My breast is angry, and it is shouting at me and spewing vile. I am fighting with it on a daily basis, trying to save the implant that my body is vehemently rejecting. I have been thinking about my breasts non-stop for the past five years and I am getting sick of them, but they won’t let me rest. The right one in particular is like a defiant child; always in trouble, always causing problems, not to mention trying to kill me.
After I finished chemo, the surgeons took out the implant that was placed during the reconstructive process post-mastectomy. They explained to me that I would have to have a tissue expander placed in my chest wall to hold the space while I underwent my second round of 35 radiation treatments in the same right breast. The tissues contract around the implant or expander during radiation causing pain and dimpling, which can result in an undesirable cosmetic outcome. So the soft implant came out and the hard tissue expander went in. I had to live with this expander for 9 very long months. I was in constant pain and discomfort, picture a squeaky toy in your chest wall. Finally the radiation oncologist and the plastic surgeon agreed that it was time to swap out the expander for a nice soft silicone implant. That was on October 19. Here we are on January 11th and the incision from that surgery has never closed. One of the many side effects of radiation is that it degrades the tissue and the local vasculature system and healing can be prolonged and complicated. Translation: they burned the shit out of my breast and severed the blood vessels in an attempt to keep the cancer from rearing its ugly head for a fourth time.
On November 19th, my plastic surgeon performed an emergency surgery to remove the month old implant and replace it with a fresh one and then revise the incision to see if he could find some healthy skin that would heal. His thought was that there was a low level of bacteria on the implant and causing things to fester instead of healing. He put the dreaded drain back in and tried a stronger oral antibiotic to see if we could prevent my body from rejecting the implant. The incision still would not close. The prescribed antibiotics caused severe joint pain and I felt very ill and in a lot of post-surgical discomfort. I was feeling as bad as when I was going through chemo, I was expecting this part of the treatment to be easier. What was I thinking? None of this has been easy for me…
A week later, I went in for a scheduled appointment to see the surgeon and he added some stitches to the incision in his office. Not a pleasant experience at all, I struggled to maintain my composure. My son was my driver that day, and he had to wait for hours for me to get sewn up again. I was only concerned for his well-being and how the long wait was affecting him. It is very hard for him to see his mother going through so much pain and suffering and for so long. I try to hide it from him, but on this day I needed him to drive me to the surgeon’s office; so he had to experience seeing his mother in a weakened and needy state. I tried to lighten the mood by letting him choose where we would pick up dinner from on our way home. He was driving his new car, so he was enjoying that a little, but I could see the anxiety on his 16-year-old face. I wanted to protect him, not ask him to take care of me, but Joe wasn’t available and I couldn’t drive.
The additional stitches didn’t do the trick and the incision slowly opened up again from the force of the fluid building up and the foreign object in my body. An infection set in. I woke up one morning with a 102 degree fever and chills so violent that I thought I was having a seizure. I immediately called my surgeon. He told me that he wanted to start me on IV antibiotics and that I needed to stay in bed while we got this acute situation under control. I honestly didn’t have any intentions of going anywhere with 102 degree fever but I absorbed the seriousness of what he was saying.
The next day I was admitted to the “Day-Stay” department of the hospital to have a PICC line (peripherally inserted central catheter) put in my artery where the IV antibiotics can be infused at home instead of in a hospital. I was happy to have the option to stay out of the hospital, but having a PICC line inserted was no easy task. The specialized nurse used an ultra-sound to locate the artery in my upper arm that leads towards my heart and then after a meticulous sterilization process inserted a long catheter into the artery. Dangling from the end of the catheter are two ports; one for the antibiotics and the other to draw blood from if need be. He put a complicated sterilized bandaging system over the opening of the PICC line and then wheeled me to X-Ray to make sure the catheter was placed correctly. Since I am on the thin side, I can feel the catheter in my arm inside my artery. It gives me the heebie jeebies, and I don’t like it at all. It makes me feel vulnerable to have a drain coming out of my side, a PICC line in my arm and an open incision on my breast.
After about four hours in the hospital and my first dose of IV antibiotics, I was released to go home and rest. I was assigned a home health care nurse; Eli. Eli is adorable, calm, and compassionate. I like all of those qualities in a human being so I was happy he was assigned to me. He came to the house and set up the IV pole, as well as the bags and bags of supplies that we would need to care for the PICC line and to get those infection killing drugs into my system. Eli got busy teaching Joe how to administer the antibiotics and to keep everything sterile. I was surprised at first that they would leave this to Joe to administer, but Eli reassured us that he would be coming daily until Joe had the process down cold.
My fever broke after a day or two on the antibiotics, but the incision still wasn’t showing any signs of healing. My plastic surgeon asked me to come into his office on a Saturday; he wanted to try to revise the incision once again and put the drain back in since he had removed it on an earlier visit. We were trying to buy us some time for the antibiotics to work. I took 2 Xanax and 2 Percocet before I went to his office, I knew he was going to “operate” on me again without general anesthesia and I needed to insulate myself from what was about to come. The drugs helped, but being awake while someone is knuckle deep in your chest is not for the faint of heart. He tried to distract me by asking questions about my son, but I could see his bloody fingers and feel the pressure of his hand inside me as he tried to push the implant aside to make room for the drain. He stitched me up and I stumbled back out to Joe who was waiting for me in the other room.
Two weeks of IV antibiotics have turned into four, and an additional broad-spectrum oral antibiotic was added to my treatment. The skin around the adhesive bandaging protecting the PICC line blistered and became weepy so I ended up at the Emergency Room with a possible PICC line infection. You can imagine how dangerous that is, since that catheter is in my artery leading to my heart; and the damn incision just won’t heal.
I was sent to see an infectious disease specialist to see if he could save this implant and get the area to heal. We knew each other from my two decades of being a pharmaceutical rep so he was very tender and kind with me and spent a lot of time talking to me and painting analogies to help me understand his opinion. Tears ran down my face as I heard his recommendation; the implant would have to come out.