My Radiation

Right now I have been changed to the other type of radiation called the boost. My underarm was starting to weep and the lower part of the field was starting to split as well. So, this is for six times and takes about 30 seconds. The only radiate the scar from the surgery. It is a stronger does having to do with something that I can't remember. However, I will be finished on Wednesday of next week, then I have vacation, then I come back to five more of the full field radiation. We are hoping that I will heal with this.

Going to the Cape this weekend for the bio-mom family reunion as well as to finally see Doug's parents. A little down time will be great so I don't mind that it is supposed to be cool.

Love

Thank you all so much for such a generous and thoughtful gift! I love llamas and I love the fact that people in need will be reaping their benefits! I couldn't have asked for anything more full of love.

To: Kimberly O'Flaherty
From: All of us

A gift of 17 Llama "shares" has been given
in honor of your strength, courage and absolute beauty.
Some friends from our Bard days have gathered together to purchase in your name "shares" of Llamas which are donated to people who need them. It is a gift which is renewed again & again when the recipients share with their neighbors all that the Llamas produce. You love Llamas and we love you! Along with all our thoughts & strength vibes we honor you with 17 shares. (which equals 2 whole Llamas and 2 shares of a 3rd) With love from---- Karin Eckert & Matt Ames, Scarlett & David Newhoff, Clare Blackmer & Brien Lang, Christopher Pennington, Cormac Flynn & Dorothy Cummings, Christopher Marino, Sandra Aistars, Peter Criswell, Chad Kleitsch, Paula McGonagle
Heifer International is a nonprofit that alleviates hunger, poverty, and environmental degradation through gifts of food and income producing farm animals and training. These animals provide a source of protein, such as eggs and milk, for children and generate income for families through the sale of animal products. Since 1944 Heifer has helped over 4 million families in 125 countries become self-reliant. Each family "passes on the gift" by giving one or more of its animal's offspring to another family in need.
To learn more about the gift you've been given, visit http://catalog.heifer.org/gifts/.

Burn

Well, my skin under my arm has "separated" (the official term). As far as I am concerned, it has split. The have changed the location of the and size of the "bolis" - the skin-like pad that they lay over me to make the radiation come closer to the top of the skin - so it no longer includes my underarm. Dr. Girsh is a little bit worried that I will have to take some time off. For me, it's no biggie as long as I am off for the first week in July and she said that is already set in stone. I have to get as much air under my arm as possible. This means sitting with my arm stretch over my head actually opening the split in order for it to get as much air as possible. I also have to use the Silvadene cream three times a day. So, it really is a good thing that I am taking this summer off from work. I will set up a lounge chair outside in the shade so that I can read while "airing out". It really looks more painful than I can feel since it is still somewhat numb under there but, as I said to Doug, I have learned that every day has pain in some sense during this time. You just get used to it. Sometimes, I still feel as though I am living in a dream or nightmare and that when I wake up, I will be me again. Right now, I have to look forward to next summer when I will once again have symmetry, cleavage, and red hair, dammit!

Reconstruction Options, etc

I met with Dr. Bernie Lee at Beth Israel yesterday. He is the second plastic surgeon I have met with (the other being at Lahey). I have an appointment next week to meet with another surgeon from Beth Israel. Both of these do the DIEP type of reconstruction. I thought I would post the different options for reconstruction and some of the positives and negatives for each.

The first is a breast implant. Because of my radiation and positive nodes at he beginning, this is not a very good option. Plus, the implants never look like the other breast and since I don't want to touch the other one right now, it is out.

The second is Tram Flap which uses your own tissue. A large portion of muscle, some fat and skin are all tunneled underneath your chest and the beast is made at the location. No blood supplies are cut but there is a full lose of that one side of your "six-pack" muscles. The other side of the muscle can come back to 110% but most people will have muscle weakness, some back pain from the loss of stomach muscle, etc. This is the most popular method since, it is a relatively easy and short surgery. I wanted more options.

The Free Flap is like above but the muscle, tissue and skin are actually cut out and then replaced at the site of the breast. However, there is still a small portion of the muscle excised completely and it does still effect movement and strength as above. The reason muscle is still taken is the fact that it holds the blood supply to be reconnected at the breast site. Again, easier to harvest muscle with the blood supply already in it.

There is also a method using muscle from your back again tunneling beneath the skin to the front. Since my right arm has already been compromised from the removal of the nodes, this is certainly not my first choice. And then there is the butt one! Like a free flap but using your butt! Again, not the first choice.

The procedure that I have sought out is called DIEP. This procedure using our stomach area fat and tissue, and harvests a blood supply from the muscles but the muscles are never cut "across the grain" nor removed. The muscle is separated with the grain to get the blood supply and then everything is transplanted to the breast and reconnected to one of three main veins in the area (under-arm, mid-line chest, or in between). Because there is no muscle cut, the recovery in both the long and short run is much easier and shorter. The surgery itself is longer because of the use of micro-surgery both when extracting the tiny arteries from he muscle as well as reconnecting them. Instead of 4 - 5 hours from Tram flap, I am looking at 5 - 9 hours of surgery. I would be kept in the recovery room for 24 hours in order to monitor the blood flow at the newly connected site. The percentage of there being a problem is very small. If there were a problem within those 24 hours, I would be brought back to surgery and the problem would be resolved. Most are a tiny kink in the artery or something like that.

There is another part of this surgery that could be done as well. In 15% of the cases, there is an exposed small artery above the muscle. In that case, that one is used and there is no touching the muscle at all!

Either way, I am looking at a fabulous tummy tuck, a very natural breast, a much shorter recovery, and much fewer side effects. I would spend up to 7 days in the hospital. I would have to return in about a month for "shaping" because it is very important for my surgeon that I have the best possible match. There is alot of other information on this at www.bostondiep.com. Please have a look.

So, as of now, I have a surgery date in Boston at Beth Israel on February 7, 2007. I am not sure whether I am going to bother meeting with the other surgeon next week because I really loved Dr. Lee. His enthusiasm, his knowledge and training, his constant contact with the other few surgeons who do this, as well as his general nice-ness has really got me excited for the procedure and what I will look like afterward!

As for my status right now, I am a very burned little chickie. Especially under my arm. I have been changed over to 1% hydrocortisone and will probably be given an even stronger prescription called Silvadene for the remainder. Wearing a bra is many times quite painful so I only do it when I need to. I have really no problems with my lopsided look when just around my family and my radiation buddies. My two therapists Frank and Chris are always looking out for me and they were concerned about my burns yesterday. It is neat seeing two people every day and we have got to know each other pretty well. Chris is actually one year older than me and from Amherst so we have lots to talk about. He actually just adopted a dog from the same place we adopt: Nevins Farm MSPCA. I am so looking forward to seeing a picture on Monday.

Also, we had a brokers' open house on Thursday and had 21 agents come! I know it is because they had lunch there! Anyways, another open house tomorrow so I am really hopeful that between 21 brokers, we will have an offer soon.