Sunday, October 9, 2011

Free floating anxiety

It's 4:24 a.m. I was still awake at 11:30 p.m. last night, then again at around 3 a.m. this morning. I have been anxious, restless. I have been in pain.

The great thing about not having to see a doctor for a while after treatment, any kind of treatment for breast cancer, whether it's surgery or chemo or radiation, or some other form of intensive treatment is just that: you do not have to see a doctor for a while. And for anyone who's been on the doc circuit, you know how gratifying this is - you are free. Free! Schedule your life around YOU! It feels awesome, for a while.

The bad thing about not having to see a doctor for a while after treatment is that you don't have anyone checking up on you. You are cut loose. You've been through major medical, in some cases a life and death situation, and you are on. your. own. And when stuff changes, and things comes up, you're left to your own devices with your mind, and Doctor Google at your bedside.

Since last Wednesday night, I've had weird swelling. Pretty uncomfortable, painful swelling in a band around my upper chest. My once comfortable bra feels like a tourniquet, mostly at night. Wait - let's back up here - did you know that you have to wear a bra 24/7 after this surgery? You do. So that means while you're sleeping, and for you men out there, that may not make an impression, but I don't know many women who relish sleeping in a bra. Oh, and I think as an aside to my aside, I should mention that you also cannot sleep horizontally. Nope. I haven't slept lying down since I was knocked unconscious by general anesthesia on September 19th. Yes, that's right, you gotta be strapped in and at at least 45 degrees for comfort. Lately, I've preferred close to 90. Forget all about how I used to sleep on my side and stomach. That's a ways off, people. But I digress.

Back to my ever-expanding torso. The feeling is of a thick and tight Theraband being stretched around my chest, around under my arms to my back. The only thing I can point to that I did differently is that I bent over on Wednesday a few times - picking very light things off the floor. I am being honest when I say they were light. And if you noted my activity level - to a person who had not had a bilateral mastectomy with immediate reconstruction - it'd come across as minuscule. Ridiculous to even note. But apparently that level of activity can make one swell.

I know, because after it got worse on Wednesday night, and better Thursday morning, I called into my plastic surgeon's office and had one of her nurse practitioners call me. Jill said that I must've overdone it a bit on Wednesday and that all would likely be fine. You see, anytime you move around, your body creates more fluid, she explained. (Remember those drains? They took a ton of fluid out, and the docs did warn me I'd see an uptick in fluid if I moved around more). My body is getting used to having a foreign body implanted in it - sending more fluid to that area. I asked her if it was OK to remove my bra, and while she said they'd much prefer me to wear a bra, it was OK to take it off if I felt like it was cutting off my circulation. OK, makes sense. I wore my bra Thursday, and although the swelling got worse Thursday night, it was better again Friday. I decided not to call and to wait it out over the weekend. And now I'm worried.

One of the things that makes you a good litigator is the ability to think situations through to various end points. The ability to think of all case-scenarios for your client, good and bad, is an asset. Particularly the bad case-scenarios, because that's what they want to avoid, right? The ability to think of all case-scenarios, particularly the bad case-scenarios is NOT a great quality in a cancer patient, because when stuff starts to hit the fan, your mind is at that nasty Point B faster than a jackrabbit. So in the last 36 hours my mind has gone all kinds of scary places with this. And the swelling has increased since yesterday. My unscientific measurements (how badly I feel like my foobs might explode outa my body, the contour of the sides of my torso) say it's worse.

Now, I have been eating saltier foods. I had half of a delectable whitefish salad sandwich on Friday that could only do bad things to a girl who's retaining water. And ate the second half of that Saturday for breakfast. A little leftover pizza, a yogurt (neutral) and some fruit (good) for lunch, and then some takeout for Saturday dinner that under normal circumstances makes me feel like junk day 2. Not good on the diet front. You see, when I haven't recently had my breasts removed, I cook most all our food from scratch. Our sodium intake is LOW. We eat so little processed food, we can control it easily. So eating all this "foreign food" can only be compounding the swelling. Duly noted. Today, that's going to change for sure.

But what could it be? Well, as Dave has pointed out in desperation, it COULD be normal. (It might not be a surprise that I haven't been all that easy to live with this weekend.) I would be so excited if this pain were normal. If it's a part of the process I will delightedly suck it up and soldier on. But it also could be lymphedema, a chronic and painful condition that can occur after the channels that carry your lymph fluid are messed with: like say, having your breasts removed. It could also be the start of a painful and complicated bad surgical outcome called capsular contracture - where your body makes too much scar tissue around your implants and they get tight and stiff and they hurt and have to be removed. My fingers have been flying over the keyboard and Dr. Google has shown me all the nasties. I've sent out a few SOS emails to contacts I have from Breast Cancer Round I to get going on an eval for lymphedema. I should anyway. But it's the weekend.

Today is Sunday. My swelling is not reduced in the way that it was the last 2 mornings. I am awake early, determined to do one thing today: eat almost no salt. To drink a ton of water. To reduce what bloat I can. To do my part. And probably to meditate a bunch. Put my guided relaxation on an endless loop and plug in my ear buds. I'm paranoid. It's hard to stop. That follow-up Wednesday can't come soon enough.




  1. Oh Sarah, hang in there! I don't have any great words of wisdom but I am thinking of you and sending healing thoughts. Maybe take a little break from Dr. Google. Take care!!!

  2. I hope you have found calm and are sleeping tonight! I am really trying to search my memory to see if I remember any swelling after surgery. Not being able to remember means it maybe didn't exist in my case or perhaps it's just normal healing and it goes away over time. I'm thinking normal healing after all your body has been through. Maybe have someone (never sure who to call after you've been "thrown from the nest"ish) check to make sure there is no infection in the fluid (if your body is fighting against the implant or something else) and then you can rest better??

    Don't be afraid to call and ask to be seen. Any doctor who doesn't help ease all the anxieties that go along with this process is nuts. Call and be seen for peace of mind.

    Hugs and happy un-swelling!

  3. I'm with Heidi. I would imagine the swelling is a normal process of recovery but would want Dave or someone to check to make sure it's not hot to the touch or red. As far as lymphadema goes, it's possible as you did have a few lymph nodes taken but I'm thinking it's likelier the healing process.

    In any case, meditation and a reduction of salt both sound like wise ideas to me.

    Feel better.