Darn Good Lemonade
Making Lemonade From My Pair of Lemons, Diagnosed at 30 & Life Beyond Breast Cancer

June 2012 archive

Advice on Taking Care of a Patient After a Mastectomy or Breast Reconstruction

I had a very nice woman email me because she is going to be taking care of a friend after her double mastectomy and asked for tips and tricks on how to take care of a patient after a mastectomy. I figured that I would also share my advice on a blog post since I know some website visitors are caretakers of breast cancer patients and breast cancer patients themselves preparing for surgery – and my life is pretty boring cancerwise lately (feeling great). So… here goes (this is going to be really long), based on my/our experiences only, please understand. Everyone is different.

When I asked Mike what advice he would give his answer was: “Yogurt, pudding, purple Gatorade, TV in the bedroom (otherwise your wife won’t lay still), and leave them alone (pop your head in once and awhile, get grunted at, go away).” Whew, I sound like a good time. Also, he knows I posted his exact statement and he fully agrees with it, twice.

My surgery before chemo - I had the option to start chemo or have surgery. I chose surgery first. I should have healed a lot better, your body does well at this time, but stress is not good for your body’s healing process.
Surgery shortly after chemo – I opted to go ahead and reconstruct the healthy side after my complications. This was much harder, MUCH. Comparing my lat flat reconstruction on each side, my body had a very hard time recovering shortly after chemo (three weeks). My body was even madder at me when I threw radiation on top of surgical recovery. I started working one week after my mastectomy from home (my choice and a bad idea for me) and I was back in the office after two weeks after my mastectomy (bad idea for me again). I did wait over three weeks after my first lat flap to go back. I found out about http://www.cancerandcareers.org long after treatment, I haven’t spent much time on that site, but it may be helpful for other woman like me. I suggest three weeks minimum healing time after any major surgery, otherwise you chance a million more surgeries and missing more work than you would have, had you taken care of yourself in the first place…

Items to buy:

  • Surgical drains. Note the pudgy belly, everyone was feeding Mandi good.

    Velcro, big safety pins & cotton yarn – Every woman manages her surgical drains differently. I bought a top that was able to hold three drains, but guess what, I had five surgical drains after my mastectomy and six after one of my reconstructive surgeries. The drains are worse than the surgeries. I am not kidding. Read about Gus (yes, we named one). I would usually use a safety pin and attach them to a velcro “belt” when I had several of them. For showers I would string them through cotton yarn while I showered and switch back to the safety pins and velcro. Once I got down to a drain or two I would just use yarn. The safety pin/velcro method helps with lots of drains because they can’t move around, once you are down to just a couple of drains it is more comfortable if you can adjust them, so I would just use yarn. I think I let Mike help me with them for about two days, they were gross and I preferred to manage measuring the output by myself.

  • Baggy button up shirts and cover up sweaters – I spent more time finding clothes to hide my surgical drains than anything. I founds that I needed baggy shirts that didn’t rub on my chest, with extra fabric on the chest and layers of cover ups really helped hide what was going on.
  • Soft foods – Yogurt, pudding, rice pudding, bananas, anything easy on the tummy. I was a fan of making smoothies – blending frozen berries, spinach, banana, ice cream (or yogurt) and milk to appease the tummy. When you have a pain killer regimen that is hard on your stomach, you need to take them with food, but half the time you don’t have the appetite. I found bananas to be easy to get in my tummy when I needed to take my medications. Stocking up on “easy food” was always first step after surgery. You may want to avoid too many foods with soy, it is a controversial food product for women with breast cancer. It is important to eat, so let them eat whatever they can get down for the first few days.
  • Knee pillow – You can’t lay on your side for a long time after these surgeries. It doesn’t matter which side it was on, it hurts. The best trick I learned for feeling like I was sleeping on my side was to place a pillow under my knees so that I could turn them. I still sleep with a body pillow now to sleep on my side after my reconstruction.
  • Recliner? - I bought a recliner before surgery having read that a lot of women prefer sleeping in one. After shopping for them I lost a few tears because the nice ones were spendy. I managed to find a used and very nice recliner by watching the local ads. We named it the “Mandi chair” and I just went to go sit in right now because it is so comfy. The dogs lived on this chair with me for many months (so make sure there is cat/dog/child room to squeeze in – they were my best buds). I was never able to sleep in the recliner, but it was really helpful for me when I was just resting and much more comfortable than the couch. On the nights I couldn’t sleep propped up in bed I would sleep on a futon recliner (it looked a bit like this one, I found that I had those sleeping issues a bit more on chemo than after surgery, but sleepless nights come with both). I would sleep on the futon with my back elevated and about five pillows surrounding me (I found that my other recliner required me to “push” to keep it reclined vs. the sedentary futon that kept my legs straight and put my back on an incline).
  • Shower chair - I didn’t use it often, but within a day or two after surgery I was allowed to take a shower (surgical glue is some crazy stuff). I would get dizzy after the shower, so either stay close by, or have a shower chair the first days after surgery.

What not to let her do:

  • I used http://www.lotsahelpinghands.com after a couple of surgeries to organize meals because Mike didn’t usually have enough energy to work all day, clean and make a healthy meal (when I was stuck home a speck of dust that I was unable to clean up looked like a boulder). The website allowed me to put everything on a calendar and I could look it up when I needed to, chemo does not do great things for your memory, having it on a website meant I didn’t have to try to remember who was coming when. One of the best things anyone every did for us was bringing us food, I still look back and appreciate it so much, but the hardest part was organizing it before I used the site. The website also works for setting up other tasks you need to make available for help (rides to appointments) and lets people sign up for what they can do to help when it is best for them.
  • Vacuum - This motion is terrible after these kinds of surgeries. Loading and unloading the dishes from the dishwasher is just about as bad. Get help or organize help for housework. http://www.cleaningforareason.com is an option for people in treatment. Mike opted to take over the heavy labor instead. We discovered he is about ten times better at vacuuming than I am, but don’t tell anyone.
  • Cooking – Chopping, stirring and a lot of motions made in cooking take many weeks to participate in again. I genuinely think I messed up a surgery chopping vegetables. Just don’t… have easy to make food or have people bring meals. When I was able to cook I would frequently make extra and freeze the other part for later.
  • Childcare – I don’t have experience here, but from my own experience, the best thing I could do is sleep as much as possible the first week. You may want to arrange people to help based using the Lotsa Helping Hands website, but please remind everyone that the point for this is to give the cancer patient quiet time to rest and heal. It takes a lot of energy to update everyone on everything as they come to visit, it is awesome to see everyone when they come (so as the patient you definitely want to chat, but have limited energy on how long), so keep it short if you can.

What to expect: I haven’t spoken to a woman that thinks that a mastectomy is the best thing that has ever happened to her (surprising eh?). It makes you depressed (reconstruction can do the same thing, it isn’t what it was, I am happy with my surgery, but you aren’t exactly princess charming after these surgeries). You can be shocked, sad, angry, screaming inside… do all of it. You make major decisions about your body within a short period of time. Mourn. We are raised with part of our sexual appeal/identity being tied to our breasts. My surgery was a skin and nipple sparing mastectomy surgery, I woke up two cup sizes smaller than I started because I had immediate reconstruction, which made it easier, but not “easy.” For women interested in this kind of surgery, my surgeon and plastic surgeon have a site about it, PLEASE understand this website is very graphic, you were warned. When I did lose the breast expander on my healthy side due to surgical/chemo healing complications I had to relive the experience again in a different way. Just understand that this is a scary time and the patient may not always be on their best behavior.

Mike also suggested not to tell the patient that they will be “ok.” I hated being told I would be ok, I wasn’t ok, and I was weird about being told that. I needed to decide that for myself (prayers, well/healthy/healing wishes, support, caring thoughts, luck, all of that is greatly appreciated, I just wasn’t “ok,” and didn’t like being told I was going to be that way). This could just be me! I am still wary about being called a survivor, I just tell people I have had breast cancer treatment. It is all about personal semantics.

What I honestly don’t know: How women have surgery and care for babies, young children, etc. I have major respect for women with children that go through breast cancer treatment. I wish I could give advice here, but I can’t claim experience in an unknown.

Please add your suggestions and recommendations in the comments below:

Strange Anniversaries

Yesterday, June 3, marks exactly one year from my final chemo infusion. Life is full of strange anniversaries after cancer treatment, some good, some less good, but each anniversary is a cause for celebration in its own way. I find myself in a strange transition between moving past everything, but knowing that everything can turn itself upside down unexpectedly. I have been putting my life back together even though it never truly fell apart. Bits and pieces just had to go on pause for awhile. We all cope with life and its ups and its downs in our own little unique ways.

I didn’t realize it would take as much energy as it has to recover emotionally from the improbable possibility that I had metastatic breast cancer to my spine and the relief that comes with the news that something isn’t cancer. I guess I didn’t realize how truly afraid I was deep down inside – life in active fear is not a good life. So you learn to tuck that fear back down, put one foot in front of the other and go on.

Recently I was thinking about how much I love my husband and how we have planned to get old and gray together. We have random plans about where we are going to live and what we will do when we retire together (the typically involve the ocean, a boat and a beach house). Today I was able to visualize myself there again, sitting on that porch, watching the waves in ocean, breeze blowing my gray hair about, sipping a beverage that several of my loving relatives wouldn’t approve of and just being together. Cancer has a way of strengthening a relationship or destroying it, and I was lucky enough that ours really did result in the life lesson to not “sweat the small stuff.”

So, I love my husband tons, my family is amazing, and I love my job (and my four-legged children Zack and Dante). My friends are awesome, I miss some of them as I see some less because life is a bit busier again. Life is good.

I am a different person than than I was two years ago. I am o.k. with that. I have always been in a hurry in life, I needed things to happen NOW. Patience is a virtue, and when you learn to spend hours and hours jumping from an appointment, to a test, to a REALLY long chemo infusion you realize that sometimes you just can’t be in a hurry. Slow down, enjoy the moments and stop focusing on tomorrow. The day goes by too fast in my opinion. I want to savor more moments (yes, I am cheesy).

My back has improved. I imagine it is related to my decrease in stress, a doctor hasn’t poked it hard recently, more exercise, changing chairs at work (no new bed yet…). I can tell that it can easily be pulled/hurt/upset. I am pulling weeds by sitting down instead of bending over (which I think is a major improvement, weeds have been pulled!). Mike and I figured out that planting the garden is when I aggravated my back, so I am a bit more careful as I build up strength. I have not gone to physical therapy yet… the decrease in back pain has loosened my resolve to go, but if the pain comes back I promised myself I would go. I am tired of appointments (it took me four weeks to make a hair appointment to tame my wild mane – I go in Thursday for haircut number four).

With anniversaries come memories. Other items and situations also stir up memories. I was giving my mom some of my radiation burn medications/ointments/sprays today (I have handy dandy stuff if you ever get a sunburn or any kind of burn) and I told her it was stirring up memories of radiation (I guess I have most of that blocked out along with most of my chemo experience). I keep the good memories, good memories are good…

Here are some photos of my progression since diagnosis:

1/9/11 – Just before surgery at Mike’s work party. I called it one of “their” last evenings out on the town…

Gussied Up

1/18/11 – During the testing phase, this is the day we found out that my breast cancer had moved to my lymph nodes.

Here I stand in a billowing gown of Huntsman oversized goodness.

Here I stand in a billowing gown of Huntsman oversized goodness.

2/10/11 – Two weeks after my bilateral mastectomy:

Two weeks after surgery and I am "rockin it" and feeling awesome.

2/25/11 – First chemo infusion, Adriamycin and Cytoxan:

My lucky pearls from my mom.

3/11/11 – Chemo infusion number two:

Another super nice "drug pushing" nurse. :)

3/13/11 – My mohawk that barely stayed in place while we shaved my hair that was falling out rapidly:

Sporting a mohawk.

3/25/11 – Third chemo infusion:

Showing off my drugs.

4/8/11 – Fourth chemo infusion, final Adriamycin:

Final Adriamycin injection.

4/22/11 – First Taxol, fifth chemo infusion:

Dad and I.

5/6/11 – Sixth chemo infusion:

Our dueling PICC lines.

5/20/11 – Seventh chemo infusion:

Dad, Dereck and I.

6/3/11 – Eighth and final chemo infusion:

Mom and I at my final chemo treatment.

7/18/11 – My first signs of some serious hair and I finally returned to work after taking a couple of months off for surgeries and my final chemo treatments:

This is my fuzzy and I shall call it my fuzzy. 1 1/2 months post chemo.

8/10/11 – My hair was long enough that I quit hats and scarves, prepped for radiation and EYELASHES!

Hair, Eyelashes and Eyebrows Oh My!

10/18/11 – Starting to really feel like I have hair:

Goofy picture that makes me giggle, but look at all of that hair!

11/12/11 – After my first haircut and *cough cough* no more gray hair, not that I ever had any:

At work after my haircut and the new color.

12/19/11 – After second haircut:

Mike took this when we were goofing off at a friend's house. I call it "deep thought."

2/14/12 – Lunch with my hubby and apparently I have breast lumps, again… but not the cancerous kind:

Lunch with Mike. :)

5/5/12 – Visiting NYC:

On the Highline in New York City

I am completely amazed that it has been an entire year since my final chemo treatment. Life is so incredibly different this year than it was last year, and it will continue to be marked with strange anniversaries, which I will celebrate on the inside or the outside. Each new day is a blessing.

PS Today I found a Gatorade in the freezer and I asked Mike why he left a Gatorade in the freezer. He laughed and said I had stuck it in there on one of my “chemo days” (which means I was out of it) insisting that I needed my Gatorade really cold and I forgot about it (chemo brain). The Gatorade is thawing on the counter so that I can pour it out. One year later…

 

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