Surgery – Initial impressions and day 2 drama

The first time I looked down at my new breasts (day after surgery, during the first dressing change), my first thought was that they were a little smaller than I expected. Now, I had told me surgeons that I’d be happy with about a 20% reduction in size, but somehow, I didn’t really internalize what that would be. Also, since my first surgery (and truthfully, since the cancer began to grow), my breasts have not been ‘normal’. Over the last 6-months they have been continually changing. So, I no longer really know what ‘normal’ would be. What I can say, is it was sure nice to look down and see breasts … as the days progress post-surgery, my breasts seem to be a different size each day … swelling a little now and then, and then receding … like the river out back. It may be a month or two before they stabilize an a “size” …

My new breasts (noobs), look a lot like my old breasts. This is because the replaced parts are all under the skin. So, the skin is my original breast skin (for the most part, I think there are a few patches that aren’t). It is still very difficult to tell how the nipples will turn out – they were initially saved during the surgery, but it isn’t completely clear how the blood flow will re-establish and what things will look like when the wounds heal.

What came a bit of a surprise was that when I look down between my breasts, I now see a flat belly. I’m really impressed with how well that turned out!

I was a bit surprised at the first few days of recovery. I didn’t expect to be quite so out of it, and quite so debilitated the first couple of days. The first day was pretty much a blur. What I remember most about the second day, was that anytime I was giving roxi (pain meds), I struggled to stay awake. The day was mostly spent sleeping. For the first 48 hours the nurses were doing doppler checks (validating blood flow to the flaps) hourly. In addition, during morning rounds I had multiple teams of doctors come in all wanting to take a look and test the dopplers themselves – first it was the plastics team, then the pain team, then the breast surgery team – and then there were my actual surgeons – my breast surgeon who seem to come at exactly the right time – and my plastic surgeon.

Throughout day 2, I requested to see the pain management team – they had come during rounds the first morning. Unfortunately, they never came again. This became a bit of a problem … on day 2 I was also to be out of bed for the first time. We spent much of the morning waiting on the particular NP that was responsible for the first transition from bed to chair, then back to bed. I was ready to give it a try at 9:30, but it wasn’t until noon that she finally appeared. It was rather frustrating to be ready, but having to wait. We transitioned into the chair, and then a little later I walked over to another chair, and it was suggested that I sit for at least an hour. After about an hour an half I was ready to get back into bed, so a team of nurses came to help with that transition. For me, this was a great success – however, I was completely shocked when a couple of hours later I learned that the order was given to remove my catheter and change my pain med regime. You see, I had transition to and from a chair, and walked about 10 paces – I was in no shape to get to and from the washroom. No one had asked me if I was ready to make that transition. I was frustrated more by the lack of consultation, than the inappropriateness of the order. I resisted as much as I could (fortunately, I resisted long enough) – After Scott returned (he had stepped out to pick up his parents from the airport) – in my incoherent state I told him of the orders. I was very upset. I the nurse came in and explained things again to Scott – the orders had been given to remove the catheter and pain button. I was still freaking out because there was no plan in place to deal with how I would get to/from the washroom. There seem to be a complete lack of logic to this decision – I tried reason with the nurse – I tried to explain my concern. My day nurse was clearly pretty junior as she really just wanted to execute the orders as given. We ended up negotiating a solution that would allow her to remove the catheter (although it wasn’t my idea solution). She didn’t really know how to deal with a patient who was non-compliant. We figured we’d wait for shift change (which was fast approaching) to get the full scoop again of what was ordered – but then in walked my breast surgeon. I broke down in tears – she could tell I was clearly upset. When I explained about the order to remove the catheter and pain meds, she said that was dumb. She noted that it was shift change on a Friday evening, and that was not the right time to be making a major change – plus she agreed that I wasn’t ready to walk to/from the washroom then taking out the catheter didn’t make sense (at this point I’d only been out of bed once). So, she got the orders reverses (which caused some level of drama as she was not known on the floor I was on – I was on the plastics floor – some of the nurses thought she was my oncologist – although I explained many times that she was my breast surgeon. In the end I got my way, but I also spent the night worried about the drama and whether it would re-play again in the morning – fortunately it did not.

  • Becky

One Comment

  • Not sure if there’s any relevance to this but my whole chest has been opened twice, the second time in a hurry and despite all the scar tissue my nipples haven’t lost any sensation. There wasn’t any work done directly under my breasts and I’m not sure how our male and female nerves differ. For me there’s all sorts of nerve activity and I think all sensitivity is back.

    Flat stomach sounds cool too:-) Too bad I read your posting after Christmas dinner, my days of wearing spandex trunks have gotten way ahead of me again.

    Catheter thing seems to be very common. One time the nurse was specifically told not to remove mine by the floor supervisor and she did it anyway when the super wasn’t looking. Luckily it wasn’t shift change so when I asked to go to the bathroom she had to help me and on standing up I passed out. A nice and shoe soaking adventure for her.

    I thought the floor supervisor was a good idea. Their job was to oversee intensive care and advise the newer nurses. The supers’ shifts also were offset from the nurses’ shifts so there was continuity of care. Plus the whole idea of “difficult” patients gets fixed right away by someone with the authority to intervene as a neutral party. I really felt comfortable in that ward.

    Merry Christmas Rebecca and Scott

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