Surgery Synopsis!

Hello everyone!

Here are my reflections on the events of my surgery!

First off, the surgery went well. They removed the tumor and 3 sentinel nodes. I believe this means that the cancer did not spread to the lymphatic system. However,  I think they also took out the lymph node that they biopsied in the spring just as a precaution. I am in very minimal discomfort and am in great spirits.

5:30 am – my alarm goes off and I decided it was best just not to get out of bed.  I weighed my options and considered what would happen if I just didn’t get out of bed. For me this isn’t a surgery or procedure I want to do, so there is really no good time to go but 5:30 am seems excessive. That said I would rather get it out of the way. I was not the only person who thought I shouldn’t get out of bed. The cat came and lay down on my chest. Which is his version of taking me hostage as he doesn’t generally sit there and also refused to move.  So after a few minutes of cuddles with the kitten I rolled out of bed drew on some eyebrows (not my most even or aesthetic but it could have been worse). Brushed my teeth and crawled into the car. We drove 2 blocks to the hospital where Steve dropped me off and went to find parking. Yes we only drove 2 blocks to city hospital as it was not practical to have me walk home post surgery so we had to drive regardless of the short distance.

Rise and shine!

6:00 am – arrived to admitting with and found a surprising number of other groggy people. I was happy to see that I was in fact not the only person who has chosen to forego makeup.

6:15 am – I made it through admitting for what must be at least the 20^th time in the past 8 months and wandered up to day surgery. Where I learnt a few things. A) I got a private room with a beautiful view! Which is pretty fantastic as I figured I would be sharing with six people! This means I could “Cave-ify” the room by drawing the curtains and turning off the lights B) my surgery wasn’t until 1:30 pm. And C) there was more than surgery in store for me, I was going to get a wire inserted into me in a very similar process as the biopsies. And then I was in for a “painful” procedure where they inject radioactive dye into me. Whoop whoop :P, this is great news at 6 am. That said, I realized this would be a great distraction from being hungry.Anyways, I changed into my hospital gown and robe and they let me keep my knee high socks on, which is good because those hospital rooms are chilly! Steve hunkered down in his chair and started working on his laptop. I got comfortable and went to sleep.

7:30 am – the phlebotomist came in and drew blood. Then the nurse came in and started going over a bunch of questions and discharge information. The nurse also put on what I like to think of as “icing” because the way looks when it is put on. It looks  like icing on a cupcake. In reality it is a freezing gel that they use to help offset some of the discomfort of the radioactive dye injections.

8:00 am – I march down to the breast health centre to get the wire placed. I was originally going to be escorted down but I said I was fine to go down on my own and it was unnecessary.  Already changed I went almost straight into the room where I was having the procedure done.  I was really hoping the radiologist would be the one I had had previously as I  really enjoyed her, and of course  she had already established a strong trust from me! Unfortunately it was not her, however I had an equally nice and skilled radiologist in her place. The process starts off with some preliminary ultrasound imaging. Then the doc comes in and they create a sterile field and get to work. As expected (unfortunately not the “usual” for me) the most uncomfortable part of the process is the freezing being inserted. It was pretty quick, the freezing went in and then they stuck a wire into my breast that stuck out about 6 inches. This was pretty comical as it just sort of wiggled like an antenna or guitar string. The wire was very small and it was not in the least uncomfortable. So all in all the procedure went smooth. As something funny has to happen to me no matter how straightforward the procedure this time the lidocaine somehow squirted out the top of the needle and into my face landing mostly on my eye. Luckily my eyes were closed and so it didn’t burn much. I then went for yet another mammogram to ensure the wire was placed in the right spot and then the wire was taped down.  This time I got to sit in the chair, somehow it made the whole experience much more pleasant.

The entire time I was lavished with fresh warm blankets making the experience so much more pleasant. When in doubt get warm blankets, aside from them keeping you warm they just make you more relaxed and cozy.

A gamma ray machine, pretty cool!

9:00 am So with a fresh warm blanket and Steve in tow I headed over to nuclear medicine.  I went into the room with a gamma ray camera.  This is the same machine that did my bone scan that lit up.  The machine tracks radio isotopes that have been put into the body system. I drank the isotopes for the bone scan but this time they had to inject them. I am quite grateful that the tech and the doctor were both very honest with me and said that the amount of pain felt by the patient seems to vary but in short it won’t be comfortable and I can either squeeze a stress ball or Steve’s hand. I said I thought I would be okay without either. So they got me all set up and prepared for the first injection. I think I failed to mention that these injections go straight into the nipple and there are 4 injections. The doctor described it well. The discomfort is caused by the amount of fluid being injected in a short amount of time, similar to the discomfort of getting an immunization, but instead of going into your arm it goes into a “much more sensitive area”. So with a nod of ascent from me the doctor proceeded with the first injection which was like a bad bee sting. The second one was a bit worse, I’m not quite sure what my face was but Steve stood up pretty quickly and came over and offered his hand to me. I declined as I was “in the zone” and didn’t want to lose that connection. “In the zone” is how a deal with pain management. It’s like “going to your happy place” but just withdrawing into yourself so you are disconnected from the discomfort, there is no beach or anything.  The doctor did  the injections very quickly and it was all over quickly.   I got to lay in the bed a bit longer while waiting for the radioactive dye to travel from my nipple to my lymph nodes. Now of course we’ve discussed that nothing major ever goes wrong but it is me so something small had to happen. This time the needle was not completely attached to the syringe so the radioactive dye dripped out the side and fell onto the bandage holding my wire down.  They did the best they could to clean it up but it did draw out the process a little longer as we had to take a few extra images to ensure the images were showing the drips and nothing else. I however was not opposed to this delay because for some odd reason those super narrow tables are SOOO comfortable for me. I am not lying. I have fallen asleep in them twice and almost did again this time. I also didn’t mind as I knew I was in for a long and hungry wait before my surgery and any distraction from the hunger was a good thing!

my smurf outfit, complete with knee high socks!

10:00 am – so after my  not so comfortable excursion on the main level I wandered back upstairs to my waiting room carefully plotting/planning my next meal. I got upstairs and was prepared to watch Netflix until 1:00 however I slept almost the entire time.

10:30 am – the physiotherapist came in and gave me some post surgery exercises and discussed what to do if I got lymphodema in my arm. She was very friendly and had some great advice!

10:45 am – Doc came up to answer any questions I had as we hadn’t met pre-surgery. Sounds like he was as surprised I was getting surgery today as I was. He said “they must have snuck you in”. LOL! Anyways I really appreciated him coming up and going over things with me between his surgeries! That was pretty thoughtful! The most important info he shared was that I would be under general anaesthetic (completely knocked out) unless I felt strongly against it.  It was good for me to be prepared for general as I have never been put under before and was a bit anxious about not knowing either way, but with my less than consistent experience with local I was on board with the plan of doing general anaesthetic! Doc left and I pretty much slept my way to 1:00 pm.

Steve doing his Steve thing before surgery! What a lovely view out the window!

1:00 pm - I was ready for battle, had my pre-battle bathroom break (any athlete probably knows what I’m talking about, that urge to go to the bathroom right before the competition). We will choc this up to some evolutionary advantage that is just really inconvenient when you play an outdoor sport.

in the OR waiting room. Waiting.

1:30 pm - Steve and I joined another guy approximately our age (going for a knee surgery) and the porter, together we all took the elevator down to the OR waiting room. We sat down in some REALLY comfortable chairs and proceeded to watch some awful daytime television.  I believe we were watching the Social and they were showing these strange faces they had put together from the faces of good looking actors. It was very odd, but obviously distracting.  I then met a doctor who would be helping Doc Groot with the surgery (I don’t remember his name but appreciate him introducing himself), I met the resident anaesthesiologist and answered some questions for her regarding my medical history, she had a great bedside manner for a resident and I was really impressed. I then saw Dr. Groot and he answered some last minute questions. Then I met the anaesthesiologist and she was also really friendly. Lastly I met one of the nurses and answered a few more questions and then went with her to the OR. I gave Steve a last hug and marched into the OR. The first thing that struck me about going “behind the doors” was that it smelt like the vet college. Somehow this was comforting to me. Then I walked into a very clean and modern looking OR. This was also comforting.  Then I looked around and there were what seems like 10 people in the room, and that’s just over whelming.  But not discomforting as I know everyone has a job.  So I crawl onto the operating bed and get comfortable. Arms stretched out, I find out they won’t be using my port and will be using an IV instead. So far Im not a big fan of IV’s Since the second last time I had an IV I had a vaso-vagal reaction and nearly passed out because the IV was not put in properly and they power injected into my tissues instead. But the anaesthesiologist gave me a good reason to not be using the port so I didn’t make it an issue.

The resident proceeded to get the IV in, when students are learning you expect a certain amount of discomfort  with that aside it all felt fine until they went to flush the line. And that DIDN’T feel fine. I believe I said “NOPE!! That not right, that hurts way too much”, the doc looked at me and checked the IV, gave the clear to proceed and then also said “nope, thats not right”. I look over and it looks like I have a two inch by four inch fluid pocket forming on my wrist. I think it was the fluid from the saline flush and I am not sure what went wrong but I will be perfectly honest at this point I was done with pain after all the additional poking and prodding from the morning and then the practice jabs and readjustments that people who are learning need to take when putting an IV in. Now normally I am really patient with people learning on me and actually suggest to the nurses if someone needs practice to let them use me because I really don’t mind. By this point in my day, this was not the case and the only thing that kept my mouth shut was how nice I remember the resident being and I didn’t want to hurt her feelings as it really wasn’t her fault, I just have bad luck with IV’s.  So a few pokes later they found a new IV site and got things running without too much more discomfort as I just put myself in “the zone” again.  Then they started putting a mask over my face, and then told me it was just oxygen. I’m pretty sure my eyes got as big as saucers when I saw the mask. Which is funny because I’ve seen people get put under before, so I knew what was going on. But it is always different when it’s you and in a different environment.  Once I was breathing okay through the mask they gave me some drugs through the IV that made me feel loopy, sort of like that really drunk, the world is spinning feeling. Being a giant control freak this was comical because I was trying with all my might to fight this feeling. I tried to focus on the voice of the anaesthesiologist who did an amazing job of talking to me through the process. Then they added the sleepy stuff and I also automatically started fighting that feeling as well. I found it funny because my physical reaction was indignation “how dare this try to put me to sleep”, but I had to remind myself not to fight it and voila, I was right out!

 Next thing I know I am waking up in the recovery room. It was really gentle process and aside from waking up with nasal cannula’s in my nose which were really itchy I was perfectly comfortable. They asked me my pain level and gave me some morphine .... I think they gave me a second dose of morphine. I wasn’t an exciting person. I didn’t see unicorns or cry or panic. I just sort of woke up. However there was a girl who was crying. She sounded really upset and for some reason I felt like she was crying because they chopped off her legs (I think this is a combination of the drugs and my stance on when its appropriate to be crying in public). I am pretty sure I asked every nurse attending me if she was okay and if she was in a lot of pain. I was really quite concerned for her. Maybe the extra compassion was from the drugs, because I was very concerned for this girl. Then they gave me some water and I was really happy as it had been 20 + hours since the last time I ate or drank anything. Then I got some apple juice and I was elated!

The one thing that is not great about recovery is that they don’t have family members there to greet you (which I completely understand!!!) but I just wanted to see Steve and had to wait until I got back to my room to see him.  So all in all I had a great experience in recovery. I later found out that I had slept in recovery for about an hour before regaining consciousness. Which means poor Steve was getting a bit stressed as he had already talked to the Dr. and knew I was out of surgery but it was about an hour and half before I came back up (an hour of which I was fast asleep).  Another noteworthy thing that is pretty funny is that your sense of hearing comes back way before your sense of sight so I was really discombobulated for the first bit. I had fuzzy eye sight for quite some time before I could properly see, so I’m sorry if I sent some odd text messages, I really couldn’t see that well.  I also thought I had updated the blog but discovered the next day that instead of publishing it I only saved it as a draft. You will also note, that there is no more time line to this story as from the moment the knocked me out I have no concept of time and was not tracking it like I did pre-op. 

a veritable feast!

I don’t remember the stretcher ride from recovery to my room but I do remember seeing Steve and being out of proportion relieved and excited to see him! It was pretty fantastic! So happily re-united we hung out in my day surgery room. And they brought me some more water and some more juice and removed the nasal cannulas after I pulled them off to itch my face about 100 times (morphine makes me itchy).Then they brought me food.... not only  food, I got cookies, and a bun, and juice and the peice de resistance.... TEA! I was one happy camper! Then they went to take the IV out of my arm and I realized that in addition to the IV in my hand there was an extra IV in my elbow and a pretty good bruise a few inches below it. Not sure the story behind that but now I have 3 IV holes in my arm. oi! Then I went to get dressed to leave. Unfortunately I have gained 30 pounds since my diagnosis, so... when I went to button up the shirt I brought for post surgery... there was no way it was going to happen.  Nope, not the remotest chance of that shirt closing in any way that would resemble modesty (I could only do up the bottom 2 buttons). So on to plan b. Steve carefully helped me get my hoody on and then zipped it up to my chin! He then went and got a wheel chair and wheeled me out of the hospital to the car.  We then went to fill my pain killer prescription and get some grub because I was hungry. Steve knowing me very well had ordered us some pizza. Steve also bought the pharmacist some pizza because she was having a rough day.  Then we went home and I ate my entire half of the pizza and then fell fast asleep. Waking up intermittently to chat with Steve. Later in the evening Steve had an omg moment when we thought I was getting a wicked rash on my face but after he said it was my nose and eyelids I remembered that the anaesthetized people I had seen always had their eyes taped shut and the nose was probably from the oxygen mask etc they had on my face. Basically any and all tape put on me takes a little skin with it right now due to the chemo.  So that panic out of the way I took some pain killers and went back to sleep.

the random bruise and extra IV "hole" on my arm that likely has a boring story, but looks exciting!

The next morning I woke up feeling really good and to date I have not taken any pain killers. I am in just enough discomfort to keep me from doing something “unwise” with my arms. Rehab started as soon as I woke up and I will be going for the prescribed walks and exercises from the physio daily.

I have been very lucky with support from family and friends. One of my besties coming over to eat pizza and cheesecake with me and my EWA family brought me beautiful flowers. I am a truly lucky person to be surrounded by so many wonderful people!