I'm Back....

It's me posting again... I want to repeat what Pete has already said - that the many messages we've received (mostly via email) are much appreciated. Bearing in mind that I'm writing this not only for friends and family, but because perhaps one day another breast cancer patient will read it and find the details useful, I'm going to fill in some gaps about my surgery experience.

Firstly, if you had asked me even 24 hours ago if I thought I would be sitting at the computer, writing, I would have said "no". My day-by-day improvement has been significant.

Monday, March 14, 2011
Surgery day. I originally had a 3 pm start time, which I was not at all happy about. I knew I was unlikely to sleep well the night before, and that I would be awake early this day. The prospect of hanging about the house all day, unable to eat or even have a drink of water (everyone knows that you have to fast after midnight the day before going under general anesthetic, right?) was not one I thought I would cope with very well. But the surgeon's scheduler managed to get me moved up to 12:45 (thanks, Karen!). I was told to be at the hospital by 10 am because I needed to have a nuclear dye injected into the cancerous breast so that the surgeon could trace what are known as the "sentinal nodes" - the first lymph nodes serving that part of the body. These would have to be biopsied during the surgery to determine whether or not the cancer had spread. For a sentinal node biopsy, I only expected to have about 3 lymph nodes removed, which was important because it means that the risk of a lymphedema (swelling in the arm caused by removing many lymph nodes) complication was very small.

I woke up early, and had a long soak in the bathtub - the last one I'll be able to have for a while (the surgical incisions will need to be kept dry until healed). I'm the sort who never leaves the house without a water bottle in hand, so I was worried about how de-hydrated I would feel that day. We ran a humidifier in the bedroom the night before, and in addition to relaxing me, I hoped the bath would make me feel less parched. I was glad to have to check in at the hospital so early, because as part of the pre-op preparations I was given an IV which provided hydration so I didn't feel very thirsty once I was there.

As Pete mentioned, the surgery was late starting. I managed to stay fairly relaxed right up until 12:45 pm, when I realized that I should have been in the OR, but still hadn't seen my doctors. I was in a large open ward, with beds curtained off for some visual privacy. It was very busy when I arrived, and I could hear snippets of conversation around me. One man was telling his friends how he had just returned from a tour of duty in Afghanistan, only to discover he had cancer. Another man, who sounded much older and who did not speak english as his first language, was in trouble with the nurse because he admitted to drinking some water only 4 hours beforehand. Eventually it got quiet and I felt like I was the only patient left waiting. Pete was able to wait with me during this time - once I had undressed and had the IV and basic pre-op work done he was allowed to sit with me. Mostly we each just read to pass the time. Just prior to surgery (around 1:30 pm) Dr. Doezie, the plastic surgeon, arrived to draw incision lines on me, then the anesthesiologist turned up to introduce himself, then I was wheeled away on the gurney, and then... I was out before they got me to the elevator.

The next thing I felt was cold air blowing on my face from the oxygen mask helping me to wake up in Recovery. I was allowed to have a few ice chips, and it seemed to me that pretty soon after that I was being wheeled to my room. Pete joined me along the way, and I was coherent enough that the first thing I said to him was "were the sentinal nodes clear?" The answer, as expected, was "yes", but it was a relief to hear it as fact.

I was put in a private room which had a long, cushioned window-seat - big enough for Pete to sleep on, and I'm so happy we was able to stay in the room with me. As you might expect, I was completely helpless and unable to get out of bed, or even reach for the cup of ice chips by myself. A catheter had been inserted for the surgery to collect urine, so I didn't have to get up to go to the bathroom. It felt slightly uncomfortable at first, but I quickly reached the point where I didn't notice it.

During pre-op I had inflatable leg braces wrapped around my legs to help circulation - they are hooked up to a device which regularly inflates and deflates the wraps to prevent blood clots. Back in the room an automatic blood pressure cuff was also attached to me and it, along with the night nurse, was checking vital signs all night long. So don't expect to get much sleep the night after a surgery, what with the machines beeping to announce they are about to do something, then the wheezing and chugging while they do it, and the nurse taking temperatures and checking monitors. However, I felt pretty good that night - as long as I didn't move. I was content to doze in-between all the monitoring. Actually, since my pain medication was self-administered, I thought it was a good thing that I woke up regularly during the night to give myself a dose before the pain level got too high. The system is designed to prevent you from over-dosing - once you press the button, you cannot press it again for a certain period of time. The nurses and doctors encourage you to take advantage of the pain relief, and to NOT try to be tough about it. They told me that it's much harder to get under control once you let the pain level get too high, and I was happy to follow their orders.

Tuesday, March 15, 2011
It soon became obvious that I would need another night in the hospital. It wasn't unexpected. I didn't get out of Recovery and into my room until nearly 9 pm the night before, so to leave the next day was rather too optimistic.

The guidelines for being released were 1) I had to be able to walk on my own, 2) I had to be able to urinate once the catheter was removed, 3) I had to be able to keep at least liquids down, and 4) I had to be off the self-administered pain pump and onto tablets.

The nurse removed the catheter in the morning - I barely felt a thing. I tried walking - made 2 very slow circuits around the hallway with a nurse pushing my IV pole beside me - then failed my next test, because that made me nauseous (probably an after-effect of the anesthesia) and I threw up the very small portion of the liquid breakfast (vegetable soup) which I had tried to eat earlier.

But, since I had been up and walking I was allowed to have the leg braces off, and that was a good thing because they were itching and uncomfortable. The nurse got me a prescription for an anti-nausea medication. Between that and the fact that I hadn't really slept much the night before, I could hardly keep my eyes open, so I slept a lot that day. When Dr. Doezie visited me at lunchtime he said he would prescribe a sleeping pill and advised me to ask for it that night - he said it is hard, ironically, for patients to rest in the hospital, so he strongly recommended I take one so I could get a decent night's sleep.

Later in the afternoon I got through one of the other tests, being able to urinate. What a production it was to just get out bed! My IV pole had to go with me, and it's not just a little pole with a drip on it, it has monitors and stuff, so it was too much for me to push by myself. And I couldn't have opened the door to the bathroom by myself. In fact, I could barely manage pushing the button on the soap dispenser when I dutifully washed my hands after.

Soon after that I was taken off the pain pump and put on Percocet for pain. The anti-nausea meds were working, so I was able to eat at least some of my dinner. Then I took my sleeping pill and had a pretty good night's sleep.

Wednesday, March 16, 2011
Was in much better shape this morning. I actually wanted the breakfast they had such a hard time delivering (see Pete's earlier post). The surgical nurse from Dr. Kushner's visited me, and then Dr. Doezie, and then I got my release orders :)

We were home by lunchtime, and I parked myself on the sleeper sofa in front of the television to read or nap or watch TV.

Pete mentioned this already, but I want to say it again: my surgeons, and the nurses and staff at Mission Hospital were just terrific.