Monday, February 20, 2012

The Kindest Cut - Life-Saving Breast Surgery!

As always whenever a major event takes place in my life I tend to document it in journal form.   Heading into breast cancer surgery, I thought, would surely quality as such an event so, pen at the ready, I jotted down every detail recounting my actions, thoughts and fears, before and after my operation.

Below is the edited version of accounts from the Tuesday afternoon through to the Friday afternoon when I was discharged.  Luckily I wrote down the facts because even at this early stage, a lot of the details have evaporated from my memory.  On a physical level this has not been one of my bigger operations but from an emotional point of view it has been the most overwhelming. So glad it's in the past now.

Tuesday, 17th January 2012:
"At around 2.00pm arrived with hubby at St. James’s Hospital, admissions department. After the usual registration and consent forms were all filled in (totally computerised!) we headed up to the ward.

Fourteen years ago I was in the ward directly overhead (total abdominal hysterectomy) with my bed next to the window on the left hand side of the door.  This time my bed was inside the door, still on the left hand side. As the wards are mirror images of each other it was a very strange, almost unsettling sense of having never left the place! Shortly after I settled in hubby left as he would be visiting later.

Two young nurses, both in their early training, went through my admittal procedure, one taking my medical history, the other, along with doing my observations, took an MRSA swab which is now seemingly routine.

At 5.15pm a young doctor, one of my breast surgeon's team took bloods through the canuala he’d inserted in my left arm (painlessly I might add!), checked my chest and lungs and did an ECG.  I was fine on all counts. He then gave me a Biobank Consent Form to read which outlined the work of the Biobank.  It collects samples of cancer tissue which will be used for research into the disease, its causes, treatments and hopefully its cure. Consenting is totally on a voluntary basis.  As I felt, rather than have my tissue ending up in the bin, I’d rather have it put to good use in the search for a cure so I had no problem handing over my bits of cancerous blubber!

With half an hour to go before the start of evening visiting hubby managed to get in.  We headed downstairs to the cafĂ© where we both had coffee and I had chocolate fudge (for the past couple of months I’ve been able to eat sweet stuff without any ill effects).  We talked about anything and everything including my fear of tomorrow’s sentinel lymph node biopsy.  Afterwards we walked up and down long corridors, one of which was in semi-darkness, very creepy indeed, perfect for a hospital horror story!  Just before 8.00pm we walked back to the ward then at around 8.40pm I walked hubby out to the corridor and just as I was saying goodnight, our youngest son texted so I rang him back.  Lovely chat.

Over the course of the remaining evening doctors from all my departments involved in my surgery arrived in, some taking more blood.  At around 11.00pm settled down for the night.  Owing to the constant coming and going of doctors to myself and the other patients who were also scheduled for surgery I managed to get about three hours sleep.

Wednesday, 18th January 2012
Just as I’d succeeded in slipping into a light doze I was woken at 7.15am for my obs.  Told I would be going down to theatre at around 10.00am.  As there was no lovely smell of toast coming from the kitchen I was spared the agony of hunger pains.  Usually it is absolute torture when the other patients are sitting up having their fries and you have to starve, now even that seems to be done away with!

The young lady in the bed opposite went down for her op at 8.30am and a few minutes afterwards I was started on my infusion of platelets which would run in over half an hour.  At around 9.00am, the woman in the bed next to me was next to go.  Now it was just me and the elderly lady in the corner bed opposite, she slept while I agonized over the pain I would be going through having the radioactive dye inserted into my breast!

At around 9.20am a radiographer arrived in to take me along to have the radioactive dye injected into my boob for the surgeon to see which lymph nodes needed to be removed.  It was a long walk to the radiology department so we had plenty of time to discuss the procedure.  I was scared shitless.

A lovely radiologist did her best to put me at ease but by the time I was lying on the examining table with her holding the first of the three radioactive injections over my breast, I was in tears.  I asked if she could put the numbing cream on and she said they didn’t do it, too late now anyway!  Aware that there were people sitting just outside at a clinic I tried my best not to shout out, instead I bit my lip and screamed silently, tears streaming.  Just then my breast surgeon came in, saw me crying and sympathetically agreed it was painful.  The last injection was probably the easiest in the sense that I was by now in a state of shock from the previous pain.  That over, I was then taken to have my right breast mammogrammed.  Nothing could be as painful as what I’d been through so onward I went like the proverbial lamb to the slaughter.

Mammogram over, I was now taken to have the wire localization thing done in yet another room. Even though my tumour was palpable this procedure was done to show the surgeon exactly its precise location.

At this point I have to say how delightful all the Radiology Department staff were in making me feel reassured and comfortable as best they could.

After I’d popped up on the table a rather beautiful dark-haired radiologist arrived in and proceeded to explain everything in minute detail, not sure though whether I really wanted that level of preciseness!

First thing was an ultrasound to again check the tumour size then the injection of the fast-acting local anaesthetic into the area close to the tumour, which of course I was dreading, but compared to the earlier torture this was a cinch. 

As with the biopsy on 14th December, I began humming and singing up and down the scales as the radiologist began to insert the fine wire into my breast lump. This was again to block out any pain that I might feel during the procedure but I needn’t have worried, it was all over before I knew it.  After the wire was taped into place I then began the long walk back, with the nice radiographer, to my ward.

The room was so quiet with the two ladies already gone to theatre and the sleeping lady still sleeping.  To take my mind off things I put on the elastic stockings which are used to prevent blood clots but are so uncomfortable, then got into my gown and net knickers. Ready for my close-up Mr. DeMille, I thought – not!

My final anxious moments were spent chatting to a wonderful Italian cleaning lady who talked ninety to the dozen about the recession and how life was better when we were less technically advanced, all this ranting might I add in no way hindering her vigorous mopping!   I wholeheartedly agreed with her on most issues.   Just as we were entering yet another topic my theatre trolley arrived. God be with the days when you were lifted onto the trolley because you were so zonked from the pre-med which they don't seem to give these days, more's the pity!

I’m never quite sure how I feel on these long trips to the theatre, sometimes I think I should give a kind of Royal wave to those who move aside to let my carriage pass through, pretend I’m the Queen herself, or imagine I’m the star of an old Dr. Kildare episode where I’m being whisked at break-neck speed into theatre while the viewer sees only the fluorescent ceiling lights whizzing by, anything to distract from the terrifying thought that I’m actually the condemned prisoner being escorted to the gallows!  

As soon as I was wheeled into the “holding-bay” area I recognised it immediately as the same one I was in back in 1998 when I was having my hysterectomy.   A nice young theatre man went through all my details with me, shortly afterwards I was wheeled into the Anaesthetic Room.   There I continued my sometimes hilarious conversations with this young man as my surgeon was still busy with my room-mate. Soon afterwards the oxygen mask was placed over my face and I was asked to keep my eyes wide open - that was a first!   Less than a minute later I felt the first woozy sensation of the magic potion filtering through my veins, seconds later, darkness.

My memory of the Recovery Room is hazy; wakening up every so often to the sound of a nurse’s voice asking how I was doing, aware of the oxygen mask still in place and hearing the incoherent mutterings of the other patients.   As always I was told my operation went well, wonder if anyone has ever been told otherwise! Best thing of all, no pain, the morphine was doing its job.  I suddenly felt very cold and started to shiver so they put extra blankets over me which lulled me back to sleep.   When I next woke up they were waiting to take me back to the ward, I can’t remember if they’d discontinued the oxygen.

On my arrival on the ward, which was seemingly 4.30pm, hubby was waiting for me. As I was half awake I was able to put together a couple of words which delighted him no end!   I don’t remember him leaving.

My next awakening was not so pleasant, within seconds I felt sick, not enough to make me throw up but bad enough to prevent any further sleep.   At around 7.00pm, hubby came back in accompanied by our youngest son, I was so happy to see them.   As I didn’t do too much talking they chatted between themselves  but I enjoyed just listening in. Unfortunately just before they left I became so nauseated hubby had to get the nurse to bring me a puke bowl.   I have to admit I was happy for them to leave as I didn’t want them seeing me being sick. 

The remainder of my night was spent with doctors examining me and taking more blood and me groaning, not from the op pain, but from the dreadful waves of nausea which continued relentlessly through the long hours with no relief from the numerous anti-nausea medications they were giving me through my drip.   They stopped the morphine and gave me another pain relief drug in pill form which certainly did nothing to help with the sickness.   Had a psychopathic killer come into the ward at that moment I would have begged him to shoot me there and then!  Somewhere towards the early hours I drifted off into a kind of sleep.

Thursday, 19th January 2012
At around 7.00am when the nurse did my obs she found my BP to be very low.   I was still feeling total shit.   Unable even to sip a glass of water I later had to deal with more doctors doing their rounds and taking even more blood then worst of all, the physiotherapist arrives to go through some of the exercises I would be doing for quite a while to come.   Fair play to her she recognised how bad I was feeling and cut short her visit.   Even a nun said she’d call back later.

Miraculously my lovely male nurse hit on an anti-nausea drug that actually worked, I wish I’d gotten its name now.   A couple of hours later I was sitting out on my chair and he removed the painful canuala they had put into the back of my hand in theatre, it was huge!  I already had one further up my arm.

It was just before 2.00pm when hubby called in.   I was feeling a lot better but far from ready to eat anything which was OK as I wasn’t at all hungry.  We had  a good old chat!  Shortly after he left at around 4.00pm one of my doctors announced that, all going well, I could go home tomorrow (sub-text = they needed the bed!). 

At 5.00pm when the tea lady came around I decided to be very brave and ask for just a few dry cream crackers and some boiled water for my herbal tea, after all I needed to provide my body with sustenance if I were to walk out of there the next day!.  She was a bit reluctant at first but eventually gave in.   

By the time the evening tea came around I was ready to have something more substantial than herbal tea so I had a lovely cup of vegetable soup which I knew would be the making of me although the nurse assistant didn’t necessarily agree with me, he didn’t think I was quite ready for it yet.   I proved otherwise.

As I was no longer on strong pain relief, every movement during the night was painful enough to wake me from my light dozing.

Friday, 20th January 2012
My first visitor of the day was a nice phlebotomist who again thought she knew me and I her.  She had a bunch of bloods to take and as usual it was like getting blood from a stone!

As I can’t take dairy my breakfast consisted of dry cornflakes, my rice cakes, marmalade and fennel tea.   It was shear Heaven!

Straight afterwards one of my breast doctors arrived to say I would definitely be going home today, he was very pleased with my healing.  Next to arrive was the other very nice doctor who had one final blood test to do! 

No sooner had he left when what seemed like the whole of the haematology department descended upon me!   They were delighted that the platelets worked preventing any chance of a haemorrhage.  A review appointment was made for July and advice given as to what pain relief I could safely take (none of which I can remember!).

Decided to take some exercise before I headed home so did about four long walks up and down the corridor.   On my way back I met my surgeon who was heading in to see me to remove the support bandage.  I noticed on my return that a couple of my room-mates had been moved over into the private rooms.  Turns out they were freeing up beds on my ward.

One of the young nurses who did my obs when I was admitted helped me with my packing as I was unable to bend down to take stuff from my locker.   We had a good laugh as she helped me get dressed, getting my cardigan on was fun!

This wonderful little nurse then carried my hold-all bag over her shoulder while I just held my hand-bag as we made our way downstairs to the Discharge Lounge.   I was so happy to be homeward bound that I didn’t take much notice of how weak I felt.   The Lounge was exactly as I remembered it back in 2003 when I left after my six day stay following my angiogram.   As soon as the lady in charge walked towards me we both smiled as we remembered each other from that day nine years ago!  She was still as nice and kind as ever.  She explained that the doctor would be a while before he’d be down with my discharge letter but as I decided I didn’t want a prescription for pain relief I told her I’d prefer if he could post it onto my GP.   Now I just had to wait for the breast care nurse to give me final instructions regarding my wound.   Meanwhile, hubby arrived.
After about fifteen minutes the nurse came along and gave me a handful of dressings and told me I could remove the steri-strip stitches on day ten post-op but I could shower when I felt like it while the outer waterproof dressing was still in place.

Hubby and I headed out on the long walk to the underground car-park and by the time I got into the car I was totally exhausted but so glad it was all over.  Arrived home around 1.30pm".

The first week at home was going really well, apart from the interminable under-arm pain and burning sensation, so when I decided on the eleventh day to take a shower and remove both the breast and under-arm steri-strip stitches it didn't go at all according to plan!  Diary extract:-

"At around 4.00pm I decided to take a much-needed shower and remove the two dressings (breast and under arm) and steri-strip stitches.   I got hubby to stay with me as I would need him to help dry me.

I got into the shower, took a while to remove the dressing (breast) and stitches. Washed my hair then began to enjoy the warm water flowing down over my body.   Suddenly I began to feel weak, as if I was going to pass out, then the nausea hit like a thunderbolt.   Sitting on the edge of the shower tray as weak as a kitten I became very distressed as I couldn’t even let hubby begin to dry me because I felt so ill.  He eventually helped me to sit on the loo seat where I began to retch and shouted to him to get me a basin.  I thought I was going to die.  Afterwards, although he didn’t want to leave me I begged him to as I didn’t want him to see me in this state.   It was around fifteen minutes later that I slowly began to feel better.  I can only guess that my weakness was brought about by my blood pressure suddenly dropping, nevertheless, it was one of my scariest experiences!"

I'm now almost five weeks post-op and beginning to feel a lot more back to my old self in the last week.  Over the next couple of days I'm planning a meet-up with friends and a trip to the cinema with hubby, can't wait! Next week, treatment! This week, fun!

Top Image: Radioactive Dye Injection for SLNB via   
Surgery Image: My scars and dressings five days post-op. 


Friday, February 17, 2012

Life Briefly Interrupted - Halfway Towards Recovery!

It feels like a long time since my last post and certainly a lot has happened since then. I've had my breast surgery which was the lumpectomy with wide margin tissue removal and also the sentinel lymph node biopsy (three nodes removed). Two days post-op I was discharged!

At the end of January I returned with hubby to St. James's Hospital, Dublin, for my review with the breast surgeon who gave me the wonderful news that the cancer, Stage 1, Grade 2, had not moved into the lymph nodes, my margins were clear and that I was estrogen-receptor-positive (ER+). He was also satisfied that my wounds were healing nicely. All going well my next visit to him will be in July for a six-month check-up.

A little over a week ago I had two appointments for the same morning. First up was the Medical Oncologist who informed us that a small sample of my tumour was being sent to the States to check which drug treatment I would most benefit from. This is the new Oncotype DX Test which effectively will help the doctor and us decide whether I will be having chemo or hormone therapy or both. Whatever the choice I will still be having the radiation, thirty three lots as opposed to the twenty five first mentioned to kill off any nasty stray blithers! I'm due to see the Medical Oncologist again this time up on the day ward at the end of February. As I've no idea what awaits me, I'm scared all over again.

My next post will be an edited account of those three days in hospital.

Above image: St. James's Hospital, Dublin via