A FUNGUS AMONG US

To contact us Click HERE
We know I am a slow writer (it's been a month since my last post; I think that's been the longest stretch so far). But I'm also a slow healer — something I never knew until my bilateral mastectomy nearly 22 months ago. It's been one long, bloody (in the British sense) battle after another with this right (aka "problem child") boob of mine.
After struggling for months with delayed healing followed by the loss of my right tissue expander followed by the replacement of said expander followed by additional delayed healing, it goes without typing that I was greatly anticipating the surgery to exchange my tissue expanders for permanent implants. (Why do they make "exchange" sound so simple, like going in for an oil change? And why do I feel so edgy?)
Turns out I was more afraid of this "exchange" surgery than any of the others. My butterflies became angry birds dive-bombing in my gut. Not sure why I was so nervous, since this was the "easier" of my reconconstruction surgeries. You know, the first dollop of icing on the recon cake. 

Two and a half months ago, I was finally visited by the "foob fairy" and had my exchange. Then the waiting game began. Since my incision line has always been problematic, I've been holding my breath since September 5th. 
I have been looking forward to getting on with life as I now know it, and the last time I blogged about my life post-surgery, I was back to hiking, and gingerly coddling my new appendages in an effort to enable great healing. But something else has surfaced: I am more emotionally vulnerable and sensitive. I don't have a lot of reserves in the "tough girl" cabinet anymore. Everyone keeps asking how happy I must feel now that this surgery is behind me. What they really mean is how happy they feel now that my surgery is behind them. I get it, I do. Being the supportive friend or family member can often be harder than being the patient. But I can't keep putting on the happy face. I have lost the desire. I also cannot relax because I know I'm not out of the woods. Not the worried-about-cancer woods  — for that forest I will forever reside in — but the healing woods. 

Sept. 27, 2012, my right incision

Here's my problem. Four weeks post-surgery and the surgical tape my plastic surgeon applied is still holding strong. So I can't actually see what is going on beneath these steri-strips. I'm hopeful I'm healing, but I don't really know. 
Being camera obsessed, of course I document each stage. Here is the steri tape starting to lift off. (I know what you're thinking: Could this get any more exciting?)
Then, after so many weeks of holding fast, the tape on my problem child side falls off. And the incision ... dare I say it ... is healing! I keep a lid on my new-found joy because I have been fooled by these sketchy Healing Gods before. And sure enough, as if on cue, I spot the tell-tale sebum spots. Drats. 

October 5th and the healing is fine; October 7th, sebum starts again.

I force down the fear that rises when I consider what will happen if this incision doesn't close. I'll be sliding into skin graft territory — and that terrifies me. 

Now my left side, which has never given me an ounce of trouble, decides it's time to join the persnickity party. It holds onto its surgical tape for dear life. For another full week. FINALLY it falls off in the shower and I have all I can do to bring the magnifying mirror closer for an inspection. Hmmm. I didn't see any oozing. No seepage. Nothing yucky under that tape but healing skin and scabs. Blessed tiny scabs. 

But will these, too, fill with sebum? I spent a few days worried about it. Then something miraculous happens. I start to heal. Like, inside and outside heal. For the first time since this %#$@ journey began, I let myself feel the happy. I tip-toe out of the woods and slip into an emotional canyon. Feelings I have been suppressing are bubbling, bubbling. The dam is breaking. I'm a hot, boiling mess.
And then my friend Shannon develops cellulitis. (See that story here.) Six weeks after her exchange. Are you kidding me? You can be fully healed and still develop an infection that requires immediate surgery and hospitalization? When does all this %$@#  end? (Oh, right. It doesn't.) I feel the air leave the room and I wish I could follow it. Then another friend named Shannon who also has already had her exchange has to have hers redone (she blogs about it here). The fun never ends.
Because a new curveball has been tossed my way. And I bet I'm the only one you know who has experienced what I'm about to tell you.

Rash is spreading beyond boundaries of my pen mark.

Six and a half weeks post-exchange, I develop a rash on my cleavage line on my right ("problem child") side. The skin is red, but not warm to the touch (hot, red skin is a classic sign of cellulitis; a fever often is as well, and I have neither). I'm not itchy, though maybe if I had more nerve endings in my skin I might be (guess that's the up side to having no feeling in your foobs!). 

Diligent photographer that I am, I dutifully email photos to my plastic surgeon, Dr. C., who says it does NOT look like cellulitis but he puts me on Keflex as a precaution. Then I take a ballpoint pen and draw a circle around the edge of the rash — that way I'll be able to tell if it's getting bigger or not. 

I wake up the next morning and the rash has grown beyond the inky demarkation line. This ain't a good sign. I take my rashy chest to see Dr. C. He says it looks like an allergic reaction. Husband and I can't figure out what I may have come in contact with just on that one side — a true allergic reaction would present itself all over my body. Dr. C. says that my right foob is my body's point of vulnerability because the circulation there is not 100%. Hmmm. 

I go home feeling unsettled and call my oncologist, Dr. D., and I get in to see him a couple of days later. He looks and prods and says the same thing as Dr. C: It looks like an allergic reaction, and he is not concerned. 

But I am. 

So I go home and I'm thinking Man, I really need to learn how to trust. I mean, two doctors whom I respect are telling me this rash is nothing to worry about. Why do I find it so hard to trust? This whole breast cancer thing has left me feeling like I have to be Dr. Nancy Drew at all times.

And when my gut tells me something is wrong, I listen.

 This is how the rash looked when I saw Dr. S.

Off I go to see Dr. S., my primary care physician, and I take Husband with me. By now the rash is dancing across my right boob, getting less red in some spots but appearing in round, red splotches in others. It's crazy. Here is what it looked like:

Dr. S. takes one look at my rash and says, You have ringworm. Huh? Ringworm? The telltale sign are the round splotches (hence the "ring"). He says he sees a lot of ringworm cases when the seasons change — hot/cold/hot weather causes sweating and we wear heavier clothes so our skin can't breath.

But wait: Isn't ringworm like Athletes Foot? Yes, says Dr. S. Apparently ringworm loves moist areas and my hot flashes from the Tamoxifen, coupled with being in a surgical bra for a month and then spandex sports bras after that, makes my vulnerable right foob a target. Turns out the ringworm fungus is in the air all around us and it feeds on dead skin and all it needs to take hold is a moist environment and some old skin cells. I got plenty! Good news: Ringworm doesn't invade the body and is simple to treat. It's not unusual to have ringworm present on the chest; you can get it anywhere on your body. I asked him if I should be showering twice a day, he said NO! Ringworm loves moisture! 

This is how I looked yesterday.

So now I am applying anti-fungal cream 2x daily and taking an oral anti-fungal once a week for a month. I am three weeks into treatment. The rash is getting better, but it isn't gone yet. Ringworm is stubborn.

Here's how I looked yesterday:

Nothin' like a little athlete's foot on the boob to put everything in perspective. I was so afraid that I had something more serious! I have never been so relieved to hear that I have athletes foot. Even if it is on my boob! 

A professional bra fitting will have to wait. At this rate, I'll be getting fitted at my two-year cancerversary (the date I had my bilateral mastectomy). If you had told me I'd be in recon hell for two years back then... well, I'm not sure what I would have done.

As for all the emotions that sprung up after this surgery... that's a post for another time. Let's just say the s*** had to hit the fan sooner or later...

But I gotta know... Have you or anyone you know ever had ringworm on your boob?