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Thursday, 8 July 2010

Outpatient Appointment

I woke up yesterday morning feeling relatively feisty, so I put all my clothes and stuff into bags, ready to go home to my own flat. Jara helped me carry the heavier bag. It was all good, but by the time I walked down the stairs, across the courtyard and up the stairs to my own flat, I was too tired to do anything. I didn't leave my flat in the cleanest possible state, and fixing this is very slow going.

In the mid-afternoon, Dr Jane came around in her awesome little sports car to collect me for my first outpatient appointment. I was very grateful for the lift and the company. Given that it was a trek for me to cross my estate, I wasn't quite ready for the tube and it's much more pleasant to go with a friend than alone in a cab.

There was a lot of traffic in central london and the outpatient plastic dressings clinic is in a strange back corner of the hospital. I arrived 20 minutes after my appointment time and then probably walked for at least another 10 minutes, around the perimeter of the hospital, until I finally found a dark hallway that seemed to be right. The plastics dressings clinic, where I was headed, was next to Bereavement Services. It's good that the hospital provides this service. It seemed to be a small, windowless room with 3 or 4 chairs around a low table. Kind of a depressing setup, but I guess that doesn't actually matter.

I apologised for being late, but they were running behind anyway and so I waited for a bit and then went in to a very warm, windowless room. There was a fan blowing, but the nurse turned it off when it kept blowing the paper off the examining table I was trying to recline on. The walls were lined with little plastic bins that contained different kinds of bandages and things like that.

I took off my shirt and chest binder and the nurse started to peel off my bandages. She did the right side first, first taking off the plaster covering were the drain had been. She said it was dry and didn't need to be rebandaged. Then she took off the plaster over my nipple. It had a bit of blood on it, but was fairly clean. I looked down at my chest.

Six days laterI had been warned that it would look weird at first, but man, it is weird. The process the surgeon used was to cut out my nipple, but keep it attached to the blood supply and nerves, and then remove the moob around it. So this left a hole, so she stretched the skin from the outside of the moob towards the middle. To visualise this, think of cutting a circular hole in a sheet. Then you want to close the hole, so you bunch all the fabric from the perimeter of it together and then put a button or something in the middle of that. That's kind of what my chest looks like.

My right nippleThere's an expanse of pale skin, that gets kind of wrinkly and ruffly, which surrounds my pink nipple, poking out from the middle. All the stitching and scabs, etc are only surrounding the nipple. The nurse said it looked perfect. Ok!

The she took off the bandages on the left. These were much more dirty and I averted my eyes for the rest of the process because I didn't want to feel faint. She also, very happily, removed an electrode that was still stuck to my back, that I couldn't reach. "You haven't taken a bath for a week?" she asked. Um, no. I started thinking about who it would be least awkward to ask to come over to rub my back with washcloth.

She was concerned about the swelling, so she asked another nurse to come have a look. The other nurse was busy, so we had a longish wait where we made awkward small talk. She put a paper towel sort of thing over my chest, probably because I was obviously freaked out by the scabbiness. I took it off after a bit to get a better look. Meanwhile, I had kept my binder on nearly continuously since my op and the sensation of having it off was also kind of strange. It's purpose is to reduce swelling, and while it was off, I could feel swelling tugging at my stitches. The nurse told me not to worry about it.

The other nurse finally came in and looked at a lump I have on my left side between my armpit and nipple. It's somewhat larger than a golfball. She said it was a hematoma, which means a bunch of blood and other goo trapped under my skin. "We could aspirate it with a needle," she said and then laughed at the look on my face, "but that would increase the risk of infection, so we'll just see if it goes away on it's own." I m deeply in favour of that plan over the popping-like-a-water-balloon plan. She said the (now extensive) bruising was also normal and not to be worried about it.

My left nippleThen she got out a mirror and showed me my left nipple. "Do see you the shadowed part underneath?" On the bottom of my nipple, below the pokey bit, about 10-20% of my nipple has darkened. She explained that this indicates a blood shortage. The shadowed bit will probably die. It will dry out and then she and the nurses have a way of getting it off. And then, I guess, somebody will tattoo the pale skin around it and the world will be none the wiser.

They told me I could take showers again! Huzzah. I should moisturise the ruffly bits of my chest afterwards and when I change the bandages, which I should do everyday. They gave me some moisturiser to use and meant to give me a week's worth of bandages, but accidentally only gave me enough for one side. I'm allowed to keep taking the same pain meds, despite the prescription ending. She told me to look out for signs of infection, which I have not absolutely committed to memory, because of my propensity to worry. If it doesn't seem wrong, it's not wrong. If does seem wrong, I should just call them. I'm to come back in a week.

I walked around to meet Dr. Jane by the café in front of the hospital. Jane came rushing over to meet me. Later she explained that I was shuffling like an old man and looking very pale. She suggested we sit for a bit and have a bite. "How are you doing?" she asked. "Part of my left nipple is dying, but it's not a part I was really using." I said.

We sat nicely for a bit and then went back to mine and hung out for a bit more. I took my last antibiotic, thank gods.

This morning, I had to go get my T levels tested at my GP office, which is a bit further than a kilometre away. I asked the guy drawing my blood if having an operation and the massive stew of drugs I've been on since my last T injection would skew the results. He didn't think so, but wasn't sure. I guess if it says the levels are too high, I can push for a re-test, since this new 0.8ml / 18 days is the best I've ever felt on T and I am not entirely keen to decrease.

On the walk back, I had to stop and sit about after every third of the trip. I was back to my old man shuffle, but trying to stand up as straight as possible. I'm so used to slouching that it's very awkward looking when I try to stand up straight. But since I'm wrapped in a piece of elastic and recovering from surgery, I'm all awkward anyway, so might as well get used to it now.

When I got back, I was shattered and slept for a couple of hours. I probably should have taken a cab home or waited longer in the waiting room before walking back. Still, stronger ever day.

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