"Negative? That's bad, right? Oh, no wait, negative as in good-negative you mean?" I asked.
I did not have the gene (woo-hoo!) and Dr. L wanted to make sure that, considering this news, I still wanted to proceed with the bilateral lumpectomy. Uh, yes please?! Telling me I didn't carry that particular gene was not, in and of itself, going to rid me of the cancer in my chest.
The night prior to surgery, Tammie called me and asked, "Did you change your mind? Are you doing the double mastectomy instead of double lumpectomy?"
"Huh? No. Why? What makes you think that?" I asked.
Tammie was perplexed when she hadn't see my name listed on the next morning's schedule of procedures. Somehow, I had not been scheduled for, or ever informed about, the wire-inserting appointment necessary immediately prior to surgery. Ever vigilant about all her patients' care, Tammie was watching out for me. She added my name to the list for the next morning.
I went to work that Wednesday morning, June 24, 2009 bright and early. My stomach growled with hunger as I wasn't permitted to eat or drink anything prior to surgery. (It was going to be a long day with having to skip my morning Starbucks.) My incredible team of coworkers joined me in wearing matching pink-ribbon t-shirts. All the women in the office, and my not-too-macho-to-wear-pink-in-supporting-Cherí boss, Craig, posed with me for a photo before I left the office. We smiled, as that's what you are supposed to do when having your picture taken, but I doubt any of us was truly in a smiling state-of-mind.
Wire localization is a technique that is used to mark the location of a breast abnormality that is quite small, or that can't be easily found by touch. This procedure ensures greater accuracy for a breast biopsy or lumpectomy. Your surgeon will use the wire as a guide to the tissue that needs to be removed. Your wire localization will be done in the Radiology Department of the hospital or surgical center where your breast biopsy or lumpectomy is scheduled. Mammograms (or in some cases, ultrasound images) must be taken to show the location of the breast abnormality. You will need to undrape the affected breast, and get into position for a mammogram. Special equipment, such as a paddle-shaped compression device may be used during your mammogram. It may be necessary to take several images, in order to find the exact location of your lump or area of concern. Now that images have been taken, and your breast has been numbed, your radiologist will use a very fine needle (smaller than is used for a blood draw) to target your breast abnormality. The tip of this needle must rest in the location that your surgeon needs to find, in order to remove the right tissue. A slender wire will be threaded down through the needle and out of its tip, to lodge at the target tissue. The needle will be removed, leaving the wire in place. Source: http://breastcancer.about.com/od/breastbiopsy/p/wire_localiz.htm
In hindsight, it was probably best I didn't know what this procedure involved before I went in that morning. Tammie was there, though, to help me understand each step and, yes, kept a hand on my shoulder at all times. I left the radiology department, headed out the double doors and across the cross walk to the main hospital. The wire was wrapped around the outside of my breast and tucked inside my tank top. I was certainly glad there were no metal detectors at the hospital entrance.
Registration at the hospital, quite surprisingly, didn't take too long. I provided my government-issued photo identification and my insurance card, paid my $250 hospital visit co-pay, removed all jewelry as instructed and received my hospital wrist-band. The last time I wore one of those I was a seven-pound, fourteen-ounce newborn. I took a seat in the waiting area.
"Sherry?" I heard the nurse call. It was time.
Protector Craig was only allowed so far into the pre-op area. He was now assigned to the hallway. Once inside the staging area and behind curtains, I changed into the provided hospital gown. Tammie joined me after this and was going to keep me company as the nurses began prepping me for surgery. The nurse took my temperature, blood pressure, height and weight. (I missed Keisha. She would have let me skip the scale.)
It was soon time to insert the IV. My left hand seemed the best location or so the nurse claimed. I decided I wouldn't watch her attempt to poke my vein with the needle and instead, I chose to watch Tammie as she watched the nurse. Big mistake. I should have watched the actual needle being prodded into my vein. Lesson learned - Tammie does not have a poker face. The expressions Tammie made caused me to think the nurse was tearing apart my flesh or was about to cut off my left hand. Turns out the nurse just couldn't get the needle in correctly. After two failed attempts at what should have been a seriously simple procedure, the nurse rushed off to find an ER nurse. Apparently those nurses were better able to find the good veins. Well, that nurse failed, too, and they decided to wait and just have the anesthesiologist insert the IV. Kinda wished they had made that decision before their four failed attempts. For the record, it took the anesthesiologist about four seconds to, rather painlessly, insert my IV.
I was wheeled into the final, pre-surgery area where I was adorned with a shower cap styled hair cap, lovely socks and leg pumps (intermittent pneumatic compression).
Intermittent pneumatic compression (IPC) is a treatment that uses an air pump and inflatable leggings to provide pulsing pressure that pushes blood through the veins IPC keeps blood moving through the legs and back to the heart, preventing blood from standing still (when clots are more likely to form).
IPC is used to prevent blood clots in the leg veins in women who are not able to walk, usually after surgery or in the hospital. Source: http://www.hearthealthywomen.org/treatment-and-recovery/pvd-treatment-and-recovery/intermittent-pneumatic-compression-ipc.html
Craig and Tammie came in for a quick hello/good luck/you'll be fine/see you after surgery.
I was ready for surgery, or so I thought. Dr. L had another procedure yet to perform before I was actually wheeled into the operating room.
Often, a blue dye or a small amount of radioactive material will be injected around the nipple area. The material moves to the lymph nodes and helps identify which lymph nodes need to be removed for testing (sentinel lymph node biopsy). Source: http://www.webmd.com/breast-cancer/lumpectomy-partial-mastectomy
Yes, you read that correctly. Not only is the dye injected into the nipple area, it is then "massaged" into the breast to help it spread faster. I shudder as I recall this experience. My right breast was shot-up first and I was, I admit, scared to death knowing Dr. L still had to do the left breast! To this day I question why I had to be awake during that procedure. Hell, the IV was in, just put some sleeping potion in there and then do your poking and massaging!
Julia arrived after I had been sent to the operating room. She and Craig sat patiently in the waiting room for hours. They told me, long after I had recovered, that Dr. L came out to see them during my surgery. He had informed them that surgery went quite well, the cancer was not in the lymph nodes, and all the cancer was out. (More on that fine topic later.)
My eyes fluttered open slowly. I sensed I knew where I was but I couldn't remember exactly. I couldn't move. I was crying. Let's back up for a moment to part ten of this blog journal. Reasons Cherí cries are very limited: 1) my body hurts, 2) my heart hurts, 3) my sisters are making me laugh too much. My heart didn't hurt, I wasn't sad and nobody was anywhere near close to laughing about anything. The crocodile tears shed that late afternoon were solely a result of the excruciating pain my body was feeling. I have not endured natural childbirth, nor will I ever, but I do understand that pain to be the worst pain on Earth. I'll concede to that as I have no personal experience to the contrary on which to argue. However, I'd like it to be made known that the pain felt when one awakes from bilateral lumpectomy with no painkillers in the blood stream, hands-down takes second place. Take my word for it.
I saw Julia standing to my right. I assumed Craig had gone off to the pharmacy to fill prescriptions I would be needing. (Julia has since corrected that assumption by pointing out that Craig was there in the recovery room ... frantically pacing and crying.) I still didn't move. I couldn't. Crying hurt. Every movement your body makes, requires, in some fashion or other, the use of chest and/or surrounding muscles. My muscles and chest had been cut open and sewn back together. My breasts were stitched closed and held in place with a material resembling saran wrap.
The nurse asked me to identify on the pain scale how severe my pain was currently. Julia said I answered a 3 (out of 10, 10 being the worst). The pain was obviously much worse than I identified with my 3, but I was still coming out of the anesthesia and couldn't be held accountable for my actions.
Which is why I can tell you about this next part of the recovery room experience. A friend of mine had sworn to me up and down, left and right, back and forth that come hell or high water, she'd be there for my surgery. Well, she wasn't. She missed it. I don't recall much about what I said during my recovery, but Julia has reminded me multiple times that I repeated over and over and over the following phrase: "If I was a (expletive) horse she'd be here!" It was anger. I was mad she didn't make my surgery a priority. But, that's how life goes sometimes. Things come up, plans change and you have to just deal with it. You have to learn to get over it. And I did that. Apologies and amends were made and life moved on.
Julia stepped behind the nurse, out of sight, and held up 10 fingers. "Say ten, say ten," she mouthed silently at me. I must have mumbled out "ten" for the next thing I knew Julia yelled at the nurses station, "She said ten! She said ten! I heard her say ten!"
The nurses, after hearing Julia's threatening tone, confirmed with me that I had, indeed, said my pain was at level ten. As if my tears and painful expressions were not enough, I added a simple, quiet, yes. The nurse said that she would have to contact the surgeon to see if they could give me a Vicodin. Again, you read that correctly. Singular Vicodin. One pill. Hell, they give you a Vicodin these days when you have a hang-nail. What does one have to have ripped, mangled and extracted from one's body to qualify to receive something a tad stronger in terms of pain relief?
Request for one Vicodin approved, pill taken, I still couldn't move. The tears flowed freely. Julia told me the nurse said it would take about twenty minutes for it to work. And thus the countdown began.
"We can do this," Julia cheered me on. "Nineteen more minutes. Here, check out this picture of McDreamy in this magazine. Isn't he so cute? There's a story about him. Okay, look, good, we're at sixteen minutes. You can do this. Easy. Fifteen minutes and you'll be all good. Look how hot McDreamy looks here! Half way there, ten minutes. Feeling any relief yet? Five minutes, come on, you can do it. Hang in there, do it for McDreamy! Just two more minutes!"
Twenty minutes came and went and I still sat motionless, tears streaming down my cheeks now soaking the pillow. Every breath pained me incredibly. I didn't dare start sobbing for that would only make matters worse. (Could it get worse, truly?)
My person sprang into even more fierce action with the nurses. (It was similar to a mother lion protecting her young, vulnerable cub. Hurt the cub, fear the wrath of the mother lion. In this case, with a friend just as vulnerable and in misery, the same level of needed protection can apply.) She insisted that they check on me and yes, they too could see their magical little pill wasn't quite so magical. They paged the surgeon. He agreed to admit me for the night for pain management. (Yep, their original plan was to send me home that evening!) I was wheeled into a room with Craig and Julia at my side. Still not completely free of the anesthesia, I repeatedly asked Julia to call Tammie.
"Tammie? Who is Tammie? I don't know a Tammie! I don't have a number for a Tammie. She's not on the list." Subconsciously, I must have felt that Tammie could be of some additional help and comfort as she works in the medical industry and has been through this battle personally herself. Tammie arrived shortly thereafter, still soaking wet in her swimsuit. She had jumped out of the pool, left her husband and best friend there in the pool and came to visit me. She stayed a short while and promised to come back the next morning before I was released. I really do have amazing friends.
I hadn't yet received morphine, but it was promised to be on its way. Craig felt it was safe for Julia to leave as she'd been there for hours and had been an incredible friend and support. Julia left the hospital and proceeded to get completely lost en route home. (To this day, she blames and hates the damned back roads of stupid Woodland.) Once home, she locked herself in the upstairs bathroom of her house. In the many years of our friendship, Julia had never once seen me cry. She had never seen me in pain. That day, however, she saw me endure complete physical torture and it was just too much. She was traumatized. Her husband knew well enough, though, to leave her be. She'd come out of the bathroom when she was ready. And she did ... three hours later.
Finally, after what seemed like hours, I was given a morphine drip and a button I could push to send a shot of that morphine through my body when needed. (However, they do have automated restrictions on how often the morphine can be released. Why they hell, then, do they give you the button? I needed the morphine more than once an hour on the hour!) Once the morphine took a slight edge off the pain, Craig called it a day and went home. I remained in tiny hospital room, IV line in my vein, television on low volume and my cell phone within fingers' reach. The tears had stopped, but the pain remained. It still hurt terribly to move, but I could safely say the pain level dropped from a ten to a solid eight. Significant improvement. I spent that night in the hospital getting very little rest. I was in a room next to the nurses station where all sorts of commotion occurred throughout the night. The patient in the room next to me screamed randomly and consistently through the night. (The nurses did apologize for this.) The machines beeped and buzzed constantly. And I still hurt. I couldn't pull up the covers for fear of pain. I couldn't adjust my pillow for fear of pain. I just didn't move. It's amazing what the fear of pain can do to you ... I made it a good ten hours before I finally called for the nurse and asked for assistance to the bathroom. Every step there hurt like hell and I promised myself that was the only time I was going to get up out of that bed!
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| My Sutter Printing Family - Becky, Kathy, Craig, Susanne, Bridgit, Janice |
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| Recovery ... can you see the pain??? |
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