Monday, July 8, 2013

Cancer Bombs: Scoop and Replace

[Note: The first of this series can be found here. All previous (and subsequent) installments of this series can be found here.]

With surgery scheduled, the prep work began.

I cooked and baked ahead for the holidays. I shopped and wrapped ahead for Christmas.

I knew it would be six weeks with limited use of my arms and at least four weeks without driving, so I did everything I could think of to knock items off the “this will drive me crazy if I leave it and have to stare at it” list.

This included loading our freezer full of home cooked, instanta meals for Mr Lannis’ food prep ease; baking and freezing all our favourite holiday treats; haircuts for the boys (I do it myself, so lack-of-arms meant no haircuts for two boys); getting a head start on the JordanCon 2013 costume (Elmindreda’s beading could be done post-surgery, but the dress needed to be, um, a dress in order for me to bead it); and flu shots for the family (we were going on a family vacation, and the image of an airplane’s recycled air and mystery germs during flu season while my body was busy healing post-op haunted my dreams).

I was going to be out of commission, and I had to be ready.

And it also meant I was not allowed to get sick, which was a tricky feat.

It was flu season and I had boys in elementary school, a kid’s birthday party to host, and holiday events on the horizon. I took my Siberian ginseng, attempted to get plenty of sleep, ate well, and trusted in the holy power of hand sanitizer.

I made it.

Four days before Christmas, and everything was falling into place...

Which was great, because I was falling apart; too bad it had to be so literally.

The stress of waiting for surgery was taking its toll. Insomnia, migraines, acne, clumsiness, forgetfulness, neck strains, hair loss, stress napping, and gastrointestinal pyrotechnics...

If I wasn’t breaking out, I was having issues sleeping, popping Imodium like candy, discovering mystery bruises decorating my legs, sporadically napping in the living room recliner (or in the van on the side of the highway or in parking lots), regularly waking to neck kinks and requiring the healing hands of my massage therapist—unless I was forgetting my appointments entirely—or having all of it hit at once.

Beautiful. I was on edge; jittery as an addict in need of a fix.

Mr Lannis began teasing that I’d hit my thirties and was breaking down, ready to be traded for a new model.

My reply was that only certain parts needed replacement. Good thing for him that they were under warranty (heh).

This and this became my theme songs, and they held an urgency in their beats that echoed in my veins.

I zipped down to the hospital for a pre-op appointment that included registering for an overnight stay and handing over our private insurance info (a semi-private room is a big deal, yo). We arranged for the grandparents to cover the boys, and we were all set.

After an excruciating wait December 20th arrived.

The day of surgery I checked in at registration at 10:30am, because my surgery was scheduled at noon. Yes, I wasn’t allowed to eat past midnight, and only clear fluids before 8am. I was running on enough adrenaline to drive the hour to the hospital myself, despite the lack of food, but I’d be lying if I didn’t admit my stomach was talking louder than Mr Lannis and I in the waiting room.

Once again I was handed the cotton garb medical professionals enjoy making patients wear. (Good money’s on a conspiracy meant to flash butts at unsuspecting bystanders. I'm betting they have an underground tally going.)

By the time I ran into my Surgical Super Team, I was ready to get on with it. I’d been poked for blood work, and was giddy from lack of food and water. Add the lack of sleep thanks to nerves, and I was ready for a good long nap, regardless of whether it involved anyone cutting me open.

Was I scared about the surgery? No. Realistically nervous about outcomes not within my control, but my inherent superpower (rationalization) had kicked in in full force.

This surgery wasn’t serious. I was not ill, nor did it involve cutting into my abdominal cavity, my chest, or drilling into my skull. The necessary organs of life would remain undisturbed.

I was literally swapping the obsolete feedbags hanging off my chest for new ones. Instead of mammary tissue, they’d be filled with silicone. Or tissue expanders. Or at the very worst, nothing at all, and we’d build again from the ground up (or ribcage out, as the case may be).

So no, I wasn’t concerned about this surgery the way I might have been if it had involved cracking open my ribcage, or peeling back skull plates.

And my job was simple: lay on a table and make a vein pop so the anesthesiologist could insert an IV, then take a nap.

No big deal.

Surgery was scheduled to be three and a half hours long. The last thing I said to Mr Lannis when he gave me a kiss good luck was to remember that no news is good news. If no one came to update him while he sat in the waiting room then that was a good thing.

One last trip to the bathroom (I think my bladder was more nervous than I was), and Dr M spirited me into a small room to doodle on my chest. She crosshatched over my sternum, outlined my collarbones and measured things up one last time. I'm only 90% sure everything she drew was medically necessary (totally kidding. She was chatty, but all business. Though I'll admit I was tempted to grab her purple marker and draw eyes above my nipples so they resembled scared mouths—if I could've done it without her noticing, I would've, too... ha!).

She reminded me that after Dr D finished with the mastectomy, she’d take over, and proper placement of the implants meant she’d have to sit me up during the surgery—while I was asleep—to see the way the new girls settled into place.

I loved that visual: me, medicated, zonked and leaden, a surgical assistant at each shoulder hefting me upright to a sitting position so Dr M could stand back like the artist she was, lining up the tilt of my boobs by eyeballing an extended thumb at arm’s length...

So I told her I was almost certain the girls were unaware they were about to be evicted. She laughed.

After getting back into my gown, Dr M walked with me to the hall lined with operating rooms, where she deposited me on a gurney outside our scheduled OR. There I was interviewed by the anesthesiologist.

No, nothing to eat past midnight. No, nothing to drink past 8am.

Then it was show time.

I was ushered into the operating room and helped up onto the table. In went the IV. A last bit of chit chat—beneath the mask, I swore at my misbehaving tongue when it had me struggling to wish my Surgical Super Team luck—and they smiled and chuckled with a confidence that was relaxing.

Or maybe that was the knockout blow of the anesthetic. Whatever.

Vague recollections of vibrant yet restful dreams, and awareness began seeping back into my consciousness.

A nurse began talking to me, and I discovered the time. After 7pm. I had been out for seven hours. I had been in surgery for seven hours.

Seven hours. For a three and a half hour surgery?!

My brain lurched leadenly into overdrive. COMPLICATIONS?!

Expanders! No, worse—NOTHING!

Shifting painfully, I looked down to see... boobs. 


No, there were no complications. My Surgical Super Team had simply taken seven hours to get the job done (more on that later).

The good news was that the scoop and replace was complete.

I asked for Mr Lannis. He was fine of course, and arrived shortly. Friends visited, and I was transferred to my room for the night, and introduced to my night nurse (Ruby. Ruby was wonderful. So was Minda, my day nurse. Can never thank them enough, they were such sweethearts!).

A nasty pair of Jackson-Pratt drains were pinned to the bra I wore. It was an old bra I'd sliced the under wire out of at Dr M's request. While I was unconscious the Surgical Super Team had dressed me in it, along with a new gown and some fancy white leggings, and some fancy pads equipped with a motor that would occasionally kick in and squeeze my legs to keep my circulation up.

My bra was overflowing, but there wasn't much to see other than that the cups were lined with giant abdominal gauze pads and filled by my quickly swelling new girls.

How did I feel? My chest burned. A swath of fire from shoulder to elbow and across. Morphine wasn’t good enough.

No, let me rephrase that: the morphine was great—for about a half hour. Then I was uncomfortable again.

Yes, uncomfortable, but not in pain.

On the one to ten scale of pain, I was at most a two. Yes, a two.

Of course, a lot of that was because I was given my meds like clockwork. And also because once you've given birth without painkillers suddenly the rest of your life is in perspective (and not nearly as painful as you'd've originally thought, heh).

You see, the cauterization of the mastectomy hurt like a bitch when it was med time, don’t get me wrong. But it was my muscles that were driving me ballistic, and the painkillers weren't touching them.

I’d been warned: the first 72 hours were the worst. In those first days, the pectoral muscles rebelled. They’d been stretched off the chest wall, and the implants were beneath them, and let me tell you, they weren’t pleased. It was as if I’d spent an entire day exercising my chest to the extreme, pulling those muscles to painful capacity, and then decided to be a doofus and repeat it the next day for shits.

Nobody would repeat that for shits, trust.

And you never realize how much you engage those pecs until they complain every time you ask them to move a hair.

There were restrictions on my arm movements. The logical (no lifting), but also no raising my arms. I had to keep my arms angled down from the shoulder. No reaching, or raising, or lifting.

Well, that was easy—thanks to those obnoxious pecs, my arms didn’t exactly want to be used. I cradled my fists against my chest and pulled my elbows in to my sides—but not enough to disturb the Jackson-Pratt drains whose tubes emerged near my underarms, because THAT was a lesson learned quickly (doped up stupor or no).

I spent my time listening to the Kindle read me The Scorpio Races, because Maggie Stiefvater's writing is mental comfort food, and dozed in and out in a drugged stupor.

It wasn’t until the next morning that I was fit to hold a conversation with any legitimate grip. Dr M had come to visit when I was in the recovery room, but it had been between her surgeries and my veil of anesthesia had yet to truly lift. This time, in my room, I was able to ask her about the duration of the surgery—why so long?

She lit up, proud. “We wanted to take our time. So we did.”

As the details accumulated, it was rather clear what had happened. My Surgical Super Team had (for lack of a better term) commandeered the operating room. I'd known they’d been less than pleased with the time allotted to them for their prophylactic fake boobage showcase. I'm going to guess they had reasoned that once I was open on the table, they couldn’t be kicked out. Thus, it's my understanding they opened me up and conveniently "forgot" to look at the clock while they did their careful work.

You have to be meticulous during a nipple-sparing mastectomy to excavate the breast while maintaining blood flow to the nipples, don't you know... sometimes it takes longer than expected. [/overly innocent voice]

And they did a great job—never once during recovery did I panic and wonder if there was an area that was falling to necrosis (tissue death). Clearly they’d managed to maintain blood flow to my skin, despite scrapping out everything underneath.


Watching Dr M smile and offer post-op instructions (I would be seeing Dr D in a week, then Dr M at the two week mark), I could see she was proud of their mutinous choice. She checked over their handwork, and told me to call if I had any concerns. I had home care nurses scheduled to come and visit, so I was welcome to take off when I was ready.

Which meant I stuck around, had another meal and a nap (food was as good as drugs—I’d buzz with warmth and pass out), while Mr Lannis waited for rush hour to dissipate before loading me into the van so we could trundle on home.

It was aggravating, getting to that van. I'd walk, then sit on a bench or chair to rest every twenty feet. There was nothing wrong with my feet, so I insisted on walking out the hospital door (it’s not policy for wheelchairs in my particular case).

But I was frustrated. Mr Lannis had pulled the van into the loading area, and I waited for him to open the door to lead me outside. I couldn’t hit the automatic door button with my arms (at all—a "surprise this engages your angry pecs" moment), and hitting it with my hip wasn’t enough force to trigger it. Kicking the button would have thrown me off my already unsteady balance and was completely out of the question.

No arms sucks, and I was only learning how much so.

Being December (and Canada), it was cold, and walking outside had a blast of icy air hitting me, the cold seeping through my coat into my chest. My arms curled over my new girls as tremors erupted through my newly-cauterized pecs.

I hurt.

Mr Lannis had to help lift me into the van, as I couldn’t use my arms for balance and support. He adjusted the seat so I was comfortably laying back without the shoulder strap putting too much pressure on me, and then buckled me in and shut the door.

I was irritated, already frustrated with my own helplessness. It grated. A lot.

Settling in for the hour-long ride home, I found relief in one important truth...

Santa had brought me what I'd asked for: new boobs.

The cancer bombs were gone.

[Note: The next installment of this series is here.]


  1. I'm smiling with tears in my eyes right now.

  2. Aw, thanks, Tina! Didn't mean to make you cry... ;)