anesthesia, breast cancer, breast surgeon, cancer, Cancer Kitten, Cathy, Dana Farber, DCIS, Faulkner Hospital, Invasive Ductal Carcinoma, lidocaine, Lumpectomy, mammogram, pathology, plastic surgeon, radiologist, sentinel lymph node biopsy, wire localization, young woman with breast cancer
I will be almost caught up after this post! Yee-haw!
On July 18th, I had a pre-op appointment at the Faulkner Hospital, where my surgery was scheduled. Kimmie was my chauffeur. I am so fortunate that she is a teacher and has the summer off.
We met with a nurse who couldn’t get over how much we looked alike and asked who was older (true story! I am five years older, BTW) and then proceeded to ask me every question I already answered in my pre-registration. Apparently, people respond to these questions differently in person than on paper. Why they don’t just ask the questions once in person eludes me, but oh well! What do I know? She also took my vitals for the 247th time since this process started, and went over the “do’s and don’ts” list for my surgery. She seemed quite confused and didn’t believe me when I told her that I was only having day surgery, as her paperwork said I was staying overnight. I explained that is probably because they reserved a mastectomy spot for me originally. You’d think she’d think that I knew what surgery I was having, but she called my surgeon’s office to verify.
In trying to find something positive with this appointment, I found my main take-away was my travel-size bottle of surgical scrub. I am supposed to wash up with it the two days before surgery and the morning of the surgery (avoiding my “privates” because the scrub is quite “drying”). I told the nurse that my mom would love to use this stuff post-op, so she threw me an extra bottle.
“My finger has a heartbeat!”
I then met with Dr. Talbot, my pastic surgeon, to learn his plan for the girls. Kim and I sat in the exam room, looking over my list of questions to make sure I didn’t miss anything important like “How big is too big?” and “Can you prescribe me Latisse?” (I decided not to ask him the latter question, it felt a little too superficial to ask – he is a surgeon afterall.) Instead, I asked about the difficulties of reconstruction if I eventually need a mastectomy, and how he planned to go about reconstruction after a lumpectomy. He explained how he wanted to make the incision to remove my cancer a semi-circle at my aereola (pronounced “a-REAL-a” by my surgeons-I never knew!). If they could not access the cancer this way, then he wanted to make a semi-circle on my boob in an area that could be encompassed by a mastectomy scar, should I have a recurrence. He then surprised me and said that given my “volume” and “droop” he will probably recommend a slight reduction and lift in my left boob to match the right. A lift in my left will be accomplished by moving my nipple. Holy crap, that sounds painful, and wait, what happened to adding volume to my right boob? I am pretty happy with my size, I don’t really want to downgrade, so this news was a tad disappointing.
I asked Dr. Talbot if he had any pictures of other boobs he’s accomplished a “lumpectomy-via-the-a-REAL-a” with, and he said that he has done more work on breast cancer boobs that had surgery without plastic surgeon involvement, and that each case is so individual at this point he doesn’t have anything exactly like mine (figures). I reminded myself that this guy went to Harvard Medical School and also teaches at Harvard, and that HMS is ranked #1 in a gazillion different medical areas, and that he practices with guys I’ve seen on national TV. If he can’t make me have twin girls, nobody can.
Kim and I thanked Dr. T and grabbed a Latisse pamphlet as we headed out the door. I looked at Kim and said “My takeaway: I have big, saggy boobs.” “Yup, that’s what he said!” she replied.
Kim and I spent the better part of the weekend running around New England. We went camping with Kristin and Rob Thursday night. Kim and I realized that I should celebrate the last weekend of having two full, real boobs, and wondered what I should do to mark the ocassion. “Really, there is only one answer to that question.” said Kimmie. “Give free motorboats.” (Despite what anyone else thinks, Kim is brilliant sometimes.) Although the men at camp seemed to agree with Kim in theory, in reality, I’m pretty sure nobody was allowed to participate in the celebration. I did, however, get one last motorboat from Bing while on the gurney in the hospital right before surgery, so MISSION ACCOMPLISHED!
We then spent a night with our cousins in New Hampshire. I am bad about staying in touch with them, but we spent much of our childhood years together so it’s always easy, relaxing and fun to be together. We sat around Grace Anne’s dining table, eating, drinking wine, and chatting. Then we attempted to play what Gracie calls a “parlor game” for a bit, which eventually turned into staying up late chatting about life while fending off an exuberant, nocturnal and naughty kitten (not me, Grace Anne’s real pet kitten). I was so paranoid about getting a scratch and not being allowed to have surgery that I kept myself bundled up in blankets and throw pillows.
We eventually made it to bed, and I easily fell into a relaxed asleep, only to awake at 5am with excruciating cramps. I tried to deep breath and relax to obtain some relief, but the waves of pain kept overtaking me and I wimpered and writhed about. I knew the cause of my pain, my new non-hormone IUD I had placed in order to prevent what I call a “chemo baby.” I found my cramps to be a rather mean reminder that I was sick, and felt frustrated and sad that I experienced so much pain during my last few days before surgery. The cramps eventually subsided and I fell back to sleep, or vice versa, a few hours later.
Bing flew into Boston the day before my surgery. I was so excited to see him, and needed him so I could worry about how he was feeling and hopefully avoid my own nerves. Also, hugging him makes me feel so good, I’m a bit of a Bing-hug-addict. Not to mention, I fall asleep easier when I’m with him. I suppose he is my multi-purpose tool, kinda like a Leatherman.
I made Bing take a picture of me topless the night before my surgery, partly because I’m sentimental like that, and partly so that I’d have a point of comparison with my post-lumpectomy boobs. I looked at his phone after he took the pic in my aunt’s bathroom, and suddenly rightie looked like an overgrown, saggy oaf of a boob. “Rightie is such a bitch.” I told Bing, “I’m glad she’s going bye-bye.” I realized that a reduction and lift was actually quite timely.
We had to be at the Faulkner Hospital at 7:45am on the day of my surgery. Kristin stayed over the night before and drove Kim, Bing, and me. I woke up to the wonderful smell of fresh-brewed coffee, and to Kristin and my aunt (“Mooie”) frantically chatting in a somewhat hushed tone. Apparently, Kristin’s Jeep had a flat tire! Whoops! The ladies were their usual, resourceful selves and pulled it together, formulating a plan to get me in on time. Kristin ended up driving us to Boston in Mooie’s mini-van, zooming about like a wild woman, finding the “secret squirrel” path to the hospital.
I checked in right at 7:45am, then was sent to the Sagoff Breast Center to have wires placed in my boobs, aka, a wire localization procedure. Not only did I have a lump in my boob, but I had a line of DCIS which is precancerous and needed to be removed, and all of this cancerous stuff spanned about 7cm of my boob. The wires help the surgeon’s accuracy, to make certain the full extent of the cancerous area is removed.
This is a picture on my way to have wires put in my boobs. Yes, Kim is waving a fragrant cup of delicious hazelnut coffee in my face…I had to stop eating and drinking at midnight. She can be quite a hobag.
Kim and Kristin were allowed into the “inner” waiting room with me, but Bing had to wait in the main area (along with two other men). I changed into my “johnny” and sat around in the exclusive waiting room with two other women in their “johnnies,” as my mom so aptly predicted would be the situation. I marveled that they were sitting alone, and realized that even though my entourage was slightly ridiculous at times, I much preferred the bountiful support.
A nurse took me back to a room with a mammogram machine. She explained the procedure to me, then the doctor came in and explained it to me again. I think I signed something acknowledging the risks. I was practically hallucinating with hunger (I love to eat and drink coffee), so who knows what I signed. They had me stand up for the first part of the procedure. My boob was smooshed in the mammogram machine, and I was positioned in such a way that I was forced to look at some metal thing sticking out of a brick wall. I wondered why they don’t put up pretty pictures or happy poems like they do at the gyno, or in the MRI machine. Maybe I will suggest that if they send me a patient survey.
They took an image to locate my lump, and then the doctor injected me with lidocaine under my boob, near the cancerous mass. Holy cow, it hurt. Next, she put a needle in to mark where the lump was, and took another image. I thought, “OK, I am halfway done.” Unfortunately, when the doctor made a second injection close to my nipple to mark the DCIS, I felt just enough pain and lacked just enough food that I ended up nearly fainting. The nurse and doctor rushed to dislodge my boob from the machine, laid me out in a chair and placed ice packs on my head and around my body. I felt woozy and clammy, but grateful that I didn’t completely pass out and end up hanging by my boob.
The doctor and nurse finally recognized that I was only a few hundred calories away from delirium, so they finished up the procedure with me seated. Once they properly placed the second needle, they threaded thin wires through the needles down in my breast tissue and took yet another image in the human boob trap. Luckily for me, the wires were properly placed, so the doctor removed the needles and taped down the wires. Lastly, she injected me with a blue dye close to my nipple. This dye is taken up by the lymphatic system, and will stain the first lymph nodes leading out of my breast. It stung but the pain dissipated fairly quickly, and then we were finished. I put my hoodie back on but couldn’t manage to put on my t-shirt, and rejoined my entourage. We were lead to the surgery waiting room in the main hospital.
The wait didn’t feel long. I cuddled on Bing’s shoulder, talked a bit, and watched some TV. I felt pretty calm and didn’t feel anxious. I cannot explain why, I even surprised myself. Possibly I felt that way because I had an idea of what to expect with anesthesia (I had bladder biopsies in 2008 and 2010), and I was confident with my choice of doctors. A nurse took me back to a small “room” in a long hallway where I put my street clothes in a bag and changed into yet another “johnny” behind the privacy of a curtain. They even provided me with an amazing pair of stretchy, nylon underwear which I opted to wear, in case I was silly after surgery and let my johnny hang loose. The nurse started an IV, then retrieved Bing and Kim from the waiting room. Bing’s expression was a toned-down version of his expression when we first found out that I had cancer. I said to both him and Kim, “I know, it’s hard to see someone like this, but it’s going to be OK.”
I feel naked without my ring on, so I took it off when they made me at the hospital and gave it to Kim, but I put it back on when Kim came to sit with me while I was in pre-op. I wore it until the nurse caught me with it on (no clue how she spotted it from across the hall). Kim then put it on for safekeeping, but it was too small for her ring finger and too big for her pinky, so the nurse offered to tape it on her!
Waiting for surgery:
My ring on Kimmie’s finger, after the nurse got her tape-on:
Only two people were allowed to sit with me at any given time, so Bing and Kim swapped out for Mom and Mooie, and then Mooie swapped out for Kristin. Mom and Kristin read all of the well-wishes written on my Facebook page to me shortly before I was wheeled off, so for those of you who posted on my wall, I really appreciated it! Then I requested that Bing come back to wait with me until the surgery room was ready.
The anesthesiologist came and introduced himself to me, and then Dr. Carter and Dr. Talbot showed up. I told them that the wire was hurting me, but that the pain was bearable until I was knocked out for surgery. They looked at my boob and Dr. Talbot showed Dr. Carter (and me) where he planned to make the incisions. A few minutes before noon, I gave Bing one last kiss and I was rolled off to surgery. I remember talking with Dr. Carter, or attempting to talk to her since the anesthesiologist had already started my sedative. I told her that I think being a surgeon is so cool, and she said she’d love to learn more about horses from me someday.
Then I woke up in recovery.