that note....

My Tip for this Phase:

Those of you who have been following my Facebook updates know that I originally intended to return to work last week at 9 days post-op.  The truth was that I was NOT READY!  Physically, I was still tired by afternoon, still feeling queasy with too much exertion, and my brain was foggy.  As a NICU nurse, I felt unsafe returning to work in a fog.  Thankfully, I have an awesome workplace and understanding boss who had already sensed it and I was cleared to wait to return until tomorrow...which will be 15 days.  So, as a note to those of you making this decision now, go ahead and plan for two weeks!  Honestly, I was stressing myself out about it and was not sleeping.  As soon as I spoke with my boss and she said not to come in, I took a two hour nap!! And, I slept almost through the night that night for the first time since surgery!!  

We often put too much pressure on ourselves...at least I do.  So, I would recommend that you plan for more and if you feel okay at one week then go back early.  There is no sense in potentially extending your recovery because you pushed yourself too hard.

I've had the opportunity to chat with several women this month who reached out to me via FB and have enjoyed getting to know them all. If I can answer questions or you just need a sounding board, please feel free to message me any time!

Enjoy your week!

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.

01/20/17  Core Needle Biopsy

01/24/17  Biopsy results positive...Stage 0 DCIS, left breast

01/25/17  Meeting with Breast Center Navigator and Genetic Testing

01/30/17  Consultation with Surgical Oncologist, Dr. K

02/08/17  Consultation with Plastic Surgeon

02/21/17  Pre-op Visit with Dr. O's nurse

02/27/17 Pre-op Labs and Testing

03/05/17 Lymph Node Injection

03/06/17 SURGERY DAY!

03/10/17 Home!

03/16/17 10 day Post-op Visit with Plastic Surgery nurse
03/20/17  2 week Post-op Appointment with Surgical Oncologist, Dr. K

04/07/17  1 month Post-Op w/Plastic Surgeon, Dr. O

04/16/17 Returning to work!
05/19/17  Appointment with Dr. O to schedule Phase 2 Surgery!

07/13/17 Pre-op Visit with Dr. O's nurse; Pre-op Labs/EKG

07/25/17 Phase 2 Surgery!!

08/08/17  2 week Post-op Visit with Plastic Surgery Nurse

Got Nipples?? Phase 2 is done!

                             WARNING:  THERE ARE GRAPHIC/NUDE POST-OP PHOTOS IN THIS POST.

Yesterday was my Phase 2 surgery with my amazing Plastic Surgeon, Dr. O.  Not as much preparation needed for this one since it was outpatient and such a big difference in recovery.

My sweet son is such a trooper getting up at
0430 to go with me to the hospital!

I had to be at the hospital at 0530 with an 0730 start time....we pretty much started right on time.  The whole surgery took about 4 hours and I was home by 3pm.  Only negative was that I got nauseated and was vomiting from the anesthesia afterward....no fun!  I was still sick all evening off and on but finally took a phenergan and tried to sleep it off.  Thankfully, I woke up early this morning feeling more like myself again.  No nausea!

I am really not in pain, just very sore.  My breasts are tender, but the flanks and thighs where he did the liposuction for the fat grafting is where I feel the most discomfort.  As I am typing this, my flanks feel sore but not painful; however, it is quite painful to get up and down from sitting position.  Once I'm up, I can walk with only that sore feeling.

Since I was sick yesterday, I didn't really eat but a few bites.  Had a small breakfast this morning and so far so good.  Just dropped a pot roast in the crockpot for tonight.....definitely wasn't working in the kitchen after last surgery!

Let's get started!  Dr. O with me just before surgery.

He marked me up all over....secret language of Plastic Surgeons!

Now for the part y'all have been waiting for....the surgery and results!

Dr. O built my new nipples (3D nipples!) from the skin flaps from my abdomen that he placed during my initial reconstruction in March.  There are sutures all around the edges and on the nipples.  It looks rough today, but I am so VERY HAPPY with them!  My breasts look like breasts again!  

Look at that dimension!

Gnarly looking today, but once they heal and have the
color tattoo, they will be practically perfect!

He also did liposuction on my inner thighs and along both flanks....these are the sore areas today!  Dr. O said I will be bruised pretty badly all along there and even maybe the back of my legs.  The fat he got from there was used to "plump up" my breasts and give me the size and lift I needed.

Hard to get a good pic of my inner thigh, but the top right is the "hole"
from the lipo cannula.
Thighs are sore, but maybe I'll have a bit of a high gap after!!  :)

My abdominal incision looks great so he did not revise any of it.  He did however cut off the overhanging skin ("mini muffin tops" or "dog ears") from each end of the abdominal incision. Again, thrilled with the results there.  Even though I am swollen and look Sponge-Bob shaped again, you can tell it's going to be great once the swelling goes down.

Incisions on both sides where Dr. O removed my "dog ears".
Love not having that overhang!

 I woke up from surgery with the ugly surgical bra on and a tight compression garment that goes from just under my breasts to my calves.  That sucker is a beast to get on and off!  The spare one I bought only goes to my knees and seems to slide up easier.  I think both will be better to get in to when I'm less swollen and sore to the touch.

I am supposed to take Tylenol or Ibuprofen every 8 hours....which I probably will just to stay ahead of this soreness (don't want it to turn into pain).  I am also on an antibiotic every 8 hours.  Otherwise, my instructions were regular diet, light walking, and to sleep!!

Sounds like a Netflix day in bed is called for!

Look at the difference!  First photo was yesterday morning when I was getting
ready to head to the hospital. The second photo was this morning, less than 24 hours later!

All in all, I am thrilled with the outcome.  I love my new breasts...nipples make all the difference!

I asked my friends and family to send me pics of them wearing their #teamJules t-shirts yesterday while I was in surgery.  It was so fun to scroll thru my FB feed last night and see all of them!!  I have the best group of friends, co-workers, and family!

Have a blessed week!

Phase 2 Surgery: Pre-op Visit and Plans

Here we are in mid-July already!  Hard to believe how quickly this year is moving along.  A lot of days, I can almost forget that any of this breast cancer stuff has actually happened...then I'll roll over in bed and feel a pinch on the side of my breasts where the drains were or catch a glimpse of my incisions in the mirror.  The scars honestly don't bother me that much...battle scars aren't all bad.  However, I am most definitely ready for the nipple reconstruction portion.

Yesterday, I met with Dr. O's nurse, Crystal.  She went over all of the pre-op and post-op instructions for my upcoming Phase 2 surgery, sent in my prescriptions, gave me my lab orders, and scheduled my follow-up appointments.

Here's what I learned:

The scar revision portion is "as needed". Crystal explained that any areas where the abdominal incision scar might be wider than necessary, raised, or have hard spots is where Dr. O would target.  As I've shown y'all before, my abdominal incision has healed quite nicely so I'm not sure how much (if anything) he will do there.

The nipple reconstruction is pretty much exactly like the video I included in my previous post.  The new nipples will be large at first (in addition to swollen) because they anticipate them reducing in size by 50%!!  Wow!  I have read from a lot of women that over time their new nipples flattened out and were no longer 3D, so I asked my nurse about that. She said that this was very patient-specific and had to do with skin elasticity and health more than anything else.  A diabetic patient or a patient with lots of stretch marks on her breasts will have a harder time with the nipple reconstruction staying as intended.  Makes total sense since the new nipples are made out of the skin flaps that he placed during my Phase 1 procedures.  Since I do not have any issues with elasticity or healing, Crystal believes I should have great results.  

The fat grafting portion of the surgery is probably the biggest portion and the one that'll leave quite a bit of bruising and soreness.  Dr. O had told me that my thighs would be significantly sore.  He will liposuction my flanks and the abdominal area to remove those "dog ears" and smooth things out as needed.  What he takes from there and my thighs will then go toward building up some size and the overall shaping of my breasts.

Pre-op for this one is easy.  I only had to get two labs and an EKG (which I took care of yesterday after my office visit).  Dr. O wrote for an antibiotic for 1 week post-op (I picked it up yesterday too!)....I didn't have to take one for Phase 1 interestingly enough.  I am allowed to take Tramadol for pain if needed (but the pain meds make me nauseated, so I'll most likely skip this) or just Tylenol and Ibuprofen.  She also recommended having the Colace around again...constipation is pretty common after anesthesia and especially with the pain meds.  I also had the option of a script for an anti-nausea med....again, I think I took one pill last time, so I'm not worried about needing this.

I will wake-up in a bra similar to the one I had after the first surgery...not attractive but it does the job.  I will only wear it for 3 days this time!  At day 4, I can switch to the underwire-free bra of my choice lined with breast pads...like the ones used by breastfeeding moms.  Crystal instructed me to cut a hole in the center of the pads "like a bull's eye" and to stack 3-4 of them on my new nipples.  The goal is for there to be enough padding to keep my new nipples from being smashed by my bra. It was a little weird buying a box of these yesterday...haven't purchased any in 15 years!

I will also wake up in a compression garment. This one will go from just under my breast to my knees. My nurse recommended that I purchase a similar one (Flexees, Spanx, etc.) since I will wear it 24/7 for 4-6 weeks (Not to mention the fact that it'll be August in South Texas at that time!!).  She informed me that the one they provide is quite thick and VERY tight so most patients are more comfortable in a store-bought version.  I was able to find one like she described at Walmart yesterday for ~$20.

I liked the Flexees brand abdominal binder best after my last surgery too.  

I am not allowed to drive for 1 week and no lifting over 10lbs for 2 weeks.  Exercise is limited to walking. Unfortunately, it's back to showering with the water only on my back for about a month and no side or back sleeping for at least 3 weeks.  That will take some getting used to again!

Follow-up with the nurse at 2 weeks and with Dr. O at one month.  Crystal said that the stitches in the nipples will usually dissolve in 3-4 weeks.  Good news:  NO DRAINS with this surgery!!!  That's definitely a BONUS!

So, that's pretty much it. Obviously, all MDs do things a little differently, but this might give you a starting point for asking questions as you discuss your surgical plans.  

Y'all know I like to have a plan and the details so I can be prepared. Now that I've got that, I'm good to go. The only things left to do is a little housecleaning and grocery shopping next week. (I'm actually working Sunday and Monday before my Tuesday morning surgery so I won't have time to do anything the day before.)  Surgery is at 0730 (got to be there at 0530) and is outpatient so I should be home by late

 afternoon/evening.  

Any of you already been thru this Phase 2 and have advice? Please comment below and share.

Counting down....T-minus 11 days...

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.

01/20/17  Core Needle Biopsy

01/24/17  Biopsy results positive...Stage 0 DCIS, left breast

01/25/17  Meeting with Breast Center Navigator and Genetic Testing

01/30/17  Consultation with Surgical Oncologist, Dr. K

02/08/17  Consultation with Plastic Surgeon

02/21/17  Pre-op Visit with Dr. O's nurse

02/27/17 Pre-op Labs and Testing

03/05/17 Lymph Node Injection

03/06/17 SURGERY DAY!

03/10/17 Home!

03/16/17 10 day Post-op Visit with Plastic Surgery nurse
03/20/17  2 week Post-op Appointment with Surgical Oncologist, Dr. K

04/07/17  1 month Post-Op w/Plastic Surgeon, Dr. O

04/16/17 Returning to work!
05/19/17  Appointment with Dr. O to schedule Phase 2 Surgery!

07/13/17 Pre-op Visit with Dr. O's nurse; Pre-op Labs/EKG

07/25/17 Phase 2 Surgery!!