Saturday, April 2, 2022. I needed to know what I was going to look like after surgery. I wanted a blueprint of my body - flat-chested - so I wasn’t shocked after surgery. My plan was to minimize any potential psychological trauma. I tried to look in the mirror and imagine my body without breasts, but I couldn’t get an accurate vision. Surgical-Oncologist-Doctor L had referred me to breastfree.org, a site dedicated to providing information, advice and support for women who want to learn more about living breast free. On the site, one woman said she’d taken a picture of herself and photoshopped out her breasts to see what she would look like. That sounded like the perfect solution for me, but I had no idea how to use my graphics program for such an endeavor.
I plopped down on the couch next to Miah for our evening TV watching. “I wonder if… don’t you think, there’s gotta be some kind of body imaging app out there so I can try to remove my boobs and see what I will look like?” I asked him.
“Oh yeah, I bet there’s tons,” he said.
We both got searching. “Found one!” Miah exclaimed. He installed it and started playing with it.
I found one too and downloaded the free version, but it wasn’t what I was looking for. I kept looking. Eventually, I came across FitPix - Body Editor. I signed up for the 7-day free trial so I could try it out. I took off my pajama top and asked Miah to take front and side pictures of me, waist up, naked.
Then, I loaded the pictures into the app and… erased my breasts! It looked real. I showed my phone to Miah. “Oh wow!” he was surprised. Neither of us thought I looked freakish or disturbing. I felt so much better. This little photo editing expedition was exactly what I needed. It reduced a huge amount of anxiety. I would keep these pictures on my phone until the day of surgery and look at them from time to time to prepare myself for the first look at my new body. I wanted to be in charge of my reaction. I wanted to sit in the driver’s chair.
Wednesday, April 6, 2022. In one week, I would be having surgery, so today I had to stop taking my supplements - CBD oil and melatonin, and Excedrin. I begrudgingly collected the bottles and put them in a storage location out of sight, to prevent forgetting my instructions and accidentally take one of them. I was nervous about the next seven days without. I figured I could take a double dose of Unisom for sleep, but I was panicky about not having CBD oil and Excedrin to help my migraines. Worrying about it had no value, so I tried not to focus on it. I still had music videos to produce for my upcoming song releases and I intended to make good use of my last healthy weekend before my body became traumatically injured.
I also wanted to make sure I was setup with my post-surgery pain medicine, so I messaged Primary-Care-Provider-Doctor A and asked her to send over the prescription at the dose and quantity we had planned on. A couple hours later, it showed up on my list of prescriptions at my pharmacy, but contained a note, “Do not start until April 11, 2022,” which meant the pharmacy would not fill it until the Monday before my surgery. This didn’t concern me too much. I wouldn’t need the medicine until I came home from the hospital on Thursday, April 14. But my pre-planner mind likes to do as much as I can ahead of time so I can move on to the next task. Guess I’d have to wait until Monday to get the prescription.
Now, because my surgery was only a week away, I was finally willing to be a good, compliant patient and read the instructions Nurse K had given me at my pre-surgery appointment the week prior. I pulled out the folder of paperwork and read through each instructional sheet, one by one.
- Preparing For Your Breast Surgery
- Getting Your Skin Ready for Surgery
- Anesthesia for Breast Surgery
- Sentinel Lymph Node Mapping and Excision of Sentinel Node(s)
- Mastectomy Information for Patients & Families
- Exercises After Breast and Axillary Surgery
There appeared to be an overwhelming amount of occupational therapy stretching exercises. I was unsure of my ability to do all of them – it felt like a lot to manage. I decided I’d probably not be able to memorize each one, so I’d refer back to the sheet when the time came for stretching.
The sheet on Lymphedema angered me when I read,
- Lymphedema can occur weeks to even years after surgery.
- Ways to reduce your risk: avoid saunas/hot tubs.
The sheet contained much more information, but those two things stuck out to me the most. I’m not a huge fan of hot tubs or hot baths, but I love saunas. After my swim, if there’s time, I like to lie on the wood bench in the sauna and rest for 10 minutes. In the past, Miah and I had discussed, on more than one occasion, purchasing our own infrared sauna for our house. It sounded like I could either kiss my enjoyment of saunas goodbye or continue using them and risk getting Lymphedema. I was upset and didn’t know what to do with my feelings. I decided to add a checkbox to my mental To-Do list: ask Occupational Therapist for more information. Wise-Woman-YMCA P uses the hot tub at the gym after every swim and doesn’t seem to have any trouble. She had lymph nodes removed when she had her surgery. Maybe the risk isn’t the same for everyone? I’d have to get more information.
The body preparation/shower info sheet was straightforward and didn’t cause significant stress. My skin is not overly sensitive, so I estimated I wouldn’t have any issues with the special “party-favor” soap, as I now think of it.
After reading through these seven documents of impending doom, I didn’t see anything that required me to take immediate action, other than stopping my supplements and Excedrin. I was confused about exactly what to bring with me to the hospital – like, should I bring my toothbrush? Could I bring my face lotion? I knew I was going to be spending at least one night there, but I didn’t have any idea if I should pack a bag and if so, what kinds of things I might need or want to have with me? This made my planner self very insecure.
Friday, April 8, 2022. My head hurt, bad. It had only been three days without CBD oil and I could already tell a difference. I was determined to miss as little work as possible, so I forced myself to keep doing my job and push through the pain. Mid-morning, my phone rang. It was a woman calling from the hospital to go through my medications list prior to my hospital stay. She asked about each medication and made notes in her system. As we talked, I learned she had been hospitalized several times in recent years and was familiar with staying overnight. I told her I had no idea what to bring with me. She could hear the apprehension in my voice and told me about her experiences. She always brought her toothbrush/toothpaste, tablet + charger, and phone. She wore comfy clothes that were easy to change back into when it was time to leave. I was so grateful for this nice lady! She wasn’t a pharmacist or a pharmacy technician – she was a call center reporter, responsible for verifying patient pharmacy needs during their stay. She’d had a whole slew of health issues over the last decade and needed various surgeries. She seemed comfortable with the process of an overnight hospital stay.
The way she described it so nonchalantly made me think of my upcoming procedure as taking a trip to a country I’d never visited before.
My mood and spirit lifted. I was glad she had joined my flock, if only for a few minutes.
1:00 PM. I sat behind the closed door of the clinic exam room, waiting for Gynecologist-Doctor B. I had made this appointment weeks earlier because I wanted to learn more about the gynecological risks of endocrine therapy. Because my cancer is hormone positive, I’d been told I would be advised to take hormone suppressants after I had recovered from surgery. The little research I’d done so far warned of some cases of endometrial cancer. I wanted to review my history of ovarian cysts, endometriosis, and abnormal pap results, and weigh the risks of adding hormone blockers to the mix.
Gynecologist-Doctor B came into the room and sat down. She pulled up my chart and told me she’d had a chance to review my history ahead of time. She explained the treatment options for reducing breast cancer recurrence and said there was nothing about my history that concerned her or put me at greater risk of gynecological issues if I took Tamoxifen, the most used endocrine therapy in pre-menopausal women. Gynecologist-Doctor B also works in the breast center, so she is well informed about breast cancer. I decided to ask her a couple questions about my upcoming mastectomy. I pulled out my phone and showed her the pictures of my flat chest from the FitPix app.
“That looks… wow, pretty accurate,” she said, with surprise. I felt even better about my planning and preparation. Not only had I created this picture, but I’d also had an expert view it and weigh in on how well it represented my future body. I don’t remember much else about our conversation that afternoon, but I know I left the clinic feeling empowered and less afraid.
Sunday, April 10, 2022. The Amazon delivery person set a small package on the doorstep and walked back to the transport van as Sparkle let loose her high-pitch-fast-bark she uses when a stranger comes to the door. It was a small, purple mastectomy pillow, sent from Childhood-BFF T. I had no idea what such a pillow was, but when I opened the package, I instantly understood the value. It covers and wraps around the chest – to give a sense of comfort and security – for example, what if Sparkle jumped up on me and hit her paws on my sore, stitched up body? This pillow would be my armor. It would also help on the drive home from the hospital and protect me from the pressure of the seat belt. It came with a small 4x6 card.
I took the card into my bathroom and taped it to my mirror so I could look at it multiple times a day. Affirmations work for me, and I felt like this one came at the perfect time.
9:20 AM. Monday, April 11, 2022. I turned my car into the parking lot of the COVID-19 drive thru clinic and drove forward into the testing lane. For my pre-surgery workup, I needed a COVID-19 test. After my test came back negative, they would officially book the surgical suite, anesthesiologist, and nurses. The warehouse door opened and signs instructed me to pull forward. I eased to a stop next to a health care worker who took my name and confirmed my appointment time. Then I inched up to a sample collection technician, who came at me with a long Q-tip. She asked if I’d ever had a COVID test before. I hadn’t. She instructed me to tilt my head and remain still. Then she inserted the Q-tip into my nose until it reached the back of my throat and swirled it around for a count of 10. My nasal cavity was dry, and it burned, like, a lot. “Woah, that hurt more than I was expecting!” I told her.
“Yeah, sorry about that,” she was at least nice about it. She repeated the process in my other nostril. The procedure went by quickly and I was driving home within minutes.
I intended to stop at the pharmacy and pick up my pain medicine, which was scheduled to be filled today. But when I checked my pharmacy app, it showed as “Delayed - Insurance Issue.” Great, I thought. I called the pharmacy and learned the issue was twofold. First, they didn’t have the full quantity of tablets in stock. Second, my insurance wouldn’t cover it because I had recently filled my tramadol prescription. The solution was to wait until the next day when more stock was delivered, and then use GoodRx insurance instead. It was too much effort to get a prior authorization from my doctor, and the medicine was cheap anyway. GoodRx would do just fine. My planner self was filled with anxiety over yet another roadblock. “Tuesday will be the day,” I told myself, “Everything will come together, and I’ll be all set.”
4:15 PM. I received another “New Test Results” email and pulled up my COVID-19 results - negative. I'd passed the test and surgery was officially a go. This whole thing would be going down in less than 48 hours.
Tuesday, April 12, 2022. I intended to work all day for my employer. I wanted one last day to make sure I had taken care of everything. I wanted to reduce stress for those covering for me. I’d already been preparing for my time away, but this was my last day for a few weeks, so it felt important to be online and working. Unfortunately, I had a crushing migraine and I had to take a sick day. I was thoroughly distressed by needing to begin my medical leave a day earlier than planned, but I could barely function. Fortunately, I work for an amazing team of supportive colleagues and leaders. Since my diagnosis, they had been keeping my workload light and allowing me to do whatever felt manageable. There was no pressure to meet any deadlines or milestones. My health was as much a priority to them as it was to me. So when I posted a Teams message that morning saying I was starting my time away early, I received back a bunch of supportive emojis and “feel better” GIFs. I set my out of office reply and powered down my laptop. For the next two and a half weeks, I would be fully disconnected from my job.
My prescription was ready for pickup at 11:00 AM. I asked Miah to go get it for me. I felt too sick to drive. I was down for the kill - blinds and curtains drawn, light-blocking eye mask on, ear plugs inserted. I didn’t leave the bedroom for most of the day. I was in so much pain I didn’t have time to worry about tomorrow’s surgery. All I could think was “plain white walls” – my mantra for clearing my mind. When I get a migraine of this magnitude, any thought slices through my head like an ice pick. My friends all know what I mean when I say I had a “plain white walls” migraine. In simplest terms, these hit the top of my pain chart.
As I lay in bed, suffering and praying for the pain to cease, I waited for the hospital to call and tell me when to arrive the next day. Finally, they called and I was informed to arrive at 9:00 AM. My surgery wasn't scheduled until 1:40 PM, but I needed to undergo the lymph node mapping procedure at 10:30 AM. I asked for the names of the anesthesiologist, surgical nurses, and surgical suite number. The scheduler seemed surprised by my questions. I told her I was having some energy grounding work performed and knowing this information would help. She provided everything I requested except for the assigned nurses, because their names weren't listed yet.
I crawled my way over to my computer and typed a message to Psychic-Healer K, "Lorie's Surgery Day Info - Wednesday, April 13th." I included the name and address of the hospital, scheduled procedure times, names of doctors, and surgical suite number.
She replied an hour later, "I'll start setting you up this evening. There's nothing you'll need to do; your job is to sit back and receive."
In late afternoon, I received a call from Surgical-Oncologist-Doctor L. She wanted to know how I was feeling and if I had any questions before tomorrow's procedure. I told her I was sick with a bad migraine from stopping my CBD oil, but other than that, I was as ready as I could be. "I even used a body editor app to create a photo with my breasts removed," I told her. She was interested in this and asked me what the closure looked like. “Umm… I don’t know what you mean. It’s just blurry, like photoshopped out,” I said. She gave me a website containing a database of “aesthetic flat closure” pictures and told me to pick out what I wanted. We finished our call and I frantically started searching the database. My surgery was less than 24 hours away and I needed to decide how I wanted the scars to look. I didn’t realize I'd had a choice in this matter. I tried the website filter, but it came up with only one picture. I went to google instead. There were straight lines, downward “frowning” half circles, and even jagged looking scars. I ended up finding two pictures I liked, with “smiley” face, upward facing, curved scars. I mean, how do you decide if you like a mastectomy scar picture? It felt bizarre to be choosing my preference for this. I uploaded the images to my Google Photos library so I would have it on my phone to show Surgical-Oncologist-Doctor L when I saw her tomorrow.
I was completely miserable when I took my special body-preparing shower at 8:00 PM. The smell of the antiseptic body cleanser made me even more nauseous than I already was. I soaped up and waited the recommended number of minutes before rinsing. I dried off, blow-dried my hair, and put on a clean pair of pajamas. Then I went in the living room to say goodnight to Miah and the dogs. Normally Sparkle and Magic sleep with me, while Miah sleeps in his own room. We’ve had this arrangement for almost a decade because my restless legs and insomnia make it difficult for Miah to get any quality of sleep when we share a bed. Tonight, I had to sleep dogless, per the pre-surgery instructions sheet. I guess they want to minimize the possibility of germs. Earlier in the day, I had also changed the bed sheets.
The dogs were confused when I kissed their heads and told them I had to sleep alone. Magic trotted instinctively to the bedroom door, wanting to settle into his favorite spot to the right of me. (Sparkle sleeps on my left. It’s a dog sandwich and I love it.)
“No Maji, Mama has to sleep alone tonight,” I told him again. He looked sad as I guided him to the couch instead and gave him a pillow for his head. “I’ll see you in the morning. Sleepy beasties now.”
Sparkle was crazy-eyed and alert, questioning this sudden change in routine. She'd already been aware something was wrong in our house for the past few months. Dogs can tell when their humans are upset. Border collies are especially sensitive. I looked at Sparkle, “Don’t worry, Mama will be fine. You just stay out here with Maji tonight.”
I kissed Miah goodnight and went into the bedroom. I closed the door, climbed into bed, and spent the rest of the night tumbling through torturous, foreboding dreams.
End of 12 - Additional Research