Surgery Report

I finally got to have my surgery. After being delayed by the ice storm and then Covid, my rescheduled surgery went on as planned. I wasn't able to eat anything after midnight but I could have clear liquids up until 5 AM because my surgery wasn't until the afternoon. So I woke up at 11:45 and had some cereal and then again at 4:45 and had some 7-Up. I think having that 7-UP made a big difference in my comfort level later in the day. 

My first procedure was at St. David's North Austin hospital at 8:30, with an 8:15 check-in. We checked in and I went to registration first, which was in a woman's office. There was a quote on her white board about weathering the storm to find the sun. It seemed applicable to my life at the moment. As she went through everything, she asked me about my emergency contacts and confirmed Roger and then asked about Jan Bowman. I told her no, not any more, then broke down in tears. She handed a box of tissues across her desk. I apologized and said I had recently lost my mom. She said, "I lost my son a year ago." We looked at each other and each took a tissue from the box. She looked at the white board when she saw me reading it and said, "that was my son's favorite quote." We both took another tissue. 

We finished the business side of things and she wished me well and I wished her the same and went back out to meet Roger in the waiting area. Soon I was taken back for my "wire localization" procedure. I had this done as well in 2019 with my lumpectomy. Basically they image the spot they need to remove and insert a wire to lead the surgeon to the area. When I did it previously, the problematic cells could only be imaged on a mammogram, so it was done with me jammed into the mammogram machine, which is awful (and how I did three of my four biopsies as well). If you've ever had a mammogram, you're stuck in compression in the machine while a needle is inserted. It's horrible and last time I passed out (which was odd because I hadn't had problems with my biopsies). This time they were able to use the ultrasound (which was how they did the biopsy for this last one as well) because the mass was able to be viewed by ultrasound because it was larger. They also had used a special marker after the biopsy that released a small amount of water making it easier to find later. The ultrasound tech was elated that they had inserted this marker. 

After I was given a local anesthetic, which was pretty painful, the wire was inserted. Then they taped the part sticking out of me down then checked it with ultrasound and after that also checked it with mammogram as well. It was in the right spot. 

After this, they covered my breast with a topical lidocaine cream for about 15 minutes and called the nuclear medicine tech. Over he came with a special white box with four injections. My step-sister recently had this done and said it was the worst part of the whole thing and hurt like a mother so I was not looking forward to this. Ultimately, it barely hurt at all. The lidocaine for the wire loc hurt way more. I mean, having four different injections in my breast wasn't super fun, but it wasn't as awful as I had prepared myself for. 

I was hoping radioactive injections would come with superpowers, but alas, no. These injections would travel to the lymph nodes that drained the area and be coupled with injections of blue dye I would have during the surgery. The surgeon would use a special device to detect the radioactive lymph nodes so she would know where to find them from the outside, then once she was in there, the dye would help her pinpoint them more specifically.

After this I got dressed and we moved across the street, arriving a little after 10 AM. We didn't have to check in until 11 AM so Roger and I just hung out in the car and relaxed (yes, while I had a wire sticking out of my boob). At 11 AM we checked into St. David's North Austin Surgery Center. After awhile they brought us back and got me prepped: urine sample (no idea why), gown, funny hat, those socks with the grippy things, IV, calf compression sleeves, EKG wires, blood pressure cuff, and pulse ox. 

Then I met with my surgeon, the anesthesiologist, the OR nurse and the anesthesiology nurse. I was give two Tylenol and a gabapentin which I was told would help me after the surgery with pain. Then I was given something in my IV to make me feel sleepy as they wheeled me back around 1:15 PM. I got into the OR and moved from my wheely bed onto the OR table myself. I looked up and saw two large lights...

Next thing I know, I'm trying to open my eyes, but they feel like lead weights. My limbs are also heavy and I can't seem to figure out where I am or what's happening. Someone is saying my name and asking if I want any water. I feel like I'm under water! I'm trying so hard to wake up but I just can't. Someone asks if I want Roger to come back with me. I manage to croak out, "yes please." 

I managed to get my eyes open and see a clock on the wall across from me. I was sitting up slightly and it appeared that the little hand was pointing at the 3. Then Roger was there. It was so hard to wake up! I finally started coming out of it more and ask for some water. Then the pain began. Tears were leaking from my eyes and it felt like someone was pounding my chest with a baseball bat. It hurt deep inside and felt like it was on fire. I managed to croak out that I'm in pain. A lot of it. They asked me for a scale of 1-10 but I could barely think. I tell them 5, but later I realize it was more I just couldn't really know what so say. They must have noticed the tears and grimace of pain because they brought me an Oxycodone. 

It took a little while to kick in but eventually I started to feel better. I still felt very weak and very tired but I also really wanted to go home. Eventually I felt like I was in a place to sit up and try. They helped me get dressed and into my special bra. I had one from my previous lumpectomy, but I wanted a better one this time and more of them because I have to wear it 24/7 for 2 weeks so I bought 5 really nice ones. It's a tight fitting sports bra that zips in front. The recovery nurse said, "Oh, that's a good one!"

Roger brought the car up and the nurse wheeled me out. I thanked her and told her how much I appreciated all the nurses. She thanked me for that and said she would pass along my thanks. Roger got me home and into bed with an ice pack. I had some crackers, oranges, and 7-Up to get a little something into my stomach while the kitties, sensing a need for some furry nursing, settled in to help me feel better as I rested.  

The Oxy made me feel really weird and emotional. Not necessarily bad emotional, but I kept crying. Not like sobbing, just weird tears leaking out of my eyes repeatedly. I'd think, "oh, I have the most wonderful friends," every time someone would check in on me and I'd start crying. Then Roger would come in and I'd go, "oh, you are best partner I could hope for. I don't know what I'd do without you!" and cry some more. I was a wreck and it was weird. 

At 6 PM I took a Tramadol. An hour early. Oops. I lived. I ate some soup that my wonderful friend Lindsey had dropped off the day before and it was absolutely what I needed in that moment. I also have a giant Doordash gift card on deck if we need it this week that was sent by my friends. Weepy Oxy emotions aside, I really do have amazing friends and an amazing husband.

The rest of the evening passed in a 20 minutes ice/20 minutes no ice haze dozing off and on. I couldn't really concentrate on anything like a book or Netflix so I listened to Rachmaninoff's Vespers conducted by Robert Shaw to pass some time. If you've never listened to it, I highly recommend it. It's just masterful and Robert Shaw was an absolute legend. Fun fact: when Robert Shaw began conducting in 1941 he insisted that all his choirs be integrated.

I got ready for bed, but while brushing my teeth I felt dizzy and suddenly hot and extremely nauseated and had to immediately get back in bed. I had Roger get out the Zofran in case I needed it but I didn't. Well, abbreviated tooth brushing it would have to be. But once in bed, I had a hard time sleeping and felt like I kept waking up and was having a hard time getting comfortable. I wanted to sleep on my right side but couldn't. At one point in the night I got up to use the bathroom (Did I mention I'm peeing bright green from that blue dye?) and got dizzy and hot and nauseated again. I did take a Zofran that time. 

When it was time for my next pain pill (this time at the right time), I woke up and ate some crackers and took another Tramadol. The pain was manageable but I wanted to stay on top of it. I also decided I would switch only to Tylenol after that because the Tramadol was making me feel crappy.

It's the next day and I'm still icing 20 min on/20 min off, though I did stop for an hour to take an actual nap this morning. Tylenol is working for the pain. My breast is looking ok with some normal swelling and bruising. I have two incisions, one on the top of my breast that's a little over an inch long and one just forward of my armpit that's just under an inch. I'll be able to take a shower in a few hours and I think that will feel good.

Before the surgery I asked my surgeon about returning to activity. She said my activity level will be as I feel. I asked her if I could start going for a walk in a couple of days and she said, "oh, I absolutely encourage that." She said I could return to the bike or other low impact exercise whenever I feel like it. She basically said, "if it hurts, don't do it." Her NP had told me nothing over 10 lbs for 6 weeks and I asked her about that. She waved that away with her hand and said, "you're different. That's for people who aren't fit like you. Just don't do it if it hurts and that's it." Tomorrow I'll try going for a walk and we'll start there.

I meet with my surgeon for a followup in two weeks and also with the medical oncologist. Then I will also meet with the radiation oncologist to begin my radiation treatments which will be 5 days/week for 3-4 weeks. Then I will be done with this nonsense, assuming everything comes back the way we hope on the pathology report for the tumor and the lymph nodes she removed. But the hardest part is over with and I'm glad it went smoothly and I can focus on healing now.