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.