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Surgery Diary

Chest Surgery Diary

August 15, 2005: E-mailing Dr Brownstein

I just e-mailed Dr Brownstein, after much 'what the hell do I put?!?!?' type wibbling.

Dr Brownstein,
After careful consideration, my friend and I have decided that we are interested in coming to you for our chest reconstruction surgery.
Would you be able to tell me if March 22nd 2006 would be an available date for us? We also would like to know what we need to do to prepare for surgery. Would it be possible to have a full expenses list as well?
We are both from outside of California, so I presume that we will need to send you photographs beforehand. I personally will be coming from England - will this be a problem? I am concerned about different names for medication (I have a penicillin allergy) and also what to do should there be any complications that arise after I have returned home.
Many thanks
Nathaniel

Now I just have to wait for his response and hope that I have enough pennies saved up.

August 28, 2005: Information Pack

I got the information pack through from Dr Brownstein so the whole surgery thing is getting closer. I need to sort out finances, flights, hotels, and who will be coming along as nurse. In six months. It's not a long time.

November 18, 2005: Rescheduling Date

I e-mailed Dr Brownstein a little while ago to see if the date I'd asked for was still available and if so, could I book my surgery for March 22nd. It's not. I'm currently waiting for an answer to my e-mail asking what the next available date is. I hope I get a reply quickly and that the next date is close to the one I wanted originally.

December 8, 2005: Confirmation of Surgery Date

A date to put in your diary: March 28, 2006. At 11.00am on that day, I will be having surgery with Dr Brownstein.

March 27, 2006: Pre-op Appointment

I had a pre-op appointment with Dr Brownstein today; it was supposed to be at 2pm but I'd got a phone call early this morning from his secretary Mary, saying that my surgery time had changed from 11am to 9am and also making my pre-op appointment a bit later at 2.15pm.

Dr Brownstein's office wasn't at all like I imagined it. I thought it would be in a medical facility but the building looks more like an office block or block of flats instead and his actual office is very cosy and open plan. I got there a little early so I was getting a bit nervous while I was waiting. It didn't take long though. I found Dr Brownstein very friendly and I felt at ease with him pretty much straight away. He explained exactly what the surgery would involve and what would happen on the day. He also gave me a prescription for Percocet. Then I went round the screened section of the office to show him what he'd be working on. I was extremely apprehensive about this, but he just asked me to lift my t-shirt and binder up, glanced at my chest and declared 'double incision'. I didn't feel as uncomfortable about it as I'd thought I might which was a great relief.

I couldn't have anything to eat from midnight onwards but that wasn't a problem. I was tired anyway and as I had to get up early to get to the surgery centre for 7.30am, I tried to have an earlyish night.

March 28, 2006: Day of Surgery

My alarm was set for 6.30am but I woke up at 6 which surprised me. I tried to book a taxi for 7 to take myself, Michael and Aria to the surgery centre but one firm told me to call back when I was ready and another sent a taxi straight away only to leave in disgust when we said we weren't ready. I was getting a bit stressed and more worried over actually getting there than the surgery. Thankfully we managed to get a taxi from a really good place so we were finally sorted. We got to the centre at 7.30am and made our way to the second floor where I had to sign in, fill out various forms and make the final payments. After that, I barely had two minutes before a nurse came over to take me through.

As the nurse, Anne was taking me to the changing room, she asked me where I was from and it turned out that she was originally from Wiltshire but her English accent had blended in with an American one so I hadn't spotted it straight away. She took my medical history, got my bracelet which the receptionist had forgotten about and then gave me my lovely new outfit: gown, cap, paper booties and the special tight stockings that are supposed to help circulation and went all the way from my toes up to my hip. She told me I could leave my underwear on and then left me to get changed.

Sharon, the nurse's aide, came to collect me. I got weighed and went to the bathroom before being taken to my bed. Anne put the cannula in my hand for the IV and then started me on what she said was Gatorade but I imagine was saline. Dr Brownstein came in to draw on me which wasn't too bad, and when he was done, Michael and Aria came to stay with me for a while. The anesthesiologist came to talk to me and explained what she was going to do and then another nurse called Michelle came to put stuff in my IV to stop me feeling nauseous. Finally, Julie, another nurse, came in to talk to me. She would be with me in the OR and explained that she'd give me some happy juice to relax me first, then take me into the OR where I'd have to scoot over onto the table before getting strapped down in what was called the crucifix position. All of the staff were very nice and friendly, I really liked how they came and explained to me exactly who they were and what was going to happen, it made me feel much more at ease about the whole thing. It was all a bit of a mad whirl though, I didn't really get time to think which was probably the best way.

A little while later, Julie came back so Michael and Aria had to leave. She put the happy juice in my IV, put my hat on and that's all I remember!

I woke up in the recovery room about 2pm. The surgery takes about 2-3 hours so it should have been finished by 12 at the latest, but it took me a long time to come round. I was sitting in a recliner, fully dressed feeling extremely groggy and finding it hard to stay awake. I also felt really nauseous so I was given some graham crackers to eat but I think I managed one tiny bite and that was all. I know I was extremely disappointed by this. Michelle kept coming back to check on me and eventually said that I would need to stand up but I couldn't figure out how to do this without using my arms. Finally I managed to get up and got in a wheelchair so Sharon could take me outside to where a taxi was waiting. The ride back to the apartment was pretty bumpy but I was rather well sedated still so I don't remember it being too painful. It had been nice just to get a quick breath of fresh air but I just wanted to go to bed. I pretty much just slept for the rest of the day, although Michael kept coming to wake me up to empty the drains and give me Percocet for the pain. That seemed to cover my entire chest though the pain meds helped a lot.

March 31, 2006: 3 days post-op - removal of drains

Michael had regularly measured and emptied my drains for the first 24 hours, after that it was just a case of emptying them when they got about half full. I was draining so little that it actually took half a day to drain about a quarter. I hoped this was a good sign which would mean I'd get the drains out earlier than usual. They generally stay in for 5 days, the earliest they can come out is 3; as I had my surgery on a Tuesday, the fifth day would be a Sunday so they'd either come out on the Friday before or the Monday after. By Thursday night, the pain in my chest was more localised to just where the drains were and was still bad enough for me to keep taking the Percocet. It didn't make me nauseous but it did have a tendency to make my head swim roughly an hour after taking one although that did soon settle down.

My appointment was at 10.30am but the taxi came super early at 9.48! It only took five minutes to get to the office but I got seen straight away which was really nice. Dr Brownstein asked how I was feeling, to which I replied that I was sore. When I took my shirt off, he said something like "Well, this isn't right, no wonder you're sore" and altered the drains. I'd been the last to empty them, the afternoon before but I didn't know the bottles had to be squeezed shut before being closed to create a vacuum. Dr Brownstein checked with Michael how much I'd been draining while I was lying on the table hoping he wasn't going to leave the drains in till Monday. Thankfully, because I'd been draining so little, and the fluid was getting more clear, he said they could come out. I was rather terrified because I'd heard that it could really hurt although I'd taken Percocet at 9.30 to help dull the pain. I didn't feel the right side at all, but the left was more painful, just a short sharp stinging pain really. Dr Brownstein put the binder back on but adjusted it so it wasn't digging in under my arms any more. I felt so much better afterwards and it was great to be able to stand up a little straighter. I hadn't realised how hunched over I'd been! I felt so good that I decided to walk back to the apartment which would also give me some fresh air and let me stretch my legs. Unfortunately, we got a little lost and ended up climbing up a rather steep hill which made me feel like I was going to pass out. I sat on the kerb and drank some water till I felt better but I was glad to get back to the apartment.

April 3, 2006: 6 days post-op - grafts check-up

My chest wasn't hurting anywhere near as much since getting the drains out, it was also doing a very odd tinging thing which I seemed to remember was an indication of healing so that was good if it was the case. I'd also been more mobile so Michael and I walked down to Dr Brownstein's this afternoon to get the grafts checked. It only took about ten minutes to walk there and the appointment didn't last that long anyway. I tried to take a look at my chest when it was free of binder and packing but I couldn't see it at all and to be honest, I wasn't really sure I wanted to. Dr Brownstein cut off the hard balls of gauze that were protecting the grafts and said that they were doing really well. He put some ointment on them which was very weird because I could see him doing it but I couldn't feel it at all. I did feel as though I could stand up even straighter than before which was nice.

April 4, 2006: 1 week post-op - removal of sutures

For some reason, I was rather apprehensive about having the stitches removed, even though I knew it hurt a lot less than the drains. Dr Brownstein actually took them out one at time, I have no idea how many there were but it must have been a lot. While he was doing that, he was going over the instructions on the dressings and showering and that kind of thing. That was actually quite good because I was concentrating on that and not so much on what he was doing. I didn't feel any of the right side at all, but I felt some of the left. I seem to have more sensation on that side already. Dr Brownstein prodded a little at my left side as he thought there was maybe a little fluid there but he said it was only very slight and my body would absorb it anyway. That side had been a little more sore than the other so that might be why.

He put more ointment on the grafts and fresh dressings, and then it was back on with the binder. There was no packing under it this time, just me and the dressings so it felt extremely odd. When I was walking around afterwards, I was conscious of the light touch of the binder on my chest and was amazed by how it felt, it was a wonderful thing.

April 12, 2006: 2 weeks post-op

For the past week, I've been changing the dressings on my grafts every morning and putting Polysporin on them. They're still scabbed over round the nipples and areola but it's coming off a little. The parts I can see actually look like my nipples are part of my skin there, and not just stuck on which is great. I've had some very scary showers, though I still have to wash my hair by bending over the bath because I can't reach up to tip my head back into the water. It's now a week since I've had the sutures removed so I no longer need to use the Polysporin anymore. I was also able to take off the paper tape on my incisions which was very scary though it only really hurt on the left hand side. I no longer need to wear the surgical binder either which is such a relief as that seemed to be making my chest more painful. It's made me be very cautious all day though without that protection for my chest. I've been able to get Dermatix (UK name for Kelo-cote) on prescription today so I'm going to start putting that on the incisions, drain holes and round my areola. Hopefully that should make them heal better.

April 28, 2006: 1 month post-op

I have nipples! It is extremely odd when I run my hand over my chest and go "What on earth - ohh, it's my nipples." They're not in the place I expect them to be. At least all the scabs have come off now. There was one on the actual nipple on the left but that came off today so I'm all scab free. Now I can have a proper shower and be able to wash my chest normally! I'm so looking forward to that.

May 4, 2006: 1 month 1 week post-op

As far as my chest goes, it seems to be healing nicely. The scars are still pretty red but all the scabs have come off now so I can shower as normal. Well, in theory, I can. In practice, I'm kind of overly careful. My mobility seems back to normal, I'm just wary when it comes to lifting stuff. I don't want to overdo it and it's not been that long really.

May 23, 2006: 8 weeks post-op

I'm now 8 weeks post-op and my scars have reached the angry red stage. They're still a little tender in places but I think it's all healing nicely. I've been using the Dermatix every morning and putting on Palmer's Cocoa Butter with Vitamin E before I go to bed. One nipple is still rather worryingly flat while the other looks fine. Sensation is coming back slowly but from what I can tell, it looks pretty good. I'm certainly very pleased with it.

May 25, 2006: 8 weeks post-op

Back to work this morning after a good 8 weeks off. It was really nice to be able to just put a shirt on and not have to bother about binding. It's funny how quickly I've got used to that, although there are moments when I'm getting dressed that I think there's an item of clothing missing and I can't figure out what it is. The annoying thing was that I've managed to ruin two shirts. I put the Dermatix (Kelocote) scar reduction gel on as usual this morning, waited for it to dry and then put my shirt on. It must have still been wet because it ended up getting all over my shirt. I had to swap it for another one. Part way through the morning, I noticed that the second was all marked from the gel as well. The information leaflet says that it stains clothing but I hoped that it wouldn't be too bad and would wash out. It doesn't seem like it will so that's two shirts completely ruined. I'm rather annoyed because shirts aren't cheap, these ones were £10 each. Looks like I'll have to go buy some replacements at the weekend. That's not exactly what I wanted to do with my first payslip!

June 28, 2006: 3 months post-op

It's exactly 3 months today since I had my top surgery. Doesn't time fly? I can't believe it's that long. It's all healing really well still. I'm still putting Dermatix (Kelocote) on every day and my scars have actually started to fade quite noticeably already. For some reason, the scar on the left has flattened out while the one on the right feels like a thin raised thread. Very odd. The marks where the drains were are rather faint marks which makes me hopeful for the rest of the scars. My nipples look like they're actually part of me and not stuck on. I think the scars round the edge look rather visible though, but I'm hoping they'll settle down. My right nipple still seems to be flat compared to the other. I thought I'd wait and see if changed but it doesn't seem to be doing. It's probably not a problem but it looks a bit weird to have one flat and one perky! I doubt there's anything that can be done with it, I'm not sure about e-mailing Dr Brownstein to ask.

Sensation is coming back slowly. I think the main parts that are numb is the centre of each pec from the nipples out. There's some very faint sensation there occasionally. I don't seem to have any sensation actually on my nipples, it's a little hard to tell. I wasn't really concerned about that to be honest. I had plenty of sensation before but keeping it wasn't a big concern.

The good thing is that I'm actually feeling better about how it looks, now that it looks more like a chest and less like an industrial accident. I've spent some time without my shirt on when I can and it's been so nice. I think now I'm feeling better about how it looks, I'm getting a little more confident about showing it off.

October 19, 2006: 6 months 3 weeks post-op

It's coming up to 7 months since my surgery. It's healing really well. I've stopped using the Dermatix (Kelocote) but I'm putting on Palmer's Cocoa Butter with Vitamin E every day. My scars have already started to fade in the middle, and the drain holes have more or less disappeared completely. I have sensation actually over my scars which is amazing. My right nipple which was worrying me because it was still completely flat has now perked up and looks fine. I'm getting more sensation on my nipples too. I've actually started to get some very fine hairs growing along my scars and I noticed today, there's a few very tiny dark hairs round my right nipple too. Ew. I so don't want a hairy chest. At least it's flat, I guess that's the main thing.

January 28, 2007: 10 months post-op

It's exactly ten months since I had my surgery. In some respects, I can't believe it's only ten months but I also can't believe it's as long as that! I've healed really well so far, although that's still ongoing. My scars have done some sudden fading over the past few days and are disappearing rapidly now. In some places, they've practically gone. I was going to take photos of my drain holes for comparison but I couldn't find them at all! I've got a lot of sensation back, it's mainly round my nipples that's still a bit numb. I've even got sensation on my scars, it feels tickly to be touched there.

I realised the other day that my memories of what it was like before I had my surgery are fading. I expected that it would take longer to forget, but that doesn't seem to be the case. I've even got used to pulling on nothing but a shirt or t-shirt and not needing anything underneath. Well, not got used to it as such, because it still feels completely amazing, but the feeling that I've forgotten to put something on (i.e. my binder) has gone.

So far the only downside that I can see is the hair that appears to be growing over my scars and around my nipples too. I really don't want to have a hairy chest at all. At least I don't have to worry about having a hairy chest while being pre-op though *shudders*

June 2, 2007: 1 year, 3 months post-op

It's so hot! And it's got hot all of a sudden. It's in the 20s, I'm stifling hot even with my window open and the ceiling fan on. I've got shorts and a t-shirt on, but I'm not sure how long the t-shirt is going to last. This is my second summer since having top surgery, although last year I was only a few months post-op so I don't think I got to enjoy it as much because I was still sore and recovering. This year it should be an awful lot better, but I'm still not 100% comfortable about going shirtless in public. I'm sure that's something that will ease as time goes on. There are still times when I'm pulling a shirt on or something and I realise how amazing it is. I hope that feeling never goes away, I waited a long time for it.

December 16, 2007: 1 year, 9 months post-op

I'm not really sure how much more I can say about my chest now. It's coming up to two years and it's healed amazingly well. The scars have faded quite a lot and although they are still visible, they're only faint. I don't know if that's down to my healing capabilities - I have no other scars to compare - or down to the regular use of Dermatix (Kelocote) and Palmer's Cocoa Butter with Vitamin E. I stopped using the cocoa butter when I finished off the second lot which was about the summertime as I don't think I'll get any more benefit from it now. I have a lot of sensation in my chest although my nipples and some parts of the scars are still fairly numb but the rest of it seems fine. It does however seem to be slowly growing hair, mainly on the right side for some reason. It started off on the scar and then around the nipple, but it's now growing in between them too. The left side is quite hair-free so it looks a little odd but I have no doubt it'll soon catch up.

I've got more used to it now, I still have moments where I marvel over the sheer ability of being able to slip on a t-shirt or shirt and nothing else, and moments when the lack of breasts takes me by surprise again. I'm getting more comfortable with it and with the idea of having other people see it although so far no one else really has other than my partner. It's still very new to me; after the amount of time I had the previous one, my new chest is still unfamiliar to me even though I've spent a lot more time looking at this one!