A Short Post About Poop

Let’s talk about poop. When you’re on pain killers, most doctors will also prescribe stool softener, since one of the common side effects of pain killers is constipation. When you have DIEP surgery, you will be given stool softeners also because you are not really allowed to or able to… push. Basically, you need everything down there to be as easy as possible so it just sort of happens on its own – your abs can’t help you with this.

Instead, you need to drink lots of water, eat lots of fiber, and stay on the stool softeners even after you’re done with the pain killers, until you feel strong enough to… push (for me this happened today – 3.5 weeks out from surgery). My breast surgeon told me that protein helps healing, so to combine everything, I have been eating lots of chili – protein (beans and meat), water, and fiber. This seems to be keeping everything running smoothly. And that is my tip of the day. I bet you’ll thank me for it.

Simple Things

Today I had a simple plan: walk to the bank three short blocks from my house, walk back one block and rest for a bit at the coffee shop, walk back another block and stop at my mother’s office to rest, walk back the remaining block to my house, chill. I woke up and was very excited about this plan. My husband was less so – he’s very worried about me going outside alone (given our experience last weekend at Costco, I don’t really blame him, but it is time for me to be out and about). I was so looking forward to taking a real walk, getting outside, being out of the apartment, and depositing some checks (ok, the last part wasn’t really the highlight). Once my husband and son left the house, I showered, got dressed, and sat down at my desk to check some email. I also checked the weather where I learned the high for today was supposed to be 17 degrees with a windchill of 3. And thus my simple plan was thwarted.

There was no way I was going outside in 17 degree weather. Normally I would, yes, go out like that – I’d walk quickly to get my blood pumping. But I didn’t have the confidence I could do that just yet. Not to mention – whenever it gets below 69 degrees in my apartment, the first thing I notice is that my boobs are cold, so I was definitely not going to go outside into the arctic blast! So I read the rest of the weather prediction – same thing tomorrow, possibly a bit warmer on Friday – and I cried while realizing I am probably not leaving the house until March. Cue the violins.

So I did about four hours of work at my desk, which was good exercise for my back and I accomplished a lot. And I decided I would start trying to incorporate more of my daily chores back into my repertoire. My mom picked up my son at school, but I prepared our dinner and cleaned up after (I’m still not doing full on cooking, but I do a mean defrost). My husband bathed our son, but I came in and gave him his cold medicine and combed his hair (I would have read him his story too, but he was feeling very attached to dad this evening). I cleaned the litter box and gave the cat his medicine. I tidied the living room of toys and blankets. I made my son’s lunch for school tomorrow. These are all very little simple things, but I’m glad to do them myself instead of nagging my husband or watching while my mom does them. I realize that only a few days ago, I didn’t have the strength to stand in the kitchen long enough to pack my son’s lunch, let alone bend over and reach up high to get the things necessary to do so.

So simple things are good. If only I could start doing them out of the house…

Posture and Pits

I’ve never had particularly great posture. I think I walk fairly straight, but I sit rather lazily hunched over. I could blame my old breasts, I suppose, but really I’m sure it mostly has to do with being overweight. Now that I’m allowed to stand straight though, I’m finding it important to try to walk tall. I know doing that will help me to continue to strengthen my core. Even though I’ve been sick with a cold the last few days, I feel remarkably stronger in my core. I can sit up more easily, get in and out of bed more easily, and bend over more easily. This morning I emptied the dishwasher, which required bending and reaching, and I also sat at my desk to do work for about three hours, which required me to use my back and core to sit up straight.

I’ve also realized that some of the pain I have in my abdomen is actually just tightness and irritation from wearing the binder. I only have ten more days of binder wearing – that’s really exciting. I can’t wait to throw these things in the garbage.

Yesterday I had yet another emotional breakdown. I was exhausted from head congestion and I wanted to lay down in bed, but I was also feeling guilty about not being able to take care of my son, who has been very cranky the last few days while he seems to be getting over a cold and possibly getting some new teeth. While I laid down in my bedroom, I could hear him crying in the living room. My husband takes care of him so well, but it makes me feel terrible that I can’t console my baby by picking him up and holding him close. So the two of them came and got in bed with me. My husband talked me through it, and my kiddo snuggled in next to me to watch his cartoons. Last night, my husband put our son on my lap so I could read him his bedtime story like I did pre-surgery; this is something I’ve been missing. Then he put him into his crib.

Lastly, this morning in the shower I decided to try to shave under my arms for the first time since the surgery. If you know anything about Jewish ladies, you know that three weeks of hair growth anywhere is no joke. This turned out to be a mistake though. My armpits are extremely sensitive (I’ve read other women say this post-mastectomy). It’s hard enough to really scrub with soap under there, so I should have known that shaving would be difficult. It’s hard to hold either arm up completely straight (the right arm is worse because of the sentinel node biopsy), and to really hold it back to get the right angle was nearly impossible. The result – I managed to snag a few hairs, but there are definitely remaining patches. I suppose no one but me is looking under there anyway.

Surgery Prep

I thought I was fairly prepared for surgery, even though I only had about four days to become so. I cooked a lot, so our freezer was full of home-cooked meals. I did laundry, cleaned up the house as much as I could, did a lot of paperwork for work, taught my husband how to cook a few things, and made lots of checklists for anyone taking care of my son. I purchased some important items (pajamas, bathrobe, slippers, drain pouch belt, medical tray, pillow), all of which turned out to be very useful.

One area in which I was completely unprepared was medical supplies. When I left the hospital, they gave me a bunch of gauze pads and alcohol wipes, but I quickly went through those. So I (or my mom) have had to make several trips to CVS to get supplies. There’s a lot of things I probably could have bought in advance: surgical tape, gauze pads in a small and larger size, extra binders, and saline. I also wish I’d had an area set up for when I got home. I have this area set up now, but it would have been nice not to have to do it in my first few days home.

Here’s what my current set-up looks like:

This vanity table is in my bedroom, and I use all of these supplies before bed and after my morning shower. The make-up mirror is extremely useful. It has a light and it magnifies. So I can stand in front of it and adjust it as I need to see what I’m doing when bandaging my abdomen or breasts. I use the towel when I get out of the shower – even after I think I’m dry, I pat the towel over all incisions to make sure they’re extra dry – keeping them dry is really important for healing and to prevent infection.

The saline is useful in cleaning any areas that might need it; for instance, this evening I noticed some dried blood on the edge of my navel, so I used the saline and a gauze pad to clean that off. The saline was also useful to clean the drain sites; those get crusty and painful and burn a bit, so even just to put a cool piece of wet gauze on them feels good. Surgical tape and gauze are for any areas where there’s discharge, bleeding, etc. I also stuff gauze between the underwire of my bra and my breast – the surgeon suggested I do this in the area of my breast incision until I heal. Gauze is basically my best friend now – I use gauze and saline for everything because it’s all sterile, and I worry that a wet washcloth harbors bacteria (I’m not normally a germaphobe, but the last thing I want is an infection with wounds this large).

I bought the Neosporin with pain relief to help with the wounds from the drains, but it didn’t do all that much. Missing from the picture is the cortisone cream I’ve been using on those wounds now that they’re healed; they are very itchy and the cream helps a lot – I keep that on my bedside table so I can reach it easily. I keep the trash can on top of the vanity because it’s difficult to bend down often and during my post-shower process, I open and throw away a lot of different items. In the middle of the table are my extra binders. I have four of these. I was given three in the hospital and one in my surgeon’s office. You definitely need to have more than one, since you’ll want to wash it often and you probably won’t be allowed to go any significant amount of time without wearing it. Make sure to ask for an extra when leaving the hospital.

I definitely recommend purchasing some medical supplies and having an area set up for when you come home from the hospital. It’s a pain to have to shlep out to get something like tape. And it’s nice to have everything in one place and at easy reach.

Current Concerns

I feel like all I do on this blog is complain, but I suppose the point is to let people considering this surgery know what they’re in for, and I would definitely want to know all of these little things that happen during recovery. I think I’ve mentioned my mother-in-law’s cousin who is having this exact same surgery in May – it’s people like her who are really my audience. So I’m not really meaning to complain so much as (1) chronicle my experience for myself and (2) let others know what to expect.

So, I have four concerns right now, none of them too major, but all on my mind.

(1) I still have the leaky spot on the right side of my abdominal incision. It only drips a bit each day – I keep a gauze pad in the binder to keep the area clean, and each night and in the morning when I change it there is always a bit of discharge on the gauze.

(2) I still have the pain on the left side of my abdominal incision where the doctor says I have a strained muscle. Today I didn’t do much and it definitely feels better. I think I will spend a couple more days laying low and staying rather inactive to perhaps let that heal a bit more.

(3) The spot under my left breast is still bleeding a tiny bit. I keep a piece of gauze taped under there too, and when I change it, there’s always a bit of blood.

(4) This is new. Toward the top left side of my left breast, there is a small bruise that has been there since the surgery. Now, I haven’t spent a lot of time feeling my breasts – they’re a bit sore and also a bit numb, so it’s an uncomfortable feeling to squeeze them or really press on them too much. But now that I’m back to wearing a normal bra, and I have to do a lot of “adjustment” to get the gals into the cups properly, I’ve had to feel them a bit more. I’ve noticed under that bruise a small lump. My husband described it as a knot. It feels exactly like I always imagined a breast tumor would feel like: a bit larger than a pea, solid yet tender, and it hurts to press on it. Even though I’m told that tumors don’t hurt and I just had a mastectomy three weeks ago, of course it’s making me quite nervous. But, I know there’s still a lot of swelling and who knows what could really be under there.

My plan is to wait until the end of this week, and then send Dr. Gimbel an email about all four of these concerns. This way I can say that I waited it out a bit to see if anything got better, and it didn’t. If #4 really is a tumor (which seems incredibly unlikely), I don’t think it’s going to kill me over the next four or five days. But if it hasn’t gone away and doesn’t seem to be getting smaller, then I will definitely want him to look at it.