If you've been following my blog, or are a close friend or family member, you know that I had surgery on Monday to remove a cancerous lesion from my breast. One of the things I really like about blogging is that it is, for me, a form of journaling, which is something I've regrettably never had the discipline to do. This blog will serve as a record of my experience with breast cancer, and so, I wanted to write about my experience on Monday, mainly as a way of preserving my memory of the day. If you are squeamish or just grossed out by things involving needles and doctors in white coats (or, in this case, scrubs), do not read on. If you are interested in hearing about what is involved in a lumpectomy and sentinel node biopsy, feel free to proceed. But, by all means, please do not feel compelled to read this post.
Eli and I left the house around 7:40, for an 8:00 arrival at the Breast Center at St. Thomas Hospital. We were actually early, which is unusual for us. This gave me a few extra minutes to sit and fret, although, in actuality, I was surprisingly calm and at peace that morning (more grace from God, I suppose).
The procedure was scheduled to begin at the Breast Center so that the radiologist could insert a wire into my breast to mark "the spot" that the surgeon was to remove. On Oct. 7, I had something called a core biopsy, during which my friend, the radiologist (she really is my friend; I'm not being facetious) removed a portion of the suspicious area. At the conclusion of that procedure, she inserted a small (very small, apparently) metal clip into the area from which the tissue was removed so that they would know where to go if I had to have surgery. Obviously, the biopsy came back showing cancer, so surgery was required.
So, back to the Breast Center. I was called back, and Diane, who has been my radiology tech throughout all of my visits to the Breast Center over the past five weeks, walked me back and joked about how she was hoping to see me outside of the Breast Center one of these days. As it turns out, my friend, the radiologist, was not working that day, and so I had a different doctor, Dr. Earthman. Cool name, huh?
Warning: next part not for the faint of heart.I put on the lovely smock they give you and was taken into the "torture chamber." (Read on; actually it wasn't that bad, but it did look like a torture chamber). I sat in a nice comfortable chair and was rolled up to the mammo machine, where they proceeded to take some films of my breast to see where the clip was. Then the fun began. I had my eyes closed during most of this, but I believe that it was Dr. Earthman who gave me a lidocaine injection, intended, of course, to numb my breast before the insertion of the needle that would go in and through which the wire would be inserted. They said the lidocaine would feel like a bee sting, and I must say that it was milder than that. At this point, I've got my eyes closed, and am holding Diane's hand (God bless that woman!) and about a minute later I could tell that the activity around me had stopped, and I opened my eyes. I asked when the needle was going in and they said that it was already in there! Whew. That wasn't bad at all.
Then, they had to take another "picture" of my breast to ensure that the needle/wire was in the right spot. At this point, we encountered what Diane referred to as a "minor complication." It seems that my little lesion was pretty far back in the breast (lovely, eh?), and that Dr. Earthman needed to "advance the needle." These are not words that one in my position really wants to hear. Advancing the needle, indeed, sounds pretty awful, especially when it comes to ones' breast. I must say, though, that Dr. Earthman took his time studying the pictures and even asked the tech for my old films to compare to make sure that he got the wire in just the right spot. Based on the overall success of the surgery (i.e. clean margins, etc.), I'd say that the extra time that Dr. Earthman took in getting the wire in just the right spot, and even the advancement of the needle, as scary as that sounded, were well worth it!
Finally, that procedure was over, and they taped a small styrofoam coffee cup (no kidding) over the wire sticking out of my breast, and put me in a wheelchair to take me to the OR. Out in the hallway, I was joined by Eli and his parents, who had come down for the surgery from Chicago. Diane pushed me and they walked with me up to the "holding area" (again, very scary sounding -- perhaps someone could work on some of this medical lingo) for the operating room.
In the "holding area," I had my own little bay (Bay 18) where Eli and his Dad and stepmom hung out with me for what seemed like an eternity. I think that I used the bathroom about 8 times in a little over an hour. A nurse in the prep area said that I had a "nervous bladder." She was right.
Finally, my turn was up, and someone came and got me in another wheelchair and took me to the prep area for surgery. There, I was put in a bed, had an IV line put in, and had warm air pumped into my beautiful blue hospital gown (weird, but a very nice touch, I must say). I had some lovely ladies attending to me there, and one very nice and cute nurse anethetist named Derek. My surgeon stopped by (was glad she could make it!) and met my anesthesiologist, Jane Thomas. Dr. Thomas asked me if I'd found a lump, and I said no. Dr. Ballinger then chimed in, and told Dr. Thomas that my cancer was caught very early on routine mammo and that I was going to be "fine." A vote of confidence that I desperately needed at that moment.
So, the best part of this story, other than the outcome of the surgery, involves the prep for the sentinel node biopsy. In addition to having my lesion (or whatever it should be called, seeing as how it was all in the milk ducts) removed, I had to have what is referred to as a "sentinel node biopsy." This is a procedure that has been developed through modern medicine in order to avoid having to do an axillary lymph node dissection, which involves removing all of the lymph nodes under the arm (and which can have some potentially very serious side effects). Someone came up with the bright idea that if they could determine where the "sentinel" or first node was, they could check that one (and maybe one or two nearby), and if those were cancer-free, then the other nodes didn't have to be removed.
In order to find the sentinel node, though, they must inject into ones' nipple a creepy, radioactive blue dye. The mere thought of this nearly sent me over the edge, and it was one of the things about which I was most nervous. I had read on the internet that the pain from the injection can be excruciating. Well, as it turns out, at St. Thomas, they actually knock you out for 2-3 minutes while they do this procedure. Dr. Ballinger came up to the side of the bed with some scary-looking tube, and I began to panic, realizing that this was the moment. The next thing I know, Derek, the nurse anesthesist, is telling me that my hand may sting a bit from the "medicine" going into the IV. My hand started to throb, and I told him so, to which he responded, "you're being a wimp." The next thing I know, I was waking up from what felt like a deep and wonderful slumber, only to learn that I was out for just a few minutes, and that the dye had been injected. Now, that's what I call compassionate medicine! (Note to anyone having this procedure done: some hospitals allow this and others don't; I believe that St. Thomas is the only hospital in Nashville that does the knock out thing for the SNB, so you may want to consider having your surgery at St. Thomas if you have to have this done, which of course, I hope you don't!!).
Since this is most of what I remember from the day, I'm almost done. After the dye injection, I hung out in the prep area for another 10 minutes or so, and then they wheeled me into the OR. The last thing I remember is moving myself from the wheeled bed onto the operating table, and the next thing I remember after that is being wheeled down the hall after surgery and hearing Dr. Ballinger's voice, and asking her about my nodes. She said that they were "clear," and after that, I was simply overjoyed. My Dad says that I was "glowing" when they pushed me back into the holding area, to which I joked and said that of course I was glowing because they had injected radioactive dye into me. But seriously, aside from the birth of my three children, I can hardly remember a time when I have been happier than after that surgery was over and I had been given, at least preliminarily, good news. After having a Coke and having my vital signs monitored for a little while, I left the hospital about an hour and a half later, went home, sent Eli out to get me a Jersey Mike's sub, opened a bag of Fritos and celebrated having completed yet another step (we'll call this a big one) in the process!
