Preparing for Exchange Surgery

I’ve been considering writing a post about how the craziness of Covid-19 is affecting my breast cancer treatment, but honestly, I am one of the lucky ones who it is not affecting any more than the average person.

One of the big concerns for cancer patients is the increased risk associated with being immuno-compromised, a major side effect of chemo and radiation. Since I did not have either, I am not immuno-compromised. I am also far enough out from my surgery (almost four months) so that is not an issue either. The third high risk category is those people with pre-existing conditions. Again, I am lucky that this is not an issue for me. So all-in-all, I am currently at the same risk level as most of the population.

There is one way I have been affected though. My exchange surgery has been approaching. April 23rd was to be the day, and as the virus has spread, service after service has shut down. I was coming to realise that my surgery probably wouldn’t go ahead.

The first blow was when elective surgery was cancelled in Victoria. Not my state, but these things seem to spread almost as quickly as the virus. While lumpectomy or mastectomy surgery is considered urgent and will not be cancelled, exchange or reconstructive surgery is elective.

In reality I can have these tissue expanders in for up to 18 months. My surgeon even gave me that option when the final expansion was done. I’ve also heard of people having them for over two years. So there is no risk medically to not have this surgery in April. I was just hoping to get it done so that I could move on as quickly as possible.

Another reason I wanted it done sooner rather than later was financial. The health insurance I have says I have to pay the hospital excess of $500 once per calendar year. I already paid it once last year, so I will have to pay it again for this procedure. Having it done earlier in the year means I have months to decide on nipple reconstruction, revision or fat-grafting, which I can have done before the end of the year without paying the excess again.

So while I was thinking my surgery would probably be cancelled, I was also holding out some hope that it wouldn’t be. And then our Prime Minister announced all elective surgery would be cancelled nationwide to preserve PPE equipment for essential hospital services.

Urgh!

I made a call to my surgeon’s office to see where we go from here. Does he need to check on me regularly over the next few months? Do I need to book another date now or will they sort it out? As I chatted to his assistant, she casually mentioned he was doing an extra day of surgery next Wednesday, the last day before the restrictions were to be in place. Would I like to have my surgery then? I said no, I would wait, after all, there is no real rush.

I got off the phone and thought for a bit. I’m not high risk for Covid-19, I have no idea when I would be able to get my exchange done in the future, and really, while they are not painful, these expanders are slightly uncomfortable and it would be nice not to have them! I had no real reason for not getting it done. My husband is even off work for two weeks from that day, so timing is perfect in terms of him being home to help if I can’t do things.

So I called back and booked in for my exchange surgery in just five days time!

Exchange surgery is the removal of the tissue expanders I had put in during my mastectomy surgery and replacing them with traditional breast implants. The implants I am having will be a silicon gel. They will be smooth, round, and high profile. I will likely have them for the next 10-15 years, although it is possible I will have them for life.

I’ve since gone in to have the pre-op appointment to choose my implants and learn all about the surgery. There’s not really a whole lot to it. My surgeon will whip out the expanders and stuff in the implants. He will try a couple of different implants to see which ones look the best, so really, it will be all up to him what size and shape I end up. With the proviso of course that I end up similar to what I am.

If it goes as easily as that, I will be in hospital only over night. If he has to “do some work on the pockets” I will come out of surgery with the dreaded drains attached to me again, and will likely have to spent two nights in hospital.

I’m told this surgery will be a lot less painful than the last one, but since I didn’t have a lot of pain last time anyway, I am not at all concerned about pain this time.

Recovery at home will be the same as last time. While it won’t be as bad for pain, I will still have to restrict my movements and not do any lifting etc for six weeks afterwards. I didn’t ask about showering, but I am crossing my fingers I will have waterproof dressings on and be able to shower like I could after my lumpectomy.

So now I’m all nervous and excited at the same time. The Covid-19 virus brings an extra element of risk, but I will be so glad to have moved one more step towards putting all this cancer crap behind me.

Comments

  1. Sally says:

    So glad you don’t have to wait – what a lovely surgeon – just as well you rang to check.

    Wishing you another straight forward uneventful procedure – and pain free recovery.

    1. Josie Kelsh says:

      Thanks Sally. Yes, I timed it just right! He only had time for six people wednesday, and most of them were people who were previously booked in for Thursday and Friday this week, so I was very lucky.

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