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!

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.

 

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.

Tissue expander fill #1

Yesterday I had my first tissue expander fill at Dr. Festekjian’s office.

For those of you who still aren’t sure of how the breast reconstruction process following a mastectomy works, here’s a rundown: after Dr. Karam performed the mastectomy (removing all breast tissue) portion of my surgery on March 13th, Dr. Festekjian came in to insert saline tissue expanders underneath a layer of my pectoral muscles. These tissue expanders are essentially little baggies that create a pocket in the muscle. They have a needle port on top, and over time, additional saline is inserted so that the baggie and the pocket can grow. Once the tissue expander has been filled enough and the muscle pocket is large enough, the tissue expander is removed and a permanent silicone implant is inserted into the pocket.

During my initial surgery, Dr. Festekjian put about 300 ccs of saline into each tissue expander. This is a pretty decent amount of saline, so when I woke up from my surgery, I actually had breasts–yes, they were small, an A cup, but there was still something there on my chest.

Yesterday Dr. Festekjian took a look at both sides. I was concerned because my left breast seems to be bigger than the right. It had only started to look like that a few days after my drains were removed, so I was worried that I had a fluid buildup. Dr. Festekjian said that there was no fluid (yes! The evil fluid, defeated!) but that the tissue on the left was “still a little pissed off” (wise words) and that it was swelling. He decided to expand only the right side, in order to make them match a bit more appearance-wise but also to let the left side heal more.

Maria, one of the RN’s in Dr. Festekjian’s office who is pretty much awesome (she removed my drains last Monday), did the fill. Sidenote: I really like Maria. She is very understanding and has a lot of patience. I took some before and after pictures, a picture of the tools, and also a video of the fill happening. Since I have to run to work right now, I’m only going to post the pictures.

These are the tools that are used for the tissue expander fill: the giant plastic syringe is where the saline goes, and the little green needle is what is actually inserted into the skin. The two connect at the top of the needle, and the saline is slowly pushed through the syringe into the needle and then into the tissue expander.

Before going to talk to another patient, Dr. Festekjian used a magnetic device to “locate” the tissue expander port through my skin. He then marked it with blue ink–“X marks the spot”, redefined! He disinfected my skin with some sort of brown substance, I think it was iodine. He then made sure I was OK with Maria performing the fill. He said he could do it himself, but I was already scheduled to see Maria the following Thursday for my second fill and I totally trust her, so I was fine with it.

The fill itself did not hurt, but I felt the needle prick for sure. That was the worst part (as it always is). I thought I would be able to feel the saline going into my tissue expander and making my muscle tighten, but I didn’t feel it at all. Maria was very slow and steady with the saline syringe.

She inserted 75 ccs of saline, removed the needle and then put a bandage over my skin where the needle had been. I could see a difference in that my breast didn’t look as droopy. I took a before and after picture, but since I have my bra on for both it’s kind of hard to tell. The biggest difference you can see is the fact that my bra doesn’t look as saggy.

On the left: before the expansion. On the right: after the expansion. Note that only the right side (in this case, looking at me, the left side) was expanded.

I thought I would be in pain after the fill. A lot of women experience tightness (from the muscle stretching) and have to take pain meds. It’s been almost 24 hours and I haven’t felt any pain at all.

My next fill is going to be next Thursday. Fingers crossed that I get both sides expanded! Jeani, Dr. Festekjian’s wonderful assistant, booked me for my next five fill appointments, every Thursday starting yesterday. We’re not sure I’ll need that many, but it’s nice to have them planned out.

I’m happy now. This process is really happening! My reconstruction is starting!