91. Operation Finale : Phase One = Complete

I'm lounging in bed with lots of pillows, cups of tea, Jurassic Park and moggits.  Two days ago I went in for my (take a deep breath......) bilateral breast reconstruction liposculpture fat grafting, nipple reconstruction and dog ear revision surgery.  Basically, I had my lardy bits pummelled out and pumped, very expertly, into my reconstructed breast tissue, had the ends of my scars snipped off and finished and had some nipples made from my own skin, which all took 4 hours.  I'm still a little swollen so it will take a while to see things settle down and I go back to see comedy surgeon in 2 months time for a review.

I've been hanging onto an extra 8-10lbs I gained over the summer (thank you implant) in anticipation of this surgery.  It doesn't look like much but they are much fuller, about a whole cup size and instead of being empty in the top of the bra cup, they now meet the material and fill the cup - AMAZING!!  From a 35A to a 36B again.  I may lose 50% of the fat injected but that is remedied by one or two more liposuction sessions.  I've never posted photos and I plan to dedicate a whole blog post  from the beginning to the end when I'm complete, like closing the book on things and demonstrating visually just how amazing plastic surgery is these days.

My breast reconstruction was 3 years 7 months ago now and over the last 2 years, after being passed to the Plastic Surgery team, I have developed a really relaxed and jovial relationship with comedy surgeon, an expert in the field of breast reconstruction and correction of breast asymmetry.  He treats me like a person, not a lump of flesh and we have a good laugh.  He knows that I expect his very best work and I know that he gives it.  

I was very impressed with his plastic surgery team, one very handsome surgical assistant and one very handsome anaesthetist - sweet!  The anaesthetist team were excellent, introduced themselves to me individually as I led on the operating table. 

Handsome anaesthetist put a cannula in my hand and joked about stuff whilst everyone else hooked me up with sticky monitor pads and tubes.  Then I had the G 'n' T drowsy stuff which always makes my heart race.  It could make you feel panicky if you let it but you have to breath deeply and relax and go with it, you are in expert hands.  They then give you the proper stuff and you are gone in seconds.  The next thing you know you're in the recovery ward.  I'm not sure if someone sits with you the whole time you are still under, waiting for you to rouse from your induced sleep, but there has always been someone right there when I wake up.  It is so comforting to have someone there.  I talked gibberish but knew where I lived and my name so that was good news.  Then, as if my magic, I am on a ward, so I guess I passed out again and missed the trip through the hospital corridors and lifts.  

Two hours later I was starving and eating cheddar Burts crisps with my husband by my side, then felt nauseous and my nose was mega itchy, so I must have had morphine somewhere down the line.  Anti-sickness and anti-itching pills were administered and 20 minutes later I felt much better.  Hooray for not eating the meatball dinner.  My backup chocolate and jelly worms would came in handy.

I bummed out on the bed lottery, the only one on the ward without a TV and a dodgy bendy light with a broken switch.  It was also closest to the toilets and right next to the nurses desk. The snoring, coughing, painful moans, old man shouting, toilet visitors and general chit chat was never going to let me sleep.  My phone had died just before I'd gone into surgery so I had no music at all.  I was left with my earphones so I stuffed them in my ears anyway, ate chocolate and jelly worms, did puzzles and drank Horlicks at 3am until I finally got to sleep, 4 sweet hours of it.

The pain is minimal unless I move.  I don't visibly bruise much but they are beginning to come out over my hips, outer, inner and backs of my thighs, under my boobs, my belly, and my boobs themselves with some uncomfortable swelling at the ends of my dog ears, but generally things went very well and my boobs are looking fuller and more even.  I can't wait to meet my new nipples next week! It's going to be bizarre!

90. Pre-Op for the Finale (Phase One)

After a second night of insomnia and only 2 hours sleep I had to get up for my Pre-Op assessment on Thursday.

What is a Pre-Op?

Pre-operative assessments involve blood pressure, weight, blood, swabs and a chat about medical conditions. I can highly advise taking an 8am appointment if you can, as with doctors surgeries, the team gradually run late by the afternoon. I have, in the past, on a number of occasions now (I am getting old hat at surgery now) spent over 4 hours in a Pre-Op Assessment ward with an afternoon appointment. Hot, stuffy, boring as hell. My 8am appointment was over in an hour and half, brilliant stuff and the best experience of Pre-Op yet.

6.45am  Alarm...eurrghh!

6.55am  Cup of STRONG coffee

7.10am  Lashings of anti wrinkle cream

7.35am  Out into the crisp new autumnal air and into the 8am rush hour

7.45am  Discovered the 8am commuters are grumpier than 9am commuters and way more aggressive.  How rude!

7.58am  Arrived at the hospital and was spoilt for choice with parking spaces, this is a rare, rare event and I liked it.

8.01am  Entered the doors to a gentle world of fresh shift of hospital staff willing to help, smile and direct me to where I was supposed to go.  Felt sad that most would leave feeling knackered and frustrated having walked past some of them clocking off and going home on my way in.

8.03am  Arrived in the peaceful and friendly Erme Ward, filled out my form and took a seat, watched the Paralympic hand cycling.

8.10am  My name was called and the poking and prodding commenced.

Step One: Blood Pressure & Weight

Having just driven there with a bunch of aggressive driving commuters, I wasn't completely relaxed, plus I always get a little anxious entering hospitals. It always baffles me why they do this bit first for that very reason. My blood pressure was fine, 112/75 (blood pressure explained), but apparently I should have been dead with 238 heartbeats per minute!! Holy cow! Thankfully the machine wasn't working properly, so it was the old fashioned wrist and watch beat count = 75bpm. Phew! I was still alive!

The next bit was the depressing bit, the weigh in. I think all weighing scales in hospitals make you heavier than you are. I had an progesterone implant put in 4 months ago, and suddenly put on 8lbs in weight, which is good for my upcoming surgery but highly unusual for my stable weight record. Back in November 2011, comedy surgeon was concerned that I didn't have much fat for him to work with for fat transfer. I can officially confirm that he now has plenty to suck out and juggle around.

Step Two: Chat & Questionnaire

I ramble at this part. Sat in room with a closed door and a nurse, there is a 4 page questionnaire that the nurse goes through with you, asking about eyesight, allergies, previous operations (which I find weird as they have records of these..surely?), mental health etc. It is this stage that I realise I'm pretty healthy at 39 years old and feel lucky to be that way. The nurse was a lovely lady, we laughed a lot and found out that she had never had a general anaesthetic - lucky woman!

Step Three: Bloods & Swabs

The blood and swab nurse was lovely and chatty.  She took my nose, throat and groin swabs for MRSA tests and took my bloods.  A few pokings, a small scratch and a nice compliment about my dress later I was done, free to leave.

9.35am  Walked out of the hospital feeling good.

9.37am  Walked past the medic team waiting for the air ambulance to land.  As it landed about 50 feet away, a sudden upwelling of emotion came over me as I remembered the day my ex-fiance didn't quite make it to hospital in the air ambulance that tried to save him.  He died as it landed on the helipad at Salisbury hospital after a big RTA.  That day I should have been driving, not him, that day I was spared my life or serious injury at least, and although I have endured other battles, I am still here and I can still fight them.  My mortality is very real to me.  Most people don't think of death but I am very much aware that I am alive and I want to feel it everyday, not sit when I am 80 and realise that I sat on my arse, watched tv too much, stayed indoors, never took risks, did nothing with the time I had here on Earth.  I shed the tears that came from nowhere from the moment, wished the person inside made it, and then sat in my car and smiled to myself remembering some good stuff and then made my way to work.

The countdown starts here for Finale: Phase One = nipple reconstruction, back scar revision (part 2) and fat transfer for breast augmentation (amending one flat one to match the other with a little extra pillow plumping).

Weeeeee!! Here we go!

87. Plumping my pillows

What an absolutely gorgeous day it was today.  As I drove around the fringes of the city towards the hospital, the school kick out traffic slowed my pace.  I was able to people watch a little and sat perched on bus stop benches in the sun were women in colourful skirts, exposing freshly shaven legs - with freshly cut and blood scabbed shins.  Lovely!  Guaranteed, the minute the sun comes out, the first 'exposure' shave will end in tragedy with blobs of tissue stuck all over the place to stop the never ending bleed that comes with a razor skinning.  

As usual, nowhere to bloody park.  I drove through every single car park in the hospital grounds before I found a spot, where I wasn't supposed to park.  Sod it!  On entering the Outpatients some woman was ranting about photocopying a piece of paper, which obviously needed the attention of ALL FOUR RECEPTIONISTS AT ONCE!! Two other patients and I waited a polite little while until I wanted to shout, 'Get the fuck on with it will you!!', but I didn't, I'm too pragmatic in such situations so I just stepped right up to the desk and forced one of the receptionists to deal with me.  She stretched with here hands on her face and yawned, "Can I help youuuu?".  Rude cow.  The usual security questions were asked.  Security, seriously? If anyone wanted to steal someones identity, just hang out in Outpatients where patients reel off all manner of personal details aloud for all and sundry to hear.  Good place for stalkers too, phone numbers given out and addresses - genius NHS, utter genius...

For once Waiting Room 2 was nearly empty and the open window seats were free.  Phew, it was hot - like 22C hot, nice for outside but not sat in a stuffy hospital.  Comedy surgeon was late but I did't mind, I was twittering to some funny ladies and looking at the people as they were called for their appointments, one by one, emptying the waiting room further.  Finally it was my turn.  Into the small room I've seen many times before along this journey but no gown today which can only mean no boob flashing.  This was a first, I often feel exposed (of course) and talk a lot with nervousness when I'm half naked in front of two men who poke and squeeze my boobs.  Comedy surgeon and sidekick surgeon entered the room and smiled with familiarity and I felt comfortable.  I proudly announced that today we were going to talk fat transfer.  He flicked though my two inch thick file and his notes, nods and mumbles then told me to stand up so he could check me over for wobbly areas.  Thankfully I'm harbouring enough lardy bits (thank you cake, pizza and revision laziness) to make the operation possible, but I am not allowed to lose weight.   

We discussed the downsides of the surgery; possible infection, cysts, fat necrosis, loss of fat cell percentage (30-50%), uneven breasts, bruising and soreness.  I have to stay in overnight for the first procedure so they can manage the pain levels.  I'm sure it won't be that bad, nothing can compare to what I have already been through with my first surgery.  

The positives of this type of surgery are that the fat transfer is natural and good results are achieved.  The fat that forms new blood supplies in the breast tissue will stay forever and change with my weight, which is one of my big issues, and I will gain volume in the upper part of my breast too which will help fill a bra cup more fully.  Obviously I will have a more svelte bottom, thigh and tummy region where they liposuck (sp??) the fat from and bigger boobs.  Yay!

The first procedure will take 3 hours maximum as my nipples are being done at the same time.  The second and third procedure will just be fat transfer via liposuction so I can grow some more podge in between each session (about 2-3 month intervals).

So, by Christmas I might look more like Dolly Parton and less like Popeye's wife, Olive in the boob volume department.  No, seriously though, I will be happy to gain a cup size and some fullness so I can go back to normality, as close as I will ever be.  Just waiting for the appointment now and I am excited!  

84. Before I actually say no to the boob plumping

I have just seen some fat transfer videos and can't believe how amazing the results When I was keen on this surgery a while back, comedy surgeon reckons it wasn't really worth it but that was a couple of years ago.  Now the procedure is more common, he is offering it to me and I thought I wanted to be finished as I am, but now I am not so sure.  Maybe I do want a bit of re-sculpting all round - as weird as that sounds - a part of me wants to experiment down the path of 'lets make your boobs bigger with fat transfer' (non-graphic fat transfer breast augmentation video here) and a fantastic before and after photo gallery of natural breast augmentation.

Now I know in my last post I said I wasn't going for this but my 'this will only be offered to you once, you only live once, why not' brain kicks in.  So, I think before I get trim for the summer maybe I should just relocate it instead? I am calling my comedy surgeon tomorrow and telling him I want the complete finish me off works.  A girl only has one life and although I am on my second pair of boobs, they could do with a little enhancing of the natural variety.  Fuck it, why the hell not? 

83. Time to get Nipple-tastic!

Time, as it does, has passed.  It's been nearly a whole year since I last posted and, as usual, its been a mixed bag of life, adjusting, accepting and blossoming in the esteem department.  The revisions that were done a year ago worked out really well (indentations now gone) but there is still work to do and I popped back for a visit to my cheeky surgeon about two weeks ago to discuss the end.  Not any old end, the end of my surgery (I hope) apart from the tattoo maintenance that comes with reconstructed nipples.

For the first time there was no woman present, which I thought was odd but it didn't bother me and I was introduced to the young male assistant I assumed was a doctor in training. 

My comedy surgeon to young male Assistant: "Now this, this is a very tidy breast reconstruction!"

I was unveiled for his perusal.  The eyebrows raised and a pleasant or surprised look crossed his face (probably a mix of both, it was hard to decipher).  He didn't say a word for the rest of the appointment - maybe I scared him a little, I can be a bit motor mouth at times, particularly when feeling nervous or exposed!

My comedy surgeon starts to discuss nipples, how they will be made, explains how they will STICK OUT ALL THE TIME.  Yes, I know this, but it poses a problem.  I hate wearing bras since my reconstruction.  Nothing fits, nothing is comfortable.  You go without a bra for 3 years then try and put up with one all day long...my god it is torture!!  Rip the bugger off at the earliest opportunity!  Bloody hate them - pretty things but not for me anymore.  And so the problem of permanently erect nipples.  How am I going to live with them?  I guess I will just have to let people stare and wonder what type of floozy I am to wander around without a bra on, letting my nips stand out for all to see, all the time.  Well, fuck them...fuck them all.  If they knew what I'd been through physically and emotionally in order to get them then they can friggin' well enjoy them too.  I am not covering them up all the time with a boa constrictor of a bra in order appease their narrow minds about women's undergarment choice.

To the procedure - here's a pic of how comedy surgeon will make my origami nipples:

Having done Graphic Design at college, this strangely reminds me of flat pack designs for packaging for toys but in real life, I've seen a friend's and they look amazing.  I just hope mine do to.  

As for boob plumping, I've been offered fat injections to make them a bit bigger but that might only last for 3 years, and the fat cells may not even take and I don't want to face anymore weirdness thanks.  I've decided that my vanity is not strong enough to want them bigger, despite old grievances about the loss of my perfect 36B breasts.  My new ones are lovely, forever pert, small but beautiful and they just need finishing off.  The ends of my 16 inches of back scars need rectifying again so that's booked in at the same time...UNDER LOCAL ANAESTHETIC!!  Local he said, where I am awake.  WTF? I did ask him if I would put him off with all my talking..and what if I sneezed?  I have no idea how this is going to work but he convinced me that I can in fact have myself cut up whilst I am awake..and I agreed.  Gas and air will be at the ready - maybe I need a training run on that to make sure I don't giggle my ass off (I can do that without gas and air) and end up with extra nipples.  I'm up for the challenge - at least I can keep an eye on them and, as comedy surgeon says, I will find it fascinating! True I guess.

So I await my appointment for the knife, again.  Hopefully my exams will be over and I can then get on with my summer and getting some areola tattoos done.  

The end is in sight.  Smooth and sticky out I shall forever be!

82. Unveil the revisions nurse!

A lot has happened since post 81. Bouncy Ball Therapy so I will try not to waffle on.

The update for today is really that I am fresh from a visit to see my GP nurse, after having my revision surgery unveiled for the first time. I can tell you, I am elated. I have suffered this last 18 months with my neck, back and muscle cramping spasms in my chest. I feel so much more comfortable today, despite the soreness and stickiness of my skin from removing dressings and sutures. The band of tightness has reduced and although it is still there all the time under my arms, my reconstruction breast muscle has been released from that spasm. I am relieved. I risked losing my flaps if the blood supply was cut by mistake but my surgeon did good.

Background story
SKIP if you know my story of reconstructed boob spasms and whining about neck pain. FIRST TIME readers - heres a brief low down...

It has been 18 months since I really re-entered life again after my LD Flap breast reconstruction some 9 months prior. I started Uni so I could retrain after being made redundant from my job. That was September 2009, and after only a couple of months back to a basic but normal life, I started to go downhill physically with weak back, neck and shoulder strength. I wasted a year of Uni because my neck was getting worse, not better and lots of typing and sitting down doing my computing course were not helping. I even had to rethink my career path because of my neck and spasm issues. I felt better being more active but without lifting weight or typing lots. I decided on an Extended Science BSc course and it has been challenging with all my appointments this year; with physiotherapists, doctors, surgeons, hospital, all on top of my studies but I made it through and did pretty well this year. Very pleased indeed!

To summarise, it has been a tough 18 months (with added complications which I don't need to bleat on about right now) but 7 days ago I had my 4 hour revision surgery with the lovely Mr Camp, my seriously wonderful surgeon. My overlapped nipple patch sections have gone - now smooth, my dog ears have gone - now smooth, lengthening my scars to about 8 inches each on my back and I have two new scars, one inch each, vertically, under each armpit through which the spasm causing nerves for the LD muscles were hunted down and snipped. I have decided to get some will be getting some photos posted soon of my whole process but was feeling a little shy before but I feel it is time to share it as I am quite proud of what surgeons can do for women in the predicament I find myself in by being BRCA1 positive.

I had my surgery at Derriford Hospital under the superb care, level headed and joking manner of Mr Camp, a plastic surgeon and the staff of Freedom Ward and Lynham Ward were brilliant. Short staffed but calm, friendly, helpful and kind. I stayed overnight with some great people under the weather with an interesting selection of different physical issues. An unstoppable nosebleed, implants balancing odd breasts, an ulcerated throat, a thyroid gland removal and a leg injury..oh and me with my breast reconstruction revisions and denervination of muscles.

Clean, infection free, comfortable overnight stay with extra helpings of toast and jam for breakfast please. You were all brilliant!

I, on the other hand, am healing very well and looking forward to going shopping for summer vests that I now feel I can wear without conscience of onlookers staring at my indented nipples patches (paddles) through my tops. I am still not sure if I will wear a bra again. So many friends have commented about how nice it would be not to wear one ever again and I am so used to it. I might just get some nude coloured covers like these after I get some little nipple bumps done - not sure I want anything too much of a nipple really - and these would help cover them up in sheerer clothing. Nipple Patch - Silicone Petals

75. Physio, Tidy Up & Fix It Surgery

Happy New Year All!

I am joining the January surgery mob (other BRCA Sisters out there are also on the list and we step forward together). On 16th December I had an appointment with two Plastic Surgeons and two other doctors. Five of us crammed in a small room and all intensely talking about my breast reconstruction, my boobs. It is a thing you get used to. I have lost any kind of shyness I may have had about getting them out with the amount of viewings they've had!

I told them about my problems with tightness, spasms and pain and they asked me to do the side front, bend twirls.

My main Plastic Surgeon is not the guy who did my Breast Reconstruction and he said he needs to discuss the surgery and how it was done with the original surgeon. They are planning to de-nervinate my Latisimus Dorsi muscles which now form the volume of my breasts. They are both still reacting to movement and tensing. Sometimes I get twitching so strong I can feel it for ages after the initial spasm, like they lock up and stay hard. Today I am going to record a video of their magical moving properties so I can look back on the changes. I will post this in BRCA Umbrella for everyone's amusement! Remember the pec dance clips of the past? Maybe I can do a version of my own. I found one!! Check out this video ->


http://www.youtube.com/watch?v=8utKIVvxaPE

Risks: as the surgery to cut the nerves from my Lat Dorsi muslces that now reside happily and unhappily in my boob skin is detailed, they could potentially cut the blood supply to the muscles themselves instead of just the nerves. Not good but I have to take the chance.

Physio says: My pectoral muscles are too strong. This is pulling my shoulders forward and I seem to be getting more and more tingling in my hands and elbows like nerves are trapped. She made me do some moves that sent a stinging and intense pain down each arm right through my elbow to my wrist. Ouch! I have some moves to do to help stretch them out but the Lats help keep your shoulders back and without them I am compensating lifting with my pecs instead and seem to have overbuilt them. This explains some of my problems. I shall speak to the surgeons about her comments too. Something is restricting my nerves in my arms and causing the pain.

Will it ever end? Yes, at some point I will just say ENOUGH but for now I have to go forward. BRCA1 gene - You shit!

3 weeks now. I am looking forward to it and dreading it too.

70. Bra meltdown

So I am now a full time student at University. It's taking some getting used to but I am loving it so far, not a lot of work started yet but it's still intro stage I guess. Starting Uni and venturing back out into the world again after my surgery has thrown up a few problems, those which I hadn't really considered before.

I get a lift to the city outskirts with my husband and have been walking nearly 3 miles into Uni. I made sure I bought a comfy, extra padded backpack to carry my stuff but I am feeling the effects of my efforts. There has been muscle tightening and pain in my left breast, like everything is still pulling internal stitches. If I try to do anything too heavy going I suffer for days afterwards. I am calling my BCN today to see if I can see my surgeon and discuss any remedy for what I am feeling. Previous posts have mentioned my issues with my left breast and I guess I gave it enough time to settle down, but it hasn't. Even as I am typing this blog post 'leftie' is twinging in protest that I am writing about it in a negative light. It knows it is smaller or more spread out than rightie and has an image crisis.

I thought all was going so well, I was getting stronger, less incapacitated but it turns out, no..actually. I stupidly tried to push and pull a few uni doors and have grimaced at the effort required to do so. I can't be wandering through uni for the next 3 years as the woman who gurns when she opens doors!! The disabled button is welcomed!! Automatic doors in most buildings which is SO helpful.

The saddest of all the problems is that I realised how conscious I am of my dented nipple patches. I know they are going to sort them out but it scares me, I don't want them to be worse than they are now. I have been through so much already and I am worried about more deformity (although my husband still tells me I am as sexy as ever).

As I walked into uni the other morning, it was windy. I have only found one bra so far that kind of fits me okay but it is tight around my back and sides and I feel like I'm in a vice. I don't wear a bra and I love not having to but I have recently found some lovely fitting long sleeved tops but they show my dents through. I had an open shirt on this particular day with a tight top underneath but all the way in I was pulling it over my boobs to hide my dents. I was sad. I realised how much that still bothers me and I don't want people to stare or wonder what the hell is going on under my clothes!

To remedy the situation I went to the shops during a lecture break and hunted for a comfy bra. Eventually I just cried. I stood in front of the mirror in the fitting room and cried. I used to be a 36B but according to the bra measuring guide I am a 36A but I'm not. Not at all! I gathered different makes of 36Bs, 34Bs and 36As but all didn't fit. My new breasts are soft and the right one goes into a bra cup great but the left one doesn't. The surgery took a lot of tissue out from further up my chest but this hasn't been filled in by much. This means I don't fill the cup at the top. If I go smaller in cup size to compensate, the cups are too close together.

A 36B is comfortable around my body but the cup is too big, the top is empty and gaping.

A 36A is comfortable around my body but the cups are too close together and my boobs don't fit in them because they are quite a lot more fixed in position than my original boobs.

A 34B is tight around my body but the cups are in a better position and fit better.

What I need is a 35B I think but it does not exist. I had this discussion with my surgeon repeatedly, I almost begged him not to make me smaller as I would have bra trouble..and here we are, smaller and bra trouble. I am frustrated. Although I agreed I would rather not have implants I would like them if he couldn't make me the same size as before. He didn't use them even though they were on standby in the operating theatre.

Why does this matter to me? I will only get nipple reconstruction if I can wear a bra comfortably. If I can't wear a bra I will always have to dress in layers or thick clothing or wear stick on nipple pads to hide my permanently erect fake nipples! This whole dilemma frustrates me immensely and sometimes I get down with the amount of thought I give to this small problem, because in the grand scheme of things, it is a small problem. I need my nipple patches sorting out first and foremost, the dog ears make bra wearing uncomfortable too and they are going with the first tweak surgery. I won't go ahead with that until I have made up my mind about nipples because I want as little surgery done as possible and the tweaks can be done the same time as the surgery. I can't decide on nipples unless they can fix the pain and muscle spasm in my left boob. I can't wear a bra until the nipple patches are sorted and so I try and deal with my feelings, my self consciousness, my daily dressing dilemma.

It's getting colder so maybe I should just invest in some winter warming devices like these to cover up with?

63. Did you want nipples today? Sorry..we cancelled

I am thankful for my strength of composure and character in what has been the farce of organising my tidying up surgery after my breast reconstruction op. I could have lost the plot by now otherwise. If you remember, this was brought forward by two whole weeks which left me with just one week to get mentally prepared instead of three!!

A couple of weeks ago my nipple reconstruction and tidy up date was 8th June. I organised my pre-op appointment for 3rd June and then I go away for a weekend, come back and it's 1st June. So I cancelled my pre-op and tried to arrange another in time as I literally had days to get in and get swabbed for MRSA, blood test etc. I couldn't get hold of them all day one day and then when I got through the lady who organised the appointments was away from her desk. Then when I got through they told me I could arrange it anytime, even just turn up and wait. So I called my surgeon's secretary just to advise her that there may be a problem if I couldn't get seen in time.

Please note that it is Friday..

Me: "Hi there, I'm booked for surgery on Monday and I am concerned that the appointment was moved without pre-op being arranged in time. I think I am going to have to cancel."

Sec: "Let me just check the diary."

I can hear her flicking through pages.

Sec: "..erm..we haven't got you booked in for surgery on Monday. You wanted to speak to Eric about nipple reconstruction before you had the surgery done so the appointment was rescheduled."

Me: "Right. When was I going to be told that I wasn't having surgery on Monday? I was prepared to go in at 7am! And my husband has taken the afternoon off from teaching to pick me up. Eric was going to call me as time was short so we could discuss the surgery rather than coming into hospital. He hasn't."

Sec: "No, I am so sorry. I can only apologise that he hasn't done so. He has a note to call you. He is on annual leave for 7 days."

Me: "This is the second time he has rescheduled my surgery because he is going on holiday. I am not very happy really. He's enjoying himself and I am preparing to go under the knife. I don't enjoy being messed around, this is my life!"

She apologised some more and insisted that she would be on him first thing on Monday to explain what had happened.

Me: "Sorry Sandy, I'm annoyed as you can probably understand. You said the surgery has been rescheduled, when for?"

Sec: "22nd June."

Me: "Oh that's great. That's my birthday. Anyone check my file? After what I have been through in the last six months I would like to spend my birthday doing something nice, not getting chopped up again."

I didn't raise my voice, I was just blunt. I can't believe that they can be so insensitive. I guess it's just a task to be done but me, on the other end, I have feelings and life to deal with.

On further discussion Sandy explained that the surgery method was a semi-circular cut for the nipple which is then twisted. It creates a button-like nipple. I explained that that kind of method flattens and has to be redone. I was not in for multiple surgery. I also asked her a few questions:

Why, upon breast reconstruction contemplation, was I not asked about my nipples and what I would like to do about them.
Why was I not offered a mould of them so I could consider prosthetics as an alternative to surgery?
Why have I not be talked to about the various methods of nipple reconstruction?
Why was I not offered different kinds of surgery with different surgeons who specialise?

I expressed to her that I felt I had just been pushed through the NHS machine and I had been given few options, even though Latissimus Dorsi reconstruction was the best option for me and that I was happy with the outcome, even if we had talked about implants on threat of making me smaller - which happened, yet no implants were used. I am happy that Eric did a fantastic job. I said I wanted to see some alternatives to the 'button' nipple option. Sandy said she would speak to the BCNs (breast care nurse) and see what they recommended and that she would call me back. Which she duly did and told me that she would get me referred to the Plastics team for consultation.

Why didn't this happen initially? Why didn't I go to see a plastics team to discuss ALL the surgery options for everything and then decide? Why is everything so damned complicated and irregular? I have some issues to raise with my genetic counsellor about what a person with family history of cancer needs when considering surgery. I am annoyed!

So..I wait some more. Will it ever end?

61. Nip 'n' tuck 'n' physio

10 days have passed since my last blog post. I haven't heard from anyone about the results of my blood test so I must ask my GP tomorrow. I am getting fed up with not having a purpose in life. I have some goals to aim for but I have no routine and feel like I am in limbo waiting for Uni to start in September. Getting made redundant, being skint, struggling to pay the mortgage, surgery, decisions and mental wellbeing have taken their toll. I feel fed up and frustrated. I was just getting used to my body, its pain, restrictions etc and then I get talked to about nipples and more surgery.

I've not seen any photos of just nipples, I don't even know what procedure my surgeon has planned for me and I feel, again, that I have no choice in what will be done to my body. Getting nipples is not important for me at the moment, what I want done is the dented nipple patches (skin from my back) cut around the perimeter and left to reheal - flat. Imagine a jelly with a circle of card on the top - press it down and the result will be a rounded edge on the outside with a flat circle in the middle. That is how some areas of the my new boobs look. One area in particular has an overlap and I have to clean this with a cotton bud. These need sorting out and my surgeon agrees. So..how do they make them? I can only find the procedure below on the net but then there are prosthetics too ..is this seriously an option? I would like to 'try' some first. I think I want my scars to settle before I get nipples. I am also thinking about my future paddling and rub syndrome. With no feeling could they rub to nothing and I bleed to death slowly without knowing?





There are also the 'dog ears' on my back which are the ends of my scars near my waist. Due to the eye shapes of skin being taken from my back, then pulled together and stitched, skin gathers at the ends and protrudes. Its a bit like wrapping a round gift at Christmas - my body is not flat either and straight lines and bodies don't work. So these will go too.

The last thing that can be done at this stage is nipples. I just don't know how I feel about them. I don't want repeated surgery and so feel a little pressured by time to get them done. I quite like not having to wear a bra - not that I could right now and I am wondering if I could just wait until much later to get them done. I'd like to get all the painful stuff out of the way.

On Monday I went to Derriford for my first physio appointment. Lisa (the physio) was impressed with my scars but said I am a little stuck down in the middle. She said it almost feels like the skin and scars have fused on my ribs and that they must be massaged daily to free them. This tightness will not help my movement. The good news is my mobility is between 80-90% which is excellent considering what I have had done. She compared me to a single mastectomy lady who had problems after 6 months and even radiotherapy was less restricting than my surgery. Effectively the latissimus dorsi muscles have been wrapped over things under my arms and some of my tendons have shortened. I have some exercises to do and some press ups at angles to increase my pressing/pushing strength which is weak without the key muscles to do that (being my lats).

All was well and I left after making an appointment to see her again on 3rd June before my booked nip and tuck surgery. I then went to another department to make the pre-op appointment for the same day. On returning to the car some very kind person had parked six inches from my car on an unnecessary angle facing me with the difficult task of trying to get in the bloody thing. A man offered to get in the passenger side and get the car out for me after I briefly explained my lack of twistiness. I declined his kind offer and squeezed painfully into my car and sat and wrote note to the badly parked car owner and stuck it on their screen before I drove away. "Next time try and park your car straight with maybe enough room for both you and I to get in and out of our cars sensibly. Those of us recovering from major surgery do not see squeezing down a 6 inch gap to get into their car as a pleasurable experience! Thanks"

Annoyed I drove home, feeling a sore and tired. Then I opened an NHS letter. They moved my surgery forward a week. Again? My husband has just got time out of work to pick me up and I just made those other appointments. I guess I have to undo them and I have even less time to think about nipples.

Just over 2 years from now it will ALL be over. After my 400 mile paddle I will have my ovaries out and be done with all this crap. I am sick of being in an out of hospital and being nudged about the appointment system. I want my life back.

52. Recovery time

I have been home for 11 days now and it's been 17 days since my surgery and all is going very well.

When I came home I was a bit of a mental mess. I had become used to no TV, no concentrating on anything, no real company. I found coming home very hard but I was very glad to be back all the same. During my couple of days I wondered how the hell I was supposed to cope at home with my husband in such pain of his own with his knees. He was so tired running in and out of hospital visiting me, not sleeping properly, worrying about me. When I got home his schedule got a whole lot busier and I hated to ask him for anything but initially I needed as much attention as I did in hospital - I could barely do anything for myself except get to the loo, eat and drink. I felt extreme guilt at asking him to do anything and so forced myself to become more independent than I should so early after surgery. My requests for drugs and things upstairs just caused him more problems and eventually we fell out with each other a little. I found being an invalid at home really hard as there were jobs I would just do without ever asking them to be done for me. I had to shut off. I couldn't do things I wanted to do, just what I needed to do.


Day 1 and 2 at home were the most difficult. I hurt, I couldn't get comfy anywhere. I got the post-op blues and cried quite a lot. Its all the drugs wearing off and the emotional relief to be out of hospital and realising you are incapacitated. I just had to let it out. Then nature thought it would be really funny to just launch my period on me. Nice one! I just wanted to curl up and disappear at moments. Day 2 at home I had to wash my hair - it was grimmer than grim. It hadn't been washed for 9 days and it felt like it was crawling on my scalp. Euwwww! Trying to lean over the bath to the shower head was a physical challenge. Both my husband and I were in agony after but we did it and I felt very refreshed.

Day 3 (Wednesday) at home I managed to wash my hair on my own in the bathroom sink with a jug and I was chuffed. I also had my stepson visit with my in-laws. He was a little freaked but wanted to see my operation results and so I happily showed him. It helped him understand why he couldn't hug me or be rough or play fight (this is a big no no and sorely missed :( ). I was knackered by the time they left.


Day 4 (Thursday) I managed to straighten my hair (don't even ask how..I must have been crazy) but I did it. I wanted to look half decent to go back into hospital to have my dressings taken off. I walked so slowly into the hospital, it was taxing. I felt so weak. I made it though. As we made our way through the people I realised I was with a man on crutches and people were dodging him and had no idea how fragile I was too. I was paranoid about being nudged, bumped or knocked. My back started to hurt a lot as I held myself upright for a long time and walked practically a marathon compared to my recent walkabout efforts in hospital and the house. Jenny my breast care nurse (BCN) was pleased to see that things had healed really well but one area on the right nipple patch was still bleeding slightly so she put a couple of big plasters on and told me to keep the scars dry until Saturday. Flannel washing is not effective enough. My armpits felt so sore and nerve damaged that I could barely have them touched and couldn't reach them to clean them myself. My skin is gross, my pores are clogged, my skin is flaking..I cannot wait for the day I can immerse myself in a bath again. I am stinky I'm sure.


Day 6 (Saturday) A bath! I sat in the bath up to my hips - it was lovely for a short time but my back started to ache a lot. It was painful but worth it. My husband washed my back down with a moist cotton cloth I brought back from hospital. It was weird to feel pressure but no sensation of touch on my back. He wiped my armpits which hurt like mad, like flu-skin all the time. I have no idea what is going on there. The surgeon told me later in the week that it was probably referred pain. That means that my arms are not damaged but the nerves have been cut under my arms where the muscles have been pulled through to the breast area and that my brain has panicked. My brain thinks my arms hurt because the nerves have been severed. I may never regain the feeling in the backs of my arms or my armpits but only time will tell. The sensation is horrible but I am trying to convince my brain that it is not painful. I hope this will help it get over the trauma. Me talking to my brain..It's okay brain, my arm is okay and so is the other one now stop sending me pain signals because its rather uncomfortable and weird and I am not enjoying the experience. Ta! I do hope my brain is listening to me.


Day 8 (Monday) I stopped day napping. Although I feel tired I can't seem to nap anymore. I know sleeping is the best therapy but I can't. I just rest instead. I wish I could just sleep but sleeping at night is hard enough without ruining my sleep pattern with day napping too. I gave up trying and just spent the following days just taking it very very easy.

Day 9 (Tuesday) I resigned myself to a day in bed. I needed comfy rest. I spent almost 5 hours in bed watching TV and just shutting my eyes. It was worth it.

Day 10 (Wednesday) Fluid draining and post op check up!! I managed to survive a ride to hospital to meet Mr Cant (seeing me in Me Drabble's absence) for a post op check up. All is fine. I haven't heard about my breast tissue exam yet and I assume all is well but I forgot to ask about it so, in the absence of news, I will assume good news and there was no cancer found or they would be on me about chemo or radiation or something I'm sure. A real 'no we didn't find any cancer' is what I wanted but I still don't know. We discussed numbness and weird sensations and he kept reminding me that it is early days (impatient me again) and that the lump in the left breast does feel like muscle and might not ever go down but should do with time. I hope so. Mr Cant felt very clinical and as I questioned the feelings in my body I almost felt like he was telling me tough, you chose this surgery. I know that's probably completely irrational but that's how I felt. Mr Drabble is much more personable and reassuring in manner. I thought Mr Cant was very clinical but very factual in our discussion. I felt a little sad though, I would have like both my breasts to be the same now, my right one is so much better than the left. I had matching boobs before and now I don't I am not sure I believe they ever will be. I know time will tell but I have to face maybe never having symmetry again. I have to focus on being alive not perfect!

Whilst I was there I showed him the fluid on my back that had been building since the drains had been removed. I managed to lay on my side (just) and didn't feel the local anaesthetic injection in my lower right back. Then a pushing sensation and then a liquid noise. 100ml of fluid removed from the right where the muscle used to be in my back. The left was less comfortable. I felt the needle go in, stinging me then burning like mad under my skin. I sucked air through my teeth in pain and squeezed the nurses fingers hard (sorry!). She told me to breathe deeply through it. Finally it subsided and then the pushing. He pressed my back and air came out as well as 150ml of liquid. My husband said it looked like I was having a wee out of my back. Nice! I asked what colour it was and if I could see it. 250ml of frothy topped lucozade orange cloudy liquid. Cool but also yuk! I felt a whole lot lighter and smaller! My back was squelchy again on the left as I moved but I prayed the fluid wouldn't come back again in such quantity. Hurry body, heal!

We then went into my husband's work to drop off some paperwork. He is a secondary school teacher and it was great to see inside his work and a school again. It was a fleeting visit and then we popped into Tescos to get some shopping and I felt utterly exposed and vulnerable. Everyone was potentially going to hurt my fragile body. I must have looked so paranoid AND lazy as my husband pushed the trolley with one hand and one in a wrist crutch. I couldn't reach anything much and I just looked totally pathetic. I felt useless. My back was killing me by now. I had already done way too much. We returned home and had lunch then I managed to sit in the car for 40 minutes travelling to see my stepson. I held up all afternoon, out in the garden, sitting in the conservatory, ate dinner at my mum-in-laws and then made it home again in the car for another 40 minute ride. I couldn't have made it without my soft pillow to lean on. Travelling right now is still very very uncomfortable and leaves me tense with no means of relaxing my muscles in my back. Oh for a massage!!

Day 11 (Thursday - today) A take it easy day. I woke twice in the night but went back to sleep without any painkillers. I think this was due to the fluid drain. I was so much more comfortable. I felt so tired when I woke up though. I decided to just hang out in the garden. Poked around in the pond and sat in the sun, not a lot else. I was totally knackered after yesterday and it was just a ridiculous amount of stuff to do so soon after my operation. I am a fool. I feel okay though, just very tired. I must slow down now, I know I am doing to much and I do not want any repercussions from my stupidity so for the next week I will try to nap at least 30 minutes a day and take it easy. Which is something I find hard to do.

I so need a trip to the beach! I could sit for hours watching people surf, fish, build sand castles, dig trenches, dams and fly kites. I have to go soon. I know I can survive the bumpy wiggly country lanes from here to the beach. It's 20ish minutes..I am going to schedule it in for next week. I have to get there. In the meantime some river sitting action wouldn't go amiss. I have started with pond sitting for now and will build up to the big stuff by next week. I need to get out! I am missing my car and I will start walking alone next week too. I need to before I go mad (or more mad).

49. The dressings are OFF!

I have realised I use far too many exclamation marks!!! I am gonna try and give it up a little (if I can).

Not quite up to recalling my week in hospital but I will soon.

Today's update is that I had my dressings off. Everything looks clean and healing really well. I am so pleased. Voiced my concerns about the slight swelling around my left armpit and side of my breast which is where the muscle has been pulled forward under my armpit and into the breast skin. The right side looks amazing but the left will need a little more loving and softening to get it to 'relax'. I know it will take time but I am rather impatient but a realist too so I am not expecting perfection.

The pain of wounds and bruising has subsided immensely ovenight - weird! I am experiencing more middle back pain as I spend more time supporting my upper body sitting. My bottom is numb a lot from the amount of lying down and sitting I am doing but a quick get up and walk around is sorting that out. In saying that, having my arms hanging is quite painful in itself. My back is now compensating for the loss of the latissimus dorsi muscles and I will have to take it easy and do lots more physio. I think I will be ready to do some more advanced exercises in a few days. Things are so much easier today but the mammoth walk into the hospital and out again was slow and tiring. I was with my husband who is on forearm crutches and people would assume I was with him and not there for me. I became quite paranoid about being banged or knocked as people avoided the more obvious disablement of my hubby. The lift made me edgy - people jammed in and I sheilded my chest and thankfully had worn a nice puffy feather gilet which made me feel more protected from a knock.

My BCN (breast care nurse) is pleased with my results and said Mr Drabble has done a good job for me and it is all looking good but that I must take it easy.

Now that moments of comfort are appearing here and there it seems I can enjoy getting better.

I have had some days of sheer frustration, dropping things, can't pick them up, making my hubby bend down with his bad knees and help me. I thoroughly advise anyone who does the back muscle op to get one of those long reach grabbers for picking up small items that go to the floor - getting down there is hard work. My core muscles and glutimus maximus are getting a good workout I can tell you.

Anyway..all is good. 2 weeks of body torture are worth every moment I stop and remember that I don't feel the fear, the anxiety. It is totally priceless and drives you onwards, even when you think you can't get out of bed, or you can't sleep. The tiredness is the hard thing, it makes everything else so difficult but it seems to be fading now..just 11 days ago I was out of it..6 days ago I was in agony..today I feel good, twinging, aching, sore but good.

Today is a good day. And I got flowers from family and they are gorgeous. Never had so much nice post in my life, its like a prolonged birthday and it is so appreciated.

Something perks you up everyday. Surgery is hard - harder than I thought but the feeling is amazing and it makes accepting the body change so much easier. I have been given a life and I want to hug my consultant and everyone. I stopped a lady I recognised in the hospital who had only popped her head in once during my stay, I thanked her and told her I was doing well. She said I had got up and on my feet, coped and progressed so much quicker than most women they had seen. That made me feel good - I know I am doing well. I am so glad.

Whew...tired arms now..signing off.

BAck in the social scene again soon..at the moment, its all about me and I only have small time slots on the internet (hubby will kill me if I am on here too long: ) x)

43. All aboard! This train is going FAST FORWARD>>>

My phone rang earlier..Private, just missed it. I picked up the message left, it was my surgeon, Dr Drabble. He just said he would call back again or if I could, to call him or his secretary.

So, what could it be? Either a cancellation or a postponement of my operation date - logic says. I'm sure he wasn't phoning for a general chat.

I call the hospital and ask to be put through. Dr Drabble's secretary picks up the call and then tells me to hang on and she will pass me over to him.

"Hello Leigh-ann, now..you know we were planning your surgery for the 30th, well I am afraid I am going to be away for some time around then. I'm sorry, but we are going to have to move your operation date."

"Right.."

"We can bring if forward 2 weeks to 16th March."

"...oh..um..when is that?"

"That's a week on Monday. I know it will make it might make it more difficult for your hubby to be able care for you. What do you think?"

"I guess I'd rather have it done sooner rather than later. We will have to sort something out."

"We could keep you in hospital a little longer until you are feeling a little more able to cope, if it helps."

"Yeah..we will see what happens. I guess I am just a bit..well..you know..shocked. I was ready for 3 weeks. I guess it's okay. I won't see you before now, not until the surgery. Should I speak to the Breast Care Nurse instead?"

"Yes, we are making all the changes that need to happen here, to bring it forward so if you could speak with the BCN that would be good. We'll be in touch. See you then, Leigh-ann."

Okay...so someone pressed the fast forward button on my life. I had a minor panic attack, light headed moment after I got off the phone. My dumbass period and hormones mean I am very sensitive at the moment. Yesterday I wanted to cry in the job centre when, yet again, the dumbasses forgot to tell me I didn't need to drive all the way into the city, pay for parking and queue for 20 minutes. I was livid! 3rd journey in a month that they have wasted my time now. The whole place makes me edgy - if you can get beyond the frontline hardnuts and security guards (yes, security guards!), there are real people sat at desks, thankfully.

Chris popped in on the way through to pick up Max. We were both shocked and both a little tense about the date move, but - it will be fine. I am just worried about Chris and school and time off. He will be so knackered running around after me, school won't give him the time off and that's why it was planned for Easter. What a mess.

So here we are..9 days until I have to climb into a hospital bed. I just want it over..I want it over. It's been the longest time coming - eons in fact!

So..all my DIY plans, my gardening plans..all gone. No time left. To top it all off, the hoover had a big accident today. Dyson fell all the way down my steep stairs and dust poofed out all over the place..bits pinged off him and he lay, battered on the bottom step..parts strewn around. Only the pipe suction worked on it before and now..after the accident, he has little energy at all and is virtually on deaths door.

Dyson is just how I feel today. A little battered, had the wind knocked out of my sails but it's okay because I know there will be a replacement one day soon.

Just like my replacement boobs.

Give me strength to get through this week calmly. This is the beginning of the end.

Monday 16th March 2009 - Operation Boob Removal commences!

42. Where am I? 27 days to Operation Boob Removal!

I decided to stop pacing around the house trying to fill my day..I decided to make coffee, sit down and get this out of my system.

My last blog was sadder than I intended. I'm okay though. Being at home with my mind is hard work - it needs feeding all the time. I must learn to slow down now or I will face frustration whilst laid up. I am keen to do DIY in the house and I am scared that I won't be able to do much of that after. It even made me think about implants instead but I don't know..it's so close now, I can't change my mind. I also know that after my op I won't be having a gardening extravaganza either and I am a keen gardener. Lots of jobs seem to loom ahead of me in the next few weeks but I can't do them all and I have to think that I will be fine after, that I won't suffer back pain or shoulder weakness. I will make myself good again - it just seems massive at the moment, I want to be normal me but I will be changed me.

It's lashing it down today and the conservatory is just warm enough to hang out comfortably in today. I may have to employ some cosy blanket around the house though for added comfort. It's a wheatbag day coming. I can feel the dull ache building. Getting my daily dose of daylight which brightens my mood even when it is lashing it down outside.

OTHER TOP NEWS..

Boat renovation. I helped hubby with his surf kayak repair project last night - masking up the stripes and revealing the great results just before bedtime. He is pretty amazing really. His blog is Adventures in Kayak Surfing!!! if you are interested. Chop a cheap battered boat up and restore it. Looks GREAT! Looking forward to the launch..camera, flask tea and the beach. About a week to completion.. : )

Life update. We might be getting a stairlift to help Chris look after me for a while and maybe permanently. Cool? Yeah..kinda :)


































Nature action. Groped female number one hasn't been seen since her ordeal with many male frogs. Three lots of frogspawn made it though. I hope she is okay out there.



A stunning new female frog is in the pond and had two suitors already. But she is facing an ordeal too. There are about 10 males in our pond..she is the second to brave their mug the woman tactics. Well..update soon.

That's all the news for today.

Back to my seeds and garden plan.

Smile.. : )

3. Surgery - the options

Well, I thought I should probably post what surgery is available to me. For the feint hearted, there is no need to worry - no real blood was spilled in the making of these videos – all CGI! It's probably easier to show you these than eventually explain what will happen to my body.

Video of Oophorectomy

Video of Free Flap Breast Reconstruction