Month: May 2020

I went in the Monday after surgery to get the drain removed. That was a pretty easy procedure. The nurse told me about how it was going to hurt for 30 to 60 seconds as/after she pulled it out. She removed stitches (which didn’t hurt) and then yanked the drain out. It was a little uncomfortable for like 2 seconds, but I wouldn’t call it painful. Super easy, and then I didn’t need a fucking drain anymore.

She said that the plastic surgeon was there and wanted to see me. So he came in and told me that the margins on the skin side were positive. I already knew coming out of the surgery that the tumor was super close to the skin, and the skin there was super thin because of it, so this wasn’t exactly a surprise, but I would have to come in for another procedure to cut out that little circle of skin. This would mean that I would have less skin, and my tissue expander would have to be slightly deflated, then re-expanded in a couple of stages.

Lameness! but manageable. The surgeon said this was better than having the positive margin be the other way, toward the chest wall.

This would be a way less involved procedure than the original mastectomy – just a sedation (like you would get with a colonoscopy) and local anesthetic. It was scheduled for the following Friday, 5/15, and the plastic surgeon said he would do it.

That was also a super quick procedure. Check-in time was 6:00 a.m. again, but I didn’t have to go to Radiology first – it was just straight to the pre-op station, change into hospital gown, get in the hospital bed, get the IV. I also talked to the anesthesiologist – the same one from before, Dr. Mc-Something, and had vitals taken, made sure I hadn’t eaten since the night before, and got some pre-op meds. Then I was wheeled into the OR, scootched onto the operating bed (it was a little harder this time since my chest was sore), and went right out.

I do remember waking up and hearing them talking in the room, and I said a few inane things – someone said they had 5-year-old twin sons, and I made some inane comment about that – and then it was right back to recovery. I hung out there for a while – they gave me jello and water – and then I felt fine enough to go out. The nurse walked me out to The Mighty Sam in the waiting area, and we headed home. The whole thing only took a couple hours, and I got a new post-op bra.

The pain after was minimal. I didn’t need any oxycodone at all and only took Celebrex for a few days.

I had a follow up phone visit with the plastic surgeon on Wednesday, in which I told him how well I was doing and he explained how the skin removal would affect how we approached the reconstruction process.

And I felt really good all last week. Better and better each day. If I had had to figure out on my own when I was well enough to go back to work I probably would have said last week. As it is I definitely felt well enough to go back on my scheduled day, the day after Memorial Day… today!

Surgery day was May 5. That’s now 12 days ago. I couldn’t take notes during the process so let me see what I can remember:

Check in time was 6:00 am. I got up at 3:30 so I could have a cup of black coffee finished before my liquid cut-off time.

We drove in and got checked in at Anesthesiology. I had some paperwork to fill out and I got called back pretty promptly. I brought my hospital bag and cell phone with me. I was able to send some text messages over the prep period, which was pretty extensive.

Sam waited in the waiting area, which looks like this:

They have a monitor that shows family members where you are in the process, and a color code for each stage.

Recovery would be in two stages. If I got to Recovery 2, i would get to go home that day!

The Mighty Sam was mostly by himself in the waiting area – there were only a couple of surgeries besides mine.

First I got to a little pre-op bed and got some hospital clothes to change into. Hospital gown, hospital socks, and a hospital cap thing. I had been worried about my now super-long disgusting hair but it worked fine – I had it in a ponytail scrunchy and the whole mess went into the cap. They also put me in a bed with a warm comfy blanket thing that they were pumping hot air into. They said that studies show that keeping operative patients warm leads to better outcomes. I was definitely warm and cozy the whole time.

They took some vitals. I then talked to the anesthesiologist, a Dr. Mc-something. He just explained about the procedure, how the anesthesia works and how I’d be monitored, and what to expect afterward, along with the measures they would take to make me comfortable, including anti-nausea medication. He asked if I wanted a scopolamine patch for nausea and I said YES. I got that, and you can leave it on for three days, and so I did leave it on for 3 days.

I was really thirsty. There was a lot of just lying around waiting. I also got some pre-op meds – if I recall correctly it was gabapentin, an anti-nausea medication, and celebrex. I also got to take it with water, which was deliciously refreshing.

At 8:00 i went to Radiology – a radiology nurse wheeled me up there. That was weird because I was totally capable of walking at that point. In Radiology I underwent a couple of procedures: One was a wire inserted into the benign mass on the left side, which took a while and was kind of uncomfortable – it involved a mammogram, then local anesthetic, then the insertion, then a couple more mammograms to check the position. The radiologist is really good (she was the one who did my MRI biopsy). Then I had the injection of a radioactive isotope so they could identify the sentinel node on the right side. That also involved a local anesthetic, but only took a few minutes total.

After that I was wheeled back to pre-op and got my IV. I was ready. The plastic surgeon came in to talk to me and made a few marks on me.

They wheeled my pre-op bed into the OR. They put a tag on my glasses case and said they would give them to me in recovery so I would be able to see. I got wheeled right next to the surgery bed and scootched myself over. That is a very, very narrow bed. They gave me a little oxygen to breathe and said they were setting up my IV. I drifted off very soon after that.

I remember my stomach feeling sore when I woke up. Also I was wearing my glasses. I heard the nurses talking to me. They had put me in a special support bra before i woke up.

At some point I was in a new recovery area, and they called Sam in. An anesthesiologist (not Dr. Mc-something, another one) came in to chat with us. I remember he said I had been fantastic under anesthesia and that everything had gone really well. They helped me get dressed but I don’t remember that very well.

After a while it was time to go home! i got wheeled to the Urgent Care exit and Sam ran off to get the car. I was able to get into the car ok and the drive home was uneventful. Sam kept warning me as he drove over bumpy spots. I remember that being a little uncomfortable but not too bad.

I slept pretty well that night. I took a few oxycodones on the two days after, but by the third day I didn’t need it.

I also had to deal with a drain. They showed me how to measure and empty it at my pre-op appointment. It was definitely a weird thing, to have this plastic tube hanging out of you. The post-op surgery bra they put me in was pretty sweet though – it has these rings that you can attach the drain collector thing to, so it doesn’t pull. You need to empty it either 3x per day, or when the collector is 1/3 full. You have to squeeze the fluid out of the tube and into the collector bulb, then empty the bulb into a measuring cup, and then track how many cc’s you collected. You can have the drain out when you have 2 days in a row with less than 30 ccs.

Recovering from full mastectomy with adequate pain management is definitely nowhere near as bad as having a migraine. I had Celebrex and Tylenol for most of the pain management. Anti-nausea medication when I needed that (did not need it after the 2nd day, since I wasn’t taking Oxy anymore).

My next appointment was just with the nurse to remove the drain. I will write more about that later.

I had my pre-op appointment on Wednesday morning. I met with the plastic surgeon, a medical assistant, a surgery nurse, and an anesthesia nurse or PA.

Plastic surgeon: did another exam, then talked about the procedure, risks, benefits, followups. Talked about the prescriptions I’ll be getting. Some other stuff. It will be a temporary implant – a “tissue expander” – which will be replaced after several weeks with a permanent implant, provided everything goes well. he also puts an ‘alloderm sling’ which is a tissue material that helps hold the implant in place. This will eventually dissolve.

Some of the stuff I will have to do after surgery:

• Sleep at a 30 degree incline. I will have to make myself an inclined bed spot. I found a bunch of extra pillows in one of the closets so I can use those. I know we have some extra pillowcases lying around too.
• I will have drains. I got trained on how to measure and empty them. When I produce less than 30 cc’s of fluid for two days in a row, I can go in to have them taken out. I already have an appointment for that but if that happens earlier I can go in earlier.
• I won’t be able to lift over 10 pounds for two weeks. I need to weigh all the things i pick up regularly to make sure I don’t mess that one up. i know for sure that Demi and all the cats weigh more than 10 pounds each.
• My expected medical leave is 3 weeks. That will have me back at work the day after Memorial Day.

I wil also have to do several things before surgery. Some of the interesting ones:

• Call the surgery center the day before to get my exact check-in time. I’m expecting it to be crazy early but we’ll see.
• Get a COVID-19 test. I did that Friday morning and got the results last night: Negative!
• They gave me a list of stuff to bring so I’ll need to pack that. I don’t know how that stuff is going to be managed – do they put it in a room? does The Mighty Sam hang on to it? I am particularly concerned about my glasses. I am not supposed to wear contacts and I am not going to be able to see anything without the glasses.
• Also I’ve got to do a fuckton of showers before I go. Shower the night before, and then wipe myself with these sterile wipes. Then sleep on clean sheets. Then another shower the morning of, and another wipe down.
• Dress in clean loose clothes. Shirt should be a button-down. I realized I don’t have any loose button-down shirts. I tried to find some online but couldn’t find anything that would be delivered in time for surgery so I decided I would just have to wear one of Sam’s shirts.

What to expect on the day of surgery:

• Check in at the surgery center. Pre-op prep will probably take an hour – they have to do a thing where they set me up to figure out where my “sentinel nodes” are, and set up my IV. I will have these removed on both sides, since they are also doing an excision biopsy on the left (even though that biopsy came back negative).
• Surgery itself: The general surgeon goes in first and does the mastectomy, the excision biopsy, and the removal of sentinel nodes. Then the plastic surgeon comes in and puts in the tissue expander and the alloderm sling. Total time: expected to be about 5.5 hours.
• They said they have a reader board out the family waiting area so The Mighty Sam will be able to see where I am in the process. I told him it was like a flight tracker! he shook his head in exasperation because I am so annoying!
• After surgery I’ll have recovery in two stages. They said they would put me into a “support garment” right away. That will be a special bra with a velcro front closure. I’m supposed to keep that on for 48 hours. Recovery is supposed to be a couple of hours.
• It seems possible that they might actually send me home that same day. But they said that would likely be a game time decision, depending on how well I’m doing.

I picked up several prescriptions: Pain meds, anti-nausea meds, antibiotics.

I am a little nervous about the surgery, since I’ve never had surgery before. Everyone seemed to be sure that I would be a good candidate for surgery and recovery, so that’s at least good. And I need it. it’s not like this is optional in any way.

I’ve also prepared a list of chores that The Mighty Sam will need to do while I am not able to. Since I can’t lift anything for a while he’s going to have to take full responsibility for taking the dog out for her bathroom breaks – she needs help up the stairs now and I won’t be able to do that. And i won’t be able to lift baskets of laundry.

But I’m NOT supposed to hang around in bed all day. I’m supposed to start walking around right away.

I’m kind of thinking that I will just queue up a bunch of podcasts for my recovery entertainment. That way I won’t have to worry about being able to read. But I’ll have lots of books available too. Who knows what I’ll feel like doing? This is brand new for me.

I am kind of thinking that having migraines might be helpful in dealing with this: I know what it’s like to have horrible nausea and excruciating pain while lying around doing nothing all day. Except with this, I’ll have anti-nausea meds and pain meds! Medical technology can be amazing.