EXCHANGE RATE

Have you ever walked yourself into surgery? As in, walked with your own two feet from the pre-op area (where they strap the pic line onto the back of your hand) into the OR? Neither had I. 

The hospital where I had my exchange surgery last week is "trying something new." Instead of being wheeled in on a gurney, I had the pleasure of walking (with a nurse) in my faded gown and anything-but-sassy, mustard-yellow, hospital-issued socks down an icy corridor — straight into the operating room. 

Once inside, they untied my gown and asked me to climb onto the surgical table. I was pleasantly surprised — it felt so soft, like a pillow-top mattress covered in warm flannel. (Turns out they just got new table pads. Score one for me.) As for the "trying something new," I reckon that just means less gurney guys in the wee small hours of the hospital morning.

Prior to my stroll into the OR, while waiting for the day to commence with my husband, we spoke to the very pleasant anesthesiologist about my vomiting tendencies. She assured us she would minimize the chance of this happening.

And so, after 19 long months, I finally, finally have the final surgery to remove my tissue expanders and replace them with permanent implants...

NORTHERN EXPOSURE

I haven't looked at myself yet. Haven't been able to take a shower so it hasn't been an issue.

But then Dr. C. unwraps my mummy-esque torso. I stare straight ahead. As my compression vest and bandages fall away, I feel — what's the word? — Oh yeah. Free! My skin hasn't felt air like this in many days. But the pleasant sensation of having nothing constricting me is fleeting; it's replaced by a strange, awkward feeling. If I didn't know better, I'd think I had two water balloons tacked to my chest. Oh wait. I do. They're called Tissue Expanders (TEs). They're filled with 400ccs of saline a piece (and held in place by my recently moved chest muscle); the TEs job is to hold the space where I used to have breast tissue. They also stretch my skin. Eventually they will be replaced with implants. I refuse to look.

Husband hands Dr. C. a slip of paper with the cc's my drains have been outputting since surgery. Good news: The drains can come out. (Yippee! One step closer to stepping in hot water.) Husband distracts himself by looking out the window as Dr. C. quickly pulls each foot-long piece of tubing from my body. To be honest, I can't look at that either. (They really should get some paintings on these walls...)

Finally, all four drains are gone. Next he pulls out the teeny, tiny threads that connect my pain pouch to the center of my chest. I don't feel it. Probably because my chest is still numb.Then he applies antibiotic ointment to both incisions. My left one is 3 inches long and runs across the center of my "foob" at an angle. My right incision, on the cancer side, is twice as long; the scar snakes up under my arm. (That's where they took out the lymph nodes.) Then he paper-tapes gauze over both incisions and slips me back into my surgical vest.

I fumble with the fasteners; my hands are shaking. Avoiding looking at yourself creates a lot of tension, apparently. Husband comes to my aide, carefully zipping my vest closed. Husband noticing that I can't hook the eye on my vest? Definitely a moment.

So I am in heaven without those stinkin' swingin' drains. I feel like celebrating. (Can I have a drink yet?) Dr. C. says I can take a shower. Whew who! Back home, I grab my spa robe and head for the bathroom, then realize I can't take a shower without assistance. Duh. Can't lift my arms. Can't shut the shower door. And yeah, you know what is about to happen next: Northern Exposure.

Because now I'm in a predicament. I haven't yet seen myself naked, and I have to get naked in order to shower. And that means I have to be naked in front of Husband. For the first time. Without. My. Breasts.

I have to get past this hurdle.

Husband sets a plastic bench inside our walk-in shower; my soaps and shampoos are within reach on the floor. A hand-held showerhead is hanging above me. He turns the water on so it can start to get warm, then leaves me alone to collect myself. If only it were that easy.

I can't get my dressings wet but I can shower; I can't remove my bandages, but I can remove my vest. As the sound of the water beats down on the bench and the room begins to slowly fill with steam, I carefully unhook my security blanket, and the constricting pressure I constantly feel evaporates. I take a deep breath and look past the hazy mirror at my little "mounds." Well. Not so bad! I don't look as odd as I imagined. I'm not flat chested. There is something there — it's just covered in bandages. Appearance-wise, I can deal.

The weirdest part is how I feel. Wearing my surgical bra masks the artificial feeling of these dead weights that are temporarily a part of me. They are awkward and foreign. Despite my numbness, I can feel their fakeness. That is the part causing me the most anxiety.

There's a knock on the door. I open it, and find my husband holding a large black plastic trash bag, a towel — and a roll of duct tape. This does not look good. The potential crime scene does little to quell my growing angst. I close the door and tell him I'll call him when I'm ready.

But I'm never quite ready. I let another few moments slip by and still I don't feel any better about any of it. And I'm wasting water. So I bite the bullet and call him back in. And we begin the very delicate dance of preparing me for the most vulnerable shower of my life.

Off with the vest. Husband pauses just long enough to review the situation and announce, "They look good." We don't dwell. He continues on, wrapping the folded towel around my neck. I hold it in place while he cuts a hole in the top of the garbage bag and slides it over my head and shoulders. Then he duct-tapes the bag to the towel. I can reach my arms out from underneath the garbage bag (think Velociraptor) but trust me, it ain't pretty.

Husband assists me into the shower and I take my place on the bench. He points the hand-held water spout directly at my head. He'll never make it as a Barber, but he does spend the next five minutes carefully washing my long hair. I don't know whether to laugh or to cry; my emotions are as jumbled as the drops of water streaming down my face. I try my best not to let any moisture get through the garbage bag and onto my bandages. We are only partially successful. Next time will be better.

With my hair complete, I ask Husband to leave me alone for a few. He is reluctant; scared that I will slip and fall (even though I'm seated). Since I'm able to hold the shower faucet at hip level on my own, I want to relax a while and enjoy the warmth of the water.

The freedom I feel in this moment is nearly indescribable. I've made it through surgery. My drains are out. I've had a shower and my hair is clean. I've faced my most dreaded fear — looking at my new self in the mirror — and survived.

I may be sitting on a bench inside a plastic garbage bag, but I'm home, and I'm free (though not home free). I'm latching onto this slice of freedom and not letting go.

HEADING HOME

BREAST CANCER LESSON NO. 213: Don’t let your husband go home the first night you’re in the hospital.

Such is how my evening begins.

After enjoying the requisite post-surgical strawberry jello and juice, my husband heads home to feed the dogs and get some rest. It’s 8:00 PM when he kisses me goodbye, saying only that he’ll see me early the next morning. (We neglect to clarify what “early” means.)

My chest is bound up like a Geisha’s feet, and I have four plastic tubes the thickness of straws sticking out of me — two on either side. The tubes are a foot in length; at the end of each tube is a plastic bulb about 4 inches long x 2 inches wide into which fluid drains from my incisions. A nurse comes in periodically to empty them; they fill up fast the first day. It’s gross and smelly.

I also have a pain pack that automatically releases medication through two very thin tubes under my chest. So I have four tubes, four bulbs and one tennis ball-sized pain pouch hanging off of me. (Anyone wanna dance?)

As a fresh-from-surgery patient, I must rely on the nursing staff to help me do everything. (Thank goodness I have a catheter.) What makes this more difficult is that a nurse, in her infinite wisdom and attempt at kindness, has closed my door so I can get some sleep. There is a visitor’s lounge a few doors down from my room, and in the middle of the night, it turns into Comedy Central. Every graveyard-shift employee is stopping by — laughing, eating, chatting on cell phones… a real hootinanny. (At least  that's what my codeine-fueled brain is imagining, anyway.)

My closed door also means I am now isolated. I can’t catch anyone’s attention as they walk by. So my night goes something like this: pain, nurse button, pain meds, BP, drains drained, nap, noise, awaken, lights, thirsty, can’t reach, pillows slip, can’t correct, itchy, can’t scratch, too hot, blanket off, too cold, blanket still off; nurse button, wait, wait, wait. Repeat.

The night nurse's aide — definitely not in the running for Miss Congeniality — is very busy and not very worried about me. I must look like I'm doing well. Her English is also not great. She doesn’t understand what I mean when I say I need her to scooch me back up in the bed. (I can’t use my arms, so it is impossible to move myself; and I’ve slid so far down the bed that my feet are starting to dangle off the bottom.) She is in and out in a flurry. (Again, this is how my brain-on-pain-meds is perceiving it.) I fall asleep with the comforting thought that soon, my husband and sister will be here to help.

Morning comes, as does my breakfast — the first solid food I’ve had in more than 30 hours. I gobble it down. No idea what it was. But my sister should be here soon. I haven’t seen her since before surgery; my husband sent her (and my mom) home when I was having trouble coming out of anesthesia. She’s an early riser so I expect her to walk through the door any minute now.

Breakfast is over. My water and cell phone are nearby. It’s 7:30 AM — too early to call anyone. I watch some television and doze off. I wake up at 9:00 AM and call my husband. He just got up. He says he’ll be here in an hour. I'm bummed. I feel like I've been waiting for him for forever.

That’s when I notice the sign taped to my door: “No BP on left arm.” What? That’s wrong! It’s supposed to be no BP on RIGHT arm! (Because I had lymph nodes removed from my right arm, I can't have my blood pressure taken on the right side.) Oh... so that’s why I had to keep correcting the nurse last night every time she came in and went for my right arm....

These are the details I focus on to pass the time.

The clock says 10:00 AM. I call my sister. Turns out she was intentionally not coming to the hospital this morning to give me time with my husband. Huh? She says she thought my husband spent the night in the hospital with me. I never said that. I ask her to stop by after lunch because hubby will be here any minute. (BC Lesson No. 214: Always ask exactly when someone is coming back before they leave.)

Nearly 11:00 AM now and still no husband. You can guess what I do next. Yup. The tears flow like a swollen stream after the rain.

And of course that is precisely when he walks in. Oh, am I cranky. I can’t do anything for myself! The night nurse couldn’t understand English! There was a party next door! I was completely miserable and hardly slept all night! I couldn't reach anything myself. I couldn't scoot myself up! I couldn't move my pillows! Blah, blah, blah! I pepper him with complaints rather than compliments. But he fluffs my pillow and flips it over to the cool side for me anyway. He gets me my pain meds and some ice water. He fixes the lousy sign on my door. And I start to relax just a little.

My sister arrives. I take my first walk down the hall, notice the visitor’s lounge and put two-and-two together. (So it wasn't just my imagination on drugs!) . My surgeon also stops by to see how I’m faring and is happy with my progress.

That evening, after my husband and sister go home, an absolute angel of a nurse on the graveyard shift appears. She is sweet, she is kind, and she is compassionate. She makes sure I have everything I need and never makes me feel like I am asking too much. She stops by often. She is like a dream compared to the night nurse before her. I actually sleep.

Morning No. 2 dawns, and my BFF arrives at 6:30AM. YAY! I called her yesterday about the mix-up with my husband and sister; thankfully she is an early riser and offered to come visit. After breakfast, we take a stroll down the hall. I’m in a purple robe trailing my IV bag on a hook. We go real slow. I feel weak but I know I need to move. As we round the bend, I see Dr. C., my plastic surgeon, leaning against the counter at the nurse’s station. He’s dressed in street clothes. 

“That’s your plastic surgeon?” my BFF asks. I think she is surprised I haven't mentioned the cuteness factor. (She later tells me she would be happy to accompany me to my plastic surgery appointments; she's only half joking.)

Dr. C. walks us back to my room, says I'm doing great and that I can go home. HOME! Yippee! He wants to see me in his office in three days for a follow up, when he’ll remove my drains and pain pack, but for now he is pleased with my reconstruction so far and even offers to show me how I look before I leave the hospital.

Oh no. I’m not ready for that. I want to stay wrapped up in the safety of my bandages a little while longer, thank you very much. I want the “big reveal” to happen in the comfort of home.