Learning From Experience

I have had quite a summer, and not a good one! I was tested in March using BRAC analysis and determined to have a BRCA-1 genetic mutation specific to my family. At that time, my sister was battling stage IV breast cancer, a battle she later succumbed to. I was given a 40% chance of ovarian cancer and a 50-85% chance of getting breast cancer! Given my age, the tenacity of my sister's cancer and many other factors, I decided to act quickly. In June I had a robotic hysterectomy at OSU. This procedure had the shortest recovery time and I was only away from work for 2 1/2 weeks. However, I continued to be very limited in certain activities.

Six weeks later and just as I was beginning to feel "normal", I headed into my second surgery. This one was a double mastectomy with immediate reconstruction. This surgery was also performed at OSU, in the James. Amazingly, I was hospitalized less than a day! However, I required help at home for simple things like taking a shower, going to appointments and even making lunch. I was not allowed to lift more than 5 pounds per arm! As a chiropractor, this created a big hole to crawl out of to get back to work. I knew that I would need to work very hard to make it back within the 6 weeks the doctors estimated.

My main goal in the beginning was to remain active. Within a week, I began taking walks. I started very slowly and listened to my body to know when to stop. My first walk lasted about 20 minutes and I went slowly upward from there. After my drains (tubes to allow the escape of fluid placed under the arms) were removed and I was given the OK to reach above my head, I started very gentle stretching of my chest muscles and my abdominals. I began standing using doorways and moved to lying on my back on an exercise ball. After surgery, I had a lot of bruising on my right side and a lot of swelling. I was also very surprised at how sore and tight my abdominal muscles were. I could literally SEE the fibers of the muscles pull up when I straightened up or leaned to the side! It felt as though they would tear if I moved too quickly or went too far. Obviously, this was an instance where I had to go very slowly and listen very closely to my body to avoid injury. I stuck with the gentle stretching and the walking for 2 weeks. Walking was a great way to loosen my chest muscles (arm swing) and to relieve the back pain that results from being hunched forward due to muscle tightness. I felt straighter and looser after each walk.

Once I was given the OK by my surgeon, I started training with light weights and a ball. It is amazing how heavy 5 lbs can feel when you are attempting to bench press with expanders under your chest muscles! It is also a VERY odd sensation that takes some getting used to. I also started by simply supporting my weight on my hands in a push up position. I have yet to manage even a girl push up, but I know I will get there. At 5 weeks post surgery, I feel I have regained my stamina and most of my strength, with the exception of my chest muscles. I will continue working on those for many months to come. As a chiropractor, I use my chest and stomach muscles all day, every day. I will have to modify things for a bit, but I cannot wait to get back to work! I will be returning at just under 6 weeks, and I am very proud to have met my goal.

Here are the main things I feel were instrumental in my recovery:
1. Early return to activity. As soon as you are SAFELY able, you need to get moving. Clearly, this will be a modified and easy activity, but you need to do something.
2. Listen to your body. Pushing too hard will result in a set back. I had one during my recovery. I went to work after 2 weeks to manage paperwork and stayed too long. I could feel the pain in my back and chest, but I felt I needed to finish what I was working on. For the next 2 days, I had trouble getting up without assistance, especially toward the end of the day. Start small and build! If you don't you will have to start over again.
3. When the doctor tells you that you can safely perform an activity, get to it. It is a false line of thinking to try to rest to get back to normal faster. If you do not move your body, it becomes accustomed to that. It is OK for things to be hard or uncomfortable in the beginning. Just start small and see how you feel the next day. Chances are, you will feel fine. It was very hard for me to attempt a bench press activity because it felt so weird with a foreign body (the expander) under the muscle. However, if I waited until it didn't feel weird or uncomfortable, I would NEVER get back to it.
4. Get enough rest. It sounds like I have been telling you not to rest, but that is not the case. After surgery, it takes up to 6 weeks to get your stamina back. That means that you may require a longer night's sleep or a nap. I napped daily for about 2 weeks after my second surgery. Having had 2 so close together, I felt pretty wiped out. I also frequently slept 9-10 hours per night if I didn't nap. Your body needs extra time to rebuild, and a longer night of sleep is an important tool in that process.

My recovery was far from perfect and is not over yet, but I have learned a lot about my body's abilities. I have also learned that pain medicine and muscle relaxers can be an essential part of an early recovery. Don't attempt to "take the pain". This will slow your recovery! When you are able, you need to leave those pills behind, but for the first few weeks, they were an important part of my recovery. After I stopped with the prescription pills, I still took over the counter ibuprofen to help with minor pain and with inflammation. I still have swelling and bruising due to a hematoma (pocket of blood) on one side, and I still occasionally take ibuprofen when needed. Many people fear addiction to pain killers and therefore try to do without. Unless you have a history of trouble in that department, those medicines will help you recover more quickly by keeping you comfortable and allowing you to REST. Getting comfortable to sleep is extremely important, and often this cannot be achieved in the beginning without pain medicine.

There is much to be learned as a health care provider from being the patient for a while. It reminds you how hard it can be and how many questions arise during the recovery period. There is fear with recovery, especially recovery from a major injury or surgery. It is important to know that all people go through it. Ask questions. Follow ALL of the doctors orders, and get back to being you!