Up until this moment I already had had 2 surgeries: One for my port placement and one for my lumpectomy. I unconventionally had a lumpectomy prior to my mastectomy to see if my tumor was responding to chemotherapy. Good news was that I wasnt going to have a third type of chemo Adriamycin® (doxorubicin). I would continue on with my remaining infusions of  Taxol for a few more weeks and then Herceptin until next year.

Dec 2, 2011 The morning of my mastectomy is hard to remember. I do not recall being overly nervous. I knew the moment I was diagnosed I was going to have a bilateral mastectomy.  It was One of the few things I could  control with this diagnosis and I was confident that it would be the right choice for me.  I wanted the cancer gone. Some of my physicians thought lumpectomy with radiation would be a better option for me given how young I was  and for esthetic reasons but I couldn’t stand NOT  doing as much as I possible could do to get this cancer gone. The even better news I would later get was when the pathology came back from the mastectomy that a second cancer in a different location had been identified and removed thanks in part to my decision to have my breast amputated. I know that sounds harsh but its what happened, mastectomy just makes it sound less barbaric but  truly it’s not.

I had a  Nipple Sparing Latissimus Dorsi Mastectomy with reconstruction. Latissimus dorsi (LD) flap is a type of breast reconstruction surgery. It uses muscle and skin from the upper back that is pulled under the skin to the chest area.  Your latissimus dorsi muscle is located in your back, just below your shoulder and behind your armpit. An oval flap of skin, fat, muscle, and blood vessels from your upper back are used to reconstruct the breast in a latissimus dorsi flap procedure. This flap is moved under your skin around to your chest to rebuild your breast.  The blood vessels (artery and vein) of the flap are left attached to their original blood supply in your back.  This procedure would offer me a better support for the implant that would take the place of my breast tissue.

The nipple sparing component of this surgery would be the only real unknown at the time of my surgery. Both my surgeons warned me that it was a real possibility that I would not be a candidate for this. They would have to see the proximity of the tumor to my areola and subcutaneous nipple tissue.  During surgery , with the assistance of a new technology my breast surgeon would do on-site pathology of the nipple tissue to see if there was any infiltration of cancer or atypical cells. Thankfully there was not and I retained my girl bits! I would have tissue expanders in place  during  surgery in place of  where my breast had once been.  The technique for breast reconstruction uses a flat expandable prosthesis called a Tissue Expander,  which was placed beneath my pectoralis major muscle during the mastectomy, this procedure would be part of the “reconstruction process”.  These Tissue Expander’s would be slowly  and painfully inflated over  the next  few months, and then I would go back into surgery where my permanent implants would be placed. These tissue expanders would stretch the pectoralis muscle and skin in preparation for the new implants. That part would be yet another surgery!!!

my sister-in-law Amanda

I remember walking up from my surgery: The hospital room was dark, hadn’t it been morning when I went in? Yes but that was 9 hours ago. Yes 9 hours of surgery. Imagine if you will being in surgery for that long…. ???? That requires no further comment.

So my first moments of consciousness where confusing, hopeless and painful. So painful I have a distinct memory of asking God why he was making me suffer so much. I asked… no I prayed that he would just take me at that moment… I told him I was ready to go. The pain in my chest, down my back was excruciating I felt like I had been ripped apart. Please God, I am ready,  take me away, make this pain stop…. please I surrender,  that is what I prayed.  I looked around my hazy fog, I  had tubes everywhere, I had no strength, very little will, and sadly could not even  sit up by myself. I was sliding down and I prayed again please take me away and make it stop. The pain was indescribable.

Later I would be made better through the power of pharmaceuticals… Yes my new best friend was my morphine pump! Crank her up and let it ride!!

I think the reason survivors of breast cancer and surgeons don’t  really talk about the post op part of the mastectomy is because it’s so incredibly painful to relive and gruesome to describe. There is nothing pretty or pink about this part of breast cancer… remember that!!

Check out my busted lip: That is thanks to my anesthesiologist it happened when they flipped me on  my stomach in surgery to do the surgery on  my back.

I was so drugged up I kept getting angry with my surgeons wondering why they hadn’t stopped by to check on me… Oh really what do you say, they have been by twice…. hmm that I did not recall. I will quit my b*tch’n now. Dont mess with me I’m medicated!

Nothing says you look like you could use a prayer more than a morning visit from the hospital clergy. My friends Maureen and Travis had a little holy communion and prayer. uh oh the big G-O-D must have gotten word and sent his troops. Faith restored

I was discharged from the hospital 5 days later. I went home busted and bandaged. I spent the next  several weeks in terrible pain, horrible back spasm, no upper body strength  and the inability to do anything by myself.  Thank God for my brother, dad and especially my angel… My MOM!!!

So when I left the hospital I carried around what I affectionately termed ‘my grenades’. Which were really the drain tubes for my mastectomy which were vessel for the accumulated fluid and blood monkeys in my incisions. I lost one 3 weeks after surgery but my other 3 pets stayed around for a few months. They became like pets, they are literally stitched into your skin and the tubes traveled to my back incisions and to my breast incisions. The tubes are long but time afer time I would catch these dam things getting dressed or moving about. The funny thing was that you had to “strip the tubes” . It  is a process that required you pinch the accumulated gunk in the long tubes and pushed it into the little grenades.  This became a favorite pastime with my sister-in-law, brother and mom.

These little suckers where hard to conceal, so big hoodies and jackets with inside pockets that held my post surgery paraphernalia was essential.  I already had a bald head there was no sense in attracting anymore attention to myself with these tubes coming out of everywhere.

Reconstruction part 2: March 2012: Happy Birthday to ME!

During this surgery I would have the painful and nuisance expanders  removed and my new silicon breast would be implanted by my amazing plastic surgeon  Dr. Fabian. I could not wait I was one step closer to all the kings horses and all the kings men putting Kimberly back together again!

December 22, 2012: How do you start the new year 2013… Oh yeah recovering from yet another surgery

I had issues with the implant and skin thinning. Dr. Fabian went back in to place Alloderm to support the breast implant where the skin was thinning.  He also had to loosen up the latissimus muscles which because of muscle memory were trying to migrate  their way back to their  comfy home in my back. Seems weird but the body is an amazing thing.

Alloderm is a collagen matrix that is acellular in nature. That is to say, it is cadaver skin that has had all the cells taken out of it, and just leaves the collagen behind. It is like having a shell of a building there, without all the walls, furniture, and people living inside. This makes it easy for your own body to incorporate your own blood vessels and tissue into the Alloderm.

My lucky socks! These socks  illegally accompanied me into  every OR!!! Good luck Contraband!!