Thursday, January 23, 2014

The Rest of the (Pains, Drains & Recovery Gains) Story

My last post was written with the benefit of a regional block feeding my chest area Ropivacaine two days after my single mastectomy (first one was in June 2013) and bilateral reconstruction. I was extremely positive, if loopy, and simply antsy to be removed from the plethora of tubes and drains attached to my body.

Now, six days post-op, I could simply revel in the fact I am now drain-free and move on from there but that would entail skipping over the two hardest days of my recovery. And I would be skipping over the reality of this whole experience.

For those of you who have been there, you may not need the recap, you’ve lived a similar experience. For those of you who won’t ever go there, you may not need the details either. But, for the women who, like me less than a year ago, are sitting on the precipice of a jump into breast reconstruction – I’ll share the whole story.

Mentally, this surgery was far easier than the first. While my pathology report on the right breast has not come back yet, I am certain it is clean. I'm not worried about hidden tumors or rouge cancer cells. As I mentioned in a prior post, this surgery feels different - this surgery is about replacing what cancer took away.

Physically, this surgery has been a bit more challenging. And that adds an entirely different emotional component.

Day 3

After my discharge, the anesthesia department called daily to check on my pain block and explained that by Monday morning my regional block would be running dry. I had options, I could return to the hospital to have the balls refilled with Ropivacaine or we could remove them. 

Feeling buoyed by a successful 12-hour gap in need for pain medication and irritated by lugging around 'extra stuff'', I chose removal. Again, I had options. I could have returned to the hospital to have them removed or have them removed by my not-that-kind-of-doctor husband.

I chose the latter for convenience sake.

While he has been an excellent caregiver, Dr. Husband did need to be reminded that saying, "Oh $hit" and "WTF" while pulling tubes out of my back is not the gold standard in bedside manner.

With the block removed, I was told I would have between 0 and up to 12 hours of continued pain relief. 

The chest muscle spasms started around 9am. 

They were scary at first, but once I figured out what they were, the spasms were completely manageable without taking any of the prescribed Valium. We walked to a local salon, per my documented goals, had my hair washed and I came home to nap. Without the pain balls, I enjoyed more freedom of movement and began my mental countdown to having my JP drains removed on Day 4.

Day 4: Tears & Cheers

With many injuries the saying is, "The third day is always the worst."

In this case Day 4 and 5 are the ones I'd like to forget.

Combine physical discomfort with mental fatigue, emotional overload and the knowledge that my 24-hour output exceeded the 30 ml daily maximum limit required to get my drains removed and all I could do was sit on the floor, cry and talk myself back into the game for 10 minutes on Tuesday morning. 

While for moments at a time, chest muscle spasms were manageable if uncomfortable, Tuesday brought a sequence that just wouldn't quit.

I sat cross-legged in a patch of sunshine on my bedroom floor reminding myself aloud, "You can do this. Millions of women have done this before. You've got this. You've totally got this." The tears may have belied my vocal confidence but, odd as it may seem to some, talking to myself really works. 

When the spasms continued, I opted to take ½ of the prescribed muscle relaxer. Two point five milligrams of Valium later my spasms subsided, as did my consciousness. I slept for 30 minutes.

An hour later, I made it to my Living Strong/Living Well class. The day before surgery, I had walked in waved my arms over my head and said, "This is what I can do now and what I want to be able to do in three months at the end of the program." On Tuesday I was much, much slower but walking in to the program four days after surgery was the true victory. Up and down a flight of stairs and 10 minutes on the treadmill was about all I could handle and we celebrated a good effort with cheers and a cup of caffeine at a local coffee house.

Bedtime arrived and I was more than aware I had missed a goal – having my JP drains removed. Frustrating to be sure but now considered a mini-defeat in a much bigger victory.

Day 5: Tears & Fears

A left side output of 15 ml and right side output of 18 ml in a 24-hour period meant that JP drains could be removed as soon as I could get an appointment. I called the minute the office opened.

Appointment on the books, I should have been nothing less than thrilled. I was nothing less than thrilled actually. But I found myself in tears again anyway.

The tears on the way to the hospital were complicated. I was tired of feeling dependent; tired of feeling like a burden and, ultimately, just plain tired. Sleep has come in fits and spurts usually 45 – 90 minutes at a time. Since my discharge, I would sleep in the bed for an hour, wander the house for an hour, sleep on the couch for an hour, wander, etc.  

Honestly the tears are the scariest part to me. While I'm intellectually aware I have a lot going on, I feel as if I should be completely focused on the goodness that is recovery and the goals I have set for myself. Tears made sense when the what-ifs of cancer were in play but this time around I feel the journey should be all about healing, all about replacing what cancer took away.

Yet the tears have also been incredibly cathartic.

I didn't realize how hard I was pushing myself to brandish strength and exude positivity. For months, I have consciously focused on the goodness of reconstructive surgery and forgot that it's not only okay to be scared but a little bit normal in the face of the unknown. 

And they haven’t all been about surgery. We lost a friend on January 6th. We didn’t lose her actually – lung cancer killed her. Then lung cancer killed my uncle on January 15th. Many of my tears have been traced back to an overwhelming sense of loss unrelated to surgery but inextricably tied to cancer.

And today? Day 6.

Today I’m good. Drain-free, showered, sleeping much better, 60-minutes of walking and cycling at the gym, completely off prescription pain medication and re-focused on the remaining documented goals:

A 10K walk tomorrow and a half marathon on February 2nd.

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