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The Lumpectomy

The image above is of me post-lumpectomy recovering on my couch with my faithful sidekick, my late dog Lido, laying as close as possible to me.  She was such a sweet dog, always needing to be close to anyone when they weren’t feeling well or upset.

 

Two weeks after my initial visit with my first breast surgeon, I was in her office again to review my genetic test results.  The good news – they were negative.  I did not carry the genetic mutations BRCA1 or BRCA2 as well as 32 other mutations for which I was tested.  The bad news – my initial biopsy only alluded to cancer, but my official diagnosis was just ADH – Atypica Ductal Hyperplasia.  With a diagnosis of ADH and negative genetic testing, my only choice was a lumpectomy.  The lumpectomy would remove the suspicious cells and determine if in fact they were cancerous.

That may not sound like bad news, but to be honest, based upon my research into what I had initially been diagnosed with – DCIS, I was ready to do a double mastectomy.  I just wanted to eliminate any future risk and hopefully avoid walking down the path of screening, finding a concern, getting a breast biopsy, the unknown of waiting for results, and more breast surgeries.  This was my second time going through this process and it was not my favorite.

I chose to continue treatment with my first breast surgeon (if you read my last post – Choosing a Surgeon – I met with two).  Three weeks later, on December 1st I began the lumpectomy process.  I say process, because it involved more than just showing up for surgery.  Before the surgery I was sent to a Radiologist for a wire localization.  Since I had bled out the indicator following my biopsy, the wire localization had to be done to locate the suspicious cells.

Mid-morning, three and a half hours before my lumpectomy, I arrived at the Radiologist for my wire localization.  This was the second time I had had a wire localization.  I had one seven years earlier for my surgical biopsy, but the procedure was done with an ultrasound.  This time the procedure involved an MRI with contrast to locate the suspicious cells.  After my initial images, I was removed from the MRI machine.  The radiologist performed localized numbing and then literally inserted a metal wire into my breast.  Just like the core needle biopsy, he used the initial images to determine the wire placement.  Once he inserted the wire, I went back into the MRI machine to verify the wire’s placement was correct.

The radiologist was pleased with the wire placement.   The remaining protruding wire was wound in a circle and taped to my breast.  I was then sent to mammography.  The mammographer took multiple images of my breast with the wire localization for the surgeon to reference.  After I was done and dressed, the mammographer walked me to the lobby with my images.  She handed the images to my husband and instructed him to give them to the surgeon.  She hugged me in parting and said:

Good luck! What an ordeal for ADH!

We had some time to spare and my husband mentioned lunch.  As with most surgeries, I was not allowed to eat after midnight the night before.  My surgery was scheduled for early afternoon, but my nerves had helped keep my hunger at bay.  I asked him if he could grab something after I went into surgery, so I didn’t have to be around food.  Even though I was not hungry from nerves I knew if I was around food I would quickly become hungry and cranky about the fact I couldn’t eat.  We decided to proceed directly to a surgery center.  My surgeon recommended the surgery center over the hospital since it was a fairly basic procedure and it allowed for my husband Eric to be with me more.  At the surgery center, he could be with me after I was prepped in the pre-opp room.  He was also allowed to be with me as I woke up in recovery – something we decided later may or may not be the best.

In pre-opp I met with the anesthesiologist, my OR nurse and my surgeon.  I had major concerns about anesthesia.  I get nauseous easily.  After my last surgical biopsy I was fine for three days, until I removed my scopolamine patch.  As soon as that was gone I could not keep anything down.  I had to make a call to my surgeon’s office for suppositories.  I was that miserable!  Discussing this with my anesthesiologist she told me gas anesthesia would make me more nauseous than intravenous.  She also suggested we do twilight, or as everyone liked to refer to it – the Michael Jackson drug.  Since I struggled with nausea so much, she gave me a Scopolamine patch behind my right ear which could remain on up to three days to help with nausea.

My surgeon met with us in pre-opp and reviewed my mammograms.  She asked how the wire localization went and asked me if I enjoyed the radiologist’s accent.  She said she loved hearing him speak. He was from South Africa.  She told me everything looked good and as soon as they were ready in the OR, the OR nurse and the anthologist would come to get me and take me to the OR.  When the anesthesiologist and the OR nurse came to get me I said goodbye to Eric.  The anesthesiologist gave me something to relax and the last thing I remember is being pushed out the door of my pre-opp room.  I was a little bummed, because I prefer being awake going into the OR.

My first memories coming out of anesthesia are of the recovery nurse speaking with my husband.  Apparently, coming out of anesthesia I was really amusing.  All I wanted to do was make out with my husband once I realized he was there.  What can I say?  I love my husband.  The nurse could not stop laughing and Eric was really embarrassed.

The nurse reviewed all my discharge instructions with my husband.  Every time she asked him a question to make sure he knew the post-opp procedures, I would answer.  He said that also made the nurse laugh, because while I was completely out of it, still trying to make out with him, I was able to correctly answer every question the nurse asked.  I guess I become Rainman under heavy medication.  I have no memory of this, but it would not be my last awkward post-opp recovery experience.  They get better and because I enjoy a good laugh, even at my expense, I promise to share… Like I said, apparently, I am amusing when I am heavily medicated or coming out of anesthesia.