Monday, March 27, 2017

Nothing Ever Goes as Planned...Not Even Surgery

I did my part for the surgery.  I didn't eat or drink anything after midnight.  I got up and trucked my butt to the hospital at 6:30 am.  I brought my husband so I wouldn't be alone and so that someone could take the car home while I spent the next three days and two nights in the hospital.  Fun for me.  I was actually about as nervous as I could possibly have ever been.  I hadn't been this nervous since the morning that I had gone in to be induced to have my son.  He is now almost 17 years old.

I had been briefed on the gist of what was going to happen to me that day.  The first thing that we did was fill out paperwork.  Just so that everyone knows this.  If you go in for surgery these days, they will ask you a bunch of unsettling questions about your death, and they will give you information on how to make a living will.  I wasn't sure what to make of that.  I guess it makes some people feel more comfortable, but it was not my thing.  I wanted to believe that everything was going to be all right.  They also ask you if you want to see a member of the clergy.  Not for me, but I thought it was a nice offer for people who are into that.

I then had to get the stent for my IV.  This is always a problem for me, because I have bad veins for that kind of thing.  As luck would have it, we'd all been through that rodeo, and the staff knew to put a hot towel on me to make my vein rise.  If you are one of those people, like me, with bad veins; suggest that.  It works.  Because of my knowing about the common problems I have and letting the staff know; it went pretty easily.  Normally, it's the worst part of my experience.

For my surgery, I had to go to a place called nuclear medicine before I could go to surgery.  Let me explain.  Because I had DCIS and had waited a while to have my mastectomy, my surgeon wished to check what they call the Sentinel Node.  They wanted to be sure that the cancer had not spread to my Lymph nodes.  I couldn't argue with the procedure.  I was going to be cut open in the area anyway.  Why not be sure?  It should be noted here that I had a choice about this.  I did not have to have this procedure, but I couldn't see a reason to leave anything to chance.  I had it, because I wanted to be absolutely certain that I was getting rid of all the cancer.  I wanted to make sure that I lived, because I had things left to do.  I was not going to give the cancer any chance to end my life before I had accomplished everything that I wanted to do.  I'm the kind of person who is neurotic about leaving things unfinished.  Life is one of those items on my list.

Of course, nuclear medicine is no where near pre-op, so I got to take my first trip across the hospital and down to the cellar I think.  I'm not positive that's where we went.  It was early that day.  The orderly was nice, but it was weird being rolled around on a portable gurney.  We had a nice chat, because he recognized me from my 15 years at Walmart.  I felt that I could walk, because I hadn't had any medications, or any procedures yet.  I guess it's policy that they roll you around once they have you admitted to the hospital and in a stupid little gown.

We arrived in nuclear medicine where they would locate the sentinel node.  They were supposed to inject me with some radioactive dye that would let them locate the sentinel node on some kind of x-ray.  I had never had this procedure done and it had come up at the end of the process.  I hadn't had much time to research the procedure, so I wasn't sure what to expect.

The first thing that I hadn't thought over ahead of time and hadn't expected, was to see the doctor that I had argued with at the mammography center.  He was my doctor for that procedure.  My first instinct was to punch him dead in the face, but I knew full well that if I reacted that way, they would make me reschedule the whole surgery in order to get another doctor when he walked out and refused to do the procedure.  I was worried when I first laid eyes on him that he would walk out and refuse anyway.

He didn't walk out.  At that point, I was relieved, because I didn't want to have to reschedule.  What he did do surprised me.  He was comforting.  He put his hand out and said that he would like to start over.  He introduced himself as though we had never met.  He apologized for everything that had happened in the past.  I was thrilled.  I agreed to start over.  I suddenly felt much better about everything.  I'd encountered a human doctor who had a bad day a few months ago and had treated me badly.  He now admitted that and apologized and assured me that he was going to give me even better than normal treatment to make up for it.  It was the most comfortable I'd felt in a while.

Next, he explained exactly how the procedure worked.  They inject you with dye in the side so that it goes to the correct area.  They give it about 15 minutes to travel and pinpoint the node.  Then they have you lay on your side with your arm over your head and they slide you under a special x-ray machine and they takes pictures for 5, 10, and even 15 minutes at a time until they see the node on the pictures.  He said it could take up to an hour.  He also said that there had been cases where they couldn't locate it at all.  He seemed to think that we would find mine easily.  Something to do with my size and previous imaging of that area of my body.  He told me that once they found the node, they would mark it with a pen and they would actually scratch my skin in the area so that the mark couldn't come off for any reason.  Okay, ready to start.

The injection didn't hurt at all.  That was good.  There was a nice technician that would be running the machine until something showed up on imaging.  The doctor had to go across the hall for other procedures.  The technician was the monitor and would get the doctor when it was time.  That was fine.

The technician and I talked for a bit while we waited for imaging time.  He recognized me and I told him that it was probably from Walmart where I worked for 15 years.  He was sure that was it, as was everyone else I ran into nearly everywhere I went.  We talked about families, pets, jobs, hobbies.  Small talk to pass the time.   15 minutes passed and it was time for me to get under the x-ray.

The technician had me lay under a machine that looked like any other x-ray machine, except that it had a kind of shelf that stuck out.  That was the part that I had to lie under.  I felt that at least it wasn't a tube like an MRI machine.  I lay down on my opposite side to expose the side we were looking at and put my arm over my head.  The technician slid me under the shelf and lowered it to just above me.  It was close quarters, but it was necessary.

I have to make a note here, for anyone who is having this done and a mastectomy.  I wanted to freak from the close quarters and my arm killed me during this procedure being over my head for what turned into a significant amount of time, but looking back it was great.  This was the last time that I would be able to lift my arm over my head for several weeks.  So, I guess it was good to get me to the point that I never wanted to put my arm over my head again.

I made three trips under the shelf during the procedure.  Each time the shelf was lower in hopes of finding the node.  I don't have many phobias, but I did not like being crammed under that shelf.  The technician was understanding.  He let me take a rest between each session and get out from under the shelf for a couple of minutes.  I have to say that things like that make the difference between good medical people and bad ones.  That technician was a good one.

We finally found it about 45 minutes into the process.  I was excited.  Then I had to lie under the shelf and wait while he went to get the doctor.  It seemed like forever, but it was probably less than a minute.  The doctor who was making things up to me came running the second he heard that the node had been located.  I was really impressed with a doctor that I had previously wanted to punch.  That took some work with someone like me.  Normally, if I hate you, that will never change.  I'm pretty stubborn that way and I do not believe that people ever change.  Lucky for me, he didn't say that he'd changed.  He said that he'd been having a bad day in the first place and made a mistake.  I think that made the difference.  Note to anyone who has a bad day when they first meet a patient.  Just tell us that it's a bad day.  We can all understand that.  Be honest about it.

The doctor looked at the images and pinpointed the node that he was looking for.  He then apologized for the fact that he was about to scratch me.  He marked me with a marker and then used a soda straw to scratch a circular mark into my side where the node was.  It wasn't that bad, but it did sting.  It was a worse feeling than the injection.  I'm not sure why.

Once it was all over, they put me back on the gurney and someone took me back to pre-op to wait for my surgery.  I was pretty well prepped and ready to go.  When I arrived back in pre-op, my husband was waiting patiently for me, asked me how I was doing and held my hand again.

The amount of radioactive material in you is minute.  The procedure isn't really that bad.  For anyone having a mastectomy, know that they are already in there.  Have the node checked.  There is nothing like piece of mind when you're dealing with cancer.  I will caution you that before you decide to have that node checked, know all that you can know.  You will see as my story goes along that I had an awful time recuperating because of that node.  I do not regret having it checked however.  It increased my recovery time almost three fold, but I'm still glad I had it checked.

Surgery day was a long day.  I will tell the rest later and hope that it helps someone deal with having a mastectomy.

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