Capsular Contracture: Check out the ugli fruit on her!

In October, 2023, I underwent surgery to remove my right breast (when I commit to being anti-right wing, I really commit). In February, after weeks of recurring infections around the temporary implant, I underwent a second surgery to have my real fake boob installed* and the left breast lifted, so I’d have a matching pair.

The recovery from the operations, infection notwithstanding, was good, and I thought I was done with treatment and surgery. Ha.

When I went in for my first follow-up after the silicone implant was placed, the team noticed there was some scar tissue – a pretty common and normal thing – developing, and recommended that I massage the area to encourage healing. So I did, as much as possible (as you might expect, massaging your own boob (or anyone else’s for that matter) is generally frowned upon in many public venues). At my next follow up, in April, the scar tissue was not better, and was in fact a lot worse. My breast did not look very breasty; it was misshapen and lumpy, sitting up higher than my other breast, and sticking out like a bad prototype of a fembot.

My plastic surgeon took one look at it and said “capsular contracture.”

In many surgeries, your body naturally creates a capsule of tissue around a foreign object; this is a normal (and healthy) reaction. In some cases – one in every six breast implant surgeries – the body gets overprotective, and the capsule thickens and hardens, create a contraction around the implant.

The most common symptoms of capsular contracture are:

  • Breasts that seem to sit high on the chest
  • Misshapen or unnatural looking breasts
  • Breasts that feel firm and tight
  • A round, ball-like shape of the breasts
  • Rippling
  • Pain or discomfort, especially when lying on the breasts

    a pair of ugli fruit
    Artist’s impression

I have all of these symptoms, made worse by the fact that my left breast looks great (thank you) so the right looks even weirder. It’s not generally painful, but if I am on my stomach or my right side, it can feel uncomfortable. Any yoga floor poses on my stomach make me feel like I have a Weeble boob. Most of the time, my bra does a lot of heavy lifting (ha) so the problem isn’t (I hope) noticeable to the casual observer. Any less-than-casual observers get what they deserve, frankly.

Like many medical issues, capsular contracture comes in a few flavours:

  • Grade I: The breast feels normal and looks natural
  • Grade II: Slightly firm but appears normal
  • Grade III: More firmness and an abnormal appearance
  • Grade IV: Hard, painful, and looks abnormal.

Mine is Grade III. I would add to this list that I can feel the implant, like crinkly wrapping under my skin. I don’t typically have pain, although my range of motion in my right shoulder is compromised by the tightness around my breast.

So, you may be asking yourself (assuming you’ve made it this far and didn’t get stuck on the image of me rolling around on the floor, balanced on one breast), how does one deal with capsular contracture?

In my case, my surgeon outlined three options:

  • Status quo. We leave things as are, and I develop a new party trick (see previous paragraph).
  • Replace the implant. I undergo surgery to have the current implant swapped for a new one.
  • Remove the implant and reconstruct the breast using my own tissue (the DIEP procedure).

I have opted for the DIEP procedure, based on my own preferences and his recommendations. I am not comfortable, physically or mentally, with leaving things are they are; I am not keen to just swap the implants, given the likelihood of a recurrence.

The irony is that I originally opted for the silicone implant, rather than the DIEP, because the waitlist for the implant surgery is much shorter, and I wanted to be done, dammit.

So I have been on a new waitlist since April, and my surgeon’s best guess is that I’ll have the DIEP surgery in April or May 2025. The timing is good, really, because I can teach the complete winter term and work from home while I recover, without having to take another medical leave.

*I assume there is a “better” word for this, but let’s call it what it is.

Shining, gleaming, streaming, flaxen, waxen

When I started my cancer journey in March, 2023, of the things I was most curious about was how cancer treatments would affect my hair–and one of the first things my oncologist told me was I would lose it.

I’m now finished my cancer treatments (details of which I will save for another post). My last chemo treatment was last August, and my hair has been slowly but surely making a comeback–subsequent anti-cancer drugs I’ve been given do not provoke hair loss. I now have a full head of hair, and my eyebrows, eyelashes, and that random rogue chin hair are all back as well. The hair that’s grown in, however, is very different from what I had before treatment.

This element of the cancer journey is definitely best as a show, not tell, narrative. Click on the image to open and zoom.

Timeline with images detailing hair loss and regrowth

Just how big are these woods?

My last post ended on such a high note that I’ve been a little reticent to write this one. I was feeling very positive emotionally, and very good physically, and it seemed like the hard part was well and truly behind me. In fact, at my November appointment with my oncologist, who is the mastermind behind the whole treatment plan, I was eager to discuss the timeline for getting back to work (and life, in general).

He said, bluntly, that I wasn’t ready.

I was a little disappointed, sure, but the holidays were coming up, and a return to work early in 2024 would have been chaotic for my department, so I accepted this prognosis, confident that our next discussion, in January, would be different.

Well, it was different, just not in the way I hoped.

Image of a tissue expander used in breast reconstruction
so hawt

As you recall from my previous post, during my surgery in early October, my doctors removed my right breast and placed a tissue expander. The tissue expander is a placeholder for the permanent implant; its job is to make sure that there is a viable pocket, as it were, for the silicone implant. The expander looks a little like what you’d get if you crossed an octopus with a teabag: it is a semi-opaque sac with six small tabs that are sutured onto the pectoral muscles. There’s a valve through which blue-tinted saline can be added; when mine was installed, the doctor added 200cc, and then I got a 100cc top-up about three weeks post-op. For people with larger breasts, more fluid can be added over time.

The problem with tissue expanders, it turns out, is that the post-operative rate of infection may be as high as 31%, 10x the usual rate in breast surgeries.

Who has two thumbs, one boob, and an infection? This girl.

My surgery was October 2nd. I had two post-op follow-up appointments with the plastic surgeon in October, and appointments with the medical oncologist and surgical oncologist in November, and everything looked great.

world globe showing parts of South America, North America, Greenland, Africa, and Europe.
Like this, but with a nipple.

At the beginning of December, I felt awful. I had a fever, my neck and shoulders were achy, and I had no energy. At first, I thought it was the flu (note that I did have my COVID and flu shots at the end of October). Then I started getting shooting pains in my new breast, and noticed patches of redness and swelling. By the time I got in to see the plastic surgeon again, the redness reminded me very much of a world globe, which is handy because I can illustrate without actually sharing photos of my boob with the world.

To make a long story (slightly) short, I spent most of December and January on antibiotics; every time it looked like the infection had cleared and we stopped the meds, the infection came back. I have felt vaguely unwell for two months, which has been extremely frustrating. I was so ready for this to be the montage of me getting back into work, fitness, outdoor activities, socializing… I have felt a little like the last year has been my own personal lockdown, not to mention all the physical challenges. So to feel like I can’t have two active days in a row because I just need to rest has been disheartening. I feel like I’ve aged, and not well. The discussion with my oncologist two weeks did not go as I had hoped, and this time it was me saying I’m not ready yet.

The silver lining of the infection saga is that my plastic surgeon advocated for me and got my surgery to swap the tissue expander for the real implant moved forward—it’s tomorrow. The waitlist is apparently quite long (I suspect it includes cosmetic surgeries as well as post-cancer reconstruction). I cannot wait to get this thing out of my body, so I’m not feeling at all guilty about jumping the queue.

If all goes well tomorrow, and I am, despite everything, confident that it will, my recovery should be about six weeks. I’m just not out of the woods yet.

 

 

 

 

 

Bye bye, boobie

Two weeks ago, my right breast was removed. This procedure feels like the pinnacle of this journey (I certainly hope it’s the pinnacle, at any rate). My recovery is going very well, but it’s taken me a while to feel ready to write it up. We’re here now, though, so here we go!

The Pre-op process

In the weeks before my surgery, I had several pre-op hospital visits:

  1. I met with my oncology surgeon to discuss the options and decided on a total mastectomy of the right breast.
  2. I had an MRI to verify the results of chemo and make sure there were no new sites of interest.
  3. I met with my plastic surgeon to discuss his role on the day of surgery, and what my options are for reconstruction.
  4. I met with a nurse from the breast clinic to discuss the recovery process and how to take care of my dressing and drains.
  5. I met with a general practitioner and another nurse to discuss my overall health and get the green light for surgery. In that same visit, I had comprehensive bloodwork done. My blood type, fittingly, is A+
Day of Surgery

The day of surgery was one of those days in which time seems to move at an inconsistent pace. From start to finish—leaving home to returning home—the process took about 11 hours total:

10:30 Leave for the hospital. Try not to take anxiety out on other drivers who probably aren’t aware that I’m headed in for surgery and therefore they should just pull over and give me priority.

11:00 Check in. I’m given two gowns. I have to remove all clothing (all jewelry as well, but all of my piercings were already out for the MRI). The first gown goes on like the hospital gown as seen on TV, with the opening at the back. The second gown goes on like a bathrobe, opening at the front, presumably in a wildly unsuccessful attempt at preserving one’s dignity. I’m wearing paper slippers and have no eyebrows; the dignity ship has sailed.

11:30 Pre-op check up. A nurse interviews me (by the way, I lost count of the number of people who made me confirm that we were removing my right breast), takes my blood pressure, and more blood. She confirms that I have been fasting since before midnight.

12:30 Pre-op artistic expression. The plastic surgeon uses a Sharpie to draw what I assume are guidelines all over my chest. We confirm once again that it’s the right breast. I am surprised that he doesn’t draw a giant X over the left one, just to be sure.

2:00 Transfer to (close to the) OR. I am taken by wheelchair (no walking!) and then helped onto a gurney in a hallway right outside the operating room. I am introduced to my anesthetist, his intern, a surgical fellow, another resident, and probably a few dozen more people. All of them are wearing masks and ask me the same questions (I’ve been fasting, yes it’s the right breast, no I’m not nervous, no I’ve never had general anesthetic before, etc., etc.) so really I have no recollection of any one member of the team, although I do remember that the surgical fellow had stunning eyebrows. My oncology surgeon comes out into the hallway to go over the procedure once more. He notes the tattoo I have on my left ring finger, and says it’s a great idea and that he’s lost his wedding ring twice by forgetting it in the pocket of his scrubs. “So not in a patient, then?” I said, which led to several minutes of us sharing our favourite Seinfeld moments, culminating in us simultaneously shouting “master of my domain!” Someone places intermittent compression sleeves on my legs.

2:30 (ish) Actual transfer to the OR. I get up on the operating table, where my perspective is somewhat limited. There are massive lights overhead, and I can hear, but not see, a lot of activity nearby. My gowns are removed but modesty preserved under a blanket. Pat Benatar’s “Hit me with your best shot” is playing. The anesthetist gives me a shot to numb my hand, then sets up the IV anesthetic…

6:45 (ish) Recovery room. I wake up in a completely different place, with a recovery nurse nearby. Over the next hour, she helps me slowly get back to full consciousness. She raises the bed a little bit at a time, offers me ice (I woke up into a full-blown hot flash. Have I mentioned that menopause sucks?), gives me a sip of juice, and a cold washcloth for my head (seriously, I was burning up). Eventually she removes the compression sleeves, which by this point are so covered in sweat that they practically slide off. Apparently, this is all completely irregular, because most people wake up from general anesthetic feeling cold, not hot.

7:30 Still the recovery room. My husband is brought in from the waiting room to entertain me while I’m still under post-op observation. He entertains me by playing Scrabble on his phone, mostly. In his defense, I was not at my best, conversation-wise.

8:30 All clear. We’re given the green light to go home, although I am confined to the wheelchair until we get to the car. I guess once you’re in the car, you’re somebody else’s problem.

9:00 Home. Ten hours later, I am home, minus one breast (pretty sure it was the right one). I still haven’t eaten in about 25 hours at this point, so Andrew makes me some Bovril, which comes back up about an hour later.

10:00 Bedtime. You would think that a few hours under general anesthetic would mean a sleepless night, but you would be wrong.

Recovery

I came home with a Jackson-Pratt drain, which aids healing by draining fluid from the incision. So for two weeks, I had a tube emerging from my side, a few inches below my armpit. The other end of the tube is a rubber bulb into which the fluid drains. While the drain was in place, I had to empty the bulb three times a day, and record how much fluid was collected. I also had to “milk the tube” to ensure that the tube was always open and fluid could travel to the bulb. My only regret is not having a deep enough knowledge of obscure sci-fi to come up with an appropriate allusion.

I also came home with two prescriptions: ten days of preventive antibiotics, and some high-end painkillers to be taken as needed. I think my paranoia about the opiate epidemic must be strong, because after one day, I eschewed the painkillers—thankfully, the pain was not intense. I took one painkiller just before bed two or three days post-op, mainly because my back was sore from sleeping in an unfamiliar position (avoiding the drain and incision site meant sleeping on my back, and exclusively on my left side after the first night).

There were two aspects to recovery that were annoying, even though things went smoothly. First, I was not allowed to shower or bathe while the drain was in place. For someone with multiple hot flashes and night sweats, this was a tough directive, but I followed it. I was hoping that the drain would come out when I went in on Recovery Day 10, but there was still enough fluid collecting to warrant another few days. The drain was removed on Day 14, exactly two weeks after the surgery, and everything looks like it’s healing very well, so I guess it was worth it. But still. Ugh.

The other annoying aspect is the general lack of mobility and comfort. Thankfully, years of yoga prepared me for this recovery, and my range of motion in the right shoulder is almost 100% already. I have gone for a few short walks since the surgery, but it’s not very comfortable to walk briskly without a sports bra, and the thought of a bra right now is very off-putting, since the major incision is precisely where a bra chest band sits. So I’m wearing camisoles with loose built-in bras, or tanks with no extra support. There are two smaller incisions under my arm, where the oncology surgeon removed lymph nodes for testing (the tests came back negative, so my lymph system is otherwise intact). I’m not allowed to drive for another week, but I’m fine with that given that our pothole-infested infrastructure is jostling enough when I’m a passenger with both hands free to clutch my chest.

During the surgery, the plastic surgeon put a tissue expander in place. The expander means that for now, my right breast is smaller than the left; over time, the plastic surgeon will add saline to the expander so that my skin stretches to accommodate the actual implant. I will have a second surgery to swap the expander for an implant, sometime next year. For now, I have a fake fake boob. Also, since the implant will sit higher than my old boob, my plastic surgeon will have to give the left one a lift. Darn it.

Under clothing, it’s hard to see any difference, especially if I’m wearing a camisole with some support. Bare-chested, it’s clear that there’s something not quite ‘normal’ about my right breast. My nipple is still there, which helps the visual. There is a large incision under my breast, already healing nicely. The breast itself is visibly lumpy, which is disconcerting. I assume that as the expander is filled, the breast will become more breasty.

I have some sensation on the sides of the breast, but none in the nipple or the surrounding area. My plastic surgeon was impressed with how much sensation I do have, so it’s possible that over time it will get even better. Thankfully, I rarely rely on my breasts to sense my way around, so I’m fine either way (and you’re welcome for that visual).

I will see both my medical oncologist and oncology surgeon in November, and map out the rest of my treatment plan. The negative results from the lymph nodes are a very good sign, and I’m optimistic that I won’t need radiation.

The important part

While I was under the anesthetic, my oncology surgeon called my husband to report that everything had gone well, and that as far as he was concerned, I am now cancer-free.

Yes, I buried the lede 😉

 

Connected through Cancer

Special post written for the Montreal CIBC Run for the Cure community

When humans, like other animals, are faced with a threat, we have instinctual reactions: fight, flight, or freeze. These instincts are deeply embedded in our brains, and depending on the specific threat, the same person may get aggressive, run away, or stand there like a deer in the headlights. So, if the threat is a mosquito, for instance, we aggressively swat it (and perhaps feel a thrill of conquest when we crush it between our palms). If the threat is something bigger, like, say, a swarm of mosquitos, we retreat. And if we’re in some weird sci-fi movie from the 80’s, and we encounter a mosquito the size of a house, we probably freeze as our brains try to figure out WTF that thing is.

Porges’ polyvagal theory suggests that our responses are hierarchal, and our reactions, if we’re more or less stable, match the situation—single mosquito, we fight, swarm, we flee. The theory is based on an anatomical nerve system, the vagus, which connects relevant parts of our brain to almost every part of our body. In yoga and similar practices, we use breathwork to “calm the vagus nerve,” that is, we self-regulate, and try to control our responses. This approach is particularly important when dealing with trauma, which may trigger responses even when there is no “real” threat present.

The polyvagal response pyramid of threat responses
Porges’ Polyvagal Theory

At the bottom of Porges’ polyvagal response pyramid, the relaxed, happy, safe feelings are related to social engagement and connection—we are social animals, and thrive when we feel positively connected to others. Community, and feeling like we’re part of one, is a fundamental aspect of feeling safe.

In my research in education, I have spent a lot of time and words on the concept of the community of practice—in a nutshell, this means that more often than not, the professional development resource we turn to is each other. As a teacher, I have turned to my colleagues for help with every aspect of the job, and have in turn provided support to them; after all, who better to help you figure out classroom management, assessment strategies, deadline policies, or that tricky projector hookup in A111 than someone who has been there, literally, before you?

Continue reading “Connected through Cancer” →

What’s in a Name?

This week was my last chemo treatment, thus ending Phase 2 of my treatment plan.

In Phase 3, I may have surgery, and I may have targeted radiation. I will definitely continue to get Trastuzumab, commonly known as Herceptin, every three weeks, until May of next year. Although this drug will be administered the same way as the chemo, i.e., in hospital via my port, it’s not a chemo drug, so I can officially say my chemo is finished.

I found this a little confusing—how can I be finished chemo, but still be getting anti-cancer drugs pumped into me? Isn’t it all chemo?

In a word, nu-uhn.

Anti-cancer drugs fall into several categories, only one of which is actually called chemotherapy. Chemo drugs are designed to kill all fast-growing cells, which is why the side effects of chemo include hair loss and changes to your nails, since hair and nail cells grow and divide quickly. Cancer cells also grow quickly, and the chemo drugs’ big mandate it to shut that shit down, full stop. In my case, this was an important step, because although my cancer was Stage 1, the biopsy revealed that it was Grade 3, which means the cancer cells were getting ready to ramp up production and spread.

Continue reading “What’s in a Name?” →

Not much happening, other than *gestures at all the things happening*

I’ve been struggling with what to write next, because I’m getting to a point at which I feel like I’m stagnating, and I don’t have much left of value to share. I’ve been very open—very deliberately so—about what I’m experiencing, and how I feel about it, but right now I feel as if I’m in a kind of holding pattern. I am midway through Phase II, which means I’m at the treatment centre every week; for two weeks the treatment is a round of premeds, including a megadose of Benadryl, then a single drug, Taxol, and the process takes about two and half hours. Every third week (or, technically, every first week in the cycle of three weeks), the session is more than five hours, and includes the Taxol and premeds as well as a combo of trastazumab and pertuzumab, designed to target the HER2+ receptors that make my form of breast cancer the special thing that it is. Once we head into Phase III, I will get only Trastazumab, aka Herceptin, every three weeks until the end of May 2024.

The side effects are not as rough as they were in Phase I. I have had a lot of trouble sleeping, primarily because of the New and Improved Menopause Hot Flashes™ and the constant nasal congestion, so my doctor has prescribed a little blue sleeping pill to use on an as-needed basis. I’ve had them since last Monday, and so far, the one night I thought “OK, I don’t need my little blue friend,” I barely slept.

I am sure that the sleeplessness is not helped by us trying to sell our house and buy a new one (because of course I decided now was a good time—have you met me?). The process is going as well as can be expected, but it’s still multifaceted stress—will we get financing?* Will our offer be accepted? Will the new place require a lot of tricky renovations and permits? Will anyone want to look at our house? Will anyone want to look at our house now that we’ve placed half of our furniture in storage, repainted, and shipped the cats off to summer camp at my parents’ house? Will anyone make an offer on our house? If someone makes an offer, will it be enough? When someone makes an offer, will we be able to manage moving dates so that we don’t have to live in a construction zone, yet don’t have to pay for two mortgages at once? Suffice it to say, my brain has many ways to entertain itself when I’d really much rather it let me fall asleep.

*respectively, the answers are yes; yes; you have no idea—short answer: yes; no; yes, thank god; ……… ; fingers crossed; and no – this is definitely going to be a one or the other scenario.

The great thing about buying and selling houses right now is that I don’t have much mental space for ruminating on having cancer, getting treatment, and turning my life upside down (I mean, I have turned it up upside down in a completely different way). I have something to focus on, which is good, and it’s something that I can manage around my treatments and side effects—if I have a spacey or shaky day, I can put the spreadsheets and paint samples aside and just indulge in some Netflix and chill (in my case, actual chills, then hot flashes, then chills again).

Some readers will recall that nine years ago, our house was bought by the Queen (while that was a traumatic experience, it turns out it was in some ways a lot easier than trying to sell one’s house the more conventional way). This time around, at least we’re making decisions based on our own plans and desires, rather than on the strong arm of the federal government. Like last time, the aspect I find most stressful is the waiting—waiting for offers to be made and accepted, waiting for applications to be processed and approved, waiting for renovation plans to be drawn up and evaluated, etc., etc. You might think that someone in my current position, with nothing better to do than wait (and heal or whatever), would embody patience, but you would be wrong.

That said, the mantra that I adopted nine years ago is one that I find myself repeating these days, as it is relevant and resonant with both the house selling/buying process and the getting through breast cancer process: this time next year, all of this will be behind me, just part of the history of who I am.

Just have to get through it 🙂

The Whoa, Man! in the Mirror

Like many people, I have spent a lot of my life worrying about my physical body. It’s too short, too wide, too soft; some curves are too big and others not big enough; facial features are asymmetrical, too small, too imperfect.

I think that part of me imagined that by now, in my fifties, I would have learned to love my body, or at least to stop obsessing about how imperfect it is. After all, beauty standards notwithstanding, my body has produced two actual human beings. It has been 145’ under water to swim with sea turtles and sharks. It has ridden bikes and horses, done yoga, hiked through forests, and paced around classrooms. It has eaten well, and not so well. It has never broken a bone; it has broken many a sweat.

Part of me also thinks that I—a well-educated, successful, privileged person—should be above such superficiality. My brain is a much more important aspect of every part of my life. Why should I care if I’m bigger/smaller/shorter/taller/rounder/flatter/older than some clearly artificial standard?

But I do care.

I have spent countless hours, and dollars, chasing a better physical me. Diet programs, calorie-counting apps, fitness equipment, etc., etc. My weight has been on a constant roller coaster wave for most of my adult life, and I am ashamed by how happy it makes me to weigh less, and how unhappy it makes me to weigh more.

***

Chemo is doing a lot to my body, good and bad. Obviously, the good makes all the bad worthwhile, but knowing that the treatment is saving my life doesn’t make it any easier to look in the mirror.

created with bitmojiMy hair is essentially gone—there’s a bit of stubble, which truth be told I’d rather be rid of—but I can live with being bald. My skull isn’t hideous, and I kind of love that I get to live out my early-20’s desire to be badassedly bald. My eyebrows and eyelashes, on the other hand, are getting thin, and the result is a sort of undefined face, which just doesn’t look like mine.

And while the bald head doesn’t bother me on its own, it does look way too small atop my increasingly doughy body. Thanks to the steroids in the chemo combo from Phase 1, along with the low energy and lack of activity, I am the heaviest I have been in about twenty years, and I hate it. I have rolls in new places. Clothes don’t sit right. Movement doesn’t feel the same. Muumuus are suddenly intriguing.

 

***

I do know that this—the whole situation, and all its facets—is temporary. Now that I’m in Phase 2, the side-effects are much easier to handle, and I’ll have more energy, not to mention no steroids. I’m working my way back to more activity, and my goal is to be able to run (mostly) the 5km Run for the Cure on October 1st (which is a fundraiser, BTW, and please feel free to contribute).

All of this is to say that some days, I look in the mirror and don’t recognize the person I see. I may not like what I see right now, but I can also see the end of the journey, and I’m eager to get there.

Good News!

Based on a manual exam at this morning’s pre-chemo check-in, my oncologist says that the tumour is practically gone. Aurora Flewwelling-Skup says I’m an overachiever 🙂 and this is one instance in which I am very happy to be crushing it.

My avatar as a newspaper graphic with the headline Good News
Created with Bitmoji

In anticipation of questions:

  • This does not change the treatment plan; it does validate the plan.
  • I have one more round of chemo in this phase, later this week.
  • Phase II begins on June 1st; in Phase II, I get weekly treatments for 12 weeks.
    • Phase I has been described to me by several members of the medical team as the hardest, so I am looking forward to Phase II. My immune system is likely to be stronger, so I can be a little less paranoid about being near people.
  • This does not affect the surgical plan; the idea with the neoadjuvant approach (chemo first, then surgery) is to have a clear idea of how I have responded to the chemotherapy before undergoing surgery, so that the surgery can be more precise and ultimately successful.

A Walk in the Lady Garden

People are probably familiar with the standard side effects of chemotherapy: nausea, hair loss, fluctuations in weight, and fatigue. Those are certainly the ones that I was expecting, and so far, I haven’t been disappointed (?).

There are other side effects that I was not expecting, such as very dry skin (and all the vigilant hand-washing hasn’t helped—my knuckles look like they have dandruff), bone aches, and heartburn from the anti-nausea meds.

Then there’s a whole subset of side effects specific to my nether regions:

First of all, hair loss isn’t just for heads. In fact, I noticed thinning pubic hair before things got patchy on my head. Chemo is the world’s worst Brazilian.

My oncologist, and several other experts in the field, claim that I’m likely to fast-track into menopause, which was the one thing I was looking forward to (quick terminology tip: a person is in menopause when their period has stopped for 12 consecutive months; perimenopause is the lead up to that no-periods period. So it’s during perimenopause that symptoms begin—hot flashes, mood swings, night sweats, etc., etc. Once a person has gone through the menopause year, they’re postmenopausal). I’m 53, and I’ve been experiencing perimenopausal symptoms and inconsistent periods for a few years. Since I started chemo in early March, I have had TWO periods and I am not impressed. We had a deal.

Seriously, though, the night sweats and daytime wild temperature fluctuations have increased, and (fingers crossed) it’s just a matter of time before we shut down production.

One common side effect of the combination I’m on in Phase I is “bladder irritation,” which is (a) basically a nonstop low-grade UTI, (b) the one side effect not given its own hotlink on this page, and (c) a pain in the ass, or at least that general area. I have found it’s controllable by using vaginal wipes after going to the bathroom, and washing the area with Noxzema when I shower.

Related to the bladder irritation is incontinence. I have definitely noticed that the urge to pee cannot be ignored, and have barely made it to the toilet a couple of times. I’ve taken to wearing period panties when I go for long walks, just in case of leaks. There are other factors contributing to this particular problem: first, I have very deliberately increased my protein intake in an effort to support my white blood cell production, and increased protein can apparently put a strain on the bladder. Secondly, for various reasons, I am also drinking a lot more water, so naturally, I’m also producing a lot more urine. I am doing Kegels as I type.

Chemotherapy drugs are hard hitters. In order to do the job they’re meant to do, they also do things like damage nerves, provoke or hasten menopause, and create hormonal changes. Add to that the very unsexy UTI and occasional leakiness, and I’m not exactly Diana Rigg in a catsuit (you’re welcome). And if we do get it on, he has to wear a condom, which we thought we were well past. That said, we have been intimate a few times, with precautions, so it’s not entirely off the table.

For the first month or so of the treatment plan, my breasts were off-limits during any intimacy, because the two biopsies just made any manipulation painful and very, very off-putting, and the port insertion point, just above my left breast, was very sore. He did get to fondle the left breast on the infamous day of everyone in the hospital having a go at the right one, just to make sure both he and the left breast didn’t feel left out.

Otherwise, my breasts themselves haven’t changed much. There’s no outward sign of the cancer, and while everyone on the medical team all claim that they feel the cancerous lumps, I have not really found them. It’s like when someone shows you an ultrasound image and you have to act like sure, you can clearly see that human baby shape when really all you see is a TV test pattern. There’s a reason that the medical community now urges people not to rely on breast self-examination as a standalone screening practice.

After the first chemo treatment, I did feel some mild twinges in both breasts, which my oncologist said were (a) normal and (b) a good thing. Shortly before the last treatment in Phase I, he’ll do a manual examination to see if he can detect softening of the lumps.

I did warn you this blog was all about oversharing 🙂