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Successful Surgery

Surgery was scheduled for 6pm last night. The Infectious Agents doctor (I finally learned her name – Dr. Colpan) was disappointed the surgery was last night. She would have wanted to stop my antibiotics beforehand in the hopes of getting a good culture and some idea of the bacteria I’ve got growing inside me. Too bad – I wanted the surgery ASAP so I could get out of here sooner.

Before the surgery, I had to take off all my jewelry (they use a tool to cauterise blood vessels that could cause a spark on metal objects) and all my clothes (luckily, no catheter this time, just a breathing tube). I also had to wipe the area being operated on with a cleansing, antimicrobial wipe. Three minutes with one wipe, let it dry, and three minutes with the other. Three minutes is a lot of time to have to wash a small, tender area.

I had to go to the main OR, instead of the Women’s Hospital’s OR. Dr. Kang took what was available. By 6pm, the OR was pretty empty, so I got lots of attention from all the nurses prepping me. Dr. Kang showed up only a few minutes late and had to complete some paperwork and sign my breast. You have to be sure to mark laterality, just in case.

I was pretty woozy after the surgery and a little nauseous, but I never go to the pukey phase like the last time I had anesthesia. They game me a couple more drugs for nausea this time. My throat was quite dry and sore from the breathing tube, so I woke up every hour or so overnight to get a drink and go back to sleep. This morning, I’m feeling pretty good. I haven’t needed any pain meds, which is pretty awesome. The surgery site hurts every once in a while, but nothing too intense. It is weird not to have the expander in anymore. The right side of my chest is completely flat now. It’s covered in gauze, so I haven’t been able to look at it yet.

I do have two gown patterns to add to the collection:

The gown pattern for the Women's hospital. I've worn several of these during my current hospital stay.

The gown pattern for the Women’s hospital. I’ve worn several of these during my current hospital stay.

The gown from the main hospital's operating room

The gown from the main hospital’s operating room

Now I’m just waiting to see Dr. Kang and probably Dr. Colpan again to tell me when I can go home and what drugs I’ll be taking with me.

 

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Surgery It Is

Dr. Kang came by this morning (at 7:45 – I was a bit surprised to see him so early!) . The site is still red, and black spot is visible, and it’s started dripping again. Looks like the expander needs to come out in order for the infection to clear. We tried to save the expander, but (unsurprisingly) it just isn’t happening.

I’m kind of excited to get the expander out (especially because it’s hurt since the beginning of the month, and I’m ready for that to stop) except for one thing. Since there’s an infection in the pocket, Dr. Kang won’t be able to put an implant into the site until the infection clears. That means he’ll be taking the expander out and putting nothing in its place. That makes a pocket where fluid can gather so I need a drain. Blech.

Surgery is scheduled for 6pm tonight. Luckily, Dr. Kang let me have breakfast. No food or drink after 9am. My breakfast arrived at 8:30 – plenty of time to finish before the ban started.

This morning's breakfast - French toast today.

This morning’s breakfast – French toast today.

The other good thing is since I’m already hooked up to an IV, I won’t have to worry about them trying to find a shriveled vein when I go into the OR dehydrated. I did have to get a new IV site yesterday since the old one started infiltrating (which means the fluid was being pumped into the tissue instead of the vein). The timing could have been better, since I was on a Vanco drip at the time. If it had just been the maintenance saline, I could have stayed off the IV until close to 9pm. As it was, I had a half hour or so free of my dancing partner. I took advantage of it and did a couple of trips around the hall.

My new IV site

My new IV site

It was very uncomfortable yesterday and I had a hard time finding a position the arm didn’t ache, but this morning it’s much better. Sleeping with it must have readjusted something since I can use the arm without it hurting today.

Drains are annoying

Body parts are continuing to heal, although not as fast as I’d like. At this point, I’m not too achy or itchy, but the drains are really annoying. I managed to go outside today to get the mail, for the first time in a while, but I have no desire to go outside of the house anytime soon. The drains just don’t fit comfortably under my shirt, let alone under the coat, and it’s not something I’d want to explain if I went out in public.

The drains are set up to remove the buildup of fluid from under my skin. I have to empty them three times a day and record the amount of fluid in each. Once a drain has been emptied, I have to squeeze it before I recap the drain to provide the suction. It’s not anything I notice or can specifically feel or even see happening, but there’s always fluid in the tubes.

Drain #1 just emptied

Drain #2 just emptied

What I can feel is where the tubes come out of my body. It’s high under my armpit, so the Ace bandage tends to slip and not cover the site well. Also, as things are healing, I’m getting more sensation come back under my arm which means I can feel the extra stuff under my arm more. Don’t worry, I won’t show a picture of the tubes coming out of my skin. That’s definitely the grossest part of the surgery. StatsGuy has to help me put a new piece of gauze under the tubes and he would much prefer to do the task with his eyes closed, if I let him.

The actual incision site from the mastectomy, on the other hand, looks much better than I expected. I am also completely surprised I don’t have a bandage on the site. I just lay a piece of gauze over the incision so it doesn’t rub on the Ace bandage. I have to check the incision site several times a day to watch for infection, but it seems to be healing quite nicely. No more burning pain with deep breaths, at least. I’m just waiting for the drains to come out so I don’t have to worry about a specific arm movement causing problems with the tubes. If you’re interested, I’m putting a picture of the incision at the bottom of the post. Click on it to make it bigger, or just don’t scroll all the way down if you’d rather not see it.

 

 

 

 

 

 

 

 

 

 

My incision site, with leftover Sharpie still defining the inframammary fold

My incision site, with leftover Sharpie still defining the inframammary fold

The day after surgery

I only had to stay in the hospital overnight, so the day after my surgery I was headed home. Dr. Engel ordered me two post-surgical camisoles that could hold my drains and protect the incision site.

The surgical camisole

The surgical camisole

Sadly, it did not work for me at all. I was able to take off the Ace bandage 24 hours after surgery which I was grateful for since it was starting to itch underneath. I put the cami on instead. The nice part is it zips down the middle and it has pockets that velcro to the inner part of the cami to hold my two drains.

Notice the velcro pouch on the right and the strip of cloth under the zipper.

Notice the velcro pouch on the right and the strip of cloth under the zipper.

Unfortunately, that’s the only good thing I could say about it. I was given a size up so it wouldn’t put too much pressure on the incision site. That meant the bottom of the cami wouldn’t lay flat to my body when I sat because of the strip of cloth under the zipper, so I seriously looked pregnant. The center piece under the zipper totally itched and the strap went right over my port, pushing on it and making that hurt. Needless to say I was not at all comfortable. I took the cami off and went back to the Ace bandage. The trick is wrapping it tight enough so it won’t quickly slip off my chest, but not so tight that it itches or hurts any of the incision sites. I did keep the velcro pockets for the drains, sticking them directly to my button-down sweater during the day or the Ace bandage itself when I go to bed.

Good thing the sweater buttons, so I can leave the bottom ones for the drains.

Good thing the sweater buttons, so I can leave the bottom ones undone for the drains.

You can see how the drains stick to the sweater, as well as the Ace bandage wrapped around my chest - tight enough to stay up, but loose enough not to itch.

You can see how the drains stick to the sweater, as well as the Ace bandage wrapped around my chest.

 

The drive home from the hospital was also a bit painful. I didn’t need a pillow to go under the seatbelt, as others had indicated was helpful. The problem I found was every bump we went over jarred my body and made it ache even more. I’ve also found that shivering is one of the more painful activities that I can do. Overall, though, the pain is lessening every day. So far, I feel better in the evening that I do in the morning so I know everything is healing.

My biggest annoyance is probably the itchiness. I’m not allowed to shower until the drains come out (and that won’t be until Monday at the earliest). At least I don’t have much hair right now, but the stuff they used to clean my skin before surgery made me a lovely shade of orange and everything itches. I’ve had to ask StatsGuy to scrub my back with a washcloth, since I can’t easily reach. I have noticed, when I’m gently scratching on my right side, that my armpit and underside of my upper arm are quite numb. Dr. Engel did mention there are two nerves he had to watch out for during the surgery – a motor nerve, which he was able to keep clear of, and a sensory nerve, that got a little roughed up in the surgery. We’ll see if sensation comes back to that area any time soon.

Surgery day

Dr. Engel performed a modified radical mastectomy, taking some of the lymph nodes under my arm as well. He was able to get all the tissue he needed, and none of the lymph nodes were obviously abnormal. I’ll have the results from the pathologist early next week to see what it looks like under the microscope. Dr. Kang worked next, putting in an expander. Because of the amount of skin Dr. Engel had to remove, Dr. Kang was only able to put 50 ccs of fluid in the expander, while the breast tissue removed was just under 200 ccs.

My collection of bracelets

My collection of bracelets

Before I went into surgery, I got a collection of identifying bracelets. The red allergy bracelet refers to the reaction I had to steri-strips when I had my biopsy. The white bracelet is my personal identification bracelet. It even had a QR code on the front the nurse would scan any time she gave me medicine. The pink bracelet says “Do not use this extremity” since I shouldn’t use my right arm for blood pressure or giving blood ever again. The yellow fall risk bracelet is because I’m getting full anesthesia and the first time I get up afterward surgery, the nurse needs to accompany me to make sure I’m stable on my feet.

My gown pattern - not too bad this time.

My gown pattern – not too bad this time.

I had an IV put in my left hand. The anesthesiologist who was did it remarked on how small my veins were. It probably didn’t help that it had been almost 12 hours since I had anything to drink. Unfortunately, he put it so close to my wrist that any time I bent my hand back, it would hurt. That made it really tricky getting out of my hospital bed since I couldn’t push with either arm comfortably. I also found out my airway is classed as a one out of four – who knew I had such a high quality airway! It’s just one of the many fun facts I’ve learned by talking to the techs, nurses, and anyone else I come into contact while I’m being treated.

When I woke up after surgery, I had an Ace bandage wrapped tightly around my chest, and two drains snaking their way out of the bandage. Every once in a while, a nurse would want to look at the incision, which was always a bit tricky because she would just stretch the bandage a bit more to look under it. The bandage was so tight to my chest, it would hurt a bit to check under it.

My pain levels weren’t too bad. It certainly didn’t hurt much to lay in bed. Getting up was probably the hardest thing I had to do since I couldn’t push my torso upright with either arm. I didn’t realize at first that I had to ask for more pain meds, so I probably let the pain build a bit more than I should have before asking for another dose, but I paid more attention after the first time. I find the pain feels mostly like I pulled a muscle, or a set of muscles. Every once in a while, I’ll get a spike of pain if I move the wrong way and activate muscles across my chest, but it usually isn’t too bad.

The worst thing about being in a hospital is the lack of sleep. A nurse came in every two hours to check my vitals. She skipped the 2am time slot, but my IV drip ran out at 3am, so I got less than three hours of continuous sleep. At least the pain meds kept me sleepy so I had no problem going right back to sleep. Even so, I looked forward to a good night’s sleep in my own house.

Pre-surgery

My mastectomy was Tuesday morning, and there’s lots to say about it, so I’ll put up a couple of posts about it. Long story short, it went well and I don’t hurt too bad today (the next day). If you want all the details (I’ll spare you the gory details, I promise), keep reading.

I met with Dr. Kang the night before the surgery so he could mark up my breast to assist him in reconstruction. By the time he was done, it looked like he’d drawn a target on my breast in black Sharpie.

Sharpie lines on my chest.

Sharpie lines on my chest. You can also see my port on the upper right of my chest. The shadow on the left is just marker smear.

Dr. Kang marked the inframammary fold as well as the extent of breast tissue on the inner and outer margins, and a line right down the middle of my chest.

The night before surgery, I knew I wouldn’t be sleeping all that well so I stayed up late wrapping Christmas presents. I didn’t get quite all of them done, but I put a sizable dent in the pile. The other advantage of staying up was I could eat and drink up until midnight. I had a snack about 11:30 and kept drinking water right up through midnight. I felt a little like a gremlin with the number of times I was reminded not to eat or drink after midnight.

I had to be at the Women’s Hospital by 8am for my surgery. We were a little late, which didn’t really matter since I didn’t head down to pre-op until 11am. I was quite impressed with the size of the room – it is bigger than some hotel rooms the family has stayed in with a fold-out couch, a recliner, and a table and chairs.

The impressive room

The impressive room – there’s a flat-screen TV on the opposite wall

The bathroom even had a shower - not that I could use it.

The bathroom even had a shower – not that I could use it.

Too bad the hospital didn’t exist when I was giving birth to my kids. There was even an awesome view of Presque Isle Bay out the window.

The frozen waterfront

The frozen waterfront

Sadly, it was too cloudy to see a sunset, not that I would necessarily have remembered it after surgery and all the good drugs they gave me. I’ll provide the details of post-surgery in the next post. This one is long enough, and the lack of sleep is catching up with me.

What to bring to the hospital

I’m did a little research on what to expect for my mastectomy, and came upon some suggestions of what I’ll need in the hospital and afterwards. I’ll put the list up now (so I don’t forget), and then let you know whether or not they were useful afterwards.

Things to bring to the hospital, in no particular order:

-lotion and lip balm (everything is always so dry)

-hard candy for my dry throat after surgery

-a small pillow to hold the seat belt away from my chest on the way home. I got one after my initial appointment with the breast cancer facilitator. Now I just have to find it…

-toothbrush and toothpaste (for some reason, I tend to forget these things)

-my iPod so I have some music and podcasts to listen to while I’m sitting in the hospital. Better be sure to update the iPod before I head into the hospital

-a good book, or maybe just my Kindle so I have lots of choices

-elastic waist pants and a front button/zipper shirt since I won’t be able to lift my right arm up for a while. In fact, I’m heading out this weekend to buy a set of warm pajamas that button up the front as well

-my sleeping beanie hat so my head doesn’t get cold. Speaking of my head, check out the hair growth:

Look - you can actually see hair!

Look – you can actually see hair!

It’s not long enough to go out in public without a hat yet, especially in this winter weather, but there’s definite growth happening! (Compare it to the photo taken two weeks ago in this post.) You can even see a shadow of my eyebrows. I still haven’t had to shave, but hair is definitely growing. And yes, I take the pictures in my bathroom because that’s where I can find the most light.