Before I get started, I have to acknowledge that I’m a little superstitious* (“I’m not superstitious, but I’m a little ‘stitious’,” as Michael says in The Office) When titling this piece, I nearly wrote “Final Surgery: the Exchange.” But I didn’t want to jinx it. I know [from my research and in taking to others] that things don’t always go according to plans with the reconstruction after mastectomy. Some people have a number of surgeries, either because of implant challenges or because of needed revisions. It felt like calling this the “final” surgery was tempting fate. So I changed it to “last phase of reconstruction” to avoid that feeling, however ridiculous. I have definitely become more ‘stitious this year.
As I’ve mentioned before, there are so many different pathways people take in recovering from breast cancer. “If you’ve seen one breast cancer, you’ve seen one breast cancer,” I’ve heard many times. Each case, stage, and grade has specific protocols.
In my case, I had neo-adjuvant chemo (neo referring to before surgery, adjuvant meaning therapy “to help” shrink tumors and suppress formation). Then a mastectomy in March. At that time, a tissue expander was inserted, with the intention of exchanging it later for an implant.
Some people are able to go “straight to implant” at the time of mastectomy. My plastic surgeon preferred to wait, allowing the body the best chance of healing and recovery, and the least chance of complications with the implant.
So I would have the tissue expander in place for anywhere from 3-12 months. If I had needed radiation or more chemo after surgery, it would have been the longer end of that time frame. But because of my pCR (“pathological complete response”) to chemotherapy (determined via labs) I was able to be in the short end of the timeframe and schedule the “exchange” surgery for 3 months post-mastectomy.
Note: seeing that “test result” of my pCR a week after the mastectomy was an out-of-body experience. I had prepared myself for the possibility of needing 3 weeks of daily radiation and 42 more weeks of chemo. I was walking up the hallway stairs when I saw the message notification and had to sit down, my legs were so weak. I reread the summary multiple times. I had my sister read it. Then my surgeon called. “Did you see the results?” she asked. “Yes…,” I said tentatively. “I don’t want to get too excited, but it read like good news?…” She laughed. “Oh yeah, get excited!!! It’s the best possible news.”
The mastectomy took 6-8 weeks to fully recover, but I was able to progressively start doing exercises after about 3-4 weeks. The doctor said the exchange surgery (to exchange the expander for the implant) would be easier than this original surgery, but I prepared mentally for a similar experience. I was so wrong, in the best of ways.
Now less than 2 weeks post-op from the exchange, I’m really mobile. I can easily walk a few miles. I have very little pain. I still need to take it easy (especially the surgical area) and can’t lift that arm completely, but it’s like night and day in comparison to the first procedure. What a pleasant surprise.
Onward!
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* “I’m a little ‘stitious” https://youtu.be/39uoolmtjSA?si=QFz6pEN7RFQ_-vKU
Just 2 weeks post- op, I’m out and about! Attended an intimate showing of ‘Annunciation’ by Lauren Groff (and an author talk back afterwards) performed by the super talented cast of Word for Word at Z Space in San Francisco. Here with Colten, my eldest, who works at Z Space.