The Lumpectomy

26 Aug

The Breast Blog #13

August 24 and 25, 2011

Truth time.

So the truth is, in spite of all my loving and supportive friends, I am feeling a bit lonely.  The truth is that even though I “need” to worry about income, I don’t have a lot of energy for anything that “mundane” at the moment.  The truth is I feel a bit sad when I look at the scars on my breasts.  I know I’m lucky that I still have them.  And I still feel a bit sad.

The truth is I’m sleeping a lot.  The truth is I’m watching more movies than usual.  The truth is I’m “tuning out” a lot.  I find I don’t want to talk very much and I’m finding it increasingly hard to listen.  I’m sure all this will pass, but it’s where I am at this time.

The truth is I hate wearing a sports bra 24 hours a day.  I know I need the support while I’m healing (and yes, I caught the double meaning of those words as I wrote them) but I don’t like feeling continuously smushed.  (I am rebelling right now.  I’m giving my breasts a literal breather for a few minutes.)

The truth is I’ve been eating a vegetarian diet since my diagnosis, and generally I’ve been feeling better as a result of that change.  And boy, some ice cream would taste good about now!!! (Maybe I’ll get some Tofutti.  I need to do another shopping trip.)

The truth is I’m worried that my left nipple area is warm to the touch.  It could mean it’s “only” an infection or that it’s healing from the surgery.  But I thought I noticed warmth there before the surgery.  (My lover confirmed it.)  What does this mean?  I must remember to mention it to the doctor.  (Oh dear.  I just looked it up and found this: “A breast that always feels warm, sometimes hot to the touch is a symptom of inflammatory breast cancer, a dangerous and rare type of the disease.”) http://cancer.about.com/od/breastcancer/p/6symptoms.htm

The bad news is that inflammatory breast cancer is aggressive.  The good news is that I don’t seem to have any of the other symptoms.  I think I will choose not to do too much more research on it at the moment as it will just cause worry.  Tomorrow the results from the biopsy should be in and I can find out what’s going on for real.

Okay.  I am going to change gears now.  I want to tell you about the surgery so that I can document the process.  If I don’t write this stuff down, I’ll forget it.  And you won’t learn anything.   (I want to warn you that this may be a more boring entry than usual.  My heart’s not really into it, but I’m doing it anyway.)

Monday was the day I had bilateral surgery.  For those who are late to the party: a lumpectomy was performed on my right breast and an excisional biopsy of a dilated milk duct and small nodule was performed on my left breast.

A dear friend drove me to the hospital and sat with me as I got my first ever IV.  The nurses and technicians I met before the surgery were all great.  My surgeon came in to give me a hug and answer a few questions.  (Where would the incision be?  How long would it be?  Would I have a drain?  Will they know anything right then and if so, will they do any more aggressive removing of tissue while I’m under anesthesia?)  (Answers: Right breast – incision curved and kind of near the armpit – two to three inches long.  Left breast – incision along the edge of the areola.  No drain.  No, they won’t know anything until pathology examines the tissue samples.  We’ll have results in about four days.  And no, I had already signed a form saying I was not agreeing to a mastectomy at this time.)

As I was being wheeled on a stretcher to the OR, my doctor came to help guide us down the hall.  She introduced me to the OR nurses.  When I was in place, she guided me in a visualization of somewhere I wanted to be (I chose St. John’s) and then did some Reiki on me.  (Wish all doctors did this.)  Then the anesthesia was administered.

The next thing I remember is being extremely disoriented.  I was waking up and I couldn’t figure out where I was.  It felt surreal.  (It was very much like coming to after the first and only time I ever fainted, after a small motorcycle spill.)  The nurse who came to me at that point was very nice and attentive.  After a few short minutes, I was taken from the recovery room to the room I had been in originally.

Apparently I’d been in the OR for about two hours and in the recovery room for about two hours.

To be honest, from this point on, I felt disappointed in the care.  I felt like they were rushing to get me out of there.  I didn’t feel ready.  I was still feeling very groggy and tired.  The nurse assigned to me at this point was definitely not as compassionate or attentive as the others had been.  She gave me discharge instructions while I was not yet very alert.  I was brought something to drink and some crackers.  I had NO interest in eating.

Because the anesthesiologist had told me prior to surgery that I could get pain meds afterwards and that I shouldn’t hesitate if I felt the need, I did realize I was in discomfort and I asked.  (I had not been asked about my level of pain by the nurse.)  The surgeon had prescribed Dilaudid, and so I was given my first ever heavy-duty drug.  (I don’t take any prescription medicines.  I usually stay away from them.)

The nurse removed my IV and I was told to get dressed.  My friend returned to sit with me.  Shortly thereafter he was instructed to go get the car.  Right about when they brought me a wheelchair so I could be discharged, I developed extreme shivering and chattering of the teeth.  I asked if this was normal and was told it was probably a side effect of the anesthesia.  It was alarming to me, but no one else seemed concerned.

Before being wheeled to the car I said I better go to the restroom, as it was at least a 45-minute drive to my house.  The nurse pointed the restroom out to me but did not accompany me.  I thought that was unwise on their part.  I did not feel that steady on my feet.  They needed to wheel me out but could not take the time to be sure I could walk safely before sending me off to the bathroom?  I thought they were nuts.  I was disappointed in them.

I returned to the wheelchair.  My teeth continued to chatter all the way down to the car and for the next several minutes.  On the drive home, my friend was alarmed by how cold I felt.  It sure would have been nice to have someone be a bit more reassuring.  It sure would have been nice to have someone say, ‘This is perfectly normal.  It will pass.  You don’t have to worry.’  It would have been nice to have someone say, ‘If you have any questions or concerns, please call.  Don’t forget to take it easy and rest well.  Best wishes to you.’

I slept in the car.  We stopped at a drug store to get more pain meds, an expense I neglected to anticipate.  Fortunately there is a generic substitute – hydromorphone.  By 4:00 I was home and went immediately to bed and fell immediately to sleep.  By about 6pm, I was awake enough to very briefly and groggily call my parents and one other friend.  I took another dose of the medication, applied ice packs and fell back asleep for another three hours or so.  I realized my sister had called and I briefly called her to tell her my status.  Then I slept for the rest of the night – zonked out, only waking to go to the bathroom and take my third dose of pain medicine.

I was wearing a surgical bra, which they’d apparently placed on me after the surgery.  It’s a bit like a combo sports bra/corset/straight jacket.  It provides support, but it also like being constantly smushed in multiple directions – not as bad as a mammogram, but definitely not pleasant.  It was NOT comfortable to wear while lying in bed.  If I hadn’t had the hydromorphone, I would have been much more uncomfortable.  But that drug basically knocked me out.  As soon as I would lie back on the bed, I would be in another zone.

By 9:00 the next morning, I felt really good.  I was surprised how good I felt.  It is miraculous how much rest can help!  I’m sure the ice packs helped as well.  I was still uncomfortable, but I wasn’t in serious pain.   It also really helped to have a companion with me, to have someone caring in such a tangible physical way. It was also a good distraction.

I spent the next day sitting outside on a rocker, drinking fluids (including pineapple juice, which has bromelain and works to reduce swelling), making a couple calls when I felt like it, napping (taking one more dose of medication), icing my breasts, and – because it was such a stunning day, lying outside on a blanket under the trees.  It was a wonderful day, actually.  By 4:00, I was ready for my first meal.  We made a wonderful salad – with lots of veggies, hard-boiled free range eggs, and toasted almonds, and I had some leftover fried zucchini sticks.  (Yeah, I know that wasn’t the healthiest of choices, but at least it was vegetarian.)

I do feel better each day, physically, and I am also definitely feeling a bit withdrawn and lackluster.  I could probably use some more distraction.  Does anyone want to take me out to a movie or for lunch or something???

And there you have it.  You are now officially updated.  Tomorrow hopefully I will hear from the doctor.  I will keep you posted.

May you be blessed.

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