Stage 2 Reconstruction and Recovery (the next day).

During the preparation for my Stage two breast reconstructive surgery (removal of tissue expanders and addition of silicone implants), I was asked a lot of questions about my health. I admitted I felt I wasn’t as healthy as I was when I went in for my double mastectomy 4 months earlier. The double mastectomy had knocked my socks off…and not in a good way.  I was foggy for weeks after the surgery, I lost my vocabulary and had mild (but worrying) short term memory.  The worst thing was my sleep pattern, I went from 7 and a half hours to 3 hours sleep a night.  If I took some natural sleep aids like magnesium calm, 5-HTP or Ashwaganda I could squeak out 4 and a half hours.  If I went to bed at 8 pm I could sometimes get over 5 hours before 6 am.  Lack of sleep is sucky, everything was an effort, I’d crash at 3 pm. I spent 4 months desperately looking for a solution. Melatonin or Ambien didn’t do anything to help.

So during the run-up to my second surgery I was very concerned about adding to my brain fog and worried that more anesthesia would remove more points off my IQ; I was tested at 12 and told my IQ was 138, after surgery I felt like I was on the slippery slope to double digits.  A month ago I started a really good job at a really good company. It was a really good career move, I want to do well. I need the sharp Mandy brain back. I want my old intellect, vocabulary, humor and life back!!!

I had brown chestnut hair 6 months ago!
I had brown chestnut hair 6 months ago!

Before Stage 2 (Exchange) surgery I spoke with a nurse from the hospital, a couple of people in an internal medicine office (where I went for blood tests and EKG) and people at my plastic surgeon’s office. During each visit I expressed my concern about my reduced sleep and (what felt like) brain damage from the anesthesia.

The nurse at the hospital asked about any neurological changes, and I immediately told her about my insomnia and fuzzy brain. She took me seriously and said she would make a note for the anesthesiologist. I felt good that it was documented. But I was worried that if I got the same anaesthesiologist again he wouldn’t take my concerns seriously.

The night before my surgery an anesthesiologist call me, introduced himself and asked if I had any questions or concerns. Alrightythen, my chance to talk to the person in control of adding chemicals to my brain.  He was very nice, very noncommittal and general with his answers. He said the anesthesia should be out of my system within hours and shouldn’t produce any long term effects. He recently had hip surgery in August and totally understood how I must have felt, he felt “off” too. The said my brain issues should not have anything to do with the anesthesia I had in July. My entire body was reacting to the trauma of a major surgery, I just needed to take care of myself, eat well, and sleep when I could, to allow my body to repair and recover.  After the call I felt relieved it wasn’t the same guy as last time, but I also felt unfulfilled. He hadn’t convinced me that he wasn’t going to etch away more IQ points.

Yesterday after I had checked-in to the Hospital and was on the gurney in my stylish backless gown and white compression tights, Dr Brian Fassel the anesthesiologist came to visit. I was strangely reassured that he was older than the last dude. He went over what we had talked about the evening before. I said I was still concerned. After the last surgery I couldn’t finish sentences. When I walked for the first time after surgery my hands shook like a Parkinson’s patient. I could hardly form words the night I went home, I was so doped up. He did a wonderful thing, he listened.  He looked at my chart that had the details from my last surgery. He mentioned I had propofol, some gasses and narcotics (or may be it was narcotic gasses). He said he wouldn’t give me the gasses and reduce the narcotics. I felt good. I was glad I had persisted and told everyone I could about my experience, and the guy who really needed to pay attention did!

When the time came I said goodbye to the Hubs and was wheeled off into the operation room. There were a lot of people in the operating room, but I just listed to Brian. He asked me to shimmy over onto the operating table, he was going to take care of me.  I smiled and laid back. I could feel cold fluid being pushed through the IV in my wrist. I was excited to feel how I would go under.  My last surgery I was talking, then they woke me up; boom, I was out.  This time I paid attention to the cold fluid then I heard a clanging sound in my ears and I was out. The sound was like someone hammering on a metal pipe, just like the clanging noise in an MRI.  I thought my eyes would go fuzzy like they do when I faint, but my sight was crystal clear, the noise got louder and then I was out.

I remember nothing during surgery. I went down with a clanging sound and instantly I heard someone saying “Are you awake?” I was, by brain was sharp, I could see the clock at the nurses reception without my glasses; 2:09 pm.  My 11 am surgery had been delayed for over an hour, I expected the time to be 3 or 4 pm.  I was instantly excited, that meant no complications, probably no Alloderm, the surgery had been fast.  I tried to feel under my armpits for a drain.  No drain.  How lucky can I get. This is better than my best expectations. Dr Fassel came to see me.  He had only given me propofol, and was now dripping in a gram of Tylenol (no narcotics) and wanted to make sure I wasn’t in pain.  I felt a little uncomfortable on my chest, but I wouldn’t call it pain. I asked him again what his name was. I was going to give him the best review ever on Healthgrades.com. I was going to ask for him at my next surgery.  I thanked him and told him I felt great.

First glimpse of the new girls. I'm not ready to unwrap them yet. May be I'll look later today.
First glimpse of the new girls. I’m not ready to unwrap them yet. May be I’ll look later today.

Bobbie the nurse who had helped me get ready for surgery was there. She probabley isn’t even 10 years older than me, but it was nice to be mothered by a nurse.  She gave me some ice for my throat that was sore from being intubated. She asked if I was in pain, or needed a warm blanket. I was cold, so over the course of my recovery she bought me 3 warm blankets and refilled my ice water cup. I checked below and I hadn’t been catheterized. I smiled and thought “it’s the little things that make all the difference.”

At about 3:20 pm Chris was allowed in. Bobbie asked if I was ready to try and walk. I was ready to pee (a requirement of being discharged). She asked if I wanted to walk to the bathroom and get changed.  Three in 1 baby.  I walked to the bathroom with Chris, peed and got dressed. I couldn’t believe how good I felt.

By 4 pm Chris was signing the discharge papers and I was ready to go home . I was wheeled to the door and waited while Chris got the car. As we drove away I noticed it was 4:20 pm. Compared to my last surgery this was a dream!

Dr. Brian Fassel, DO Rocks!

Thank you Cheryl and Bobbie, sorry I never got to say goodbye!  You guys were great and made a scary situation very pleasant.

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