Surgery Details

I am having a GREAT week!  Getting a lot of things crossed off my pre-surgery list, visits with some family & friends, quality time (Christmas shopping) with my husband, and snuggling with the kids.  Tonight, we will put up our Christmas decorations.  I LOVE this tradition with my family.  We turn on the Christmas music and put out the decorations.   Then we will put on our jammies and have hot chocolate and popcorn while we snuggle up with a Christmas movie and a warm fire.  I CAN NOT WAIT!

My last update was full of different emotions.  As the week went on, I noticed a growing sense of comfort and peace about what is about to happen.  I know it’s because I have so many people praying for me.  So, THANK YOU!  I can guarantee I’ll be nervous come Sunday night, but for now, I am doing ok.

Here’s the run-down of what is about to happen.  If you don’t care about details, I’ll stop you here and say THANKS for the prayers and support.  Keep them coming!  I’ve said it before, that some day I hope all of this is a distant, blurry memory.  So, I’m going to put it in writing so I don’t forget.  And anyone else who wants to know the ins and outs will have the details too!

Monday, Nobember 25
6:00 am: Arrive at the hospital
7:00 am:  Sentinel Node Biopsy Dye Injection
I will be having a sentinel node biopsy on my right (cancer) side.  A sentinel what?  We all have normal fluids that drain from the breast tissue to the lymph nodes.  Our lymph nodes collect the waste that our body does not need and sends it out via the kidneys.  The reason for this test is to see if any of the cancer decided to spread out from the breast area and hop on the lymph node train.  The sentinel nodes are the first lymph nodes that receive the drainage.

I will be injected with a radioactive dye.  I’ve heard straight from the nurse that this hurts.  At least I’m prepared.  They did not say specifically where this is injected and I didn’t think to ask on that teaching day.  But, in talking with one of my BC Sistas, I learned that her injection went right in through the nipple.  Ouch!  The dye will collect in the breast area.  This is the pain the nurse warned me about.  She said that the breast area is full and there is no room for excess liquid.  And since there will be excess liquid, expect discomfort for about 5 minutes until is starts to move.

After the 5ish minutes, the radioactive dye will follow the path to the lymph nodes that my breast uses to drain.  Once it reaches the lymph nodes (the first ones aka sentinel nodes) they will begin to “light up.”  When the team is satisfied that I am “lit up” well, probably after an hour or so, I will move on and wait for anesthesia.

Anesthesia will consist of first, what has been referred to as both a “nerve blocker” or “walking epidural.”  It’s like an epidural we all know and love for childbirth, but it only numbs the chest area.  This is supposed to minimize pain after surgery, and allow less pain medication to be needed.  I believe I will also have a bladder catheder.  And, then of course, general anesthesia for the actual surgery.

10:00 Surgery should be a total of about 4ish hours.
First up is the sentinel node biopsy.  Remember that dye from earlier in the morning? My sentinel nodes are now “lit up” and my surgeon will be able to track the path of my lymph nodes.  She will remove the very first one and send it to the lab.  They will be testing it for cancer.  If it comes back free and clear of cancer (meaning, no cancer migrated out of my breast) they stop removing lymph nodes.  This is what we are praying for!  As my bestie Leah said we are praying for “one and done.”  If the lab results indicate that there is cancer found in that lymph node, my surgeon will then remove the next one.  Repeat test.  If clear, stop.  Cancer cells = keep going.  And so this continues until they come upon a clean node.  Worst case scenario is that all lymph nodes are removed.  This happens to women.  I’m confident that I will be a “one and done.”

Mastectomies on both breasts.  My surgeon will remove as much breast tissue as she possibly can from both breasts.  There is really no way to get it all.  There will always be some remaining tissue/cells.  She will have one of the other surgeons on her team helping to reduce the surgery time.

Initial Reconstruction will happen immediately after the mastectomies.  My plastic surgeon will come in to finish the job and do his magic.  He will insert tissue expanders which serve as temporary implants to stretch my skin.  I’m calling them “boobie balloons” that get filled up a little at a time over the next several weeks.  He said they will be 30-40% full when I wake up.  Surprise!  I had no idea I would be a little full.  My scar will be straight across the middle of each breast.  No more nipples.  I’ve seen pictures.  It is an adjustment to see a breast without nipples.  But, those can be tattooed on with final reconstruction.

Also, I will wake up with 4-5 drains.  I am praying for 4.  5 drains means they took all (or a majority) of my lymph nodes.  These drains are thin tubes with a small bulb at the bottom that will be hanging off the left and right sides of my upper chest area.  I’m not exactly sure where they are placed yet.  Fluid that needs to drain post-surgery will flow out the tubes and collect in the bulbs, which look like hand grenades.  The fluid will be emptied and measured several times per day.  Once I am released, we will have to empty and measure at home.  I will get further instructions at the hospital, but the drains stay in place until the fluid levels decrease to a certain measurement.  The first of the drains could come out as early as a week later.  The last drain will most likely be in place for 3-4 weeks.

I was given an ultra attractive camisol (which really looks like a vest) that has pockets inside to hold those grenades so they’re not in the way of anything.  I also have a lanyard that I can use to keep the drains out of the way when I shower.  Button down/zip up shirts will be my new wardrobe for the next several weeks as I am not allowed to lift my arms above shoulder level.

No lifting anything heavier than 8 pounds for the next month.

Other than that, I’m not sure what more to expect.  I’m probably forgetting something or maybe even have something wrong.  The nurse did say that people usually remember 40% of what they learn at the teaching appointments.  I do know that I will be sore, probably in a fog from pain medication, and tired.  I plan to use my hospital stay to rest, do mindless things, and follow directions so I can be back to normal asap.

But this weekend, I will enjoy being my regular self.  We have decorations to put up, Ella’s basketball games to watch, Ella and Abby’s dance recital to attend, church, and lots of family time.  With grateful hearts, we will rejoice in all our blessings.