Monday, 22 October 2018

Why, oh why, am I puffed up like a balloon after my operation?

I'm swollen around the chest area as I'd expect after the double mastectomy - there are some sloshy seromas building up which I've been told not to worry about - the seromas should self-resolve, and if not they can be drained with a needle.

I was particularly aware, as I woke up this morning, that my face and neck feel quite puffy. My eyes feel all crowded in by swollen eye lids. I feel like I've gained 10 pounds around my middle too.

This swelling has been developing since my operation three days ago. I thought it was my imagination until I looked in the mirror and saw a big round moon face looking back at me.

Why, oh why, am I puffed up like a balloon after my operation?

Thank goodness for the internet. While it can on occasion lead us down dark alleyways, often it can take us straight into the light...

It seems evolution provided a way for injured animals to lay up for a few days to recover from traumatic injuries. With an injury hormones are released which amend how many of the body's organs and systems work to facilitate survival.

So the post-operative swelling away from the surgery site is fluid retention - a deliberate strategy on the part of my body to conserve water - and the fluid will be released in a few days as my recovery progresses.



The stress response to trauma and surgery

J. P. Desborough; The stress response to trauma and surgery, BJA: British Journal of Anaesthesia, Volume 85, Issue 1, 1 July 2000, Pages 109–117, https://doi.org/10.1093/bja/85.1.109

"The stress response is the name given to the hormonal and metabolic changes which follow injury or trauma. This is part of the systemic reaction to injury which encompasses a wide range of endocrinological, immunological and haematological effects."
"Although it seems that the stress response developed to allow injured animals to survive by catabolizing their own stored body fuels, it has been argued that the response is unnecessary in current surgical practice. "
"The overall metabolic effect of the hormonal changes is increased catabolism which mobilizes substrates to provide energy sources, and a mechanism to retain salt and water and maintain fluid volume and cardiovascular homeostasis."
"Arginine vasopressin, which is released from the posterior pituitary, promotes water retention and the production of concentrated urine by direct action on the kidney. Increased vasopressin secretion may continue for 3–5 days, depending on the severity of the surgical injury and the development of complications."

Sunday, 21 October 2018

Brimming with possibility

The day after my last post I fell ill with flu, which delayed my operation by two weeks.

I'm now two days post-surgery, back home, and recovering.

I had breast cancer operations in 2001 and again in 2008. Those were traumatic experiences, my post surgery recovery was tainted with feelings of loss, and fear for the future. Each of those operations were just the heralds of more debilitating treatment - the long hard slog of chemotherapy and radiotherapy.

Following on from that were the yearly scans and tests to check for new cancers and secondaries, a regular cycle of building tension as each appointment came due, plunged back into the medical world for the tests, then the gruelling wait for results, hoping to hear those precious words "all the tests came back clear" and feel the giddy relief once more.

This has framed the last 18 years of my life.

I allowed it to box me in.

I focused on getting through each day.

I made no long term plans.

I did not peer into the future.

I did not allow myself to have big hopes and dreams.

Now I have set the agenda. I picked the time and the place to start my new journey. With this operation I've released myself from fear and risk. I'm calm, confident, and positive.

Tomorrow is a new day, brimming with possibility.

Tuesday, 2 October 2018

Both breasty-dumplings

A little over 18 months ago I had my ovaries and fallopian tubes whipped out. In two days I'll say goodbye to both breasty-dumplings, with a double mastectomy.

Image result for blackadder breasty dumplings

8 years ago I wondered on this blog:

How would I feel if I went down the free-martin path and said goodbye to ovaries and breasts? Once done there is no turning back. Answers on a postcard to...

I'm now on the verge of finding out. Will I wake up one morning suddenly feeling released from fear when the cancerous Sword of Damocles hangs over me no more? Will I mourn the loss of my breasty-dumplings? Will I revel in being free of the bouncy bits and take up jogging? Or will life continue much as before?

Cancer in 2001 reduced left-breasty dumpling to a B, whereas cancer in 2008 resulted in right-breasty dumpling growing to a FF. So I'll certainly be glad to lose the lopsidedness.

I'm going flat - no reconstruction for me. I will not subject an innocent part of my anatomy to the surgeon's knife in order to construct a pair of foobs. I feel no need to conform to societal expectations regarding my shape. Flat will be fine for me, thank you very much.

I've been thinking about my gender identity recently. Not what dangly bits I have or my genetics, but who I am. I certainly don't feel my gender is being changed by the oophorectomies and mastectomies. The surgery is just triggering an internal debate about my gender. Up to press I've simply allowed society to decide for me - I was born female - I've led my life up to now as a woman. I've not been a very "girly" person. I've been more tom-boy in behaviour and dress. While I haven't wanted to be a man neither have I felt overwhelmingly glad to be a woman. So this surgery is making me ponder. Can I be neuter?

Tuesday, 21 March 2017

Springing surprises

At some point in the last 12 hours we've passed through the vernal equinox, so by my reckoning we're in spring. The plants in the garden have already jumped the gun and are visibly growing day by day. The mild weather we've had in the last few weeks means that several species are already flowering. Not only are the daffodils and primroses flowering, but the ornamental blackcurrant, the forsythia, the magnolia, the grape hyacinth and the camellia are all bursting into bloom.

I haven't had much time to potter in the garden. For the last 6 weeks I've been switching my working hours from evenings to days for a project at work, and for the last month I've ramped up my hours to over 40 a week. I'm looking forward to the lovely juicy overtime, but I am feeling drained.

The turning of the seasons has been working its magic on my lodger Sam. It must be the time of year for springing surprises. Last year around this time he announced he was in a relationship, and last night came the anticipated news that they've put a deposit down on a place and Emma and Sam will soon be moving in together. Their new house just needs a little spring clean and some fresh paint to turn it into a home. I'm very excited for them.

Friday, 20 January 2017

Hang on to your hats

Today Donald Trump will be inaugurated as President of the United States of America. I'm British, so this should not be of any relevance to me, but of course the influence of the US is felt across the world.

Many outside the US watched the elections and were quite confident that Mr Trump would not be elected, as in much the same way most thought we in the UK would vote against Brexit.

No one quite knows what to expect now. Brexit & Mr Trump are paradigm shifting moments of the 21st century. I find it hard to summon the confidence I once had in the democratic process. Can elections be a good way to make decisions if these are the are the choices the public makes?

I have this forlorn hope that, through some bizarre accident in the physics laboratories where I work, I have been transported to a parallel universe temporarily and it is just a matter of time until a rubber band effect yanks me back to my own reality.

Meanwhile I wonder whether the ordinary people of the late 1930's felt this sense of disbelieving dread as events sucked them into WWII.

If the potential consequences weren't so apocalyptically terrifying, "Trump in the White House" has all the ingredients for a great slapstick comedy. It would be so pleasant to sit back with popcorn and be entertained by his outrageous antics for the next 4 years - if only it weren't so damn real.

Hang on to your hats, people of planet earth, the ride is going to be bumpy.

Thursday, 19 January 2017

Return of the luddites

Luddites were English workers in the 1800's who destroyed the machinery that was making their jobs redundant.

Fast forward to 2017. Self service tills at supermarkets have decimated the workforce in our large stores. Self-driving cars are being developed and companies like Uber are looking to use them instead of human taxi drivers. Amazon are developing drones to deliver parcels, so delivery vans and their drivers will be going the way of the checkout assistant. Chatbots are seen as being the future solution for customer service, so call centre jobs are also threatened with redundancy.

Companies are doing this to reduce overheads, remain competitive, and increase profit to their shareholders. Understandable, but short sighted. If there are no jobs, who will have the money to buy anything? Companies might be driving their cost base down, but they're also destroying their customer base.

It would be nice to think we're heading towards a cashless post-scarcity society like that of the Star Trek universe, but I suspect we're a long long way from developing the kind of replicator technology that such a society requires.

So while the corporates unwittingly destroy the very foundation of capitalism that the paradigm relies on (paying customers), I'm predicting the return of the luddites.