Sometimes we take steps forward, sometimes we take steps back.  Usually, we have a net gain in forward progress, other times we remain stationary.  Cathy had her third drain removed yesterday at the plastic surgeon's office.  That's good news!  Drains are ok, but they are kind of an inconvenience.  Speaking of inconveniences, Cathy has a leaking expander.  Her right expander is doing its job, holding fluid and stretching the skin and muscle to prepare for a permanent implant.  In the last fortnight, the left expander has gradually lost volume until it was empty and slightly buckled, much like a deflated soccer ball.  It was originally filled with slightly more saline than the other side, so to see it so much smaller made its malfunction a certainty.  

Dr. Butterfield was ill with the flu and thankfully didn't attend her office hours yesterday, so we saw the physician's assistant, Kristin.  Kristin conferred with Dr. Butterfield by phone and they decided the best course of action was to fill the left expander to see how fast the fluid is exiting.  If it is a slow enough leak, the plan is to fill it every week or so instead of every other week, then make the swap for the permanent implant early in January instead of late in February.  If the leak is too fast for that it will likely need to be replaced sooner.  

It was explained to us that there is a kind of no-man's-land for follow up surgeries.  Cathy is currently in that no-man's-land at 15 days post-mastectomy.  If a second surgery is pursued within 7-10 days of the initial surgery, the tissue hasn't begun the healing process in earnest yet and can defend itself against infection and excess bleeding.  The same is true 5-6 weeks after the initial surgery.  In between week 2 and week 5 the tissue is healing and building new blood supplies, making it difficult to work with.  So, we're hoping that plan A works and we don't have to think about plan B and C.  We'll go back tomorrow for an evaluation and hope that we can continue down the path of frequent saline injections.