Showing posts with label cancer. Show all posts

My mysteriously swollen neck mysteriously deflated in late December and early January. The doctors never figured out what exactly was wrong, though they did notice a lovely case of lymphodema in my left arm. Well, duh, thanks for the newsflash.

Any activity more vigorous than typing is likely to make my arm swell. The more prolonged the activity, the more swelling. Just for fun, flying also causes swelling. The solution is a compression sleeve. Not one of the flashy ones that basketball player wear, but an actual medical version. Translation: it costs $90 instead of $20.

Nearly 10 days ago, Matt and I wasted a week of perfectly good vacation days to move all of our belongings out of the rental house and into our garage. Because we just had to move everything across the street, we naively decided to do it ourselves. However, due to scaffolding and other construction detritus, across the street became down the street, around a 180 degree curve, and down a steep hill.

My left arm and hand started to swell on Thursday, and on went the sleeve. The sleeve stayed on all night and all day Friday, as the swelling increased and increased. By early Friday evening, I could barely bend my fingers or elbows.

Puff, the magic hand, dangled from my arm. And wallowed in the extra lymph that wouldn't move along.

Poking any spot was incredibly painful, while at the same time, my entire arm was cold and tingly. Not just cold to me, but cold to the touch. Oh, and my fingers were starting to turn purple. Time to call the on call doctor!

I described my symptoms over the phone, and the doctor sent me to the emergency room. No big surprise there.

I told the doctor that I was suffering from a lovely case of lymphodema. The doctor decided to be all responsible and not immediately believe me. A vascular technician was called in to scan my veins and arteries for possible blood clots, which would explain the cold tingliness.

The ultrasound showed no problems with blood flow, though that wasn't good enough. The next step was a CT scan of my lungs, as a blood clot there could cause my symptoms. In order to inject the IV contrast, my right arm, which was feeling a bit neglected, received an IV.

Anyone who has spent as much time as me getting imaging done knows the drill. Lie perfectly still for the first round of zapping, get dosed with contrast, and remain in the exact same position for the second round of zapping. The whole not moving thing is incredibly important to get good results. That's why, when the IV detached during the contrast diffusion, I didn't move. My heart, on the other hand, kept pumping blood. SQUIRT! SQUIRT!

It turned out that the little screw that attaches the line to the plastic tube inside the vein wasn't screwed in all the way. When the pressurizing by the contrast injecting machine, it came completely apart. Thankfully, the contrast was clear. Regrettably, my arms were above my head so all the blood and contrast were soaked up by my hair.

Once the mess was cleaned up, the whole imaging process had to start over. All in all, a ten minute study took the better part of an hour. Matt was worried about what might have happened to me, then confused as to why my hospital gown magically changed from green to blue.

After all of that, around four in the morning, the doctor declared me to have lymphodema and sent me home with instructions to see my doctor. Apparently my worries about a giant needle being used to drain my arm were unfounded; lymph swells every cell individually, and a giant needle would be very imprecise to drain them individually.

After the family farce disaster that my previous post caused, I've been very hesitant to post another update without an actual diagnosis. But it's been three months and four specialists since this started, and still no one has any idea what's causing stupid neck syndrome*.

Dr. Oncologist ran out of ideas for which to test. Dr. EarNeckAndThroat ran a similarly thorough series of imaging and blood tests and came up empty. Dr. Lymphodema did a whole body lymphoscintigraphy and made the shocking discovery that my upper left arm has lymphodema. Considering the amount of surgery in that general area, it's actually doing rather well. But she doesn't want to subject me to any treatments stronger than a compression sleeve until the neck issue is straightened out.

About two weeks ago Dr. Rheumatologist received her invitation to the party. After her initial consultation, she prescribed naproxen to help alleviate the pain. Unlike Dr. ENT's steroids, the naproxen actually significantly helped with pain and didn't make me go crazy! I can turn my head to the right! My emotions are no longer limited to cranky and bitchy!

Sounds wonderful, right? Well, not quite. I can't just keep taking naproxen forever, so the actual cause of stupid neck syndrome must still be determined. With that in mind, Dr. Rheumatologist ordered me exsanguinated to the tune of seven vials.

Note to vampires: I do not have possession of these tasty, tasty carafes.

The results of whatever esoteric tests are being run this time are supposed to be in two days from now, on Friday. I won't hold my breath.

* Stupid neck syndrome is characterized by the elongated lymph nodes and the extended and hardened jugular on the right side of my neck, despite both my lymphatic and cardiovascular systems running smoothly.

I volunteered for take your child to work day because I had nothing else to do on a Thursday afternoon. Why just the afternoon? My morning was already booked with happy fun time shot of Lupron. Therefore, aside from the obvious problems associated with putting me in front of a bunch of impressionable youths, there were no other reasons for the organizers to be worried. So I fainted.

I was informed afterwards that I was out for about 10 seconds and my eyes rolled back into my head. And yet somehow I convinced everyone not to call an ambulance, since the person who just lost consciousness is clearly the person who should be making medical decisions. More than one doctor made me promise not to do that again. Yes, the next time my brain completely misfires, I swear I will be more rational.

My brain continued to misfire for the next few weeks. Massive headaches, severe balance issues, and lots of nearly fainting. To top it all off, I managed to get TWO periods because why not. So instead of going to work, I spent lots of quality time in cold exam rooms under the tutelage of various doctors.

After thousands of dollars worth of nearly every medical test possible, not one doctor could satisfactorily explain what went wrong. The only thing they agreed upon was that things went awry.  Useful.

Time for another stab in the butt! This time things went more according to plan. The hot flashes came back and the brain problems stayed away for an entire month. At my next pre-stabby-time conference with Dr. Oncologist, she became suspicious. Completely unheard of side effects randomly appearing mere hours after administration that disappeared equally mystifyingly the next month? Sounds like a bad batch.

A quick look through my dismayingly large file revealed that the lot number on the malfeasant dose was different from all of the others. While rare, bad batches* do occasionally occur, so she was going to look into it.

Then things got really weird. Blood tests revealed that my hormone levels were correct for someone on Lupron. Clearly the drug was working, and yet Aunt Flo continued her monthly visits. Dr. Gynecologist and Dr. Oncologist asked colleagues for second, third, and twenty-seventh opinions, but no one could explain it. They concluded that it had to be some sort of fluke and that it wouldn't happen again next month.

Was anyone surprised when they turned out to be wrong? Nope! An ultrasound revealed that the cyst on my left ovary was back, and Dr. Gynecologist dove in for a closer look. She took a sample of uterine lining straight from the source, which was merely uncomfortable. The biopsy, on the other hand, was absolutely horrible.

Using the external ultrasound, Dr. Gynecologist attacked with a ten inch needle via the internal route. She stabbed her way into the normal looking cyst on my left ovary and grabbed a piece of tissue. Even worse, it took ten excruciatingly long seconds. "One one thousand. Two one thousand..."

The assisting nurse wiped away my tears, while complementing me on my lack of screaming. I think it's safe to assume that will never happen again. Then came the bad news - I have two ovaries. Time for round two, despite the right side never having any cysts.

I patiently waited a full week for the results. There was absolutely no random panicking or needless fretting. I certainly didn't check my phone for missed calls every three seconds. And yet the phone eventually rang! Everything was normal, for whatever version of normal applies to my entrails.

Still completely unable to explain what was happening, the doctor brigade decided to continue with the Lupron shots. Any further weirdness would trigger a new round of intricate tests of my intimate parts, but there was nothing left unturned for now.

I assume my ovaries were waiting to hear that. "We've experienced every possible test, so let's behave for awhile and see if something new happens!" "Great idea!" Miraculously they did just that - August came and went without a period. I can only hope September is similarly uneventful, but I'm not holding my breath.

* Unscrupulous douche canoes sell watered down or completely fake medicine to idiots who don't stop to think "huh, this brand new supplier is disturbingly cheap." Dr. Oncologist assured me that this was not the case here. If it was a bad batch, it was a legitimately manufactured bad batch. Yay?

The sole benefit of being stabbed in the butt by a Lupron-wielding nurse is not getting a monthly period. Well, that and the whole cancer prevention thing. But anyway, when I managed to get a period despite the Lupron, I did the only rational thing - "MATT! HELP!"

Oddly enough, he didn't have any useful advice, so I fell back to my usual plan of panicking and calling Dr. Oncologist. Of course she wasn't on call that weekend, forcing me to explain all the gory details of my lady bits to an unknown male. At least he was more knowledgable about the subject than Matt, and he assured me that while rare, it was not unheard of for a system to empty out any lingering material. Panicking could wait until after more than 48 of bleeding.

Gee, want to guess what happened next? If you said a Monday morning visit to Dr. Gynecologist, you win! I, on the other hand, did not win, though I received a thorough poking for my troubles. And the phlebotomist withdrew enough blood to run every possible test and feed two hungry vampires. And the radiologist got a good look at my uterus from every ultrasound angle. EVERY angle.

Once all of the test results were in, the standard doctor conference call ensued. The official result? I have mighty ovaries! For some, 3.75mg is just not enough to block estrogen production, and they "break through." Time to double my dose! Oh, and I was the proud owner of a 5cm cyst on my left ovary.

If I was normal, the cyst would also be normal. Apparently they come and go without causing alarm. But I'm not normal, so while more panicking wasn't called for, it was something to keep an eye on. Thankfully, further scans showed it shrinking, and within three weeks, it was gone.

After previous surgeries, I was still able to use my right arm. This time righty was subjected to the knife, so I had exactly zero useful arms. Matt had to help me with everything. Everything. To make matters worse, he refused to make airplane noises and pretend the fork was coming in for a landing when feeding me! With such subpar hospice care, it's a miracle I heeled at all.

Having long since grown sick of being stuck at home, I quickly grew restless. I needed something to occupy my drugged out mind. Clearly there was only one solution: Lego video games! By the time I returned to work, I managed to not only beat, but get every achievement on Batman 2, Harry Potter: Years 5-7, and Lord of the Rings. A worthwhile pursuit, if I do say so myself.

Alas, even with the drugs, mindless video games weren't enough to overcome the ennui associated with never leaving the house. This resulted in me deciding that we needed to buy lots of tiny drawers to better organize things RIGHT NOW, which is how I found myself at The Container Store less than two weeks after surgery.

I stumbled through the aisles, completely amused by nearly everything, such as a two foot tall metal filing cabinet with oodles of thin drawers. The best part? It was orange! Imagine the fun I could have opening and closing the drawers if only it wasn't on the very top shelf!

Matt valiantly attempted to get down the new object of my affections. What he failed to notice was a three inch clear piece of plastic at the edge of the shelf. The bottom of the cabinet caught and all the pointy metal shelves tumbled out. I instinctively reached up to save Matt's head from imminent peril. If that wasn't bad enough, I managed to deflect the impudent drawer into my left boob, pointy side first.

"AHHHHHHHHHHHHHHHH!"

The employee a few yards away helpfully chastised us with, "The plastic is there so you don't take things down off the top shelf. It's clearly labeled." Then he calmly strolled away, under the guise of getting help. He never came back.

Eventually I stopped screaming, if only because I needed to inhale. Meanwhile, Matt surveyed the shelves looming over head. Sure enough, some of the plastic "guards" were labeled, just not the one in question. Hmmm... lawsuit?

The overwhelming desire to evict the evil expander counteracted most of my fear, making my time in pre-op less horrific than previous visits. However, not even Lupron-induced hot flashes could counteract the sub-Arctic temperatures common to every hospital. Luckily for me, this hospital uses Bair Paws, which provided me with both amusement and warmth at the same time!

My temporary residence in bay 4, prior to operating room 4.

After nearly a year with the horrible expander, I was actually looking forward to having it replaced with a nice, comfy silicone-gel implant. Just the thought of being able to sleep on my stomach made me giddy. Not giddy enough to merrily skip into the operating room, but enough to ward off most of my normal pre-surgery fears.*

As the operation date loomed near, I had the standard rounds of doctor appointments. What was not so standard was being handed a binder full of Playboy models and being told to pick out my ideal breast shape. I was even given post-its to note particularly good features. Having never been a teenage boy, I never realized that there are so many different considerations.

While I carefully compared 1959 boobs to 2006 boobs, Matt very carefully ignored me in favor of his phone. "What do you think of these?" "Umm..." "Do you think these are too big?" "Err..." "JUST GET OVER HERE AND HELP ME LOOK AT BOOBS!"

Ultimately, I gave Miss December 1963 best overall, though a few 1970s centerfolds made very good showings. Matt agreed.

With that out of the way, what size would I like? Honestly, I never had any real desire for bigger boobs. Alas, it would be impossible to make them reasonably symmetrical without increasing the right side at least a bit. Considering how highly I value symmetry, I decided that a slight increase was something I could live with.

A weighty matter hangs in the balance.

Dr. PlasticSurgeon explained that she wouldn't know exactly how much of an increase I would receive until she took out the expander. If I was lucky, the right side would only have a vertical scar extending downward from the areola. By pinching the skin underneath, the top would be perkier and a closer match to the entirely fake boob on the other side. If I wasn't lucky, I'd wake up with a lollipop scar, with the top part encircling the areola. Admittedly, when I stopped giggling, I was okay with either option.

I asked the doctor if I could have the expander after removal. I had grand plans involving a rifle and YouTube. She understood the sentiment, but deemed the lab techs to have a higher priority. I suppose being slowly dissected for biopsy is a crueler fate than instant destruction, so I acquiesced.

With all of the formalities taken care of, I managed to maintain my eager anticipation until the day prior to surgery. The real miracle, however, was that I didn't change my mind about my choice of new boobs.

*It's really not a good thing that I have a well-established baseline for "normal" surgery apprehension.

I have Obsessive Compulsive Disorder, though apparently I forgot to tell the internet since there isn't an existing label for it. While I now freely admit that my functionality highly correlates to the number of milligrams of Paxil I took the night before, I used to be quite embarrassed about the whole situation. And with tidbit out of the way, we may now begin our story.

Normal people whose tumors with estrogen receptors have been thoroughly eradicated are prescribed five years of Tamoxifen. Assuming the patient doesn't ingest the entire supply at once, it prevents new tumors from growing. If things go as planned, the Tamoxifen gets to the receptors before any estrogen, making the cancerous cells too sad to multiply. It is the standard treatment for pre-menopausal women and slightly super important.

Why did I bother mentioning the OCD? Because combining Paxil and Tamoxifen is equivalent to combining matter and antimatter, so taking both is a laborious way of doing absolutely nothing useful. But wait! Oddly enough, it's common for cancer patients to be on anti-depressants such as Paxil, so there is a standard solution: Effexor for everybody!

The faster I switched to Effexor, the faster I could start preventing future tumors. Doctor Oncologist and Doctor Psychiatrist talked about me behind my back, and Doctor Psychiatrist prescribed an agressive titration from Paxil to Effexor.

To say that the Effexor didn't work would be an understatement. It anti-worked. It was such a fail boat that I missed work. Doctor Psychiatrist made the executive decision that not having me committed to a mental hospital was a higher priority then preventing theoretical future problems. An even more agressive titration back to Paxil was prescribed.

My brain had enough and went on sabbatical. Massive headaches prevailed. It ended up taking nearly three weeks to fully switch back to Paxil, and I ended up on a higher dose than when this mess started. But I was functional human being again! Hooray for the little things!

Doctor Psychiatrist declared her job done and sent me back to Doctor Oncologist. She clearly couldn't give me newfangled Tamoxifen, but she could use good old-fashioned estrogen prevention drugs. A monthly shot of Lupron makes my butt sad and prevents estrogen production in my ovaries. A daily Letrozole pill prevents estrogen production in my brain. While usually reserved for post-menopausal women, this regimen has a slightly better long-term outcome. If there's absolutely no estrogen production, none can elude the Tamoxifen and bind to a receptor.

Of course, Doctor Oncologist wants to do this for ten years. Only 120 shots in the butt with a three inch needle. But on the bright side, I get an equal number of skipped periods. I can think I can live with that.

Late Sunday night, I received an email pleading for speakers at a wine-tasting breast cancer fund raiser in three days. As "desperately" was bold, italicized, underlined, and fully capitalized, I knew the situation must be grim. Being the nice person that I am, I replied that I would "happily blab publicly about frankenboob", assuming I could spend the day up north and they could cover the flights.

No response came on Monday, so I went to bed confident that I had successfully avoided a public speaking engagement. Alas, it was not meant to be, as Tuesday morning brought not one but three emails. The first thanked me profusely for volunteering. The second said that they weren't sure if they could cover the cost and they'd let me know by Wednesday morning. The third implied that someone thought this through a little further and realized that booking flights the day of was a bad idea.

Well, crap. It was time to exert effort, starting with asking my manager if I could spend the day at headquarters. He readily agreed, and even pointed out that I could easily come up with a business reason for the trip, eliminating all remaining obstacles.

It is now Wednesday, I have less than four hours before my adoring public shuns me, and I have no idea what to say. I thought reading through past posts might inspire me, but clearly that just turned into an exciting new way to procrastinate. Bad me!

I tried to work. I really did. But unless "work" is the new hipster word for "fretting," I was not a bastion of productivity. With about forty minutes before my shameful public debut, I decided to head over. Due to my awe-inspiring ability to get magnificently lost in the process of finding my way to a building across the street, I made it with a mere twenty-seven seconds to spare. A personal best!

The person I had been conversing with via email was nowhere to be found, but the other organizers were happy to provide me with two pink ribbon stickers and an empty glass for wine tasting. The extra sticker informed the masses that I was a victim of cancerous masses. The empty glass informed the wine pourers that I was out of wine.

I sampled the wine over and over, right up until it was time to talk. The other speaker went first, at my insistence, and told the crowd how important mammograms are. Her precancerous lump was found during a routine screening, and since it was found so early, she merely needed some surgery and radiation. I refrained from calling her a lucky bastard as she continued stressing regular checkups, a mild feat considering my earlier wine tasting regiment.

Since I was already out of people to speak before me, it was my turn. I started from the beginning, with my mom getting diagnosed while I was in college and her suggesting that the doctor examine my boob eight years later, as she was slightly less qualified. I followed with a brief description of all the things that went wrong, right up to my current state. I made sure to mention that silicone implants are amazingly fun to play with, and anyone with the opportunity to examine an unimplanted pair should not pass it up.

The previous speaker had a message. I needed a message to close with. Perhaps I should have thought about that earlier? Luckily, the wine told me what to say. "The past two years have really sucked. A lot. But you know what would have sucked worse? Being dead." Speaking done.

Afterwards, people kept thanking me for my speech. I received all sorts of compliments on bravery, inspiration, triumph, and other embarrassing things, not to mention countless hugs. The wine rush wore off and I reverted to my normal awkward self, leaving me to wriggle around under their good intentions.

I quickly discovered that once my audience was reduced to one or two individuals, I had no trouble recounting tales of boobular heroism. Of course, soon after that realization it was time for carriage to whisk me away to the aeroport.

When I get super excited about something, I fail to shut up about it. When I get really pissed about something, I similarly fail to shut up about it. When the moon continues its orbit around the earth, I continue blabbing on and on. However, when something upsets and me and leaves me sad and miserable, I just might close my trap. The most relavent example of this phenomenon occurred just a few months ago.

First, some background. Frankenboob was already inflated to nearly 500cc, the initial volume of the expander. The expander is made of magical stretchy stuff and can hold 1500cc, a disgustingly large size for someone of my stature. My untrained eye was perfectly happy with 500cc, which seemed to match my unmolested right boob. Dr. PlasticSurgeon, who is more versed in choosing boob sizes, pointed out that radiation causes the muscle and skin to shrink, making one or two more inflations necessary.

Anyway, there I was, innocently lying topless on the examination table while Dr. PlasticSurgeon and her minion examined Frankenboob. The horrible latitudinal scar is about 1/3 down from the top. Ergo, the best way for the skin to accomodate inflations is for the skin above the scar to stretch down. But Frankenboob would have none of that. It didn't even stretch the skin on both sides. Oh no, it had to be impudent and stretch only the bottom skin, widening the scar and making everything red and miserable.  As a result, there would be no further inflations.

To top it off, my stupid insurance company refused to authorize the radiation being scheduled by Dr. RadiationOncologist. Why? According to them, the type of radiation requested is "experimental" and not indicated after "breast conserving surgery." That's right, the same people who paid over $100,000 mere months ago for a mastectomy were claiming that I had two boobs.

The situation was by far not worst I'd experienced in recent memory, but it was enough to make me shut down. I stopped caring about writing. I stopped caring about my few remaining hobbies that didn't require me to leave the house. Oh sure, I still complained about doctor stuff when around other people, but I stopped inflicting the gory details upon unsuspecting masses. As one person at work pointed out, I was a lot more serious about my medical prospects.

I won't claim to have freed myself from the ups and downs of depression, especially since I'm currently lying facedown in the bottom of a trough. Despite this week being awful, the overall trend has been upward. Sadly, the contents of my stomach have also shown the same upward trend, but that's a physical problem, not a mental one.

That's what Matt said when I refused to stop trying to yank open the stupid car door. He ended up opening the door for me, while I retaliated by kicking the door. It totally deserved it.

Meanwhile, Frankenboob has been inflated a total of three times, for a total of 370cc. It's now more ovular than ever, so I had to go buy a couple of new sports bras that would normally be way too big. For some reason, Victoria's Secret doesn't make anything for the irregularly shaped boob.

A weird bump of skin is poking out at the left end of the scar. It's gotten more pronounced with every inflation, even though I've tried to poke it flat. According to Dr. PlasticSurgeon, it's called a dog ear, and is caused by a pleat forming when the skin was stitched back together by Dr. Surgeon. She made sure to stress the part about Dr. Surgeon causing it. But not to worry, she can easily erase its existence when creating the nipple.

Reese, who finds it necessary to say hello to every dog in a five-mile radius, clearly heard about of Frankenboob's dog ear. Sadly, her version of first contact involved stepping directly on Frankenboob while in our bed this past Monday. Not understanding why I suddenly started screaming, she immediately froze. Matt, sensing something was amiss, came bursting out of the bathroom and removed the offending paw, along with the rest of the puppy.

Reese feins innocence, sleeping with what's left of her favorite toy.

Oddly enough, I woke the next morning to find a multicolored Frankenboob. And did I mention it hurt? As the day progressed, it changed from purple to a nice red. Time to call the doctor!

By that point, I had completely forgotten about Reese's attempt to compress Frankenboob into a singularity. All I could think of was that it hurt and it was an odd color, even by Frankenboob standards. Luckily, Dr. PlasticSurgeon's secretary happens to be my neighbor and knows that both Reese and Zero can be jumpy when excited. Perhaps one of them did it? How on earth I managed to forget that, I'll never know.

Since I already had an inflation appointment scheduled for the next day, I decided that I could wait a day for a thorough medical probing. In the meantime, I could continue taking prescription levels of ibuprofen out of an OTC Advil bottle.

At today's appointment, it took Dr. PlasticSurgeon about three femtoseconds to locate the point of impact. And then she jabbed it with a stick! Or she just lightly touched it to make sure nothing was horribly amiss.

Apparently it isn't the best of ideas to inflate a bruised boob, so that was delayed until next week. For today, her minion was dispatched to fetch the brown tape (as opposed to the white tape). I'm not entirely sure how it works, but a few pieces of tape are holding the bruised area in stasis such that it can heal in a more timely fashion.

In other news, this morning I inadvertently discovered that I can flex Frankenboob! It looks very similar to videos of Chippendale dancers flexing their pectoral muscles, except there's a boob on top. And no, I can't flex the right. Believe me, I've tried.

Shockingly, I was still taking Percoset the Monday after my first inflation. It was a mere week and a half since Frankenboob's excoriation, and just over two since Frankenboob's creation. Therefore, it was time for something disastrous to happen.

Matt drags me out of the house most days. While he claims it's for my benefit, I strongly suspect he just wants to get himself out the house. On that fateful Monday, it was definitely not me who benefited. The mistake was stopping at a 7-Eleven on the way home. A giant guy accidentally elbowed me in the Frankenboob! He immediately turned around and apologized, so it would have been a bit rude to kick him in the balls.

Somehow I made it make to the car without screaming, though my eyes did tear up. When we finally got home, a visual inspection didn't make me feel any better. A bruise was forming, and there was clearly a dent at the site of the impact.

The new disaster area continued to throb the next day. Time to call the doctor! Dr. PlasticSurgeon assured me that the expander requires much more than a giant elbow infraction to pop, so I needn't worry about that. As for the pain, the area had just experienced two traumatic surgeries and was therefore much more vulnerable. A small bump that I would otherwise barely notice could cause severe pain in these circumstances. I should just keep popping pills, and the extra pain would go away in three to four days. Woohoo.

The day after I received the all clear from Dr. Surgeon, I went to Dr. PlasticSurgeon so she could survey the damage. But before she could gasp in horror, her minion had some fun with a magnetic stud finder. The device is basically a magnet suspended in a little plastic holder, with which the minion was able to locate the metal marker indicating the injection site of the expander. Of course the site was under the tape Dr. Surgeon used to hold my boob together, which meant that after a week of dread, I finally got to see the extent of the horror.

Much to my dismay, the scar is about five inches long, and mostly horizontal. While the spot indicated by the stud finder was marked, I poked at the scar, trying to make it go away. I failed.

A piece of medical tape with a daub of topical analgesic was placed over the mark, limiting my poking range. After about five minutes, all poking was ceased as the numbing goo had taken effect. A white surgical drape was placed around the area, which was cleaned with an iodine drenched swab. Dr. PlasticSurgeon further sedated the area with an injection of some sort. Then came the scary needle.

While I watched with a fascinated horror, a two inch needle pierced the muscle and entered the expander. To confirm the needle was in the correct location, the doctor drew out some blue liquid. When she filled the expander during the first surgery, Dr. PlasticSurgeon mixed the initial saline with methylene blue. Bright blue liquid is generally not naturally produced anywhere near the boob, so the blue liquid gave her reasonable assurance that the needle was in the correct location.

Having verified the needle's insertion, it was time to start filling. A 200cc bag of sterile saline was hooked up to a bizarre pump. When released, the pump filled with saline from the bag. When compressed, the saline travelled down a tube, through the needle, and into the expander. Oh, and it made a loud and highly disconcerting noise after every compression.

After only 100cc, the pressure made it uncomfortable for me to breathe on my left side, so she stopped for the day. That more than doubled the size of the expander to 170cc. Though the expander has a maximum size of 500cc, Dr. PlasticSurgeon expects to reach the correct size around 450cc. This will be accomplished over four fillings, though it could be done in just one. By spreading it out over weekly fillings, the skin is less likely to develop stretch marks. Also, filling it at once would create even more pressure, preventing me from breathing easily or comfortably.

The expander is fairly football shaped, though it's not particularly obvious yet. With the latitudinal scar, Frankenboob will look particularly footballesque once fully expanded. While clearly not the ideal shape for a boob, it does the best job of readying the surrounding muscle tissue for the permanent implant. Sadly, I will be stuck with a malformed Frankenboob until approximately six months after radiation is complete. At that point, the expander will be replaced with the permanent implant and a 50cc implant will be inserted under the muscle on the right side. I'm a big fan symmetry, especially when it comes to personal pillow perkiness.

To relax the muscle holding the expander in place, as well as to immediately knock me out, more Valium was prescribed. In other words, I spent the rest of Thursday and most of Friday slipping in and out of consciousness. On the rare occasion that I woke up long enough to be cognizant of my surroundings, I spent most of it begging Matt for pain medicine. Just think, I'll get to repeat this process after each inflation!

Right before leaving the office, I was given an implant card. It has my name, the type and serial number of the expander, and the doctor's information. While I don't have to carry it with me, some people choose to keep their cards in their wallets. Since I had a few empty slots in my wallet, I figured I might as well put it there. Just in case they find my charred body in a ditch. With my wallet. And all the other cards are melted.

For whatever reason, the card made me think to ask about MRIs and other magnetic scanning devices. Shockingly, they are no longer a good idea, assuming I don't want further damage to Frankenboob. Also, the TSA's nude-o-scopes may be able to detect the implant, though the operators are supposed to know what they look like and to not cause a problem. Since I refuse to go through one of those machines as a matter of principle, I guess I'll never find out.

Every time some bit of me is cut off, an unfortunate soul wearing rubber gloves gets the highly enviable job of examining the piece of me. In case that wasn't stimulating enough, the hapless lab tech then gets to compile all the minutiae into a captivating missive known as the pathology report. Once it's ready, Dr. Surgeon walks into the examine room with my exponentially growing chart and delivers the inevitably bad news.

During the mastectomy, Dr. Surgeon checked visually and tactilely for anything untoward, but did not find anything unexpected. As a result, he merely excised the nipple and areola and left the surrounding skin intact, per the original plan to save as much boob as possible. The pathology report told a different story; there was a tumor in the subcutaneous fat. The size and location of the tiny tumor left me with two options.

The first option was to remove the nearby skin in case of any cancerous invaders. The expander would be deflated so that the remaining skin could be sewn together. The second was to bombard the area with extra radiation. Dr. Surgeon stressed that both were medically acceptable and that it was entirely up to me. For once in my life, I made a decision instantly. I'll repeat that for those of you in apoplectic shock - I made a decision instantly. Everyone resuscitated? Can we move on? Excellent.

When could I be scheduled for further Frankenboobing? Dr. Surgeon wanted to perform the excoriation before any more healing took place, so he managed to squeeze me in for the next morning. In other words, more surgery before I was even a week out of the hospital! And, as Dr. Surgeon put it, it was a shame to ruin the good work that Dr. PlasticSurgeon had done. But he did agree with my decision. After some phone calls, so did Dr. PlasticSurgeon and Dr. Oncologist. With that, everything was set for the next morning.

And that's how Matt and I found ourselves back at the hospital the following morning before even the sun bothered to get up, much less the valets. Mom, who I ever so subtly told to not to go home a few days prior, stayed at home with the leaky puppy and Zero, since the whole mess wasn't supposed to take more than a couple of hours. I think it was just a rouse to stay in bed. Anyway, I checked in and was lead into the workshop within fifteen minutes, leaving me with little time to dehydrate and shrink every vein in my body.

Along with the standard no eating or drinking after midnight, I was told no pills. This included the antibiotics, which I couldn't care less about at the time, and the incredibly important narcotics that made life worth living. I was told I had to wait until the IV was in and a doctor approved the pain killers, so I was thoroughly shocked when the nurse got the IV in my arm on the FIRST try.

About that time Matt was allowed in to see me. Unfortunately for him, I was more interested in narcotics. Shortly after his arrival, the anesthesiologist came over to introduce herself and check for allergies, a standard practice. The IV was in, a licensed doctor was in front of me. The first thing out of my mouth was, "Can I please have some Dilaudid now?"

Clearly that was not the right thing to do. "How do you know about Dilaudid?" was not the response for which I was hoping. Thankfully Matt was there to explain that I'd had a mastectomy the previous week, complete with a Dilaudid PCA, and that I'd been denied pain medicine since midnight. Still not convinced that I wasn't a druggie and apparently incapable of reading the giant binder at the foot of my bed, I had to wait for Dr. Surgeon'sAssistant for relief.

Per normal procedure, Dr. Surgeon'sAssistant confirmed the doomed side and wrote "YES" above the existing bandages. A few minutes later, Dr. Surgeon himself came to make sure everything was ready. When I mentioned that the "NO!" on the right side was fading, he rewrote it and even underlined it a few times. There would be no tormenting of the behaving boob that day.

Instead of general anesthesia, I was given sleepy meds and local anesthesia. As a result, I was much more aware of my surroundings when I was wheeled into the operating room. My attention was drawn to the whiteboard on wall with spaces to fill in all sorts of information. I remember asking about them, but the only one I remember was labeled "FRED." I wish I remember what it meant, but all I recall is laughing hysterically at its existence.

Presumably I woke up in recovery and Matt drove me home, but all I can recall from the rest of that day is feeling like absolute crap. I planted myself on the living room couch and refused to move, eat, or breathe for the rest of the day.

A week later, I was both off the couch and in one of Dr. Surgeon's examination rooms, waiting the inevitable. This time the bad news wasn't nearly as horrible. There were tumor emboli in the skin they removed, which further validated my decision to have the skin excoriated. However, the margins were nice and clean. Oh, and he removed 180cc of the initial 250cc from the expander. But more importantly, no more surgery! At least none involving Dr. Surgeon! I practically skipped out of the office, with Matt trailing behind me. Okay, that was a total lie. Skipping would have hurt like hell. But I was rather elated at the news. Good-bye for now, Dr. Surgeon!

Hospitals are built on the principal that if you have to wait long enough for treatment, you'll either die or decide that it's not bleeding *that* badly and go home. Either way, that's one fewer patient needing medical assistance. Ergo, I shouldn't have been surprised that arriving promptly at nine, the time they said to arrive, was unnecessarily early. First they decided that my surgery was scheduled for one, and therefore I had checked in a mere two hours before they expected me. Shortly after noon, someone realized that I wasn't due for chopping until THREE THIRTY! I could have, oh I don't know, slept, instead of slowly losing my grip on reality in the waiting room.

Finally, after three days of waiting in the world's most uncomfortable chair, I was more than happy to donate my body to science. One of the nurses gave me the standard unisex gown and asked if it happened to be that time of the month. Of course it was, or I wouldn't have bothered mentioning it. The nurse disappeared for a minute and returned with "the latest from Victoria's Secret." After a cursory examination of the offending garment, I was forced to ask which side was the front. Let's just say the unfortunate regalia was one size fits no one, and I was no exception.

Once I was appropriately defrocked, it was time for the IV to be jammed in my arm. The standard veins in my right elbow are so scarred from chemo that they are no longer valid options. My entire left arm is off the table due to the removed lymph nodes. That just leaves the right forearm. A small shot of lidocaine, and then attempt one. Even with some unsettling wiggling, the nurse couldn't get the standard gauge needle in my vein. After examining my arm, the next shot of lidocaine was aimed at the back of my hand. Coincidentally, so was the next IV needle. Sadly, it was also the second failure. At this point, the nurse was complaining about how thin my veins were due to dehydration. How on earth could that have happened? Maybe it was the doctor saying that I couldn't eat after midnight since I had to be at the hospital by nine?

Apparently lidocaine causes further constriction of the veins, so the stabby nurse tried my hand again, this time with a full dose of agony. An IV in the elbow, when done properly, is not that painful. Everywhere else, well, that's just not the case. Despite my loud opining on the procedure, the nurse failed a third time. Time for the big guns and a smaller gauge needle.

Dr. Anesthesiologist and his minion joined the party. The minion was introduced as a medical student who would be observing. Not wanting to wake up at an inauspicious time, I asked for clarification on his role. In other words, would he be actually doing anything? No. Are you sure? Yes. Any chance of that changing? No. Okay, minion accepted.

With my safety ensured for later, it was time to return to the current predicament. The next venture into my arm was performed by Dr. Anesthesiologist. He, too, noted my dehydration for posterity. However, after failing to properly puncture the top of my forearm, he successfully got the needle in a bonafide vein, near the inside of my wrist! I may have screamed in pain as the sharp pointy thing forcibly reinflated my desiccated vein, but at least it was the last stab. In case you lost count, that was two shots of lidocaine and five IV needles in decreasing gauges.

The first thing the IV was hooked up to was a bag of hydrating something or other. While my veins dilated, I was allowed some time to panic in the company of Matt and my parents. We had some extra time together due to Dr. Anesthesiologist and his minion disappearing. Good job putting the patient at ease.

In the meantime, Dr. Surgeon and Dr. PlasticSurgeon took turns marking me up. Dr. Surgeon asked me to confirm which was the victim boob. He marked it with a giant "YES." But what about the good one? After months of nightmares in which too many boobs were removed, I wasn't leaving anything to chance. He inscribed a large "NO!" on the good boob.

Dr. PlasticSurgeon was much more methodical. She had me standup, then went to town with a tape measure. Between the dots, dotted lines, and solid lines, I looked like a demented runway from an airport requiring the planes to land upside down.

After Dr. Anesthesiologist reappeared and some amount of slicing and dicing, I woke up in my berth. First order of business: how many boobs do I have? Surprisingly enough, the number was greater than one. The right side was still intact, so the total wasn't due to two partial boobs. But the left side wasn't nearly as flat as expected. As it turns out, even after removing the nipple, there was enough skin and room behind the chest muscle to inflate Frankenboob to approximately 3/5 of normal size! In retrospect, of course there was some room behind the muscle, otherwise how would normal people get boob jobs without always requiring expanders?

The less pleasant surprise was that the patient-controlled analgesia would only fork over Dilauded once every eight minutes. The button would helpfully light up when a dose was available, but that didn't stop me from jumping up and down on the damn thing in hopes of getting a more useful dose. The other "problem" was that the Dilauded made me too groggy, so I spent the first day and half barely conscious. Eventually, I was switched to Norco pills, which failed to fully alleviate the pain, but at least kept me aware of my surroundings. Considering I was still stuck in the hospital, I'm not sure that this was the greatest trade-off ever.

At some point during my stay, the IV started to really hurt at the insertion site. A nurse, whose sole purpose in life was to set up IVs, removed the current one and inserted a new one ON THE FIRST TRY. I was in love. Then I realized that the removed IV wasn't where the one from the hour of poking ended up. At some point during surgery or delirium, they had switched the IV location. In other words, I was on my seventh IV, and I had the black and blue marks and holes to prove it.

I spent the next couple of days in my hospital bed, occasionally getting up to pee when absolutely necessary. I was happily discharged after my fourth day of hospital food. The dogs were happy to see me, though confused as to why they weren't allowed near me. While I was happy to see them, I was more happy to see my own bed.

Today is Frankenboob Day, the national holiday in celebration of the stupid boob being replaced with a medical-grade balloon. Having been scarred for life by before and after pictures of the procedure, I can state with reasonable certainty that the result will be a frankenboob.

There is only one way to remove a boob, and that's with a rusty spoon. Boob replacement, on the other hand, comes in three flavors.

Option one is an expander, in which the surgeon puts a glorified balloon behind the chest muscle. After it has about six weeks to heal, they numb the skin and inject saline until the expander reaches the desired size. Then the expander is replaced with a silicone gel implant. If only one boob is being restored, the other one often receives a small implant to achieve symmetry in the perkiness department.

All breast implants go behind the chest muscles, otherwise they would slip down and result in a belly button boob. There is only so much existing room behind the muscle, which is why the expander is used. However, since an expander starts out small, their is an initial asymmetry. Plus an additional surgery to switch the expander for the permanent implant.

Option two uses a different muscle, the latissimus dorsi. The medically inclined may have noted that this is a back muscle, and most people prefer their boobs on the front. Well, the surgeons don't let that little detail stop them. The muscle is detached at the bottom, swung around to the front, and used to hold an implant in place. This creates a horizontal scar along the bottom of the muscle's usual position on the back. However, it creates an instaboob of the correct size, and the implant is not a temporary one.

The obvious drawback is that you lose use of that muscle. I am assured that people with this type of reconstruction don't miss the muscle, and that the other back muscles compensate for the missing one. Oh, and there's a large scar on the back. Sadly, the muscle is numbed so there is no accidental or purposeful boob flexing.

Finally, option three is a tram flap. There are four vertical muscles in the abdomen. One of these is rolled up and used to create a boob. Like with option two, the muscle is numbed and there is no ability to perform boob flexing. On the other hand, there is an instaboob without the no longitudinal scar on the back. But that's all moot as I do not qualify for this procedure. All the surgeons agree that I don't have enough belly fat to use, plus things would become messy if I were to get pregnant. That leaves me with only two options.

Option one is much less complicated, so there is faster healing. However, it does require a second, though fairly routine, surgery. Not to mention I'd have uneven boobs for a couple of months. Option two is more complicated and has a longer healing period, but the end result tends to feel more like a real boob since it uses more of the patient's own tissue.

Then there are considerations involving the implant itself. Generally, they last for somewhere between ten to twenty years before requiring replacement. The new silicone gel ones feel more correct that the saline ones, plus the gel is cohesive and will not leak out should the implant burst. Choosing the silicone gel over saline was the one easy decision.

After much consideration and discussions with four different surgeons, I have selected option one. Why start with the more invasive procedure, when I have a good shot at getting the desired results without rearranging extra body parts. Should things not work out well, they can always take out the implant and switch to option two with a different implant. On the other hand, once muscle is detached and numbed, it cannot be restored to its former glory.

Compared to choosing the number of boobs to remove, that was an easy decision. I still haven't made a decision on that front, and I very well may end up talking with yet another doctor. I figure if I talk with enough doctors, eventually they will converge on a number. Of course, with my luck, that number will be something like 1.47, which is as useless as it gets.