When It Rains, It Fracking Pours (Part II)

You know you’ve been blogging a while when you recycle an earlier blog title.  The last time I used this title, I had just found out I did not have the CA 125 marker for ovarian cancer but had also been let go by my old firm.  That was mid-March of this year.  Again, it’s crazy how fast time is going by.

The reason for the title this time is the fact that not only do I have new nipples installed, but I’m also moving to the Bay Area.  After several months of applying for jobs in the Bay Area, I landed a gig with a disability rights firm in Oakland.  The timing is so crazy since I recently accepted a position with my current firm that I adore.  This job came out of the blue — a job I had applied for before accepting the position with my current firm.  It is all very fitting, given my journey with Karla for the last couple years.  I’m switching sides (as you may recall, I do defense work right now), jurisdiction (although I passed the California Bar in 2002, I’ve never practiced in this California), and practice area (construction defect vs. civil rights) – not to mention moving to a whole new city!  Holy fucking crap.  I’m finally fulfilling my dream of moving to the Bay Area.  I’m not sure if I will live in Oakland or San Francisco, but I have enough friends in both to couch surf while I decide the best living situation for me. 

I have a whole life in Seattle I need to pack up and fit into a U-Haul that will ship my ass to the Bay Area, and although I am sad to leave my family here in Seattle who has taken such good care of me during my battle with Karla, I am ready for the next step.  If Karla taught me anything, it’s to stop talking and start doing, and right now, “doing” means moving to the Bay Area and working for an amazing civil rights firm.

The other big event is that I’m having my uterine fibroids taken out on Tuesday.  Complications with my health insurance have made it imperative that I have any major procedures/surgeries before November 1st, and I’ve had this surgery planned for a while.  Yesterday I had an intravaginal ultrasound yesterday to track my fibroids, which I’ve described in prior blog posts as the most fucked up experience I’ve ever had in a hospital.  Here’s a dildo that I will maneuver around inside of you for the next 45 minutes.  Would you like to insert it yourself or would you like me to do it for you?

I go in this Friday for a pre-op appointment with Dr. Rothblatt, my gynecologist and fibroid surgeon.  If the only benefit to this surgery is the fact that my periods will be lighter (i.e. less of a murder scene in the bathroom), I may opt out of the surgery, but if removing my fibroids will increase my chances of conceiving a child in the future, I’m on board 100%.

Given my recent news of moving, I am feeling my close friends in Seattle start to pull away from me and my friends in the Bay Area fight over where I will live.  I recognize that the Bay Area will not be the panacea to all my woes here in Seattle — I will still struggle with the fears of recurrent cancer, I will still struggle to find an appropriate mate, and I will still deal with financial difficulties galore (even with my new job).  I just hope I will find a space that is my own to carve out and to own as mine and mine alone.  I’m excited for the new path on which I’m traveling.  I hope it will be healthy, happy, and fulfilling (in mind, soul, and body).

I’m being swept up in a sea of change that I can’t control right now and it’s so exciting and scary all at the same time.  I’m not sure how this will all end, but what I do know is that every bit of it sounds right.  I’ve been looking for appropriate cliffs to dive off of for a while, and I think I found the appropriate ones from which I’ll soar.

That all said, I leave you with an amazing soundtrack from Shawn Lee & Clutchy Hopkins.  These peeps grooved my soul today and deserve some props: http://www.youtube.com/watch?v=ytcKXCJrx8A.  If this link no longer works, the track is called “Ancient Chinese Secret.”  Given my part-Chinese ancestry and the bumpy-get-me-in-a-good-mood-feel this track has — it’s appropriate.

How You Like Me Now?

I have new nipples.  I can’t believe it, I better type it again – I have new nipples!  And how fitting that I got them almost one year after my mastectomies.  My how time flies.

I went in on Wednesday for the “in office procedure” to have my nipples installed by Dr. Paige, and little did I know how involved this procedure would be.  My girlfriend, Kiko, picked me up very early to take me down to Federal Way (about 30 minutes south of Seattle) for my 7:30 check-in time.  Immediately upon my arrival, I went through full surgery prep with the nurses, stripping down to my underwear and socks and putting on a hospital gown.  Dr. Paige came in to greet me and mark where my new nipples were to be installed.  He then escorted me to a mirror and asked me if I agreed with the marks.  It’s been so long since I’ve had nipples, I had a hard time envisioning nipples where these two sharpie pen marks were on my chest.  I exited the bathroom and told Dr. Paige that the marks “looked fine.”  Inside I prayed that he really did mark them in appropriate locations. 

I was transported to an operating room where the nurses situated me on the operating table and strapped my arms down (at my request so that I’d keep my arms in place).  As I lay on the operating table, I noted how cold the room was and realized that I would have to withstand the whole hour-long procedure with my bare chest exposed to the cold.  I was thankful that they didn’t hook me up to a heart monitor, as I could feel my anxiety level rise. 

Dr. Paige entered the room and explained that he was going to give me the local anesthetic to numb the area.  As he started injecting Lidocaine into the area of my left breast where the nipple was to be installed, my gut twitched with every other stab of the needle.  I realized that I could feel a lot of what was going on in that area.  Dr. Paige noticed that I was in discomfort and apologized.  I looked at him and said that I was very grateful to feel some of the needle work, as it is a sign that some my nerve endings are rejuvenating.   Dr. Paige smiled and commended me on my positive outlook. 

As he injected a bunch more Lidocaine in my right breast, I realized that I have been in this exact situation before.  You may recall that before my mastectomies the radiologist performed a lymphoscintigraphy to identify the sentinel lymph node (the first node to receive lymph from a tumor) in each breast.  This procedure involved him injecting a bunch of Lidocaine in each nipple before injecting dye that would ultimately drain into the sentinel lymph node of each breast, allowing him to identify the nodes for my breast surgeon to remove for biopsy.  I cried on the radiologist’s examination table while he injected me with the Lidocaine in each nipple.  The procedure was fucking painful.  I sobbed, knowing that this would be the last sensation I would remember of my nipples.  By the end of that day, I no longer had breasts or nipples.  So as I lay on Dr. Paige’s operating table this past Wednesday, I realized how fitting this whole procedure was — this is the way I lost my nipples, and this was going to be the way I got them back.

After Dr. Paige completed injecting all the Lidocaine, he left to give the Lidocaine some time to take effect and to allow the nurses to prep my chest for surgery.  The nurses sanitized my chest area, put rolled up towels around my chest area, and then put up a blue sheet to block my face.  I suspect this blue sheet had two goals: (1) prevent me from breathing on and contaminating the surgery area; and (2) prevent me from passing out or otherwise freaking out by being able to see what Dr. Paige was doing.

Dr. Paige returned to the room within 10-15 minutes, checked the areas to make sure they were numb, and then proceeded to make the incision that would serve as the basis for my nipple on my left breast.  It was surreal to lay there and feel him poke, prod, and tug on me without feeling any pain.  I experienced a lot of cognitive dissonance in that moment — Dr. Paige was cutting, pulling, and stitching in an area that has always been a very sensitive area for me.  Although I have not had nipples or very much sensation in that area for almost one year to the day, not being able to see what was going on or feel any actual pain was making me anxious.  I felt like I should have been feeling pain, and with each stitch that Dr. Paige made (I could make out some of his movements based on sensation I felt in other areas of my chest), I was deathly afraid that I would feel the needle go in.

One of the nurses sensed my anxiety and started talking to me to distract me from what Dr. Paige was doing.  I was grateful for the distraction.  By the time Dr. Paige was done with my right nipple, he had spent less than 45 minutes doing the whole procedure.  The nurses cleaned up my chest area, put on these dome protectors for my nipples that look like Slurpee cup tops, and brought me to the recovery area. 

Dr. Paige warned me that the nipples would look huge right after the procedure, but they would soon heal down to nubs that would be more reasonable in size.  When the nurses brought down the blue sheet covering my face, I saw what he was talking about.  They have a bunch of stitches in them and they look Frankensteinish, but I can totally see how these will heal into attractive nipples.  I pray that I don’t experience any complications.

The nurse in the recovery area helped me get dressed, went over my post-op instructions, and immediately released me.  My girlfriend Eza picked me up, we had brunch, and then she took me to work, where I proceeded to work a full work day.  Dr. Paige prescribed some pain killers for me, but I haven’t picked up the prescription and I don’t think I will, because I don’t need them.  As long as I don’t stretch my chest area, I’m not in any pain. 

I have one more step in this process – areola tattooing.  Dr. Paige tells me that he wants to wait a couple months to allow me to fully heal from the nipple installation before starting the tattooing.  I can’t wait.

For today’s soundtrack, I heard this on one of my favorite online radio stations, KCRW.com, and immediately got into a great mood.  The title of the song became my battle cry after my new nipples were installed:  http://www.youtube.com/watch?v=sVzvRsl4rEM.

The Final Stretch Begins

I’ve just returned from a total of 15 days in the Bay Area, attending a wonderful bachelorette party, a housewarming, and a wedding.  That’s why I’ve been offline for a bit, and also why I’m overwhelmed that my nipple reconstruction surgery is scheduled for tomorrow morning.  When I first tried to calendar this procedure with Dr. Paige’s scheduler, Laura, she told me that Dr. Paige’s first available appointment was November 18th.  But then Laura worked it so that my procedure will take place at the Federal Way branch of Virginia Mason, just south of Seattle, where Dr. Paige spends a couple days a week.  Thank the heavens, since Dr. Paige explained to me that he wants to wait a couple months after my nipple reconstruction before he tattoos on my areolas.  With my nipples being “installed” tomorrow, if I don’t experience any complications with this procedure, I may be done with this whole process before the holidays!  I sure hope nothing goes wrong.  As you all know, I’m very ready for my reconstruction to be complete.

I’m told the procedure itself takes an hour total for both nipples.  I’m not under general anesthesia during this process – Dr. Paige will use a local anesthetic only (lidocaine or a lidocaine derivative).  That means I’ll be able to watch what Dr. Paige does if I’m so inclined to look down and pay attention.  I’m not sure I’m going to do that, as I can barely make eye contact with a phlebotomist while she/he is sticking me with a needle to take blood.

After the procedure, I’m told I’ll be in “recovery” for a bit before I’m released for the day.  Patients are advised to take the rest of the day off, but many go back to work, which is exactly what I intend to do unless something goes screwy and I’m physically unable to type on a keyboard.  Unfortunately, I’ve gained a bit of a flippant attitude about surgery and treatment.  I’ve had so many surgeries that I can’t count them on one hand anymore, and I worked all throughout chemo, so in my mind, why not go back to work after my nipple reconstruction?  I have a ton of work to get done this week, and I don’t expect this procedure will set me back too much.  However, now that I’ve gotten cocky and typed that out, I just know I will have a Murphy’s Law day tomorrow and something will go wrong . . . but let’s hope not.

I will have to wear little plastic domes over my reconstructed nipples for a couple weeks to prevent any direct pressure on the freshly created nubs.  I can shower, but I’m supposed to refrain from baths, hot tubs, saunas, and the like.  After a few weeks, I’ll go back in to see Dr. Paige for a post-op follow up and have my stitches taken out, which I suspect will be a very weird experience too.

Given my many days of bliss in the Bay Area, I’ve chosen a remix of a very special song for today’s soundtrack: http://www.youtube.com/watch?v=UW1QGrRmRQ4&feature=fvw.