Tuesday, August 6, 2013

Implant Post-Op

I am a little over one week post-op.  Thursday, 8/1, I had my follow-up with the nurse, and she removed the bandages (ouch) and gave me another rundown about what I should not be doing.  No pushing, pulling, lifting (over 10lbs), overreaching, swimming, sudden movements, stretching, or exercising.  These restrictions could last up to 12 weeks.  I have a follow-up with the surgeon in 4 weeks and hope some of the restrictions will be lifted.  The incisions are healing well.  The cancer side has dissolvable stitches and also 9 stitched on the outside to give some extra protection against the incision opening.  Since this side was blasted with 28 rounds of radiation, there is a potential for the incision to open up and not heal properly.  Overdoing it and overuse of the muscle on that side could also make the implant raise and open up the incision.

The implants look ok.  The cancer side is a little smaller and is definitely holding the implant closer to my chest than the other side.  I probably should have asked to have the expanders stretched bigger on that side so the tightening caused by the radiation would have made them a little more symmetrical.  At this point, it is what it is, and having the expanders removed is a vast improvement.  During the appointment, I forgot to ask what size (cc's) they put in, but when Steve talked to the surgeon after the procedure she mentioned 300 cc's.  That’s about a B after a mastectomy with no other tissue in the breast.  There are some noticeable ripples under the skin, which may go away as swelling goes down.  They could possibly do a fat graft and do a little lipo to inject into the location.  I have to wear a sports bra 24/7 (except for showering) for at least 6 weeks and have to do implant massages 10 times a day.  I am only allowed to do this on the non-cancer side for now.  The cancer side has to be babied for a while to make sure the muscles and incision heals properly.  The risk of capsular contracture is high for the cancer side.  This occurs if the scar or capsule around the implant begins to tighten.  Capsular contracture can be treated in several ways and sometimes requires either removal or scouring of the scar tissue, or perhaps removal or replacement of the implant.  Radiation therapy dramatically increases the risk of tightness around the implant due to radiation fibrosis.  This could mean many additional procedures, but hopefully I will be an exception.
The surgery went smoothly and lasted over 2 hrs.  There was some damage to the muscle from the radiation, so they had to do some extra work on that side.  I was in recovery for awhile, because they had a hard time managing my pain.  The meds they give in recovery work quickly, but wear off just as fast.  I was home by late evening and after eating a little, I was headed to bed.  The first few days the pain was bad, but it has gotten a lot better.  Now, it just feels very tight and sore mainly on the cancer side.  There are still times when it hurts, probably from moving around too much.  Charlotte fell off the couch the other day and my natural instincts had me moving to catch her.  I didn’t make it in time, which was good because just the sudden movement of reaching out hurt pretty bad.  I can’t imagine how painful it would have been if I had actually caught her.  
I will say having an active toddler around has been difficult for recovery.  She is so fun and makes me laugh, but wants to be picked up or held, and she gets a little frustrated with me.  Even though we were always good about taking turns with different things, she has wanted her mommy a little more than usual.  It is hard to send her to daycare while I stay home, but it’s the only way for me to really rest.  It’s a good thing she loves daycare and happily leaves each morning, marching her little butt out the door.
Overall, I am doing well, aside from the limiting restrictions and am feeling better each day.

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