Dec. 19, 2012

~For the record. I am writing this post surgery day… I would have never been able to write anything on the actual day of surgery~

Driving in the dark is not something I do often. Today my husband and I are up early and on the highway before either of us are normally out of bed. The traffic isn’t bad. We are quiet. He holds my hand. I love that. It is warm and comforting. Like a continuous hug, mini version. After 35 minutes on the road we arrive. Park. Admire the lit driveway trees that run the length of the entrance to the hospital. They are covered in white Christmas lights. They look so pretty against the crisp, dark sky, with a hint of sunrise far off in the distance, just above a far off tree line. He gives me a hug. Holding me tight for just a second longer than usual. We turn toward the entrance and walk together. Hand in hand. Into the hospital.

Today I am scheduled for a lumpectomy and sentinel node biopsy. I am a bit nervous. If all goes as planned I will come out of this with a removed tumor with clean margins and one removed sentinel node that is negative. We caught this early so I am very hopeful that surgery goes well and I will be back home before dark. The only other surgeries I’ve ever had were both done under “twilight” anesthetic and were only an hour long, each. This one is scheduled to be a two and a half hour surgery with general anesthesia and much more complected than either of the others. I am ready though. I need to get this unwanted “thing” out of me so we can proceed to the next step.

Standard surgery prep is done upon checking in. Once we are taken to my recovery room I am given my IV and we go over all the details of the day. First up is a trip to ultrasound where my Dr. with the same name as me, threads a wire through my tumor. Yep, you read correctly. She numbs the area and uses a thin needle to place a long thin wire from the other side of my tumor straight up and out of my breast. She used the ultrasound to guide her in finding the tumor and then placing the wire in the right place. It didn’t hurt at all. The nurse taped the wire down and I was done.

Next stop on the fun train was nuclear medicine. Where I am told “I’m not going to lie to you. This is going to hurt. A LOT! Some women handle it well and others…not so much.” My heart is racing. We talk about what is going to happen. In order to find the closest sentinel nodes I need to have 6 injections of dye. Into basically what is the outer rim of my areola. The dye will then travel into the lymphatic system. Making it easier for the doctors to use a little wand (like my husband uses at work) to pick up the dye and find the sentinel node. The dye is injected three at a time just under your skin. I understand and they ask my husband to step out of the room (Um…why? Will he want to punch you when you hurt me? Oh. Probably? Good idea then.) Now, I am a pretty strong person. I’ve given birth to three children and only one was with any medication. Not that it was fun but I would be more willing to give birth again than to ever have to go through that again in my entire life! It was over in less than 30 seconds. I remember squeezing the nurses hand and saying owwww owwwwww!!! I was just about to come off the table when the doctor said “Done”. I held back my tears when the nurse asked if I was ok afterward and although I said yes, I wasn’t. Why hadn’t anyone told me about that part? Is it because it sucks beyond anything you can imagine? Maybe. But I do better when I am told and have a chance to prepare myself.  The nurse brings my husband back in with me. Then leaves us alone for a few minutes while I lay flat letting the medicine do it’s work. She closes the door and he leans down to kiss my forehead and tears immediately flow from my eyes. It hurt so so bad, is all I can say in between sobs. He holds my hand. His face next to mine. Thank God he is here. I need him so much. Eventually, I compose myself and we wait the 45 mins needed for the dye to work. After the doctor comes back in he uses the cool little wand to find the nodes. Marks them with a Sharpie. Packs me up and now we go back to my recovery room and get ready for surgery.

Dr. M comes in goes over the procedure once again and it’s time for me to go. He leaves and my recovery room nurse tells me it’s time to go. Hubby kisses me once again. I remind him to please go eat some lunch while I’m in here. He says he will but I know he won’t. One more kiss and the nurse pushes me out of my little room and through the doors to the operating room. Here the anesthesiologist greets me once again. We make small talk while I am wheeled in and make the awkward transfer from my bed to the table. (why don’t they just let you walk in? It would be a hell of a lot easier to actually sit down onto the table than it is to scooch over, in a gown with one hand all taped up with an IV sticking out of it. Not to mention the table is just that! A two foot wide plank in mid air with nothing to put your hand on to steady yourself…who thinks of these things?? Whatever!) Now that I am laying down and comfortable the assistant puts “the mask” on me and says “this is oxygen. Take a few deep breaths.” I do. I also decide she is mashing my face with the mask so I put my hand up and take hold. She let’s go. The anesthesiologist is still talking to me and also says he is giving me something to help me relax. Followed by “watch her hand”.                     Lights out.

It is go time.

Waking up feels so strange. Slow. I can hear and then I’m asleep again. I can hear again. Then I am asleep again. I remember thinking, Wake up. No, take your time. Sleep if you need to.  I want to see my husband. I want to go home. Wake up so we can get out of here. I want to go home now. Ouch…my head is pounding. Why is my hand all wet? Wake up! Someone says my name. I try to open my eyes. Ouch my head! I go back to sleep. My name again. This time its my doctor. I manage to open my eyes. He says I did very well. He talked to my hubby. I just nod my head. Ouch!! My head hurts so bad. He tells me hubby thinks I should stay overnight. I nod again. (we agreed that staying was absolutely fine and he would make the call on that one if the doctor gave it as an option.) He says he’ll see me tomorrow morning in my room before I leave. He leaves. I close my eyes. I try to process what is going on. Why is my hand so wet? Why does my head feel like it was run over? Why am I staying over night? Can I move my arm at all? Do I have an arm?? I open my eyes and look. Yes. Good. All body parts are in tact. I am watching a nurse run around. She is loud. This is a big room! There are many people recovering. There goes that nurse again. Close my eyes. The loud crazy nurse is standing at the foot of my bed. She asks how I’m doing? I reply in a very soft voice, I’m ok but why is my hand all wet? She says it’s probably just cold. Then I squeak out that my head is throbbing. She says she will go get me something for that. She leaves and comes back. I tell her my hand feels very wet and so does my sheet. She finally walks over to look at my hand and laughs and says “oh your IV came out, that’s all”. Then gives me something for my headache through the IV. After some time I am taken to my room where my husband is waiting. The first thing I notice is, the darkness outside of my windows. Dark, dark. How long was I in there?

Surgery took four hours. Not two and a half but four! I am still very groggy and my headache is borderline migraine strength. It makes my eyes hurt so I talk quietly and slowly with them shut. Hubby explains why he decided to keep me here. The doctor had to take the first three sentinel nodes. Nodes 2 & 3 were positive for traces of abnormal cells. My doctor has said many times that it took a lot of looking to find these trace amounts, it wasn’t like they were loaded with them. Each one had a few that’s all. Regardless this meant they had to take more to make sure no cancerous nodes were left behind. Grand total of 19! Removing the tumor was less intense than removing the nodes. This is what took so long. Removing and checking each one.

So, 19 lymph nodes removed and one tumor with clean margins measuring 2.7cm. Step one. Complete.

Dec. 20, 2012

Waking up alone in the hospital was ok. I wanted my husband to be with the kids over night and in the morning to get them off to school. When he got back to my room I was happy to see him and a coffee he grabbed for me! My headache was mostly gone by now and we suspect it was due in part to my lack of caffeine the day of surgery. I was still quite numb but sore non-the-less. My surgeon came by to check up on me. Everything looks great and he will fill out discharge papers so I can get home first thing this morning. Home. A place I really want to be. Just the thought of our couch, my own blankets and pillows sends a wave of warmth and love through my body. Yes, lets get me home.

All in all, surgery went well. I was very sore. Mostly in my arm pit area. Ice was definitely my best friend for days! The prescription strength meds were a bit to strong for my liking so I only took them at bedtime and opted for the extra strength Tylenol during the day. Which worked just fine for me.  I had hoped surgery would only put me “down” (as in on the couch unable to do most things) for no more than three days or so. It ended up being closer to ten days before I was comfortable doing most things alone and several more days to feel like I was getting back to normal. The kids were off of school for Christmas break during this time and I knew this would be a good thing, since they could help out quite a bit and I was able to rest up a little more with the extra help around the house all day. Christmas was good. Very quite which we all enjoyed. New Year’s was the same. With the exception of running back and forth for a few doctors visits things were very low key for those two weeks.

Surgery is over. What treatment will be recommended?