Well time for an update as it’s all been happening since I last shared my views on bras, bullet, comfort or otherwise.
The pre-op assessment on Friday 1st September was a walk in the park, it appears I’m in excellent health – barring the obvious flaw in that statement. For the first time ever I also got away without a comment on my weight – I think the nurse took pity and figured I’d got bigger fish to fry. Other than that I appear to have shrunk half an inch – that’s aging for you. The even better news, despite my op being scheduled for the afternoon, I was still down as a day patient, barring disasters in the operating theatre there was no reason for keeping me in overnight.
I had anticipated a quiet, if not subdued weekend, but a surprise visit from my Spanish tutor on Saturday morning, was followed by my Brother in law and his wife who came to take us out to lunch. It was exactly what we needed and really helped to take our minds off the impending events. Sunday was spent doing the things I’d planned for Saturday, a rather mundane food shop and returning the various pyjamas etc I’d bought while labouring under the misapprehension that an overnight stay might be a possibility
My first hurdle came on Monday when I was dispatched to the Nuclear Medicine Department at Royal Stoke University Hospital for my radio isotope injection. I will admit I was feeling apprehensive about this and not particularly looking forward to it. The squeamish among you might want to pass on the next bit which explains why.
Sentinel Lymph Node Biopsy
The injection was to facilitate the sentinel lymph node biopsy performed during my breast cancer surgery to help figure out if the cancer has spread to nearby lymph nodes. A small amount of radioactive fluid is injected into the breast and this fluid is carried into the armpit by the lymph and trapped in the sentinel lymph node. During the operation a hand-held gamma probe is moved over the skin and guides the surgeon to the lymph glands, which have radioactive material in them. Sounds lovely doesn’t it. The whole procedure thankfully didn’t actually take more than 10 mins, it was the getting there/back and the usual hanging around that took the time. Once locked (which was a worry) into the treatment room and made to confirm 3 times that we were definitely injecting my right breast, I was all for having them feel Boris and check out my biopsy scar while shouting out just bloody get on with it. In an attempt to re-assure me, I was told it would feel like a bee sting. This was no re-assurance at all, for one I’ve never been stung by a bee and if I had I doubt it would have been anywhere near my nipple! I can confirm it does indeed sting, but thankfully not for long and that was that. Driving back home listening to the radio discussing radioisotopes and Kim Jong-un’s recent nuclear assault was a bit disconcerting considering what was sloshing round inside me.
Bye Bye Boris
The big day got off to an early start as if I wanted breakfast it had to be by 7 o’clock, so it was an early alarm call so I could have some tea and toast. That left a lot of time to kill before we headed off for the hospital and our midday check in. It was another subdued ride to the hospital and a small wait at reception while Mrs Jobsworth finished her clearly private conversation, before demanding my admissions letter. Of course, it was in the car, in every other part of the process I have never been asked for the corresponding piece of paper until now. Like who in their right mind would pretend to be someone else and put themselves through this. Anyway she clearly felt she should make up for her less than exemplary customer service and let me off with confirming the usual details. So we then had a short wait in reception. Here we were treated to another conversation between a nurse and her patient that should, in our opinion have been conducted in private. I’m not sure whether we are getting more curmudgeonly or whether people don’t have any sense of privacy any more – says she who is sharing all with the world! It was a heartfelt (but not teary) goodbye to the OH in reception before I was whisked off to admissions.
I was checked in, by a lovely 15-year-old – OK I exaggerate but not much, and the pattern was set for the afternoon as I repeatedly went through my General Surgery form. Once I’d been ankle tagged and sent through to change into a regulation gown, I was handed a bag to put all my personal belongings in. I was beginning to think I’d wandered into an episode of Prisoner Cell Block H, the only difference being we could wear our own dressing gowns – hurray. The next stage was being taken to a holding area, where I delighted to see H one of the ladies who’d been ‘nuked’ at the same time as me yesterday. What followed was a like a bizarre version of hospital speed dating as I was called in and out of various rooms to meet my surgeon, assistant surgeon and anaesthetist and confirm my medical details; that I still had my lump, and more worryingly that I understood all the things that could go wrong before I signed my consent form. The final joy was to be despatched with a cardboard bowl to provide a sample. Easier said than done when you’ve not drunk since 10:30am and you made the mistake of going to the loo earlier.
It was then just a case of clock watching which was actually marginally more exciting than what was being broadcast on the TV. I have never watched an episode of Judge Rinder before and won’t be chomping at the bit to watch it again. I did at least get to see his verdict to put me (literally) out of my misery before I was measured for my compression stockings. My complimentary 2 pairs of regulation tortuous white stockings were duly ‘prescribed’ and added to my personal belongings bag – fat chance of those going missing.
Finally it was my ‘turn’ and I was led through the other side of the swing doors, allotted a trolley and taken through for theatre. My auxiliary nurse was lovely, and I’ll admit at this point that when she’d finished securing my canula for the anaesthetic, patted my arm and asked if I was OK I was the nearest I’ve been to crying. It was suddenly very real, time for the joking to stop and hopefully come out the other side Boris and cancer free.
Another technical bit for the squeamish to gloss over
Wide Local Excision
My surgery comprised a Wide Local Excision (or lumpectomy as we older ladies would know it as). This is surgery to remove breast cancer along with a margin (border) of normal, healthy breast tissue. It’s a type of breast-conserving surgery which aims to keep as much of your breast as possible, while ensuring the cancer has been completely removed. It’s important that the cancer is removed with an area (margin) of healthy breast tissue around it to make sure no cancer cells have been left behind.
The breast tissue removed during surgery will be tested to check the margin around the cancer.
- Negative (clear) margins mean no cancer cells were seen at the outer edge of the tissue removed.
- Positive margins mean the cancer cells are very close to or reach the edge of the tissue.
In addition to further facilitate the Sentinel Lymph Node biopsy there is the Blue Dye Injection, performed once you are asleep in theatre. This dye stains the sentinel lymph node or nodes blue, which helps the surgeon to find the correct lymph node. This dye can have some side effects some more dramatic (and thankfully rarer) than others
More commonly :-
• The blue dye may be visible around your scar following surgery – but this usually disappears over the following weeks or months.
• The blue dye can initially make your urine and your stools appear blue in colour, but this will settle. – Yes is does.
• After your operation your skin colour may appear a very pale colour sometimes with a tinge of blue. This is nothing to be alarmed about and usually settles within 24 hours.
More rarely :-
• Urticaria (skin reactions)
• An anaphylaxis allergic reaction can occur.
Are you still awake? Well thankfully after all that so was I. I came round about 2 hours later and had a chat with the nurse tasked with making sure I was still breathing and compos mentis. You would all have been so proud of me as somehow the subject got round to books and reading. We swapped our favourite authors and genres and I even managed to mention my blog which she duly noted. If only I was so vocal at other times I’d increase my stats no end!
The next stage was the recovery ward where I met up with my compatriots from this afternoons holding area. We were all looking mightily relieved to have survived theatre and were now on water watch to make sure we were drinking and not dehydrated. Although I somehow managed to miss that stage and was offered tea and toast virtually straight away. Manna from heaven and not one cup but two (must have known I was from Yorkshire, all that was missing was the intravenous drip to guarantee speedy absorption). The toast was very welcome but did highlight a symptom I’d not immediately been aware of, a distinctly sore throat, thanks to being inchubated in surgery. The tea performed a secondary function in softening aforementioned toast and washing it down. As if by magic another two cups of tea appeared – much to the dismay of the others who seemed to have not had the same luck.
As my bed fellows all started to leave, it was the breast cancer patients that were last to be released. We needed to wait around to make sure there was no adverse reaction to the blue dye. Though we could confirm it does indeed colour ones urine and the general concensus was that it’s a lovely shade of toilet duck blue. A quick lesson in how to put on our compression stockings (for the next two weeks!) and a final injection in the stomach of blood thinner to prevent blood clots and finally I was allowed home. My OH was mightily relieved to see I was not a quivering wreck and looked an ashen gray rather than the fetching shade of Smurf like blue I’d been hoping for.
If anyone is still with me at this stage – you deserve a merit badge as this has been a long one. Hopefully the next one will be shorter.