House of Pain (it’s a long one!)
20 Mar 2011 Leave a Comment
I feel like I’ve finally emerged from my own little world of pain the last several weeks. And I think it deserves a little blogging.
Back on January 24, I met with my plastic surgeon, Dr. Madry, to get the “approval” for scheduling surgery and being done with expansion injections. We were at the right # of cc’s for the size implants I had decided on – including the over-expansion. He came in and noted that the right side was smaller than the left because of radiation. I know I’ve covered this before, so bear with me. I’m going to re-hash it a little for the sake of those who haven’t been reading all my blogs . . . radiation burned the muscle on that side of my chest and because of that, now has a tremendous amount of scar tissue. Scar tissue doesn’t want to stretch. At all. The stretching scar tissue has to break apart, which is painful, and then it rebuilds itself. Since radiation, the expansion process had been somewhat painful, but totally manageable. No pain at all on the left side, which did not receive radiation. So Dr. Madry says “I want to put another 50 cc’s in just the right side and see if we can get it up to the same outward size of the left side”. Fine. The nurse practitioner, Robin, comes in and gives me the injection. He wants to see me again in 2 weeks. There is an eight week wait between final expansion and final surgery.
February 7 arrives and I head in to see Dr. Madry once again, and hope to get approval and a surgery date. I never considered the idea that he might want to continue to inject the right side because it STILL didn’t look the same as the left. But he did. He wanted to inject another 50 cc’s in just the right side. This happened again the next week, when he said “I won’t do another one. If this doesn’t work, we’ll have to take some out of the left side and go with a smaller implant.” So I agreed – and with the ridiculous size of the expander under my already stressed out muscle, each week hurt more than the last. The week before it had been bad enough for me to call the office and tell them I was pretty sure it was pressing on a nerve and it the sharpness of the pain AND the persistence of the pain were really tough to take. Robin said to me “I’m honestly surprised we haven’t had this call from you weeks ago!! You’ve been such a trooper and I’m amazed at how well you’ve tolerated this so far! I’ll call in some pain medication to your pharmacy. . .” I didn’t take the pain meds that week. Just advil and tylenol. But the next week, it was worse yet and I couldn’t handle it. It was the only thing I could think about. I was cranky and preoccupied and unable to think. I hate pain medicine. It always makes me nauseous and sleepy. But I caved, and hunkered down on the couch, turned on the t.v., ate lunch and took some hydrocodone. Sweet relief. Sure enough, the sleepies came, and then nausea. But my arm and shoulder and back were not throbbing and aching and glowing with nerve and muscle pain. I asked Dr. Madry WHERE the rest of the expander was expanding if it wasn’t on the OUTSIDE of my body like it’s supposed to be and as I suspected he told me it was pressing down on my rib cage. I have been feeling a little “crowded” when I sit just right, or bend a certain way, and apparently it’s because I AM a little crowded. At this point, I have 150 cc’s MORE saline in the right side than in the left, and the right side is STILL smaller. But just by a TEENSY bit. I go in the next week hopeful that he will say it’s close enough. He says “WOW! We’re so close!! I know I said I wouldn’t inject you again, but this last one got us so close, I think we should try one more . . . you’ve come this far and you are so close!” FINE. Robin comes in, starts injecting and we’re chatting. About halfway through the pain kicked in. I don’t typically have pain DURING the injection. It comes on gradually AFTER. But this time, it started hurting in the office. Robin saw my face and said “are you ok?”. I got tears in my eyes – TEARS – and said “this one REALLY hurts. It hurts NOW. It’s going to be a rough couple of days.” She offered me more pain meds and off I went. About 15 minutes into my 45 minute drive home, I’m full on sobbing it hurts so badly. My skin was practically GLOWING red and you could just about see the heat waves coming off the skin. For sure, I could feel heat, and the most searing pain I have ever felt screaming down my arm into the palm of my hand, into my shoulder and down my back, under my armpit, both front and back and down the side of my ribs . . . one spot just outside the corner of my armpit was beating like a drum with a piercing, steady nerve pain. I cried the rest of the way home. It was all I could do to get some food into my body so that I could take the pain pills and curl up on the couch. I couldn’t even turn on the T.V. this time. I didn’t want noise. I didn’t want to look at anything – not the computer, not a magazine, not a book. I didn’t want to talk or walk or think – the ONLY thing that mattered was getting rid of the pain. It was, quite honestly, the WORST pain I have ever experienced in my life. Worse than chemo? Different. Chemo was gross – I thought I would die after my first treatment, but it wasn’t PAIN . . .
Three or four days went on like this. Every waking moment I was rubbing or pressing on different muscles trying to calm them down. Dave was always rubbing my shoulder and back and arm . . . but if he so much as came close to that spot just outside my armpit I would nearly knock him out. Finally started to subside a touch after several days, so that it was manageable with advil/tylenol. I went to see my pilates instructor, Erin, and she helped with some massage and stretching. I went to see my chiropractor, Dr. Todd Bowers, and he was able to help me with some stretches and some adjustments that made ALL THE DIFFERENCE. So grateful. FINALLY I was able to begin to function in normal life activities. I still feel it from time to time, but it’s intermittent and mild pain at this point. I have some lymph-edema and very tender nerves in my right hand, which makes it hard to do certain things. Anything requiring a tight grip is out of the question, but I am hopeful that this will let up once the expanders come out, and the softer, smaller implants go in – and can be repositioned.
When I went to see Dr. Madry again. I was ready to tell him to shove it if he suggested another injection. At this point, I would rather take these things out altogether and go boobless than to endure that again. But he didn’t. He said the muscle was just determined to contract down on the expander and hold it against my ribs. The solution? He’ll use 2 different size implants. A larger one on the right, which will appear smaller because the muscle will hold it down more tightly, and then a smaller one on the other side. Will it look okay? Remains to be seen . . . he said I would just have to trust him, which I do, and that if the size difference is TOO much, insurance WILL pay for him to go back in to correct it.
**Interjecting a different thought here before everybody starts reminding me that natural boobs are typically not the same size: I have absolutely NONE of my breast tissue left. Just skin & muscle. That means that it’s ALL implant, once the implants go in. The reconstruction process is TOTALLY DIFFERENT than the enhancement process according to my doctor. It’s all about the “pocket” they create in the muscle. If the skin/muscle on the right side doesn’t expand fully to accommodate the size implant we have picked, it will continue to press into my ribs too much. He needs the extra muscle and skin to comfortably fit the implant. The right side here will always have a little more pressure on the ribs, but if the pocket is large enough, it won’t press my ribs inward. I’m okay with a little size difference, but that is the reasoning behind my doctor wanting to make them the same size. This isn’t the ideal situation, but he comes highly recommended, and I know he does a LOT of reconstruction. At this point, I just want to be done.
Surgery is scheduled for April 25. So now we just wait!!
