The Day of Surgery

The Day Before

Last Thursday, I prepped for surgery the next day. I went to the gym and had a good workout, my last for a while. I wanted to feel as strong and positive as possible going into surgery, and I knew that working out would help me sleep well the night before. 

That afternoon, I had an appointment at the hospital to have an injection of tracer dye that would help guide the the biopsy of my lymph nodes so that as few needed to be removed as possible. I thought fresh flowers in the hospital bathroom was a sweet thing. 

We had a quiet evening with a surprise visit from a friend and some good food. I made a smoothie for myself at bedtime to get in the last little bit of nutrition before I had to stop eating. 

The Morning Of

As Dave said, the hardest part of the whole thing would be getting me to the hospital bright and early the morning of the surgery. My mastectomy would be done as a day surgery which necessitated an early start. I was due to get there at 6:15 and we almost made it - I arrived at 6:20. I even had a little time to drink black coffee, which is now on the approved list of "clear liquids" allowed before surgery. And this guy got up early to see me off and give me one last hug before we left. 

When we first arrived at the pre-op area, it was relatively quiet and there was a little delay as the nurse waited for her computer to warm up. As soon as 7:00 hit, the noise level went up considerably as the rest of the surgical staff arrived. I had visits from my two surgeons - Dr. Nguyen, the breast surgeon, just walked up and gave me a hug. I chatted a little with Dr. Tomcyck, the plastic surgeon handling the reconstruction. We discussed my sensitivity to adhesive and plans to use an alternative dressing. Then the anesthesia team introduced themselves. At this point, things began moving quickly, and I don't remember much more after about 7:20. They gave me an anti-nausea patch and placed my IV. They began the IV drip, suggested that Dave say goodbye, and turned me over to administer a nerve block for my upper torso. The gentle pressure on my back is the last thing I remember until waking up in the recovery area later that afternoon. 

Throughout the morning, I felt upbeat - I was glad to get to this step and get it behind me. So many questions would be answered and clarified through the process of surgery, and I could begin getting used to post-mastectomy life. I also felt supported and confident in all the medical team I worked with that morning. 

The Evening After

Surgery was longer than planned. Instead of 3 to 4 hours, it took about 7 hours. I believe that I was in the recovery room from about 4pm to 5pm, before being transferred to the post-op area where Dave was able to join me. He explained that the dye injected the day before did not travel to my lymph nodes as intended, and Dr. Nguyen attempted to do the procedure again during surgery, which also did not work. As a result, I had to have a group of lymph nodes removed, rather than one node at a time.

As I came out of anesthesia, the sensation I remember most is incredibly dry mouth. I drank some apple juice. I tried to choke down some very well done toast which did not work well. One of the last things my first post-op nurse did before the end of her shift was to make me better toast. 

At that point, I was the last patient in post-op and my care was transferred to the last nurse on duty, just waiting until I was ready to walk out of there. My main task was to walk to the bathroom and back, which I did but which caused me to get dizzy, nauseous, and tired. I lied back down for a while before I felt well enough to get dressed and get into the wheelchair to go home. I think that discharge home the same day after a mastectomy is a relatively new thing, but I am pretty sure that I was way more comfortable and well rested being at home than being in the hospital where I would be checked and disturbed frequently. 

The ride home was uneventful and I walked into the house and took over the recliner in the living room. My pain was very under control - the most pain I experienced was when I tried to open the Tylenol bottle, which I did not attempt again for a while. The nerve block did not wear off until later at night. I told Dave that I thought I swelling up, but it turned out to just be my sudden ability to feel the rolls of gauze supporting my dressing.     

Although I had these wings of gauze under my arms and four drains collecting fluid hanging at my hips, it was startling to see my new more streamlined form in the mirror for the first time. Clearly, my body is incredibly sensitive to the effects of hormones, and  underwent significant changes with my two pregnancies. I am working to hold on to the appreciation I have for this part of my body which was able to feed my babies so well while also accepting that it was the same sensitivity, activity, and growth which (in my mind, even if scientifically hazy) led to cancer. There are a surprising number of ways my life changed after having children just because of my breasts. One of the outcomes of having a mastectomy is a normalization of some of those things - making it easier to get dressed and feeling more comfortable. It is another way in which I always anticipated this happening at some point in my life, though I could not have predicted exactly when or how.