Do people not realize that perhaps someone who has just finished their chemotherapy cycles and is trying to make a transfer back into "normal" life may be a little bit SENSITIVE!?!?!?!?!
It boggles my mind how many people come around and don't even consider this! Okay so perhaps this is me being a little bit selfish right now, but I am sorry I feel that at times I am allowed to be a little selfish, after all if this taught me anything it was to stop letting people walk all over me because I am number one!
I am so excited to go back to work I can hardly contain those emotions! I talk to Dave about it everyday and about all of the projects that I had on the go and accomplishments that I was working on when I left and how I cant wait to achieve those! Anyone who has been around me in the last year knows how much I love my job and strive to succeed at it, that I have developed great relationships and pride myself in the fact that I live to work not work to live! I wake up in the morning excited to go to work - FINALLY!
Therefore, the other day when I had a miscommunication with a friend/co-worker who told me not "stay home and not bother coming back and let the person filling in for me continue to do my job if I didn't want to do her any favors upon my return" - Perhaps I FREAKED OUT!!!!!
WHAT???????????????? Are you kidding me right now??????????????
For anyone not going through chemotherapy or has never gone through it, for those of you that have never fought cancer, please understand one thing - While I may seem healthy to you on the outside, I smile all the time and yes, I lost a breast and not my sense of humor....you see me at these times and these times only, but do you see me laying in my bed crying at night or confiding in my husband all of my fears, do you see me staring in the mirror for 20 minutes every morning feeling unbeautiful because of my lack of hair and breasts and the constant redness around my eyes, do you see me sleeping for 16 hours a night because I am exhausted, do you watch me every day struggle to remember what I was just talking about in mid sentence because I suffer occasionally from chemo fog.
You can sit there and comfort me and say "you are beautiful no matter what, don't worry about forgetting things, don't cry you should be happy because your a survivor.
I know these things! However, do I feel AS beautiful as I did a year ago or as I will in a year from now? No I do not and neither would you without your hair or your breasts, it is not about the beauty within at ALL TIMES, it is about feeling like a woman!
So please - just have some compassion for the things that YOU DO NOT KNOW. It doesn't matter how close you are to people unless you are with them 24/7 just assume there are things you do not know and emotions they are going through that you cant possibly understand.
January 29, 2012
January 27, 2012
Reconstruction
So yesterday I had my appointment with Dr. Kanashiro to discuss reconstruction. Without a doubt I have decided to remove my right breast. It will be called a prophylactic mastectomy (meaning preventative).
So a little bit about my reconstruction options...
My options are
1) DIEP flap
Patients
typically ask in consultation what the recovery is like following DIEP or TRAM
Flap surgery. I find that patients may have some misconceptions regarding how
they are going to look and feel post-operatively. Typically at one week
post-operatively, most or all drains have been removed and steri-strips remain
in place on the breast reconstruction or on the abdomen. Bruising and swelling
often persist after the first week and being to improve over the next several
months up to one year.
The above photograph, the patient is status post bilateral mastectomy.
The lower abdomen and perforators (blood supply) to carry the abdominal skin and fat from the abdomen to the chest wall is marked. The preferred vessels in the chest are the internal mammary vessels when available.
In the above photograph, the patient is one week post-operatively. All drains have been removed. Steri-strips remain in place for two weeks and are then discontinuesd. Bruising and swelling improve over the next several months to one year.
2) Implants (which will require spacers to be put in to strecth my skin over a period of time before the implants can be placed)
Breast reconstruction following mastectomy can be challenging for both the patient and surgeon. Breast reconstruction can be performed immediately following mastectomy or can be performed in a delayed fashion where a patient undergoes a mastectomy in one procedure and then implant or autologous tissue reconstruction in another procedure.
I typically educate patients who undergo reconstruction with tissue expanders or implants that these procedures are frequently performed in stages. Often, the first stage of reconstruction requires the placement of a tissue expander, followed by a second procedure where implants are placed and a final symmetry procedure is performed.
I have found great utility in the use of the neo-supracapsular pocket to control and reposition the inframammary fold in breast reconstruction. I find that the surgeon can have excellent control of the fold position without any untoward puckers or dimpling. One of the goals in breast reconstruction following mastectomy, is to have the patient feel comfortable and confident in clothing and/or in a bra.
1) What is autogenous breast reconstruction?
Autogenous breast reconstruction is the use of your own body's tissue to reconstruct the breast. This includes the TRAM (transverse rectus abdominus myocutaneous flap), gluteal flap (gluteus maximus myocutaneous flap), latissimus dorsi flap, DIEP (deep inferior epigastric perforator flap), SIEA (superficial inferior epigastric artery flap) and GAP (gluteal artery perforator flap) techniques.
..........................................................................................................................
2) What are the benefits of autogenous reconstruction versus implant reconstruction?
Since autogenous reconstruction uses your own body's tissue to reconstruct the breast, the tissue is there for life. You cannot reject it. It will change in volume as your normal weight fluctuations occur through life and often tends to improve in shape over time. The breast is reconstructed with fat, which is similar in density to breast tissue, thus the “feel” is similar to that of a normal breast.
Implant reconstructions tend to require multiple operations prior to achieving the final result. These could include sequential expansion of breast skin, repositioning of the implant, correction of infra-mammary fold distortion, correction of shape deformity, correction of implant extrusion, correction of implant leakage, correction of capsular contracture, removal of implant because of infection, replacement of temporary implant or expander with permanent implant. If a patient has had radiation or is planning to have radiation, implant reconstruction is discouraged because of the unacceptably high complication rate. The implants often require replacement. Implant manufacturers do not consider them “lifetime devices”. Their life expectancy is <10 years per manufacturer documentation. The occurrence of capsular contracture is often a concern with implant reconstructions. It is the result of your body's recognition of the implant as a foreign material. A capsule of scar is layed down around the prosthesis to as a barrier to contact with the body. The capsules vary in thickness and can sometimes calcify and become hard. As a result implant reconstructions tend to be more firm than a normal breast, thus feeling more artificial and remaining somewhat immobile to normal activity.
..........................................................................................................................
3) Are there any benefits of implant reconstruction over autogenous?
Implant reconstructions are typically shorter operations (1-2 hours) and do not prolong hospitalization. Autogenous reconstruction, specifically perforator flap reconstruction, typically takes 4-5 hours for a single reconstruction and 5-7 hours for a bilateral breast reconstruction. The hospital stay is 3-4 days for perforator flap reconstruction and may be slightly longer with TRAM flap procedures. Implant reconstructions also do not require a donor site and recovery is therefore usually shorter.
..........................................................................................................................
4) What is a DIEP flap?
DIEP stands for Deep Inferior Epigastric Perforator. This is the named vessel for which the tissue to be transferred is based. “Flap” is a plastic surgery term referring to the tissue which is to be transferred.
The deep inferior epigastric vessels arise from the external iliac vessels (the external iliac vessels become the femoral vessels in the leg). The deep inferior epigastric vessels course beneath the rectus abdominus (the major abdominal “six pack” muscle) on each side. These vessels send off branches to the muscle as well as through the muscle into the overlying fat. These perforating branches are those which are identified, preserved and transferred with the overlying tummy fat to reconstruct the breast.
Please comment your thoughts or what you would do
So a little bit about my reconstruction options...
My options are
1) DIEP flap
Patients
typically ask in consultation what the recovery is like following DIEP or TRAM
Flap surgery. I find that patients may have some misconceptions regarding how
they are going to look and feel post-operatively. Typically at one week
post-operatively, most or all drains have been removed and steri-strips remain
in place on the breast reconstruction or on the abdomen. Bruising and swelling
often persist after the first week and being to improve over the next several
months up to one year.
Autologous reconstruction such as DIEP flaps are a
great alternative to implant based reconstruction if the patient has enough
tissue on their abdomen to donate to one or both reconstructed breasts. In
patients who have had repeated infections or capsular contracture with implants,
DIEP flaps represent a great method for reconstruction.
The above photograph, the patient is status post bilateral mastectomy.
The lower abdomen and perforators (blood supply) to carry the abdominal skin and fat from the abdomen to the chest wall is marked. The preferred vessels in the chest are the internal mammary vessels when available.
In the above photograph, the patient is one week post-operatively. All drains have been removed. Steri-strips remain in place for two weeks and are then discontinuesd. Bruising and swelling improve over the next several months to one year.
Breast reconstruction following mastectomy can be challenging for both the patient and surgeon. Breast reconstruction can be performed immediately following mastectomy or can be performed in a delayed fashion where a patient undergoes a mastectomy in one procedure and then implant or autologous tissue reconstruction in another procedure.
I typically educate patients who undergo reconstruction with tissue expanders or implants that these procedures are frequently performed in stages. Often, the first stage of reconstruction requires the placement of a tissue expander, followed by a second procedure where implants are placed and a final symmetry procedure is performed.
I have found great utility in the use of the neo-supracapsular pocket to control and reposition the inframammary fold in breast reconstruction. I find that the surgeon can have excellent control of the fold position without any untoward puckers or dimpling. One of the goals in breast reconstruction following mastectomy, is to have the patient feel comfortable and confident in clothing and/or in a bra.
1) What is autogenous breast reconstruction?
Autogenous breast reconstruction is the use of your own body's tissue to reconstruct the breast. This includes the TRAM (transverse rectus abdominus myocutaneous flap), gluteal flap (gluteus maximus myocutaneous flap), latissimus dorsi flap, DIEP (deep inferior epigastric perforator flap), SIEA (superficial inferior epigastric artery flap) and GAP (gluteal artery perforator flap) techniques.
..........................................................................................................................
2) What are the benefits of autogenous reconstruction versus implant reconstruction?
Since autogenous reconstruction uses your own body's tissue to reconstruct the breast, the tissue is there for life. You cannot reject it. It will change in volume as your normal weight fluctuations occur through life and often tends to improve in shape over time. The breast is reconstructed with fat, which is similar in density to breast tissue, thus the “feel” is similar to that of a normal breast.
Implant reconstructions tend to require multiple operations prior to achieving the final result. These could include sequential expansion of breast skin, repositioning of the implant, correction of infra-mammary fold distortion, correction of shape deformity, correction of implant extrusion, correction of implant leakage, correction of capsular contracture, removal of implant because of infection, replacement of temporary implant or expander with permanent implant. If a patient has had radiation or is planning to have radiation, implant reconstruction is discouraged because of the unacceptably high complication rate. The implants often require replacement. Implant manufacturers do not consider them “lifetime devices”. Their life expectancy is <10 years per manufacturer documentation. The occurrence of capsular contracture is often a concern with implant reconstructions. It is the result of your body's recognition of the implant as a foreign material. A capsule of scar is layed down around the prosthesis to as a barrier to contact with the body. The capsules vary in thickness and can sometimes calcify and become hard. As a result implant reconstructions tend to be more firm than a normal breast, thus feeling more artificial and remaining somewhat immobile to normal activity.
..........................................................................................................................
3) Are there any benefits of implant reconstruction over autogenous?
Implant reconstructions are typically shorter operations (1-2 hours) and do not prolong hospitalization. Autogenous reconstruction, specifically perforator flap reconstruction, typically takes 4-5 hours for a single reconstruction and 5-7 hours for a bilateral breast reconstruction. The hospital stay is 3-4 days for perforator flap reconstruction and may be slightly longer with TRAM flap procedures. Implant reconstructions also do not require a donor site and recovery is therefore usually shorter.
..........................................................................................................................
4) What is a DIEP flap?
DIEP stands for Deep Inferior Epigastric Perforator. This is the named vessel for which the tissue to be transferred is based. “Flap” is a plastic surgery term referring to the tissue which is to be transferred.
The deep inferior epigastric vessels arise from the external iliac vessels (the external iliac vessels become the femoral vessels in the leg). The deep inferior epigastric vessels course beneath the rectus abdominus (the major abdominal “six pack” muscle) on each side. These vessels send off branches to the muscle as well as through the muscle into the overlying fat. These perforating branches are those which are identified, preserved and transferred with the overlying tummy fat to reconstruct the breast.
Please comment your thoughts or what you would do
January 26, 2012
Moving Forward
This last bout of Chemo was the hardest without a doubt! My hangover lasted longer and was way worse than any other and to top it off I developed a very nice chesty cough and a fever that held on for almost six days!
Now...I am feeling better!
And with that I am ready to jump of this train of life that I seem to have been sailing by on for the last 26 years. Lets start slow ok!
Dave leaves back to Fort Mac tomorrow and with that I am gonna give myself a couple of rules to live by. Something to get me started back in every day life!
1) I am going to start setting my alarm every morning and getting back to a normal routine. Enough sleeping until noon!
2) I am going to start enjoying some exercises and taking the dogs out for a walk every day! I don't know how far I will be able to go, but I can go a little farther every day in hopes of doing the Weekend to End Breast Cancer Walk soon.
3) Mentally - I joined a support group with six women in it which my doctor referred me to, I go every Monday and my first time was last Monday, it feels good to be able to talk to other women in my situation, but still have yet to find women of my age to talk to.
Also mentally, today I met with Dr. Kanashiro (my surgeon) again for a follow up to have my other breast removed and to begin the Reconstruction phase, I will keep you up on this but at this point I have chosen to have implants.
I have also started reading a book called picking up the pieces, which I am absolutely loving! There are a lot of quotations in there from real life survivors and it is very inspiring, I am going to dedicate more time to this book in the next couple weeks.
I think for right now, those three goals to focus on are quite a bit and just to get back into every day life if really hard, so here's to that!
Now...I am feeling better!
And with that I am ready to jump of this train of life that I seem to have been sailing by on for the last 26 years. Lets start slow ok!
Dave leaves back to Fort Mac tomorrow and with that I am gonna give myself a couple of rules to live by. Something to get me started back in every day life!
1) I am going to start setting my alarm every morning and getting back to a normal routine. Enough sleeping until noon!
2) I am going to start enjoying some exercises and taking the dogs out for a walk every day! I don't know how far I will be able to go, but I can go a little farther every day in hopes of doing the Weekend to End Breast Cancer Walk soon.
3) Mentally - I joined a support group with six women in it which my doctor referred me to, I go every Monday and my first time was last Monday, it feels good to be able to talk to other women in my situation, but still have yet to find women of my age to talk to.
Also mentally, today I met with Dr. Kanashiro (my surgeon) again for a follow up to have my other breast removed and to begin the Reconstruction phase, I will keep you up on this but at this point I have chosen to have implants.
I have also started reading a book called picking up the pieces, which I am absolutely loving! There are a lot of quotations in there from real life survivors and it is very inspiring, I am going to dedicate more time to this book in the next couple weeks.
I think for right now, those three goals to focus on are quite a bit and just to get back into every day life if really hard, so here's to that!
A Toast!
While I write this I proudly sip on a glass of wine!
Here is a toast to goodbye...
Goodbye from what you might ask?
While allow me to explain the absolutely terrible things that chemo does to you!
While most people may have worse symptoms to complain about, I suffered from a five day hangover, the absolute WORST smelling farts in the world which Dave, Burgandy and myself proudly call chemo farts, and as gross as it is, I almost had to plug my nose every time I peed!
This may have been a little bit too much information, but I proudly sip on my wine while I think of the happy days ahead of me that will be free of that god awful chemo smell!!!!!!!!
Here is a toast to goodbye...
Goodbye from what you might ask?
While allow me to explain the absolutely terrible things that chemo does to you!
While most people may have worse symptoms to complain about, I suffered from a five day hangover, the absolute WORST smelling farts in the world which Dave, Burgandy and myself proudly call chemo farts, and as gross as it is, I almost had to plug my nose every time I peed!
This may have been a little bit too much information, but I proudly sip on my wine while I think of the happy days ahead of me that will be free of that god awful chemo smell!!!!!!!!
CHEERS!!!!!
January 17, 2012
Graduation Day
ALL DONE!!!
The Beginning of a new Chapter or the Closing of One....either way....I am done!
On January 17th I successfully graduated from Tom Baker University! I was accompanied to my last Chemo by my Auntie/Sister Pauline. She called me about a week before treatment requesting to take me. We haven't spoke in a very long time due to family drama etc (you know how it is...) but I thought this may be a nice opportunity to let the past lay in the past and that is what we did, we did not talk about our issues or problems that we had, we just simply enjoyed our time together and it was really nice for me to have family there at my last chemo session, something that I have been feeling a void in for a very long time.
I thought there would be more to this, when I walked out of the Tom Baker there was no red carpet, trumpets playing, hands clapping, drummers marching, cheerleaders cheering....nothing. Just me and my empty feelings of no where to go. What do I do now? I will not be returning here in 21 days, However I will not be returning to work either and I know I still have two weeks of feeling like shit so....what now?
I have been so positive through all of this but I must admit, it has not been easy!
Relationships have changed, some got stronger, some are no longer there.
I have changed.
My way of thinking is no longer the same and I think more in depth these days, I think with purpose. I dream more these days and remember them as well, for what reason I do not know. I must admit my relationship with God these days is stronger and we talk quite regularly. I care about things in a different way, I want to help people that are in my situation. I value my time more, I take time to cuddle my dogs and Dave in the mornings rather than jumping out of bed right away. I smell my coffee and food before indulging. While this all sounds very cliche it is very true!
The Beginning of a new Chapter or the Closing of One....either way....I am done!
On January 17th I successfully graduated from Tom Baker University! I was accompanied to my last Chemo by my Auntie/Sister Pauline. She called me about a week before treatment requesting to take me. We haven't spoke in a very long time due to family drama etc (you know how it is...) but I thought this may be a nice opportunity to let the past lay in the past and that is what we did, we did not talk about our issues or problems that we had, we just simply enjoyed our time together and it was really nice for me to have family there at my last chemo session, something that I have been feeling a void in for a very long time.
I thought there would be more to this, when I walked out of the Tom Baker there was no red carpet, trumpets playing, hands clapping, drummers marching, cheerleaders cheering....nothing. Just me and my empty feelings of no where to go. What do I do now? I will not be returning here in 21 days, However I will not be returning to work either and I know I still have two weeks of feeling like shit so....what now?
I have been so positive through all of this but I must admit, it has not been easy!
Relationships have changed, some got stronger, some are no longer there.
I have changed.
My way of thinking is no longer the same and I think more in depth these days, I think with purpose. I dream more these days and remember them as well, for what reason I do not know. I must admit my relationship with God these days is stronger and we talk quite regularly. I care about things in a different way, I want to help people that are in my situation. I value my time more, I take time to cuddle my dogs and Dave in the mornings rather than jumping out of bed right away. I smell my coffee and food before indulging. While this all sounds very cliche it is very true!
 |
| BYE BYE CHAIR!!!! |
January 16, 2012
The Hard Feelings I Dont Like Sharing
It is hard to explain since there are so many great people around me and having Dave attend two chemo's with me and my amazing Porshia to the other don't get me wrong I feel like the luckiest girl in the world, but there was something missing not ever having a blood relative sitting next to me and unfortunately a sadness that came with that. Perhaps this had something to do with the fact that every time I had chemo I was under the understanding that my Mom and Dad would be by my side and while I wouldn't argue with them leaving Calgary the day before my treatments I was extremely hurt and felt a sense of unworthiness. Always feeling like my treatments weren't important or worth sticking around for and in all honest that hurts alot. I have never wrote about it and didn't think that I would but when all of this began my parents were my number one supporters and they planned to move in with us temporarily to make sure I would be okay and unfortunately it did not work out that way I felt like through my treatment I was constantly disappointing my Mom and I didn't know how to fix that or make it go away and it was wearing on me every day, there was nothing I could do to make this disappointment of Cancer go away.
January 10, 2012
Young Adult Cancer Canada
I am sooooo excited to have found this website community of young adults diagnosed with cancer that provides information, support, skills and opportunity.
When I was diagnosed the hardest part was trying to find sources that I could relate to, how are people my age dealing with this, were they able to have children after, how did they and are they coping....
My profile on YACC is listed here and is one of my ways of hopefully touching others my age as the people on this website were able to touch me.
http://www.youngadultcancer.ca/community/profiles_archive/beige_plotts-waldner/
I am also sooooo excited and proud to say that I have registered for the Retreat Yourself with my best friend Ashley from May 3-7th in Morley, AB where I will get to share my experience with others my age as well as hear from them and make new friends!
When I was diagnosed the hardest part was trying to find sources that I could relate to, how are people my age dealing with this, were they able to have children after, how did they and are they coping....
My profile on YACC is listed here and is one of my ways of hopefully touching others my age as the people on this website were able to touch me.
http://www.youngadultcancer.ca/community/profiles_archive/beige_plotts-waldner/
I am also sooooo excited and proud to say that I have registered for the Retreat Yourself with my best friend Ashley from May 3-7th in Morley, AB where I will get to share my experience with others my age as well as hear from them and make new friends!
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