Wednesday, 29 October 2014

Day 419: Fat arm getting smaller and plan for reconstruction

I have spent the last month + taking the family back to Hamilton Island (late Sept - early Oct), learning to wear my fetching compression garments (sleeve and glove) daily plus my Caresia (quilt-like sleeve designed to break up the fibrosis in my arm) every night and getting massage and laser on my arm, and investigating reconstruction options.  I'm also trying to rebuild strength, get the kids to their activities and appointments and get some rest.  As you'd imagine, the latter is not really happening.

My lymphoedema seems to be gradually improving.  My arm circumfrence has decreased by 3cm in the past 5 weeks and the bio-impedence measure of fluids has come down from 72 to 50.5 (normal is between -10 to +10). To get it under control, i need to do my daily routine as per above, get a lymphatic drainage massage at least once/month and get the hard area around my elbow lasered at least once/month.  I put the garments on when I first get up and try not to think about them.  They are unsightly and hot, but they are doing their job.  The other appointments are time-consuming and cost about $250/month, not reimbursable by Medicare or private health.  Drag.  I am soldiering on in the hopes of consistent improvement.

When I saw Dr. Andrew in Sept, he suggested I seriously consider a tirrue reconstruction as it might improve my lymphoedema, so I had consults with 2 different plastic surgeons.  I learned that it's a massive operation to take the tummy tissue and move it up to rebuild a breast (I already knew that and thus has no interest), it's a 6 week - 3 month recovery and I only have enough tissue for one breast.  I considered the benefits of the possibility (no guarantee) of improving my arm swelling with the introduction of fresh tissue and the transplant of the superficial lymph nodes from my groin as a part of the operation.  Then I decided that I don't want another major surgery at this point in time.

After weighting my options, I decided to go with my original plan to go perky.  On Tuesday Dr. Andrew booked me in for a right mastectomy and implant reconstruction on both sides.  He will remove the expander on the left (which needs to be done soon anyway and it driving me nuts) and try to go directly to implant on the right.  If he can't, he'll do an expander.  I'm going in on 13th November (before summer and Xmas and before the kids move to a school that requires a drive) and will be in for at least 5 days and maybe more, depending on how quickly the fluid drains.  Onward and upward!

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