Brave

Yesterday Cathy made her first long public excursion without any headgear.  While her hair is a couple of inches long, the coverage is not as complete as prior to chemotherapy.  I'm sure it made her feel self conscious, even at church, where everyone knows her and loves her.  She's in a tough transitional phase.  When all of your hair is gone, people (strangers) assume there's chemo or some other story that engenders some sympathy.  When your hair is full and normal, people either don't notice it or comment on it's beauty.  When your hair is growing in from being gone people don't know what to think. This is somewhat of an issue for men, but it's a whole different story for women.  There's a whole cultural context issue here that doesn't need to be discussed - why it's different for men than women.  The bottom line is that my sweet wife is really brave and I love her.  Nothing about this last year has been easy for her, physically, emotionally, or mentally.  She takes it in stride and looks for whatever is next.

If you are one who prays, Cathy is feeling a little under the weather and is in need of some healing.  We don't know if it is a cold, allergies, sinus infection, or what.  She's just feeling generally rotten - the kind of rotten that needs soup, tea, a shoulder rub, and some sleep.  More than any of that, prayers will help.

Blessings to you all.

Fiddlesticks

Yesterday, I took Cathy to Jewish Hospital, across the street from Dr. Butterfield's office, to have a drain re-placed.  The redness from the apparent infection had improved, but with an ultrasound the radiologist was able to determine that there was enough fluid present to require a drain.  When the radiologist placed the drain the fluid pressure caused the fluid to squirt out a bit.  Since then, there has been a moderate flow, slightly greater than just before Cathy's first drain was removed.

It seems this is a fairly common occurrence.  The radiologist said he did three of them last week on reconstruction patients.  Cathy felt nearly instant relief from the pressure, but now has a little bit of pain from being fussed with.  She will probably have this drain removed Thursday or Monday.  There isn't much fluid flowing, but it's nice to know that it's going somewhere and not just accumulating.  

After the drain was placed we went over to Dr. Butterfield's office to have a Jackson-Pratt ball put on the end of the drain tube.  The JP ball provides the negative pressure necessary to gently draw the fluid out of Cathy's body.  The JP ball holds about 80 ml of fluid.  The most that I've ever seen Cathy put in a JP ball, right after her mastectomy was about 40 ml.  All these numbers will give you perspective on the hilarity of why we went to have the JP ball put on the end of her tube.  Jewish only uses drains with bags and a super long tube.  Cathy left Jewish with a tube so long it went down to her knee, came back up and looped around into her pocket before connecting to, get this, a 600 ml bag. Needless to say, this setup was a little cumbersome.  Now she has a tube that is about 8 inches long, connects to the little JP ball, and clips neatly to her bra.

She's doing well.  There was a short bout of frustration, but in typical Cathy style, she powered through it and is her normal, bright, cheerful, determined self.  I'm amazed by my wife.

Symmetry, Colors, and The Gift That Keeps On Giving

Symmetry
Cathy is pleased to be symmetrical after a few months of asymmetry and bunched up shirts.  Her surgery follow up appointment went well.  She got rid of her drain, had some sutures removed, and got answers to a few questions.  We're continuing to pray for good healing, comfort, and a favorable result this time around.

Colors
Some interesting colors have appeared on Cathy's chest.  Her predominant skin tone is a jaundiced yellow, which doesn't worry us too much.  Yellow could either be old bruising or the persistence of betadine that is too stubborn to wash away.  Below her right breast there is a bit of redness that seems to be growing and darkening, but it's happening so slowly that it's difficult to tell if it's really happening.  It isn't warmer to the touch than the rest of her chest, nor does she have a fever.  Those are two good signs.  Hopefully, that means it's just bruising and the healing process.  She also has a little bluish, green dot that we hope is not anything significant.  Cathy is going to call Dr. Butterfield tomorrow to see if she can get it checked out.

The Gift That Keeps On Giving
Like Clark Griswold's bogus Jelly of the Month holiday bonus in Christmas Vacation, chemo is the gift that keeps on giving the whole year through.  Psoriasis and joint pain are still an issue for Cathy.  Perhaps with a little more sun exposure and vitamin D absorption it will improve.  I think that I wrote about some blurriness in her right eye, as well.  Cathy went for an eye exam a few weeks ago.  The optometrist was amazed at how dry her eyes were - especially her right eye.  The optometrist described her right eye as "flaky".  Wow.  Apparently dry eye is another wonderful side effect of chemo that we probably read about, but didn't anticipate.  After a few weeks of eye drops, I'm happy to report that Cathy has returned to her regular eagle eyed self.  While we expect that many of the chemo side effects will subside after some time, we'll have to work to make those cognitive functions strong again.  Chemo has made Cathy's memory almost as bad as mine.  If hers gets worse we could be a dangerous combination of forgetfulness.

As much as I complain about the side effects of chemotherapy, I am grateful for the main effect - cancer is gone.  

Impatience

The report on Cathy is good, but we're all a little impatient.  This surgery has brought a higher degree of soreness and a greater feeling of being generally uncomfortable than the last surgery.  All of that means that Cathy is moving a little slower than she would like.  The blood and clots are still flowing in the drain.  Sometimes the clots clog the drain and the blood won't flow.  After Cathy or I strip the drain, the blood flows more freely, undoing the sense that quick healing is occurring.  Cathy and I find ourselves in a frustrating pattern that we are able to recognize and laugh about.  Cathy wants to be normal Cathy and do all of the things that she normally does.  I want Cathy to rest and heal while I do the things that she would normally do.  Neither of us are doing a very good job of either of those things!

So, we're both a little impatient with the situation.  We both had the realization that we're coming up on a year of dealing with cancer next month.  Spending an entire year or longer with this is a bit frustrating as well.  We will go as long as it takes, though!

There is good news.  So far, Cathy feels symmetrical - at least to an acceptable degree.  She did not feel symmetrical after the last surgery.  How many of us have symmetrical bodies anyway?  Her incisions seem smaller than the last surgery.  She is able to sleep and can stay on top of her pain and meds.  Tomorrow we will go to the one week follow up and see what that holds for Cathy.

Surgery Report

Cathy's surgery went as expected yesterday.  She was in the OR for two full hours and apparently had to have some pretty significant anesthesia administered to allow her muscles to relax for the best removal of the scar capsule.  She was really sleepy for about 3 hours after she was in recovery.  Today she is pretty sore, more so than her first implant exchange, but less than with her mastectomy.  Dr. Butterfield put a drain in the right side, the side with the hardest scar capsule.  She told me that removing the capsule caused more bleeding and that excess bleeding can increase the risk of future contracture.  Hopefully, the drain will be removed next week when Cathy has her follow up.  Cathy is doing well.  Her spirit is predictably good, but she would certainly prefer to not be dealing with this.

Surgery Tomorrow

Tomorrow Cathy will go under the knife again.  With Dr. Drosick's thoughts on her joint pain and psoriasis flareup, Cathy has gone with her gut feeling that another try with implants is the way to go.  Cathy will have a capsulectomy and explantation of her current silicone implants.  She will have them replaced with saline filled implants in hopes that the scar capsule won't contract this time.  Dr. Butterfield has been very straightforward in her (and the profession's) lack of understanding of what causes capsular contracture.  She has also put Cathy's odds of dealing with it again at 50/50.  We'll just hope and pray that she's on the good side of 50.  I will update her progress as the day goes on tomorrow and the next few days.  Thank you for your prayers and concerns.

A Little Clarity

Cathy had an appointment with Dr. Drosick on Tuesday.  We left the appointment feeling very good.  Cathy is thinking that giving saline implants a shot is the best move.  Neither of us is 100% sure of that, yet, but we think it is worth a try.  Here's why:

Cathy's bloodwork for autoimmune disease came back negative for everything.  No rheumatoid arthritis, no lupus, nothing of the sort.  She does have some rocking psoriasis, but Dr. Drosick feels very strongly that the psoriasis flareup and the arthritis are both the result of her body's reaction to chemotherapy.  He said that some morning about a year from now she will wake up and have no pain.  It will just vanish.  We don't completely understand because it's so complicated, but he said that the chemo suppresses the psoriasis, so when the chemo is gone the body attacks itself with an increased vigor because the immune system has been confused.  The immune system and autoimmune responses are such difficult things to understand, that I feel good taking his word for it with my limited comprehension of the information I've read.

Knowing that Cathy is negative for autoimmune disease (aside from psoriasis) and that the pain she's having is from chemo, we're thinking that her issues are not silicone related.  We still don't have an explanation for her poor vision in the right eye, but everything else is making sense.

With that in mind, saline sounds like a good solution - or at least worth a try.  We both think (and Dr. Drosick agrees [Dr. Butterfield, too]) that microvascular flap surgery is too traumatic of a surgery for Cathy to endure with too long of a recovery.  She doesn't have fat enough to consider adipose stem cell fat transfer, so it really comes down to saline or no reconstruction.  Cathy has a strong desire to give reconstruction another shot.  She's a beautiful and strong person.  She doesn't want reconstruction for any vain reason.  She just wants Clara to grow up familiar with her mom as a normally developed woman.  Cathy hopes for Clara to see herself as the same kind of person as her mom.  If that works out, Cathy will be very happy.  If it doesn't work out, Cathy will be disappointed, but I think that she is confident, strong, beautiful, and still the same person.  We both wish things could be the way they were before, at least physically, but Cathy knows that we will love her any way she is.  I'm so thankful that she's here and that she's going to continue to be here for a long time.  I praise God for healing her and I'll take her any way He'll let me have her.