Hubby's Notes...

November 1, 2010... Surgery day! This was a long one for all of us... Lisa and I got up a 4:30 AM to get her ready for the 6:30 AM check in at the hospital, then walked into the front doors of the surgical section at 6:15 AM. It was pretty rapid fire from that point on. We were immediately taken back to one of the little surgical prep rooms, Lisa was gowned up and I got to hold the bags of her street clothes which is a roll reversal in this family. It's usually her taking my stuff back to the car and me being rolled off to some other section of the hospital.

After having an IV placed and given a going over by the prep team, she was rolled off to Radiology to have radioactive dye injected into the lymph system in her right arm pit and I waited in the waiting room until she was returned to her prep room after the injection. She remarked that her arm pit was stinging a little and that she could feel the stinging begin to extend out from her injection site, but she was pretty comfortable and up beat. Her primary surgeon came into the room first and had a brief talk with her, but was on the way to his first procedure of the morning so it was just a short chat. He remarked that his end of all this required about an hour and a half to two hours and that he would start on the right breast, known to have the tumor while also taking several of the primary lymph nodes from that side's arm pit for examination, then would move to the other side while the plastic surgeons began the reconstruction on her right side.

Next came the plastic surgeon and his talk and prep actually came as a bit of a surprise to me as he was carrying a measuring tape, one odd looking instrument that I have no idea what it really did other than being some type of template and a magic marker. He first had Lisa lay down, did some measurements and then began to draw out his incision lines. He then had her set up and took more and more measurements and continued to make more incision lines with the marker. In all honesty, being an ex-iron worker this all pretty much reminded me of what we would have done had we been laying out lines to fabricate something out of a flat piece of steel with the exception that I get the distinct idea that a lot of his layout came from years of experience and visualizing instead of a blue print and then he was done. He gave her a pat on the shoulder and told her that the primary surgeon was running a little long on his first surgery and that he and his partner who spell one another over the hours that lay ahead would get started on some of the simple stuff while her primary surgeon wrapped up his first surgery and got ready for hers. It was at that point that the day really began to get long! We said our goodbyes and she was rolled off to the OR while I retreated to the cafeteria for a quick bite of breakfast.

Once I returned to the waiting room I was greeted by the surgical liaison for the hospital and told he would keep me up to date on the procedures that were going on and that if I left to hospital to make sure that I left my cell number so he could call me. I pretty much curled up with a cup of coffee and a book and at 11:50 AM her primary surgeon came out and gave me the best news I'd heard in several weeks. He had completed the mastectomies and upon examination the "nodes" were negative. In essence he had removed the right breast with tumor and verified that there doesn't seem to be any of the stray cancer cells in the lymph system. This was a very big deal and it may well mean that by performing the mastectomies he had removed the cancer from Lisa's body and that it hasn't spread. As to the other breast he noted that there was no tumor present, but that there was a little abnormal tissue that might well have developed into a malignancy over the course of a few years. In essence when you have breast cancer and the breast tissue is removed, basically you can't develop breast cancer again and that really was the primary objective that Lisa was hoping to accomplish in her choice to remove both breasts.

After the talk with the surgeon and seeing how relieved he was, I bailed out for a while to get the dogs out for a potty break at home and for me to just get out and get a deep breath.

At this point we were into the segment of the surgery where the breast are rebuilt by the plastic surgeons. I knew that we were looking at another five to seven hours of surgery and then a couple of hours in recovery, so I began to make phone calls to family and friends updating them on the progress in the procedure, that the nodes were negative and now off to the Pathologist for a complete study. The tumor itself was sent to Pathology for assessment as well as its makeup and type will determine the next phase of this fight. Lisa may be fortunate enough to not have to go through Chemo if she can be treated with hormonal therapy and the double mastectomy had eliminated the need for her to go through radiation treatments, so the day was gaining check marks in the plus column.

After a couple of hours with the dogs I returned to the hospital checked back in at the desk and began receiving reports for the surgical liaison again.

At 4:00 PM our Plastic Surgeon came out and had a very positive view of what they had accomplished with the surgery, telling me that she was going to be one big bruise with a lot of stitches for quite some time and that there will follow up procedures to balance everything out and make sure her new breasts are even and match, but that she was out of surgery, on her way to recovery and everything thing came out even better than he had anticipated.

Knowing that recovery and finding her a room would take a couple of hours I grabbed a sandwich, made another quick dog run and upon returning to the hospital I was given her room number and told she'd be up shortly.
I went to her room and was told I could just wait for her and then really began the only concerning aspect of the day as far as her condition. It seemed she'd developed a blood sugar problem in recovery and that they were also having problems stabilizing her temperature. I had a couple of hours wait in an empty room and then finally saw them rolling her down the hall towards me at 7:30 PM. They got her settled in. She was awake and still pretty goofy from all the drugs, but in an hour or so I was able to have a nice visit and even get a look at the work.

I have a new respect for what a plastic surgeon can do! Like he said, lots and lots of stitches, they even relocated her belly button, but she actually has what I'd have to call a "nice chest". More work will have to be done over the next several months to get things "plumbed up" as we used to refer to evening out the steel structure when we were building high rises, but she is going to be very very nicely built and very functional when this is all over. The only thing that makes me cringe is that she is basically one bruise from below her chin to her lower belly. Having had far less complicated procedures done on me I know that this is going to be a really tough time for her as she heals. We parted ways with me headed home to feed the dogs a bit late and both of us smiling, although I'll have to admit the pain killers she's on gives her kind of a crooked smile at this point.


Positives for the day:
1. The decision to remove both breasts has greatly increased her odds at never having to deal with breast cancer again. It's really pretty simple, no breast tissue, no breast cancer.

2. The lymph system seems clear of any cancer which gives her very high odds that this stuff hasn't spread.

3. Having chosen the double mastectomy will eliminate the need for radiation therapy as again, no breast tissue, no tiny little breast cancer cells hiding anywhere in her breasts, no need to kill the strays with radiation. Radiation can be tough and I'm glad she played the higher odds of having the double procedure.

4. We were fortunate to have a great primary surgeon and a superb plastic surgical team. They really did a beautiful job of beginning the process of her looking and feeling normal and not dealing with prosthetics.

5. Last, by playing the higher odds and really taking the more difficult road of having the double done, she probably jumped from the… I have cancer column to the I'm going to be a cancer survivor in one bold move. Recovery certainly won't be easy, but she's got a lot of life a head of her at this point and I'm sure that at some point in time we'll look back on this as just being one hell of a speed bump we ran into along the way.

Negatives:
1. Long road to recovery and lots of work yet to be done regarding her full reconstruction, but she's a tough one and that will all come together...

2. Long term therapy if the best treatment takes the hormonal route and at this moment we can't rule out that she won't have to go through Chemo. That will be determined when her oncologist get the final pathology report from the tissue taken in the surgery.

All told it was a hell of a long, but good day with good news.... I slept well for the first night in two weeks! Please excuse the typos... my tail is dragging!



November 2, 2010... Post surgery day number one. My morning was pretty tied up with picking up paper work from the Plastic Surgeon's office for the FMLA claim, making sure the required items were faxed to the right people. I stopped by Lisa's office and spoke to several of her friends there giving them an update, filling them in on the happenings of the day before and thanking them for having done such a great job of having her back through all of this. Then I headed for the hospital where I met our daughter who had driven up from Denver. On Lisa's part I could best describe the day as long periods of being out of it on pain killers, followed by brief periods being very uncomfortable, having to deal with pain and all the poking, prodding and needle sticks that go along with a hospital stay. The nursing staff was super and saw to every need Lisa had, but what was really kind of neat is our daughter is a Certified Nursing Assistant with the VA in Denver and she got to do the little extra things that make staying in the hospital bearable. Jess, our daughter braided Lisa’s hair and washed her up, helped the nurses with some of the care issues and was a real comfort to Lisa. As for me, Jess was a real life saver at I was exhausted from the previous day. Even after a good night's sleep I was wiped out, but having Jess around kept the family interaction thing going while I grabbed some meals, saw to the dogs at home and made phone calls to family and friends. Lisa is right on track as far as her condition, but I've got to give it to her.... she's tough and she bit her lip through the first day which was very uncomfortable! She wasn't able to eat, but did get fluids down and actually was so buzzed on the pain killers that she'd forget to push the little button that administers the next dose. She had hoped to get out of bed today, but she couldn't quite pull that off so a late evening attempt to make it to a chair was aborted. Both the surgeons made two visits over the day and were very pleased with how she's doing. On one hand she looks wonderful and is getting her color back, but she's dealing with a lot of pain and the bruising continues to darken. I left for home in the evening happy she was doing well, but concerned in that she looks like a lovely lady who's been in a train wreck. Having had surgeries myself I understand the healing process, but even after several heart surgeries and a couple of car crashes over the years, I've never seem a body bruised like she is right now!


November 3, 2010... I was amazed to arrive at the hospital early and find Lisa in a chair setting beside her bed. She wasn't very comfortable, but she insisted that she get as much time out of bed as possible. She and I spoke through the morning while she sat and occasionally slowly shifted her position. I figured this might go on for an hour or two, but the lady has brass ones somewhere and she remained setting for the entire day. A good friend from Denver came in for a visit about noon and I snuck away for lunch and the every present potty break for the pups. Lisa and I got to spend the afternoon together and then another good friend from Fort Collins came to visit and we all had a good time shooing the breeze. Lisa over the course of the day was able to get to her feet a couple of times for trips to the lady's room and over the course of the day her color steadily improved. She hurting like hell, but she's shaking it off and getting herself on the move. Her primary surgeon came into check on her early in the evening and advised us that that they haven't gotten the pathology reports back on the tumor they removed or the abnormal tissue from the other breast, but that they should be available tomorrow and then he advised her she's going home tomorrow. I was a little surprised, but in all reality there's really not much they can do for her at the hospital that I can't at home, they've switched her off the IV pain killers and on to oral pain killers and she's functioning so tomorrow some time I get to bring her home.

In that regard I've managed to get the house ready as the baths are virtually sterilized. Clorox in solution does wonders! She won't be comfortable in a bed for a couple of weeks, so the recliner has been moved into the bedroom from the office and she will have about a ten foot stroll to the bath. The laundry is caught up and this evening I packed her coming home bag and made a pretty decent pot of beef vegetable soup that should be easy for her to eat as a primary food source for a day or so. It's going to slow simmer on the stove over night. I'm about as ready on this end as I can be although I'm thankful that our daughter is coming in from Denver tomorrow to help me get her home and settled. The blankets for her stay in the recliner are washed and dry and I'll give the place a quick once over with the vacuum in the morning. As always I think her return home might be a day or two early, but I know my way around stripping her drains.... One for each breast and two for her belly and tracking fluid output is no issue so in all reality I think she will be more comfortable at home. She's got some great pain meds and will be on anti-biotics for several weeks and I think I can make her more comfortable here that she would be at the hospital. Poudre Valley Hospital is exceptional in the level of care they give and I've frankly never dealt with a better run hospital, but any one who has ever spent time in a hospital knows that there's no place like home. We should have an idea of what we're dealing with as far as the pathology results go tomorrow and she's scheduled for an exam at the plastic surgeon's office on Monday. The following Wednesday she will meet with her Oncologist to discuss further treatment options from there on. It's conceivable that Chemo is in her future or she may be able to go the hormonal route, but we won't know that for several days. I'll continue to knock out the occasional update until she is up to setting at the computer.
On my end I'm just glad she’s beginning the healing process from having taken a first step towards killing this stuff. For the next couple of days my biggest issue should be keeping the dogs from pestering her too much as they are lost without their Mom. The rest of it is just beginning to heal and prepping for whatever will be recommended by her Oncologist.


November 4, 2010... Well today didn't turn out to be Lisa's day to go home. She's doing quite well, becoming more mobile as each day passes and is up walking the hallway and making bathroom calls as the cath has been pulled. She's developed some blistering where the abdominal binder that she has to wear was rubbing and those blisters along with having to get hooked up with the physical therapy department and getting in some more "on your feet time" has moved the "go home day" to tomorrow. I'm glad for that as she's looking great and getting stronger every day, but having an extra day let me pre-cook and freeze some meal portions for her and I've got to pick up a couple of goodies over at the pharmacy so for me it like getting a second breath.

We spoke to her primary surgeon regarding the pathology report on the tumor material and he defines it as a 1B type tumor (1 being a very early stage of development) and the B we'll leave to the Oncologist in a couple of weeks. He explained that the Oncologist will leave a fair amount of the decision making for Lisa's future treatment in Lisa's hands. She is at a point where having caught it early on, then having done the double mastectomy, she'll be given percentages to mull over that will basically define if she takes this or that treatment, what is the average percentage of this problem reoccurring. The nodes are negative and the pathology report looks very positive so at this point it's more a matter of setting at home and healing for a bit than jumping immediately into choosing a path for further treatment. She'll be released tomorrow and things are ready for her here at the house, Monday she has a follow up with the plastic surgeon, then later in the week she will see her primary surgeon again. Her next real big day will be November 17th when she sees her Oncologist for her first post op visit and they begin planning the next stages of treatment.

One other occurrence that took place early this evening is that she originally had four drains for excess fluid. One drain from each breast and two from the abdominal area where they removed the muscle and skin for the rebuild. They pulled the drains on both breasts before dinner so now she only has two. Based on the fluid she's draining from the abdominal area having turned decidedly clear I think there is pretty good shot at her having all of her drains out by the time she finishes up with her visit to the plastic surgeon on Monday. That will make it far easier for her to get around and relax a bit. All in all it's been a hell of a week for her, but she's handling it like a champ.

On my end, tonight was all about moving flowers. Lisa's received some beautiful arrangements from friends and the folks at work and I got a jump on getting the majority of those home this evening so we won't have to deal with it tomorrow. Also my daughter is coming up in the morning to help move Lisa back into the house. Helping get her up the stairs... that type of thing will be a big load off my having to do it solo.

At any rate things continue to look good!



November 5th, 2010...
Lisa was released this afternoon and we've had her home for several hours at this point. Our daughter was up to help get her situated and as Jesse works with patient care it all turned out great. While I was over picking up pain Rxs, Jesse got her Mom in the shower, dressed her and got her situated in the recliner in the living room. Lisa is having problems getting comfortable, but she'll be unable to lie in bed for quite some time and the recliners offer her the best option. She's moving well, able to get herself up and take care of bathroom stuff and such, but everything is in real slow motion. She's developed some large blisters where her abdominal dressing was a bit high and up towards her breasts and to boot these blisters have filled with the dye that was initially injected so the Doctors could follow the duct routes on her surgery day. Essentially her blisters are bright green and as each begins to pop she stains her gown with bright green dye. At this point she's rotating gowns and I'm rotating loads in the washer and dryer. Mostly she's exhausted and incredibly sore, but she's toughing it out. I have the thought that she'll finalize her sleeping spot to the big recliner in the living room and if so I'll grab the couch for the night. I don't want her trying to get up and make the bath in the middle of the night without help, but the couch is comfortable and it will let me keep and eye on her.

Jess headed back to Denver about 7 PM and Lisa is zonked out in the living room at this point so I thought I'd let everyone know she's home, doing well, surprisingly strong after the last week and in pretty good spirits.

I'm sure this will be a rough weekend for her and she has a visit scheduled with her plastic surgeon on Monday so I'm just going to keep her down as much as she'll let me and we'll go from there. She's got a bite of dinner down and her pain pills are kicking in so hopefully she'll at least get spats of sleep.


November 6th, 2010... Lisa's first full day home and she's actually done quite well, all things considered. Lots of up and down as being trapped in the recliner is no picnic and she has to walk to prevent clotting in her legs so she's walking laps through the place. The pain meds are seemingly taking care of the majority of the pain she's dealing with and she's been able to eat off and on through the day. The two abdominal drains are showing far less fluid than yesterday and the one on her left side is almost running clear so it's about ready to come out. The one on the right side is showing a bit more color, but is clearing as well so she might have both out by the time we get through with the Doctors visit on Monday. The biggest obstacles today have been her not being able to stand straight due to the incisions which is causing back spasms and the blister on the lower corner of her right breast that has filled with fluid and the dye they injected for the operation. We've been waiting all day for this thing to burst on it's own as we're not to mess with it, but as yet there’s only minor leaking. The only time I've ever seen a blister of this size is in burn cases as it's about two inches in length and maybe and inch across. Not trying to be descriptive, but this is a common side effect and folks should be prepared for it. The good news is the dye washes right out of everything so when we do spring a leak I'm just running repetitive small loads in the laundry. The rest of the day was taken up with stripping and measuring the amount of fluid in the abdominal drains, one re-dressing of the incisions, lots of stops in the ladies room and basically just seeing to what ever she needs. I've been checking her breasts for circulation and they are being well supplied with blood. Then we're applying a little heat to her chest every few hours to just warm the area. Simple trick there is just to have a regular blanket you can cut in half and then run in through the drier on high to heat it. The warmth helps stimulate blood flow add a warm blanket and a couple of pain pills and she's off snoozing in no time.

I have to remark on her attitude as I know there are some rough days ahead, but right now she's doing a great job and addressing all the problems beautifully. As the living room recliner is the most comfortable for her I'm sleeping on the couch again and will be sleeping in the living room for quite some time. I've got to talk to the kids about this as they love to sleep on this thing when they come by and I need to know the secret. It about kills me, but tomorrow I'm going over to storage and pulling one of my camping cots out. I sleep well on those things!

Lisa is periodically getting calls off to all the folks who have been so supportive in all of this, but even twenty minutes on the phone kind of poops her out at this point so she'll catch up with everyone over the next few days.

Just as a personal note I’d really like to thank all of you folks who have been there for her during the last few weeks. The support has meant an awful lot to her and its just nice to know you have folks out there that care! You are all a big help in this process….


November 7th, 2010... Lisa is doing real well today! A little more mobile and puttering around the house once I get her up out of the recliner. The blister issues solved itself this morning as it finally burst and for a little bit there was blue dye every where, but that got taken care of pretty quickly. Also had a bit of an issue with a drain/bleed. We're stripping the two drains she has religiously, but on developed a clot and popped a little outside bleeding. Easy to stop and after increasing the suction on the ball portion of the drain the bleed stopped. Also managed to get her into the shower for a long slow scrubbing. She's able to let the water run over her incisions so it just felt good to her to have the warm water flowing. One thing of note is that the shower seat one of our friends lent us is a life saver letting Lisa stay in the shower much longer than if she was on her feet and it also makes bathing her much easier.... At any rate today has gone well and tomorrow I have to take Lisa to see the Plastic Surgeon in the afternoon for a post op appointment so we'll have a little better grasp on how things are looking at that point.

We're both hoping that the drain output which has decreased greatly will let her come home without drains or at least with one less....

November 8th, 2010... Good stuff and maybe a bit of a problem at the Plastic Surgeons office. First the good stuff... They removed the abdominal drains and all of the staples associated with the abdominal incision. Lisa will have to wear an abdominal binder for an undetermined amount of time, but her incision is so clean that it doesn't even require dressing at the point. The possible bad news comes from the large blister she developed on her right breast after the mastectomy. The Plastic Surgeon is concerned that the area, which is directly over the area where the breast tissue was removed the most closely to the actual base of the skin may not be receiving enough blood flow and if that's the case she will have to undergo a graft to the area. The good news there I guess is that the area is about an inch and a half square so if the healing fails there, at least we're not dealing with a really large area of the breast. This will be closely monitored and a decision will be based on the surgeons opinion sometime here in the near future.

Lisa is scheduled to see her primary surgeon on the morning of the 12th so an additional assessment will be made at that time. All in all she's doing great! Today's outing to the Doctor absolutely exhausted her and she's been asleep most of the early evening, but now that we're not stripping drains and having to apply dressings to the staples things will lighten up a bit. As I say a good day, but also an exhausting day for her so I'm letting her sleep through the night and she can do a long extended shower tomorrow as she'll be able to more comfortably sit on the shower chair now that she has a bit more freedom of movement.

November 9th, 2010... First real quiet day we've had since the operation. With the drains and dressings gone it was all about long showers and just kicking back and catching a breath. Lisa is not hurting nearly as bad as she was just a couple of days ago, the pain killers have been cut back to almost nothing and she's becoming more and more mobile. She's still pretty taxed as far as her energy level and tires easily, but the healing process seems to be going well. Being more mobile she is getting up to walk around the place more and that helps with not being all kinked up from being in the recliner. I have no idea how long it will be before she can actually lie flat in bed, but she's looking pretty decent and finding the strength somewhere to return to her old habit of being a bit of a smart ass.... so were making progress.

Top photo is from November 5th when she came home and the lower photo is from this afternoon so we're seeing quit an improvement.  The dogs missed their Mom while she was in the hospital and they are pretty much her constant companions now.

November 12th, 2010...  The last couple of days have been pretty mellow.  Lisa is getting a bit stronger each day.  Without drains and dressings it's mostly showers and rest.  Our son Cody had been sick right after her surgery and used his head...  he stayed away from is Mom and just yaked with her on the phone.  Then late Wednesday he came up having gotten past the sniffles and spent the evening and most of the next day with his Mom.  It was good to see him as he's doing great and Lisa was really happy to have him around.  I think the two of them stayed up Wednesday night until something like 2 AM just shooting the breeze, but the old man called it an early night and crashed.

This morning we had Lisa's first post op visit with her primary surgeon and other than the area that blistered she's doing great.  The lack of blood flow to that one area of the breast is going to cause her to have to see the plastic surgeon for another procedure earlier than we had anticipated, but it's a relatively small area and it won't be anything like what she's already gone through.  The really great news from the surgeon today was that had this been ten years ago, she'd be considered cancer free at this point.  The double mastectomy would be considered a bit of a radical move on her part by some, but they got the  tumor and it was in the early stages so it wasn't at a point where it was terribly invasive yet.  The abnormal tissue in the other breast is gone as well and the lymph system is free of any signs of this having spread.  All the pathology reports are looking great and we're now just waiting on one more that was sent to the west coast for a second opinion.  In short, by the grace of God it looks like she caught this early enough that we're probably looking at a very positive outcome.  As the surgeon said, ten years ago she'd have been completely cured at this point and just looking at finishing up the reconstructive aspect of the procedure, but we'll see what really gives when she sees her plastic surgeon for a second post op and then her oncologist next week.  It's been explained to us that the more radical treatments (radiation etc.) should not be necessary at all, but that there's been a number of advances in the last ten years that may have her involved with taking some anti-estrogen medications for a number of years to insure any stray cells are killed off.  I certainly don't understand the ins and outs of all this, but it seems that the tumor tissue proved to be estrogen reactive.  In essence, although she'll probably have to take the drugs for something like five years, she probably won't be dealing with hair loss and a lot of the really terrible side effects of some of the chemo routines.

So far everything is looking about as good as we could have ever hoped for.  Lots of healing to go through and there will be several procedure involved with the final reconstruction, but right at the moment the big issue she's going to be dealing with is fatigue.  After her visit to the Doctor this afternoon I was going to take her home and then head back out to the store to pick up the fix'ins for a pork loin with spuds and carrots, but she decided she wanted to enjoy her time away from the house and tried to go to the store with me.  She went in the door moving pretty good, but after about ten minutes in the store she was pale and dragging her butt big time.  I got her home and tucked back in for a long nap before dinner and as I'm setting here writing she's well fed and snoozing like a bear in hibernation again.  She pushed it a little too far, but I can't get on her about it as I've done the same thing a number of times when I've been fixed up by the Docs.  I think it served to reinforce that she's got a long way to go in her recovery and the Doc was real up front with her this afternoon in telling her that she'll be about back to full speed in six months.

At any rate all is moving along well and will write more after we see her plastic surgeon on Monday.

November 13th, 2010...  Today started off on a pretty decent tone, but for the first time since the surgery Lisa was hit with some pretty extreme muscle spasms in her shoulders and upper back.  This is probably the result of her having over done it a bit yesterday, but also a coupling of the fact that she's not quite able to walk upright yet due to the tightness of the incisions and regardless of how comfortable a recliner is you eventually wind up with a kink in your neck.  Felt terrible for her as about all I could do was apply a little heat, put her back on a muscle relaxants and get her going on the pain pills again as she's gone several days without taking anything for pain.  I finally got her bedded down and sleeping this evening, but in general it was a pretty rough day.  It will be nice when she can bed down in our regular bed, but she's really uncomfortable when trying to lie down.

November 15th, 2010...  Second visit to the plastic surgeon and although it's not an insurmountable problem the blisters that developed right after the original surgery had now all given way to very dark dry tissue and skin so what I thought at one time was bruising was actually blisters that were much larger than I was aware of.  The dark area in the right breast is now complimented by a very similar and slightly larger area in the left breast.

The plastic surgeon is pleased with the over all healing, but now says that sometime within the next three to six weeks he'll go in and perform a procedure to remove the tissue that isn't doing well, even things up a bit and we'll go from there as far as the next steps in the reconstruction.

I will say this as, they surgeon left more than enough tissue to rework the area and I think both Lisa and I will be a little happier if she's downsized a bit.  The plastic surgeon is a great guy and really knows his stuff so we're confident in the final outcome, but we're definitely adding one additional "nip and tuck" to the recovery with this blistering problem.

Other than that Lisa is doing great and actually caught a few hours sleep while propped up on the bed this afternoon.  She said it felt good to just have room to spread out a bit in bed after sleeping in the recliner for the last couple of weeks.  She'll still spend her nights in the recliner, but the flexibility is coming back and she's beginning to get around pretty well.

The only other thing she's having problems with is fatigue.  The surgeons had warned that it would be at least six weeks before she felt human and probably six months before she was back feeling like she did before the surgery.  I'm a believer at this point as even a ride to the doctor's office and a brief trip to pick up a Starbucks for her totally wiped her out.

Next big thing will be Wednesday as we've got to go see her Oncologist for the initial post surgical visit, get a handle on where she's setting regarding necessary treatments over the next few months, etc.

November 17th, 2010...  The first visit to the Oncologist was a flop!  The local Pathology reports are all in and looking good, but one sample of the tumor was sent the the West Coast for some very elaborate DNA testing and those results are not back yet.  We missed the call from the Oncologists office that was intended to cancel toady's visit and set up another for next Wednesday, so we showed up only to have the appointment moved back to the 24th. 

I think that kind of drained Lisa as she's been very much looking forward to the Oncologists assessment and the outline of the up coming therapy.  It's kind of a bench mark for her and it got postponed so that left her a little on the blue side.  She slept well for most of the afternoon after we returned home, but it was definitely a big let down for her and actually for me as well.

November 18th, 2010...  The day that will always be remembered as the day we sprung a leak.  Lisa's reconstruction was done using the Trans Flap method and that required a fairly large abdominal incision.  It's been healing well and looks great, the drains were removed several days ago and other than an abdominal binder that she wears when she's up and about it doesn't require much more care than a coating of antibiotic ointment once or twice a day.

It's been obvious that there was still a little fluid retention in the area of the incision, but nothing to raise any alarm flags.  Then as she got up this morning she just sprang a leak.  The fluid had found or caused a pin hole in her incision that really wasn't any larger than a pin, but when she'd stand up it would shoot fluid just like a damn squirt gun.  I got her showered and off to see the plastic surgeon who assured her it was actually better that it happen this way than to have him have to stick a needle in there and draw off the fluid.  It was one of the most minor medical issues shes had to deal with, but it's annoying.  I dressed the site with a good amount of absorbent gauze and backed it with a towel and the abdominal wrap when we got home and within a couple of hours she had soaked through the gauze so a trip to the pharmacy was in order and I came home with enough gauze to soak up a couple of spilled beers.  Got her cleaned up a second time and she's been asleep for several hours now.

At this point I think she's sleeping off her frustration....  The visit to the Oncologist was delayed and today she turned into an oversized super soaker squirt gun.  I can't describe her mood as being particularly depressive, but she's not a happy patient right now.  In fact I'll just leave it at her being ill humored and sleep will be the best thing for her at the present.  She likes Chicken Alfredo so theres a batch in the oven as I write this and I'll wake her early enough to make sure she doesn't get too much rest and can't sleep later tonight.  Tomorrow's another day!

November 22, 2010....  We went through the weekend  changing bandages on this small leak that Lisa has developed, but noted on Sunday night that she was developing a small tear on the incision line.  That prompted a quick visit to the Plastic Surgeon this morning where he took a couple of stitches and redressed the wound.  He also did a quick examination of her breast and the areas that have, for all practical purposed died back as they were originally huge, very deep blood blisters.  He feels that the areas effected are defined clearly enough at this point to begin setting up a surgery date to remove these areas and either do a tuck or graft to take the next step in the reconstruction.  We were originally looking at the 29th of the month, but before we even got out of the parking lot we got a call on the cell and asked to come back in and fill out some paper work.  He was able to book the OR at the hospital for tomorrow morning so we're off again to the surgical ward.  The good news is that we're first on the list so the surgery will be done very early and secondly, taking into consideration what she's already gone through, this surgery won't be quite so tough.  He figures two hours of surgery with three or four hours of recovery.  Then she will be able to come home tomorrow evening and it won't have to stay in the hospital unless there are unforeseen complications.  He's also going to redo a section of the abdominal incision where the leak developed and reinstall a drain that she'll have to deal with for a few days, but that will take care of the leak.

So we're off to check in at the hospital at 5:30 AM, Surgery scheduled for 7:00 AM and after I get her home I'll try to update this page sometime tomorrow evening.  The rest of the day has been filled with filling prescriptions and getting her prepped for tomorrow.  We didn't think this would happen so quickly, but it's kind of a relief to be making the next step.

This of course screwed up the appointment with the Oncologist that was scheduled for Wednesday and now has been rescheduled for Thursday, Dec 2nd, but we're adapting.

November 23, 2010...  Just a quick note.  Lisa second surgery went off without a hitch, took two hours and I actually got to bring her home early in the evening.  The necrotic areas are now all removed, a few new stitches are in place and we're back playing with drains again, but she's doing great.  It changed her "profile" a bit, but actually for the better, in my opinion.  There will be other surgeries to even her out, but each is less invasive than the last so now it's just a case of getting her to heal up well.

Kids are coming up for Thanksgiving so we're all looking forward to dinner on Thursday and it will be fun to have the herd back together for a day.

December 2, 2010...  Well, after a long healing period after the second surgery we finally made the rounds with the Doctors today.  Nothing but good news!  The Oncologist had all of the genetic testing results and the good news is that Lisa had a stage one, slow growing and not too invasive tumor.  After having tested the thing's genetic makeup the Oncologist is recommending a five year treatment period using a hormone based drug called  Tamoxifen.  There won't be any need for Chemo!  The truth being we couldn't have hoped for a better outcome regarding tumor type and treatment!

On the Plastic Surgeon's side the second surgery is looking like there's a good outcome and today Lisa got all of her drains pulled and half of her staples are out.  She'll lose the second half of her staples next week and the following week the Plastic Surgeon will lay out the plan for the further rebuild of her breasts.  That will require a couple of more surgeries, but compared to what she's already been through each is becoming less and less complicated and more and more easy to heal up from.

Over the last couple of months we've had a lot of days where we were optimistic about the outcome of all of this, but today reinforced all we had hoped for.  Statistically, once she's on this drug routine, she will have a 94% probability of this problem not reoccurring over the next ten years and that's a pretty decent hand of cards to play....  Good day and I was even able to sneak her out for a bite of lunch!

December 14th,2010.... It's been quite a while since I've made a note on this page and Lisa is about up and ready to go back to blogging herself so we'll be able to deal with things of substance when she gets back. Everything on this page is just updates and she'll be able to get into the meat of all of this.

All we've been doing over the last three weeks has been healing... Her surgical scares are looking good, but we've had a minor problem with a stitch that abscessed and caused a minor infection. The end result being that I've been packing the abscess with surgical gauze and it's getting smaller by the day.  It's kind of a pain for her as the rest of the surgery issues look great and she;s still got this one little nagging problem.  At any rate the Dr. says its looking good, she's back on antibiotics and mostly we're dealing with getting her disability extended for a short period as originally it wasn't set up for double surgeries.  She's due to go back to work at least on a part time basis on the 20th of the month, but with Christmas and New Years falling so close behind and the years business all but wrapped at this point the Dr. is on a mind that she should look at going back about the second week of January.

Her stamina is still pretty low, but she's up and doing stuff around the house, we're getting out on a fairly regular basis if for nothing else than to get to the store and walk to regain the strength she lost.  It's funny as she's actually practicing setting up in an office chair for longer periods each day and also beginning to monitor her accounts again, so she's about fed up with this "at home stuff".  The office beacons!!!

Next Dr. appointment is after the first of the year and then will hopefully begin the three month healing period he wants prior to the next phase of reconstruction.  I think that that should give her about enough time to rest and get ready for that phase.  She won't begin taking the Tamoxifen  until she's through the next surgery, but it's setting here ready to go.