April 28, 2022

Day 422: The Weight is Off My Chest

Day 422: The Weight is Off My Chest

It’s the day after Kristen’s surgery to replace her expanders with permanent breast implants, and she’s already feeling much better. For the last 33 weeks, Kristen lived with a constant 2-4 pain level from the uncomfortable and awkward expanders. Today her chest looks normal again, even if it will never feel the same.

It’s the day after Kristen’s surgery to replace her expanders with permanent breast implants, and she’s already feeling much better. For the last 33 weeks, Kristen lived with a constant 2-4 pain level from the uncomfortable and awkward expanders. Today her chest looks normal again, even if it will never feel the same.
Kristen trusted her plastic surgeon Dr. Sal Pacella to choose the size and shape of implant that looked best in her body, and was amused to find out that she is the proud owner of Mentor 700cc high profile silicone gel implants, also known as “porn star boobs.”

Since this was her 2nd major surgery, things went much more smoothly with the right surgery buddy and all of her favorite comforts in place ahead of time. She spent the night in her velcro surgery bra, Ana Ono robe, and pillow recliner, and woke up feeling like a different person.


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Meet Kristen’s doctors: surgical oncologist Dr. Louis Rivera, hematologist and oncologist Dr. Sonia Ali, plastic surgeon Dr. Salvatore Pacella, and radiation oncologists Dr. Anuradha Koka and Dr. Kenneth T. Shimizu.

About Breast Cancer Stories

Breast Cancer Stories follows Kristen Vengler, a 56 year old single empty nester in San Diego, from her diagnosis of hormone positive breast cancer through chemotherapy, mastectomy & breast reconstruction, radiation, and whatever happens after that.

In 2020, Kristen moved from Austin to San Diego to be near family and start her life over after a life-shattering workplace trauma. A few months later she had that terrifying moment in the shower we all hope we never have.

From her breast cancer diagnosis, through chemotherapy, breast reconstruction, and radiation, we experience each new milestone as it happens. This podcast is about what happens when you have breast cancer, told in real time.

Host and Executive Producer: Eva Sheie
Co-Host: Kristen Vengler
Editor and Audio Engineer: Daniel Croeser
Theme Music: Them Highs and Lows, Bird of Figment
Production Assistant: Mary Ellen Clarkson
Cover Art Designer: Shawn Hiatt

Breast Cancer Stories is a production of The Axis.



Eva Sheie (00:07): Last time you heard from us it was the night before surgery, and now it's the morning after surgery. And I'm happy to report that Kristen is doing great and she's in excellent shape.

Eva Sheie (00:18): Good morning.

Kristen (00:19): Good morning. Perky.

Eva Sheie (00:23): This is a story about what happens when you have breast cancer told in real time.

Kristen (00:28): This is a story about what happens when you have breast cancer told in real time.

Eva Sheie (00:34): Were you expecting to feel this good this morning one day later?

Kristen (00:37): No way. No way.

Eva Sheie (00:40): Okay. I just have to say who predicted it?

Kristen (00:44): I know. I know. Well, Dr. Pacella said it would be a fraction of the pain. And what's interesting, though, is that the left one, the one that didn't have cancer that had the smaller expander, that one hurts more because he had to do more work with the skin and the lift of it. It's still sensitive where the expander was, but with that expander being out, it's a whole different thing because I mean, you can tell it's not this big boulder pushing it. It feels like boobs.

Eva Sheie (01:16): Did he give you a summary of what all he did?

Kristen (01:20): No. He will either do that Thursday or what they usually do is they put it in the portal. I didn't see him after the surgery. I was in recovery and I think he was probably already busy. And I asked the nurse there, I'm like, "What size are they?" And he said, "700 CCs." And of course I'm looking that up, right? And someone of course online was asking, well, if I'm like 5' 2", 120 is 700 CCs, a lot for an augmentation?"

Eva Sheie (01:47): Yes.

Kristen (01:47): And ...

Eva Sheie (01:48): Those are stripper boobs. Sorry.

Kristen (01:49): Right. No. Basically, they said, "I'm not trying to be rude, but those are porn star boobs." And they said the 700 CCs are usually best for women who are undergoing reconstruction because they've taken all the tissue, and someone with a larger statue. And so clearly I'm 5' 8", not 110. And so even when- I'm not going to say if anymore- when I lose all this chemo weight and the puffiness goes down and stuff, they're going to be proportional for my body because I was a CC plus before. And so this doesn't feel much different than that. I haven't seen the whole thing either. We talked about, that he's not finished. Up here, it's a little bit flatter and I know these are going to settle and stuff. But he's going to do some of the fat transfer. But really, I mean, they look even. There's a little bit of cleavage. I could live with this.

Eva Sheie (02:45): Sure.

Kristen (02:45): Yeah.

Eva Sheie (02:46): Do you have a sense for whether they'll drop? I know traditional breast implants that have nothing to do with reconstruction, they settle and come down after a while.

Kristen (02:56): I think we're at the point right now where we could consider this a typical breast augmentation in the sense that what you're going to see for them to settle a little bit. Because that's what I understand. It will be interesting to see because of the skin that's been radiated and how taught that skin is, if they'll stay even. The work he did, I'm sure, was to make them stay even. I mean, he's very good at forethought on it and he's done it so many times. I'm sure that he's taken that into account.

Eva Sheie (03:26): How long were the expanders in?

Kristen (03:29): 33 weeks.

Eva Sheie (03:30): 33 weeks.

Kristen (03:32): Not that I counted. It was from June 22nd until yesterday, the 7th of March.

Eva Sheie (03:39): Would you say that today you're in less pain than that?

Kristen (03:43): No.

Eva Sheie (03:44): Or just different pain?

Kristen (03:45): Different pain, different pain. What I'm noticing is that some of the nerve endings are probably reconnecting. So I'm getting some, I call them lightning strikes just here and there. And now I mean, I told you at the beginning, "Warning, Kristen just took a muscle relaxer and a couple hours before that was some pain meds, some oxycodone." So if I sound a little drunk...

Eva Sheie (04:09): Is it going to be nappy time soon?

Kristen (04:14): It's going to be nappy time soon. Yes. It's going to be nappy time. But staying ahead of the pain like I did before has been key. And Lanie's been really good about that. She's setting alarms for me, which is great. And we're alternating it. We're alternating the oxycodone and the Robaxin.

Eva Sheie (04:29): Now, what would you say makes a surgery buddy, like a recovery buddy, a good recovery buddy? And feel free to get Lanie to answer that if you want to.

Kristen (04:38): Okay. I know, right. She's outside on the phone. Somebody who is...she asked the right questions the night before. She's like, "What do we need to do today to get you ready mentally, physically, like all that. Where are your pills? Where are your prescriptions?" And she was willing to look at all of this too. I gave her the packet that they gave me for pre-surgery post surgery, what to expect, all of that. And then she took pictures on her phone of just the things that she really felt would pertain to what she needed to do.

Kristen (05:11): So to answer your question on that, she's really easy to be around and she's asking the right questions. And she also understands that it was really important for people to know what was going on. As soon as she heard from Patella, then the recovery nurse called her and she pulled the car around. She was right there, ready. And I think she had probably already texted everybody by that time saying, "She's out of surgery and she's doing well."

Kristen (05:42): And I think it's that she knew the right things to ask and she was willing to listen and she wasn't afraid of what was going on.

Kristen (05:52): It's funny because she's not a blood and guts person. So when I had her feel my expander the other night, she's like, "Oh, oh, oh, oh, oh, oh." So she's not that person who wants to empty the drains or anything, which shouldn't have to. I can do that because it's kind of gross. I mean, you're not getting anything on anything, but it's bodily fluid that's coming out into these JP drains that you have to open up and drain. And, you know, it's bodily fluid. Right? And right now it's red.

Kristen (06:19): And so she was just upfront. She was squeamish about that. But she's just super easy to be around. And it's somebody that I don't have to explain anything to her. It's like you and I being around each other.

Eva Sheie (06:33): So I just want to recap because I heard a couple different things.

Kristen (06:36): Okay.

Eva Sheie (06:37): One is be fully present. Don't expect to go somewhere for a while. Obviously, she probably could if she needed to and you'd be fine for a while, but not everybody's going to recover like that. So if you're the surgery buddy, you need to make sure that for the timeframe you've agreed upon ahead of time, I think, you're a hundred percent there with no expectation of, "I'm going to go to LegoLand and I'll be right back."

Kristen (07:02): Exactly. Yeah, exactly.

Eva Sheie (07:05): So number one was just be present.

Kristen (07:08): Be present.

Eva Sheie (07:08): Number two, ask a lot of questions of you.

Kristen (07:13): Well, and be sure that you know what's going to be happening the next day, what to expect. And I would say to her... Last time I forgot my nausea patch and they had to give me another one. And so I'm like, "I'm putting this here. Please help me remember it."

Eva Sheie (07:27): I really like that. Write down all the things that went wrong last time so you can be in front of them.

Kristen (07:33): Right. And just her being open to looking at the literature. I looked at it, but having someone else know was super helpful.

Eva Sheie (07:43): I love this one, right? And you know why, right?

Kristen (07:46): What?

Eva Sheie (07:47): Well, because the number one reason people find themselves unhappy with a surgery is that they were unprepared for recovery across the board.

Kristen (07:56): Yes, yes..

Eva Sheie (07:57): Any kind of surgery.

Kristen (07:57): Yep.

Eva Sheie (07:58): And I've talked to so many people who say they made it seem like it was going to be a breeze and it was nothing even remotely close to a breeze.

Kristen (08:07): Right. Completely. And the thing is I got up this morning and so I'd been propped up on my wedge and all that. And I got up to go to the bathroom to let Jack out. And I was like, "Oh gravity." Okay. Even though I'd been taking pain meds, it was just a shift. And it wasn't horrible, but it was like, "Okay, just a reminder."

Eva Sheie (08:28): Did you sleep all night?

Kristen (08:29): Mm, in and out, because I was sitting up and I don't do well sleeping on my back.

Eva Sheie (08:34): But it wasn't the pain waking you up. It was just...

Kristen (08:37): No. Oh no, no, no. Mm-mm (negative). And when I crawl on the bed, it's kind of like a pillow throne. I have these pillows that are up on top of the wedge. And then I remembered from last time that what was painful is the weight of my arms pulling on the sides of my breasts. And so I have pillows that are like arms. When I get in the bed, I have to crawl all the way in because I can't use my arms to push myself.

Kristen (09:10): Think about when you get in bed, how much you use your arms. And if you're also getting into a position where you're sitting up, you want to get your butt as close to that wedge as you can.

Eva Sheie (09:20): So what you're really saying is you built a recliner of pillows on top of your bed.

Kristen (09:26): I did.

Eva Sheie (09:27): You probably could have gotten a recliner and it may have been easier. Or for some people, might be easier to just sleep in a recliner for a little while.

Kristen (09:37): I think a lot of people do that actually. Yeah. I think so. But my place is so little I'll go with...

Eva Sheie (09:44): I thought of it because when I fall asleep in the recliner, my arms always fall asleep because they're not supported. When you said that thing about your arms, that's what it made me think of.

Kristen (09:55): Yeah. I have a table that's right next to my bed, but I realized that I couldn't really reach around to get the stuff off the table. It really is like a recliner that has cup holders because I had my water bottle that was right next to me. And then I had my little pillbox and I had my phone and I have the remotes and my journal.

Kristen (10:19): So for people who are listening, what I have on is I have...there's cotton, like a big wrap of cotton over some plastic bandage wrap. And then I have, they call it a surgery bra. I mean, it has hooks and a zipper in the front and it's white and it has these Velcro- every bra should have Velcro- Velcro tops to be able to adjust rather than having to reach around the back and do that. And so I'm just kind of packed in here, but I can see my armpits and all of that. It's like a really, really, really grandma bra. And then I have on a robe over it, the Ana Ono robe that I love so much.

Eva Sheie (10:59): So the last thing I'll just call out about your surgery buddy, is that person is in front of the medication schedule and food and probably-

Kristen (11:11): Yes.

Eva Sheie (11:12): ... any other...

Kristen (11:12): Water.

Eva Sheie (11:13): Yeah. Water.

Kristen (11:14): And really, I'm probably just hypersensitive about it because I felt so badly about people not getting called and notified. I mean, I don't know how quick it was that she notified you, but people got what they needed. And my phone wasn't blowing up.

Eva Sheie (11:32): It was 2:20 PM here. So it was 12:20.

Kristen (11:35): Yeah. Perfect. So I hadn't even gotten in the car yet. And she had done that.

Kristen (11:41): So the surgery buddy, it's somebody that really is just really there for you. They get it. They don't have an ego about it. They just want to help you.

Kristen (11:51): And this is my cousin who I haven't seen since we were little bitty. And we're very similar in that we can just say what we need to say. And we don't have to tiptoe around things.

Kristen (12:03): And she's been through a little bit of this with some friends. She didn't have reconstruction, but she's been through breast cancer. This woman had had it three times. And so she knew what was important.

Eva Sheie (12:14): So you recommend calling long lost cousins to come help.

Kristen (12:19): Find a Facebook cousin who seems like she's like you and has the same sense of humor and then schmooze her to come down and sit at the beach and watch your boobs become blue.

Eva Sheie (12:36): So what did it feel like riding in the car on the way home?

Kristen (12:40): So I have my mastectomy pillow that goes in between the seatbelt and my body. And so I made sure that was in place. I felt unsteady because I'd had plenty of pain medication. The first thing she said is, "I'm going to avoid the bumps. I promise." So that's another thing you need to really have in a recovery buddy.

Eva Sheie (13:02): Good driver. Okay. Got it.

Kristen (13:04): Good driver. Good driver. Yeah. So it felt good coming home. I didn't get in bed right away because I wasn't sure if I got in my bed, my reclining bed, whether I was going to be able to get up or not.

Eva Sheie (13:17): And then did you take a nap or did you just hang out or what did you do?

Kristen (13:21): We just kind of hung out. I kind of dozed in and out also. And Cleo, who works for the family that I live with here, but own the house, she's a chef. And she came up with muffins and dinner. And so it was very low key, very chill even though I was in pain. Everybody here was completely surprised. Cleo came in and she goes, "I thought you were having your boobs done today."

Eva Sheie (13:46): "Yeah, I did."

Kristen (13:49): And I said, "I did." She goes, "You're sitting up." I'm like, "Yeah." I'm like, "You want to see?" She's like, "Oh, you're that girl. You're going to be showing everybody your boobs now." I'm like, "I waited long and hard for these things."

Eva Sheie (14:02): I can tell that you're slowing down a little now. Just-

Kristen (14:05): My voice.

Eva Sheie (14:06): ... from when we started. Yeah.

Kristen (14:07): Oh.

Eva Sheie (14:08): Yeah. You might be getting a little bit tired.

Kristen (14:11): Loopy.

Eva Sheie (14:12): Yeah, maybe, maybe. So I won't keep you too long. So let's wrap it up just by covering what you're going to do this afternoon.

Kristen (14:21): Okay.

Eva Sheie (14:21): And then we'll be really, really excited to hear about how you're doing in 10 days or two weeks. It's going to be like, "Put those things away."

Kristen (14:34): Seriously. So part of what was, made this successful also is that I put the clothes that could open in the front within arms reach and put dishes and things I needed to get to not above my shoulder. And having been through it before I want to share something with you. I talked to the anesthesiologist when he came in and he said, "How was it last time?" And I said, "I was in a lot of pain, a lot of pain." And he said, "Well, I'm going to give you as much as I can. I'm going to do my part of it. And then you just need to be really honest in the recovery room with how you're feeling."

Eva Sheie (15:10): Was it the same anesthesiologist or a different person?

Kristen (15:13): Mm-mm (negative). Different. It was done before an ambulatory surgery center that was strictly outpatient. The guy next to me is having a colonoscopy.

Eva Sheie (15:22): What was he talking about?

Kristen (15:25): I don't know. I think he wanted to be awake for it. He had this British accent and I think he wanted to understand what was happening and just be in Twilight. And I'm like, "Oh man, I don't know what's going on there." But it was too much information, too much.

Kristen (15:44): And it was funny because Dr. Pacella came in to draw. And so he's sitting there marking what he needs to mark. And I'm like, "What's with the guy with a colonoscopy?" He goes, "I know. I was listening to that. Who wants to be awake for that?" Cause I guess he was around the corner at the counter doing some paperwork and I didn't see him and I didn't realize he'd heard him, but I was like, "What's with that?"

Kristen (16:05): And so it was a completely different situation where the doctors weren't the same. There was actually a resident that was in there with him. And I think his name was Dr. Cooper. I don't remember. Maybe. I don't know.

Eva Sheie (16:20): That's a little too much Big Bang Theory.

Kristen (16:24): And so what was interesting is when I went in, I walked in again, too.

Eva Sheie (16:30): Oh, yeah.

Kristen (16:32): I had a recliner there. And the anesthesiologist was like, "Can you taste the saline?" I'm like, "Yeah." And then he says, "Does it feel cold?" I'm like, "Yep." And then that's the last thing I remember.

Kristen (16:42): But with the recovery nurse, I said, I had a lot of pain before and he had given me some pain meds and he was like, "How is your pain?" I'm like, "It's a seven or an eight." And there were tears streaming down my face a little bit. And he's like, "Okay, I will call Lanie and tell her we're going to be here a little bit longer."

Eva Sheie (16:57): Oh, that was yesterday and that's what you said.

Kristen (16:59): Uh-huh (affirmative).

Eva Sheie (17:00): Yeah.

Kristen (17:00): Mm-hmm (affirmative). And so he gave me more pain meds and I stayed there for another half an hour just to stabilize. And then I think that psychologically too, knowing I wasn't staying in the hospital made it feel like it wasn't as an extreme surgery, which it wasn't. Having a mastectomy is like... You can't even explain that, but...

Eva Sheie (17:22): You had something amputated.

Kristen (17:23): Yeah.

Eva Sheie (17:24): Yeah. Okay.

Kristen (17:26): Well, and my chest was filleted open also. As opposed to this time, Dr. Pacella went in under the fold of the breast underneath the bottom. And so it was a different kind of situation.

Kristen (17:38): So this afternoon I'll have a little nappy before we go, but I want to take Lanie to this cute little breakfast place or lunch place if I can stay awake. And then at 2:45, we have an appointment with Dr. Pacella's nurse. And I'm hoping that maybe the drain... I don't know if the drains will come out yet. And then if I have it in me, we'll probably go down to the beach and watch the sunset so that she can see that.

Kristen (18:03): It's nice where I can just tell her, "I really don't want to do this." Or it also helps me get up and about to have somebody here that I want to see these things. She lives in Seattle. So she knows water, but Seattle in...

Eva Sheie (18:14): Not sunshine, she doesn't know sunshine.

Kristen (18:16): Right. Right. Seattle in March is a little different than San Diego in March. And she woke up today, she's like, "Ooh, it's cold but there's sun."

Eva Sheie (18:25): Are your drains full right now?

Kristen (18:28): They haven't been full the whole time. Since I got home yesterday, I think I've pulled out 40 CCs on the left, which is where he did more work and maybe 25 on the right, which isn't much.

Eva Sheie (18:42): I've known about drains forever. But I didn't really understand the purpose until recently is that they are there to prevent you from fluid buildup. And if you have a fluid buildup that can actually cause complications and infections. They might be inconvenient for a couple of days, but they're really there for a good reason.

Kristen (19:03): Before I was really freaked out about these drains. I was like, "How am I going to do it? Is it going to gross me out?" There's not much in it. The hardest piece for me is not getting the cords stuck on things. I tuck them into my pants.

Kristen (19:20): But I feel remarkably better. I think a lot of it, too, is I don't have the unknowns that I had before like, "What was the pathology going to come back as?" And there was a whole mastectomy situation happening where this is really reconstructing the breast. This isn't about the cancer.

Eva Sheie (19:40): Not to get overly philosophical, but I kept saying for the last couple of weeks or months that we were in a valley and we didn't know how long or wide it was going to be. And this to me feels like the way up.

Kristen (19:55): Absolutely. That combined with the scan that I had. I mean, this definitely is the next step to where I can feel somewhat back to myself, I guess. And I don't need boobs to feel like myself. I just know that I wasn't ready to see myself completely flat. Everything was happening so fast. I couldn't even process that piece. And so to actually have some kind of feeling of normalcy is a gift. And I think, I feel like we're out of the valley and maybe I'm climbing up to the mountain a little bit, which is, I can't tell you how good that makes me feel. Cause I've been so afraid I was going to be stuck for a long time and I didn't know how to get out of it.

Kristen (20:45): We talked about this, but what the scan did for me, too, is it helped me to reframe my side effects to, "Okay, they're just side effects. It's not cancer, not more cancer." And so that really did help to take... I literally had weight taken off of my chest. But that was like weight taken off my soul. Short title?

Eva Sheie (21:09): Weight off my chest. The weight is off my chest.

Kristen (21:17): Yep. I love it.

Eva Sheie (21:19): So check the show notes for links to Kristen's articles. I think there's going to be two new ones. One is how to be a great surgery buddy for a friend or a family member who's going through this. And the other one I think you should write is how to get your house ready to recover.

Kristen (21:35): Seriously.

Eva Sheie (21:36): Yeah, we'll do that. You can find those both in the show notes. And sign up to get email updates from us. Thanks for listening to Breast Cancer Stories.

Eva Sheie (21:45): If you're facing a breast cancer diagnosis and you want to tell your story on the podcast, send an email to us at hello@theaxis.io.

Eva Sheie (21:55): I'm Eva Sheie, your host and executive producer. Production support comes from Mary Ellen Clarkson. And our engineer is Daniel Croeser.

Eva Sheie (22:03): Breast Cancer Stories is a production of The Axis, the axis.io.

Kristen (22:10): Signing off.