So, what do Angelina Jolie and I have in common ?

Well, aside from long, dark hair, a couple of kids, our moms both had cancer, we both have BRCA+ diagnoses.We are a bit different in the fact that she has a BRCA1+ and I am a BRCA2+.

I have to admit. I have never been a big fan of Ang. The whole Billy Bob, blood in a vial.... She just always seemed weird to me. When the whole "Brad/Jen" split happened, I was totally on Jen's side and made me like her even less (Like anyone cares). Didn't like her. Didn't like her movies. Thought she was fake. Adopting kids from all corners of the earth- I thought she was just trying to change the public opinion of herself. Then the article came out that changed my mind. Angelina Jolie's op ed- Please read

I read the article and I felt sad for her. She had lost her mom and grandma at very early ages. I am proud of her for being tested so that she could be there for her kids. No matter if they are her's biologically or adopted, no one deserves to grow up with out a mom. My Mom was diagnosed with breast cancer in 2012. When she called me, I cried. I'm 34, but I didn't want my Mom to die ! Thank God, she caught it very early and is clear today, a year and a half later. She also gave us a gift- The ability to be tested for the BRCA mutation. Of the 5 girls in our family tested, 3 of us were positive.

When I was going back and forth about the surgery, THAT was the reason that made my decision. How silly if I decided not to have surgery and then eventually get cancer. Why would I take the risk of leaving my kids without a mom when there was something that I could do to prevent it ? Now, near the end of the surgical process, I can't believe that I even hesitated.

So, although I may not have millions in my bank account like Angie, we both do have our kid's best interest at heart. <3

Do's/Don'ts and everything that I wish that I had known......

Ok. Here's a crash course on what to do before/during and after your surgery:

Before:

• Make sure that you have arrangements for yourself. You can not do this alone. I don't care if you are Wonder Woman. You can't do it. Be sure to have a ride home and someone to stay with you for a week or two. You will also need someone to drive you to and from weekly doctor's appointments. 
• Make arrangements for kids and/or husband. Who's going to get the kids from school ? Can they stay with Grandma and Grandpa for a few days ? Maybe make a few meals and freeze for Dad to toss in the oven. Let school know that maybe the kids might miss a day of school or maybe their homework won't be on par because mom is going to be away for a few days. You don't have to be specific.
• Get laundry done and put away and get things set up for when you return home. If you are like me and see something out of place, you want to fix it. But you can't. Let it go !!!! It will be ok. I promise !!! 
• Pack your bag for the hospital. I thought "I'll bring books, my Kindle, phone, paper, extra clothes, socks, etc. ". Guess what I used. My Kindle and my phone. I checked Facebook occasionally and email and called home a few times. other than that. I slept. The hospital gives you the gown to wear and socks, so just wear home what you wore to the hospital. 
• I went grocery shopping before and bought everything you might need for a month. I also made sure to get some bland things that I like to eat, just in case you are not feeling great when you get home. The hospital has most of this stuff, so don't bother bringing your own.
• Graham Crackers
• Saltines
• Lorna Doones
• Pringles
• Bagel Chips
• Jell-o
• Pudding

• Make sure your husband or caregiver can do a multiple text or phone call to all those who are worried about you. 

During: Not much YOU can do DURING surgery, but as I said, get as much rest  as you can. Sometimes it can be hard when the nurses come in every two hours to check your vitals, but you can make up for that sleep during the day.

• How does it feel ? It is hard to get into a seated position from a reclining position. It is hard to twist and turn. Ask for help and you life will be so much easier !!!
• It may be hard to breathe. It feels very tight in your chest. You may feel like you are able to walk around for a bit, don't overdo it !!!
• Follow the exercises that the nurses give you about flexing your feet and be sure to get your heparin shots ! These will help keep you from getting blood clots.
• Listen to what the doctors and nurses say. If you don't feel like you will remember, ask them to write the instruction down or have your caregiver listen for you. 
• If you have ANY questions, ask them ! Doctors and nurses have heard/seen it all. You are better off being embarrassed and having a direct answer than going home wondering.
• One thing that I did not know when I was going to have the TRAM surgery was that there would be drains in my pubic area. ACK ! Embarrassment city !!! I almost asked my doctor's assistant at my last appointment, but I was too embarrassed. They at least waited for me to pass out before they trimmed the hedges, but they also have 2 drains in that area, where they are constantly stripping, checking and showing to students. So basically, I am no longer ashamed about my body, since just about every single person on the earth has seen it by now. So, just be prepared.

After: Don't be a hero !!!! Just because you think you can, you shouldn't ! You may be feeling great, but it is going to eventually come back to bite you in the butt.

•  How does it feel ?  The tightness has moved down more from my chest into my waist area. remember, the doc pulled all of that skin down and the area where the two areas come together is pretty tight. By staying on top of meds, you can avoid some discomfort. I also feel a lack of appetite or just a smaller appetite (not that I am complaining...) I am not sure if this is temporary, but I'll take advantage of it. 
• The first time I looked at the mirror to see the "new me" I kind of freaked out. I looked like a penguin. I was really puffed up on top (rib-area) and I was super hollowed out in the waist area. I almost wanted to cry. I told my PS and he said that the swelling would go down and it would look better (P.S. It did go down and it does look better :).
• It has been almost two weeks and I still have both drains in the groin area and I can not wear underwear because it tugs on the drains. I just change pants everyday :)
• Just a warning- When the drains come out, they don't feel good. It is not horrible, but a very quick, sharp pain. Literally, it its over in a second. Nothing to stress over, but just a warning.
• Sleep when you can. Sleep when you can. Sleep when you can.
• If you have any questions, don't hesitate to call your doctor if you have a question or if something doesn't seem/look right. Any leakage, seepage, discoloration.....Call. Trust me. I have sent cell phone pics of a rash on my breast "just to be sure". (BTW- One and only time I have taken naked pics of myself with the phone). You will feel much better for them to say "Don't worry" rather than sit and stress about it.
•  Some of your drains will produce different amounts of "stuff". It may be clear, cloudy, chunky, wormy, dark, light, just about anything. The color may be different too. One of mine is rosy colored, while the other one looks like it could be used on CSI for blood splatter. No joke. Just keep track of how much and what color the discharge is and this will help the doctor decide when to take out the drain.
•  This is a long-distance race, not a sprint. Be prepared that things are not going to happen over night. Every morning you will wake up, you will be better than the day before. I asked my doc's assistant this week (day 8) when I would start feeling better or at least more like myself. She said that by next Friday (day 18), you will feel more like your regular self. Looking forward to that day !!!!

Upkeep

Whew. Life is rough. Sleeping and eating. LOL Of course, there is a lot more going on daily in order to care for everything. First, there are the "granades" or "JP Drains". Here's how to strip and empty your drains Your doctor or nurse will show you how to do this, but this is a good refresher (We never had gloves, we just used the alcohol wipes). For the first few days, I had my husband doing this, but at about a week later, I am doing it myself. (Go me !)

Showering: I invested in a hand-held shower before, so that seems to be the easiest for me to clean off. I can wash my hair quickly and quickly clean off all of the necessary areas with soap and water by sitting on the edge of the tub. I had a bad experience with staples and showers with one of my pregnancies, so I prefer to keep it is as dry as possible. I know that I don't have staples, but I am weird, ok ?

I did have a blister when I left the hospital and they did not really explain what to do with it. We finally called the doctor today and they instructed that we clean it well, use Silvadene cream and a loose fitting pad. After a few hours, repeat. Of course, if you have any issues, call your doctor immediately and follow their instructions.

Sleep: Sleep whenever you are able to ! Visitors will understand. Tell them to drop the Tupperware on the counter and you'll call them later. :) If they don't get it, just start nodding off and maybe they will start cleaning up for you. If all else fails, just come out and say it. "I'm really tired. Would you mind coming back next week when we can chat more ?"

My main piece of advice: Even if you think that you can do it, you shouldn't ! Your pain meds will give you false confidence. Yes, you will be able to do things like laundry and lift children, but it is not a good idea. This is your time to take it easy and let someone else have a turn.

The aftermath

I woke up in my room, so I must have been on some good drugs ! I remember lots of ice chips and that I had a pump for meds, which I used as often as I could. :) So, other that that, the first day is a blur. I think that I actually felt like eating and ordered a sandwich, but when I smelled it, I pushed it away. I tried a little Jell-o, but that didn't turn out so well, either. I think that I just called it a night at that point.

Day 2  I can't believe how well I felt ! Of course, I am not going to do cartwheels, but, I was able to move a little bit. I was still hooked up to a catheter (YES !) so that saved me from having to have to go to the bathroom and I could just relax and sleep.

The nurse made me get up and walk with a walker to the end of the hallway. I thought. "No freaking way !", but being a good little patient, I flipped my legs around and miraculously, my legs worked ! I did my lap and did not die. It was a little tight breathing, but I did it.

Day 3  Today, she wanted me to walk longer and a few times, which I did. I even did it without the walker. I was off of my IV, and on some pain meds orally, so I was able to use the bathroom, brush my teeth, walk around the room. Still pretty tired, the meds made me sleepy and it is important to get the sleep when you are tired.

Day 4 Go Home Day !!!!! The kids and hubby came to get me to go home. I had an extra pillow to go between my tummy and the seat belt. I got home and headed straight for my recliner. My trusty recliner has been through a tough pregnancy, numerous surgeries and now this. We bought a cover and my husband put some nice, cushy blankets over the top, so we could wash them if something gross made its way on to the blankets (We're practical, OK  ?).

Day 5,6,7....... Nothing really stands out other than taking my meds, sleeping, waking up, eating, going back to sleep. As the days go on, the amount of sleeping decreases. I can walk around just fine. Going to the bathroom is fine, until, well, you know, #2. It is hard to bend in the way to clean properly. Either ask for help or use a wet wipe or cloth.

This is IT !!!!!

Finally. I was within a week of the surgery. I had let school know, made plans for the kids, packed my bag. Filled all of my prescriptions. I thought that I was ready. Maybe. I have to admit, I did have a moment (or two) where I thought about the "what-ifs". Do I need to make out a will ? Should I write out a list of songs and readings that I liked for my funeral? I knew that it was silly, I just remember hearing about people my age who die from blood clots after surgery or something weird and I didn't want to be unprepared. But then I just said to myself  "Self, you are being silly. There is nothing that you can do about surgery. You are going to knocked out. You aren't doing any of the cutting, stitching or anything. The only thing that you CAN do is follow the directions from the docs and nurses after". And that is is exactly what I am doing. BTW- I didn't die, just in case you were wondering ;)

Ok. Let me back up a bit and go over the surgery, hospital, blah, blah, blah......


The day has arrived. All of the planning, waiting, hoping, dreading, crying, worrying has come to an end.
I was scheduled to be at the hospital at 6am. Since I live an hour away, I was pretty darn tired. I knew that I would sleep most of the day anyway, but my husband was going to be exhausted ! I checked in, they called me right back and I got all dressed up in my beautiful gown. Met with the anesthesiologist, my breast surgeon came in a reassured me. Then my plastic surgeon came in. another awkward artist session, at least this time, I was a little numb in the breast area. :)

So, after my IV went in, off to sleep I went. I don't even remember going into the Operating Room like I usually do. So, for the next 5-5 1/2 hours, I was sleeping soundly without a care in the world. And then I woke up.

The "S" Word

Ok....... It's been long enough. I have been waiting it seemed like forever to get this surgery over and move on with my life. My doctor and I had discussed two possibilities: Mastectomy with implants and a TRAM Flap surgery. (Here's some more information about the TRAM FLAP surgery).

My doc said I was just on the edge of the weight recommended for the TRAM surgery, so, unless I could lose a little weight, we would probably go with the straight implant surgery. I thought that I would do what I can and see what happens. I tried to watch what I ate a little bit and started walks around the neighborhood, But I just couldn't lose any weight. I figured that I was destined to go implants.

My Mom and both sisters went with the implants and were happy to choose what breast size they would ultimately be. My Mom and one sister went straight to implants, while my other sister did expanders. She said that it was uncomfortable, but not horrible. I wasn't really looking forward to going in every few weeks or month and tweaking it (Bad memories from braces !).

At my next appointment, my doc did the measurements, head tilt and grabbed at my fat again. He said no problem, we can do the TRAM and I could be C, just like I was after the reduction. YEAH !!! I knew that it was going to be a tougher surgery, but I would be happy with the results after it was over. Even if I was slightly slimmer, I would be happy. I couldn't get any fatter, right ?

Subtraction before addition

So. The reduction. I have had several surgeries throughout my life, so I wasn't too worried about the surgery. This surgery should only take an hour or hour and a half, so no big deal. I have to say, the most embarrassing part of the whole thing was when my ps came in to the pre-op room and drew all over my body with a sharpie. My husband was watching and I am soooooo ticklish !!! OMG My body probably looked like a drawing that my 3 year old did. I felt like I was on Nip/Tuck, but I'm not hot. LMAO.

After surgery, I elected to stay for the evening, and went home the next day. At first, my boobs were ROCK hard ! They were really hard for quite a while. They felt like I was breast feeding again. I actually followed my doctor's orders and took it easy for about 6 weeks, then went back to work. I would say that I was feeling like myself after 3 weeks or so, but I enjoyed the "free" time anyway, just to be sure.

Can I tell you how exciting it was to actually fit into my clothes again ? You know, those ones that have a place in the back of the closet for when "You lose a little weight" although that have occupied that corner for 3 years ? I pulled those out and they fit ! They FREAKING fit !!!

Ok. I am 5'2 and I have been wearing DD+ bras since having my kids. Just because I could wear a medium shirt because it fit my waist, my giant boobs would make me have to buy an XL blouse. Then, the shirt hangs off of my and I look like I am wearing a garbage bag.

So I could finally bring back clothes into my rotation and everyone compliments me "Is that a new sweater ? Did you lose weight?" It's awesome !!! 

Surgery Scheduled. Just Kidding !!

***Attention*** This is not for everyone and not every surgeon will suggest this, just my personal experience :)
After a few consultations with my plastic surgeon, we discussed options about surgery. I have had 3 kids and had "National Geographic" boobs. AKA "Fruit Roll Up" boobs. Basically, you gather them up and shove them in a giant bra. They contort and somehow come out in a round-ish shape. So, since they were "sizeable", my nipples hung down quite a bit and wouldn't look right if they were to clear out the tissue and reconstruct them to a smaller size. If I wanted to save my nipples, I would have to have them removed during surgery, placed elsewhere on my body (under arm, stomach area)and then have it reattached once things had healed a bit. This could go off with out a hitch (worked for my Mom and one other sister). However, there were some things that could happen.
1. The skin could reject it and it could die.
2. There could be a lack of blood supply and it could die.
3. I would be a "Barbie" for a time until the nipples were reattached, not to mention, I would also have udders. LOL
We scheduled the surgery for the "Nipple-Sparing Mastectomy" and I started to prepare for that (mentally and physically)...
Then my doctor had an idea. What if we did a reduction first ? It would give me an idea of the "end product" size, They could put the nipples in the final position, so we could avoid that procedure later, it was also give me a little more time to get myself into shape since my boobs were going to be smaller, they couldn't hide my my "mommy gut" as much anymore. One of the biggest advantage if that it gets rid of excess tissue, making the final surgery shorter and the blood flow is increased, which will help in the tissue healing and less chance of necrosis (tissue loss).
Well, at first I was like. "Really ?" I had already told my boss I needed time off, got the kids arrangements all squared away, now this ? AND, if I did do the reduction, that means another surgery and having to wait another 3 months until I could through with the "BIG" surgery.
What to do, what to do..... As much as I really wanted this OVER with, I called my breast doc and asked her opinion. She said flat out, it was my decision, but if it were her, she would do it this way. OK, so I decided that this makes sense and I would suck it up and have the second surgery because it would look the best in the long run.
So, I called my Mom and my sisters and...... they hated the idea. I bawled my eyes out. It was so hard to make this decision, and I felt like I was on my own. I tried to remember all of the positives that the doctors had said and I thought for sure that by telling my Mom that Dr. K had recommended it that she would support me. I was feeling really down, but I figured "This is my body and I don't have to do what everyone else wants me to do". I do highly value what others have to say, but when did they go to medical school ? So, I went along with the scheduled date and had the reduction, as planned.


***UPDATE***
Once I explained the advantages of doing the reconstruction, they were on board. I am soooooooooo happy that I did the reduction first. The results are wonderful ! I will not need to do any further surgeries to "touch up" any scars or to have nipples placed or tattooed. All of the nurses at the office comment on how great my breasts look. I was very surprised, but the doctors did not have to cut around the nipple during the TRAM flap surgery, they just cut along the same line as the previous surgery. It is six months later and the scars have almost faded around my nipples. I would definitely  recommend doing both surgeries if you are able to and your doctor recommends it. I am very pleased with the results !!

Plastic Surgeon..... Round 2

Soooo.... where were we ? I guess it was a bout a year ago. I just had my oophorectomy and life was pretty good. The surgery wasn't horrible and I was back to work after a few days. No one even knew (other than my boss), and I was ok with that. I am a pretty private, modest person. I like people, but I don't like them knowing my business. I really like my co-workers, but I just wasn't ready at that point to broadcast it. I knew that I was going to do the surgery, just not exactly when or how.

Shortly after the ooph, I made an appointment with my sister (another one) and my Mom's breast surgeon and plastic surgeon. My mom had not troubles, but my sister had a few issues, which made me hesitate about going with this ps. I had my appointment with the breast surgeon first. I LOVE her. Can I say that ? She was so accommodating and made me feel like a person, not just a patient. She talked to me like a friend rather that someone paying her. She answered all of my questions and didn't make me feel dumb for asking. I did ask her about the other doc. She reassured me that if I wanted to meet with another one, she would go with me and we could talk about it together or whatever made me feel the most comfortable. I asked her about the doc that my Mom and sis saw and I asked her "If it were you, what would you do ?". She said 100% she would go with him. No question about it. So, I figured if he was good enough for a top breast surgeon, he would probably be good enough for little old me ;) So, next on the checklist was meeting with the plastic surgeon. I was a bit worried because I am kind of joker and I had heard that he was kind if a dry guy. Looking back, what the heck was I thinking. I wasn't going to to go with a skilled surgeon because he didn't laugh at me jokes ? Silly.

At first it was uncomfortable, stripping down for him, his assistant. Taking pictures (really uncomfortable). I just tried to put myself in a different place. My head wasn't on any of them and they were from the waist up, but they definitely weren't flattering ! The reassuring thing was that this was the WORST that they were ever going to look. I was going to look better. Not immediately, but we would get there. By the way, although he wasn't Jokey McJokester, he was no where near as bad as I had imagined. Once again, make your own judgements based on personal experience. Others will have their opinions, but this is about YOU and your comfort level !!!

Wow. It's been a while, huh ? Time flies when you are having fun !

I don't remember if I have said this before, but I will say it again anyway because it it so true. This takes over your life. Not forever, but from the time you find out that you are positive until your surgery (and recovery), it seems like it is always on your mind. Planning school conferences, vacations, your job..... everything gets the "Do I have an appointment that day?" or "I should be out of the hospital by that time." before you can commit. The important thing to remember is that this is temporary. Five years from now, you won't even think about.