LIVESTRONG:

And in June 2013 we are back in the revolving door of doctors, this time for my heart. So the focus has shifted, BUT... I continue to THANK YOU for your prayers, love & support. I receive them with open & loving arms. My wish is that I will gain strength from you, will provide strength to others & will help to strip away the fears we each experience.


LIVESTRONG: I am strong. I am loved. I am healthy. WE WILL WIN!

Have you or your loved one had their annual mammogram? PLEASE, don't put it off. Speaking from experience, I highly recommend monthly self exam as well.

WARNING:
Contents may be uplifting, sad, funny, scary, downright depressing ~ THAT IS CANCER .... at it's best, at its worst.

PLEASE ~ Feel free to share this blog with anyone who is interested to learn about my journey. While I welcome their support, I hope that by sharing this experience freely to the universe I may help to support others by breaking down some of the barriers and fear associated with breast cancer and the treatment.

Sunday, June 26, 2011

Partial Mastectomy, aka Lumpectomy

Surgery is behind me now and it went well, although it was a long day. A Partial Mastectomy was scheduled for Friday, June 24th. This is the official medical term for what many, including me, call a lumpectomy.

Surgery day began for me at about 5am. I had to "frost" my left nipple and areola area with a lidocaine cream 2 hours before the first procedure to get it adequately numbed. Donna arrived from Montana on Tuesday and Alura and Stephan arrived Thursday night. So I had my sister and daughter with me to drive me in for the first procedure appointment at 7:45am at Redwood Regional Medical Center. The plan was that Mark would stay back and get the alpacas fed and meet up with us around 9:30 am before the actual surgery. Stephan would stay back and work from home.

So Mark helped with the "frosting" and taping it in place with plastic wrap, and then the three girls headed into Santa Rosa at 7:00 am, arriving 15 minutes early for the appointment scheduled for 7:45am. We waited about 45 minutes for me to be called for the first procedure, which was the wire placement to mark the area of the tumors for the surgeon to know exactly what to remove. 

Mammography was used for the placement of the wires, and the three clip markers that had been placed earlier in January and May during ultrasound and MRI guided biopsies were used as the guides during the Mammo since these areas had tested positive for cancer. The Mammography room was freezing, and of course it was a nice cool foggy summer day here. So I sat there in the chair for the Mammo technologist to get me all set up for the Radiologist, Dr. Schmidt ,to do the numbing and wire placement. It was very much like a regular Mammogram, complete with compression, although there was a window in one of the compression paddles with letter and number markings. It took about three tries of compression to get things aligned correctly, since one area is close to my chest. The good thing here is that Dr. Elboim assures us that this area close to the chest is nothing to be concerned about. Meaning it is not cancer that is metastasizing, just an area in the breast very close to the chest. Once the area was aligned, which was determined by taking films, then I was numbed by needle, and then the wires were placed with a separate needle. Actually, the wires were two thin plastic pieces; one marking one long side of the tumors, the other marking the other side. Then the radiologist numbed an area right at the areola for the next procedure and some gauze was placed and taped down to make sure I did not bump the wires as I walked a short distance to the Nuclear Medicine department. 

In nuclear medicine, I was asked to lay face up on a table so that a radioactive material was injected into the area at the edge of the areola where the numbing had just occurred earlier. Then two films were taken, each lasting five minutes. One was taken with the camera face down over my breast, the other taken from the left side of my body. 

Both of these procedures were not too uncomfortable. Between the lidocaine they had me "frost", and the numbing med the Radiologist injected, the discomfort in placing the wires was minimal. The most uncomfortable part was the repeated compressions for the wire placement and mammogram films, and the chill in that room while I sat there disrobed from the waist up.

Since things seemed to be moving slow, Alura had already asked the staff of Redwood Regional to call over to the hospital so they knew where I was and that I was in the que, so to speak. So now Alura, Donna and I, with films and CD in hand, walk the one block from Redwood Regional to Memorial Hospital. Parking at the hospital can be a nightmare and there was no need for us to move the car as I was perfectly capable of making the walk. As I was being admitted to Memorial, just after 9:30am my sister Nancy surprised us with a visit. She works in the area for the local Hospice, so was able to take a moment to give me a hug and wish me well. 

By the time I arrived at the surgery waiting room to check in, the attendant said, "You must be..." and before she could finish, I said, "You must be wondering where I was", and checked in. They have this pretty cool system in the waiting room for loved ones to know what is happening. It is almost like at the airport where you have a monitor so you can check on arriving and departing flights. Only the patients first and last initial is used for privacy purposes. The initials are laced adjacent to the surgeon's name and the time of the surgery. In addition, each line was color coded to show whether the patient was in surgery, or recovery, or released to go home. Quite a nice tool for those waiting for someone in surgery. And as I arrived for me it showed, "Not Yet Arrived". By now it was just before 10 am and my surgery was scheduled for 10:30 am, so I am sure they were anxious for my arrival. Honest, I was there early at 7:30am, ready and raring to go!  :-)

So they brought me in and you could tell they had me on the fast track. After all, I was Dr. Elboim's first surgery of the day, and I'm sure they did not want to get off to a late start with the first surgery. So the nurses were very courteous and got me all set up, asking me questions about allergies, what was I there for, when had I last eaten, accessing my port, etc. Once they had me situated, Alura and Mark were invited back into the pre-op room. The anesthesiologist stopped by to tell me his procedures, that he would be loading me up with some good pain meds before they finished up so I would be comfortable until I got home. Dr. Elboim then came by to talk with me, mark my left shoulder, and see the films we brought to him. I could see a bit of a scowl on his face as he excused himself after glancing at the films. He was gone for a bit and when he returned I asked if everything was okay. Apparently the wires were not exactly where he expected them to be and had a bit of a curve to them, when he expected them to be straight. But he said he had called over and talked to them and that he could still work with what he had. So there had been a bit more delay before surgery. But all was still good, I was in a good frame of mind and ready to get on with things.

As they rolled me off to surgery, I noticed a wall clock read 11:15 am, so we were 45 minutes past the originally scheduled time. Other than that, and remembering sliding from the one gurney to the operating one, commenting on the space age lights hanging from the ceiling in surgery, I remember not one more thing. I don't recall anyone draping me or putting a mask on my face. So off to la-la land I went for this much awaited for surgery.

The very first step in this surgery is thy lymph node dissection. Dr. Elboim injects a blue dye into the tumor area. This dye, along with the radioactive solution injected while I was in nuclear medicine, is used by the surgeon to track which lymph nodes are most closely related to my tumors. It is not the nearness that is important, as the surgeon never knows which lymph nodes are those associated to a specific duct, and hence the tumor. So by tracking these two agents, the surgeon knows which lymph nodes to remove for testing. Usually 2-3 lymph nodes are then removed (Level I). These are then immediately sent to the lab for preliminary testing, which takes about 30 minutes. In my case, thankfully there was no cancer in these lymph nodes so there was no need to remove any more nodes, as it is assumed other lymph nodes will also not contain cancer. A member of the surgical team came out to the waiting room  during my surgery, just before noon, to inform Mark of this wonderful news. Not only is it wonderful news to know the cancer appears to be contained in the breast, but also because of the discomfort and lymphedema issues associated with removal of Level II lymph nodes. The lymph node tissue will be examined further and we will get those final results at my post-op appointment on Wednesday. Until that time, this is great, GREAT news.

Surgery ended about 1pm, and I awoke in recovery about an hour later sometime around 2:00 pm. Right after surgery, Dr. Elboim came out, and collected Mark and other family members to walk across the hall to a private waiting room and explain everything in great detail and say that things went just as planned. During surgery, Dr. Elboim took some tissue from below my breast to fill in the large area removed on the inside of my breast. At the same time, my nipple was moved over slightly to prevent pulling from the incision and surgery moving the nipple to an awkward position.  This is called oncoplastic breast surgery, where surgery is combined with a bit of plastic surgery for a better aesthetic outcome of the surgery. Lastly, a drain was placed to relieve fluid build up from the surgery. Then a "mega bandage", as Dr. Elboim calls it, was placed over my entire breast from the center of my chest up over the incision where the lymph nodes were taken and over under the arm. This bandage will remain until my appointment on Wednesday. He discussed my recovery over the next week, what I can and can't do, etc.

At the pre-op appointment earlier that week, Dr. Elboim explained that he would for sure be performing a lumpectomy, or in medical terms it is called a partial mastectomy, although it was quite a large area to be removed. That was a relief to learn. Apparently, cancer is not visible to the naked eye. We know it is in just one quadrant of my breast, but to remove all the cancer, a margin area is taken all around the identified area. And the area is identified by the clips that were placed when the ultrasound guided biopsy was performed in January and the MRI guided biopsy performed in May. So these were the clips used to then place the wires. Dr. Elboim removed only this area during surgery, and will send several samples of tissue from the margins to the lab to be studied. This pathology report will also be back by my post-op appointment on Wednesday. 

At the post-op appointment we will learn the definitive news about both the lymph nodes and the margins, hoping for a report of clean margins, at that time. If all is negative (no cancer) then the only other surgery would be if I choose any type of reconstruction on the left breast once I see how things look so far after the bandage is removed on Wednesday.

While in the recovery room, I learned that brother Matthew had stopped by while I was in surgery and brought a lovely azalea and card, although I was not able to see him before he left. He, Nancy, Donna and Alura were able to visit with each other while they waited patiently.

We thought I would be leaving the hospital for home around 3:30 pm or so, but that was not to be. I had a heck of a time getting to the point where I could sit up a bit without getting light headed or nauseous, and keep my oxygen at the level the nurses wanted. Apparently the Delotted (actually spelled Dilaudid)
drug used for pain relief at the end of surgery was the culprit. After soda crackers, ginger ale, slowly raising my head ever so little at a time, 3.5 hours later I was ready to leave at 5:30 pm. I'll admit I still wasn't feeling all that great when we left, but I was so anxious to get home. The drive home went well until we got off Highway 12 onto Arnold Drive in Glen Ellen. A quick stop for me to upchuck the bile in my tummy, and then I felt wonderful!  :-) All in all, it was a very long day, but I think I did very well and was thrilled to be home with family.

Daughter Sarah came by for a visit that night which was very nice. We all had dinner together. My two pregnant daughters look beautiful and are doing very well. Alura is at 31 weeks, and Sarah at about 24 weeks. How blessed we are to have our first grandchildren to welcome this August and October, especially after this year of cancer. I just cannot wait.

So it is Sunday morning as I am finishing up this post. Alura and Stephan left yesterday afternoon. Everyone is taking very good care of me and not letting me do a thing. I need to restrict just about all movement with my left arm, so they have all been a huge help to both Mark and I... cooking, dishes, helping me to open my prescription bottles and empty my drain from surgery... attending to my every need. Vicodin is keeping me comfortable, and the joy of a new cria being born Saturday morning to our boarder's alpaca was a beautiful diversion. Donna and I even walked down to the mailbox yesterday evening.

That's it for now. Stay tuned for news on the lab reports from surgery later in the week.

Hugs,

Debbie... aka the cancer warrior ... AND SURVIVOR!!!
Sonoma Relay for Life Team (8/6/11) ~  Debbie's Blasting Crew.
LIVESTRONG
I AM STRONG. I AM LOVED. I AM HEALTHY. WE WILL WIN!

1 comment:

  1. Debbie,
    Wow, what a day.You write with such clarity and detail about an experience that is very invasive . You have a talent for writing that I hope you explore in the future. We (meaning the Sonoma relay for life crew and I )raised $105 dollars at the festival on saturday which I committed to match so I will be donating $210 dollars to our team total on Monday. I saw Marian Martini Ritner Saturday. She sends her love and prayers.
    xoxoxo
    X

    ReplyDelete

Thank you for visiting and leaving a comment. Your comment will be reviewed and approved the next time I visit.
Debbie