Monday, November 8, 2010

Visit with the plastic surgeon . . . and side effects

I saw the plastic surgeon today and ultimately, he said that he would do the lat-flap surgery (use the latissimus muscle under my armpit) and that ultimately the timing of the surgery would be up to Dr. F, my surgeon. So, I'll wait a couple of days and then call Dr. F's office to schedule an appointment and talk about timing.

There's a part of me that wonders if the whole area would eventually heal itself. However, I remembered that the wound probably wouldn't heal as long as I'm on Abraxane. Dr. K would like for me to be on Abraxane for six months, which means that I'd end up with an open wound for at least that long. And, with an open wound comes the risk of infection, like I had last month. I also have a surface infection, too, which looks like a green discoloration on my dressings. It's "pseudomonisis" which is the bacteria that grows in your vases when you have flowers. I've been trying to get rid of it for almost a week now. It got a little bit better after I saw the wound care nurse - as she cleaned the area really well - and even though I've cleaned it with iodine once and have been trying to flush the area with saline, it's hard for me to do this without getting saline everywhere . . . Anyway, I guess I think that that armpit area seems to get infected easier than the other wound I had, so I might as well get the whole thing repaired to decrease that infection risk.

I told Dr. H (the plastic surgeon) that Dr. K (my oncologist) would be willing for me to take about a 6-week break from Abraxane in order to have the surgery, and probably even more so now that my tumor marker dropped so much in just one month, so that there will probably be very low levels of cancer cells running around in my system. Then, after I am recovered from surgery, I would go back on Abraxane to knock the rest of those cancer cells out.

I also asked Dr. H if he could trim the "dog ear" that was left at my beltline from the reconstruction surgery. He said that he would. I also asked if he could drop the implant down to match with the TRAM flap and he said that he'd rather not mess with it, since I have such a major wound on the armpit and he didn't want to open anything else up. If, however, cancer or bacteria got onto the implant, he said that it would have to come out. So, in the end, he said that he might bring in a spare implant and would try to drop it farther down into the pocket, so he might be able to make me more lopsided. That is, if the implant had cancer or otherwise had a risk of infection.

So, in terms of other side effects, I wanted to report that my scalp is now breaking out in zits. It's also pretty tender in some places. Now, I have to figure out how to take care of the scalp - one website said to treat it as you do your face, with milder moisturizers and cleansers.

In addition - and forgive me if this is too much information (Daria at LIving With Cancer also wondered about reporting these side effects the other day in her blog; in the interest of passing on my experiences to other cancer survivors, I'm telling my readers what's going on) - I have had some constipation (from the anti-nausea meds). I have some Chinese herbs from my acupuncturist that seemed to help me become regular again sooner than I did previously. But, last night, my stomach muscles starting cramping again. I think I reported that it seemed to do that the evening of my treatment. But this time, it happened three days later. It's been acting up all day, too. It seems to cramp up a couple of hours after I eat. And, I have had some mild diarrhea off and on all day and the cramps seem to get a little bit better afterwards. So, I started wondering if the cramping was happening in my intestines rather than in my stomach - and that they are cramping trying to get the food processed through my digestive system. So, I'm trying to drink lots of water. And, it's all complicated this time by having a head cold and taking some nasal decongestant medicines. (I am going to do my best to avoid crowds and public places while I'm on Abraxane - I don't need to deal with colds on top of my other health issues!)

So, a talk with Dr. F is in order sometime this week. I see the wound care nurse tomorrow and will also see what she says.

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