DIEP Reconstruction Aftermath: 10 Days

So basically I have had an awesome 24 hours. I feel... happy.

This happy spell interrupts a long week of blah. Not really unhappiness, just a lot of discomfort, restlessness, and fatigue. Oh my God, the fatigue.

Two days ago, Wednesday, was probably my worst day of fatigue, and I pretty much slept the whole day. Yesterday, I felt very blah, and probably would have spent the day sleeping, except that I had arranged to have a massage therapist come to my house to try to help me with my back pain. Lesson learned: massage therapists that make house calls are used to massaging house-bound, 90-year-olds. She was useless, and it's among the worst $65s I've ever spent, but whatever. It was worth a try.

Anyway, I was pretty wiped out all afternoon, then my husband had a meeting at 6:00, which meant I was in charge of the kids during dinnertime. This is the most responsibility I've had in a long time, which sounds pathetic, but like I said earlier, Oh my God, the fatigue.

A little before 6:00, one of my friends from my wine, oops I mean book club ;-) came by with dinner for the family. I was a little bummed because there was a book club meeting, but there was just no way I could make it, even though it was happening less than a block away. Oh my God, the fatigue. And anyway, I had the kids, I was only half dressed, I had these gross drains hanging out of me, yada yada yada. But then my friend suggested that instead of meeting at her house, everyone could just come over to my house, if I wanted the company. Yes, please.

I would detail the events of the evening, except that at some time close to 11 PM, chock full of inhibition-reducing substances, those of us who remained made a pact that what happens in Waning's back yard stays in Waning's back yard. Needless to say, fun times were had, and it was good for the spirit. I think one of the hard things about this (among many), is trying to find a balance between resting and languishing. I have now learned that sometimes pushing through the fatigue is a good thing.

I woke up this morning with a little bit of fog on my brain, but had to quickly sweep it away to tend to the kids while my husband had back-to-back teleconferences (my daughter did not have school today, and my son's preschool does not start until 8 AM, so my husband couldn't get him there before the teleconferences), then shower, then get dressed in real clothes, then make myself presentable to go out in public. For today was a big day: my first post-hospital post-op appointment with Dr. T.

I don't think I've ever been so excited for a doctor's appointment before, because I was so hoping that he would take out the God-awful drains, which are not just gross, but also extremely uncomfortable (and at times painful). And he did, and that alone made it an awesome day, but the rest of the visit was good as well. I think we were both just so much more relaxed than we have been, with the tension of Is this going to work? behind us.

Dr. T started off by asking me how I felt - that dreaded question I never know how to answer these days. I told him I felt okay, but Oh my God, the fatigue. He told me that was normal, then went into way too much detail about how he had cut into my chest, done 'muscle work' with my chest muscles, and taken out pretty much all (as in ALL) of the fat in my abdomen. I must have started to look grossed out at one point, because he then said, 'The point is that you see the scars on the outside, and they're pretty big. But it's nothing compared to the surface area on the inside that is trying to repair.' He said healing would take the same amount of energy as running a marathon, so massive amounts of fatigue for several more weeks should be expected.

When Dr. T asked about how much fluid was coming from the drains and I told him it was less than 30 CCs per day for all three drains, he said, 'Okay, we can definitely rip them out then!' Then he gave me sort of a mischievous grin and said, 'I mean... we can gently pull them out.' LOL. I had heard mixed things about getting the drains out, ranging from It doesn't hurt at all to It was the most painful thing I've ever felt, and I've had 10 kids with no meds. (This, by the way, is one of the more annoying things about discussing various procedures; any time anyone tells you something hurts, it is inevitably followed by a resume of that person's proven record of high pain tolerance.) Needless to say, while anxious to have the drains removed, I was also anxious about how much it would hurt. (For the record, I also begged for an epidural when my daughter was born.) Now that I've experienced drain removal for myself, I can say that it really didn't hurt, although it did hurt a little when he pulled the stitches around the drains out, and a little bit afterward, because now I have three holes in me, which should close up in a few days, according to Dr. T. It's actually rather amazing it didn't hurt, considering that for each drain, there were about 4 inches of drain actually inside my body. Dr. T also removed the wire that ran through the flap transplant, and that, too, was weird and uncomfortable but didn't hurt, probably because I have little to no sensation in my fake breast, and likely never will. I guess there are some advantages to numbness. I saw Dr. T pull out one wire, then go back in and pull out another. 'There were two wires?' I asked. 'No,' he replied, somewhat sheepishly. 'I just broke the one in half.' When it was all done, I felt slightly nauseous, which is apparently normal, and I regretted that I had eaten sushi in the car on the to the appointment. Fortunately, the feeling of wanting to throw up passed within a few minutes.

Other highlights:

• I've been worried about my nipple, despite the fact that everything seemed so positive in the hospital. It seems that she has taken a turn for the worse, poor thing. The past few days, I've been convinced that it was farewell nipple time, and even Googled pictures of nipple necrosis to see what it looks like, to see if this is what's happening to me. (All Dr. T had said is, 'It's not pretty,' and I definitely do not recommend Googling this on a full stomach. LOL.) However, I was pleasantly surprised when Dr. T looked at my nipple and declared, 'It's alive!' 'It's going to make it?' I asked. 'It did make it,' he replied. 'But it looks so sad,' I said, making sure he wasn't being overly optimistic. He gave a knowing little laugh and said that yes, my nipple was obviously very sad, and would probably never be a normal nipple again, but... it was alive, and had a better chance of recovery since I didn't have an implant. And that is honestly fine with me. Nipples are a nuisance, unless you are feeding a child, which I won't be, ever again. At the same time, not having a nipple is weird, without a doubt. I've been debating whether or not I'd put myself through the trouble of nipple reconstruction for the recreation of an unwanted body part, and I'm glad I don't have to think about it now. 
• I told Dr. T about his fellow, who, the day after my surgery, visited me, and told me in a very animated way that she was having a heart attack during my surgery because, 'You're so skinny! I didn't think we were going to be able to close you back up. I asked Dr. T, How are we going to close her back up?! and he said, I don't know yet!' (Talk about something you are happy you are hearing after the fact.) Interestingly, he didn't deny any of this. He just smiled with his heart-warming and confident, semi-cocky smile, and said, 'Dr. Lu is a new fellow, so she had never seen anything like this before. When I showed her the reconnected blood vessel feeding all that tissue, she couldn't believe it.' Then he admitted that sewing me shut was difficult, and started to detail how they had stretched my skin to do so, but I must have looked away, because then he stopped. It's funny how much easier it is for me to hear the nitty gritty details on a molecular level than on a surgical level. Not that it bothers me that much; I just don't crave the details the way I do with my medical oncologist. The whole idea of the surgery boggles my mind, to be honest, whereas I understand cells. 
• Since the surgery, I've had to wear a binder around my abdomen. It's a lot like a corset. It is uncomfortable, but also sort of a comfort at the same time. It's very thick, and a little too big for me. (Can't they make these things in different sizes? Seriously.) I need to keep it from compressing my boobs, but if I pull it down, it goes over my hips, which is uncomfortable and creates discordance with my underwear. (TMI, sorry!) At the same time, it's good 'protection' for my sliced-up abdomen. I asked Dr. T how much longer I had to wear it, and he said three weeks (!!!), to keep fluid from building up in my abdomen. Ugh! At least it is a lot more comfortable now that my drains are out. It was very difficult adjusting it without pulling on at least one of the three drains, which hurts.
• I asked Dr. T when I could start straightening out again, and he basically said to let pain be my guide. Then he looked at me suspiciously and said, 'Don't go crazy, though.'

Overall, fatigue and back pain are my biggest problems right now. My chest and abdomen are mostly numb, so I have little pain there. Most of the discomfort was from the drains, plus random itchiness and occasionally shooting pains. A lot of those pains were where the wire was, though, so I hope that will improve. All in all, I'm feeling very positive and looking forward to my continued healing.