Another Step on This Long Road Completed

Welcome back to CarrieHatesCancer, where something is always happening!

So yesterday was surgery day, and it went... pretty well. But lemme tell ya, we got off to a bad start.

The first part involved my pre-surgery prep stuff at the breast center at Rose Medical. I had a REALLY nice nurse, so that was great. She told me parents and sister, who all came to my big surgery day, that I'd be back in about twenty minutes. And she said that the doctor who would be performing my wire localization was a good one. What's a wire localization? Well, let me explain...

In my pesky right breast, I had a metal clip (sort of like a small metal bead) placed into each tumor at the time of my biopsy. These clips mark where my tumors are/were. So that the surgeon can find the tumors to perform a lumpectomy, the radiologist inserts thin wires through the skin down to the tumor. The wire sticks out of the skin and made me look like a porcupine!

The wires are inserted into the breast with a hollow needle with the wire inside of it. But the radiologist first injects lidocaine, a numbing medicine, into the breast. This stings A LOT, plus has the charming sensation of a needle being pushed deep into the breast. Yeah. I know.

Because my last ultrasound gave good images of my tumors, the radiologist decided to use ultrasound to guide him to my tumors. Since my last ultrasound, though, I'd had one last chemo treatment. I did tell him about that, and that the most recent MRI showed that one tumor was no longer visible and that the other had shrunken significantly. Anyway, he used ultrasound to find my clips and tumors, and inserted two localizing wires into my right breast.

I'd like to take a moment and say yes, it is as unpleasant as it sounds. But if it were performed only once, or twice, it would certainly be very bearable.

So once the wires were in, a radioactive substance was inject into me. This was to help the surgeon find my lymph nodes in surgery. Then the nurse ordered a mammogram to make sure we got the wires in the right place. Going into the mammogram, we already knew that Wire #1 was something like 1.3 cm past the tumor. He tried to pull it out a bit, but the wires have little hooks at the end to keep them in place. And since I'm a youngster, my breast tissue is still quite dense. So imagine trying to pull a fish hook attached to a wire through a sirloin steak. And Dr. Radiologist said he *thought* he got Wire #2 in the right place, but it was hard to tell, and something about it not being an exact science. (Oh really? Isn't that what this should be? I know I'm coming off like he was a moronic ass, but he was actually a very nice man.)

So off I go to get a mammogram. They said it would be a light smoosh (very technical term, sorry I forgot what they really said) and it was.

When the results came back, it turned out that he'd missed my tumor entirely. There was some discussion that what the radiologist had termed "12:00 and 1:00" was more like 11:00 and 12:00 to him. (To the uninitiated, they indicate where tumors are in the breast as if the breast were a clock. Weird, yes.) Anyway, he takes another stab (ha) at it using ultrasound again, and then I have more mammograms. I've had probably 20 more mammograms than all my peers. The mammograms come back, and show that he missed the other tumor again.

At this point, I get to wait in a little alcove where my parents and sister have been waiting. The original time quote of twenty minutes has been WAY overshot. The doctor came to talk to all of us to get everyone up to speed with what's been going on. He was very apologetic, which was nice, but it would have been nicer if we could have just gotten the damn wires in place on the first try. Anyway, he spins it as a good thing, sort of, because it means the tumors are very difficult to find now. Which is, truthfully, a good thing. And he tells us that we're going to try another approach using the stereotactic table. He admits that we should have just done this from the beginning, but my ultrasound films made it appear that he'd be able to find the tumors using ultrasound.

The stereotactic table is a long bed-like table with a hole in the middle. I get myself situated on the table, with my right breast hanging through the hole. The table then rises up so that the doctor will be below me, kind of like when you drive over the hole at the oil change place and the guy is underneath, changing your oil. A technician starts taking some pictures trying to locate both clips. She can't find both, and then gets me to put my arm through the hole as well. She still can't get both. Then she messes with my breast and squashes it to the point that tears are coming to my eyes and I'm yelping "OW OW OW!" (Keep in mind, there are WIRES in my breast, and squishing it around does not feel dandy.) She has finally found both and gets the doctor.

I'm about ready to snap at this point because I'm in quite a bit of pain and nobody seems to care. I'm thinking to myself that it's Friday, and I have to have surgery to remove breast cancer from my body. That I'm 26, and that my friends are at work. That people my age are out there thinking, "Thank God it's Friday" and making plans for a fun night out. And here I am with my breast bleeding and smashed in some stupid machine, with three wires poking out from the skin, awaiting further torture. And that once that's done, I'll be ready for a potentially disfiguring surgery. Usually the "it's so unfair" thing doesn't bother me, but at times like this, times when the cosmos seem to be rubbing it my face how much my life sucks, I have trouble holding it together. I'm really stressed out at this point because of the pain and the frustration and the fact that the nice nurse told me it would take twenty minutes and it's been hours. I want to have a total freak out meltdown, but I don't like to do that in front of people and there's always someone around. And then they're back, the doctor and the technician.

I can't see the doctor, which adds a different edge to everything. I can't see when he again injects lidocaine into my breast, which hurts more and more each time. He puts in the wire. Then he injects more lidocaine in my breast, and I ask why, because I thought he had gotten Wire #1 in the right place. He said he wanted the wires to be perfect, so he was going to do that one again. Another wire is placed. So now I have had 5 injections of lidocaine and 5 wires placed. He then wants to pull out the wires that were misplaced. Two of them come out with very little pain. Then he tries to pull the third and it hurts a lot. He says he'll quit trying and leave it. He attaches a little note to it to have it removed during surgery, and indicates that this wire does not lead to any tumors. Seriously, I had a little note attached to a wire IN MY BREAST. It looked a little like I had raised the flag at Casa Bonita meaning I wanted more sopaipillas.

I think I had to have another mammogram to prove that he got the wires in the right place. This time they were indeed FINALLY in the right places. YAY!

When I come out, I had gotten some little bag full of samples and a nice robe. I think it's because I was a pretty good sport, considering the morning I'd had. It pissed me off that there was a sample of shampoo because I'm bald, but then my parents reminded me that it was a sign of optimism, that it was for my future hair.

My surgery time was 1:15 and I think it was about 1:00 when I was wheelchaired out of the breast center. What was supposed to take about twenty minutes took over three hours. The nice nurse was the one to wheel me to my surgery so we didn't have to wait for a transport. She told me that I did a great job, that this was the most difficult wire localization she'd ever seen, and that she admired my attitude in a difficult time. That was nice. Then she left, and I was with new nurses.

I changed into a different gown and put on an extra pair of socks with no-slip grips on them. A nurse came in and took my vitals, and she brought a selection of hats her mother had made. I picked a funny pink one. She tried to get an IV in me, which meant more stinging lidocaine. Two tries, and then she gave up, giving another nurse a chance. The other nurse didn't use the numbing stuff, which meant it hurt more, but she did hit my vein, which meant we didn't have to keep trying. At this point I was really over having people stab me with needles.

The anesthesiologist came in and talked to me and made me drink this sour grape antacid stuff.

Then my surgeon came in to talk to me. I had one burning question for her: the day before my surgery, a surgeon friend (and also a young breast cancer survivor) told me that if my surgeon made her incision around my nipple, I'd probably lose sensation. As a huge reason I wanted to keep my breasts was that I wanted to keep sensation in my breasts, this concerned me. I brought it up to my surgeon, and she was pretty surprised. I asked how likely it was that I'd lose sensation, and she said there was maybe a 15% chance. I asked if she made the incision higher, would I lose sensation? She said no, I wouldn't, but that most girls my age prefer not to have a scar on their breasts over losing sensation. She told me to think about it for a while, which I tried to do, but of course there are people everywhere and I'm all jittery about having surgery. She comes back to ask me what I've decided, and about five pairs of eyes are staring at me. I'm hemming and hawing, and she says, from my experience, it seems that 15% is too high of a risk to you, and I don't want to be talking you into having the incision around your nipple and then you lose feeling. I decide she's right, and she will make the incision on my breast. I had decided the night before that I'd rather have a scar and feel my nipple than no scar and no sensation. I think I made the right choice, and the scar shouldn't be visible in a swimsuit or in clothes.

I get moved into the OR and switch beds. As I'm lying there, I say, "I know I should have asked this earlier, but how many times do people die from an operation like this?" The nurse told that she couldn't remember it happening once in her 9 years at the hospital. The anesthesia goes in... and I go out...

The lumps were going to be removed as one sheet, not separately. And a blue dye was injected into me to help the surgeon locate my lymph nodes. I peed bright blue when I went to the bathroom as we were leaving the hospital. Think Windex colored!

When I wake up, I'm very sleepy and grouchy. I think I was dreaming about someone I'm mad at, and that made me grouchy. I got to talk to the surgeon about my lymph nodes, and I think she said that she ended up taking out 10, and that one is suspicious for having cancer in it. She said something like, "This is a very sophisticated conversation to be having as you're coming out of surgery, Carrie. I'm thinking you must be pretty smart." I took that as a very big compliment, as I find my surgeon to be a very smart woman. Anyway, I can call on Tuesday to find out the pathology on my nodes.

I slept most of the ride home. Once I got home, my parents got the reclining chair set up right next to the bathroom in my old room. I set my phone alarm to go off every four hours to take a percocet, and my mom ended up sleeping in the same room because she was worried or something.

Today was a pretty slow day, but I haven't been napping all day or anything. I slept in, ate, got a visit from my brother and sister-in-law, watched some Gilmore Girls with my sister and mom, and now I'm ready to eat dinner.

This was a long post; thanks to everyone who made it to the end! Surgery wasn't as bad as I feared, and I'm not really in much pain at all (yay for percocet!). I have this surgical drain thing that's gross, but I think I'll talk about that in a later post.

Ciao!