So for the good news: Surgery went well. I really like Dr. Aycock. Preop was easy. My preop nurse was Sandy, as I said. I wish I remember the name of the OR nurse, too. When I told her I'd gotten an infection at Mayo, she didn't bat an eyelash about telling me they'd prep me twice. I'm not sure if she understands how much that meant to me, and eased my mind. I felt safe, and in really good hands.
Brittney was my CRNA, and she listened to me, too. I told her I threw up every time I had anesthesia, and so she said she'd give me drugs instead of the gas. Propofol, apparently, and Versed and Ketamine. Again, it's these little things people do that they aren't aware make all the difference in the world to a patient. I am so grateful to her, because my recovery was a snap. I was able to start ice chips within 10 minutes of waking up in PACU.
Rachel was my PACU nurse, and she was fantastic. She's been an RN 25 years, and she is really good at what she does. It's the little things. She gave me extra fluid...in PACU alone, she gave me 2L of NS, by drip. In the ICU, you have to use channels and pumps for most things....like you don't let Levophed or insulin in by eyeballing the drips. You don't run in stuff for hemodynamically unstable people...(well, unless they're hemodynamically unstable because you NEED to be slamming in fluid, blood, etc.) (Or in HF, obviously.) But more than you suspect just doesn't matter if it goes in drip. I can look at a drip and guesstimate what's about 75cc/hr. Rachel had the 2L run in pretty fast. It was the best. thing. ever. for me. I think it also helped prevent nausea, and cleared the anesthesia faster. And I felt really good this morning. That's due to Rachel and Brittany, and also the skill of Dr. Aycock.
We were home by noon, and I was able to keep down fruit. The drive made me a little nauseated, but I had 4mg of Zofran, and I was golden.
Didn't sleep well last night, not sure why. Dropped off to sleep sometime after 1am, I think, and woke up when Mark went to work. Am feeling good today, and then forgetting, and doing a little too much. Can't shower yet, but I am doing laundry and litter box, and probably should not. Also, want to cook one of the Blue Aprons today...it's cloudy and cold-ish out, so am thinking the Udon Noodle Soup sounds great.
Anyway. That's the good news. Remember: I can breathe now, freely for the first time in my life. I no longer have a chronic cough, and so far, I'm not getting upper respiratory infections at the drop of a hat. And I no longer have, and will never get, breast cancer ever again. Big upsides here.
There's complicated news, too. Dr. Aycock wants to show me pictures of my chest at my postop appt. I should have seen this coming, and I did actually think of this....I just avoided thinking hard on this. So. The silicone implants are UNDER my pectoral muscles, right? So what's between them and my pleural cavity? Nothing. That's inherently a not-great idea.
On the slightly less concerning side, the left, is a plate Jarozsewski used to affix my rib that she fractured when correcting the rib flare. Had to be done so the bone wasn't poking my ventricle. (I showed the CT to Dr. Johnson last week, and I may not soon forget the look on his face when he said, "Michelle, you could have died." Something about hearing that with that level of seriousness from him....anyway.) (Not like I didn't know, but it's different when it comes from him.)
So there's a bag of silicone that will always be rubbing against a plate. Aycock wants the plate out. That's reasonable. It means more general anesthesia, more cutting, more annoying time off and scheduling....but she is right.
On the right, one of the bars is coming up above my ribs, "poking" out. It's not really "poking," as it is a smooth bar. It's my anatomy. The right side of my chest, the right cartilage, has been the most warped, because the sternum was rotated medially, and deeply, toward the right. (Look over at the page with my CT if that does not make sense.) So the cartilage is more jacked up on the right. The bones are fine; pectus is a cartigilatinous malformation. So the bar is higher than the cartilage, probably. However, that bar is constantly up against the silicone implant.
This isn't good because implants rupture without help. And if...and Aycock says all implants will rupture in time...and when it does, silicone dumps into my pleural cavity.
That would be bad. A level of bad fairly equal to a bone shard poking my ventricle. The bone shard would have been a quick and painless death. How do you get silicone out of pleural space? Even if you surgically went in and suctioned, how would you ever get it all?
So we don't want that to happen. But it's not as urgent as the bone shard, and after all I walked around for four months like that, and only knew about it for about six weeks.
So I'm not really done. Multiple options. Aycock wants to talk to Jaroszewski, which I support. Aycock wants to know J's thoughts on taking the bars out early, which I would prefer not to do. My sternum could easily collapse back in and all of this was for mostly nothing...I mean, the no-breast-cancer thing stands, but then I go back to a life of URIs and dying sucking on a ventilator. Aycock also said I can consider a flap surgery, which would eliminate the silicone-bursting risk completely, of course. I didn't want to do a flap initially because it's a longer recovery. But it may be safest in the long run, and right now, she's proposing only the right at the moment. However, if the left pops, I have buffalo chest....the silicone would still go into my pleural space. Not just the left...my left and right are connected now. Aycock may not be aware of that....it was Lavelle who told me that when he supervised the taps.
Aycock wants to go back and do something about this within the year or so. So I'm not really done. I have to work at least 2000 hours before I can get FMLA again. All of this is damned irritating.
I asked Lavelle to order a CXR for me, and he did. Will get that snapped this week, so we can kinda see what all Jaroszewski did in there. Aycock has pictures of the innards, but I think it would help with planning to understand the placement of stuff. Aycock wants to consider regular MRIs as well, though she isn't sure how well she'll be able to visualize with the hardware.
So. There you have it.
Recovering well today. Will try to do somewhat less, because I need to remember to not lift stuff. Will work on readings for school instead, that'll keep me sitting. Took Advil today, which am not really supposed to do due to "bleeding risk," which I'm not. But I'd rather do the Advil than oxy if I can. I think I had two oxys total since coming home yesterday around noon, which is pretty decent. And yeah, Udon soup. That's the plan today: homework and Udon soup.