Just One Pill

It’s been a while since I’ve written.  I think about it, but just don’t do it.  I still have an open wound, but I’m healing.  I had home health care nurses visiting every other day to tend to my wound, and then my husband took over.  The nursing folks decided I should pack the wound with calcium alginate, which comes in squares similar to a 4×4 gauze and looks/feels somewhat like gauze.  It is working, very slowly, but I am finally healing.  I’ve returned to work.  And, I’ve developed adhesive capsulitis of the shoulder, a fancy term for “frozen shoulder”.  The range of motion issues with my right shoulder began shortly after my incision first opened up, which was right before Thanksgiving.  Because of the pain from the surgeries and healing complications, I was rotating my shoulder forward and holding my arm in front of my chest — partially to protect myself but also to guard my chest and to keep from extending my arm too far and tearing the incision open any more than it was already.  Now I can’t move my arm higher than shoulder height and can only extend it outwards about 4 inches.  It hurts like a bitch and has caused even more restrictions in my activities.  I can’t even reach high enough to wash my hair.  So, every morning, I rise at 4:30 a.m. so my husband can help me shower and then do my wound care.  Again, I am grateful to have him and feel lucky to have such a wonderful caretaker.  But I am so tired of getting up at 4:30 a.m., I am tired of not being able to do things for myself.  I am just tired.  All I want to do is sleep.  It takes all I have to make it through the work day and come home with a smile and energy to interact with my kids and husband when all I want to do is go straight to bed.  The pain in my shoulder wakes me up every 3-4 hours.

I was starting to get depressed and was even considering anti-depressants.  I mentioned it to my oncologist and he said that some anti-depressants can affect the metabolism of the Tamoxifen so I needed to make sure that whoever prescribes them is aware of that.  At  a subsequent primary care appointment (for the shoulder), I received referrals for x-ray, MRI, physical therapy, orthopedic surgeon, and mental health.  I’ve moved out of the depression funk a bit, so anti-depressants are off the table now.  It was really a last resort, a hope that a pill could fix everything but I really didn’t like the idea of taking them.  I don’t begrudge anyone for taking them – I think they serve a really good purpose and can save lives.  I was on Zoloft for years to help deal with anxiety and depression, but I realized that, for me it was situational and my inability to deal was just that: poor coping skills.  The Zoloft just masked the symptoms and kept me from having to deal with my issues and move through them; rather, I just moved around them.  I stopped taking it about 3 years ago.  Getting off of it was a NIGHTMARE and I remember saying that I would never take anti-depressants again due to that.  Still, I was thinking maybe right now would be a good time to consider doing it short-term, to help me through this rough patch, but then I did some research on the drug my oncologist recommended (Effexor) and read that it is the worst one to go off of.  I’m done considering anti-depressants, for now anyway.

I also saw my OB (annual checkup) recently and she recommended I find a breast cancer support group.    I don’t think I’m brave enough to walk into a room full of strangers and talk about this, but maybe it could be helpful.  I may look into it.

I can’t help but wish there were a pill to fix everything, a pill that would have no ramifications, no side effects, just one swallow and everything would be better…man, that would be epic.

Advertisements

Back to Work Again

Tomorrow I return to work again. I recalled writing about returning to work after my surgery in October. That was supposed to have been my last surgery. That was supposed to have been my return to work for good with my little breast mounds all resplendent with scars. Never would I have dreamed that in less than two months, I’d be returning to the OR to have those implants removed. I am still stunned. I was always a good healer, yet my body refuses to heal. When I was newly diagnosed, awaiting my double mastectomy, I was struck with the realization that until cancer, I controlled what happened to me. I was in charge of my health and fitness and appearance. Now I have no say. My body is in charge and it has failed me.
This morning I had my stitches removed and now I am having a good deal of drainage due to seromas. This is alarming to me and certainly inconvenient, but it appears to be common and nothing to worry about. Except that tomorrow I have to go back to work. I am already self-conscious enough about my breastless, concave chest, and now I am worried about incision leakage. I’d already been trying to decide which shirt to wear that would somewhat camouflage my breastlessness. Now I must consider that I’ll also have gauze taped to my chest and that I may leak through the gauze. Should I bring a change of clothes? I’m also worried about injuring myself or my wounds, which aren’t completely closed yet. I’ve decided I may need to suck it up and tell my boss exactly what my limitations are in terms of lifting and reaching…it won’t be an issue, but I just hate having to say it.
I feel sad and anxious about having to go back to work tomorrow. However, I’m sure that If I were to write tomorrow night, I would say that the day went just fine. I would say that I found something perfectly suitable to wear, no one stared at my chest, I didn’t leak through my clothes, I had plenty of help with opening doors and such, and everyone was just lovely. And truly, I would be surprised if it is any different.

Setback

I finished radiation to my right breast (where my right breast once was anyway) at the end of April and had my first reconstructive surgery (placement of tissue expanders) on June 4. At that time, my skin was discolored and somewhat tight, and I had limited range of motion. My plastic surgeon wanted to get to work as soon as possible after radiation was done because of the damage it would continue to cause long after treatment was done. I was completely unprepared for the pain I experienced following that surgery. It was like nothing I’d ever imagined, and I like to think I have a pretty high pain threshold. For a full week I was unable to lift myself from the bed unassisted. I needed help doing simple tasks such as brushing my hair or lifting a shirt off the closet rod. I had to swallow my foolish pride and ask for a third week off from work because I was still in pain and too weak to return.

Time and rest helped and soon I was back to my normal routine, even flipping upside down at yoga, doing my first handstand since my mastectomy (soooo exhilarating! Today as I write this, I can’t imagine being able to hold up all of my own weight, upside down, again).

On October 1. I had my second reconstructive surgery (replacement of tissue expanders with “permanent” silicone implants). This surgery wasn’t so bad. I was able to sit up and do most things for myself pretty quickly, although I was (am) so fortunate to have a husband who dotes on me and takes care of everything before I even have to ask. I went back to work as planned after my two-week recovery. But I was exhausted. So for the first week I cut back to 8-hour days instead if 10 hours. And then I was still exhausted. The surgeon said to give it a good 6 weeks before the exhaustion got better. I also had this nagging pain at the incision site on my right side. At some point, I just became accustomed to always having some sort of pain, so I just try to deal with it, maybe pop a Percocet, and try not to whine or let it hold me back. But then the nagging pain turned into a stinging, almost stabbing pain, and my incision started to look weird. My surgeon gave me antibiotics and said to return in 2 weeks. I went back sooner, at which time he said it looked like one of the internal sutures was working its way out and causing irritation. He removed the suture and gave me instructions on cleaning and dressing the area and said to come back in a week. Two days later it was clear that I was headed towards infection, so the nurse called in another round of antibiotics for me and told me to come to the office after the weekend (sooner than my scheduled appointment).

So today I saw the surgeon. He examined things, poked a little, shined his flashlight on me, and finally told the medical assistant to move me to the big room. He was going to give me a local anesthetic and remove some stuff and sew me back up. And, he added, this was his last shot at saving the implant. I had no idea things were that serious. So he performed his procedure (turns out, the “stuff” he removed was dead skin and tissue…as in necrotic…as in it died because it didn’t have proper blood supply, one of the effects of radiation), and he sutured me back up. Although I was numb, I could feel a lot of pressure and pulling and tugging, so I figured I’d be feeling it later, and I am. It hurts like a mother.

It had crossed my mind before, fleetingly, how much it would suck if this whole reconstructive process failed as the consent forms indicated it might. When I was reading all the warnings about healing and failure to heal after radiation, I thought, “Nah that won’t be me. I’m a good healer. Those types of complications only happen to other people.” Hmmmm…that’s what I always thought about cancer – that it only happens to other people. Again I am reminded, shit can happen to anyone. And right now, I’m hoping the shit that happens to me next is that this incision heals and I get to keep my implant. A week ago I was considering what type of tattoo art I might get to hide my mastectomy scars. Today I am just hoping I am not headed towards more surgery.