Hope Floats...Arm Flies

So I got past it finally . I underwent surgery last week. It was not lumpectomy after all but mastectomy. Browsing through my surgeon's orders that she left at the ER upon my admission, I almost panicked when the scheduled procedure she wrote was mastectomy. I had an idea it would be something short of that but when the word mastectomy is right at your face, it's like a bomb just dropped from the sky.

Subcutaneous mastectomy was done, removing the tissues beneath the skin and nipple. When I palpate my left breast now, it brings me to the ribcage directly underneath it. I'm not entirely hopeless. I was advised reconstructive surgery but the plastic surgeon suggested that we wait for the final biopsy to be sure that we were not dealing with malignancy which will require radiotherapy, which in turn is not compatible with implants. The other option presented to me was lattisimus flap, wherein they pull my muscle from the back so it fills in the area underneath the breast. The idea of having scars at the back and more wounds didn't appeal to me.

The final biopsy yielded ductal papilloma with florid epithelial hyperplasia. Not Cystosarcoma phyllodes as we were expecting. The clinical presentation of my case did not follow the typical ductal papilloma. The mass was too large for it, 13 cm in greatest diameter and I didn't have signs of nipple discharge. But then the pathologist has the final say. Good news is that it's benign and has less tendency for recurrence than phyllodes. Bad news is, it can develop into malignancy, especially with the florid epithelial hyperplasia accompanying it. The chances are slim but the risk is there. My battle is over for now and I'm praying hard it doesn't haunt me again.



It feels weird when you're a doctor knowledgeable of the procedures that will be done to you. I'm lucky I didn't have to witness my intubation. I was awakened right after they extubated me. The skin testing and IV insertion hurt, as expected. Post-operatively, I was squirming in pain even with the toradol. I asked for more pain coverage but I couldn't tolerate tramadol since it made me puke. I was thinking of nubain but I guess they're using it with more discretion now. When I got to my room, I had to pop in my stocked celecoxib just to alleviate the tormenting pain I was under. But then nothing beats the pain of having the jackson pratt drain removed. It was a grenade-shape plastic with tube that collected the blood from the operative site. I kept it for 6 days. When it was due for removal, I knew it would hurt but dang I didn't expect it to hurt THAAAT bad. Imagine a tube gliding against a fresh wound. The minute my doctor told me to breathe deeply, I wanted to dash out of the room. It was the famous line we deliver to patients when we're about to do something hurtful. In between supressed screams I thought I'd faint as the tube was being pulled.

I'm pretty okay now except for the brachial plexopathy i suffered, a sequela of the mastectomy, a result of the positioning of my left arm during operation. Initally, I couldn't move my left upper extremity. Though I'm typing with both hands now, my left hand is still numb and the structures proximal to it have a limited range of motion. Doing the most mundane tasks such as squirting toothpaste out of its tube, shampooing my hair, using the fork have required humongous effort since then. I can't supinate my arm. I couldn't even tuck my hair behind my ear. I've dropped softdrinks bottles.I have to push my arm laterally before I could raise it. My other arm has to catch it before it lands somewhere. Yes, I have a stubborn flying arm. Allowing it to move as it pleases is like a pathetic attempt at breakdancing. It defies my brain's commands. A post-stroke picture. Now I understand how it is to try moving your extremity with all your will-power, yet it refuses to. It gets frustrating. I'm having a hemiplegic gait. My left shoulder is lower than my right and I walk with my upper extremity really close to my trunk. Not a pretty sight, I know. I've been referred to rehab medicine but I'm still hoping I could do this on my own before I resume work on Monday.

Everyone is looking forward to my reconstructive surgery. They say it's the perfect excuse to acquiring the endowed chest that nature hasn't granted me. Sounds exciting, yes, but I have a year to think about that. As much as possible I don't want to lie on the operating table again, not with another drain left. Good Lord. Presently, all that I'm hoping is that I don't get recurrence of the mass and I restore the normal function of my left arm. Although I couldn't help feeling like some mutant now that I'm living with just one breast, all that matters is that I'm alive and with a clean bill of health again. For now, that will do. Now excuse me while I try to catch my flying arm.