Surgery Update April 29

OK, the latest news you have been waiting for. Kristin's Surgery today was completely successful. We were with her until she was taken to the OR about 3PM and she was moved from recovery to a room at about 7PM. The doctor told us after the surgery that they found NO cancer in the Lymph nodes and that Kristin handled the surgery well.
We just left her and while she is a little sore and still a might groggy, she is in good spirits and wanted me to make sure I thank all of you for your support, thoughts and most of all, your prayers. We expect Kristin to be going home either Friday night or Saturday at which time she will update this blog.

Kristin's Mom and Dad

April 28

"How are you?" seems to be the popular question this week. I think I am as surprised as you that I am doing great. I am a little anxious to get the surgery done, but am not exhibiting any of my normal signs of stress - fistfuls of chocolate, screaming at my children, and weeping at reality tv. I need to finish a little bit of laundry and pack a bag for the hospital and then I'm ready to go. I've decided to graze on food all day, since I won't be able to eat past midnight for the surgery that doesn't start until 3:30 (have I complained about this before?). The kids and I are going to out to dinner. At 11:30 tonight, I'll be finishing my bottle of Jose Cuervo Classic Lime Margaritas - there's only 1 or 2 drinks left - probably with a grilled cheese sandwich. I'm still deciding on the appropriate snack for my last night as a bimammary being (not sure if it's a real word, but sounds kind of scientific).

Tomorrow, I'll have a normal morning and then head to the hospital around 11:00. I'm planning to have my phone with me, but not to use it until the pain meds have been reduced and my brain is clearly functioning. Just in case my phone eludes my mother's watchful eye and you receive a text or email from me, please know that anything said under pain medication is not to be taken seriously. I do not think anyone has ugly children, I am not in love with any of you, and I think any requests for the delivery of margaritas or underwear models should wait until after my drains are removed.

Thank you for all of your support, prayers, and well wishes. I know tomorrow is going to be a long day, but that I'll wake up from surgery cancer free. And I have an amazing list of family and friends who will see to it that my recovery is as easy as possible. Keep your prayers coming for healthy lymph nodes for one more day! Thank you.

Nipple Notes

Since some of you have been asking, here's what I know about the nipple-sparing mastectomy. It is a fairly new procedure in the U.S. and is gaining popularity. The accepted view is that since the nipple and areola are connected to the duct system they need to be removed since they could be cancerous. Also, when nipples are left on after mastectomy, there is a high rate of tissue death due to inadequate blood flow. During the procedure, the incision is made right under or right over the areola, the breast tissue is removed and the skin (including the nipple & areola) are inverted and scraped to ensure all breast tissue is removed. The blood vessels need to be reestablished to keep the skin alive and this is helped by having the chest muscle pushed up to the skin with the expander. None of the other doctors I visited before Dr. Wallace would offer this procedure for me. Either it was not a procedure they were comfortable with or they said the risk of leaving cancer behind in the nipple was too great. Dr. Wallace has been performing nipple-sparing mastectomies for 2 years and has one of the highest success rates in the world. Is there a chance that the remaining nipple will be cancerous. Yes - about 1 percent. And if it is cancerous, then the solution is to remove it. So, on the rare chance that there is cancer after my mastectomy, I will just have the nipple and areola removed and proceed with the tattoo/reconstruction options I've written about before. There is also a 15 percent chance that not all the nipple/areola tissue will survive. In that case, Dr. Wallace has said it is better to have some of the tissue because she can use it to reconstruct a more real looking nipple area during my cosmetic reconstruction. So I really see no downside to the nipple-sparing procedure. If I can wake up from surgery and look whole I really think it will help my recovery. And if the tissue doesn't survive, or cancer remains I'll deal with it then. As for now, I'm excited to be able to have this option. In one post I've managed to mention nipples 11 times - I think that's a record!

Pre-Op Appointments

Today I had 2 pre-op appointments - one with Dr. Wallace and the other with the anesthesiologist. Everything is set for next Thursday's surgery. The time of the surgery has been pushed back, so I don't even have to check in at the hospital until 11:30 for a 3:30 surgery. I'm a bit annoyed at that, not because of the delay in surgery, but because they didn't change the time I need to stop eating. No eating after midnight on Wednesday - not even gum. How cranky will I be going into surgery without my daily Snapple and M&Ms? I did get permission to take Tylenol PM that night though, so at least I'll be able to sleep. I received my pre-op instructions and some are pretty funny. - like "your copay is required on the day of surgery. We accept cash, check or credit card" That itself isn't funny until you read the next instruction, "Please leave valuables at home, including credit cards and money (except your co payment)" I find it scary that patients need to be advised to shower or bathe before coming to the hospital and to arrange for an adult to drive you home. If I need to share a hospital room with another patient, please let it be with someone who has followed the bathing instructions!

The surgery schedule is still the same - check in, go to radiology to get injected with dye for the sentinel lymph node biopsy, wait, then surgery. I did learn that the dye is injected at the nipple - no that doesn't sound painful at all! For the surgery, Dr. Wallace will decide where to make the incisions that day. Basically she'll wait until I'm unconscious and topless and poll the surgical team for their opinions on the best places to hide a scar. Not really, but she will decide the best places to make the incisions on surgery day based on the type of reconstruction necessary (lift, no lift, etc) The best news was that I will be able to shower after the 2nd day! I'm a grump without my shower, so this makes me and my caretakers very happy!

Also go0d news is that I get to go Nordstrom and buy lingerie paid for by the insurance company. The lovely post-surgical camisole seen here has interior pockets to place the 2 drains I'll have hanging from my body (one under my arm and one under the missing breast) and built-in breast forms so I won't look so lopsided. Who knew such an ingenious garment existed? Now if it only came in red...

I met a current patient who had a bilateral mastectomy a few months ago. She was very reassuring and said the whole thing was a piece of cake. She also said that I should milk the entire experience for all I can get. I really liked her :)

So, with all the pre-op stuff out of the way, the only thing left to do is worry (and shop for lingerie). I've gotten pretty good at the worrying part, so let the countdown to surgery begin!

Finally a Date!

It might sound crazy to be excited about a surgery date, but I've been waiting for so long that I really am excited to put a date on the calendar. My surgery is scheduled for Thursday, April 29. I'll check in at 9:30 am and go to radiology to be injected with dye for the sentinel node biopsy. The actual surgery won't start until 1:00. I'll spend the night at Thornton Hospital and assuming everything is fine, I'll go home the next day. Before surgery, I have a pre-op appointment to go over the surgery details and an appointment with the anesthesiologist. I'll keep you posted on how those go. I see a light at the end of the tunnel and it's getting brighter!

No Mutated Genes!

My test for the breast cancer genes, BRCA-1 and BRCA-2, came back negative (no mutations detected). That means my chances of getting breast cancer in my left breast or ovarian cancer are the same as everyone else. That also means no mastectomy on the left side.

Nuclear Boobs

I have a 3-ring binder (thanks for the great suggestion K2!) to keep all of my cancer info - doctor's contacts, insurance info, notes, bills, etc. I keep this photo of the nuclear boobs on the front. I do get some strange looks when I bring it into a doctor's office. At least it's not the night version with the flashing red lights on top. If you're interested in other breast-shaped architecture, check out the following site from Environmental Graffiti. Maybe my new boobs will inspire a great building - maybe even a new Chargers stadium? A girl can dream...