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Monthly Archives: May 2009

Drug Retention?

Today was a long day between getting my hair done and an event of our oldest son’s that I absolutely had to attend. By 7pm I was falling asleep in my chair. Even all that aside, I’ve noticed something over the last several days about my brain function, or lack thereof. I have very little ability to focus. I can’t keep things straight in my head for very long. Even writing this post is difficult for me because I just can’t get the words straight in my head. I haven’t had any pain meds since 3pm Monday afternoon because I haven’t really needed them. So I know it’s not being unfocused because of that. My pain level is also not to blame because I’m really not over a 1 on the OMG-It-Really-Fucking-Hurts scale.

I am beginning to think that, because I am overweight, it is possible that my fat cells have stored up the opiates and are still releasing trace amounts.  Since I am very inactive because I’m still recovering, my body has not had an opportunity to burn it off.I’ve been told that it can also take as long as 6 weeks for the anesthetic to be completely out of my system.

On the other hand it is possible that my erratic sleep schedule may also be responsible in part. I have also been inconsistent on the time of day that I have been taking my Levoxyl, which is the med I take for my Hashimoto’s Thyroiditis. I MAY eve have forgotten to take it for the last few days. I just don’t know. So that may be a contributing factor as well. It could be one, two, all or none of the above.

I’m rather looking forward to being able to think clearly for more than a few minutes at a whack.

 

The “After” Shot

All medical issues aside, another minor concern of mine has been “Will ANY of my old clothes fit???”. In MY perception my new breasts are still VERY big. I believe the phrase I used earlier today was “Release The Krakens!!!”. Since we have to go to Atlanta for my 1 month check up, I was VERY concerned that I wouldn’t have anything appropriate to wear and I’d be stuck with nothing more than ill-fitting tank tops with shelf bras.

It turns out that changing clothes 30 or so times is quite a workout. I DID end up losing three tops that zipped, but the lion’s share of my wardrobe still works. As a matter of fact, my clothes actually look BETTER now than they EVER have before. My favorite blue and brown beaded top looks absolutely amazing. There have been about four times today when I looked in the mirror that I started laughing and crying at the same time. I’m just SO filled with emotion now when I look in the mirror: Happiness, fulfilment, joy…all overflowing. My heart is whole again.

I can see already that bra shopping is going to have to happen pretty soon. My breasts look great. They’d just look a bit better lifted and supported properly. We’ll be off to Miami in the next couple weeks to a boutique that was suggested to me on the Larger-Cup Ladies discussion thread on http://www.Knickers.com The chain is called Intimacy and their website is http://www.myintimacy.com They have a store locator on the web site and they come highly recommended.

So here, as promised, is “The After Shot”

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So I Was Wrong

Ken just changed out my wet-to dry bandage on my back and I got a chance to look at it. I’m a bit more concerned now than I was before. I know that everything is going to be fine in the end. At the moment though, the separation in the stitches is about 3 inches long. It’s not deep, but it is just chock full of glop at the edges of the opening. Tomorrow morning, if the wet to dry bandages haven’t removed more of it, I’m going to have Ken clean out the wound with antibacterial soap.

As usual, I will update as things progress.

 

Sucking Rocks Through A Straw

This is an older draft I found but I really feel like the issue of prescription drug addiction and the healing process in general calls for me to post this. Enjoy :-)

5/10/09: This morning I faced the conundrum that most surgical recoverees will face at some point: Hit the top of the pain charts by getting up or wet the bed. I had been blissfully asleep until my bladder woke me. Apparently it had also been quite some time since I had taken my last pain pill.  So I laid there debating which was worse: Pain or Embarrassment.

I took Door Number One there Monty Hall.

Side Note: Speaking of Monty Hall and Let’s Make A Deal, *I* think that was an early instance of cosplay on the part of the contestants.

Now back to our regularly scheduled program: And I was right. My chest was screaming louder than it had since the end of Week 1. I’m starting to feel a bit like for every two steps forward I take, there’s generally this one little backwards stumble. First there was the over doing it with walking. Then it was the non-infection infection, Then came the Elephant with Barbed Wire Boots followed by the Darvocet Disappointment. Now this.

Recovery, while it IS a good thing and DOES continue forward, just has days where it sucks rocks through a straw.

In the mean time I’m still waiting for the Hydrocodone to kick in all the way. It’s better but there’s still pressure and the occasional muscle pain. Soon though. I can actually take deep breaths without wincing. That’s progress.

I’ve got to be careful about how often I take the Hydrocodone now though. I thought I had more than I do and every one of those halves is precious. Granted I DO have the muscle relaxers and those work too. So I’m just going to have to figure this out. OR I could do the smart thing and ask for a refill on the Hydrocodone IF it comes to that. Maybe Dr. Elliott will do it and be glad I’m off the Oxy. And for the record kids, I REALLY understand why doctors make that a short term med. It’s SO very addictive. When you’re on Oxy, you’re wrapped in a cottony cocoon where nothing bad ever happens and the world is filled with caviar dreams and champagne wishes. It’s a wonderful place that you really never want to leave. So of course at the first inkling of pain…even low level pain, you just pop that wonderful little pill and you’re back in that safe, warm place again. I could very easily see myself becoming addicted  to it. So as much as I complained, it really is a good thing that Dr. Elliott switched me to hydrocodone.

 

Hooters

At 4:30 today I got the right side drain removed. YAY! I also found out one of the reasons that the drain site is so sensitive. Dr. Roxanne Guy said that there was something called “proud flesh” at the site. According to a medical website “Proud flesh is an excessive growth of granulation tissue that has the appearance of cauliflower. It usually develops over an open wound, and most often occurs in areas of excessive tension and motion”.

Granulation tissue is the perfused, fibrous connective tissue that replaces a fibrin clot in healing wounds. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size it heals. In other words it’s the brand new flesh.

In other words, my skin was trying to heal OVER the drain site and the drain was in the way. Since I only had one stitch holding it in (I tore the other one clear out last Friday night) the drain itself tended to wobble around causing tension at the site. On top of the proud flesh and raw granulation tissue, the site is also infected. AND there were fiberous tissue strands trying to come out of the drain as well. So it’s just been a pain fiesta at that drain site. 31 flavors of pain, to quote Scott Sigler’s book “Contagious”. Which, if you haven’t started listening yet, you’re SERIOUSLY missing out.

Dr. Guy also looked at one of the suture sites on my back. She removed a greenish string of matter about an inch and a half long from that site. It’s just a very small area but as a preventative measure she wants us to do wet to dry dressings for a little while.

A wet to dry dressing is gauze that has been dampened with saline and packed into the site. It is left for several hours to dry. When it is removed, it has stuck to the matter that needs to be removed so it debrieds the area. Debridement: The act of debriding (removing dead, contaminated or adherent tissue or foreign material)

Don’t worry, there isn’t any dead tissue. She just wants to make sure the little area gets cleaned up so that it will heal properly. I am not overly concerned. After what I’ve been through, a 1 1/2 inch long area is really easy to deal with.

After seeing Dr. Guy I was absolutely ravenous! I haven’t been that hungry in a VERY long time. So we stopped by Hooters since it was on the way home. It is SO nice to feel like I’m on par with these beautiful women. We sat and talked with our server, Ashley, about the state of the economy and other political things that I’ll spare you the details of since this isn’t a political blog.

Ashley WAS right about one thing though. The chocolate mousse cake there really IS almost better than sex.

 

Four Weeks

While the sutures are doing just fine, I’ve managed to develop an infection in the remaining drain site. The area is inflamed, pussy and a shade of red no skin should ever be. So back on Cipro I go for the next 10 days. I’m back to living on my heating pad, too. It’s the only thing that seems to make the drain site more livable.

Of course we reported the infection to Dr. Elliott’s people, thus the Cipro script. We were also told that the site needed to be cleaned with soap and water.  It’s amazing the pain control you can accomplish with a focal point and slow exhalation during the cleaning process.

For those not familiar with the process, simply pick a spot that will keep your attention then take a deep breath and while the cleaning takes place, then control your exhalation keeping it very slowly and even. What this does is give you something else to think about, first. Secondly, it keeps you from gasping and screaming, or at least cuts down on the likelihood. When we scream we also tense up just as when we gasp. Staying as relaxed as possible is a key to any kind of pain management.

In the ‘good news’ department today, I got up this morning without taking any pain meds of any kind before getting out of bed. I *was* very stiff and sore, but I wasn’t experiencing pain like I had been previously. I do hope that this is the first step towards really being healed.

More good news: The level of drainage is starting to go down again. It’s still over 30mls in 25 hours but I think I broke the 50ml plateau finally.

Finally, in the ‘things you never thought you’d ever say in your life’ department, here’s an interesting tidbit. My mother is a 25 year cancer survivor. She had Stage 2 breast cancer which means that it had spread to her lymph nodes. The doctors performed a double radical mastectomy. At that time in Wyoming they weren’t doing breast reconstruction at the time of the breast removal. She was told she had to wait two years before she could have reconstruction.

Two years later she decided to just do implants because it was easier rather than any of the flap procedures. She told me she didn’t do her homework like she should have. Unfortunately, she developed necrosis and had to have both implants removed. She never had them replaced out of fear of having the same problem nor has she had any type of breast reconstruction surgery.

With her own experience and my previous experience she has been scared to death. Of course I wanted to reassure her that I am doing well. I also wanted to show her the marvelous work that Dr. Elliott did. So I text messaged her a pic that I had taken of the Twins at the 4 week mark. She said something I never thought I’d ever hear my mother say to me. “You have beautiful boobies”. Yes it’s a little freaky to hear something like that from my mother. It’s nice to know that she IS reassured though.

She has told me that if she ever decided to have reconstruction done, Dr. Elliott is the ONLY person she would trust to do it.  I’ve said it before, but I cannot say it often enough, I cannot recommend Dr. Franklyn Elliott of Atlanta Plastic Surgery AND his staff highly enough. They have been absolutely amazing throughout the entire process.

 

I’ll Take “Drain” For $1000 Alex

It’s another early morning. My sleep pattern is SO messed up it’s not even funny. Monday night I went to bed about 11 and woke up at 2 am. I stayed up until around 10am Tuesday and went back to sleep because I was incredibly exhausted. I finally woke up around 2:30. Then went back to bed around 11:30pm. This morning (Wednesday) I woke up at 3:30. I only seem to be able to sleep in 4 hour blocks right now. I’m guessing because that’s how long the acetaminophen is lasting.

After almost  month you would think that the worst pain would still be from the incision areas. It isn’t. The worst pain is from this stupid right side drain. The only thing aside from acetaminophen that makes it better is the heating pad. I’d have it taken out but I’ve been stuck at a steady 50mls of serous fluid for the past four days. It’s not lightening up.

As Ken reminded me though, this is the only outlet for drainage now so it may take longer for this one. As I see it, I don’t really have a choice other than to suck it up and deal. If the drain is taken out too early, I’ll develop a seroma. A seroma is defined as a pocket of clear serous fluid that sometimes develops in the body after surgery. When small blood vessels are ruptured, blood plasma can seep out; inflammation caused by dying injured cells also contributes to the fluid. The only way to get rid of one of those is to use a syringe with a HUGE needle to remove the fluid from the pocket. So since my choices are Drain or Harpoon Gun, I’ll take Drain for $1000 Alex.

I do have to wonder if the heating pad is exacerbating fluid production though. I can’t find anything about that anywhere. Even though the heating pad makes the drain site more comfortable, I *might* be making matters worse. Maybe I should call Dr. Elliot’s office today and talk to them about what’s going on. They should probably know that I tore that stitch. Since it’s Wednesday, they’ll be seeing patients in the office so I should have no problems getting in touch with Patti or Chris.

As usual I’ll update as I have more information.

 

Turning A Corner?

Two days ago I was talking to my mother, who has been through MUCH more medical crap that any human being should EVER have to endure. She said that soon I would have to start learning to differantiate between pain and stiffness. There IS a difference. Pain does not improve with movement. In fact movement simply makes pain worse. Stiffness, however, is eased with movement until the body feels nearly normal again.

This morning I woke after only about four hours of sleep feeling very sore and stiff. I went to use my usual method of rolling out of bed only to discover that it was MUCH easier to get up. I was really surprised. It’s actually a bit of a shock at how quickly I seem to have started turning a corner. There are still spots, like my triceps, that hurt but don’t top out at more than a 1 on the pain scale.  Of course the spot where I ripped the stitch is still a but tender. All in all things are getting easier though.

I am by no means totally there and I’m going to have to take things slow still to make sure that I don’t  overdo and really hurt myself. I still have muscle relaxers for when I need them and two different types of pain meds if and/or when I should need those.

I think the thing that’s the worst right now is the lack of sleep. I’m so very tired right now but I can’t really sleep. I just got up. I need to eat because I’m nauseous from lack of sleep and I’ve GOT to move around more. Plus there is morning maintainence to be done. I’m just so tired. I’ll probably take a nap in a bit after everything else has been accomplished.

In the mean time, I’m relieved that it looks like I may finally be turning a corner.

 

Post Surgical Depression

From what I’ve been reading, lots of people go through this. Whether it’s hip replacement, heart surgery, cosmetic surgery or something else altogether, many people have bouts of post surgical depression. Personally, as happy and relieved as I am to have this done with, I never expected to be one of those people.

At first I had no idea why I was crying. So I broke out my laptop and googled the subject. The more I read, the more I began to understand. I expected to just have new pretty breasts and then go on with my life. I was fairly active before the surgery, able to accomplish thing and now there are times when I can’t get up without help. I expected to recover faster. I expected something different and sometimes I’m scared that because I’m not recovering faster maybe there’s something wrong.

Logically, expecting to be back to my old self in a little over 3 weeks might be a bit unreasonable. A part of me still thinks that I should be able to do everything I was able to do before April 16th. I still think that I SHOULD be able to do more than I’m doing. When I realize I can’t, it’s kind of a brutal wake up call. I have to remind myself that this is recovery and that there is nothing wrong. How I feel is supposedly normal.

My reading tells me that post surgical depression is caused by a number of factors. It could be anesthesia, which stays in the system up to a month. It could be a side effect of the pain meds. It could be unmet mental expectations. Pain, discomfort, disturbed sleep and constipation can also contribute to post surgical depression. All in all, according to my reading, if you’re not feeling like yourself and you expect to, like I do, that’s really going to wear on you.

I just wish I knew what to do about this.

 

Flagstone Minefield

Yesterday afternoon after some debate, we made the 90 min. trek to Disney. We rented a wheel chair for $10 and Ken pushed me around all afternoon. The trip over was bearable but I DID get a bit motion sick about 20 min. in. So I popped a few pieces of candied Ginger. It really is wonderful stuff and it got rid of the nausea and dizziness in about 5-10 minutes. It’s important to start eating it when you begin feeling motion sick though. I have yet to find anything that will fix motion sickness when you’re in the midst of it.

I also ended up taking half a hydrocodone before we even got there because I was spiking about a 5 or 6 on the pain scale. It’s not the bumps, it’s the vibrations from the road that really are the worst part of traveling. I’ve talked to others about this too and they all agree with me that it’s the road vibration that really makes riding painful.

When we got to Magic Kingdom, Ken maneuvered our way into the Minnie parking lot and found a space closest to the entrance in the row behind the handicapped parking row. I stayed put, still waiting for the pain pill to kick in, while Ken walked across to the main handicapped lot to grab a wheelchair.

The way it works at MK is that you use the parking lot wheelchairs aka the really crappy ones, to get to the gift shop by ticketing. Then you pay the $10 rental fee and transfer over to the better wheel chair with the wider seat. From there it’s up the ramp to the monorail.

The monorail then, after going through the Contemporary Resort, stops at Magic Kingdom. Then it’s down the ramp to the turn styles. We went to one of the gates that either wheelchairs or parents with strollers can use and a cast member ran our passes through the machine. We were in.

Usually the first stop is the Haunted Mansion but as we were both half starved we decided to stop by The Plaza restaurant on Main Street and see if they had any openings. Unfortunately, the next availability was in 30 min. Too long for us. So we headed for Tomorrowland and Cosmic Ray’s.

It’s really surprising how oblivious people can be to anything that is below normal line of sight. So I indugled in some cheerful “BeepBeep!” sounds when folks would stop directly in front of us. The park wasn’t very crowded so that didn’t happen too often.

Once food had been consumed, we headed for Haunted Mansion in Liberty Square by way of Fantasyland. Now HERE is where the flagstone minefield comes into play. Remember earlier I mentioned vibrations? Well wheelchairs have less shock absorbing capabilities so running over very rough flagstones such as are ALL OVER on the ground in Fantasyland, is rather like being IN a jackhammer. There are concrete paths around these islands of flagstone but it’s quite a bit like being in a mine field. The worst area for it was up by Ariel’s Grotto and Pinocchio’s. Unfortunately, that’s where we got caught.

Once we were out of that particular area of Fantasyland, it got much easier to deal with as the paths are all concrete.

As far as the attractions themselves, I had to walk the farthest for Haunted Mansion. They’ve worked out the best way to get people past the cue but after that, you’re still standing. Pirates of the Caribbean will let you roll all the way down to where you get on the boats. There they give you a tag so that you can retrieve the correct wheelchair after you come out. But you still have to walk from the boat, through the gift shop, back to the entrance to retrieve your chair.

The BEST attraction we went on for a wheelchair was Jungle Cruise. They have a boat that you just roll right onto. Then the lift swivels around and settles you in facing forward and you’re locked in nice and safe. No muss, no fuss.

There was also Philharmagic, which is a 3-D movie and for that you just roll into a space and watch the show. Also easy-peasy. By the time we’d eaten, done a little pin hunting and rode a few things, I was done for the day. So I popped another half a hydrocodone and we headed home.

This time I folded up the spare sweatpants I keep in the car for emergencies and used that as a cushion for my back. That really cut down on the vibrations and made the 90 min. ride home MUCH more tollerable. That, and we caught up with the last few episodes of the Geologic Podcast. A good dose of Geo always helps.

To review: Candied Ginger is your friend; Fantasyland is a Flagstone Minefield; Jungle Cruise is the best wheelchair-friendly ride and Sweatpants make a great cushion.

 
 
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