Tuesday, November 20, 2012


We know I am a slow writer. But I'm also a slow healer — something I never knew until my bilateral mastectomy nearly 22 months ago. It's been one long, bloody (in the British sense) battle after another with this right (aka "problem child") boob of mine.

After struggling for months with delayed healing followed by the loss of my right tissue expander followed by the replacement of said expander followed by additional delayed healing, it goes without typing that I was greatly anticipating the surgery to exchange my tissue expanders for permanent implants. (Why do they make "exchange" sound so simple anyway, like going in for an oil change?) Turns out I was more afraid of this "exchange" surgery than any of the others. My butterflies felt more like...
angry birds. Not sure why I was so nervous, since this was the "easier" of my reconstruction surgeries. You know, the first dollop of icing on the recon cake. 

Two and a half months ago, I was finally visited by the "foob fairy" and had my exchange. Then the waiting game began. Since my incision line has always been problematic, I've been holding my breath since September 5th. 

I have been looking forward to getting on with life as I now know it, and the last time I blogged about my life post-surgery, I was back to hiking, and gingerly coddling my new appendages in an effort to enable great healing. But something else has surfaced: I am more emotionally vulnerable and sensitive. I don't have a lot of reserves in the "tough girl" cabinet anymore. Everyone keeps saying how happy I must feel now that this surgery is behind me. What they really mean is how happy they feel now that my surgery is behind them. I get it, I do. Being the supportive friend or family member can often be harder than being the patient. But I can't keep putting on the happy face. I have lost the desire. I also cannot relax because I know I'm not out of the woods. Not the worried-about-cancer woods  — for that forest I will forever reside in — but the healing woods. 

Sept. 27, 2012, my right incision
Here's my problem. Four weeks post-surgery and the surgical tape my plastic surgeon applied is still holding strong. So I can't actually see what is going on beneath these steri-strips. I'm hopeful I'm healing, but I don't really know. 

Being camera obsessed, of course I document each stage. Here is the steri tape starting to lift off. (I know what you're thinking: Could this get any more exciting?)

Then, after so many weeks of holding fast, the tape on my problem child side falls off. And the incision ... dare I say it ... is healing! I keep a lid on my new-found joy because I have been fooled by these sketchy Healing Gods before. And sure enough, as if on cue, I spot the tell-tale sebum spots. Drats. 

October 5th and the healing is fine; October 7th, sebum starts again.

I tamp down the fear that rises when I consider what will happen if this incision doesn't close. I'll be sliding into skin graft territory — and that terrifies me. 

Now my left side, which has never given me an ounce of trouble, decides it's time to join the persnickity party. It holds onto its surgical tape for dear life. For another full week. FINALLY it falls off in the shower and I have all I can do to bring the magnifying mirror closer for an inspection. Hmmm. I didn't see any oozing. No seepage. Nothing yucky under that tape but healing skin and scabs. Blessed tiny scabs. 

But will these, too, fill with sebum? 
I spent a few days worried about it. Then something miraculous happens. I start to heal. Like, inside and outside heal. For the first time since this %#$@ journey began, I let myself feel the happy. I tip-toe out of the woods and slip into an emotional canyon. Feelings I have been suppressing are bubbling, bubbling. The dam is breaking. I'm a hot, boiling mess. I was warned this would happen by my BC friends who have been through their exchanges. Some of them twice, like my friends named Shannon.

But then Shannon develops cellulitis. Six weeks after her exchange. Are you kidding me? You can be fully healed and still develop a life-threatening infection that requires immediate surgery and hospitalization and IV antibiotics and weeks and weeks of oral antibiotics? When does all this %$@# end? (Oh. Right. It doesn't.) I feel the air leave the room and I wish I could follow it. I am scared out of my mind. Then another friend named Shannon — who has also been through exchange — has to have hers redone (she blogs about it here). Oh the fun never ends.

So I have to figure out a way not to let my anxiety get the better of me. I focus only on the moment at hand. Rest. Eat my protein. Feeling jittery is not going to help my healing. Keep hiking. Writing. Start Christmas shopping. Anything to keep my mind calm and not focused on what could go wrong.

I am OK. I'll be OK. No matter what happens. I know this. So when a new curveball is thrown my way, my mind automatically goes thereAnd I suspect I'm the only one you know who has experienced what I'm about to tell you.

Rash spreads beyond boundaries of pen mark.
Six and a half weeks post-exchange, I develop a rash on the cleavage side of my right ("problem child") foob. The skin is red, but not warm or sensitive to touch. (Hot, red skin is a classic sign of cellulitis; a fever often is as well. I have neither.) I'm not itchy, though maybe if I had more nerve endings left (guess that's the up side to a BMX). 

Diligent photographer that I am, I dutifully email photos of my lovely rash to my plastic surgeon, Dr. C., who says it does NOT look like cellulitis but he puts me on Keflex as a precaution.
Then I take a ballpoint pen and draw a circle around the edge of the rash — that way I'll be able to tell if it's getting bigger or not. 

I wake up the next morning and of course the rash has grown beyond the inky demarkation line. That ain't a good sign. I take my rashy chest to see Dr. C. He says it looks like an allergic reaction. Husband and I can't figure out what I may have come in contact with just on that one side — a true allergic reaction would present itself all over my body — but Dr. C. says my right foob is my body's point of vulnerability. Due to its poor circulation and all. Hmmm. 

I go home feeling unsettled. I put in a call to my oncologist, Dr. D., and manage to snag an appointment a couple of days later. I was actually due to see Dr. D. for my six-month oncology checkup, and I vividly recall the last time I saw him, because as I was leaving his office on that day in March 2012, I received a startling text from my friend Shannon (the very one who developed cellulitis) telling me our online friend, Mary, had passed away. (See my post about Honoring Mary here.) 

Now I'm back at the Cancer Center, and I am flooded by memories of Mary. Dr. D., unaware of my memories, looks and prods and says the same thing as Dr. C: Looks like I have an allergic reaction. Dr. D. is also not concerned. But I am.

So I go home. And I think: Man, I really need to learn how to trust. I mean, two doctors whom I respect are telling me this rash is nothing to worry about. Why do I find it so hard to trust what they are telling me? (This whole breast cancer thing has left me feeling like I have to be Dr. Nancy Drew at all times.) But the point is, when my gut tells me something is wrong, I listen.

 This is how the rash looks when I see Dr. S.
So off I go to see Dr. S., my primary care physician, and I take Husband with me. By now the rash is dancing across my right boob, getting less red in some spots but appearing in round, red splotches in others. It's crazy. Here is what it looked like:

Dr. S. takes one look at my rash and says, "You have ringworm." Huh? RINGWORM? The telltale signs are the round splotches (hence the "ring"). He says he sees a lot of ringworm cases when the seasons change — hot/cold/hot weather causes sweating and we wear heavier clothes so our skin can't breath.

But wait: Isn't ringworm Athletes Foot? Yes, says Dr. S! Apparently ringworm loves moist areas and my hot flashes from the Tamoxifen, coupled with being in a surgical bra for a month and then spandex sports bras after that, makes my vulnerable right foob a target. Turns out the ringworm fungus is in the air all around us and it feeds on dead skin and all it needs to take hold is a moist environment and some old skin cells. I got plenty! Good news: Ringworm doesn't invade the body and is simple to treat. It's not unusual to have ringworm present on the chest; you can get it anywhere on your body. I asked him if I should be showering twice a day, he said NO! Ringworm loves moisture! 

So now I am applying anti-fungal cream 2x daily and taking an oral anti-fungal once a week for a month. I am three weeks into treatment. The rash is getting better, but it isn't gone yet. Ringworm is stubborn.

Nothin' like a little athlete's foot on the boob to put everything in perspective. I was so afraid that I had something more serious! I have never been so relieved to hear that I have athletes foot. Even if it is on my boob! 

A professional bra fitting will have to wait. At this rate, I'll be getting fitted at my two-year cancerversary (the date I had my bilateral mastectomy). If you had told me I'd be in recon hell for two years back then... well, I'm not sure what I would have done.

As for all the emotions that sprung up after this surgery... that's a post for another time. Let's just say the s*** had to hit the fan sooner or later

POSTSCRIPT: For an update on my rash, please see my "Still Not a Gift" post here.


  1. Oh my goodness you had me going up and down with this post, so I can only dare to imagine how it has been for yourself. Now that the fungus is sorted, I hope you heal-heal-heal without any more events.

    As for the ringworm . . . nope. That's something new to me. ~Catherine

    1. Thanks, Catherine! Me too (on the heal-heal-healing front)! I saw my plastic surgeon last week and shared my ringworm diagnosis. He was so surprised, as he has never seen ringworm on the chest, but he also said he will remember this in the future if he sees an unexplained rash on a patient.

      I just love educating my own doctors. ;-)

  2. Renn, One of the major points here is the fact that you LISTENED to your instinct. More of us need to have confidence in what our guts are telling us. I hope that you continue to heal and try not to be gone for so long next time :)

    1. Carol, yup you're right, we have to listen to our instincts! The gut never lies. We just don't always want to hear what it has to say. Thanks for stopping by.

  3. No, not on my boob (or my foob - I now use that term often!)....but I DID develop a violent, rapidly-spreading case around my mid-riff shortly after we moved to Darwin - the outcome of spending several days unpacking wearing denim capris with a belt in the tropical 'wet season'. Welcome to the tropics!!! I ditched the denim pretty damn quick - NOT a good fabric for this climate. As I quickly discovered, the humidity level is so mindbogglingly high during the 'wet' that fungal infections of the skin (and ear canal - they call it 'tropical ear') are commonplace in this part of the globe. A Darwin local could have diagnosed you!!! I sympathise with the drag of getting rid of it - I know from bitter experience that fungus is an infuriatingly stubborn foe. While it's one hell of a pain, I'm relieved it wasn't anything more sinister. I look forward to your reflections on your emotional reaction to the surgery. What a road, huh?

    1. Liz, thanks for sharing, I don't feel so weird now! And that is pretty funny that a local could have diagnosed me quicker than my doctors did! ;-)

  4. I am happy to see you posting again, it has been a while. It is awful when you know there is something wrong and people phoo, phoo it... I just keep going like you, I tell more and more people until someone figures it out :) Good luck with getting rid of the rash:)

    1. Launna, nice to see you, yes the bottom line is to keep pushing until we get the answer we need to hear! We know our bodies, and doctors see dozens of us daily. We have to hold up the stop sign and say hey — listen to me! Glad that you are doing the same! :-)

  5. Renn,
    I had the same issues when I had a lumpectomy for what turned out to be grandulamatous lobular mastitis a few years ago. Was told the same thing--the moist cleavage area, the damp bandages etc were prime conditions for ringworm. Talk about piling it on, eh?
    Best of luck with your healing,

    1. Dee, you are the first person I have heard of who has experienced this too! Thanks for letting me know. It really is quite an odd thing to get. And yeah, piling it on is def. the term for all this %$#^! ;-)

  6. Hey Renn.... I asked my PS about it after I read your diagnosis on BC.org and she NEVER heard of it. But my son had it when he was a wrestler.

    As far as not trusting or believing in our doctors... we did when we started and then shit happened.

    This weekend I felt a terrible ripping pain along the natural fold and under the armpit of my right noob. UGH... I took a valium and rested as much as I could.

    Honestly...... I HATE THIS F&ING IMPLANTS!!! mine feel heavy and uncomfortable and cold on good days. Painful on bad days.

    The whole process is so frustrating. So glad I've got you to post rants with. xoxo

    1. GM: Fo sho! You're so right, we used to trust and then $#@% happened. Once bitten, twice shy! (Hey that's a good title for a blog post.)

      I'm so sorry you are not only unhappy but uncomfortable (to put it mildly) with your implants. I'd really get a second opinion. Remember my other friend Shannon? She loves her new implants. They were too low before. Our bodies know when something is wrong. As my PS told me (and I never forgot it): Our bodies are very wise. (We just have to listen.) What is your gut telling you about this new pain and the weight of the implants? BTW I had been warned they would be cold but it still surprises me how hot they get and how cold they get. I am my own freezer!

      PS Rant away!!

  7. Apologies, it seems I have been a slow blog reader! I am trying to catch up, but...I do have a ways to go. So sorry about your rash and for the worries. It's always something isn't it? Good for you for listening to your instincts. Hope things have cleared up by now. And no, I haven't heard of ringworm on a boob! Now we all know it's possible though, so thanks for sharing the info. Big hugs.

  8. No apologies every needed, Nancy! It's hard to keep up, especially during the holiday season. Thanks, as always, for stopping by!

  9. I am dealing with this issue right now. It is bothersome. Thanks for posting this, because i thought @ 1 moment I was going crazy...

  10. Thank you for posting this and providing the pics, I have this same thing and have treated it with anti-fungal medication and have found relief.


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