Saturday, January 29, 2011


The last surgery I am to have, the final dollop in my cancer sundae, is the creation of nipples. A nip, as it's known in cancerland, is the cherry on top of a scarred mound of ice cream, without which the dessert is not complete.

It's a minor surgery, but one that requires anesthesia. A false nipple is made out of skin from another part of your body (in my case, my doctor said the stomach) and then once that is stable, tattoos are done to make it appear that you have an areola.

Many women, however, stall at this point. Including me. The idea of one more surgery isn't appealing - at all. Women who have had double mastectomies sometimes even prefer their nipple-less state - being able to go braless without having to worry about turning the headlights on is a real plus for them. Once you have them done, your headlights are on all the time. Doubles have to decide - lights or no lights?

I, on the other hand, only had a single mastectomy. Each time I look in the mirror, it appears that my body is winking at me.

Maybe it is.

Would having the nipple/areolas done help stop that visual?

Now that the initial swelling has gone down, the breast mound does not look as good as it did immediately post-surgery. There is some rippling along the sides and lumps where the scar is puckering it. I'm still okay with it since I got my wish - to look normal in clothing. But, I'm not convinced that adding a decoration to it will improve it any. As it is now, my breast mound is a dignified reminder of my struggle to survive and not a piece of art. Perhaps adding a nipple on that would be like craggy-faced actor, Sam Elliot, putting on a dress and lipstick. Just wrong.

I also don't know if I want to go through more surgery, especially now that it appears I might have to have shoulder surgery too. Adding a nipple is purely elective - being able to use your arm? Not so much.

And, to add insult to injury, apparently, you have to put some sort of plastic cone over your newly created nipple while it heals, and how on earth do you hide that? I picture one of those cones you put on a dog's head to keep it from licking open an injury, mentally project that onto my breast mound and then imagine putting a shirt on and going to work in a high school - and I'm a lot less excited about it than I should be.

There are alternatives: instead of surgically building a nipple, some women have 3D tattoos that appear to be of a nipple and an areola, but which are smooth. That doesn't really work for us Unis though.

So, do I or don't I? Do I get a nipple recreation with an areola tattoo, or not?

The deciding factor might be this: I am dying to ask my future grandchildren if they want to see granny's tattoo.

Yes, I'm evil.

Once it's done, it's permanent. So, I was very excited to come across a product that will help me decide. They are called rub-on nipples and they are designed specifically for mastectomy patients.

Remember as a kid you'd get a tweety bird tattoo in your box of crackerjacks, wet it and rub it on your arm to shock your friends with your bad-ass new tat? But, you could never get the water right and it would sort of be tweety's beak and feet and if you were lucky, maybe a wing, and the rest would just peel and crumble off?

Well, this product is similar to that, only not similar at all. First, to my recall, they never put nipple/areola complex tattoos in cracker jacks.

Second, these work much, much better.

I got two assorted variety packs in colors I thought might be right for me, and went to town.

I can honestly say, this product works beautifully. They solved the problem of crumbling rub-ons - you wet it and it's on perfectly. And, it doesn't come off at all, which is magic. It really looks like a tattoo, or like your skin coloring - like it's permanent.

It's also annoying because my first attempt was so wrong. I didn't follow the instructions, which suggested you cut the tattoo into a circle for better placement. I took the square, imagined where I thought the nipple would be, and wet it with a washcloth.

I now have a nipple very close to my cleavage. This would not be disturbing, except it looks exactly like a nipple and it's very strange when in the wrong place. You can remove it with rubbing alcohol, which I don't have, so I'm walking around with a cockeyed nipple.  When I look in the mirror, I'm getting cross-eyed stares rather than winks.

Not sure that's an improvement.

My mother always told me to go out with clean underwear in case I got in an accident, and not only did I take her advice to heart, I never leave my house without imagining that I'll be hit by a bus. If I die with this nipple in the wrong place, I'll be so embarrassed.

I'm going to hit the store today and get some alcohol and try again. Maybe I'll send my husband. "Honey, I need some rubbing alcohol to get my nipple off before I get hit by a bus."

Even though I haven't gotten it perfect (yet), I can only blame my ADD impatience in not following the directions. I highly recommend this product, for many reasons. It helps us Uni's decide if we want to have the surgery - a harder decision for us because we never will match perfectly. At least, with this, we can get an idea if adding a nipple/areola complex will highlight the mismatch or mask it. It will help you Doubles decide on color and placement for your permanent nips/tats. And, because it is such an easy and yet effective product, it might just put a tattoo artist out of business. With this product, you can change it up and have a pale pink cherry one day and a nice brown one the next. I know, if I was a double, I'd probably stay bare and just use these for fun.  Implants may not be permanent, but tattoos are, and being me, I always think to the future.  That perfectly placed nip/tat in 2011 might be way off in 2021.

The place to get them is: They are $20.00 for the variety pack.  I recommend starting with that because the colors look a bit different on your skin than in the package.  (A little darker from my one test; maybe that's because I tan.)  Each variety pack comes with two colors and you get 8 tattoos total. The website says they last two weeks, and while I haven't tried one for that long yet, I tend to believe them as everything else they said was right on the money.

I like them.
In fact, I'm thinking of putting one on my shoulder - just for fun.

"Hey kids, want to see granny's tattoo?"


Friday, January 28, 2011

CPT 238.1 Unc Behav Neo Soft Tissu

73220 Magnetic Resonance Imaging Any Joint Upper Extremity w/out & W Contrast-73220 REQR

73222 MRI Any Joint of upper extremity; w/contrast REQR
77002 Flouroscopic Gude for Needle placement Narpos
23340 Injection for shoulder x-ray - 23350 AA

Those were the diagnostic codes I received in the mail today - after my 73220 MRI. Yes, I said after because I got a phone call this morning at 8:30. Apparently, this MRI required a radiologist in attendance to read the first films to find out if I needed contrast for the second set or not.

No radiologist is going to work on Saturday.


My nice boss said, "Go" and so I did. I signed in by 9:30 and got it over with. Back in the old familiar tube, back to the rhythmic noises, back to sleeping in machines. No contrast was necessary and I returned to the office by 11:00. They said they would fax my doctor the results immediately, so I would find out today - same day service.

I tried to figure out: was the decision to not have contrast good news? Or, is it bad news? I decided it was probably good news, since they didn't need to see details they probably didn't need to treat it.

But, I wasn't sure.

By 2:30, my anxiety was building up, and I decided I didn't want to wait and so I called my doctor. He wasn't there but a PA would call me right back, and so she did.

After speaking to her, I called my oldest son, and told him he got a reprieve. For, if the news had come out differently, I would have expected him to begin the job of making me a grandbaby immediately. As it is, while the full report has not come in, it does not appear to be metastatic cancer.

No immediate grandbaby making necessary.

Off the rollercoaster until the next time. And, I know there will be a next time, there always is in this rotten, Sword of Damocles disease.

I think breast cancer should be one of Dante's circles of hell, perhaps replacing lust, which really isn't all that bad. Any disease that creates the terms "scanxiety" which is completely descriptive and gag-inducing at the same time, deserves it's very own circle.

Now I can go about my life, clutching my shoulder, swearing, wincing and gulping pain meds. Such a relief!

I am ready for my 73222, 77002,23350 for my 840.7 Superior Glenoid Labram Lesions though. Ouch!


Thursday, January 27, 2011

Humerus MRI

One question: When people in the UK or Canada have an MRI on their upper arm bone, do they spell it humerous?

My hilarious MRI - the one to check out that funny spot on my humerus, is scheduled for Saturday morning at 8:00 a.m.

Eight. A.M. On Saturday.

I think the joke is on me.

I've been all, "oh, this is ridiculous and a waste of time. I am only seven weeks out of herceptin, it is unpossible for me to have a mets to my bone this early."

Then I was like, "Wait a sec. I'm only thinking about herceptin - what about chemo? Like, I totally forgot - not everybody responds to herceptin! It's been ten months since my last chemo infusion, and dude, the average age to relapse is 16 months. I could just be a cancer over-achiever instead of the slacker I thought I was."

See, boys and girls - this is what we cancer patients - all cancer patients - go through. Your friends with cancer might not tell you, but they are just like me. Because invasive breast cancer "survivors" are only considered in remission, not cured, we are aware it could always come back; therefore, we are always worried it will. Most people with breast cancer will die of old age. Or, perhaps a tragic piano-related high-rise accident. But, they'll never know which - until the day the music dies.

Some people think every ache and pain is a relapse, and worry themselves into penny ulcers. I'm not like that. I knew my shoulder pain was an injury and even knew it was a rotator cuff. When I get a headache, I think headache, not brain cancer. When I have a sore rib, I wonder where I bumped it. My mind does not jump to cancer with every sneeze.

It's not until a medical professional escorts me there do I climb into the rollercoaster. When a doctor says, 'I don't want to worry you, but look at this...." I start to hear the rumbling.

On the rollercoaster I climb.

I hate rollercoasters.

I like the relief you feel when you get off them though, and that's what I expect to feel next week.

What's really not amusing is this: I have to wait until February 18th to get my arthrogram MRI for my real problem, the shoulder. If you knew how much this hurts you would feel really, really sorry for me. You might even buy stuff using my Amazon link to the right, just to make me feel better. ----->

What is also laughable is the fact that the injury I likely have in my shoulder typically does not respond to anything but surgery. The top ligament that attaches the bicep to the shoulder is ripped out and has to be surgically repaired. So, another scar, another healing period, more time off work.

More feeling unhealthy.

2 years ago, I was a very healthy, fit, youthful (for my age) woman. I couldn't imagine having surgery, I couldn't believe anything worse than a migraine would be my fate.

Isn't that humorous?


Monday, January 24, 2011

With your history.....

So, I tried to get out of having an x-ray. I really, really did. The nurse came in and got me and I said, "no thanks." I explained that I'd had several CT scans, a bone scan and had enough radiation to power a small IKEA lamp. She said she'd tell the doctor and see what he thought.

Hell, I figured it was pretty clear cut, some sort of ligament injury. Why x-ray me, it's not like my shoulder is broken.

The message back was, get an x-ray, there isn't that much radiation. I gave up and dutifully followed along. Like with raising children, you have to learn which battles to pick. I posed for my films and went back to the room.

My new, super darling (I wish I was 25 again) doctor came in and apologized for the x-ray but said "With your history...." a phrase I've heard before and will continue to hear. "With your history, we had to check. Cancer can metastasize to the shoulder."

I knew it was a tear though, so I wasn't worried about that.

He pushed and pulled on my arm and made it hurt really bad. I was thinking there'd better be a lollipop afterwards. Then he pulled up my x-rays and said something startling.

"I don't want to scare you but do you see that spot right there?" And, he pointed to a white spot on my arm that was nowhere near my shoulder and was caught just by happenstance. I nodded, calmly. "We need to get that looked at. It's could be nothing but with your history...." He added, "If it is cancer, than I'm the one to deal with it, my specialty is tumors."

All I'm thinking is, "some lollipop."

If it is cancer, that really is not a very good sign. I only finished herceptin six weeks ago. If it's an old injury, that's not a very good sign either, because I don't remember it. Either way, I lose. Bad memory, bad bones.

Now, for the good news: my shoulder problem is almost certainly a labral tear. A labral SLAP tear. Unfortunately, that sounds a lot dirtier than it is. Apparently, the labrum is part of the shoulder that athletes, such as myself, injure frequently, doing the same kinds of things that I do. Like, getting out of bed. It could be frayed, and then will get better on its own. Or, it can be torn, and then surgery has to be performed.

I'm to keep doing PT (although it doesn't work for tears) until I have an arthro-MRI to determine what exactly is going on in there. No cortisone shot as it doesn't help this particular injury. I'm just going to have to live with this pain.

And, about that spot on my bone?

Time will tell.

Saturday, January 22, 2011

Physical Therapy

So, I found myself back at the old familiar medical complex - the place I'd hoped to get a month-long vacation from. I was there for my first physical therapy session in the hopes of restoring movement and reducing pain in my shoulder. I arrived late, because as many times as I'd been there, I couldn't find this particular office.

I'd never experienced physical therapy before and wasn't sure what to expect. The therapist, a pretty, granola-ish California type, did some measuring of my range of motion, or ROM as they say in both the computer and PT business. She moved my arm in certain directions, had me put my arms behind my back and see how high I could reach them up my back. My good arm could scratch between the shoulder blades, my bad arm hovered around my waist. Clearly, it is an under-achiever.

She gave me a free massage, which was much appreciated, and then had me lie down on my back with ice on my shoulder and a tens unit. For those who don't know, a tens unit is an electrical muscle stimulator that is supposed to disrupt the pain pathway on your nerves. She turned it high enough to make my muscles jump and then lowered it just under that threshold, and left me there for 15 minutes.

Long-time readers of my blog will know what happened next. Yes, I fell asleep.

I have finally found my true talent - falling asleep during medical procedures.

A bell woke me up and it was time to go. She felt I had something called impingement syndrome, with a possible rotator cuff tear, although she said there was so much inflammation it was hard to tell. There had been a "hitch" in my movement she thought indicated ripped muscles - and not ripped in the bodybuilding sense. She gave me some very mild stretching exercises to do, and I went home.

A day later, I felt much worse.

First, let me rant a bit about that stupid pain scale that every medical professional uses. "Describe your pain on a scale of 1 to 10, with 10 being the worst pain you have ever experienced."

Well, those of us who are Barbie number phobic have a hard time with this. Pain doesn't equal numbers, it equals words. I want to use my own scale:

It doesn't bug me
Okay, it's there but I'll live with it.
Hmmm....maybe I need to soak in a hot tub.
Hi, do you have a spare vicodin?
Hi, do you have two spare vicodin?
Why are you talking to me, can't you see I'm suffering?!
Hey MoFo, give me some oxycontin or I'm going to rip your head off!
Yes, I'm crying, what's it to you?
Oh God, why me?
You #@%&*ing piece of !*^( Get the #$%^& away from me you #&$^%@

I don't handle pain well.

So, my pain had gone from a "hi, do you have two spare vicodins" to "Oh God, why me" in a couple of days. It also feels like it's pulling out of the socket now, and I have the attractive habit of holding my arm on with my other hand.

I went back to PT, and I had a new, yet similarly granola-ey therapist. This one was nice as well although just a teeny bit condescending. When I told her that it had progressed to feeling like it was pulling out of the socket, she told me, "Dear, shoulders don't dislocate that easily." Um, I didn't mean it was ACTUALLY coming out, just that was the feeling. I also told her I'd made an appointment with a doctor to get a cortisone shot and she seemed absolutely shocked that a layman such as myself knew what a cortisone shot was. However, she was very gentle with me physically, and understanding of my discomfort. She was very careful not to hurt me. I suppose it's possible that most of the people she deals with are pretty ignorant of medical terminology and treatments. I wasn't before cancer and certainly am not now.

It was time for the ice and tens, and instead of having me lie down, she left me sitting up, which made it pretty hard to nap.

Hard, but not impossible. Remember, I'm very talented.

Anyway, since the pain is now at swear word levels, and I'm tired of doing everything with my left hand (which makes it really hard to drive and talk on the phone) I decided to give in and see an orthopedic surgeon. I'm requesting a cortisone shot on Monday.

Just by chance, the doctor I'm going to see is an orthopedic oncologist. It was a fluke, since I never mentioned cancer during the request for an appointment. I don't know if that's a good thing or a bad thing. I know my problem has nothing to do with cancer, except in the peripheral sense, but due to his specialty, he may decide he wants to check for it anyway. I specifically said I don't want any more x-rays as I've had enough radiation for quite a while. On the other hand, he'll be well aware of the complications of breast cancer surgery, which often include shoulder problems.

Considering I only finished herceptin a month ago, and my shoulder injury happened immediately after my last surgery, the chances of it being cancer that metastasized to the shoulder, on a scale of 1 to 10, are: "it doesn't bug me."

This is one time I'm 100% certain it's not a recurrence.

I'm sure he knows that too so maybe I can skip the scans. I'll see him Monday at 3:00.


RIP Daria

One of the breast cancer bloggers that I linked to in my blogroll, Living with Cancer, has died. Daria has been very generous in sharing her struggles with metastatic cancer with her readers. She fought to the end, and never gave up hope.

We never met, but I considered her a friend.

My heart goes out to her family.

Monday, January 17, 2011

Where have I been?

I know you are all frantic about the fact I haven't posted in two weeks. When a cancer blogger stops posting...well.....minds wander.

The fact is, my mother died. She passed away on December 31st.

I hadn't seen her in a couple of years, and we have only spoken a couple of times since I began this blog. My mother had her own health issues, as I had mine. I won't eulogize her in this space, but I will say this: my mother was proud of this blog and the writing I've done here, and knowing that, I have had a little trouble composing my first post since her death. Writing about a torn rotator cuff seems a little trivial at this point in time.

However, in truth, life goes on, as it will when I pass too.

Mom, I hope that you don't mind that I continue this blog as I always have.

Of course, being my mom, you know I'll do what I want anyway.


Sunday, January 2, 2011

Winner Announced!

The winner of the fabulous Paula Young wig is.....

ta da!


I drew names out of a Santa hat but it was too dark to show up on video - relentless rain here in my parts combined with a dark house means poor video quality.  You know me, as much as I like you, I'm not going out in the rain for you.

So, congratulations Suzanne and please email me at butdoctorihatepink AT and I will send your contact information to the Paula Young representative.  If you want to send me a photo of you in the wig, I'd be happy to post that too.

And, thank you very much to Paula Young for allowing me the opportunity to give this lovely hair piece away to somebody in need.

As an added bonus, if anybody wants my "review" wig, I would be happy to mail it to you.  I wore it for exactly as long as you saw in the video (which was actually taken a few weeks ago, so any lice should be dead by now.) If the thought of putting something on that was on a cancer patient's head doesn't gross you out, it's yours. (Okay, seriously, I'm  lice-free.)   It is an 80% grey color so probably not for everybody but since I never intend on my cancer coming back, I won't be needing it.

One note:  I am horrible at putting things in the mail.  Absolutely horrible.  Christmas presents sit around my house until April sometimes.  I promise to send it but it might be a week.   I know the Paula Young rep will be a lot faster than me.

I hope everybody had a happy New Year.  I know it will be a tough year physically for many of you, but keep your spirits high, and keep your eye on the goal - health!  If I have learned anything from this miserable experience, it's that your outlook can really help you get through some rough times.

Hopefully, I will have many more giveaways this year for my faithful - and new - readers!