Not sure which was worse, having to wait 3 days to shower after being in a hospital with COVID-19, or seeing what was left of my breast that was surgically removed. Oh you guessed it, the latter. The anticipation of removing the bandages for three days caused a fair amount of restlessness and by day 3, substantial grief.
I was a humbly breasted woman my whole life, never identified myself with being busty. I am all about my legs! When I was diagnosed with cancer, my surgeon laid out my options: 1. Mastectomy the removal of the entire breast, followed up by reconstructing a new breast with the help of a plastic surgeon. OR 2. Lumpectomy, taking only the cancer out. As my surgeon put it, 'You will likely not end up with an aesthetically pleasing breast due to the amount of tissue that would need to be removed.' Due to the size of my cancer, a large chunk of my breast would need to get cut out, the breast would likely end up grossly malformed, especially as it would need to be followed up by weeks of radiation treatment to kill any remaining leftover cancer tissue. My husband and I discussed the options, read the many breast cancer books we had and I CHOSE Mastectomy. That choice felt instinctively the best, healthiest, safest option for me, plus I figured it would not be a big impact on my personal flat chested body image. But how could I possibly know this?
For weeks leading up to the surgery I did a lot of writing about how I may feel after surgery. Completed meditations and visualizations to practice seeing my body without a breast. It was always very emotional, but I knew I could handle it. The surgical plan was to remove the cancerous breast and on the same day begin the reconstruction of a new breast. I figured I would be without my original breast, which would be sad, but I would get to meet a newly reconstructed one. The process of 'immediate reconstruction' seemed like it would be easier to wake up from surgery with an expanded breast, placed there by a plastic surgeon, than to have nothing at all. But due to the complexity of my case, the amount of skin, fascia (muscle connective tissue) and larger size tumor than my surgeon expected, I was not a candidate to get the reconstruction of my new breast on the day they took my own.
The day of surgery, after waking up groggy out of the anesthesia, my nurse had me call my husband who could explain this to me. The surgeon had called Adam to inform him how surgery went (as he was not able to come to the hospital due to COVID-19 regulations). Adam was the one who informed me the reconstruction could not take place for the reasons above. This hit me hard for a second, but the joy of knowing I had negative margins (no signs of cancer left in my breast) and negative lymph nodes (no signs that cancer had spread), was a much bigger deal! This fact would have to give me strength in the next couple of days, weeks...
The night before I got to remove the bandage I was hit with waves of fear, regret, grief and sadness over my decision to remove my breast. I suspect I was feeling all the things that occur when you are mourning the loss of a loved one. DENIAL. ANGER. BARGAINING. DEPRESSION. ACCEPTANCE. I said a lot in the way of what have I done wrong? I am a kind person. I eat clean foods. I exercise daily. How did this happen...Cancer SUCKS! This sucks! THIS SUCKS!
Adam was smart, kind and patient to let me scream these things out. He agreed wholeheartedly, THIS SUCKS. I laughed, cried again, and cried a little more. It was all he could do, be there for me, hear me out, not judge my words and hold space for me. I was exhausted from the surgery. Tired of telling everyone I was doing okay, to make them comfortable, because I realized I WAS NOT COMFORTABLE. I was no longer interested in sitting in fake happiness, and fully let myself feel what ever I needed to feel. This lasted a few hours into the evening and eventually lulled myself to sleep.
The next morning came fast, waking up early, so ready to have a hot shower wash over my body, cleaning the sadness away. I woke, ready to greet the new body, see the wounds and take it all in. The process of removing the tape around my bandage was odd. As I did not have any sensation around the area (due to the normal damaging of the nerves by cutting into the skin), the removal was not like pulling off a band-aide. It was creepy painful to see the lifting and pulling of the skin, but have no awareness of the sensation. The skin got red, clearly irritated and shocked, but no pain. I began the process slowly, Adam helped remove the parts that were not in reach, behind my back, and the part around the drain coming out of my left rib cage.
This process felt very clinical, and I became very objective. It wasn't so bad I thought. I started noting things a Physical Therapist would note on an evaluation, swelling, muscle guarding, light bruising, good color around the incision. Oh and YEAH my NIPPLE was there!! Most alarming was the Jackson-Pratt (JP) drain tubing. The JP drain drain that is used at surgical sites to remove bodily fluids from collecting and causing problems like infection is essential and awful. It was in place for a week post surgery to collect excess fluids, at first 100cc/day, down to 7 cc/day when it was finally removed. FYI, the goal is 2 days under 20cc/day before the doctor will remove it, so you track this daily on a sheet you doctor will hand you!! Fortunately the removal of the drain is pain free and I can almost guarantee you will feel so much better when it is out! For me, once the drain was out I could move my left arm with less pain, walk more normally by swinging the left side, turn onto my left side during sleep. I noted huge quality of life improvements with the drain out!
I could see the JP drain, like a snake coiled up in my chest right under the surface of the skin. As all the fat and tissues of my breast are gone, my left chest is practically see through to the ribs.
The tube was horrifying to look at, and caused a great deal of sensitivity (I think you will see why in the photo to the right). I would say it sent out evil electrical signals when touched or brushed against. These evil signals I listened to, and they prevented me from 'doing too much' after surgery because it felt awful to do anything (even take a deep breath).
Once the bandages were off and I could get into the shower, Adam helped me rig up the long drain with a string (as they recommend to do in post-op instructions and all support books) to take the slack off. This allowed me a freedom to shower, attempt to use both hands to wash my hair. HA! My left arm still would't move from the side of my body so Adam helped me wash my hair. I could not lift my left arm from my side so shaving the armpit was not an option. What was most important was feeling the hot shower water rise the surgery off my skin, scrub of adhesive left form the sticky bandages, wash off the iodine that left my body with an orange tan! The shower washed away a little grief, but not much.
The process was physically and emotionally taxing. I remember doing a lot of sitting and staring out the window the rest of that day. But no more tears. I honestly felt like I was beginning to sit in a place of ACCEPTANCE of my current physical state. You can not force ACCEPTANCE, it will come to you with time, like the acceptance that a loved one is no longer with you, it could take years. This accepting state would wax and wane of course over the days, but I started to really see this new body I was in. Remembering fondly, I look so much like my maternal grandma now, with her single mastectomy she got far too young as well.