Wednesday, September 25, 2013

Countdown To Surgery

Kevin accompanied me to the plastic surgeon's office this morning. The doctor was 45 minutes late, but I never get upset at him. He spent 30 minutes talking to and comforting Kevin after my last implant failure. He really cares and gives each patient all the time they need.  If he did that for Kevin, I always think that he could be doing that for someone else.  

When he did come in, he examined me and was VERY pleased with how much the skin has softened. He explained the TRAM flap procedure and told us of the other options, and that it was our choice, but he believed the tummy was the best place for donor tissue and I wouldn't need an implant at all. We agreed.  Kevin and I had already discussed it, so we didn't have to think very hard about it.

I had a laundry list of questions, which he answered carefully and attentively. The nurse should call me in the morning to schedule the surgery. It will be 4-6 weeks from now. Late October or early November. I'm a tiny bit nervous, but MAJORLY excited. Let's get this show on the road.  I'll be in the hospital for 2-3 days, and home from work for anywhere from 3-6 weeks, depending upon how I feel.

Sunday, September 22, 2013

Home

The doctor didn't even come by my room Saturday until around 5:00.  He said he was "on the fence" about letting me go home.  Kevin, the girls, and my buddy Brooke, had been in the room with me since before 11:00, and I know how much they all wanted me to go home.  I answered his questions and he agreed to let me go home with the condition that I see my primary care doctor within the first couple days of the week.

I didn't sleep worth a darn.  I think I'll try the recliner tonight.  The redness has gone down in my arm, but there is still a lot of heat in it.  He doubled the amount of Bactrim that I am to take.  Oh goodie.  Twice as much of the medicine that makes me feel crappy.  Oh well, if it works, it works.  I finally forced a can of soup down this afternoon, but even that didn't sound good.  I figured I should eat something before it comes time for the next dose.

I'll go back to work tomorrow and see how quickly I can get in to see our family doctor.  If I get a fever, the pain gets too much, or the redness grows, I am to go back to the ER.  *sigh*  I'm supposed to find out my surgery date this Wednesday, and I'm scared to death that this is going to delay reconstruction.  I sure hope not.

I had a little breakdown on the way to the store today.  I hate it when I do that.  Kevin doesn't know what to do and he wants to fix it.  I try not to feel defeated too often, but it hits me sometimes.  I was so naive last year.  I made it through chemo and radiation by telling myself, "By this time next year, it'll all be over."  Yeah right.

But we march on.  It will do me good to get to work and start taking some calls.  It's full-blown busy season, and it will be a great distraction.  I'd much rather be helping customers solve problems than to be dwelling on my own.

Thursday, September 19, 2013

Cellulitis Does NOT Mean You're Fat

After a couple of therapy treatments and faithfully wrapping my arm, I noticed a spot on the inside of my forearm, just above my wrist, that was hard under the skin.  When I saw my therapist on Tuesday, she said that it could possibly be cellulitis due to the hardness and the warmth, and told me that she didn't want to do the massage because it could push the infection out into my body.  She sent me upstairs to see my oncologist.

It was 7:00 am, so the nurse was the only one there.  She looked at it, told me she'd contact my doctor and then call me.  I went to work and waited until about 11:00 before calling to check in.  "Oh yeah" she said.  *sigh*  She said that the doctor wanted to have me start a double strength bactrim right away.  She told me she'd call it in.

After work, I stopped at WalMart to get it and they said nothing had been called in.  I drove home mad (doctor's office was closed by now.)  After I got home, I called the on-call line and immediately got a call back.  My doctor was on-call!  Yay!  She didn't sound happy that the nurse had dropped the ball, and told me she would call it in right then.  Now it involved a 30 mile round trip, but I got my medication.

Wednesday morning, the area was nearly twice the size.  That afternoon, I called back in.  The nurse called the doctor and she said to give the bactrim a couple of days to work, and to lay off the LE massage until next week.  Fine.

This morning, I decided to keep my appointment with the therapist, just so someone would look at it.  I got there, she unwrapped me and the area was larger still, and she was concerned about how warm my arm was.  She thought I should go upstairs again.  Same nurse was there.  I showed it to her and she said that she agreed it was worse and that she would talk to the doctor when she got there.  I went to work.

15 minutes into my day, the phone rang.  The nurse told me to go to the ER for IV antibiotics.  She told me to be prepared for the chance that they might admit me.  I hurried to tie up some loose ends at work and headed back to where I'd just left.  Kevin met me there and we waited.  And waited.  Finally they took me back, drew some blood, and hung a bag of fluids and a bag of antibiotic.  It was four hours later before they had a room available, but they did admit me.

I don't know how long I'll be here.  The were pretty vague.  I assume they'll want to see how the arm reacts to the antibiotics.  I am to get them every 12 hours.  I don't feel horrible, the nurses are sweet, and the food is good.  Things could always be worse.  I also get some cute visitors.


Thursday, September 5, 2013

The Beginning of LE Therapy

I had my first therapy session with the lymphedema specialist this morning at 7.  She explained a lot of things, and then did the massage.  She massages areas with all lymph nodes that she wants to get moving, and then my arm, trying to push the lymphatic fluids toward those working nodes.

After the 30 minutes of that (it will be 45 minutes during future appointments,) she started the process of wrapping my arm and showing me how to do it.  I have to do it alone, because Kevin is long gone to work before I wake up in the mornings.  Because of that, I unwrapped and re-wrapped it tonight, to make sure I could.  I made Monica take pictures for me so I could remember everything.  Wanna see?

First, I put on this sleeve.  It's a lot like what they put on you before wrapping you in an old-school cast: 


Then, I wrap this foam around me.  It's not tight, but it is beneficial in some way.  I don't remember how because that was 13 hours ago.  LOL


After that, I wrap my fingers in this thin gauze wrap.  She told me that it has to cross the back of my hand between each finger wrapping, and if it's done correctly, there will be nothing crossing on my palm.  I got it right!


After that, I take the first of three bandages and wrap my hand and wrist.  They look like ACE bandages, but they have different properties and push fluid out while keeping more fluid from building up.  I have to use tape to hold them in place, because the little clips that you use with an ACE could nick the skin, and that would be a problem.  For the rest of my life, I have to make sure that I don't get any injuries to that arm, because it will be prone to infection.


Finally, I use the other two (wider) bandages to go up my arm.  They have to be uncomfortably tight.  It doesn't hurt, but it's annoying as heck.  It's going to be 15 minutes added to my mornings, and it's going to be uncomfortable, and it's hard to type.  It's also not cancer.  I'm trying to get my attitude in check and stop whining.  


I can do this.  I did chemo, which made me crawl into bed at the end of each day (sometimes crying) and couldn't move until I left for work the next day.  I did radiation, which made my skin so raw that I had to wear special gel pads under my bra.  I had 3 surgeries in 3 months.  This is a wrapped arm.  Just a wrapped arm.  I've got this.

Wednesday, September 4, 2013

Lymphedema

Yup.  I have it.  I saw the LE therapist this afternoon, and start with her tomorrow morning at 7:00 am.  I'll see her on Tuesday and Thursday mornings for up to four weeks, depending upon how my body responds.  I found out that I am NOT guaranteed to wear a compression sleeve for life, but I'm also not guaranteed NOT to wear one.  That made me feel better, because I assumed that I would have to.

Each session will involve her doing a very gentle massage that moves the lymph fluid out of my arm and toward the remaining lymph nodes.  Some toward the opposite side and some down, toward my stomach/groin nodes.  It won't hurt and some people fall asleep.  Cool.  Then, I get wrapped.

There is a thin layer of foam that will be wrapped around my arm, and then a wrap that looks like an ACE, but works completely differently.  Instead of being immobilized, I am to use my arm as normal.  The wrap will help push the fluid out of my arm, and prevent fluid from building back up.  She warned me that it is hot, uncomfortable, and annoying.  She also said to remember that it is temporary.

If the best case scenario comes to pass, my body will respond favorably and the swelling will go down.  Then, I will get a compression sleeve.  How much I wear it, and how long I wear it, will be determined later.  I truly do feel better than I did before this appointment.

Oh, and I told Kevin that there was no need for him to go to this appointment.  I didn't need him there.  He met me there anyway, and it made a world of difference.  I was able to tell all the details of the past year and talk in depth about things without tearing up a single time.  Yup.  I need him there.  I have to stop arguing with him about that.

Monday, September 2, 2013

Labor Day Weekend

Labor day weekend was fun for some of us, and meant two full days of Kevin lying under a car in the heat.  Monica had brake issues and nothing went as planned when it came to fixing it.  When you don't live near an auto parts store, you realize how seldom you get everything you need in one trip.  We drove to Buckner four times.  *sigh*

Today, I took Natalie, Monica, and Monica's friend Cori to the mall.  Cori fits in so well with our clan.  We laughed and listened to music too loudly and made inappropriate jokes.  I was able to finally get Natalie some things for her birthday.  It seems she always has to wait.  August is often a difficult month for us for various reasons.  Broken down cars, for instance.

My arm swelled last Thursday and Friday.  It swelled alarmingly fast and wouldn't go down.  I called my oncologist who told me to call my plastic surgeon who told me to call my breast surgeon.  I made call after call as the hours ticked away toward a long weekend.  I finally got a plan from a nurse at 3:00 on Friday.  Go home, stay in the air, and go see Dr. Shook on Tuesday afternoon.  If it swelled more, I was to go to the ER.

I measured often and it has stayed the same all weekend.  It is one inch larger than my right arm in all three places that I measure.  It could be from being in a sling for so long (which is what we hope,) it could be cellulitis (dangerous but controllable by antibiotics,) or it could be lymphedema (Lordy I hope it's not lymphedema.)  I certainly am tired of new complications.

Tomorrow, we launch into super busy days of busy season.  It's been increasingly busy for the past couple of weeks, so the time is here.   No more long weekends or vacations for a while.  Unless you call medical leave a vacation, because I should be having surgery sometime in mid-October.  Somehow, I don't think that counts.  :)