Phase 2 Begins

With yesterday's chemo, I've completed the initial treatment phase, and now we move into the ongoing, long-term treatment phase. We can probably consider this the maintenance phase.

During this phase, I will get reconstructive surgery, which I am scheduled to get on January 29. For those of you who don't know, my reconstructive surgery will consist of a TRAM placement and an implant replacement for my expander.

The implant replacement should be fairly easy. Since my mastectomy, I've had an implant expander in my right breast in order to stretch out the skin and any remaining tissue in the area to make room for the implant. They'll remove that and replace it with the permanent implant.

The TRAM will be much harder. The TRAM is necessary because they removed so much of the skin and breast tissue on the left side that there really isn't enough skin to stretch it out for the size breast that I'd like to have. I've requested C-cups by the way. Previously, I was a D-cup, so this is a reduction for me. But, I think to reduce any further would have left me looking disproportional. I talked about it with a friend when I made my decision, and she agreed that a C-cup is probably the right size for me. This also just felt like the right size for me. I felt like I would still feel like me.

Anyway, during the TRAM, they move the fat and small piece of muscle from your adomen and use it to shape your new breast. They also have to remove one of the two of the blood vessels that carries blood into the area (which serves to strengthen the other one), but they did this during my mastectomy. It's called a delay and, since it's had all this time to get stronger, hopefully it won't have to work quite so hard to make sure my TRAM gets enough blood to get and stay healthy once it has been moved.

I didn't have enough fat and, particularly, skin on my belly to do both breasts, which is why I'm doing an implant on the right. And, we didn't have enough skin on the left to do a implant on both sides. So, the doctor ordered up one of each, and I agreed.

Since they have to cut into the muscle on my abdomen for the TRAM, the surgery is harder to recover from than my mastectomy was. So, they'll keep in the hospital a little longer. The surgery itself is scheduled to last 6 hours, which is a little longer than my mastectomy lasted as well. I won't notice the difference in time. For me, my mastectomy passed in the blink of an eye. If my TRAM surgery lasts longer, maybe it will feel like two blinks, but probably not much more.

I will definitely want some friends around on my day of surgery and to visit me throughout my hospital stay, but I suspect that I will also want to sleep a lot. That's my standard M.O. when I'm not feeling well. Sleep through the pain and general yuckiness, and wake up feeling better. Both Cathy and Dave are going to be staying with me for several days after my surgery until I can get around a little better on my own. If her work schedule permits, my sister may also be here for a couple of days during that time as well.

After I've recovered somewhat from my surgery, I have another doctor's appointment with my oncologist, and that's when I'll start on the Tamoxifin. That will officially put me into the next phase of my recovery.

While on one hand, it seems like that last year has been a long journey to get to this point, on the other hand, I can hardly believe it's already here.