Day of Surgery

From midnight on, the night before the lumpectomy and sentinel node biopsy,  I was told to not eat or drink anything.

At 8:30 am I arrived at the Women’s Center, where the needle localization would be done. This is a wire placed, with the help of ultrasound, at the tumor area, so the surgeon has a guide on where to begin. Compared to the previous day, the procedure went well. The technician used a local anesthetic, so that, while I was able to identify the object “That feels like it’s been inserted” there was no pain at all. I was warned to not raise my arm above my head, “as the wire inserted has an end a lot like a fish hook, so you don’t want to disturb it.” I was then brought over to the mammogram room. I waited for the developed pictures, so that I could bring them with me to the hospital.
The drive over to the hospital was uneventful. We arrived in good time, and once I was checked in, we were brought by a volunteer up to the second floor Day Surgery area. I was sent to a bed, given a nightie, and my height and weight was taken. An IV was started. I half dozed until the orderly arrived to take me into a room where I met the surgeon again, as well as the anesthesiologist. Soon, a nurse arrived, and I was wheeled to just outside the operating room. I was handed two warmed blankets, and led into the room on foot. I climbed onto the narrow table/bed and another staff inserted something into the IV.

I woke in Recovery, feeling good. A short while after, I was wheeled back to Day Surgery, and soon given water and juice to drink. The IV was removed, blood pressure checked a few times, and late in the afternoon sent home.
I remembered that the nurse navigator and the surgeon’s nurse had both told me to “be sure and ‘take your medication, even if you are not feeling any pain. Don’t let the painkillers wear off.” I took the Percocet I’d been given at the hospital, for three days, then switched to my Tylenol 3 which had been prescribed by my family doctor much earlier for something else. That worked well, although I was not able to sleep on my right side – even today, May 3, I cannot rest completely comfortably yet on that side, but it is getting better. I did move on to 500 mg Tylenol for a few days, after the pain lessened, then to no meds.

The tapes covering the three inch wide incision on the side of my right breast, and the one inch incision under my arm, where the two lymph nodes were removed, were soaked and taken off in 10 days.

At 14 days, I had an appointment with the surgeon. He said the incisions looked good. He told me that the tumor had not spread, that the edges looked good. The lymph nodes were also negative for cancer.

That afternoon, my nurse navigator called, to say that I would soon hear from the oncologist’s office for my next appointment, this one for treatment plans. She told me that because I have HER2 I will probably have to have chemotherapy, radiation and Tamoxifen. Since I’d originally been told  ‘surgery and radiation’ I was devastated by this news. I have done some reading on HER2 and it is described as very aggressive.

The next day, the oncologist’s office receptionist called to say my appointment is for May 6 at 8:45 am. Hopefully, I will learn a lot on that day, about treatment and prognosis.

In the meantime, I have attended a (free) class on post-surgery, and learned that I must massage the incision 2 or 3 times per day, for the next six months, to prevent adhesions. That means, to avoid having the scar tissue adhere through the fat, to the muscle, the skin must be lightly and gently moved towards the scar, on both sides, for about 5 minutes each session. So far, I have been able to avoid looking at the scars, as my  husband has been caregiver and helper through all of this. I know that soon I will have to steel myself to have a look.

I am learning far more than I ever cared to about having surgery and about having cancer.

If you are facing surgery etc I hope that what I am writing will help you as you move forward on your journey.

More soon!



The Sentinel Node Mapping


I can finally type without too much discomfort, after the April 10th surgery, so I am going to begin with the first procedure, just prior to and at surgery.

The sentinel node mapping – the preparation for the sentinel node biopsy- the dye injection – was, for me, the worst of the two days of procedures, including the wire insertion and surgery.

The sentinel node biopsy means the removal of a couple of lymph nodes under the arm, on the side where the breast cancer has been found. It is an exam to find out if the cancer has spread. A radioactive substance is injected into the breast, and then the next day, the surgeon has a marker to help him find the location of the sentinel node and other lymph nodes, for removal.

The nurse navigator (and the brochure I was given) had explained that I must purchase Emla cream at a pharmacy, and apply it to the areola and just outside it, about an hour and a half before the injections would be done. Supposedly, this cream acts as a anesthetic so the procedure of injecting the radioactive dye will not be too painful. Perhaps my husband, who assisted me, did not apply it quite correctly but the results were not good.

The morning before the surgery day, I arrived at the radiology lab at the health center for my appointment, and I was brought to a small room. I changed to a short, upper body only nightie and laid down on a small cot.The radiologist came in with the nurse. She had told me that the injections would hurt, but not too bad. She said the pain was similar to a bee sting. Well, I am a rare one, as at age 59 I’ve never been stung, so I had no idea what might be coming. But I think  she was wrong!

When the first needle was inserted, I could feel it a bit, and I thought, “Oh, not too bad.”  But then came the ‘real’ injection, and oh my. After living through the birth of two children, one of which was about 16 hours, of mostly hard back labor, granted many years ago, I have never in my life had a pain like that. It hurt terribly. Not for long –  I had enough time to think, “Oh my, that really, really hurts. Oh my, I don’t think I can stand it. Oh it hurts. How long is it going to go on? Oh my. I don’t think I can stand it. It really hurts!” And then it stopped. Once more, the same thing. Then it was all over. I would not wish that pain on anyone. If you must have this procedure, be sure to find out how best to apply the Emla cream, if you are using it. If you have an option, of a local anesthetic, by all means, choose it!

I had to return to the radiology lab two hours later, for the scan. This is not pleasant, if you are claustrophobic, but at least it doesn’t hurt. The technician asked me to change to a nightgown, upper body only, and I had to lie down an a narrow cot. She asked if I was claustrophobic, and I told her, “A bit, so I am going to keep my eyes closed for this.” I could feel the bed moving forward, into the scanner area. Then some small whirring sounds. She was nice, explaining how the machine was going to take a picture, “Lie still for one minute” and then, “Lie still for five minutes.” After that, another technician came in, and using the photos just taken, he made marks with a pen on my underarm to show where the lymph nodes were located. This was painless. Then it was all done, and I could go home.

The following day would be the insertion of the wire at yet another health center, and then the surgery. More on that later.

Tentative Dates Set

I received a phone call from Wendy, the nurse liaison yesterday. She asked if I would be able to have the surgery done on April 10th. I said, “Yes, please, the sooner the better!” The other procedure will be done the day before, on April 9th, at the same place where the core biopsy was done. Then I will have the wire inserted the morning of the 10th, before the surgery.
I am now just waiting to hear back on a confirmation and the appointment times.
I have a birthday on June 20th. I have hopes that *everything* will be done by then, surgery, healing and radiation.

I dread the pain and discomfort to come, but I also look forward to getting it all taken care of.