When the Physician's Assistant, Jennifer, came into the examining room, I immediately sensed that something was amiss. She asked several times, "Why didn't I know you were here?" Well, that's hardly a question to ask me. I didn't know. She asked me if I was having any problems or wanted to pursue any revisions to the reconstruction. There is one place under my arm that's still hideous, so I mentioned that, even though I couldn't see that the conversation had much relevance to the reason we were there. Jennifer told me that all revisions must be completed before the nipple construction. Somewhere along the way, I noted that the nipple was my whole raison d'etre for being there. Uh oh.Gwen, the lady who made my appointment stuck her head in to verify that I'd originally been scheduled for last Thursday. "That's absolutely right. That's what I thought." I was puzzled that they thought there was any way I'd be confused about when to show up.
Dr. Kroniwitz finally arrived to tell me that he doesn't do procedures on Tuesday. Gwen (who is generally excellent at her job) scheduled me for the wrong day. Dr. Kronowitz was embarrassed and clearly felt terrible about the expense and inconvenience. He personally went to reschedule my appointment for January 29. He offered to see me next week, but I couldn't do it. I needed a break before the trip, a break from the stress.
"Well, we have to do something, Dr. Kronowitz," I told him. Otherwise my supplemental insurance wouldn't reimburse me for any of the travel and hotel expenses.
"Okay. Let's do some injections," he suggested.
I was cheered up and agreed immediately; he was awed by my enthusiasm. I waited, flat on my back on the exam table for about 15 minutes; it was beginning to hurt by then. Eventually, they arrived to perform the steroid injections on various chelated scars. We did my reconstructed breast. No problem, except for a huge scar underneath the breast. It's not numb and, though the steroids are mixed with lidocaine, the anesthetic didn't have time to prevent pain as he stabbed me several times with the needle. Jennifer commented that the needle was larger than she expected. Then the real fun began.
He began a series of injections in the scars across my lower abdomen. I am not numb there, either. He also injected the two scars on my pelvis where the drains were inserted. Nope, not numb.
I think one of the biggest revelations of my breast cancer journey is the discovery that there are a lot of different kinds of pain. I had no idea pain could take so many forms. (I'm certain that I still haven't experienced all of them.) There's surgery pain and chemo pain (which in itself involves several previously unknown types of physical suffering), there's pain from needles inserted into my breast, pain from having massive amounts of skin and tissue moved from one place to the other. I've also experienced unspeakable psychological pain from simply trying to withstand the process and, after my tram flap, from being dependent on other people to move me from one place to another. Steroid injections into the abdomen and pelvis definitely provided me with yet another novel form of pain.
The steroids are systemic and the revved up feeling reminded me of the way I used to feel the day after chemo. A chilling memory.
There is yet another surgery coming, but I deferred it for six months. I have officially hit the wall. I don't have the mental strength to undergo another surgery any time soon. It took several days to steel myself for the nipple reconstruction. As I sat in the living room on Sunday (the day before I left town), I knew that I've reached the end of my psychological rope. The warrior spirit has been completely depleted.
For the next week and a half, I'll be trying to mentally prepare myself for another round of stress, another visit to a previously unknown type of pain. I can do this. Yes I can.
