Preparing – Diagnosis Pink

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# Category: Preparing

## Vaccination Day

Posted on April 21, 2017May 4, 2017 by admin

Post op day 11

Today I went to get my shingles shot. With the impending start of my chemotherapy, I needed to make a very important decision- vaccinations. Cancer increases risk for infections especially for pneumonia, influenza, respiratory difficulties and Hepatitis B. Increased risk may be due in part to the cancer itself stressing our immune system and from chemotherapy or radiation therapy. Even though I know the risk of shingles is very small, that is my fear. I spoke to my oncologist and she reported she has not had any patient get shingles while getting chemo. However, I know too many non immunocompromised people to not be concerned. This is a point that feelings vs. statistics collide. I looked into the risk of getting the shingles vaccination prior to getting chemotherapy. Shingles is not recommended get while undergoing any immunosuppressive treatment. Shingles is a live attenuated virus vaccination- meaning the vaccination is made up of active virus that has been weakened to prevent an active infection but allow for the immune system to mount a defense. With a decreased ability to mount a defense for immunosuppressed a live attenuated vaccine can potentially cause the illness. For any live attenuated vaccination you need at least 4 weeks prior to the start of the immunosuppressive therapy and 2 months after the end of the immunosuppressive therapy. I was just within 4 weeks prior to the start of my chemo. Therefore I could safely get the vaccination now. The efficacy of the shingles vaccination is at 51%. This means that it will work to prevent shingles in about 51% of the time. While this isn’t as robust as I would like, it does help to decrease the possibility of me getting shingles and it will help to lessen the severity of shingles if I do in fact get shingles (it is 67% effect at preventing severe pain known as post herpetic neurologia). While the vaccination potentially may not help prevent shingles, the risk of an adverse affect vs. the stress and fear I feel from worry about shingles made me choose to get the vaccination. I will also get the Pnuemovax to prevent pneumococcal infection (one cause of pneumonia). Strange how I am not as concerned about pneumonia as I am for shingles, even though the pneumonia is more common for people undergoing immunosuppressant treatment than shingles, I went first for my shingles vaccination and am lackadaisical about the Pneumovax. A more detailed description of vaccines can be found here.

The shot was not more painful than any other vaccination. However, I have a 1-2 cm hard bump that developed and is really painful and difficult to move my arm. This can occur in just over 1% of people receiving the vaccine. It is not to the point that I regret getting it but it is an annoyance since I was finally able to have full range of motion post surgery. I hope that I do not get shingles but at least for now, one less stressor is welcome.

## Pillow talk

Posted on April 11, 2017April 15, 2017 by admin

First day post op

I found a way to sleep last night. I found that using a low step stool helped me get into bed. I had trouble getting deep enough in bed by just sitting on the edge of the bed. The step stool allowed me to have some extra height to situate myself further on the bed. I have discovered that two different shaped pillows have been helpful to support me during sleep. A sports bra or other comfortable bra should be worn to help give support to your breast. I woke up refreshed and able to move better in the morning. But as the morning progressed I became fatigued and needed to nap. The area for my lumpectomy felt good. There was very little pain and the swelling was going down. However, the area for my porta cath became red. Not warm. I began reviewing the reasons to call my doctor. Increased warmth or spreading redness of the skin area near the site, increased swelling, increased pain or tenderness, increased discharge at site (green/yellowish green), foul smelling odor, fever or chills. I will have to watch it. Some tenderness and redness is fine but increasing redness or tenderness is something to watch closely. I guess I am a little hyper vigilant right now. I really don’t want anything to derail my recovery.

Sleep is of course one the most important things for recovery. Fatigue or excessive sedation from the anesthesia is common. This feeling can last for a few hours post op or several days. It may be exacerbated by not being able to have a fully restful sleep at night. The right pillow can help. I have found, for myself, the heart shaped pillow that the hospital gave me was perfect the side of my lumpectomy. It helped first with going home and not having the seat belt rest on my breast and then for sleep by placing the “V” part under my arm pit or surrounding my breast. It protected my breast from having anything rest on it. It also gave me some support under my breast. Support is important to help not put stress across the incision.

Another pillow that was helpful was a knee pillow I had. The knee pillow is supposed to go between your knees to help align your spine but I found that my knee pillow was the perfect shape for support on my porta cath side. I placed one curved side against my body and one against my arm. By pressing my arm into the pillow I was able to give that breast support. My porta cath feels heavy and really needed support. I struggled at getting up from sitting without supporting that breast.

I found that laying flat put too much strain on my porta cath. My porta cath feels like it shifts toward whichever way I am moving and hurts with every movement. I had a wedge pillow that really helped.

My final pillow was from a friend of mine. Her mother had breast cancer several years ago and a friend of hers made her an oblong pillow. My friend made one for me. This pillow acted like a wedge to support the side of my body. It is about 3 feet long and 8 inches wide.

Pillows are not only important for sleep but also for support doing other things. Sitting may require a lumber support pillow or a coccyx pillow. A pillow as a head rest may also be necessary when you are sitting. This may be especially true during chemo since the sessions are a few hours in the same place. I have a head rest pillow that a friend gave me. I will give it a trial run in the next few days. Here is the link to the site. I have the microbead one.

Here are some other pillows I have found on the web that might be helpful. Here, here, here and here.

Now it is time to go back to sleep. Hopefully, when I wake, I won’t remember the pain and feel fresher.

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