Post-op progress report No 1: Biting off more than I can chew

I realised I’d bitten off more than I could chew when I found myself on my back on the living room floor, unable to get up, with no-one in the house to help. I know, funny image, but I wasn’t laughing.

That was on Monday afternoon. Andy and the boys had gone out for a couple of hours; I’d said I would be fine. I was being lazy and decided to do my post mastectomy/DIEP flap reconstruction tummy exercises on the floor just where I was. The alternative was to climb two flights of stairs – which I can do fine now – to the bedroom and do the exercises lying on the bed.

What I’d failed to take into account was that getting up from the floor would be so much more difficult than getting up from the bed. Even getting out of bed is still quite painful because of the strain on the hip-to-hip incision when you roll over from your back on to your side, then again when you swing your legs over the edge of the bed and yet again when you have to get into a sitting position on the edge of the bed so you can stand up. I still can’t use the operated arm (the right one in my case) for support and my left arm isn’t the support it normally would be as it still hurts from where all the needles went in for the various “lines”. So basically all I could use to get up from the floor were my legs and abdomen… and anything that stretches the incision too much is very painful.

Anyway, I managed to manoeuvre myself, still on my back, over nearer the sofa and somehow used that as leverage to get myself up and back on my feet. Or rather back on the sofa, which is where I spent most of the rest of the day. Lots of pain involved. Lots of swearing involved.

That episode notwithstanding, I think my recovery from the major surgery I had less than two weeks ago is going well.

It’s hard to believe we’re already on Day 11 post-op. You do make considerable progress day by day, but I still tire easily and there is pain involved in doing the most mundane things, even when you’re on painkillers. I spend a lot of time on the sofa, reading, watching TV (I’m on Series 2 of House of Cards and loving it) or writing. It still hurts to sit down and to stand up. Getting into bed is relatively easy at this stage. Manoeuvring while in bed is not.

Things are generally fine when you’re sitting down and not moving although there is a constant painful numbness on the underside of my right arm from my armpit almost to my elbow. I’m hoping that will go in time. I’m following instructions and am doing next to no weight bearing or carrying with my right arm; also at this stage I’ve not to lift my elbow any higher than my shoulder.

On the upside, I can shower standing up although drying and dressing myself takes an age. I can stretch my legs out flat in bed; previously I’d needed a pillow under my knees all the time I was horizontal. I still can’t quite lie completely flat and sleep on my back propped up on two pillows with one cushion under my knees and another by my right side on which to rest my right arm.

I can more or less stand up straight, although once I’m on my feet it takes a good few minutes of loosening up to get there as everything tightens up when you’re sitting down and not moving.

Nothing hurts anywhere near as much as it did a week ago, or indeed even a few days ago. I can now laugh – a little – without doubling up in pain. It still really hurts to cough although not so much that I need to resort to the wonderfully low-tech but effective “bracing device” that you see in the photo – a rolled-up towel held together with tape. One of the nurses put one of these together for me when I was in hospital. If you press it onto your incision while you cough or laugh, it decreases the stress on your incision and you feel less pain than you otherwise would.

I can walk quite well and I make a point of going out – accompanied – for a short walk every day now. Yesterday I ventured out by myself for the first time – to the doctor’s surgery just round the corner to put in a prescription request for iron tablets (anaemia is common after major surgery and for the first time in my life I’m anaemic; I’m to take one tablet three times a day for the next three months).

I’m doing my arm and shoulder mobility exerises and abdominal exercises as directed; they’re going ok. We step them up in week 3 post-op. However well things are going, though, I think I’ll stick to doing the tummy exercises on the bed for a while yet!

 

 

The least sexy washing line ever

It occurred to me as I hung up some items of clothing to dry over the radiatior rail that this was possibly the least sexy washing line ever. Check out the photo below… I’m telling you, with breast cancer it really is all glamour.

Starting from the left, we have:

Item 1: the wig liner, to stop your wig sliding round your head.

Item 2: the post-op bra, to support your reconstructed boob. Look at the SIZE of that thing! Andy reckons you could use it to transport bricks.

Item 3: the anti-DVT socks/stockings, to be worn 24/7 for the first week after the op then during the day for another two weeks.

Item 4: the compression knickers, to stop you feeling like your insides are going to fall out through your abdominal scar.

I know what you’re thinking and yes, I know and I do apologise… the bra and pants don’t match.

 

 

In-hospital weight gain was not in the plan

I came out of hospital three kilos heavier than when I went in.

How on earth did that happen, especially when I had my right breast* and plenty of other tissue removed?

Maybe it’s some weird practical joke the surgeons play; they bury some weights inside before they sew you up for a bit of a laugh. Or maybe it has more to do with the fact that I was eating more or less normally from right after the op but was also on fluids for the first three days I was in hospital and was more or less immobile and not burning any calories the whole five days I was there. Or maybe there’s some other reason of which I’m not aware.

Whatever the reason, in-hospital weight gain was not in my plan. I’d lost 4 – 5 kg in the past few months (Immediate reconstruction – the decision is made) and had been thinking that if there was one good thing I’d got out of this damn thing, it was that I’d lost some weight without even trying.

So much for that. And it doesn’t help that it’s Christmas…

*Ever wondered how much a breast weighs? The one they removed from me weighed 700g.

 

 

Merry Christmas! From home, not hospital

It’s Chrismas Day morning and I’ve just been brought breakfast in bed.

I’ve had breakfast in bed every morning since my op (mastectomy, reconstruction and full lymph node clearance) on 19 December, so no change there. Today, though, I’m in my own bed rather than a hospital bed and breakfast was brought to me by my elder son rather than by a member of the hospital catering staff.

So, yes, I did get home yesterday as planned. The breast and plastic surgeons had both been by 8am and declared me fine to be discharged. At some point later yesterday morning/early afternoon, the final drain was removed, I had a shower (seated and in incredible discomfort), dried myself (harder than showering) and got dressed (very slowly and painfully).

It was rather an emotional day. I had a “this is all too much” few minutes in the shower when I just sat on the little seat and cried. Showering and drying were only marginally less difficult than I’d feared they’d be. I burst into tears as soon as Andy walked into the room when he came to collect me at around 3pm, I cried again when we left hospital and then again in the car on the way home. And again watching Mamma Mia on TV at home later – at the same point I always do, though, so maybe that doesn’t count. I’ve been fine since.

And yes, we did play Chris Rea’s Driving Home for Christmas in the car on the way home. How could we not? This has a special resonance for us which goes way back to the couple of years in the late 1980s when Andy was a radio journalist in Birmingham and worked Christmas Day mornings. When he’d finished reading the lunchtime news, he’d hop in the car to drive down to London to see me. He’d get the DJ who followed the news to play Driving Home for Christmas “For our newsreader Andy, who’s on his way to London to see his girlfriend, Maureen”. Ah, the romance.

Have a lovely day, everyone. It’s good to be home.

Homeward bound on Christmas Eve

It looks like I’ll be going home tomorrow.

I should be cheering. I am cheering, really. However, I am so far from being able to cope on my own that it’s also quite a daunting prospect. It’s a small room in here and it’s a big world out there. But I’ve been assured that as long as I have a lot of support at home, I’ll be fine.

So thank goodness for Andy, Jamie and Finlay!

Those of you who are chuckling scepticallly should be ashamed of yourselves ;-).

The fluid bottle

Andy has already had shown his mettle by rinsing through my post-op bra the other evening here at the hospital; it was stained with body fluids that had leaked from the drain site under my arm (the marriage contract did say for better or worse, honey). That might be too much information for some of you but the story really is too good not to share, especially as you all already know how squeamish Andy is.

As for Jamie, I’m looking forward to him serving up some of his famed poached eggs and toast and his prawn and chorizo risotto (though hopefully not on the same plate). And I can see Finlay’s yummy yoghurt, dried fruit and honey combo becoming a bit of a breakfast staple. And I’d almost forgotten his delicious penne carbonara.

The boys will no doubt use my limited mobility as an excuse to have suppers in front of the telly. I guess we can live with that for a bit.

So what has happened over the past day-and-a-half that means I’m ready to go home?

Well another drain was removed today, as was the remaining cannula (look it up if you’ve forgotten, folks, I’ve explained it before). I now have just one remaining “attachment” – the drain under my right arm and that’s coming out tomorrow.

Also, I’m much more mobile. The physiotherapist arrived shortly after breakfast this morning and we went for a walk. We went up and down a flight of stairs and once she’d seen I was fine doing that, she declared I was mobile enough to be discharged. I did the stairs again later for reassurance – this time with Jamie and Finlay as escorts. The right arm and shoulder mobility exercises are also going well.

Finally, both surgeons are pleased with the reconstruction and my various associated wounds.

What else? I’ve to try and have a shower tomorrow morning, and I guess then I’ll have to try and dry and dress myself. I can see all that taking a long time. Even the thought of it brings me out in a sweat. If/once I manage, though, I guess I’ll be all set.

So all going well, I’ll be homeward bound on Christmas Eve. Bring it on!

 

Feeling a million times better than this morning, but what a struggle

I’ve just had lunch, and before that the physiotheraptist and I went for a spot-the-Christmas tree walking tour of the corridors of the ward. I walked unaided.

You did what?!, some are you are no doubt thinking. Well, it was in the plan to be up and walking about on Day 3 so things are just going to plan. Really, I’m no hero. However, if you’d seen me a couple of hours earlier, you’d never have thought me capable of such a thing. At that time I was honestly thinking that this part of the “journey” was much worse than anything I endured during chemo. I’m not going to bore you with the details but several taxing events happened this morning (some of which now don’t seem so taxing; it’s always the way) and I was really feeling there was no way I was going to get home this year, never mind possibly this week.

I was feeling so down that I texted my two sons who were about to leave the house to come and visit me to tell them not to come. That’s how bad it was. They’ll come later with their dad.

So what else can I do now that I couldn’t do when I woke up this morning? Most importantly, I can get out of and back into bed on my own (although I’ve only been back in once as I’m spending the day in the chair and keeping myself mobile by moving around the room from time to time). I can lift the water jug and tea pot and pour my own water and tea (so much less calling on the nurses), and I can go to the loo (the catheter came out this morning). And I’ve just leant down from the chair and picked something up of the floor, which would have been unimagineable yesterday. And obviously, I can now walk unaided.

Things are very tight round the abdomen join but I’m trying to stand up a little bit straighter every time I stand up. It is not easy.

Two drains came out yesterday. I still have two in, one in the underarm and one in the abdomen. The fluid drains into little bags and you carry those around with you in a plastic bag when you go walkies. You only forget you’re attached to them once.

So, massive strides today, but this morning was tough. With hindsight I probably took the setbacks harder than I needed to or should have, but it was what it was.

As for this afternoon, I’m off for another walk around the room, a friend is due to visit and then I’ve got a few episodes of Desert Island Discs lined up to listen to. 🙂

“It’s perfect.”

I awoke this morning to the sound of the plastic surgeon saying my name. It was 7am.

We chatted about how I was feeling (fine) and how the night had been (good). She dismissed yesterday’s fainting episode – “it’s really common” – then examined her artwork and declared it “perfect” in terms of the medical procedure having been a success.

The reason it’s checked so often initially is that there can be problems with the blood supply in the first 48 hours. If this happens, you need to go straight back to theatre. In extreme cases, the “flap” they’ve transferred from the tummy and reattached in the chest area can die and the procedure fails.

At seven this morning, I was just 40 hours out of surgery. If it’s looking this good at this stage, says the surgeon, “we shouldn’t have any problems”.

So it’s gone well in a medical sense. Perfect in an aesthetic sense would mean the reconstruction was identical to the original. It’s pretty darn close, I would say. I’m amazed, as are the nurses who do the checking – a couple have said it’s the best they’ve seen.

The lovely boob is one thing. The hip-to-hip scar is another. “You look like someone’s tried to cut you in half,” jokes one of the nurses.

The consultant gets down to business with the on-duty nurse. It seems I have a busy day ahead. I’ve to get out of bed and spend time sitting in the chair. Two of the four drains are to be taken out today and the urinary catheter should come out tonight. The loo is only about eight steps away from the bed but I fear that tonight when I have to go, each step is going to seem like a mile.

I’m envisaging lots of effort, sweat and perhaps some tears today as part of my “remobilisation”. It has to be done. Wish me luck.

The basics

I could write a book about the last 36 hours alone but instead I’ll just give you basics.

I have been out of intensive care since around two o’clock this afternoon. The plastic surgeon came in the morning and declared herself happy with things, saying it had all gone “very smoothly”. There’s a lot of bruising but the reconstruction looks quite amazing. The breast surgeon managed to spare the nipple, at least for the time being. I’ll get the results on whether that can stay or not, on how much cancer was left in the original breast and how much was in the lymph nodes in one to two weeks’ time.

Andy came to visit this morning just as I was about to try and get out of bed for the first time. They let him see me for two minutes then shooed him off to the waiting area so they could get on with things.

It took a massive effort just to get into a sitting position on the edge of the bed. I was sweating buckets within seconds. Standing up was ok, as was shuffling four steps sideways to the chair and sitting down. However, I started to feel dizzy within seconds of sitting down, closed my eyes and started taking deep breaths… then fainted. It was just for a few seconds. I came round to see the outstretched hands of three intensive care nurses who would have made sure I didn’t fall off the chair.

I managed to sit in the chair for the designated ten minutes and then retraced my steps and get back into bed; there was no fainting on the return journey. It wasn’t easy and it wasn’t pretty, but that’s another hurdle passed. Andy said when he came back, I’d changed colour.

I had been warned it would be hard. The plastic surgeon had told me twice “you’ll feel like you’re 105 the first time you get out of bed” but explained it was important to do it on the first day. Tomorrow apparently I’ll be up and walking. Great, but hard to believe at the moment.

I’m still on loads of painkillers but I’m taking all of these by mouth now, except the morphine, which I still self administer via a drip as and when needed. To be honest, I haven’t used it that much today. I did of course use as much as I was allowed for the getting out of bed event.

What else?

Well Andy came back earlier this evening, this time with the boys, which was lovely.

My potassium levels are low so I’ve been given Nutrisip “oral nutritional supplements” to drink. They’re seriously revolting.

The physio’s been round, and has given me lots of exercises to do.

I’m now on two-hourly checks. Luxury! Night, night.

 

Before and after (don’t worry, it’s not what you think)

It’s 3.30am and I am moving from half-hourly to hourly checks. Now I can try to sleep for more than 15-20 minutes at a time!

I am comfortable and am making liberal use of the on-demand morphine drip. I think the two may be related. I had a bowl of soup, some ice cream and a cup of tea earlier, all fed to me by the nurses. I am drinking litres of water and one of the nurses has just offered to make me a hot chocolate!

Here are the before and after photos…

 

 

 

 

And here’s where one of the intensive care nurses captured the very minute it was no longer the day of my op!

 

“A star patient.”

“A star patient.” The words of the plastic surgeon after the operation. All appears to have gone well, Maureen is awake and talking rather a lot (no change there, then) and taking her usual interest in her surroundings, which currently amount to a labyrinth of tubes and various plastic bottles containing er, stuff (biology was never my strong point). So, a difficult day over and let’s hope she’s back home in time to cook the turkey (I mean, to be looked after and waited upon by her loving family!). Thanks for all your good wishes. Andy.