I set my alarm this morning so I could actually get up and eat some breakfast. I woke up at 6:30 and scarfed down some cereal before my fasting deadline for the PET scan this afternoon. Fletch wakes up early so I just stayed up with him and got some work done for my next Pampered Chef shows so that was good. I also found out that Evelyn woke up with a fever this morning so apparently we spoke too soon about her getting better. She was hoarse again and so mom made an appointment to take her back in.
Meanwhile, dad picked me up and we went in for my first pre-op appointment which was for the hospital. They told me that the appointment could take three hours which I didn’t believe but they were right on. After going through registration, they took us back to a private room and we met with several people. We did tell her we had a PET scan at 1:00 so if we needed to leave for that and come back to finish, we would. Spoiler alert: we did.
First was Physical Therapy. The therapist came in and we went over my history, she measured my range of motion (normal), took measurements of my arms, and went through all the exercises with me. They are on a sheet of paper so I just go based on that unless I have issues. I may look into doing PT on my own but we’ll see. I need to do the exercises twice a day, three repetitions to start and work up to 20. There are easy exercises and then advanced which start after I get my drains out. My range of motion will be limited due to the tissue expanders to shoulder level rather than putting my arms up over my head.
Next, a nurse that I know came in – she is basically the cancer nurse to me, she runs the support group and is the main contact for all kinds of cancer support. I wasn’t sure what she was going to talk about but it turned out to be basically the whole hospital experience which was good. I will go to check in at 5:30am, come in to a room much like the one we were in but in the pre-op area and do the pre-op stuff. Not exactly sure, but I’m sure I’ll be busy. They will most likely access my port rather than using an IV which will be good. More comfortable for me at least. I will go to the breast care center and get the dye injection at 7:30. For the dye injection they will numb me like they did for the biopsy and inject the dye in several places – into the tumor site as well as all around the nipple area. She said I will be numb but I will feel a good amount of pressure from the dye and it sounds like it won’t be super comfortable. So basically my plan is to be drugged before this happens if possible. My favorite nurse from the breast care center told me she would see me during the procedure so at least I will have a friendly face there. After this, I will go to surgery starting at 8:30. The dye takes 2-3 hours to make it down the lymph nodes. Since I am starting surgery one hour after the injection she is assuming that the surgeon will start with the right side mastectomy. After she is done, the plastic surgeon will come in to place the tissue expander on that side. The surgeon will move to my left side while the plastic surgeon is working and start the lymph node dissection. She will inject more dye at that point (I’m not sure why they do it twice, sounded like different dyes) and use a device that makes noises like a geiger counter to locate where the nodes are under the skin. She will then go in and take out 1-3 nodes and send them for immediate testing. Based on the results of that test, she will decide whether to take more nodes. Then she will perform the left side mastectomy. Once she is done, the plastic surgeon will move to that side for the tissue expander placement and the breast surgeon will go talk to my family in the waiting room. She estimated the surgery at five hours. When the plastic surgeon is finished, he will go talk to my family and I will be moved to recovery. She said to expect me to be in recovery for about an hour and then I would be moved to my room on the 6th floor which is the oncology floor where they are super familiar with these surgeries and will take great care of me.
She said that after surgery, I should expect to feel a little bit like I’ve been hit by a truck. That makes me laugh although I know that it shouldn’t. She said that I will be padded while on the OR table, but no matter what they do I will have back pain and be sore from lying on the table for that amount of time. Plus, obviously my chest is going to hurt. A lot. I will have a catheter for the first night and be on IV pain meds. I will most likely have the Intermittent Pneumatic Compression leggings to prevent blood clots. I have been told repeatedly that there is very little bleeding from this surgery so at least that is something. She said that the biggest thing I can do is try to relax. Anything I can do for that will help – practicing meditation or breathing exercises is helpful and just remembering to relax. Tensing up will make everything a lot worse and can be a normal reaction so I just need to keep thinking about relaxing and doing whatever I can towards that.
I will have at least two, maybe four drains after surgery. These will be in for 1-3 weeks. This is what the drains look like:
It’s actually better than I anticipated, the bulb is marked to measure the amount of fluid and you don’t have to take anything apart to empty it, just flip it over and squeeze the fluid out of that little valve at the top. From what I’ve read, having them in isn’t going to be super fun but at least they’re pretty easy to empty. The fluid will look like blood at first and over time get lighter and lighter, and of course less and less will come out. She said that the amount of fluid that drains out is in no way tied to how much I’m drinking so don’t stop drinking water in an effort to get the drains out earlier. The nurses will of course manage the drains while I’m in the hospital.
She said that the doctor will decide if I need more than one night in the hospital based on my pain, nausea, etc. It is apparently a pretty frequent occurrence to need more than the standard one night so it’s good to know that is a possibility. She also said that women who go through chemo first tend to take surgery a bit harder so I need to just take it easy and be open with my doctor about how I’m feeling. Overall, a very good visit.
Next came another nurse who did more history, drew blood and finished the check in process for the hospital. At this point we were getting close to 1:00 so we made arrangements to come back for the chest x-ray and hightailed it across the street for the PET scan. I got checked in there, injected with the radioactive stuff and sat down to watch TV for the required hour to let it circulate. Here is the case and syringe for the radioactive stuff:
So yeah, that big silver cylinder is actually a syringe. Let me tell ya, it feels really good when they’re injecting something like that into your arm. I did at least manage to remember to bring pajama bottoms to wear for the scan this time instead of the see through paper pants I got to wear last time. The room with the machine in it was probably 20 degrees colder than the rest of the facility and even with warm blankets over me, there were several times that I didn’t know if I was going to be able to keep my arms up over my head because it was so hard to keep from shaking and shivering in that room. It didn’t help that there was a breeze (I’m assuming the AC) coming straight down on me from the top side of the machine. I was actually relieved when I finally got all the way inside the tube because at least it was warmer in there. When I was finished, the tech made me some hot chocolate which was nice. I also got to eat some crackers because by now it was 3:00 and I hadn’t eaten since 6:00 in the morning. She said that they would rush the results to have them for the morning and she would run them across the street to my oncologist. She also spoke to my contact at the university and would overnight a copy to them so that they would have them for our appointment on Wednesday.
Next we walked back to the main hospital building where I went in for the chest x-ray. I didn’t bring my phone back or I would have gotten a picture. But she did show me the images and said they looked great. She also showed me a bunch of air in my colon so apparently I’m going to have gas later. I told her I would warn my husband of it’s immanent arrival. The x-ray tech was nice, but she did tell me that some people find mammograms with implants so difficult that they tell her they would have gone without reconstruction if they knew before hand. I understand she’s trying to help, but I can’t imagine having a mammogram with an implant will be so hard that I would regret having reconstruction the other 363 days a year. I guess we’ll find out.
Then – we finally got to go home. Sigh. I only spent a few minutes at home and went to pick up Fletcher. We met my dad and all got in the car to go pick up my sister. With Evelyn still needing to be quarantined, I couldn’t figure out another time when we would actually get to see her. So we got to visit for a while tonight and will see her more tomorrow. I’m not complaining – we are very happy to have her in town.
So tomorrow is a big day – I have another pre-surgical appointment at 8:30 with the breast surgeon and then meet with the oncologist for her pre-surgical appointment (she has to clear me for surgery) and to go over the PET scan results. Then I have a massage at lunch time because I figure by then I will need it. Hopefully it will be a celebratory one. I’ll post an update as soon as I can. For now, good night!