They’re even at last!

Monday was my final final final *crossing my fingers* surgery. Going into it, I felt a little like Veruca Salt. “I want perfect boobs Dr. Festekjian and I want them NOW!” “Festekjian…how much do you want for the perfect boobs? Name your price!” (I guess the answer to that will be arriving after the insurance adjustment in a few weeks!)

But really though. I did feel a bit…oh what should I say…spoiled? After all, I emerged from November’s implant exchange surgery with a pretty decent rack. After the swelling went down and I let things settle in for a month or two, I realized they were a good size and shape. But they weren’t perfect. And perfect is what I wanted, because, well–why not? After all of this–a mastectomy and an infection and reconstruction and all of these surgeries in the name of not getting breast cancer–I might as well get exactly what I want.

The main problems were the unevenness in nipple height and the rippling on the right side. But even the week before the surgery, when I sent an updated photo to a blog follower, she said they looked great and she thought I had already had the surgery to adjust the nipple height! For a moment there I considered canceling the surgery because I didn’t want to push my luck.

But…obviously I didn’t cancel it, and I’m sure glad I didn’t.

Per my usual routine, I spent all of Sunday chugging water like a crazy person to prepare my tiny veins to be poked and prodded. My mom picked me up from my apartment at 6:00 am on Monday morning. Jeani, bless her heart, had scheduled me for the earliest appointment because of the snafu that happened last time.

I checked in at the outpatient surgery center, changed into the sexy hospital gown and matching accessories, then chatted with a nurse. It’s kind of strange when you start to recognize the doctors and nurses…I’m pretty sure this particular nurse, who has been a vegan for over twenty years and always eats salad for lunch, has checked me in three times.

The most miraculous thing happened next. Brace yourself, because what you are about to read may rock your world and make you question everything you know.

A nurse anesthetist came in to talk to me about the anesthesia cocktail and start my IV. She was young, kind…unassuming. Little did I know of the POWERS SHE POSSESSED.

As is custom, my mom and I launched into our tirade about my horrible veins and the atrocities that have befallen me at the hands of IV nurses and anesthesia doctors alike in the walls of the UCLA Medical Center: the constant pokes, the unyielding veins, the need to “call in the big guns” and of course, the multiple PICC lines.

UNSCATHED by these warnings, the young nurse did persist with a smile. “I’ll have to numb you up then!” Haha, you fool! Numbing medicine will do nothing but make my uncooperative veins further retreat into the depths of my wrist/hand/arm/foot/every other part of my body, I mused as she left the room.

Moments later she returned carrying a tiny needle and an IV kit. As she stationed herself to my left, the noble Dr. Festekjian appeared, clad in a red track jacket. As we exchanged the standard hellos, the young nurse poked me with the numbing needle, warning me of a slight sting. “‘Twas nothing”, I murmured.

Then she started the long, daunting process of stabbing me with the IV needle to find a vein. I settled in for the long haul, turning my attention to Dr. Festekjian, when suddenly…within seconds…the voice of an angel rang out.

“All done! Your IV is started.”

A MIRACLE. It took her only ONE TRY, only ONE MEASLY POKE, to start my IV. I wanted to hug her, become her best friend, then follow her around from place to place for the rest of my life so she can always be the one to start my IV.

I was giddy with excitement at this point, but tried to remain steady while Dr. Festekjian played Connect the Dots on my chest with the pretty sterile pen. I figured that if I moved too much and the lines were uneven, it would be my own damn fault if my nips still looked lopsided.

A few minutes later the happy drugs were put into my IV, I was wheeled into the operating room, and then I was out. By 10 am I was awake in the recovery room, and I was discharged by 10:30 am.

Wisely, Dr. Festekjian warned my mom that I would be very bruised and very swollen for a while, possibly with some dimpling. I’m sure he was hoping to avoid the “WTF!” email he received last time. Even with the painkillers, I could definitely feel a dull soreness on my right side where he did all of the work. Even the arm fat near my armpit was super bruised.

I stayed home from work yesterday and today and took a shower this morning. I’m on antibiotics for a few days, and I’m definitely swollen; my right breast looks about one cup size bigger than the left breast, like I have a 1000 cc implant in there instead of 800 cc. And there is certainly some dimpling, mainly where the stitches are holding the skin up. But the nipples sure seem even and the alloderm seems to have gotten rid of the rippling, so I can’t wait to see how they look in a week or two!

My post-op with Dr. Festekjian is on Tuesday morning. I feel okay right now, still a bit sore, but I’ll be returning to work tomorrow. I did go on an hour-long walk this evening to stretch my legs, and that felt great. Hopefully I’ll get permission to head back to the gym next week. Interestingly enough, I am using my pit pillow again. It works well to support my arm when I’m on my computer and when I’m sleeping. Thanks again to my friend Kim who originally introduced me and my mom to pit pillows!

Pictures soon. Right now I’ve got them tucked up nicely in a sports bra so I don’t really feel like digging them out of there.

Instead, I leave you with a photo of the Chester Bug, keeping me company while I worked from home today. Isn’t he just the cutest little kitten? (Yes. I’m that person now. #instacat #catstagram #ilovemycat.)

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At last, a surgery I can actually call “cosmetic”

Greetings!

First off, I want to thank all of my readers for supporting Young Previvors after our Facebook trouble a few weeks ago. Our original group has not been restored yet, nor have we heard anything from Facebook about why the group was deleted. We have, however, started a new Young Previvors group. Our admin, Liz, continues to do a phenomenal job of screening all potential new members, so if you are a previvor or a high-risk young woman, consider joining us. You can email me or search for “Young Previvors” on Facebook.

Things have been uneventful in my world of breast reconstruction, but they’ll pick up a bit in a few weeks. My final-final-final-last-one-I-seriously-promise-you’ll-never-have-to-read-about-it-again-unless-it-looks-ugly surgery is on Monday, February 25. Dr. Festekjian will be doing some minor cosmetic adjustments.

When I saw Dr. Festekjian at my two-month post-op a few weeks ago, I was still concerned about the difference in height between my nipples. Although they’ve certainly improved since my initial implant exchange surgery, the right nipple is still noticeably lower than the left.

At the appointment, Dr. Festekjian asked me point-blank which side I like more. I told him the left side, and to my relief, that was the acceptable answer. He can make my right side match my left side, but because of the extensive work he did on my left side during the implant exchange surgery, he can’t make the left side match the right. Unless, he joked, I get an infection on the right breast. Har har har. Funny.

In the outpatient surgery, he will lift up the right nipple and put some internal stitches in place so it sits higher. He will also add a layer of alloderm underneath my skin, to cover up the rippling. I plan to take a few days off work, but given my quick recovery from the past surgeries, I expect to be back in the office by Thursday. Watch…now that I’ve said that, I’ll have some horrible allergic reaction to the ice cubes in the recovery room and be bed-stricken for the next two months.

Okay, moving on: I have some very important and exciting news to share with everyone. I’d like to introduce you to Chester Frito Horn, my new furry child.

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He’s an 18-week-old American medium hair. I officially adopted him from the animal shelter at 11:30 am on Saturday morning, then promptly sent him across the street to the vet surgery center to have his balls removed. Sorry, bug…YOU’RE IN MY WORLD NOW.

I picked him up this afternoon and he seems to be doing just fine. Here he is, Cone of Shame and all. He is now, in my parents’ words, a consultant.

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Cat people: how can I get him to stay off of the kitchen counter? I’m scared he’s going to set his tail on fire with the pilot lights on the stove!

Have a fantastic week, everyone. Happy Valentine’s Day!

 

A helpful tool for assessing cancer risk

Good morning, everyone. I just wanted to pop in and share with you all a nifty little tool from Stanford University, called the BRCA Decision Tool. If you are BRCA 1 or BRCA 2 positive, this calculator could help you assess your cancer risk.

According to the Stanford website, this tool: “calculates the probability of health outcomes for women ages 25-69 who carry a BRCA1 or BRCA2 mutation, and who have never had the following: 1) cancer; 2) screening mammograms or magnetic resonance imaging; 3) preventive surgery to remove breasts, ovaries or fallopian tubes; 4) preventive medications such as tamoxifen or raloxifene.

Obviously, you should NOT take this tool’s information as the final word in your cancer risk, but it’s sure helpful and makes it a bit easier to understand your individual risk. I found it very beneficial when thinking about my risk of ovarian cancer. I am BRCA 2 positive and honestly didn’t know too much about the correlation between BRCA 2 and ovarian cancer. I know that my mother had a prophylactic oopherectomy at age 58, but I had no idea when I should start thinking about my own preventative surgery. Obviously I’d wait until after I have kids, but at what age would I be pushing the envelope?

BRCA Decision Tool

The above screencap shows my results. The age minimum is 25 but I am only 22, so I just went with it and pretended I had my mastectomy at 25. I’m breathing a small sigh of relief seeing those numbers. While I still plan to be diligent about screening starting around age 25, at least I can enjoy knowing that my ovarian cancer risk is much lower than what my breast cancer risk would have been had I not done the prophylactic mastectomy.

This tool was brought to my attention at a recent FORCE meeting in Santa Monica. It was a great meeting–the Young Women’s group met for the first time. And I got to see Trisha as well as a few of my blog readers! Incase you’re all wondering, Trisha looks fantastic.

On Thursday I have my two-month post-op appointment with Dr. Festekjian. Details to come, but for now–off to work!

 

Wrapping up 2012 and welcoming 2013

Hi friends! I hope you all had a great holiday, whatever you celebrate. Over here at the law firm of Horn, Horn & Horn, we celebrate Hanukkah and Christmas.

It’s been more than a month since my implant exchange surgery, and I am much happier with how the implants have settled in. There is still some difference in nipple height, but I think the breasts have evened out  in size and look much more similar.

People have asked me what size I am now. The answer? 14.2 cm 800 cc–duh, obviously.

Don’t worry. I get it. Unless you’re Dr. Festekjian, that means nothing to you. It doesn’t really mean much to me, either. While Christmas shopping at Target a few weeks ago, I bought a cheap bra on a whim. I tried on three different sizes: 36C, 36D, and 38D. The 38D bra fit the best, so right now that’s my size, but I will go to a professional to be fitted soon. (And FINALLY use the Victoria’s Secret gift card my dear friend Anna gave me right after my mastectomy–whoohoo!)

I’ve been dressing up a lot and I love it. If you know me offline, you know that I prefer comfort over style. My weekend uniform consists of yoga pants, a tank top, and sneakers. Sometimes I shake things up with a sweatshirt if I’m feeling daring (or cold). But since I have these brand spankin’ new boobs, I’ve been looking for an opportunity to show them off! Luckily, this holiday season did not let me down.

At the beginning of December, I went to Vegas for my sorority sister Cami’s bachelorette party.  My favorite thing about going anywhere with sorority sisters is that we all share clothes. On Friday night, I wore one of Jennifer’s dresses and I actually had CLEAVAGE for the first time since March! Sorry, Bryce.

The next weekend was my company’s holiday party at the SLS Hotel in Beverly Hills. It was amazing. There were EEL TACOS. EEL FREAKIN’ TACOS. I used that magical Forever 21 gift card to buy a cute strapless dress for the party, and I even got to wear my giant heels because Bryce is 9 1/2 feet tall!

SLS hotel party

“Hey Bryce, how’s the weather up there?”

AND THEN…Cami and her fiance Nick got married this past Saturday! Their wedding was at the Balboa Bay Club in Newport Beach. It was a small, intimate ceremony. Cami looked beautiful! Nick is a lucky man.

I wore the pink dress I wore to my graduation dinner in May. The only difference was that this time I had two boobs! Last time I had one tissue expander and one falsie. I think I prefer the two boobs.

Sorority sisters! From left to right: Jennifer, Marissa, Cami, Danielle, Rachel, Nora

Sorority sisters! From left to right: Jennifer, Marissa, Cami, Danielle, Rachel, Nora

Clearly, I’ve come a long way in my crazy mastectomy journey. But it’s not over yet. I like my implants now. I think they are a good size and they look and feel natural. However, I’m not in love with them.

Should I go back to Dr. Festekjian and ask him to do more work on them? Maybe. Probably. But even then, I won’t be IN LOVE with them. Because I am not IN LOVE with the rest of my body! Until I am completely happy with how everything else looks, I’ll never be 100% satisfied with my implants.

So 2013 is going to be about changing my body the difficult way…without plastic. I’ve struggled with my weight all my life. (Literally, all my life. I learned over Christmas that I weighed over NINE POUNDS when I was born. HOLY SHIT.) Anyway, 2012 was one of those struggle times because of the mastectomy. Now it’s time to get back into shape.

"Stop right now, ma'am! Put the spoon down and back away slowly."

“Stop right now, ma’am! Put the spoon down and back away slowly.”

Here are some of my goals for the new year:

  • Develop some upper body strength. If my arms look toned, my implants will look better. I am going to keep seeing my physical therapist Jenni to learn how to do this safely.
  • Get my abs back. Believe it or not, for the first half of high school, my stomach was really toned. I did Pilates all the time and it really worked! Then, for whatever reason, I stopped. And on came the flab.
  • Get back into spinning. It’s my favorite workout, because it’s effective, and everyone looks like shit afterwards. I know that sounds harsh, but I’m a sweater; no, not a cardigan–someone who sweats a LOT. I hate working out at the gym next to girls with immaculate hair and makeup who look amazing the entire time. NO ONE looks good after 45 minutes on the stationary bike at a spin class.
  • In addition to spinning, I want to try more cardio. I am going to join a local gym, probably the YMCA, and I plan to take advantage of the classes offered. Dance Aerobics and Zumba both sound pretty fun to me.
  • Eat out less and cook more (good for the waistline and the wallet!). I need to learn how to cook and be more adventurous with my meals. A few weeks ago, a friend made Bryce and me enchiladas for dinner. He put spinach and mushrooms in mine because I’m a vegetarian. They were DELICIOUS. I would have never thought to put spinach in an enchilada…it was life-changing
  • Buy a castle.
  • Appear on Jeopardy.
  • Win Jeopardy.

I’m not sure yet how I am going to measure my success. My friend at work, Garineh, had a similar New Year’s resolution for 2012.  She wrote a blog post on eHow with tips for keeping a resolution. I’ll develop my actual numerical goals based on some of her advice.

One thing is for sure: once I meet my goals, I will have Michelle Obama’s arms, Gwen Stefani’s abs, Wolfgang Puck’s skills, and Warren Buffett’s wealth. (Yeah, that’s how often I eat out now and how much I plan to win on Jeopardy!) Oh and this castle.

What are your goals/resolutions for 2013? Happy new year, everyone!

Settling down, physical therapy, and a little bit of Pam Anderson

Let me start with a huge THANK YOU to the wonderful people who congratulated and endorsed me for the WeGo Health Rookie of the Year Award. Your kind words, thoughts and support always make me grateful. Nominations end December 31, and judging follows shortly. I will keep you all posted, and if you would like to endorse me or share my endorsement link with someone else, here’s the URL: http://badges.wegohealth.com/endorse-me?referrer=f7fq%22

It’s been exactly three weeks since the “big unveiling” after my implant exchange surgery. You’ll remember that I was less than pleased with what I saw in the mirror: my left nipple seemed to be about twelve feet higher than my right nipple, and all together the left breast appeared much smaller and tighter. I never thought I’d end up with a rack like Pam Anderson’s after the surgery, but I also didn’t think I’d end up looking like a little kid playing dress up with socks and tissues in her mommy’s old bra.

Hey…I’m a vegetarian too…maybe my boobs WILL end up looking like Pam’s after all!

Dr. Festekjian told me to give it time to settle, even going so far as to suggest that I STOP thinking about my breasts for a while. Fat chance, Dr. Festekjian.

Well I have to give the man credit–he was right. The left breast has settled a lot, looking rounder and less tight, and the nipples are also much more even. Dr. Festekjian said to wait two months, but it’s not even one month after the surgery and I can already see a big difference!

I guess he does know a thing or two about plastic surgery. He’s more than a pretty face, you know.

At my post-op appointment after the implant exchange surgery, he wrote me a prescription for physical therapy. I researched offices in the area that accept my insurance and landed on a place nearby called Women’s Physical Therapy.

In addition to standard sessions with physical therapists, Women’s Physical Therapy offers massage therapy, Pilates and yoga. They specialize in breast cancer rehabilitation, including post-reconstruction.

My first appointment was Tuesday, December 4. I met with a PT named Jenni. As it was an introductory session, we spent a fair amount of time discussing my mastectomy, complications, and ultimately reconstruction, as well as my goals (get strong in a healthy, safe way) and current exercise plan. Then she took some baseline measurements and stretched me out. The stretching was almost like an upper-body massage; she did a lot of kneading. Knowing that my left implant needs to drop and settle, she showed me stretches I can do at home to help.

Jenni then assigned me some resistance band exercises to work my triceps, biceps and shoulders. I’m supposed to do them every night, and right now they are so simple (just one set of 10 reps) that it takes less than five minutes.

I’ve met with Jenni twice, and I also had an appointment with the Pilates instructor, AnnaLisa. In high school I did mat Pilates DVDs all the time. (Side note: if you are ever in the market for a Pilates DVD, pick an Ana Caban series. AVOID MARI WINSOR LIKE THE PLAGUE SHE IS SO ANNOYING.) This Pilates session was NOTHING like the Pilates I remember! Nope…there was no Seal, no Corkscrew…not even a measly Roll-Up!

Instead AnnaLisa had me focus on very small movements using my muscles in ways I’ve never tried. There was no cardio involved, yet I felt like I did get some sort of a workout. It wasn’t easy! Who knew drawing circles in the air with my elbows could be so tiring? Oy, I was exhausted after!

After my sessions I’ve felt a bit sore, but it’s not alarmingly painful. It’s almost more of a pleasant indicator that the sessions are working and that my upper body muscles are being stretched out and strengthened just a little bit each day.

I have another session with a physical therapist on Friday, and then a few more next week. My schedule is spotty since I signed up with the office so late in the year and I can only stop by in the early morning or late afternoon. Hopefully I’ll be able to set up a steady plan for 2013.

Speaking of 2013, what’s everyone doing for New Year’s and the holidays? Bryce and I are going up to Yosemite for Christmas, where we’ll see my parents and my cousin Justin. Then we’ll be celebrating New Year’s in Redondo Beach. But before all that there’s my company holiday party this Friday night. I stumbled upon a Forever 21 gift card in my wallet (lucky find), so I’m going to treat myself to a new dress for the party–my first since the implant exchange surgery!

Well, I’m signing off. It’s bed time! Now if I could just pry this giant sleeping baby off of my lap…

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I’m sorry Bryce, I had to do it. You just look too cute in that onesie.

Ten days after my implant exchange surgery

It’s been ten days since my implant exchange surgery. I admit that I originally planned to post about it much sooner, but emotions took me by surprise and I decided to wait a bit longer. Details about that to come later in this post.

My implant exchange surgery was at the UCLA Outpatient Surgery Center. I was told to arrive between 9:30 and 10 in the morning. I got there on time and completed the necessary paperwork after changing into the lovely surgery garb. Then I waited. And waited. And waited. By 11:45 am, Mom and I were rather annoyed. We were told that Dr. Festekjian was still in surgery from an earlier case.

It’s frustrating…but there’s nothing you can really do in that situation. If some sort of complication happened during my surgery, I’d want Dr. Festekjian to care about fixing it instead of trying to rush so he could get to his next case.

Finally Dr. Festekjian came by around 12:30 pm and drew all over me in marker. My chest looked like a game of Connect the Dots. Then the anesthesiologist stopped in to ask me a few questions and to start my IV. If you’ve been following my blog, you know about the IV drama. Well, the saga continued with this most recent surgery:

I mentioned to the anesthesiologist that I have very bad veins. After much prodding and examining, he informed me that “whoever said you had bad veins was wrong; you have NO veins.”

Well, shit.

He first tried my left hand. The needle went in and he poked around for a while but couldn’t get into a good vein. Ouch. Then he got wise and gave me a numbing shot, got down on his knees and poked my left wrist. After a few minutes he struck gold. Rejoice! No more poking. After he finished, he remarked that I could now put it on my CV that I “bring doctors to their knees.”

My veins really piss me off. Let me just rant for a minute: WHY ARE THEY SO AWFUL?! The day before my surgery I drank more than 80 ounces of water just to plump them up. And it was all for naught, because I still had to get stabbed multiple times! BLEHHHHH.

After the IV fun, I was wheeled into the operating room. That’s always a strange experience, because the anesthesia sleepy medicine has just been administered so I start to feel a bit giddy but I’m still coherent. Also, the operating rooms are never what I expect them to look like. I guess I’ve seen too many dramatic operating room scenes on TV.

Well I guess I conked out, because a while later I woke up in a recovery room to the sight of my friend Dustin, a first year UCLA medical student. Dustin and I went to high school together. He stayed with me for about 45 minutes, which was nice because it forced me to stay awake and to come out of my loopy state.

I was discharged around 4 pm and at my parents’ place in Redondo Beach by 5:30 pm. Bryce had a nice cold Jamba Juice waiting for me, and my mom whipped up some tomato soup. Yum. (I could really go for that right now, actually…)

All in all, the surgery process and immediate recovery was very reasonable. I did not take any narcotic pain meds (Tylenol was fine), and I could move around the house with relative ease.

Wednesday morning was the “big reveal,” the first time I would see my implants after surgery. I woke up early, excited to see them. I stood in front of the bathroom mirror, eyes closed, while Mom helped me cut off the ace bandage bra. The bandages were removed…I opened my eyes…and…

bleh. Bleh bleh bleh. I was not happy. My new breasts looked completely uneven. The left side was small and tight, while the right side seemed large and droopy. The nipples were no where near even. North and South Pole!

I stared for a while and then started to get emotional. Mom snapped some pictures and fired off a distraught email to Dr. Festekjian. I texted Bryce a very cryptic “my boobs look bad I’m sad leave me alone” kind of text, posted a quick “OMG” message to the Facebook previvor group, then cried myself back to sleep.

A few hours later I woke up to a reply from Dr. Festekjian and a bunch of comforting messages on Facebook. Apparently I was the only person in the world who did not know that you cannot judge the implants’ appearance immediately following surgery. Things are swollen, bruised, tight, uneven. They need to settle, and that takes time–weeks to months, even.

In addition to his email reply, Dr. Festekjian called later that day. He explained in detail that my left side had more scar tissue from the infection, so he did much more work on that side. Over time that side will drop and adjust to match the right side.

Well…that makes sense. The more he explained, the more I understood. He said he was still very happy with the results and could see symmetry in the breast folds. I don’t particularly know what that means, but a happy Dr. Festekjian is never a bad thing.

The reason I didn’t post on my blog that day or even the day after is that I didn’t want to be too emotional and scary. Emotion is good–and it’s honest–but I didn’t want my uneducated, post-surgery freakout to worry someone else who might be having the surgery. I hope that makes sense.

Yesterday I had a post-op appointment with Dr. Festekjian. Already he can tell that the left side is settling more. He said I should give it about eight weeks to relax into place, and that my right side will not drop anymore. We discussed options for after that eight weeks is up, incase I’m still not happy with the results. Fat grafting could be done to fill out “bumpy” areas (such as underneath the breast) and nipple alignment could also be adjusted. Insurance will cover those procedures since they are still a part of breast reconstruction.

I’m very pleased to know that I have options in the near future if I’m still not happy. But for now I’ll try to give it a rest and let nature take its course. Dr. Festekjian advised me to “stop thinking about your breasts for a little while.” I’m not so sure I’ll ever be able to do that, but I’ll try.

For now I leave you with these two comparison shots of the tissue expanders and implants. The implant shots were taken this evening. Also, if you are interested in seeing a comparison shot without the sports bra, send an email to rachel@tickingtimebombsblog.com. If I determine that you are not a creepy spammer/stalker, I will send you the pic.

 

My implant exchange surgery is on Monday!

That’s right. You read that correctly: I GET MY SILICONE IMPLANTS ON MONDAY.

I’m going to be honest with you–that’s something I never in a million years would have expected to ever say, write or even think in my life. Me? Breast implants? Nah, never, not for me…but it’s happening! I’ll eat those thoughts with a fork and spoon (just not after midnight on Sunday).

After more than one year since finding out about my BRCA mutation and more than eight months since my original mastectomy, I am finally going to be done with surgery.  I almost don’t believe it’s real, but it is–two breasts, four Jackson-Pratt drains, three tissue expanders, one cellulitis infection, two falsies and many wireless bras later.

I had a pre-op appointment with Dr. Festekjian on November 8. He told me my implants will either be 700 ccs or 800 ccs, most likely Natrelle style 45 silicone. A few posts earlier I said that I probably wouldn’t get those implants because they’re very narrow, but Dr. Festekjian knows that I am most concerned about projection and they offer the highest projection. The total size of the implant (700 vs 800 ccs) depends on the width he needs to cover (13.5 cm or 14.2 cm).

At this point I’ve really stopped worrying about what size my implants will be. I trust Dr. Festekjian’s judgment completely. He did such a good job with my tissue expanders; people are always surprised to find out that my tissue expanders aren’t actually my permanent breast implants.

The night before my surgery I plan to take some photos of my chest with tissue expanders. I really want to create a visual of the different “stages” of breast reconstruction. The final stage photos won’t be ready for a few weeks since there will be swelling after the surgery.

Sigh. It’s happening. Finally.

Final fill update and implant exchange surgery scheduled

I’m the worst blogger, I know. I’m sorry. I moved into my new apartment in September and I still don’t have Internet, but I don’t want to get it until I get a TV, which should be around November 10. For now, I have to mooch teh Interwebz off of work and my friends. But it is really awkward to post a new blog entry at work, when all of my blog posts have pictures of my boobs. It just doesn’t seem like the best idea, you know?

Let me update you on my breast reconstruction status: I had my final tissue expander fill with Dr. Festekjian on October 4. He filled each expander up to 700 ccs of saline. My expanders can hold up to 750 ccs, but Dr. Festekjian discouraged me from filling anymore. He said that the expanders already felt very firm and that the skin was tight, so more saline could be painful for me.

Stopping at 700 ccs was fine with me; I’m (at last) happy with the projection of my tissue expanders. You can’t see much of a difference between 650 ccs and 700 ccs, but here’s a comparison:

My implant exchange surgery is set for Monday, November 19, which is the Monday before Thanksgiving. I’ll be taking Monday, Tuesday, and Wednesday off work, then Thursday and Friday are vacation days. I should be back to work the following Monday.

Here’s me and my 700 ccs of saline on each side!

Last Wednesday was Breast Reconstruction Awareness (BRA) Day at UCLA Medical Center. I went with my mom and Bryce to show some love for Dr. Festekjian. I’m actually really glad we went; I didn’t think I’d learn much, but I asked Dr. Da Lio (another plastic surgeon) about the differences between silicone implants and “gummy bear” implants.

I’ve been hearing a lot about gummy bear implants lately, and I wanted to know what was so great about them. Dr. Da Lio told me that UCLA does offer gummy bear implants (a form of very dense silicone implants), but they are not yet approved by the FDA so patients who opt for them must participate in a study. He said they’re firmer than silicone implants and that they retain their shape when cut. But the negative is that they are not a perfect circle (unlike other implants); if they flip around under the muscle, the breast shape will change. They are not guaranteed to flip, but Dr. Da Lio said that upper body exercise could make it happen. I like to kayak and I want to get into weight lifting, so the risk of gummy bears flipping is there for me. Silicone implants it is!

I’ll be going in for a pre-op appointment with Dr. Festekjian on November 8. I already know that he is going to order a few different sizes of silicone implants for me, but hopefully he’ll give me some idea of the actual numbers and sizes.

Once my implant exchange surgery is done, I should be finished with surgeries. Since I had a nipple-sparing mastectomy, I don’t need to worry about nipple tattoos. But when I was at BRA Day, I met a tattoo artist named Ruth Swissa who does medical tattoos for breast reconstruction patients. Her work was AMAZING! She had a bunch of temporary 3D nipple tattoos. They looked SO REAL. She had one on her arm and if I didn’t know anything about mastectomies or breast reconstruction, I would have been really freaked out by it because it really did look like she had an oddly-placed nipple! To any of my readers who are going to have nipple reconstruction: email me if you want a few of the nipple tattoos! I snagged some and would gladly mail a few to you.

OK, I’ve been mooching off of my friend’s Internet for too long. Happy Halloween, everyone! I leave you with this picture from Saturday evening of Bryce and me. Can you guess who we are?

The FORCE meeting, another fill, and the Pan-Mass Challenge Teen Bike Ride

Is it really Sunday evening already? Where did the weekend go?! (Note: It’s now Monday and I am posting this while at work since I don’t have access to the Interwebz at home!) Well, now’s the time for reflection…starting with last weekend!

Last Sunday I attended a FORCE meeting in Agoura Hills. FORCE (Facing Our Risk of Cancer Empowered) is an organization focused on hereditary breast and ovarian cancer. There are chapters all over the country, including a few in Southern California. Until last week, I’d never attended a FORCE meeting.

There were about twenty women present, as well as a few brave husbands. We spent some time mingling and getting to know one another. Trisha was there and since I felt like the awkward new kid, I stuck to her. But I did make some new BRCA friends, too! Finally the guest of honor arrived: Dr. Karam!

If you’ve started reading Ticking Time Bombs recently or you’re a veteran reader who hasn’t been taking copious notes on every post, you might need a quick lesson on Dr. Amer Karam. I always talk about Dr. Festekjian, my plastic surgeon, but he is only half of my mastectomy dream team (I bet you didn’t know there was such a thing!). Dr. Karam is the breast surgeon who performed the first part of my mastectomy in March, removing all of my breast tissue. His official title is gynecologic oncologist; he performed my mom’s oophorectomy in February. We Horns really do like to keep things in the family.

With Dr. Karam’s arrival, we started the actual meeting. First there was a round of introductions; most people shared their name, family history of cancer, BRCA status, and if they have had or are planning to have any surgeries. There were a fair number of women who had already undergone prophylactic mastectomies and oophorectomies, but there were also quite a few who were just beginning to consider surgery.

Check out Dr. Karam’s red shoes…he’s a breast surgeon with impeccable fashion sense. (Photo borrowed from Trisha.)

The Q&A with Dr. Karam was very random and tangential. It seemed that one person’s question would inspire a new question from someone else, and we sort of bounced around the room for a few hours going from question to question. To be honest, all of the talk about breast cancer bored me—it’s really not on my radar anymore since my mastectomy! But I did find the discussions about ovarian cancer and breast reconstruction very useful.

Dr. Karam is a fantastic resource and I think he helped a lot of women at the meeting. He knows how to explain complicated scientific concepts in much simpler, easy-to-follow ways. I felt very proud to tell people there that he was my breast surgeon! It was almost a sort of “hahaha my breast surgeon is better than yours neenerneenerneener sticking my tongue out at you” moment.

The best part of the FORCE meeting was the breast reconstruction “show and tell” at the end! I felt relieved that my tissue expanders looked similar to those of other women at the meeting. And I got to see someone’s “finished product” which made me even more excited for my implants—hers looked amazing! A few of the ladies who are considering prophylactic mastectomies were very impressed by what they saw…my tissue expanders included. I think it’s very helpful and reassuring to see that the final outcome of a horrendous surgery can look so fantastic.

On Wednesday morning I had a tissue expander fill with Dr. Festekjian. I’m now up to 650 ccs of saline on each side, and I can certainly feel more tightness. We talked about what I want in an implant. I am most concerned about projection. Dr. Festekjian mentioned that style number 45 gives the most projection, but those implants are more narrow so they usually look best on people with a small chest. He said the next best option is style number 20, which my mom has.

Just for reference, this is what a tissue expander looks like.

And this is what a silicone implant looks like.

I know for sure I will have one more tissue expander fill, putting me up to 700 ccs on each side. I could go up to 750 ccs, but I think that might be a bit too big for me. These tissue expanders are starting to get pretty bulky! Plus, I want to have the implant exchange surgery on November 19, so the final tissue expander fill needs to be six weeks before that date.

Dr. Festekjian said that he will order a few options for implants. During the actual surgery, he’ll “try them out” to determine which looks best. Gee, it sounds like we’re shopping for prom dresses!

OK, now for something completely different: I want to mention the Pan-Mass Challenge Teen Mountain Bike Ride, an event organized by my niece and nephew.

First, a bit of background on the Pan-Mass Challenge: The Pan-Mass Challenge is a bike-a-thon held every summer in Massachusetts. 100% of the money raised by riders is donated to the Jimmy Fund, a cancer research and treatment center at the Dana-Farber Cancer Institute.

My sister Wendy has participated in the Pan-Mass Challenge for twelve years, raising over $127,000 for the Jimmy Fund. This year, my niece Nicole (age 14) and my nephew Matthew (age 16) are stepping up their game by organizing the first Pan-Mass Challenge Teen Mountain Bike Ride, for 13-18 year olds.

The Teen Mountain Bike Ride will be held on October 13 at 9 am in Westwood, Massachusetts. If you know of any teenagers in the Boston area who are in need of community service hours, please let them know about the ride. It sure beats picking up trash on the beach!

Needless to say, I’m very proud of Matthew and Nicole for taking the reins on this idea. The Pan-Mass Challenge is a well-respected event in New England, and there is a similar bike ride for younger kids. Matthew and Nicole saw the need for a ride aimed at teenagers, and they’re making it happen.

Matthew and Nicole, the founders of the PMC Teen Mountain Bike Ride. Just a side note: aren’t they ridiculously good looking?

They’ve always been very receptive and caring kids. This past April, when they came to visit for their spring break, Nicole pulled me aside and asked how my boobs were doing (her words, ha!) Okay, I know that’s not a huge deal, but she’s only 14. (Actually, she was still only 13 at the time!) I was so touched and impressed that she not only understood my choice to have a mastectomy, but that she wanted to check up on me. It’s not exactly a light topic for anyone, let alone a teenager.

For more information, please visit the official page for the Teen Mountain Bike Ride, as well as this article published by a local newspaper. I wish I could be there in person to support Matthew and Nicole during this great event. There’s always next year!

 

Today is National Previvor Day…

…and I want SO BADLY to blog about it, but I am so freakin’ exhausted from work–it was an almost twelve hour day! And I loved pretty much all of it, that’s the great part. Because really, how lucky am I to be able to spend my time running around like a crazy person, worrying about getting the proper tools and wrapping paper for a video shoot instead of worrying about chemo drugs and hospital visits?

That is really the essence of being a previvor for me: not taking the little things for granted. Because even those long, hard days that make me collapse on the couch are just reminders of LIFE and how fortunate I am to enjoy it all!

Check out more information about National Previvor Day and learn what it means to be a previvor.

And I promise that once this crazy work week is over, I’ll have a fresh blog post with updates about my first FORCE meeting, an amazing fundraising event for cancer research, and my latest tissue expander fill. (Just a teaser: I’m already up to 650 ccs of saline on each side!)