Discovery Health Channel starring ME!

You will all be certified medical students after reading this blog OR you will feel like you are watching the Discovery Health Channel :)

This first appointment with my plastic surgeon was highly anticipated because it isn't just a "check-up" on the surgery it is the first step in phase 2 of my reconstruction.  I also have a second cousin who is going through this exact same process but is about 3 weeks ahead of me.  So, having been in contact with her I knew that this first appointment was going to be painful... more pain... JOY! 

So, I went into battle prepared and on heavier doses of pain meds.  Three things were going to happen at this appointment: 1) Checking the wounds for proper healing, 2) Removal of 2 drain tubes, and 3) "Expansion"- the filling of my tissue expanders with saline which are preparing my body for implants in a few months.  The easy part: the wounds are healing fabulously and Duane got a high five from the staff for great wound care :) I also got the OK that 2 drains would be removed but she wanted to do the expansion first.  Oh, the expansion-- hang on folks this gets interesting!

I have a tissue expander on each side placed under my chest muscles. A tissue expander is a sack that they fill with saline to stretch out my muscles and such to prepare a place for the artificial implants to go.  There is a port on each expander and that is the "port of entry" where they can inject more saline into me.  How do they find this said port if it is IN my body you ask: there is a magnet in my expander and they place a magnet on my skin, find it, and mark it. It was very odd!  Anyway, then it is as painfully simple as sticking small needle into my chest and filling the internal sack with saline.  It is again very odd!  So I walked into my appointment at one size up top and walked out... bigger and feeling like at any moment my chest was going to cause me to fall flat on my face! A few word pictures would be: imagine carrying an anchor around your neck or walking around wearing one of those weighted vests like the super athletic people do when they workout.  That is how I now feel and it is quite an awful feeling.  My neck, upper back, and lower back are very mad at me!  And this is just the beginning-- expansion is a process and a painful process over several weeks until you get to a "size" that you are happy with. So I have a few weeks here that are apparently going to be quite dreadful all in the name of attempting to return a piece of my womanhood. However, the pain is starting to make me far LESS attached to my "womanhood"!

Now to the drain tubes part of the appointment which made Duane feel like he was watching a show on the Discovery Health Channel.  It was very, very odd!  As I have mentioned before the drain tubes drain the fluid that builds up in void that was created from the removal of my breast tissue.  I had 2 on each side of my body located just below my underarms.  When the drain tube isn't draining a significant amount of fluid any more they consider its job done and remove the tube.  I was very excited about this because I was getting tired of trying to keep Mason from pulling on my drain cords, tired of sitting on them, or getting them caught on something.  What a bother!  But the idea of them taking out something that is SEWN into my body in a NORMAL EXAM ROOM-- this isn't surgery people-- made me a little nervous.  So here is how it went down: she removed the protective tape over the drain site, made some sort of cut somewhere, and then told me that this next part was going to feel a little "weird".  I turned my head because I believe in "see no pain, feel no pain" but the look on Duane's face was priceless! She literally began to pull a tube out from my body... and kept pulling... and kept pulling! It was like the clown trick where they pull the handkerchiefs out of their mouths and then it just keeps coming out and keeps coming out.  When all was said and done she had pulled 8 INCHES of tubing from one side of my body.  Duane about lost his lunch! I mean how crazy is that?!  Another amazing part is the fact that the "wound site" where the tube was inserted into my body just closes itself... heals itself... it is like a minor cut! The human body is truly AMAZING-- can I get an AMEN? :)  Of course, the same thing had to be done on the other side and it was!

The appointment finished up with normal goodbyes and being told that they need me back on WEDNESDAY to do this all over again...

Photo Book

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Some days just aren't good...

So I promised that I would be open and honest with this blog. I am a naturally happy-go-lucky, optimistic person but today was not that kind of day. It was a low day... a very low day.  I suppose you have to blog about the good and the bad--so here it is.

I woke up this morning in an AWFUL mood! In a stay-out-of-my-way, can't-make-me-happy-so-don't-try kind of mood.  I'm sure none of you can believe that I would be in such a foul mood ;) I woke up in PAIN, lots of PAIN.  I had to make the transition late Monday to ween off of some of the heavy doses of prescription pain meds because my body was not waking up and I was not allowing it to "work properly"-- in other words apparently you have to have a bowel movement and I was going on a week with no action.  (Sorry to be so blunt but it is what it is!)  I was highly functioning on the pain meds-- holding coherent conversations, playing gently with the kids, walking around-- and some of you can attest to these activities so I felt that everything was going fine.  I could totally live like this: very minimal pain and a fairly active mommy! Life was good last week-- life is not so good on crappy, over-the-counter "pain" medication.  There wasn't a moment today that I didn't feel like I had just had surgery... not one! Aches, pains, soreness, tenderness, ouchy, ooooo, aaahhhh-- I HAD IT ALL! But mission accomplished: my body was working properly now--YAY (rolling eyes).  Of course, Duane had to hear about it all.

Then came the waterworks. Duane had just come home from dropping the kids off at a friend's house who we are nanny-sharing with this summer.  I am sleeping very well and had slept through the whole morning routine apparently so Duane was catching me up on everything while he was getting ready for work. As he was catching me up I thought scanning Facebook would get my mind off of the pain-- how brilliant am I... or NOT!  I begin reading post after post of people doing and taking and entertaining their kids at various places today and I lost it and had a 3-minute pity party.  I made myself so upset because I had elected to have this surgery, I chose this pain and discomfort and the result was I was spending VERY little time with my kids and had made myself completely useless this summer.  And while I know that they are off having so much fun with friends I couldn't shake the feeling of guilt. I was also jealous of Duane being able to go to work, get out of the house, and embrace the real world.  Bottom line was I was crying, mildly depressed, and in pain.  I'm sure that is a dangerous cocktail of emotions...

As I type this tonight I know that we all have to go through the valley, we all have to be in the dark so we can appreciate peaks of life and the light at the end.  And everything I feel is completely normal! Goodness, if having a body part removed through major surgery and reconstructed was SO AMAZING everyone would be signing up and that just doesn't seem to be the case-- LOL! Ironically on Sunday I listened to a sermon my pastor had preached 2 or 3 weeks ago that I had missed and it was called "Happy People Get Depressed".  It was about how even happy, blessed people get the "blues", "get down in the dumps", and can even fall into major depression.  I remember thinking (then I was not depressed because the happy juices where still flowing in my veins) so glad that's not me! I'm too blessed to be depressed!  HA! Boy, did the Almighty show me how quickly that can change and put me right in my place!  Our Lord is very good at that but he is also so good to remind me that leaning on Him through my valley is the quickest way to bring me out :)

So, I came up with a plan-- does that surprise anyone?! I always have a long list of things that I would love to do but NEVER have time to do because I am keeping up with kids or housework or chicken work.  So, I have no excuses and nothing holding me back so why not tackle that list that never gets tackled!  Things on that lists are like: create photo books with the gazillion pictures I have taken, um... Mason doesn't even have a baby book started-- I could do that, etc!  I think you get the point so that's what I did today.  I started on a photo book of pictures and got about halfway done when I started feeling tired.  It did get my mind off the pain (which never really went away today) and made the day seem to go by faster.  So... this summer I may become known as the crazy photo book lady but I am happy to have something to help get me through :)

Post Surgery Life





It has been an interesting 4 days to say the least!  Tuesday, June 5th was the big surgery and boy what a day it was!  It was a day of lots of waiting.  I almost wonder if they were waiting on me to say, "Ya know... no thanks! I have decided not to go through with this, but thanks for the experience!"  Surgery was delayed almost 2 hours when we finally received the green light that the OR was all mine. The one picture above is where my surgical team initials the body parts that have been approved to remove. I found that interesting!

Everyone on my pre-op and surgical teams were very nice.  Duane was carrying around his Chick-fil-A work bag to get some work done while I was "under the knife" so the sight of the Chick-fil-A logo always sparks lots of conversation with everyone-- patients, doctors, and nurses.  I guess it was a good icebreaker and a good way to talk about anything but the obvious.  I do not remember anything after I was wheeled from my pre-op holding room to the OR.  I remember that Duane went right, I was wheeled left, and then I woke up back in the pre-op holding room and in pain and out of my wits.  Apparently, I was in surgery for 6 hours and Duane received many updates which he passed along via Facebook.  When I finally woke up it was by a very rude nurse who was shaking me and telling me to breathe.  I suppose I should be grateful that she wanted me to breathe but the whole experience freaked me out a little-- as that is not the way you want to be flung back into reality.  To top it off that nurse had a very strong accent of some sort so trying to understand what she was saying was very difficult in my very woozy state. I remember telling Duane out loud and with her present that I did not like her and wanted a different nurse. 

It took a while for me to get into my private room.  Finally at about midnight we got into a room and Duane was able to settle in.  The train of doctors, nurses, and assistants started in as soon as we got in the room.  They wanted to check everything and I kept letting them know that I was in P-A-I-N!  And that was the name of the game for the next few days.  They were hoping that I was going to be out by Wednesday afternoon but I was not leaving until they had my pain under control! And that took a while... they had to play with a mixture of meds, times, and dosage until we finally found the right pain med cocktail.  Luckily, I have a great tolerance for pain meds.  They do not make me sick or nauseous!  I suppose everyone would describe the pain differently.  My pain begins in my chest with intense pressure like someone is sitting on my chest and then radiates to my back.  It is the pain in the back that is the most uncomfortable and the most puzzling.  Someone called it referred pain-- I'm not getting wrapped up in terms-- I just know it hurts! My sides also hurt as this is where my drain tubes are sewn into my body so for obvious reasons that part of my body is sore!  I finally allowed them to release me after I was confident that I had a good handle on my pain and I went home at 4 pm on Thursday with a sack full of wound care supplies and medication. 

So, the home health care by my favorite man-nurse DUANE begins :) I just love him to pieces and I know that this recovery process will only make us closer.  We have a few responsibilities to make sure that I stay healthy. 

1) Drain Tube Care:  This is a drain tube bulb. I apologize if you are easily made queasy but this is reality!

When tissue is removed from the body the body goes into "fix-it" mode and wants to fill your new void with fluid; however, this fluid does not help in the healing process though so it has to be removed from the body so no infection occurs.  So, I have plastic tubing hanging from just below my underarms that are sewn into my body that hang down and lead into these round bulbs.  The fluid fills up the bulb and they have to be drained twice a day.  To drain it is very easy-- you pop off the top and squeeze fluid into a pre-marked dixie cup.  We also have to record the amount of fluid that the drain collected.  When the fluid gets under a certain amount of MLs then the drain tubes can be removed.  We are pretty confident that I will have 2 drains removed at my first follow-up appointment next Friday! Duane has added Drain Tube Expert to his resume :)

2) Medication: We realized very quickly that we needed to set alarms to keep my pain under control so we a line-up of bottles that I have to take throughout the day-- everything from stool softeners to antibiotics to the stuff that handles my pain!  I am a one-woman CVS right now ;)

3) Wound Care: I will spare you from that picture as Duane says that is TOO informative-- LOL! Although I am not ashamed of my incisions or my scars-- they are pretty crazy right now!  I have incisions that runs from one side of my breast to under my underarm on both sides.  Ladies can picture that much better but just know it spans the entire length of the breast.  So, we have to clean the incision and replace the dressing at least once a day.  I am totally clear to shower and I have once (even though I was totally nervous) but my mom helped me through that process. Duane was very nervous about applying the ointments and dressings (in fact he feels awful because when he watched the nurse do it in the hospital he almost passed out!) but he has come full circle and is a rockstar at it now! I am wearing a surgical bra 24 hours a day to protect my wounds and keep everything safe.  Ladies you can picture your first training bra-- hehe :)

So, now to answer your burning question: Does Erica have any boobs?  YES I DO! Since I am opting to have implants put in-- after they removed my breast tissue they put in tissue expanders which prepare my body for implants over time. However, my plastic surgeon was able to fill my expanders up with 400 CC of saline so I actually have small breasts to begin my reconstruction process.  Over the next few weeks we will concentrate on getting the drain tubes out, filling up the expanders, and preparing for phase two-- the implants-- down the road!  Now for lunch and a nap-- I'm exhausted :)

Reconstructing Erica

This post is about boobs and for some that is uncomfortable to talk about or read about so hit "close" now and I will never know :)

Yesterday (Wednesday) I met with my plastic surgeon who will be performing my reconstruction following my double mastectomy on June 5th.  I had done minimal research on the different options but I did have a fairly general idea of what we were going to go over and I had talked to several people about their experiences with reconstruction.  So I went into my appointment pretty sure I knew the road that I wanted to go down.  I came out however with a completely different plan of action and while that very abrupt change was a little emotional for me I am VERY much at peace with my decision and I know that it is the best LIFESTYLE decision for me at this point.  Let's get down to details friends:

Two basic options for people who need to reconstruct their breasts: implants (silicone or saline) or a TRAM Flap.  There are a few different types of TRAM flaps but for the purpose of this blog I am going to lump them all into a general bucket and call it the TRAM flap.  There are pros and cons to both kinds of reconstruction.  Implants have a quicker recovery time and surgical time but the process of getting to the final result-- which is your actual set of boobs "installed" you-- is done over time (generally 3 months or so).  You can also pick the size breasts you want within reason.  MD Anderson WILL NOT make you look like Pamela Anderson ladies :) There is still lots of pain, soreness, limited mobility at first, yada, yada, yada...  The TRAM flap is the kind that is growing in popularity.  It is where they use YOUR tissue from YOUR body to recreate breasts on you.  They generally use your belly tissue although it is possible to use tissue from your butt and back to make it happen.  It is a more "major" surgery because not only do they operate on your breasts but they are operating on your abdomen as well.   And for ladies who have had c-sections-- we are talking much more invasive than that!  It is even more invasive than a tummy tuck because they have to re-route a vein and an artery to supply blood to your new "breast" tissue. There is a greater (although still small) chance of infection, obviously more wounds to care for, and a longer healing process; however, I receive the a final product (my boobs) immediately.  This type of surgery is much longer-- approx 12 hours.  It has been coined the "Tummy Tuck Reconstruction". 

So who wouldn't L-O-V-E a tummy tuck?  Seems like an easy, no-brainer decision huh?!  Well, it is never that simple is it and while I walked into my appointment pretty sure that that is the way I wanted to go...  I have elected to have implant reconstruction and let me explain my decision.

• Reason #1: I am a 28 year old mom of a 4 1/2 year old and 19 month old.  My plastic surgeon said one phrase that rocked my world, "After you are completely healed from your TRAM flap surgery you CAN NOT pick up anything over 25 pounds without risk of an abdominal hernia or bulge".  For those who don't see my 19 month old often he is almost 30 pounds.  I can not imagine never lifting my baby again and I know he won't be a baby forever but I still pick up my 4 1/2 year old as well! That is TOO much of a mommy function and I know that I would end up harming my incision and it would result in unfavorable results. 
• Reason #2:  This reason is more superficial but a reality.  I was told I did not have enough belly tissue and/or back tissue to reconstruct to the size I wanted :(  Probably the only time in my life I was sad that someone said I was too lean... and probably the only time someone will tell me I am too lean! LOL!  As you know I am not a small-chested person and while my desire is to go down a size or two they are not confident enough without cutting me open to know if I have enough tissue to create the size I want.  And I have to believe them!  They are professionals that know what a body needs to look like, they know what adequate tissue looks like, and they do this ALL DAY LONG.  If they are not sure then I am not going to risk being unhappy with the result.  They quickly said that they can always supplement my belly tissue with an implant but why go through all that extra pain and recovery when in the end they needed to use an implant anyway.  If I am electing to have this procedure I need to know that the end result will make me happy or why do it?!
• Reason #3 (or really just a neat fact):  Since they use belly/body tissue your reconstruction can gain and lose weight just like the part of your body they look it from SO if you are a person who loses weight from their tummy areas when you work out you will now be a person who loses weight from their boobs!  I happen to be the person who can lose weight pretty easily from my belly.  Usually through diet and exercise I lose my weight from my belly, face, and hips first.   Currently with my breast tissue I never lose weight in my breasts (not even after breast feeding ladies!) but if I chose the TRAM flap I would lose my fat tissue from there now.  Crazy fact huh?!  So... I can't risk getting smaller than expected results and then possibly losing them through exercise anyway!

I know for many of you this was TOO MUCH INFORMATION! But I believe that knowledge is power and some of the facts are just kind of neat.  You never know when you might be on Jeopardy and the category is Breast Reconstruction ;)

So implants it is!  Another thing to know is because I am so young they told me that I will have multiple surgeries as maintenance over my lifetime.  Who knows what they (my breasts) will look like in 20 years and the implant companies recommend getting new ones every 10 years anyway so they wanted to caution me that this is not a one time thing.  I have to mentally be in this for a lifetime.  They also said that in 20 years if I want to come back and have a TRAM flap done because I am done lifting kids, weight is harder to keep off as we age, etc that I can elect to take the implants out and do the "tummy tuck" version.  So my decision is somewhat temporary and they are willing to work with me to ensure that I am happy with my body for LIFE-- not just the months following my surgery.  It is so nice to know that I have advocates in the medical field!

So that will be my next step! I am praying for a speedy recovery because I have too much left to accomplish in 2012-- can I get an AMEN! :)

Remembering when...

There are a zillion things I need to be doing right now such as working, returning emails, TAXES! LOL! But I needed to blog so here it is!

Feeling domestic this morning I had planned on making banana bread. I was pretty sure I had all the ingredients so after a few quick errands this morning I went to it.  I start to it and pretty quickly realize that this must be divine banana bread-- I had just enough flour, just enough sugar, and just enough oil to pull off the recipe.  It takes lots of stirring and lots of muscle to pull it all together so as I am stirring away my mind starting drifting back to the days of yester-year. No too far back... just the newly married years. Remember those?

For me that time is only a mere 8 years ago so I am not travelling too far back but when I think about me then and me now-- well it might as well have been centuries ago!  I remember lounging on the couch in our first apartment.  Duane was a Chick-fil-A owner by this point and we had our first store in Beaumont, Texas.  It was located inside a mall so his hours were a little different.  The mall didn't open officially until 10 AM so I would leisurely get up, relax on the couch, eventually get ready for work, etc.  Ahhh....  I also baked and cooked a lot more (may seem odd but it's true!).  As I was laying around on the couch I would flip through channels like the Food Network and TLC.  I would go online and search for the recipe that the Barefoot Contessa was making and plan it for dinner.  I would watch a Baby Story or two on TLC and dream about having a baby someday... when we were ready (such a silly phrase right-- who is every ready?!)

In the middle of my daydream into yester-year, I was flung back into reality when Mason began throwing Tupperware on the ground and emptying his sippy cup drawer onto the ground for the fourth time today.  BANG! BANG! PLOP!  So, I chuckled a bit.  WOW Erica that was your life and in 8 short years it looks very different! And not just a little different... astronomically different! Is it better?  Is it worse?  I don't think that you can even compare one to the other and I bet most moms would say the same thing.  I've traded TLC's Baby Story for two amazing kids with sticky hands, screaming voices, and runny noses.  I've traded a small, quaint apartment for a beautiful home with LOTS of bathrooms to clean and a yard to maintain. I've traded Food Network for "It's Whatever You Find In The Fridge" Nights or "I'll have Daddy bring home CFA... again" :) 

After the Tupperware fiasco I put Mason down for his afternoon nap, put the banana bread in the oven, and just for kicks I turned on the TV.  Calliou came blaring from the TV as I went searching for TLC.  It took me 5 minutes to even find it (it use to be on speed dial) and wouldn't you know... a Baby Story was on.

It's in the genes, baby!

Our genes make us who we are. They tell us we have brown hair and blue eyes. They tell us whether we are short or tall. Within the last decade they have been able to also tell us whether we have genes linked to cancer. The research is absolutely amazing. What an amazing gift God has given those scientist to be able to make those discoveries! However, when you sit across from you OB-GYN and she tells you that you are BRCA-1 positive for a very split second you think, "Darn you science for being so advanced!"

So, let's back up because I have been keeping a small secret from many people and now that I have a plan I would like all my friends to be informed-- to both pray for me and encourage all woman to take charge of their health as well.

After a friendly push from my OB-GYN at my yearly check-up in November 2011 I elected to have the BRCA genetic testing. It tests for BRCA 1 and 2 which are now know as the breast cancer genes. THESE GENES DON'T MEAN THAT THE CARRIER HAS BREAST CANCER. The genes simply significantly increase your chance of developing breast cancer in your lifetime. By significantly I mean up to an 80% chance that I will diagnosed in my lifetime! So, I am BRCA-1 positive. I have the "breast cancer" gene. I am 28 years old, a wife, and mother of two small kids. So after I blamed science for being so advanced my second reaction was "Lets beat this thing!" and so starts my journey...

I contacted MD Anderson and they immediately accepted me as a patient, I received genetic counseling, and my whirlwind of tests and procedures began. Since December 2011 I have had my first mammogram, multiple breast ultrasounds, ovarian ultrasounds, and blood tests. I've been picked, prodded, and felt up so many times it is ridiculous but all with good intention! I made the decision in February 2012 to met with my cancer doctor (yes they assign you a cancer doctor without cancer... in my opinion that's how inevitable it is...) and discuss my real options to really beat this-- not just keep having tests until they find something one day. They are truly all about saving people's lives at MD Anderson and have been completely supportive of my decision to have a double mastectomy and reconstruction.

Yikes! Why so extreme you ask? Surgery to remove my breast tissue is the ONLY way to almost guarantee (95% chance) that I will never have to deal with breast cancer. There are no guarantees in life but what a change going from an 80% chance of developing breast cancer to a 95% chance of NEVER developing breast cancer. I feel it was a pretty simple decision! So my double mastectomy (removal of both breasts tissue) and reconstruction will take place this summer-- June 5th-- with a possible 2 month recovery time depending on a few minor decisions that haven't been made yet.

I can't lie and act like there is no emotion involved with it. Back in November when I first found out I had a few pretty dark days. Days of "why me... why me!" but that quickly came to an end when I began my appointments in the Mays Breast Clinic and began witnessing real women with breast cancer fighting the real fight in such a strong way. Naturally it also made me never want to have to fight that fight. God has equipped me with the knowledge of this gene for a reason and while we sometimes do not know every detail of His plan I want to use this information to protect myself, my family, and inspire other woman to do the same thing!

And it might be working. My aunt (breast cancer survivor extradanaire) and myself ironically had the BRCA testing done on the same day. It was shocking and a little weird when we found that out actually. Since then my mom and grandma(breast cancer survivor) have been tested. We are all BRCA gene carriers. They don't call it your genetics for nothing! Now we are 4 women with so much power! There is a 50/50 chance that I passed this gene on to my kids-- Emma and Mason. When they reach 18 they will both go into high-risk pools and begin receiving insurance supported testing to make sure that nothing surprises them. You may think why does Mason need to worry. Well, males can get breast cancer but more importantly if Mason has a baby girl one day he must be able to educate her as well! One interesting fact I learned: once a baby is out of the womb most genectic testing can't be done until they are 18 and at the age of consent.

I am so very thankful for my very supportive, amazing husband who has been my best cheerleader through the last 4 months. I'm thankful for family, friends, for prayers, for my phenomenal insurance company that has footed the majority of all costs thus far. I'm thankful for my doctors and whole team at MD Anderson.

So now you know! Don't be afraid to ask me about it. I would be honored to tell you my story, encourage you to take charge of your health, or answer any burning questions you have. These procedures are becoming more common as insurance companies have learned that they would rather help me pay for permenent prevention then years of testing and chemo, radiation, etc when I am diagnosed. So I am counting down the days and nerves are building. Please pray for my kids. I know they are going to take this the hardest but one day they will know it was all for them :)