Tuesday, November 3, 2009

use your outside voice

My dog is usually content to stay in bed when dw gets up at 4 in the morning for work and waits for me to get up later and take care of her. But this morning the dog knocked on my door and she asked me to please take her out cuz she needed to poop. While she doesn't speak english, she does know how to get her message across and she is never afraid to do so. I should take a lesson from this dog.

This is a tale of two surgeries, things left unsaid and lessons learned for next surgery. Warning: boob shots below

I went into my first lumpectomy not very well informed. I was a bit in shock still and hadn't done a lot of research. And I still hadn't stumbled upon FORCE, a great website for the brca community, full of all kinds of information. I didn't know what to expect and didn't really know what questions to ask. There is plenty of opportunity to speak up. Before surgery I was visited by a nurse for all the pre-op questions. They are basically running through your history and making sure they have the right info and the right patient. Then you will be visited by the surgeon for any last minute questions and they may briefly explain what they are about to do. Then the anesthesiologist comes in and away you go. Kiss your loved one goodbye as they go sit it out in the waiting room.

Once in the operating room, I was introduced to the rest of the team and things got down to business. They ask you again what surgery you are there for. You should be asked this every step along the way. I was not worried at this point that they would not know which boob to work on. I had a wire sticking out of it, so hard not to miss. Pretty funny since some brca women feel like their boobs are 'ticking time bombs' and mine actually looked like one. The first thing they do in the OR is try and knock you out. The anesthesiologist takes a few pokes at me and tells me I am his challenge of the month. This is reassuring as he will be in control of my life for the next couple of hours. But I understand that even when I am not dehydrated (you can't drink anything after midnite the nite before surgery) my veins are not easy to hit. He must have found a good vein cuz I ask him if it is in as I start to feel woozy. I see hands reaching for my glasses and I am out.

When I woke up, I knew exactly where I was, in the recovery room at the hospital. Yet for a second I was excited because I thought I didn't need surgery after all! Then it hit me that I had already had it and I started crying. My nurse, who I like to call no-nonsense nurse, placed a box of tissues on my lap and went about her business. I took a peak at my boob and could not see a thing. They had bandaged the entire thing so I had no idea what was left under there. I was scared and I felt like asking the nurse what was going on under there but decided I would just wait and see in 2 days when I would take the bandage off. NN nurse brought me some ice for my boob and asked me what my pain level was. I said about a 5, which I didn't think was that bad. She suggested some drugs through my iv, so it would start working faster, then a pill. So I said sure. She made me eat some crackers first, which I was happy to as it was late afternoon now and I was hungry. Then she gave me a percocet, which she said the anesthesiologist had prescribed. I thought that was odd as my surgeon said she was giving me some lortab to take home but I didn't question it. She then left me to dress myself which I was a little surprised that I was able to do this on my own! I was wheeled into another room where I was finally reunited with dw:) I felt ok at this time. More questions from another nurse. She went over some instructions and said I could take another pill when I got home then every 4 hours after that. So we went home, hungry but I didn't want to stop anywhere. Took a lortab when I got home and almost got sick but managed to hold it together. 2 days later I unwrap myself and am happy. I survived with a couple of dents and a small frown under my boob, only noticed when I raise my arm. 

I ended up needing another surgery because they like to have a certain amount of space surrounding the tumor just to be safe that they got it all out. I didn't have enough margin so they needed to go back in and take some more. First surgery was on Monday and I decided to get it over with and do the second one right away on Friday. Maybe I should have given my body more time to heal but the doc said it would not have any ill effects and I just wanted to be done with it. So I am feeling good. Went to the gym Thursday and walked on the treadmill. Think I overdid it cuz I ended up pulling my stitches. Not a big deal since I had to get them cut open again. Friday comes and I am nervous all over again. Should have asked if I could get an iv nurse to put my lines in this time, but I didn't. I end up getting the same anesthesiologist as last time. I am on the table while he is jabbing away at my left arm. It hurts, but not enough to cry about. He moves on to my right arm, says I am difficult. I said I would be happy to leave. Everyone laughs but I didn't think it was funny. Several minutes have gone by and I can't fight back my tears. I am scared and just want to go to sleep. Finally he decides to put a mask on me to get me to sleep. I panic as I feel like I am suffocating, then calm down and take a few breaths and fall asleep. When I wake up I see fluffy nurse. She is very smiley and makes small talk with me. I am in more pain this time. Maybe around an 8. I can see my doc sitting across the way, talking into a recorder. I want to ask her how it went, but I didn't. My nurse is taking out my iv. I want to ask her to put some drugs in it but I don't. I do ask for some ice and a pill. She asks me what kind I want and I say bring me something good. I am wondering if she is really a nurse. I ask for diet coke rather than water and she says sure! I know I should be drinking water at this point but if she's going to let me have dc, then I will:) She gives me a percocet with no crackers this time. I don't get sick but my pain has been growing and it feels like a 15 by now. She says she will help me get dressed now and I think to myself that I am not ready for that. I am in too much pain but I don't say anything. She wheels me out and I see dw. I am grimacing in pain, clutching the ice to my boob and trying not to cry. I do not want dw to see me like this. DW looks a little shocked. I notice the two other patients there look so stoned and I wonder how come I am not. The check-out nurse sees I am in trouble and comes over. She remembers me from Monday as she checked me in that day. She asks if I still have pills left over at home and what am I taking. Tells me that I have to leave 4 hours between taking percocet and lortab as they shouldn't be mixed. Oh, that is good to know! She gets me another pill and some crackers. Finally, I start feeling better. I can tell she is a real nurse. I get home and this time it really hurts to try and lay down. Need a lot more pillows this time to prop myself up. This time I need the pain pills all nite long. Didn't need them the first time. I take them again in the am. Then start weaning myself. Try to nod off on the couch and am startled when my cat uses my lap as a launching pad and I jerk up in surprise. The pain rips through my boob and I scream and then wimper. Take a pill and decide to lock myself in the bedroom. Stupid cat.

I feel much more prepared for my next surgery. This time I will see if they will give me some pain med before I wake up and if they won't then at least have them ready to drug me asap. I will be more vocal. This is the time and the place to really let them know how you are feeling. They aren't just asking to be polite. I want the doc to take a pic for me before they wrap me up. I want to see what I have under the bandages and don't want to worry about it for 2 days or however long it will be. I will ask who is going to be putting in my iv. I still have several scars from that last guy. I have seen my surgeon's finished work in person and I am not too anxious about that. I know she can make good boobs. I've talked with a couple of women from Utah that used her. I know what to expect when it is over. I know the flight home is going to be difficult. It is still scary, even with all this info, but at least I will be ready. And for those of you that are going to have breast surgery, start getting used to sleeping on your backs now. You will not be comfortable on your side and it will be awhile before you can sleep on your stomach!


  1. That is quite the bruise! I'm so sorry you are going through all of this. What you wrote about how you felt, after you woke up from surgery, how you wanted to say something, ask something, but couldn't. That same thing happened to me on the evening of my hyst/ooph. I was literally unable to get the words in my head to come out of my mouth. It was a weird type of claustrophobia. Remind me again when you DIEP is scheduled...?

  2. All the more reason to go to nola or sc because those nurses can probably read our minds, all they do is take care of boobs all day! I don't have a real date yet. They think they can fit me in early Feb but that will depend on if the insurance goes through.

  3. Wait a second... WHOSE dog?! I love that you have feelings! Yay. You go girl. Thanks for sharing. I too am learning, slowly but surely, how to be an advocate for myself instead of a passive patient. Think I'd know by now since I am a nurse and advocate for my patients all the time...