Friday, November 30, 2007

Cubicle Patient 19 11.30.2007

Recovery, continued

Steve and Alicia help me off the cart and into the "Lazy-Girl Chair" as Steve called it. Alicia has opened yet another warm blanket into the chair, and I, kind of wobbly-like, with Steve on my right and Alicia on my left, totter over and be seated. I feel like somethin'. She wraps me in a few more warm blankets, Steve raises the footrest, says goodbye and good luck, I thank him again for taking very good care of me, and he's off.

Alicia wraps the blood pressure cuff around my arm again, and the O2 sat monitor is clipped onto my left thumb. The numbers are the same as earlier. She has waiting for me a fresh soda, a pack of saltines, and one of grahams. Hm. That's nice. She busies herself with documentation, I fumble my way through the package to the saltine cracker. That's funny/odd, being clumsy like that. I smile at my awkwardness, knowing it will pass. I nibble on my cracker, and sip my soda, and Alicia asks how I'm doing. Pretty good, I think, Great, compared to last week. Yeah, she agrees, saying I look so much better. Do you need anything more for pain? No, thank you, I'm good for right now, maybe a 2. I ask Alicia for a huge favor. Could you write out a list of the meds that I was given today, pre-, intra-, and post-op?? I had thought of asking for a list last week also, but didn't. Sure, she agrees to do that. Are you ready for your family? Yup, bring 'em in.

A few minutes later Dan, Polly, and Jim file in, all with smiles, but with that hidden look of anxiety, not knowing what they're going to see. Well, let me tell you, the surgical cap is off, and I still have good hair. I'm sitting up, taking nourishment (such as it is), not puking, not painful, and happy to be doing so well. They are too, and the relief shows on each of their faces. Thanks, you guys, for worrying about me. Jim comes up and kisses me, Polly comes up and kisses me. I don't remember her looking at the first dressing, so I show her this one and we check it out together. Daniel comes up and kisses me and checks the dressing. He looks a lot better, too.

Polly and Jim leave after they are convinced I'm doing well. Thanks for coming.

The blood pressure cuff inflates again, Alicia comes in with the anesthesia record to show me. (Whoa, thanks) Vitals are good. She removes the BP cuff and sat monitor. On table time, 1200. Off table time, 1300. Hm. 1 hour, like Dr. said. I scan the format of the form, it's very similar to ours at Foote. So I take my time and read it over. Remember, I'm post op, and the only way I can read is to take my time. I will add the list of meds to the end of this post. I see the iv bag is about a quarter down, is it the second or third bag? Alicia checks, it's the second, and she goes out of our cubicle, telling me to use the call light when I'm ready to get up, that staff need to help me. Ok, I've had 1200 ml iv, most of this 14 oz soda, and I think I might be needing to go. I'm hungry, and she exited like she had something else to do, so I consumed those graham crackers. Isn't it queer, I miss those packaged graham crackers. (Does anybody know where those individually wrapped grahams can be purchased?) Now I gotta pee.

I say this out loud, and Daniel reminds me to use the call light. Ok, like, I know... I press the red button and hear a faint beep in the hallway. (don't miss that noise) I ask Dan to put down the footrest, he reminds me not to get up by myself, Yeah, I know.. and I scooch forward in the chair. It feels good to move myself. I am perched on the edge of the seat, holding the ice pack in place, when someone came in. It was a different someone; she may have told me her name, but I have forgotten. She and Dan help me up and assist me to the bathroom. Much better than last week. They both help me turn around and move the giant gown's fabric (and yes, I did take my slacks off today) get my panties situated, and sat on the pot. She leaves (thank you nice lady) and all goes as is expected. And goes. Finally the bladder is emptied, the paperwork is done, and all fabric gets replaced in its proper places. I go to the sink, wash up, and of course, have to check that dressing. Looks good, no bleeding or drainage noted. I poke at it a little, kind of feels numb on the top of the breast. Hm. Time will show what that's about.

Dan and I return to Patient 19, and I'm walking pretty good and wobbling very little. This is great. Alicia comes in with discharge instructions for Dan, the list of medications, and a prescription for Darvocet. Eww, thanks, but I don't like that medication. She offers to call Dr. Sanchez for a new med, Tylenol #3? Ok, I agree. She leaves and comes back in a bit. She goes over the discharge instructions, and asks if we'd like her to call the script in. Ok, thanks. CVS in Holt. She smiled, that's what I thought I remembered. I need to urinate again, so we get me up and over to the restroom. Still improving, and I can see that Dan is visibly relieved. I go, wash up, and Alicia brings my clothes in. Dan helps me dress, he's so cute putting my slacks and socks and shoes on. We get to the bra; my shoulders are a little stiff and slow to move. Alicia pokes her head in to see how we're doing. We're cautiously getting the shirt on--she makes a comment that he's accustomed to taking my clothes off, not putting them back on. He turns a faint shade of pink. We get back to the Lazy Girl chair, and Alicia calls for transport. She says all the pleasantries, then turns back and hugs me. She holds me just a bit longer than a "I liked taking care of you" hug. As I closed my eyes and recalled this moment, it seems that we breathed several breaths together. What a gift, Alicia, your sharing your vulnerability with my fear.

Post Op. MUCH BETTER!!! 11.30.2007

I wake up, I don't know to what stimulus. It's shortly after 12 noon. Hi, I'm Steve, You're in recovery. (Cool. Awake. And mostly alert. System check -- nausea, nope, pain, yeah, some, maybe a 4 or 5. Definitely not as intense as last Friday. The iv site is still annoying. Hm. Warm. So far, so good. Let's check the dressing--yup, bulky dressing like before, and the 4 x 4 gauzes are placed over the entire breast, off to the outer side of the breast, and another few overlap into the axilla. I see the drain has been removed, yay, and wonder if the steri strip was removed from the axillary incision. Can't tell. There is white perforated tape over the whole shabang. Wait--tape over everything? I look for the nipple area to see if it got taped. Nope, whew, my poor nipple, it got spared this time. The corner of the gauze is protecting it, and the tape is on the skin.) Steve watches me, I tell him I had to check this dressing. I don't know if he looked before, but he looks now and sees that all is well. I must say the dressing feels good, supportive? maybe. He pushes Toredol 30 mg. The sequential compression stockings are doing their thing. They squeeze kinda tight, I was surprised. Last week, the stockings had been removed by the time I regained memory. Steve offers me ice chips, water, or pop. I ask about fresh coffee :) But he wisely offers me cola. 1215, BP cuff inflates. 123/76 or something good like that, pulse high 60's. Good. Steve documents the vitals, asks about pain. We have the discussion about pain control options, and he ends up calling one of the Docs for something other than Dilaudid to push. I think he takes the legs things off, too.

While he's gone, I see that Jan (my recovery nurse from last week, is across the room with a patient. She's finishing up his recovery and discharges him, taking his cart, I assume, to one of the cubicles labeled Patient and a number. Then I see her approaching my cart. Hi, she says, smiling, and takes my hand. She says that they don't often see patients again, and saw that I was back. She asks how I'm doing, and why I had a re-excision. I tell her that it's good news, about the margins being clear, and the only positive lymph node of the 19 total removed was the sentinal node. That Dr. Sanchez wanted a larger area of clear margin. Wow, she says. That is good news. She's smiling and stroking my hand. She tells me that she has been praying for me all week. WOW I feel my eyes well, and don't know how to tell her how powerful that was for me. I tell her thank you with all the sincerety and love I can muster. Thank you, God, for Jan in this world.

Steve comes back with Morphine 2 mg, and shoves it in, kinda fast, I thought, over a few seconds, as I could feel a slight sensation as it went in the vein. Ok. He has also brought me a diet cola over ice. I sip on it and find I'm able to tolerate it. Mmm. Jan moves on. 1230, BP. I twist my head around and see that I'm stable, (Thank you God) and that I'm not nauseated. (thank you again) In fact, I think I'm feeling pretty good. Steve comes at my iv port with another syringe. What's that?? Another 2 of Morphine, he says. Oh, you think I need it? I ask. (I don't know, I've never done this before. And I'm not sure if I need it or not.) I ask, If I have that, do you need to keep me another time interval?? He says no, as far as he's concerned, I'm ready to leave now. Ok. He pushes that Morphine, I sip my soda (through a straw) and he goes to call report. I check in with myself: no nausea, and yes, most of the rest of that discomfort has gone. I'm glad he gave me that other 2 mg.

I see Steve calling report, and hear a few words drift over: he's speaking to Alicia, who took care of me last week, I hear my name, the procedure, there's a dressing, and ice over the incision. There is?? I don't remember seeing an ice pack. I look, I don't find one. He hangs up, comes over, and tells me he's called report to Alicia, who remembers taking care of me last week. I tell him that Alicia was very patient with me when I wasn't doing very well. He smiles and says she's one of the good ones. I also tell him I don't have ice on the incision--he looks down at my chest, recovers quickly, and says,"sure you do" as he lifts the glass with cola out of my armpit. Good save, Steve. He scurries off, fills an icepack and brings it right back. "There" he says, and helps place it under the blankets. I will say I'm glad to have that ice again. He unwraps the blood pressure cuff, removes the sat monitor, and we're on our way back to Same Day Surgery, cubicle Patient 19. Steve tells Alicia that he's sent me over with my chart and an application for employment. Thank you, Steve, for taking such good care of me. Will you hire an LPN with 26 years experience, and give me 4 weeks paid vacation, at or above the wages to which I've become accustomed?? He laughs. Me, too.

Pre Op, Again 11.30.2007

Dan and I started out at 0830, checking in at the admitting desk, then waiting.... to be called to be registered. The nice lady called us in, sign here, here, here,... copied the insurance card (that was a first), then we were off to Same Day Surgery. 0910.

At the desk, a couple of the same people were there as last Friday. One of the familiar faces showed us to Patient 4 cubicle, and "someone will be right with you." Connie came in and got the processes started. I verified my name, birthday, everything's spelled correctly,.... and got my bracelet. I signed the consent for the Re-Excision of the Left Breast Lumpectomy. Connie was very nice, and helped me feel more at ease. Daniel, too.

My BP was better than last week -- 123/67 as compared to a diastolic of 99. Ya think because I didn't have the pre-op breast invasions?? Daniel's, however, was 160/100. No Kidding. He did some breathing and brought it down to 146/96. Somewhat better, we'll go with that.

Connie strings up the iv, and I tell her I have poopy veins. She says, yeah, I was watching while the BP cuff was inflating. We'll let anesthesia put it in. ok. She finishes up her nurse paperwork stuff, marks above the left breast with a surgical skin marker, leaving the marker for Dr. Sanchez to initial the site, also. She goes out to find the lab results from last week. When she comes in, I ask her what my Hgb was. 14.1. No Kidding!! I don't know if my hemoglobin has ever been that high. Anyway, the crit was 36 something, platelets 236 or something. All good. Time to urinate.

I go over to the bathroom with my giant patient gown trying to fall off, and me trying to hold it on, as well as hold onto the drain bulb, because that tubing pulls pretty good when it's not supported. Of course, a couple of the snaps are non-functional, adding to the design concept. I pee ok, wash up, and get back on the cart. Connie comes in with warm blankets (whoa, Connie, thanks, that feels really good) and the trick is to support my swollen, pendulous breast, drain tube, and bulb, with some level of comfort. Jim and Polly have arrived.

Finally, the surgical team drifts in. Dr. Bez is the anesthesiologist, and he does his little interview thing. He has kind eyes and a warm smile, and is about mid 40's. He tells me the CRNA is Denny Herm (sp?), and that Denny is very fond of telling that he has more experience in anesthesia than the Dr. We discuss the fentanyl issue of last week, and choose to do Toradol instead, as well as other meds intra op. He says he'll take very good care of me, and keep me comfortable. I trust that he will.

Dr. Sanchez comes in, greets us, and initials the surgical site. She and Dr. Bez discuss the fentanyl concern, and we all are in agreement that we'll do something different, and if I need more pain control post op, they are a phone call away. Thank you for your concerns, Drs.. Karen Little comes in, who will be the circulator. She and Dr. Sanchez talk business about the case to follow being cancelled, notify the patient scheduled next, and get things in motion to move up that case, blah, blah. Dr. Sanchez has been writing in the chart, addresses my family members about what to expect at their post op discussion, and drifts away. Dr. Bez gets a page and goes away. Karen goes away. I go over to the bathroom again before the iv start. nervous, anxious. I am experienced now with my billowing gown and Dan wraps it twice around me. And in the bathroom I have to unwrap, hold the bulb, get the panties.... use your imagination. I giggled at my situation, and did get everything taken care of. Back to Patient 4.

Connie walks by, peeks in to see we are on track. Denny CRNA comes in, pulls up a chair beside me, and looks for a vein. You know the procedure. Karen drifts back in, tears tape, and Denny gets the iv started in the back of my right hand. Ouch. It's the achy vein syndrome. It's running well, so I don't complain. Things are moving along, with personnel moving in and out. Dr. Bez comes back and sees that Denny is here and has started the iv. It's very obvious they are not only good co-workers, but good friends, as well. (Sometimes I miss my job and the comraderie.....) Indeed, they tease each other about the gray in their beards, I knew him when.... I ask to decline the versed, and they oblige. Why? they ask. I don't like the not knowing, but I also wanted to see their OR. They chuckled, and gave me a verbal tour of their new suites when we got in there, after hugs and kisses and see-ya-laters to my family. Seems they've been about 2 months in their new ORs, and were pleased to show Room 7 to a fellow nurse. Someone is changing out the warm blankets with fresh ones. Oh Yeah this is good. Thank you. I think her name was Millie or something, she's a Scrub Tech, and speaks with an (hispanic, central american) accent. I'm liking this team. I do tell them we have prayed for the OR team this morning, and trust that they will take good care of me. They get quiet for a moment, and a couple of them say thank you. Denny makes some kind of comment about not needing it right now, he's been good, or that he really needs it right now, or something like that.

Karen put the O2 mask over my face, both she and Denny explaining that they are "pre-oxygenating" me. Somebody (I think it's Karen) is adjusting the arm boards and asking about the comfort of my shoulder, etc. Denny tells me he's pushing the propofal, and my arm will probably burn. Ok, I've felt burn this last couple of weeks. Holy DoDah! Burn?!! Ache!! Ow!! My arm feels like it is falling off. I mean, oh-my-gosh, maybe I should have had some versed before he pushed the propofal..... Not just the vein, and I couldn't really identify the vein, but the whole arm, from the inside out, up to the shoulder. Ok, I say, yup, it burns, whoa, that's amazing, and I feel the drug moving through the shoulder and into my heart, then centrally diffusing, (Yes, I did, I was trying to pay attention so I could tell you...). I consciously snorted big whiffs of oxygen, and said I was going to go to sleep. I felt hands on my head going to tip me back, but, I'm not asleep yet, so I open my eyes. I smelled something, must have been added to the O's, and indeed, I went out.

Surgery, Again 11.30.2007

And we're off, hopefully for an easy surgery today. I'm anxious, but not as anxious as the initial procedure. Keep praying, please. Right now I don't feel so strong.

I'll try to write again this evening. Love to all.

Thursday, November 29, 2007

Pathology 11.29.2007

Dan and I saw Dr. Sanchez this morning, and she reviewed the pathology with us.

The good news:

The tumor was removed in it's entirety, and the margins are clear.
The sentinal node was positive for cancer cells, which we knew and was why she went on to do an axillary dissection.
The axillary nodes, 18 in all, were ALL CLEAR!!!

Woo Hoo!! Praise The Lord!!

HOWEVER--

The margin for the ductal cell carcinoma was only 1.1 mm, and the margin for the infiltrating/invasive cell carcinoma was only 2.2 mm. I had to get out the measurer to see the sizes. It's not much. Dr. wants to re-excise the margins of the defect (take more healthy tissue from around where the tumor was removed), to get appproximately 3 cm of healthy tissue. Her description was that the milk ducts are like tree branches going from the nipple (trunk) through to the back of the breast (branches). Because the amount of clear ductal tissue was so small, she wants to take more tissue to make sure those pesky ductal cancer cells haven't taken up residence further out in the branches.

So, I am scheduled for a Re-excision of Left Lumpectomy, tomorrow, Friday, at 11:15.


For those who may be interested, here are the specifics of the pathology.

Sentinal node specimen=1.8 x 1.5 x 1 cm
-Metastatic ductal carcinoma

Left breast lumpectomy=1.5 x 1 x 1.5 cm
-Ductal carcinoma in situ (DCIS), grade 2
-Closest margin to DCIS is 1.1 mm. (lateral)
-Infiltrating ductal carcinoma, grade II, 1.4 cm in greatest dimension
-Closest margin for infiltrating carcinoma is 2.2 mm (posterior)
-Lymphatic invasion
-Previous hormonal studies-estrogen and progesterone receptors are positive; Her-2-neu is
2+, but negative by FISH
-Pathologic staging - pT1c N1 Mx

Axillary contents left=7 x 5 x 1.5 cm
-Eighteen lymph nodes negative for metastic carcinoma
-Including specimen A, one of nineteen lymph nodes is positive for metastatic carcinoma


So, that's that. Surgery, tomorrow, 11:15. Again.

Thanks for checking in on me/us, and thanks ahead of time for all the prayer activity and positive energies being sent our way.

Wednesday, November 28, 2007

Uh Oh 11.28.2007

Today I showered again. (Yes, I generally bathe more frequently, but with the drain still being in, I want to minimize contamination at the insertion site.) I unzipped my sports bra, and my breast sprung forth!! Whoa!! It's even more swollen than Monday. As I was looking at it, and cradling it with my right hand, (because it was so heavy it was pulling), I had a Duh! moment.
I've had that sports bra on since post-op Friday, only taking it off to shower on Monday morning, then put it right back on. I have also been using the ice pack pretty continuously since Friday night. So there hasn't been much circulation there. Duh! And the lymphs are compromised, so what are ya thinkin?? Oh. Let's see. What can I do?? Cuz this thing's huge. It's so swollen the areola has blanched out. (The color has gone from it)

I remembered that back in February, when my breast and arm blew up, I had had a few appointments with Betty Toll, at the Foote Wellness Center downtown at One Jackson Square. Betty is one of only 3 (at that time) Certified Lymphedema Specialists in Michigan. She evaluated the swelling in my hand (I couldn't wear my wedding rings) and performed a sort of massage-type treatment. It would help some, and after a few visits she taught me how to move the lymphatic fluid myself, and gave me the handouts to follow.

Using this background, while I was in the shower, the warm water helped the circulation, and I gently massaged that breast, chest, underarm, and hand and arm to help move that fluid. I will say that I enjoyed that warm water for about 20 minutes, and the breast did seem to be softer. I had emptied the drain of approximately 20 ml of fluid before I got in the shower, and as I was toweling off I saw there was already fluid in the tubing. Maybe I did some good, huh?

I finished doing what I was doing, and took 2 tylenol extra strength and a whopping 1/2 tablet of a tylenol 3 at about 11:30. I've been using the ice for discomfort, but I'm going to try to stay away from it for a bit. I had a bite to eat, then laid down on the bed with my arm elevated and nothing on my chest. I rested for about an hour, I guess, the got up and got dressed. There is definitely more fluid in the drain. Before long it was time to go to Jackson, so I filled the ice pack and tucked it under my arm for the ride down. I got Mom fed, washed up, and tucked into bed and headed back home. I tucked that ice pack in again, too. But not since I've been home, and I think I'll try the other half of the t3 tonight and leave off the ice to sleep. I don't know about leaving the bra off, though. It isn't comfortable to have that area unsupported.

Tomorrow morning, 0900. Dr. Sanchez. Answers.

Tuesday, November 27, 2007

Tuesday 11.27.2007

Today was a nondescript sort of day. We were just kind of together, Dan and me.

I emptied another 20 ml of yellow-orange fluid from the JP drain this morning. My breast is still swollen, sore, tender, itchy. I think the itch is the fullness in the areola. Of course it's full--I was adding it up. That left breast was infiltrated with 9 ml of fluid on Wednesday, the day of the biopsy. Two weeks later, Friday, surgery, it was infiltrated with another 8 ml of fluid for the needle localization, then the 6 ml injected into the areola, then during surgery Dr. Sanchez injected I-don't-know-how-much of the dye in there, too. So at least 14 ml needs to be absorbed from Friday plus whatever was leftover from the biopsy. Without the aid of the lymph nodes in the armpit.

My left hand feels slightly full, and occasionally the skin itches as well. The armpit itches at the margins of the numbness. That's a strange feeling, being numb in the pit. Well, the front half of the pit. The numbness comes down the inside of arm, too, with the diameter of the numb area maybe 6 or 7 inches. The incision is numb. I guess that's a blessing. Will the numbness resolve?? I guess time will tell. Sometimes it's hard to be patient. Sometimes it's hard not to be scared.

Thank you all for reading, and for your wonderful support. Your feedback, comments, emails, phone calls are treasures. I value each of you.

Much love, Kathy

Monday, November 26, 2007

Punky 11.26.2007

Monday. I got up, it's a great day. Had breakfast, and you know, just felt kind of punky. Hm. I haven't had any pain medicine since yesterday afternoon--I took 2 extra strength tylenol and 600 mg motrin after I got to the Care Home. That didn't really do the trick, but I didn't take anything else during the night. Just kept the ice pack tucked under my arm. So, now, what to do?? Let's see.. don't like the Darvocet, have some Vicodin, have some Tylenol #3. Don't really need a lot of something, just a little boost. I decided to try 2 tylenol extra strength and 1/2 tab of a tylenol 3. I know, it's not much, but maybe it will be enough. I emptied the drain of approximately 20 ml of serous fluid, light tan with a few blood cells.

I called over to Dr. Sanchez' office as instructed to make my appointment for Wednesday. Amy says she doesn't see patients on Wednesday. I tell her I had surgery on Friday, and Dr. was specific that I call for an appointment for Wednesday. Kim comes on the phone and listens to me. "I don't see you on the surgery schedule for Friday", she says, and I explain that Dr posponed the surgery from Wednesday. Oh, yeah, she says, I remember your name. Ok, she says, Dr has surgery all day today. Let me take your number, I'll get a message to her and I'll call you when she knows what she wants to do. ok.

I went up to the loft to lie down on "my" sofa. You know, familiar furniture, been my sofa since 1994. It embraced me. I covered up with the afghan that Mom made for me, and I rested comfortably for about 1/2 hour. The medication was starting to work, maybe I was starting to feel better.

I asked Dan if he would drive me around, as I didn't feel up to driving. He took me over to the library, and while I was inside, his daughter Breon called, asking if he could come over to the car lot and check out a couple of cars she was looking at.

My phone rang, it was Kim from the office. She said Dr. Sanchez did want to see me Wednesday, but no one is at the Breast Care Center this week, and she thought it would be better to have someone around to help get the drain out, and paperwork, and so on, and since there will be a Physician Assistant at the office on Thursday, Dr wants you to come over first thing Thursday morning. Ok. 9:00 Thursday morning, Dr. Sanchez' office. Drain removal, discuss pathology, treatment options.

We went over to the car lot, and I waited in the car while they did their thing (with my ice pack tucked in place). We went from there over to Meijer, as I was in need of fresh vegetables and some fruit. Dan dropped me at the door and joined me after parking. We picked up the few items we came for and was on our way.

At home, we had our lunch, and I sat on the sofa and dozed again. We had 2 floral deliveries--one from Dan's friends, a pretty oranges and reds arrangement, and the other from Jennifer, Jeremy and Jasmine, a lovely yellows arrangement. It was time to head to Jackson. It had been snowing all afternoon--beautiful, lovely, large snowballs--and was very messy slushy driving. There were 3 cars off the road in the first 10 miles south of Holt. (I took myself down, I was feeling somewhat better) I took my time and arrived safely.

Got Mom fed and put to bed, came home, had a bite, and watched Monday night football. Emptied the drain again of another 20 ml tan serous fluid.

That's that. Thursday morning, 0900, Dr. Sanchez.

Sunday, November 25, 2007

The Unveiling 11.25.2007

Today was the day. I took the dressings off. Hm. Dam, ow, shoot, that tape hurts. Ow. Oh, yeah, a little skin came off. As the breast comes into view, I see that it is really quite swollen. The nipple/areola (that has been injected with 6 ml of stuff before surgery and also an unknown amount of blue dye) is very swollen, too. It looks funny, tight maybe. There is an incision above the areola from 12 o'clock to 10 o'clock, covered with a steri strip. There is blue staining around the areola and under the steri strip. Another incision at the front side of the armpit, approx. 2 inches long, also covered with a steri strip. The front side of the underarm is numb, like a nerve may have been cut. That's probably why it doesn't hurt under there. Posterier to that, or towards the back, is where it's sore. Below the armpit, midline, is the tube insertion for the Jackson Pratt drain. It is sutured in. There is some bruising around that. Overall, I think it looks real good. Swollen, tender, but ok. I took some pain med--I'll try 1/2 tab of Darvocet, and 1 tylenol es. I emptied the drain of approximately 25 ml pinkish tan fluid.

I showered, (happiness) and was surprised at the "hospital smell" that was there. Got rid of that. I did ok in the shower, and asked Dan to help me with the dressing and bra. We put some triple antibiotic ointment around the insertion site of the drain, a drain sponge around it, and a regular 4 x 4 over it, held in place by my bra. No more tape. When I was done, Dave and Catherine had arrived, and I refilled the icepack and placed it under my arm and across the top of the breast. We had a nice visit, and they went on their way down to Jackson to visit Elaine at the Home. The Darvocet, even though it was only a half a tab, still made me feel a little loopy, so that's enough of that. I'll stay with the t3 or vicodin, or just plain tylenol at this point.

That's it so far. Doing extremely well, I think. I'm most surprised that the immediate post op pain is not what I feel now, not even in that area. Just sore and achy under the arm and across the nipple area.

I'll keep in touch. Thanks for reading.

Saturday, November 24, 2007

Home 11.24.2007

We had a pretty good night, got up about 7:30. I have been using 1 darvocet and 1 tylenol extra strength for pain. I have explored my wound; the front of my armpit is numb (that explains why it doesn't hurt) and the breast is somewhat achy. I've been keeping the icepack on, and that seems to help a lot. I emptied 60 ml of pinkish fluid from the bulb drain. My left hand has been swollen off and on, it seems to be better when the icepack is in the pit area. I finally was able to eat--a scrambled egg and toasted english muffin, cranberry/grape juice cut with water, and fresh brewed coffee. Yum. Took a little time to get it in, but I felt better after I ate. I have also drank at least 60 ounces of water today. When I urinated, it was green!! Hey, Dan, my urine's green! Oh, yeah, he says, Dr. Sanchez said it would be. (anything else I should know....)

Dan's daughter Kristen arrived for her Daddy to take her to the airport. We had good conversation, and they left about 1:20. Frank got here about 1:40. He's my driver today. We left about 3 for my hair appointment, then over to the nursing home to see mom. I emptied the drain of about 25 ml pinkish fluid before we left.

Mom was good--she had lots to say. Not upset, just vocal. My friend Chris B. offered to get her ready for bed last night. What a gift. I fed Mom, Frank helped me get her into the bathroom, I got her washed up, and Kendra the aide helped finish up and get back to bed. Mom had her meds, I tucked her in, and we left.

Frank and I stopped for a bite to eat at Fazoli's, then on home. I tried 1 T3 and 1 tylenol extra strength. I feel better, not so squirrelly. Dan took Kristen to Detroit Metro, I think he did some grocering, then he and a man-friend Lee caught a movie.

Frank left, we wound down for the night. I emptied another 25 ml of lighter pink fluid from the drain. The ice pack helps with the discomfort.

Thank you all for reading my posts. I have been hearing that you're not able to comment? Try going over to the profile and using the email option. Maybe that will work?

Post Op 11.23.2007

I wake up, see the clock, it's a little after four. Hmm, maybe I've been in here a while. A nice faced lady, she tells me her name is Jan, is at my side, and she takes my hand and strokes it. How nice is that?? She asks me how I feel--let me see. My breast really hurts. I mean, like really hurts. More than I thought it would. And I'm a little nauseated. But I'm not cold, there's lots of blankets on me. And the legs are off. (the compression stockings) She tells me she'll push me another dose of fentanyl. (another dose?) I drift off, and wake up about 4:25. Jan--I'm really nauseated. She helps me with the retching, belching (this is weird--) and I end up with a couple of drops of clear stuff. What's that about? She puts a cool cloth on my forehead. Oh, that's nice. The BP cuff inflates. I've watched the clock and see that it's set at 15 minute intervals. I doze off. The cuff inflates again. 15 minutes already? Nope, it's 5 o'clock. I know that I've been in there for at least an hour, and I'm sure longer than that, and she probably wants to get me moved on. She asks about the pain. Yeah-the fentanyl does a good job making it go away, maybe down to a 2, but the pain is back again. This really hurts, down by the nipple, a sharp pain. She draws up another dose of fentanyl. I mention that maybe the fentanyl is causing the nausea. Go ahead and give it and we'll see. The pain goes away. The BP cuff inflates. 5:15. Nausea. Yup. Urp, belch, spit a drop of clear stuff. She calls Dr. for different medication. She gives me 12.5 mg of benadryl, the cuff inflates, (5:45?) she disconnects me and somehow I get rolled over to Patient 23.

Alicia welcomes me, gets me settled, Betsy comes in, they hover a minute. Alicia asks if I'm ready to see my family, I say yes. Daniel appears through the curtain, and Alicia goes off to get the rest--Frank, Jim, Polly, and Tom. Daniel tells me that the sentinal node was positive and that I've had a full axillary dissection. Boo. Wow, what a deflation. I really was not expecting that. Daniel is saying other things, I'd better pay attention. What? My breast really hurts. That Dr. Sanchez explained everything to them about 3:00. It's now 6. I've been in recovery 3 hours. I don't feel ready to leave. I see Polly, Jim, Tom, Frank coming through the curtains. Jim comes up and kisses me (aw, thanks Jim) and Polly comes in and takes my hand. I tell her the sentinal node was positive (of course she already knew) I think I was whining. I tell her my breast really hurts. I think I was whining then, too. Tom stands at the foot of the cart, smiling. Hey sis, you look like shit! Yeah, I feel like it, too. Polly kisses me too after reassuring me that we'll get through this. Jim and Polly leave. Thanks for being here. Frank is hanging back with Dan. Alicia asks about the nausea and pain. I tell her I'm ready for more pain medicine, she offers Reglan for nausea, then pain medicine later. Ok, whatever. Shoot the Reglan. I doze off, and wonder what bag of IV fluid I'm on, I think my bladder is stirring. I must have asked, because Alicia tells me that's the third bag. Yeah, I probably should get up to the bathroom. It's been about 15 minutes so she gives me dilaudid for pain. I've seen my patients with this on board--I wondered how I would tolerate this one. The pain's better. Kinda woozy. Close my eyes. Ok.

Time to go to the bathroom. With Alicia on one side of me, and Daniel on the other, I weave into the bathroom. How strange. They help me with the IV bag and tubing, the patient gown, and my pants. I went to surgery with my pants on!!!!! No kidding. I sit down, and urinate. Good. That works. Ok. Stand up-whoa-Dan's holding me steady. I get my clothing straightened around, and get over to the sink. I look in the mirror--Tom's right. Eww. But my hair still looks almost good. In the front. I wash my hands, then pull some water to my mouth. I rinse and hold a couple of handsful of water, then back over to my cubicle. I need to stay awake, and accept Alicia's offer of sitting in the recliner. I'm tremoring now, and they cover me up. Alicia takes out my IV. I have some ice water that I'm really trying to sip on, and saltines. As I nibble on the saltine, I don't dare open my mouth, because it's so dry I'm afraid I'll spray cracker flour. I manage to alternate cracker crumbs with droplets of water and swallow some paste. I want to get home. I end up being able to drink a few ounces of water. Ok. She asks me about the prescription, I ask could she call it in to the CVS in Holt?? Sure... She does, and goes over discharge instructions with Dan. I take the opportunity to go back to sleep for a few minutes... Dan and maybe Frank help me into the bathroom again, I pee again, (Frank left) and Dan helps me with the bra and shirt. (I put a separating zipper into the front of a sports bra--it works well) I have my jacket on, and Betsy takes me to the door in the wheelchair. I get poured into the car, and we make it to the drugstore, then home. The drive I don't remember much.

Daniel pulls up in front of the garage, he and Frank help me out of the car. Frank helps me through the garage, then up the stairs. That was a giggle. Whoa. Had to stop and regroup a few times. Let me say, I was happy to be home. I couldn't walk by myself, Dan helped me into the bathroom again, then into bed. He brought me the laptop so I could make that brief entry. I also remember that I asked him to take me to the bathroom about 2:00. After that, I was ok to be up by myself.

What a day.

Pre Op 11.23.2007

I know this is after the event, but I just have to document the events leading to the actual surgery.

Dan and I got to admitting at 0920, got registered, and got called to go into the Lab for the CBC and type & screen. One poke and done. From there we were directed to Same Day Surgery. At Same Day Surgery desk, she showed us into a cubicle, Patient 3. She said she'd be right with us. It's approximately 9:50 now and we were told the Needle Localization was scheduled for 11:00. 10:15, no one comes in. 10:30, I go to the desk to ask them about my time frame. (pesky patients.... we'll be in in a few minutes....) Finally someone comes in and drops off the admission consent and the surgical consent. I notice that the surgical consent is dated and timed for Wednesday's surgery that was postponed. So when (she didn't tell me her name) came back in, she changed the date and time and initialed the change. I initialed it, too. Then she compared the consent with the surgery schedule, and the wording was different. She instructs me to get into the patient gowns, the first one open in the front, and the second one open in the back. Dan helps me with the gowns. She left again to page the Dr to verify the wording on the consent. My brother Tom arrives. It's now 11:00, and we are getting anxious about getting over to the Breast Care Center. Dr finally calls back, says the consent is fine, and the transport guy is here with the wheelchair to go the the Breast Care Center. Tom, Dan, and me in the wheelchair, (he tucked me in real good with blankets, too) got over to the next stop.

At the Breast Care Center, Charlene, who did my films at my first appointment, showed Dan and Tom to the waiting room, and me into the exam room. She explains what we're going to do. This is a stereo optic mammogram. (oh) And it's a table, with a hole in the center. Underneath is the plate squisher thing. Looks quite ominous. She helps me climb onto the table--I have to use the step thing with the handle--and get positioned "in the hole". No kidding. It is not a comfortable table, and I can imagine that people with back issues would have problems. So you're kind of down in the well with your breast in the mamm machine. Charlene maneuvers my breast tissue and moves the plates and sqooshes the breast, then goes behind the divider and takes a picture. It shows on the screen, and there's my breast, I can see the marker that had been placed in the tumor, and the tumor itself. Decent. She goes behind the divider and takes another picture from another angle, and there it is. Stereo optic images of my tumor.

Dr. Lewis Jones, Director of Radiology, a very pleasant man, comes in to do the Needle Localization and Radioactive Injection. A phone call is made because the radioactive stuff is not here from Nuclear Med. Seems it got used for another patient, and they need to mix up another dose. Dr. Jones checks his watch, because this stuff needs to be injected a couple of hours before surgery. He shrugs his shoulders, says it's no problem, by the time Dr. Sanchez is ready to search for the lymph nodes it will be time enough to have been absorbed. OK. Dr. Jones is under the table and calls out some numbers to Charlene--she confirms that that's what she's got, too, and I realize that must be some kind of measurement/marker system that correlates with the films that Dr. Sanchez is going to use in surgery. Dr. Jones tells me he's going to inject the breast with lidocaine (like we did with the biopsy), then place the marker for Dr. Sanchez. He rolls his chair under the table (is this weird or what--because, you know, I'm still squished in the machine) and he numbs the breast. So far, so good. It did burn just a bit. Then he placed the hollow needle through the breast and into the tumor. Then he and Charlene went behind the divider and took a film. They come out. There's the image. He advances the needle just a bit more, and they both go behind the divider, take the film, and come out. Perfect, he says. Then he tells me he's going to place the wire, threading the thin wire through the needle, and somehow hooks it into the tumor. When he does that, I feel a pinch, and sure enough, that's where it's been achy. It was reassuring that the breast discomfort was originating from the tumor. After the wire is placed, they go back behind the divider and shoot another film. They come out, look at the image, and says "perfect". He gets back onto the stool underneath the table, and removes the outer hollow needle, leaving the wire. He rolls out, and Charlene stoops under the table. She proceeds to inform me that she will coil the external part of the wire and secure it with Tegaderm (clear plastic) dressing. I don't really feel her do that, either. She then sticks a very small BB over the very insertion site of the wire, so that Dr. Sanchez will know precisely where to go. Charlene comes out from under the table, releases the plate (whew), lowers the table some, and assists me to roll onto my back. ok. Breathe.

Dr Jones comes back in with a vial of stuff from Nuclear Med. He's drawing the stuff up, and says he's going to inject 1 ml in each of six sites around the areola, the dark part of the nipple. (Hmmm????? My pulse quickens) ok. breathe. Hold still, now. It might burn. (Holy dogs--shouldn't I have had some of that anti-anxiety medicine for this procedure.....????) And it goes like it does in the movies--he holds the syringe up, getting just a bead at the tip of the needle, and wipes it on the sterile 4 x 4, the aims for the site. "2 o'clock" he says aloud, and inserts the needle and injects 1 ml of fluid. (Good, that part's still numb) "4 o'clock" he says again, and inserts and injects. (Didn't really feel that one, either) "6 o'clock" -- ouch, that one bit. "8 o'clock" That one burned, too. "10 o'clock" He's concentrating on getting the bead just right and wiping it off each time, and I ask why. So the geiger counter thing doesn't get confused. Oh. That one hurt just a bit. "12 o'clock" Didn't feel that one at all. "Very good," he says, looking quite pleased with himself. Maybe that's why he's the head of the department. I breathe a few times. Charlene asks me if I'm ok. Sure. She helps me to sit up, then off the table. She helps me change the gown around to close in the back "because that's the way surgery wants it" and kindly wraps me in my blankets and escorts me out into the hall. My films are up on the screen, Dr. Jones is finishing his notes. After he leaves, I talk with Charlene about how much tissue there appears to be. If the tumor is 1 cm, and Dr Sanchez takes 1 cm surrounding it, how much is left to the skin surface? She has her handy dandy ruler, and holds it up. Hard to tell, but 3 cm of tissue looks to be quite a bit of my breast.

Tom and Dan are summoned, I repose to my wheelchair, and wait for the transporter. The boys look at the x-rays and are appropriately impressed.

The transporter arrives to take us back to Same Day Surgery. It's 12:05 when we arrive back at the cubicle for Patient 3. Jim and Polly find their way in. Good to see familiar faces. What's-her-name comes in and hooks me up to the blood pressure machine. 128/99. Whoa!! I'm a bit anxious!! (you think??) She has difficulty getting the thermometer to read, so I walk her through putting the probe back into the machine to reset it. Oh, there it goes. 98.1. O2 Sat 100%. (of course--I've been deep breathing to keep my s*** together) Pulse 78. ok. Now the flurry of personnel--Jackie will circulate, she's going over the paperwork. Dr. Bob somebody is the anesthesiologist. Well, you're healthy, open your mouth, yeah, good, we're ready to go. She doesn't have an IV yet. No IV? Matt can start it. (I hope so) Matt comes in, he's the CRNA. He glances at the blood pressure machine. I tell him my pressure is normally 100's over 60's, so when my pressure drops after I'm asleep, don't panic and start pushing stuff. He smiles and says ok, good. He gets a 20 gauge in first try, right at the bend in the back of my right hand. Whew-was worried about that, too. Dr. Sanchez is there, too, and she's busy in the chart, writing something. (H&P?) While the OR crew is in there, I remind them of the torn rotator cuff and frozen shoulder on the left side, the one they'll be working on. Dr. Bob turns around and looks, and asks me where I can put my arm. We talk about positioning and support, and he says something about giving me Versed and heading out. I see the needle coming at my port, and say just a minute, I want to remember talking to my family. Someone on staff chuckled. I tell them see ya later, hugs and kisses, the medicine is injected, and I remember the cart moving.

Friday, November 23, 2007

Surgery 11/23/2007

I'm home, 8:10 pm. A long day. I'll skip to the news--I ended up with a lumpectomy, and the sentinal node came back positive. :( So she did a full axillary dissection. I have a bulky dressing over my breast and into the pit, with a JP drain inserted under the arm.

I didn't do well with nausea, and my breast hurts pretty good. The armpit is ok right now. We discovered that the fentanyl ivp was causing nausea that zofran didn't really help. The fentanyl did help the breast pain, though. So I ended up in recovery 4 1/2 hours.

The JP drain was emptied of approx. 40 ml. before we left. The nurse gave me reglan for the nausea, then maybe 10 minutes later gave me 0.1 mg dilaudid. I tolerated that much better, but what a sensation--kind of like drunk but not really. It's difficult to stand without weaving.

I took 1 darvocet and 1 tylenol es. I'm going to rest now, and write again when I can.

Thanks to all, Love you, Kathy

Thursday, November 22, 2007

Thanksgiving

Happy Thanksgiving all.

May I say, Please be kind to the people in your world?? Hugs and smiles go a long way to ease fears and reassure each of us that we're OK.

Thanks to each of you for taking the time to read, respond, phone, hug, cry, talk, listen, share, give, support, pray for, pray with, and love each other.

My love and hugs to every single one of you.

Kathy Jean

Wednesday, November 21, 2007

Too Hot 11.21.2007

Dan and I were on the way to the hospital, my cell phone rings. I miss the call, and don't recognize the number. Dan drops me at the door, and I go in to register. At the desk, they tell me just a minute, I think the Dr. wants to talk with you first. Oh?? I am directed to go over to the Breast Care Center (around back on the opposite side of the building), so I go outdoors to meet Dan who is walking through the parking lot and tell him that we need to drive around to the Breast Care Center first. As I am getting out of the car, my phone rings again, and it's Dr. Sanchez. She says she wants to talk with us before we do the surgery. I tell her I we are right outside the Center, and she says she'll join us soon. Dan parks and joins me inside.

I am standing at the window to let them know I am there, and the receptionist girl is on the phone, saying my name. I tell her I'm here, and she asks me to have a seat. Yeah right. I'm pretty jumpy about now. Dan too. Dan comes in, we wait a few minutes and get called back. Dr. Sanchez comes in with my file (which is about an inch thick already) and flips some pages. (Come on, come on, what's up???)

She tells me that all the scans that were done Monday came back normal. (Exhale) However, with the amount of radioactive stuff that had been infused into my body, she was uncomfortable with looking for the sentinal nodes in the axilla. The glow-stuff takes about three days to clear, and we're not there yet. She explained that the way she looks for the sentinal node is to inject glow stuff, then a second stuff that turns the nodes blue, and she's afraid that I'm still so "hot" now that all the nodes will glow and she won't have a clear indicator as to which are the sentinal nodes. So, after consulting with the pathologist, radiologist, and who knows who else, she says she's not comfortable doing the procedure today and will reschedule for Friday November 23 for 1:00pm. (Exhale again.)

Ok. Kathy the scheduler comes in, and tells me that Dr. Sanchez has been on the phone this morning for 2 hours trying to figure this out. And, by the way, were you called and told your surgery was moved up to 12 noon?? (Oh??) Nope, not called. The patient scheduled before me cancelled her surgery yesterday, so they put me in that slot. Oh. Irrelevant now. We've rescheduled for Friday, and I need to be at admtting at 0930.

Breathe.

Tuesday, November 20, 2007

11/20/2007

We had a good day today. I slept better, and that pesky cold is better. We putzed around the house, readying the guest room for potential guests for the weekend, then Daniel went to his first golf lesson, then played 9 holes. It started misting/raining before they were done. I altered a sports bra by putting a separating zipper in the front. I think that will work ok for support while I have the dressings on. I went to Jackson and took care of Mom, got some hugs from the girls there, then back home. Had a bite to eat, then a little computer time, then off to bed. I can have clear liquids until 0815, then nothing. It's a long day tomorrow.....

Thank you to all who have prayed with and for me. All prayer indicators show that the hotline is fired up!!! I hope to be able to write something tomorrow night after I get home.

Monday, November 19, 2007

11/19/2007 Glowing

Anyone got a black light?? I started drinking that contrast solution this morning at 0540. Tasted like bad banana chewy candy. Took a long hot shower, then drank the second bottle. Dan was ready to go, and so was I. Off we go.

I had to wait until 0810 for my 0745 CT scan. And in the interval, the intestines start making their thoughts known of the artificially sweetened 30 ounces of thin creamy white fluid they had just been presented. Plus another 16 ounces of yellow, almost lemony clear fluid to suck down. I was told that it was the second half of the oral contrast solution. Oh. 3 trips to the bathroom, I hope this exam doesn't take real long. The technician, June, was very nice. Blew the first needle in my left hand, put a 24 gauge in the right antecubital. (I did mention to her that my veins can be, elusive? could be a word.) I also asked her to save the good one for Wednesday....

I just had to move the zipper and snap down from my pants off the pelvis, not change completely. On the table, and it was a good thing the needle was on the right side, as the arm needed to be held up and over my head during the exam. That's an uncomfortable position on the left shoulder. This machine was a circle with the table moving though it. I don't remember hearing it; I do remember that the flourescent lighting seemed extremely bright. And that there seemed to be an amount of air accumulating in my intestines. June told me that the contrast would be infusing, (Afterwards, I asked her how fast that infused--3 ml/second, or 33 seconds for a 100 ml bag) and that I would feel warm, from the inside out, and it might feel like I'm wetting myself. Oh, Yeah--I could taste it, then feel the warmth in my chest and in my middle, and, oh yeah, it did get warm "down there". That was weird. The machine moved over my middle, slowly, and then we were done. She was going to pull the needle, but I reminded her I was having 2 other tests, and at least one of them needed IV access, so she flushed it. I took myself over to the bathroom, and I flushed there, too. A couple of times. Another employee came in to escort me to the next test. Thank you, June, for being so kind.

Oh, good, a bathroom right here.

We got to the next place, I signed in, and saw a sign that said that since this was a waiting room for more than one type of procedure... Oh-a waiting room. I asked the nice lady could my husband come join me? She called out to the Radiology area and asked that he be directed to this next area. There he is. Such a little thing, I felt my anxiety decrease a half a notch. We sat in that smaller area until Geoff came for me. A 21-year old student at Ferris. He lead me to another room where the "real" tech joined us. She watched him draw up the stuff--something radioactive for the bone scan--and told him to get the injection in and ask his questions after. He had already asked about the allergy stuff. When he went to inject the solution, he said he was meeting a little resistance--yup, the blue clamp was closed on my IV port. I saw that and opened it, then held onto the hub at the insertion site so as not to lose my needle in case he jerked or pulled or something. You know?? He injected the solution, then flushed the needle with a 10 ml prefilled NS, and then another one. (For all us nurses--they don't use the needles with the needle guards, and he recapped each of the ones he used). Back to the bathroom and then in with Daniel.

The nice lady, whose name is Bonnie, and Dan were having a conversation. It was about 9:30, and Bonnie said the MRI was going to be about 10:30. And I was not NPO anymore, so I could have something to eat. I was brought some apple juice and a water, and Dan went to get a bagel, as their cafeteria was in the process of dealing with the asbestos it found. I had a couple ounces of the apple juice, and gurgle, gurgle. Hmm. How about chewing on some of the bagel, maybe that will absorb some of that stuff. That did help some. We sat and visited, then I was called to go back for the MRI. And a stop at the bathroom.

Two girls were going to take care of me. I changed into a patient gown (open in the front) and bottoms. One of the girls helped me get my right arm out of the shirt I was wearing, because of the IV, and my other shoulder doesn't work too well. The preceeding patient was not quite finished, so I dashed over the bathroom. Ok, my turn. We go into the room, and there's the table with a sheet on it, and, no kidding, to holes for the breasts to be suspended into. They instruct me to climb onto the table on my hands and knees, then lower my chest onto the table and make sure the breasts hang into the wells. NO KIDDING!! So you're face down on the table, there's a cut-out for your face, (you're looking down at putty colored plastic about 5 inches away from your nose. It's got light from somewhere, and some air movement, too.) and you have to keep your arms at your side. Then they say they are going to check the placement of your breasts, and the hands are moving the dangling breast tissue through the sheet. She hands you a small blue squeeze ball to call them if you need something. One of them puts headphones on my head--they're crooked, but I manage to wiggle them around so they fit a bit better. The have connected my IV to another container of contrast stuff that they tell me I need to hold REAL STILL when that's infused, because those are the important pictures that the surgeon will use during surgery. Ok, here we go. The table slides into the machine, and my forehead support moves a little. Then I can feel my arms going in, and the voice in the headphones says we're going to start. A MRI machine makes lots of quick static-like noises, and it's quite loud. This first series takes about 15 minutes, then there's a pause, and the voice tells me that they're injecting the contrast. Oh, yeah, I can taste it, like the other stuff. The machine starts up again, and I kind of doze off, and wake up with a start. OH NO--I've got to cough. I try to suppress it, but I'm going to cough. I squeeze the bulb and hear a tone, but I don't hear a voice. I cough. And I think--I've just moved during the part the the surgeon is going to use. The voice asks if I need something, and I tell her I need to cough, and she tells me she's paused the machine so go ahead. And I do. And my nose runs, and my eyes water, and on the plastic below my face is a circle where my nose is dripping and another from my right eye. Oh, yeah, life is good. They resume the test when I tell them I'm ok now, and tell me there's about 4 minutes left. ok. I can do this.

We're done, the table slides out of the tube, and the 2 girls help me off of the table. She wants to take my IV out, but I tell her I have one more test. She goes and talks with the next group, who says they've already injected the stuff they need, and she takes the needle out and puts a bandaid on.

I asked if I could see the images, and she says yes, but she can't answer questions. I don't see anything real recognizable, like the marker that was left in the tumor, or the tumor itself, but the left breast is definitely larger than the right. I went to put my clothes back on, then to the bathroom, (it's slowing down some), and back down the hall across the waiting room from Daniel.

I pop my head into the waiting room while they are entering data into the machine, then go over and jump onto their exam table. The girl places a bolster under my knees, and uses a tied tourniquit around the toes of my shoes to keep my feet together. This is a Total Body Bone Scan. Jamie is the nice lady going to take care of me, and young Geoff is at the computer. They position the plate, which is suspended on a frame that fits over the bed, close but not touching my body. Starting at the head, the machine slowly moves down. So slowly, that Jamie leaves and comes back in with a Christmas Trivia game she has created for her family. She is taking them on a surprise vacation to Chicago for Thanksgiving, which is the prize for her game that they will play Wednesday evening. We got a few questions in, and I asked her if she would go across the hall and fetch Daniel. I'm sure he must be quite bored by now.... He comes in, it's good to hear his voice. I can't turn my head yet, so I can't see him. We answer about 20 questions or so, and they have to reposition the plate over the right breast, then the left, then over my head turned left, and my head turned right. When we were done, I was surprised that it took and hour and a half. They untied my feet and helped me off the table. Young Geoff at the computer asked if we wanted to see the images. Sure!! There it was, my skeleton, right there on the screen. Looks pretty good. Dan notices that the left shoulder looks different than the right. It sure does. And look at the bright white spot in my pelvis--my bladder's full. We were finally done. One more trip to the bathroom and we were on our way.

Daniel and I went to the Flapjack Shack for 'cakes and eggs (and a pot of coffee for me) as we had shared the bagel and juice earlier, then home. I was home for an hour or so before I headed to Jackson. My intestines have finally slowed down. When I got home I checked email, wrote some more here, then off to bed. Tomorrow is a more restful day.

Hey, turn on the black light. See my teeth??

Sunday, November 18, 2007

11/18/2007

The second day at work since The Diagnosis, and the last until after surgery. The girls look at me, subdued, and we try to be "normal". We smile, hug, routine chatter. I told the few "new" people I saw and shared stories--today's stories were of positive treatment and survival. The workday itself was ok, good patients, good staff, good pace.

In the long of the afternoon, I had a pretty good coughing spell (I've been fighting a cold), had a bit of nausea, and recognized that I was pretty uptight about the scans I'll be having tomorrow. I start drinking contrast at 0540, the second bottle at 0640, and the CT of the abdomen is scheduled for 0745. After the scan is completed, I'm scheduled to have an injection of something at 0815, and take 0.5 mg of Ativan before having a MRI of the breasts at 1000. The Bone Scan follows at 1200. After that I hope I'll be able to glow my way home with Daniel.

I told myself I'd have to settle down, breathe, and not get caught up and "go there", just settle down, I'll be ok. I was doing pretty good. Then my wonderful coworkers brought in a Parting Gift--a pink bag full of pink grooming/self care items. Freesia Rose shower gel, lotion, and body butter, a pair of soft pink print pj's, pink socks, pink hairband, you get the picture. A pink breast cancer ribbon on a lot of the items. O my gosh--somehow the gift made it "real". OK, I can breathe now. I can feel the love, and support, and the kindness that the gifts bring. I know when I smell that smell I'll remember the gentleness in your eyes and promises of support. Again, thank you so much.

At the nursing home, mom was quiet, looked comfortable. Frank came over, I think just to be with me, and we talked a little about the tests and the surgery. I got mom washed up and into bed, and Frank and I left. Big hugs to Frank. Big hugs to me.

Home, and more hugs with my wonderful husband, Daniel. What a gift he is.

Simple chores, and to bed. Contrast is waiting for me just a few 6 hours away...





Saturday, November 17, 2007

11/17/20007

Wow, what a day. I worked today--the first since sharing The Diagnosis. Can I say, "what an outpouring of love"? All of my co-workers are absolutely wonderful. The hugs, and some tears. (what is that for, fear?) Yeah, the fear is the hard part. It's really easy to face the "now". And the nows of today added up to a really great day.

Thank you Lord for the people in my world.

Thursday, November 15, 2007

11/16/2007

After a mostly sleepless night, this morning started with a phone call from Jeremy, who is in Afghanistan. We had as nice of a visit as we could, considering.

A short while later the Pre-Op Registration gal called. Yes, no, no, no, etc. I need to be at Admitting 10:30 on Wednesday morning. Blood draw and such. They will take me to the Breast Care Center where the "needle localization" will be done, as well as the radioisotope injection, which are scheduled for 12:00. Then back to Pre-Op, to calmly : ) await surgery, which is scheduled for 2:00.

I have to say, I'm getting a bit anxious. I soooo appreciate everyone's support. The hugs, prayers, and kind words, and the reinforcement of my positive attitude and re-stating the belief that all will be well. Knowing you are standing beside me is as powerful as knowing that God's wisdom and strength surround us.

Thank you all.

November 15, 2007, The Day After

So we've been diagnosed now for 24 hours, and what a whirlwind of activity. Yesterday I had a chest x-ray done for pre op, and today Daniel picked up the contrast for the tests to be done Monday. We are both quiet and contemplative, wondering what the future is going to be.



My breast kind of aches today--not the soreness from the biopsy, but an ache, maybe like menstrual cramps. And it feels more swollen, like the bra cup is a size too small.



Kathy, the person who has been scheduling all of this for me, called with surgery time. 2:00 Wednesday, November 21. I ask a couple of questions, like will the surgeon use staples or subcutaneous sutures?? She makes the comment that us health care people are all alike. She flags the chart for no skin clips.

I went to the nursing home and fed Mom, who was more awake tonight. The staff at the home have listened to my discomforts, a few knew I had a biopsy, and are asking what the results are. I tell them, and then offer them to see the lump, and touch it too, as we don't know many others during this part of a cancer process. And we are all supposed to do self breast exams, so how do you know what the change is?? For me, I sensed there was something different, and as others look, then touch, they are able to tell right away where the tumor is. (That's kinda creepy--is that a bad thing--being able to see it so readily???)

I've had lots of phone calls and email responses to the initial email. Thank you all sooooo very much. Daniel's family is calling, too, and I thank all of his people too. It sure helps to know that we're not alone.

Please be sure to leave a comment if you'd like, and read other comments. I see that the comment selector thing is not real easy to see. Maybe I'll be able to reset it or something.......

Wednesday, November 14, 2007

Results 11/14/2007

So today my husband and I go to the Breast Care Center for results of the biopsy. We have to wait, a good 45 minutes beyond our 10:30 appointment time, to get called back to see the surgeon. She finally comes in.

She tells us the results: Breast Cancer.

I have infiltrating ductal carcinoma, grade II, and ductal carcinoma in situ, noncomedo type, nuclear grade II with associated calcifications. The largest area measures 1 cm.

The plan is to do a lumpectomy. That is an outpatient procedure. So for preop, a whole bunch of diagnostics to make sure the stuff hasn't infiltrated anywhere else.

Today I had a chest x ray, and Monday I have a CT scan of abdomen and pelvis, MRI of both breasts, and a bone scan. All are scheduled for the morning half of the day; I am hoping to be able to come home and have a nap before going to the care home to help Mom with her dinner and bedtime.

Yes, we'll have a road to go down. I ask for prayers and for God's peace and grace.

A Little History 11/14/2007

I've been having breast discomfort in the left breast for about 3 months. So, you know, you wait and hope it gets better. It kindof did, but then not really. So the second month, I wondered, hmmm, maybe something's not right. We we'll give it a little more time and see how it feels. The third month I'm thinking, hmm, this isn't any better. In fact, it appears a bit more full and now it's really tender at the top. Maybe I'd better have this checked out.

So I call Passages, the local breast health place, and my favorite nurse calls me back to say a mammogram would be diagnostic, and they would not be able to help me, and to see the primary care physician. Oh. Ok.

Another week and a half or so and I can coordinate my schedule with the Doctor's available appointment (but I have breast changes--can't you see me any sooner???). He does a breast exam and agrees that I have changes in the breast, and offers me to see a surgeon in the area. I have done some research, though, and found the Ingham Regional Breast Care Center, and we both agree that that would be a good choice for comprehensive care.

I went to the Breast Care Center November 7 for a mamm and ultrasound. I met some great people, and made an appointment for the next day for a needle biopsy with ultrasound guidance.

The biopsy was done November 8, and I also met the surgeon that day. I came away with the sense that all was not well, but they did not say as much. I had a follow up appointment for the following Wednesday, November 14.