Showing posts with label prophylactic mastectomy. Show all posts
Showing posts with label prophylactic mastectomy. Show all posts

Friday, 26 October 2018

It's Prophylactic Mastectomy Day

Today's the day. I'm actually feeling really calm. I'm not due in until 11am as the nurse called yesterday to let me know I could come an hour later as I was on the afternoon surgery list.

We head to the hospital, with my bag packed with everything on my mastectomy bag checklist and this time I head to a general surgery waiting room. I check in but I'm told my husband cant stay with me - the waiting room is for patients only. Why? I start to feel anxious even though I've been ok all morning.

Chris sits down with me while I sort my things out.

"Leanne Nash"

The nurse calls me through just to measure my calves ready for my sexy DVT tights. I'm handed the tights and sent back to the waiting area.

We take a few minutes and then say our goodbyes. It's so scary being left on your own. I hate it.

"Leanne"

Another nurse calls and we head off down a different corridor. First she goes through my details; name and date of birth first and then on with the ID bracelets -both wrists! Next, I'm asked what operation I'm having, I reply right prophylactic mastectomy but explain I still need to talk to my consultant about my nipple options. She used to work with my consultant and puts me at ease about all of the different routes I can take, she even shares anecdotes of her time with Mr M, my doctor. We laugh - a lot. Back to the tick boxes though...Allergies? Metal work? All my own teeth? The nurse is so lovely and we end up chatting and giggling for so long that another nurse knocks on the door to see whats taking so long. The phlebotomist and the anaesthetist have both been calling my name. She wraps it up and takes me to get my bloods done. I do wonder why they are needed again when I have already had blood taken during my pre-op a couple of weeks ago.

This time it's the anaesthetist .  She checks my ID bands and goes through the same questions as the nurse as well as asking if Ive ever had any reaction to anaesthetic before. I haven't but I get a flash back to the poor lady that I heard during my last operation. The anaesthetist tells me Im first on the list so should be going down to theatre at 1pm. Not too long to wait, thank goodness. As she wraps up I can here my consultant Mr M outside. As she leaves he comes in.

He greets me and tells me I'm his only surgical patient today so as soon as theatre opens again after lunch I'll be called. First, I have a few questions about my nipple. I lost my left nipple during my wide local incision. For the prophylactic surgery I was given a number of options for my nipple:

1. Lose the nipple
2. Keep the nipple on the right but no nipple on the left
3. Share the nipple - keep it during the mastectomy but at a later date split it in two and share it with the left side.

Mr M had said that I could just let him know on the day which option I would take.

In all honesty, I had been certain that I'd just lose the right nipple too however this week I had a big heart to heart about how I feel about bad boob and how I want to feel and look as 'normal' as I can. It's just the risk of keeping even a small bit of breast tissue that is playing on my mind. If they find anything untoward at all in the right breast then I'd rather lose the nipple but if its clear then I'd like to share it. I'm also worried that the nipple might die after the op due to lack of blood supply but Mr M explains that he's never had an unsuccessful share.

It's time to make the final decision. "I'd like to keep the nipple and then share it."

Mr M explains that this means he can likely go straight to implant and i'll avoid the bulky heavy expander that I have on the left. I take my top half of clothing off and he marks me up ready with a big black marker. The line goes around my nipple and off to the side across my breast. A different scar to last time.

He leaves  and I go back to the waiting room. I really wish I'd have had someone with me to ask more questions. I immediately panic that I've made the wrong decision and head out to the corridor. I'm in floods of tears. I feel like I'm now tempting fate for the sake of vanity. I hate this.I head back to the waiting room to wait. After 20 minutes....

"Leanne"

The friendly nurse calls me through. It's time for me to don my gown and my sexy DVT socks. She insists we take a photo to document my sexiness. We giggle a lot as I pose for the camera!

Before I know it I'm walking down to theatre. This time there is no pre theatre anaesthetic area so I head straight in to the theatre and lie on the operating table. The cannular goes in easily this time around and I'm given oxygen to breathe. I don't even make the countdown. I'm out.

Two hours later I come around in the recovery room. I'm sore and I groan as I regain consciousness. I ask for something to ease the pain and I'm injected in to the cannular. I fall back asleep.

When I wake up again, they call the porter. I'm ready to be taken to the ward. Last time there were no beds soI had been gifted an ensuite room in the private part of the hospital - no such luck this time.

There are two other ladies already on the general surgery ward and they stare as Im wheeled in. The pain has resumed and I hate the fact that I have company. The nurse comes in to check my obs and I ask her to pass me my phone so I can call home and message my Mum.

My husband says he's going to come straight in. I give a a list of things I want - Lucozade Orange, chocolate and grapes. He delivers!

At 7.30pm we say goodbye for the night. I know it's going to be a long one as I'm on 2 hour observation. I get woken through the night and have to keep asking for more painkillers. I'm given oramorph again so soon im vomiting despite the anti sickness tablets.

Despite hardly any sleep the light comes on to wake us just after at 6.30am - what the actual hell - it's Saturday for Gods sake! I close my eyes and go back to sleep.

A general surgeon visits at about 9.30am and asks how I am. He says i'll be able to go home around lunch time. My consultant isn't here because its the weekend. I ask if the op went welland for confirmation as to whether I now have an implant oran expander. The doc seems confused and has to thoroughly read through all of the notes to confirm I have an implant. I'll be sent home with codeine, paracetamol and a course of antibiotics. As soon as the pharmacy send them up I'll be able to go.

It feels strange this time around. I don't know if it's because it's now the weekend or because I've chosen to have this operation rather than it being a necessity but I feel Im just not being looked after the same. There's no physio to see how I'm doing, tell me what exercises to do. There's no support session like before. When the breast nurse arrives she tells be I wont be given a specialist bra like last time because they are just for cancer patients. It makes me feel a bit down and I just want to go home to the children.

Finally my husband arrives at the same time as my meds. I grab my pillow, he grabs the bags and we head home. I feel a sense of relief that I got what I wanted. It's over. I can start to move on.




Thursday, 10 May 2018

Prophylactic Mastectomy - Should I keep My Nipple?

So last week I went back to see my surgeon. We're really happy with the scarring and the overall shape I have with the expander in and Mr M says I'm ready to have the exchange surgery to switch from the hard bulky expander to an implant. At this point I raise the fact that I still want to go ahead with the prophylactic surgery on the 'healthy breast'. 

I can tell my my consultants face that he's against this and re-iterates the fact that it's not necessary. I explain that from Day 1, back in December when I got my diagnosis, I have always asked for them to take both breasts. It just isn't worth the risk for me. I have 2 children, I live for them, I'm not risking it. No way. Mr M says I will need to see the psychologist agan to get final approval. I explain I have already spent sometime with him and I know he will approve it.

Because I'm opting for the second mastectomy, the exchange surgery will need to wait. I now have a number of options to consider for the mastectomy surgery:

1. Lose the nipple
- this would mean I have to go through exactly the same process as before. When you have your nipple removed you have to have an expander to enable the skin to stretch. If I go ahead with this then I'll have mastectomy with expander,weekly fills up to 450cc as on the left side and then once complete and rested the exchange to implants will happen together to allow a better match.

If I go ahead with this option then there are more options of what I can do to look like I have nipples again. 3D areola tattoos, prosthetic 'stick on' nipples and I can even have flesh taken from elsewhere to make a nipple shape in place of those that I have lost that can be tattooed over too to give a realistic colour.



An example of customised nipple prosthesis.
Image: www.feelingwholeagain.com

2. Keep the nipple on the right breast
- this would leave me with 'odd' boobs and looking pretty much like I do now. One breast with a nipple and one without. I already know that this isn't the option for me, I want uniformity. I want to match both sides regardless of whether I have nipples or not.

3. Share the nipple
- this is something that I had actually read upon myself and decided to ask about. So, if I went ahead, I would keep my right nipple. It would remain in place after the mastectomy but at a later date (probably after the exchange surgery and during another day case under anaesthetic) my nipple would be split it in two and made in to two nipples. Half will remain on my right breast and the other transplanted and 'shared' on to the left side.

Keeping the nipple does leave me with a slight risk as there will still be a small amount of breast tissue that remains but given that my right breast is healthy, I am torn. There is a lot to think about. I just need to consider all of the options and do what is right for me.

Mr M explains that once Ive been approved my the psychologist he will go ahead an complete the operation for me. With regards to my nipple, I can just let him know my decision on the morning of the operation. I'm likely to be on the waiting list for 6 months to a year. Thank god I'm getting what I want finally!