“OMG. They’re HOW big?”

When I first started having conversations with friends about my decision to have a double mastectomy and reconstruction with implants, the usual reaction was: Are you going to go Dolly Parton on us? Granted, most of these comments came from my male friends.

My answer was always simple: No! Large breasts are not conducive to an active lifestyle. Especially with triathlon. Of course, they may be slightly beneficial in the swim — added buoyancy — but they would definitely become problematic on the bike — surely they would interfere with my aerodynamic abilities? And the run… well implants are just unnecessary additional weight.

A week after surgery, once the drains had been removed, I was finally able to get a feel for the size (not by physically touching them, but by how my clothes fit over them). And I was worried. And there may have even been a few tears… Why? Because I was worried I was too big.

Large Breast..noooo

Am I the first person in the world to cry because my breasts were going to be too big after getting implants?

The sinking feeling of worry in the pit of my stomach was only amplified when I had to return to the specialty bra store for another post-operative bra, and I was measured for a D size. A D!

A little sparkle of hope shone through when the lady fitting the bra mentioned it would take 2-3 weeks for the swelling to completely subside. So fingers crossed this D is really a swollen C.

It’s amazing what can spark different emotions through this journey. For me, it’s usually in reverse of what would be expected. When I had the double mastectomy I was actually calm, happy and relieved; and now that I have had my final reconstruction I have been worried. I think most people would be excited about having their final implants.

With each day, and a little more reduction of swelling, I’m finally joining the “Excited About My Implants” club.

Standby for the next post where I’m worried and panicked that they’re too small…

And according to this assessment, I’m should definitely be a C; you know I don’t like to complain.

Bra Size Chart

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The Luck Of The Irish

Today is St Patrick’s Day, and a bunch of four-leaf clovers would have been a welcomed gift for my family. And not because today was my surgery.

The early morning alarm went off and I woke to my usual pre-op thought:  reminding myself not to eat or drink anything! Whilst getting ready Mother received an unfortunate call — my grandma had suffered a second stroke (the first being earlier this week).

We have (or should I say Mother has) a tradition of ensuring I’m highly entertained on the car ride to hospital — musical mash-up singalongs at 5am are her favourite. But this morning there were no singalongs; we had our heads down on our phones researching flight options for her to make her way back to NZ to be with gran. It turned out that the best options was an 11:20 flight that morning, which meant that it would be a drop and run for me at the hospital; they would have to make the hour journey back home to quickly pack before another hour journey to the airport. A bigger and more stressful day for The Olds.

I know it was a hard decision to make, to not be there with me, but it was the right one. The saving grace was that Trevor was already there waiting at the hospital and happy to assume role of carer and entertainer. And he excelled at both roles.

Now this may sound strange, but I love getting changed into hospital robes. It does not bring about feelings of fear, but rather comfort. Because I know what will follow will be a benefit to my health. And  I also love the compression stockings and wrap-around leg massage device that helps with circulation. After Mooloolaba, they were both a welcome treat and I couldn’t get them on quick enough.

Without much waiting around — the joys of the private system — I was on the stretcher and getting my cannula in ready. Dr O’Mahoney was excited to hear reports of my race on the weekend, but also concerned about my readiness to operate due to the news of my grandma. I assured her I was ready.

And then it was time. Time to be put to sleep with classical music filling the operating theatre. My anaesthetist has good taste. I was about to ask him what he was playing but  1…2…3… and I was out.

The worst part of an operation for me is waking up in a groggy state. The nurse caring for me in the recovery ward aptly made a comment that it may have something to do with my ‘need to be in control’ nature. When treating my pain, which was sitting at an 8 out of 10,  I asked if I could have some pain medication that wouldn’t make me sleepy. I had the choice of sleepy meds or nauseating meds. I chose nauseating meds.

As usual, whenever waking up from an anaesthetic I seem to assume the role of a comedian. So when a nurse asked another nurse if she would like a cup of tea, I thought it was my place to butt in and say: “Yes, she’s been working hard.” Oh to be a fly on the wall in the recovery room.

With sheer determination and stubbornness I managed to snap out of my groggy state and was wheeled back to the ward by 12:30, much to the delight of John and Trevor who had been waiting patiently. In my room awaiting me were some beautiful flowers and an abundance of beautiful messages of well wishes – I felt very loved. Although my determination and stubbornness was short-lived and before long I was back dozing off.

The afternoon passed by hourly check-ups and half-finished conversations. Word spread that there was a triathlete in the ward, but only because my blood pressure was consistently low (which is common with fit people) not because I still had my race number on. I’ll take that.

After a few continuous mid-story naps John made his way home, after what had been a long and exhausting day for him. Trevor remained and assumed the role of bed controller/pillow adjuster/un-packer/water-glass filler/chicken cutter/toothpaste squeezer….And much more.

I thought the luck of the Irish had finally arrived when my night nurse came to introduce herself, who, in a strange twist of luck, is Irish. But even after a cocktail of sleep-inducing drugs I’m wide awake at 1am. Not so lucky.

To avoid going stir crazy staring at the ceiling, I decided to pull out my iPad and watch some previously downloaded Ted Talks.

And this is what I stumbled across: Debra Jarvis – Yes, I survived cancer. But that doesn’t define me.

A 16-minute brilliant speech. A speech that anyone that has experience any type of trauma in life — not just cancer — should listen to.

And here are two brilliant lines from her 16-minute speech…

“Only a small part of the cancer experience is about medicine. Most of it is about feelings and faith, and losing and finding your identity, and discovering strength and flexibility you didn’t even know you had. It’s about realising the most important things in life are not things at all, but relationships. And it’s about laughing in the face of uncertainty …”

Thank you Ted Talk.

Goodnight (hopefully).

A little bit about Triathlon. A little bit about Cancer.

Yesterday was Mooloolaba Triathlon, my first Olympic Distance triathlon (1500 swim/40km bike/10km run). I had always planned for it to be my last race of the season before I went under the knife for my final surgery. And as the timing turns out, that final surgery is tomorrow  — the last surgery in my cancer journey *jumps with joy*.

First things first: Mooloolaba.

Now you would think that someone who trains most days, every week, sometimes twice a day, would feel prepared. But for some reason, the past few weeks I have been filled with doubt. Had I done enough? Of course I’d done enough to finish the race…but I’m competitive (with myself), so ‘just’ finishing was never going to be enough. I want to finish with a good time. Had I dreamt all those 5am alarms for training… was I just delirious and sleep deprived, or was I fit and ready?

My main concern was my preparation for my bike leg. I hadn’t had much training on my new fancy-pants TT bike, would I even be able to ride it? Last week, leading up to Mooloolaba, my concerns were only amplified as news of a cyclone forming off the coast surfaced. I was already nervous about my biking abilities on the exposed highway as it was, so how would I manage with the additional extreme weather conditions. News didn’t improve and reports of rain and strong winds Friday night only fuelled my fears. All I could do was eat my bowl of pasta and try not to worry – surely it would pass by Sunday.

Saturday was compulsory bike check-in day. Trevor (MOH) and I made the one-hour drive from Brisbane, and as we approached the coast the trees told me what I already knew: it was windy. And the sea looked angry with waves crashing in all directions. My nerves were not being calmed. It was to be my first race using my fancy-pants TT bike, but with added gusts of wind, all I could picture was me being blown off the bike. Trevor assured me this would not happen…

After a good nights sleep and many carb-loaded meals, I woke up excited. Tri suit on, race number tattoos on…it was time to trek back to Mooloolaba. It wasn’t long until excitement turned to nerves and the conversation in the car started to drop off.

After a few detours due to road closures, we were parked and on our way to transition to get organised for the race.

Trevor, doing such a great job as support crew, found out some vital information for the race: the swim course had been changed due to the conditions! Although the water looked calm and flat (phew), there were strong currents further along the beach. So, to make it safe for the competitors, the 1500-meter swim was now a loop finishing near the start line, with an 800-meter beach run back to transition (instead of a 1500-meter swim along the beach).

I still struggle swimming; I’ve lost a lot of power due to my pectoral muscle being cut to house the expander. And unfortunately things may always be this way, as my implant will also take residence underneath my pectoral muscle. I’m confident, and hopeful that in time, I’ll regain the power required to be a front-of-the-pack swimmer, instead of a mid-pack-please-don’t-be-last swimmer…

 

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I made it out of the water in a surprising time of 28 minutes and jolted along the beach. Just as I approached the stairs to reach transition and to face the music of the bike leg, I heard the commentator over the loud-speaker say, “The winds are starting to pick up for those heading out on the bike.” Are you serious! Did he really have to say that!

Once on the bike all my concerns diminished. I felt like a pro powering along on my aero bars (although I’m nowhere near as fast as pro!). Forty kilometres of straight, flat, fast, smooth highway… and not much wind! Hallelujah. The course was a good test for my fancy-pants bike and the person atop of said bike. Although I may look at investing in a seat that is a bit more forgiving…

 

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Back of the bike and only a 10km run to finish off the day…only… Running, no worries…I got this. I soon found out that too much confidence is never a good thing. One kilometre into the run I was struck with stomach cramps — maybe I took carbo loading too far? Or maybe it was the hot, melted gel that was sitting in the sun during my bike leg that I consumed as I ran out of transition? Who knows. But it was not enjoyable. And the “why am I doing this” thought quickly entered my head.

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I had given myself a “comfortable” goal finish time of 3 hours, and with three kilometres left in the run I knew it was definitely within reach. So I reassessed my goal time. By how much could I get under 3 hours? I crossed the line after 2:53 of racing.

As I crossed the finish line, and finally made my way out of the recovery zone, I was greeted by Trevor, my number #1 support for the day, with additional recovery supplies of water, Gatorade and engery bars. He did well too.

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With my last race for the season over, and the number tattoo scrubbed off my arms and legs (they don’t come off easily!) I am now faced with the task of packing a bag for hospital tomorrow. I am by no means nervous or worried; I know I’m in good hands. Also, why do I need to worry when so many others are taking on that emotion for me.

I’ll be in hospital for up to a week, a little longer than I first thought. So it’s turned into a mini holiday at St Andrew’s. The best thing (for me) is one of my favourite Japanese restaurants is conveniently located around the corner from the hospital. I have already warned The Old’s and Trevor that there may be a few detours required prior to visiting. Seems reasonable?

Time to pack.

A little word beginning with: R

Re… Re… Remission.

There has always been one question that causes me to pause. Not because the question upsets or concerns me, but because I have never known the answer. (Google hasn’t been much help for this one.) The question is:”Are you cancer free?”

It’s a hard one to answer because every cancer patient’s situation is different. Some patients say they are cancer free from their first check-up post treatment. Others mark it from their final round of chemo; radiation; or surgery.

So when am I worthy of the nickname: NED (No Evidence of Disease)?

My theory is this: If I had chemo and double mastectomy for ‘preventative’ purposes, haven’t I been cancer free from when the lump was removed last year? My medical team are yet to mentioned the word ‘remission’, so I’ve always assumed it hasn’t applied to me yet.

To understand my mindset, here’s a recap of the past year (for those who missed the start of the journey).

September 2, 2013. Surgery #1: Lumpectomy and Sentinel Node Biopsy. The cancerous lump was removed, along with three lymph nodes to test and determine if any cells had escaped. (They hadn’t! Phew.)

September 6, 2013. Surgery #2: Re-excision. When they remove a mass there needs to be a clear margin of healthy, cancer-free tissue surrounding the cancerous mass. The pathology report showed the lump was bigger than they thought and they didn’t have a clear margin, so they needed to take out more tissue. The clear margin was achieved after the second surgery.

October 11, 2013. IVF: Extraction of eggs. Sort of a surgery but not. Let’s not count it as an official surgery.

October 16, 2013, First round of chemo: The moment we realised I was allergic to chemotherapy drugs. Oh joy.

January 31, 2014, Last round of chemo: Finally…

July 31, 2014, Surgery #3: Double mastectomy with reconstruction. All tissue removed was clear; no cancer cells identified.

And we’re not at the end yet! In the future I will need a fourth surgery to insert the implants; a fifth surgery to re-create nipples, and tattooing to make them look real.

The next stages of the reconstruction process may not be completed until 2015 or 2016!

So, do I really have to wait another year, or more, to celebrate being in remission, or NED?

Knowing my treatment is still ongoing, all preventative, when would be my “end of treatment, I am now cancer-free date be?”

It shouldn’t be after my double mastectomy – that was preventative, nor should it be after I finished chemo – that was preventative too. When was I truly cancer free? When was there no evidence of any cancer cells in my body.

That, my friends, was after my re-excision. That was September 6, 2013. That was a year ago today.

Without wanting to get too carried away and excited about this, I thought I would put the question to my oncologist, Dr Oliveira (I had a follow-up appointment with her last week). After a long-winded explanation about not being labelled ‘cured’ for another 15 years, so said she was happy to say I’m in ‘remission’. I then asked when my remission technically started. I told her my theory, and she agreed with it. I have been in remission for a year!

I’m yet to meet with my surgeon and ask if he agrees with my theory – he probably won’t. I’m sure he’ll have his own theory about my remission date.

So I’m throwing caution to the wind and marking today as my one-year remission anniversary. (Maybe NED should be my nickname instead of Rocky… not sure it has the same ring to it). Only 14 more years until I’m cured (apparently).

So pop some bubbles, grab a beer or go hard with a Whiskey. I’ve got a hot brunch date and a glass of bubbles with my name on it.

Bottoms up. Salud. Prost. Kippis. לחיים. Gesondheid. Salute. Na zdravi. Şerefe. Terviseks.

 

 

 

What goes up, well, may stay up.

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When Isaac Newton said: “What goes up must come down” he definitely didn’t have any knowledge on breast reconstruction. Especially reconstruction using tissue expanders. They’re up and they are staying up.

The word ‘bolt-ons’ is often used to describe implants. I’m not sure what a normal breast enlargement is like, as it’s slightly different, but the nickname definitely applies to expanders. They feel like they are, quite literally, bolted on. No movement. Hard as metal. I need to start handing out waivers before people hug me: Hugging may result in bruised or broken ribs. The owner takes no responsibility for such outcomes. The owner being me. The bruised or broken ribs, you.

Each week I have been visiting my plastic surgeon to have a ‘fill’. The expander is a large, deflated implant with a one-way valve. They stick a needle into the valve to inject the saline. Obviously they have to be very careful with this step, if they miss the valve there is the possibility of piercing the expander. The valve is magnetic, so to find where it is she hovers another magnet over my skin. (I must remember not to get too close to anything magnetic…) I tend to look away as the needle goes in. Even though I can’t feel it – there are limited, if any, nerves in this area – having a large needle coming towards you is never pleasant.

Here’s some pictures that may help explain it better.

tissue-expanders

This is an expander.

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This is a smaller version of the needle she uses. Yes, it’s bigger!

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Expander. Skin. Needle. Job done.

It has been a slow and gradual increase, thank goodness! I’ve heard many stories of women getting 100+ mls added with each expansion. No wonder they are in pain! I’ve been getting 60 mls and have been comfortable and pain free. Thanks Dr O!

It’s hard to get a clear picture of what the foobs will eventually look like. The expanders need to make room for the implants so they are slightly larger and wider, which results in them looking ‘square’. At the moment mine are flat on top and they creep around under my armpit. That’s just how mine have been filling, and it’s very normal. It was a little strange at first as my arms would rub against the sides when I walked. To avoid my arms coming into contact with my side-boob resulted in me walking like a cowboy, arms out wide, ready to draw my pistol.

cowboy

At today’s appointment I asked Dr O what she thought, about my size. I’ve made it very clear, I don’t want to be as big as I was. Big boobs and triathlons just don’t mix! She said “we’re close” and next week may be my last expansion. We just need a little more room at the front.

I should have been happy hearing the expansion process is nearly over, but I wasn’t. Thursday has become my favourite day of the week. Not because I gain a little more cleavage – I’m not too bothered about the foobs – but it has become a social day for me. I catch the train to the ‘big smoke’ and squeeze in a breakfast or lunch date around my appointment. Little-Miss-Independent-Rochelle, roaming the city, eating and drinking. Today Dr O apologised for the appointment, thinking it was an inconvenience for me. I explained it was the complete opposite, as I had lunch plans and a date with two hot chicks and a Lobster roll. No apology necessary!

Since the expansion is nearly over, I thought I might be able to squeeze in the next surgery before triathlon season starts. She explained that she likes to wait at least six weeks after the last expansion before going ahead with the exchange operation. Well, that rules it out. I’ll be keeping these expanders in until March next year.

Before leaving I cheekily mentioned to Dr O that next week is my six-week mark. Soooooooo can I swim, run and cycle? Can I? Can I? Expecting to get her blessing I was sorely disappointed. As next week is my last expansion, she’s asked if I can wait another two weeks. TWO WEEKS. Patience, Rochelle… Patience *sigh*. She knows best…

Sorry runners, and googles, and bike.

 

day seven: drain away

Warning: For those with a weak stomach, or are yet to eat breakfast, you might want to skim read the next four paragraphs.

I haven’t gone into too much detail about the aftermath of surgery, by that I mean my physical appearance. Some people take photos of themselves post surgery, not me. I know it makes some people feel uncomfortable. So unless you’ve come to visit, you wouldn’t have known that I’ve had four drains coming out of me. – two on each side. I thought it would be confronting seeing tubes coming out of my skin, more confronting than seeing my breasts removed (you know I’m a little strange…) but it hasn’t been. It can, on the other hand, be a little off-putting for others – some friends had no problem telling me this (I’m looking at you, Michael… ) other friends may have though it, but didn’t say anything.

If you’re on my Facebook you would have known that two drains were removed on Tuesday, and the other two were due to be removed today, signalling home time. Dr O has always been adamant that she doesn’t like to leave the drains in longer than a week. The risk of infection from having open wounds outweighs the benefit of draining away a extra few mls. So I’ve always felt quite certain that I would be going home after a week. Which is today.

When Dr O visited yesterday she hinted that if the rate of drainage continued at a high rate – my left was 180 mls Tuesday and then 100 mls yesterday, she may push things one more day. As of yesterday there was 50/50 chance things could go either way. The alternative would be to have a small drain inserted under ultrasound (to avoid piercing the expander) and monitor at home.

I woke up this morning as they were changing the bags from the remaining two drains. The nurse saw me looking closely at the number line, trying to work out how much was in each bag. 50 mls on the left, 40 mls on the right – still decreasing significantly during the 24-hour period. I’ve heard from other friends, who have been through this, and 30 mls is usually the magic number. My gut was telling me I was going to be here one more day. I hope I haven’t confused you all…

My surgeon, Dr P was the first one to stop by this morning. He walked in as I was discussing the chance of going home with the nurse. He asked the numbers, she told him, he then looked at me and make a big ‘zero’ with his thumb and forefinger. He’s not one for subtlety.

Then Dr O arrived, in all her glamour – she is one of the best dressed women I know. She mentioned the numbers from each side (I pretended to not know) and said, ‘Let’s get you out of here!’ WHAT! I was shocked. I was convinced she would stretch it out one more day. She is happy with the progress and not concerned of any complications that may arise. She briefed me on how to manage the dressings until I see her next week, and what to look out for. She’s even given me clearance to go for a walk around the block (she obviously hasn’t known about my double laps).

So now I sit here (YES I’m sitting at the desk – it’s the most civilised I’ve felt all week!) writing my last blog from hospital. All drains have been removed, I am free from my cannula, and I am showered and wearing normal clothes again. This morning was the first time the mirror in the bathroom steamed up, I didn’t want to get out. That one shower washed away all the frustrations and challenges from the past week – my world is now right again.

I’ve been down for a coffee and I’ve purchased a thank you card for the girls who have looked after me – signed off ‘Your Speedy Walker’. Bags are packed and Mother is on her way to collect me.

It’s time to check out.

Surgery number one. Tick.

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day six: part two

Before I call it quits on day six and zone out to some TV that is sure to lower my intelligence – The Bachelor – I want to share a little story from today.

After my last blog, when I said I was going to tackle the day with an accepting mind, well, it didn’t last long. I was still feeling a little sorry for myself and my one-arm-bandit state.

I ordered my breakfast, did my double lap around the ward and waited patiently for my cereal and poached eggs, bacon and toast. I love breakfast – it’s my favourite meal of the day, so I was excited when my tray arrived. Excitement quickly diminished when I realised the additional challenges I was about to face to be able to enjoy this meal. Have you ever tried to open the plastic from a cereal packet with one hand? It’s not an easy task! But I soldiered on (complaining internally).

A few friends messaged to check I was OK after my last blog post – I was – and I replied saying, “This is only temporary, there are people who lose an arm permanently.” I wasn’t just saying that; the thought had been on my mind. There is no need for me to complain about being challenged for the next 24-48 hours. I had to keep reminding myself of this, and as I did my mood started to improve.

Then, by some divine intervention, I was flicking through the movie selection and listed was Soul Surfer – a true story about a young surfer, Bethany Hamilton, who loses her arm to a shark bite. Of course that movie happened to be in the random mix of films available, thanks Mater. It’s not a movie I would normally choose, but today it seemed appropriate. And it was exactly what I needed. Without too much of the ‘cheese’ factor, it serves up a big cup of faith, perseverance and belief for a total of 106 minutes.

You can rest assured I didn’t have an ill thought about my silly little cannula, in my silly little elbow, for the rest of the day.

It could always be worse…