08
Mar
08

March 8, 2008

Ouch.

Do you know what happens when you are startled, say, when someone sneaks up behind you and touches you, or when you’re playing a computer role-playing game, and the bad guy jumps out in front of you unexpectedly?

You jump.

But do you know the specifics? Your pelvic floor tightens and jerks upward, your abdominal muscles tighten and pull inwards, and not only that, but quite probably, if you’re sitting down, you involuntarily push yourself upwards in a flight response, however aborted.

Ouch.

I had thought that, in spite of the ongoing pain as the usual bowel function has been restoring itself, I was starting to really improve, and that the abused muscles and tissues were starting to reach normal levels of usage without too much pain.

What the above reaction showed me is that in fact, I’m still babying my body, and with very good reason. I started paying attention, and I noticed that I still move very slowly, and initially I walk hunched over my abdomen slightly and straighten up only after several steps. I’m still resting against the backs of chairs when I sit down, although normally, I typically sit forward. Trying to stay upright on the exam table requires a lot more effort from one’s abdominal muscles that I realized. Bending over, I’m using lots of support from my arms, which is OK as long as I don’t push down, or put a lot of weight on the arms (or move them very far in any direction). When you just have laparoscopic surgery, you depend on your arm and chest muscles to compensate for not being able to use your abdominals. When you have breast surgery, you depend on your abdominal muscles to compensate for not being able to use your arms or your chest muscles. When you’ve had both. . .

So no scary movies for me for another week at least.

Weight-wise, I’ve actually dropped four pounds in two weeks, mostly because I haven’t been eating a lot. I’m generally back to normal foods, but my appetite is feeling pretty reduced.

We met with the plastic surgeon on Thursday – he’s pleased with the general results, although I think he agrees that the right side is currently not looking the way *I* want it to look (it may look fine to him, as far as being a surgeon goes, but aesthetically, I’m not happy because it still bulges too much to the side and is still fairly flat on top). Of course, there’s swelling, and so it’s hard to tell what it’s going to look like in the long run – before I freak out and start demanding that it be put “right”, I’m going to control myself and wait to see what it looks like once it is declared healed. The left side looks pretty good – still bulges a little to the side, but it’s more rounded and evenly proportioned. I have to do nothing with my arms for another week, and have another appointment in two weeks.

My ovary surgeon is in Maui for ten days (I hadn’t realized that I’d forced her to do a major operation the day before she was leaving for vacation, but it explains the hesitation her scheduler had about the 29th, and also why in the face of the hesitation she didn’t suggest moving to the next week). I’ve had some difficulty getting the pain medication and the stool softener dosages correlated properly – Brian and I call it the Porridge Paradigm, and decided that the point is searching for the Goldilocks Effect. You know the story – this porridge is too hot, this porridge is too cold, this porridge is just right; this bed is too hard, this bed is too soft, this bed is just right – substitute stool for bed, and you’ve got the point. However, I’ve managed to reduce the pain pills to roughly 1/4 – 1/3 the maximum dosage I was taking (although I bumped that up briefly after the little “dungeon exploring accident”). My follow-up with her is in a week.

I also met with the oncologist for the first time since my last chemo in December. Now that I’m post-menopausal, he wants me to start my aromatase inhibitor, and we’ve settled on the particular one (Letrozole, brand name: Femara – don’t you love these drug brand names? This ones sounds so feminine yet mature. . .). He gave me a month’s sample to get me started. I’m planning on starting it on the 16th (he doesn’t know that – I decided that after I’d gotten home from a long tiring afternoon). But I don’t think my body is quite ready for a major influence change this close to having had surgery – I’m going to give it another week to heal, and to shake out the new status of being a (mostly) estrogen-free state (not quite like Jefferson Free State, but we no longer owe those annoying hormonal taxes). I haven’t had a lot of reaction yet to the lack of estrogen – as I mentioned in my previous post, I had started sleeping warm again, and that is continuing; however, I am starting to have hot spells during the day (they don’t really “flash” – that makes it sound as if you are just all of a sudden sweating and way too hot – mine creep up on me, and if I ignore them they will kind of “flash”, but if I take care of it as I feel it coming on, by removing my hat or scarf, it’s usually just fine). I asked the oncologist how quickly one should expect the estrogen to be gone after surgically removing the main source, thus triggering official menopause, and he admitted that he doesn’t know. I’ve tried to find it on the ‘net, and haven’t found anything that really specifies that particular information. Should I be searching for “estrogen half-life” or something? I guess if I don’t know what my base level of estrogen was to begin with, knowing the half-life wouldn’t really be any help.

So that’s how it’s going for now – mostly not too bad as long as nothing sneaks up on me.

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