Tags: Mastectomy

I am on some very strong pain meds as I write this.  Please forgive any typos!

Before I give an update on surgery I have some very exciting news! Tom trimmed my hair this morning! Woohoo! The back of my neck needed to be cleaned up so he got out his trimmer and did it. With everything I’m going through right now, it’s the little things I’m excited about! Yay for hair trimming!

Let me give a quick update on how I’m doing and then if you want to keep reading all the details about my day of surgery and procedures you can. I wrote as much down about it all as I could in hopes that it would help someone else in the future (and also for my memory which is not very good right now).

It’s Saturday, 2 days after surgery. I’m taking Percocet and a muscle relaxer for pain. I’m tired, but yet can’t sleep, mostly because it’s too uncomfortable to lay down on our bed and I don’t sleep very soundly propped up with pillows. Eventually I will be tired enough to sleep, right? 🙂

I’m really sore, especially under my arm pit, but if I’m just sitting on the bed or couch, the pain is minimal. I can eat and type with the computer on my lap, without pain. But that’s about it. Everything else hurts to do. Thanks to Tom and Mom, I don’t have to do anything. (And thanks to chemo, I don’t even have to worry about styling my hair.)

Overall, we are all surprised I’m doing as good as I am. I ate breakfast at the table this morning and sat on the sofa and played mindless games on my phone while laughing at I Love Lucy episodes with Mom.  I also sat outside in the sun with Tom as he worked for a bit in the yard.

The most bothersome thing right now is actually my skin. It’s very irritated. I can’t shower until the drains are out, so I’m stuck cleaning/washing in a shallow bath with washcloths and help from Tom. It’s dry and still a little itchy from the pain meds and all the tape, iodine, gauze and whatever else was taped and put on me during surgery. The first pain medicine they gave me on in the hospital (Dilaudid) was horrible. I was going out of my mind itching like crazy everywhere, even with Benadryl. No rash, just crazy itching!! They switched the pain medicine to Percocet and it’s much better, but my skin is still not the happiest it’s been.

So that’s how I’m doing. So many of you have commented on the blog and Facebook, sent texts and emails – thank you! Sorry I have not been able to respond to them all.

Thank you for praying with us and please continue to pray as I recover. Some specific things to pray for:

• This one is not for me, but for my cousin. She is having a baby (c-section) in a just a couple days.  She and her family are missionaries overseas, so please keep them in your prayers as they get ready to welcome their new baby girl!
• Please pray my skin will calm down a bit. I would like to take one more day doing what we are here at home before I ask the Dr. about switching to another pain medicine or for other pain management ideas. If you have dealt with this before and have a suggestion (besides call the doctor), please email me.
• Tom and Mom as they take care of the girls and our home (and each other).
• That I will be able to sleep tonight
• For a calm home – with 3 young kids, things can get a bit chaotic.       I would love happy, calm children.       I would actually love this all the time, but would REALLY REALLY REALLY love it for the next few days as it makes it easier to rest.
• For healing
• For peace as we await the pathology report

For those interested, and for my records, below is a detailed account of my surgery day. I’ve included names of doctors and nurses for my memory and also for those who have had similar procedures done at the same location. I feel a bit funny writing about all of this in such detail since it’s about my breast (giggle giggle), but since I have breast cancer, I can’t really leave that part out. If it’s too much information, just close the window on your computer or phone and go on with your day. 🙂 Also, please remember I still have chemo brain and have no experience in the medical field. I have a college degree in Liberal Studies – not medicine.

Checking in

I got to Valley Medical Center at 8 am. They took me back to a private surgical waiting room. The nurse immediately put 3 tubes of EMLA numbing cream all around my nipple so it would be very numb for the Sentinel Node Biopsy I would have later in the day. She then covered it with a piece of what I would call sticky surgical saran wrap. There were a few jokes made about how it looked like frosting…

Tom and I hung out playing 2048 on our phones for a while until it was time to be wheeled over to the breast center for my Wire Localization procedure.

So what is Wire Localization?

Basically, a radiologist places a small wire in a lymph node (or lump) so the surgeon can find it easily.  It sticks out of your skin and is taped down until surgery.

In September when I had a biopsy of a lymph node and the large tumor, they left a tiny metal clip/marker in both areas, so they could find them again. The marker in the breast was easy to find. The one in the lymph node . . . not so much. 🙁

The tech started off with the ultrasound machine. When she couldn’t find it, the radiologist came in and tried.   It hurt because they were pushing down really hard as they moved it around in my armpit. I don’t know if you’ve ever had someone press really, really hard in your armpit for an extended amount of time, so just take my word for it – it’s uncomfortable.

The next attempt to find the marker was using Sterotactic Imaging. I had never even heard this term before. Feel free to google it. Picture a high narrow table with no padding. Then picture a hole in the table just large enough for you to fit your breast, arm AND shoulder through, with your face and jaw jammed against the non-padded table. Picture yourself having to hold this position for an extended period of time. Ugh!!  This was the worst part of my day.

It wasn’t the worst pain I’ve ever been in, but being that I had just come from having an ultrasound done in that same area, the fact that the surgeon was going to be cutting off one of my breasts a few hours later…I was very emotional and had a small crying session with Debbie, the sweet mammography tech who was with me for over an hour. Debbie said that in 16 years she has always been able to find markers using this equipment and technique. Now she can say, “All but one time…” Dr. Thomas, the radiologist came in and the two of them still had no luck.

The final attempt was a regular mammogram. My previous mammograms had not hurt at all, but since they were trying to see a lymph node in my arm pit, my beast was being crammed, twisted and who knows what else, in the machine.

And still no luck finding that silly clip!! My body did a great job of healing itself. So good that the lymph node looked very different in the images and must have shifted a bit.

2 1/2 hours later, I was back in the ultrasound room and after talking with the surgeon, the radiologist ended up putting the wire in near a cluster of lymph nodes that he believed contained the one with the marker, based on previous and current images. He did a great job of numbing the area and that part of the procedure did not hurt much. If they would have been able to find the marker right away, this procedure would have been very short and relatively painless. Instead, it was 2 1/2 hours long and miserable. Fortunately, it’s not like that for most women. I’m just lucky, I guess.

Next, they wheeled me down to Nuclear Medicine for a Sentinel Node Biopsy.

So what is a Sentinel Node Biopsy?

Dr. Bowen, a radiologist in nuclear medicine, and his assistant Irene (who is a breast cancer survivor), did a great job of explaining this procedure and how the whole lymph system in our body works. While the entire day was centered around getting rid of my cancer, there were a few enjoyable moments, like this one, where we learned something new and were fascinated. God has created so many incredible parts of our bodies that all work together. The lymph system is amazing!

The radiologist started by putting lidocaine in the area around my nipple to make sure it was totally numb. Then, he injected tiny radioactive particles around the outside of the nipple (at the 12, 3, 6 and 9 positions if you were looking at a clock). Those particles flowed through the ducts and got caught up in the lymph system and then a picture was taken.

The sentinel node is the first lymph node that catches drainage from the breast and would be the first node cancer would go to. By doing this procedure before surgery, the surgeon can use a small Geiger counter to find the node and remove it.

Single Mastectomy and Reconstruction

Both Dr. Unger (Surgeon) and Dr. Barker (Plastic Surgeon) said surgery went really well. When Dr. Unger took out the sentinel node, the mysterious clip that no one could find earlier in the day was inside of it. Yay! Because the rapid pathology report on that lymph node came back negative for cancer, she only removed a minimal amount of lymph nodes. There is still a chance there is cancer in some of them that she took out, but we will not know until the full pathology report comes back next week.   She removed all the tissue in my left breast between my skin and the muscle, including the nipple. Her part of the surgery took about 2 hours.

Then Dr. Barker stepped in and started the reconstruction by placing an expander in. This is what will be filled over the next few months with saline to stretch the skin. Then I’ll have another surgery (outpatient) to remove the expander and to place the implants.

I got to my room after surgery around 11 pm (surgery started around 6 I believe, and lasted about 4 hours. I was very nervous about seeing my new lopsided chest for the first time. I was pleasantly surprised at how it looked. The Plastic Surgeon was able to put a little liquid in the expander because of the amount of skin that was left for him to work with. So while I’m deformed, have a scar going up and down most of my breast and have 2 drain tubes coming out from under my arm (hidden under gauze – I haven’t actually seen that part), I’m not totally flat. It kind of looks like I have a partially deflated old balloon under my skin.

I was pretty wired from the drugs after surgery and Tom said I kept asking the same questions over and over (which I don’t remember). I dozed off and on until about 3 when I finally fell asleep. The first pain medicine they put me on (Dilaudid) made me itch like crazy. I finally stopped pressing the button for the pain killer as it was better to have pain than to be itching everywhere. For some reason the Dr. on call didn’t want to give me more Benadryl. As soon as my surgeon came in the next morning, the meds were changed and I was more comfortable.

The emotional part of the day…

I mentioned above about my crying episode on the very uncomfortable table in the mammography department. I was hurting and uncomfortable, but the crying was really more about all the emotions and thoughts that were going on in my head and I couldn’t keep them in any longer. I just kept thinking, “I hope my girls NEVER have to go through this. It’s so horrible.” I have breast cancer and I have 3 girls. I did test negative for the BRCA gene, but my girls will have to tell every Dr. as they get older that their Mom has/had breast cancer. They will probably always wonder in the back of their mind if they will get it. The thought of that was just too much to bear at the moment.  So I sobbed for a few minutes.

I thought about what my body was going to look like at the end of the day. My breast hurt, but at least at that point I still had one that could hurt. I wondered what they would do if they couldn’t find that silly clip they placed in there last September.

And of course I thought briefly about dying during surgery. I teared up as I said goodbye to Tom as they wheeled me off to the operating room.

I’ll be honest.  There have been a handful of times over the past 6 months I have seriously thought about dying and wished I would, so I didn’t have to go through this and so my family would not have to see me in pain. I know what it’s like to lose a mother to cancer and I was 27, not 11, 8 or 6. I remember seeing my Dad in pain and still think of his loss often. Death is horrible this side of heaven.

I remember my Mom saying that it was easier to be the person with cancer, than to be the loved one of someone with cancer. At the time I didn’t believe her. How could that be? I saw all the pain she was in. I saw her suffering. But now that I’m here, now that I’m the one with cancer, I understand. It’s very true. You see, if I were to die today from breast cancer, I would be instantly in heaven with Jesus. Plus I would have a new body, no pain, no suffering, no worrying – perfection!   Even without cancer, death is still better because of my relationship with Jesus Christ, my Savior. But until God chooses to take me home to be with Him, here I am, to be used for His purpose. Philippians 1:21 says, “For to me, to live is Christ and to die is gain.” Having cancer makes the meaning of this verse much clearer.

As the loved one of the person with cancer, their death brings sadness here on earth. Yes, I know I will see my Mom again one day in heaven and I am so happy about that. But in the meantime, it really stinks. I am far from being a perfect daughter, wife or mom, but my death would be hard on my family, even though they know they would see me in heaven. I know it would be.

That’s why it’s easier to be the person with cancer than the loved one of the person with it.

All these thoughts were going through my head as I processed everything the day of surgery. I kept thinking, how do people go through this without Christ? Without hope? If death was the end? I don’t think I could even get up in the morning if that were the case. I just can’t imagine.

Please! If you are reading this and you don’t know what I’m talking about, if I sound crazy or even if you don’t agree with me and want to argue about it, call me and let’s talk. No matter how horrible things are or will get, I will always have hope and the only reason for that hope is because of God. Death is not the end and I am so thankful that Jesus took my punishment on Himself on the cross so that I would not have to spend eternity separated from God because of my sin.

If you are still reading, thank you.  Thank you for letting me share this part of my journey with you.

Before every procedure I’ve had, it’s been really nice to be able to talk to someone or read about someone who had already experienced it. That’s one of the reasons for all the details above. If you know someone who can relate, please share this post with them. I would be happy to talk about what I’m going through just as others have talked and encouraged me. No one should feel alone as they walk this journey…

So much to be thankful for . . .