HOUSTON, WE HAVE A PROBLEM

I'm at a follow-up with my plastic surgeon, Dr. C. Unfortunately, he's not 100 percent happy (his words) with the way my right incision is healing. He used the term "delayed healing." It's worse on the right (cancer side) than the left. My skin is red on that side and looks bruised. I have surgical tape on both incisions, but beneath the tape a dark area is visible. Dr. C. cautions me to pay close attention to this area, because if it gets any darker, that means my skin is dying.

Necrosis? Oh, joy.

I'm to use Xeroform as a wound dressing. But first I apply Bactroban (an Rx antibiotic ointment), which I then top with a strip of Xeroform, which I then top with gauze which I then tape to my skin. I’m to continue to wear my compression vest 24/7. (Confession: It’s become a rather comforting contraption.) And if my incision doesn't decide to heal, Dr. C. will decide whether to surgically reduce the pressure in the tissue expander by removing some saline. Super duper!

And as if all that weren’t enough, Dr. C. is leaving the country in four days — for three weeks. Yikes.

I get home from the doctor, pull out my digital camera and start shooting close-up images of my incisions. I do this each morning. Husband finds it odd. I tell him it’s the only way we can be objective; from day to day things look fine, but if you compare Day 1 to Day 3, well, you can see a difference. (Note to all surgery patients: Photograph your healing journey.)

A few days go by. After my shower one morning, I inspect the wound. I don’t like the look of it. More redness, more darkness at the incision line (under the surgical tape). I take more pictures.

My dear friend M. comes over for lunch. But I'm in a bad mood — definitely not like me when I am spending time with friends — and I can’t seem to shake it. M. asks why I’m feeling unsettled, then encourages me to call my doctor. It’s 1 PM on a Friday afternoon. What are the chances I’m going to reach anyone? But lo and behold, Dr. C.’s nurse answers the phone, and I lay my worry out there like a blanket on a fire. But she is not alarmed. The redness I'm experiencing sounds normal, she says. She’ll mention to Dr. C. — who happens to still be in the office. Psyche.

I hang up and feel good that I’ve taken action. Yet something is still nagging at me. Finally, a light bulb goes off: Email Dr. C. a few photos so he can see exactly what I’m talking about! (This also saves me a trip to his office, not that I could get in on a Friday. Just sayin'.) I call the nurse back and tell her to check the JPegs I just emailed. If I don’t hear back from her today, she says, that means Dr. C. thinks things look fine and I should keep up with the Xeroform program until he returns from overseas.

OK! Now I can finally relax. I enjoy the rest of my lunch with M. and she leaves in the late afternoon.  No call from Dr. C.  I take a nice, long nap, then rummage through the refrigerator for something to eat.

While I am downstairs, my cell phone rings upstairs. I don't hear it. By the time I realize I have a message, it's 7:30 PM.

Guess who. Yup.

Dr. C. apologizes for messing up my weekend, but he wants me to meet him at the hospital tomorrow morning — yes, Saturday morning — at 5 AM. He has secured a surgical room for what he is calling a “minor intervention surgery.”

I don’t have time to think, to worry, to even wrap my head around the fact that I am about to have another surgery just 16 days after my bilateral mastectomy. (Cancer: The gift that keeps on giving.)

Husband and I go to bed early, get up at 3:45 AM and drive to the hospital in the dark. I’m prepped and wheeled into surgery by 7:30 AM. Luckily my anesthesiologist hand-tailors an Rx cocktail (along with a patch behind my ear) so that when I came to, I am alert and not dizzy or nauseous, and am able to go home 90 minutes later. (So not like last time.) I am also not in any pain.

Turns out too much pressure on my tissue expander was causing my skin not to heal. I have necrosis on the top of my incision, but there is also a spot that is necrotic under the skin as well — and that is the dangerous part. If we don't fix it now, I run the risk of losing the expander and starting over again. So Dr. C. removes 50 cc's from my right expander (originally filled to 400 cc's), debrides my wound and re-sutures my skin.

I feel like I dodged a big, necrotic bullet, and am proud of myself for staying on top of this, for diligently taking photos of myself, for coming up with the idea to email them to the nurse, and for trusting my gut throughout. This surgery wouldn’t have happened otherwise. (Listen to your instincts, my friends, even if it means calling your physician on a Friday afternoon and having surgery on a Saturday.)

The following day, just 30 hours post-surgery, I show up at a party to meet our neighbor’s first grandson. People are surprised, even shocked, to see me; they tell me how great I look, that they can't believe I just had another surgery. Me either. Even though I am light-headed and have very low energy, it still feels good to get out among the living. I even forget about my pressurized chest for a couple of hours.

The next few days are hazy. I feel woozy, but we manage to take in a matinee. (Again, a sense of normalcy I desperately need.) And yes I'm still watching these incisions like a hawk. Snapping pictures every day, oh yeah. And applying my ever-trusty Bactroban and Xeroform.

But my smile belies how I'm really feeling: blah, depressed, unfocused. What does going through all this cancer %$#@ and subsequent complications mean? What's the point? I feel like there is something I am yet to do, something bigger, but I don’t know what it is.

Three weeks post mastectomy, one week post second surgery, and I wish I could say I have some energy back, but nowhere close. I have discomfort and pressure on my chest 24/7, feel like there's fog in my head, have a headache that comes and goes. Internally, I think I'm still 30 years old, so am expecting my body to bounce right back. Then I remember I'm really 52. So I need to cut myself some slack. I need to become more patient — a virtue with which I will become very well acquainted in the coming months.