Appointment 11 - Surgery

Wow, I have a lot to write about today. I will start by saying that I think you all misunderstood my previous post about hugging. I don't LOVE getting hugs; I just tolerate them better now. I don't go around asking people to hug me, but I won't run away from one like I have been known to do in the past. Got it? Good.

I just woke up from a Vicodin-induced fog. It was awesome! I can see how people can become addicted to this stuff! Actually, it makes one unable to function, so I don't know if I would want to be taking it all of the time. I would be a walking zombie. I may take one or two more tablets today (they gave me a vial of 30!) but that will be it. I have to get on with life starting tomorrow.

The day started at about 5 am - I couldn't sleep anymore. I actually had a dream/nightmare that one of my co-workers  made this really good blue (?) cake of some sort and it ended up at my house and I ate a piece before I realized that I wasn't supposed to eat before surgery so I tried to spit it all out. So I got up and showered and removed all my jewelry. Our friend Cathy drove the kids to school and Lisa and I were on our way to the hospital by 7. Traffic was really light (perhaps everyone was staying home to watch bin Ladin news coverage) so we got there 20 minutes early. I was much hungrier this time around, for some reason, even though I pigged out last night. After gowning up (this time they gave me heated gowns and a heated blanket!), I was brought into the room where the radioactive seed was to be implanted. The radiology technician was from Poland, and since I actually visited Poland a couple of years ago, we had a pretty good conversation about  it. She described the procedure and kept talking about how they would give me frequent breaks and I should let them know if I felt light-headed, plus there were all of these packets of smelling salts taped to the equipment, so I got a little nervous about fainting. How often does that happen, anyway? I was left alone in the room for about 5 minutes while she got the radiologist, so I decided to explore. The Geiger counter was an oddity because it looked like a relic from the 1950's - it was old and even rusty. The radiologist came in and I made a comment about it and she got all defensive! No sense of humor! She's like, It works just fine, but I can get you another one. Do you want me to get a different one? Jeez, no! I was just trying to lighten things up! I wish I had the radiologist who did my stereotactic biopsy. She was funny! She would have got the joke!

Anyway, the procedure is like this. They have you sit down while they squeeze your breast in a mammogram machine from the top and bottom. Then the radiologist looks at the image and marks the coordinates of the metal clip that had been implanted after the biopsy. Then the radiologist injects a local anesthetic and then places a needle so that it is near the clip. Then they switch the machine to squeeze from the sides (you know, to get a 3D view), and adjust the needle so that it is near the clip from all dimensions. The entire time, the tech wouldn't let me look at the needle. Probably because they thought I would faint if I saw it sticking out of my boob? When the radiologist is satisfied with the placement, she injects the small radioactive seed (it is the size of a pencil tip, I was told). Then a couple more views to confirm placement, and THEN the ancient Geiger counter was used to make sure the seed did give off radiation (it's a super small amount).

Shortly after, Lisa and I were led to another part of the building for surgery. I had to take off all of my clothes except for underwear and put on a paper Bair Hugger gown. I will interject here by saying that my hospital wristband was checked at least a dozen times today, and I was asked to state my name, birthday, and procedure being performed at least that many times. The nurse took my vitals, reviewed my history, and placed an IV. That damned IV - you know how I hate them! By this time, my mom and Lisa were allowed in the prep room. I was there for almost an hour and during that time, I was introduced to the anesthesiologist, anesthesia tech, and visited by the surgeon. The surgeon talked to me about genetic testing. I had called and made an appointment, but couldn't get in until July. She said it would be better to get in earlier, before starting radiation, because if I tested positive for the BRCA genes, it would probably mean bilateral mastectomy instead. Yeah, right, I said. What are the chances of me even having the gene? Like one in 10,000? No, she replied, more like 10%. Really? Obviously, she is a breast specialist so she knows a whole lot more than me, so I'll go with her recommendations. Although I don't really believe the risk is that high. The anesthesiologist and I (and Lisa) had the best conversation, since we told her we were vets and discussed the similar drugs we use. Finally, I was walked to the OR. We opened the door and behold! Bright lights! The surgery table prepped for me! It was weird because it had two "wings" to put my arms out to the sides, and it looked like a cross. So close to Easter... Anyway, I got a little excited at that moment because I am a little narcissistic and it hit me then that all of these people were here and ready for ME. For the next 45 minutes, I was the center of their universe. Just being honest here.

They had me lie down and almost immediately I could feel a burning sensation in my arm. That was the propofol going in. They could have warned me! I chatted with the team for about 30 seconds and then woke up back in the prep room 40 minutes later. So weird! I love anesthesia! I've been under a couple of times in the past and it is always such a trip. In fact I may even have said that I could see how people get addicted to plastic surgery because the anesthesia is so cool. And the anesthesia tech also told me afterwards that I announced in the OR room how cool it was to be the center of attention. I said that out loud??? Oops!

The procedure (as it was described to me) is that the surgeon anesthetizes the breast with lidocaine. Then she makes an incision and uses a small Geiger counter to find the radioactive seed. She removes a pingpong ball size piece of breast tissue around and including the seed, which is then x-rayed to make sure the clip and seed are in it. Afterwards, the incision (which is maybe 3 inches long) is closed up. No external sutures.

The anesthetic that was used, propofol, is the same one that killed Michael Jackson. I hate using the stuff on animals, because in my experience thay are either awake or they are so deep they stop breathing. The anesthesiologist said the same is true with people, so I was monitored very carefully. It is tricky, she said, so it's generally only used by boarded anesthesiologists.Well, I have to admit, it was a good drug in this situation.

I started feeling a little painful after waking up, which was weird since I was given a local block and that should last several hours. So the nurse gave me a Vicodin tablet at noon. We left by 12:30 and I told Lisa I was ready to go shopping! But then I started tripping about halfway home and crawled into bed for a 2 hour Vicodin nap. Now I'm awake and feeling pretty good and Lisa left me (against doctor's orders to have an adult with me for 24 hours) so that SHE could go shopping. Well, just to get milk. And peanut butter and chocolate chips for me.

A few minutes ago the Piper Breast Center called and told me my genetic counseling appointment has been rescheduled to next Monday, and my surgery follow-up would be right after. I guess my surgeon has some pull with the counseling department! Also, the final pathology report will be back late tomorrow or Wednesday. My surgeon said she'd be the one calling me. I'll let you know.

So that's my day. I hope I do get painful again so I'll have an excuse to take another Vicodin...