Surgery Day – Cystosarcoma Phyllodes OUT

June 10, 2011

Nothing by mouth after 9 a.m. Do you know what it’s like to be awake and hungry? Guess I’ll find out. I get up early so that I can have a protein fruit smoothie and hydrate myself. The nurse said you tolerate anesthesia better if you are well hydrated. And she said that if you do well on boats and car riding you’re not as likely to get sick from anesthesia. I did just fine, thank you, when we went deep sea fishing last summer. There were at least 4 others puking into red buckets, and I think secretly others would have liked to join them, each with their own little red pail. However, I do not do so well reading in a moving automobile. I do not like puking, so I need to do what I can to avoid that nasty, smelly occurrence. I play some CDs that I find help me go inside where it is quiet -  Enya, Yanni, James Galway flute music and others. I focus on the music, retreating to where it is calm within, scrub the kitchen floor, clean the bathroom, put some of the clutter out of view. 9 a.m: Nothing by mouth.

Somewhere around 11 I say, “Mr. Scott, I’m ready for my favorite stress relieving activity.” Quizzical, suspicious eyes look at me. “Walk, I need a walk.” Dutiful man, he puts his shoes on and we go out. About half way through the walk I get a call from the surgeon’s office. “Melody, can you be here by 1pm? Dr. I thinks he might be able to get started early.” “Sure.” I hang up and wonder if they have coordinated with Dr. C – must have, but I won’t know if I don’t ask. Ring, ring – “Has Dr. I coordinated with Dr. C?” “He is going to talk with him and make sure that he can be ready.” Good. I’ve done what I can do.

Back at the house, I take my shower, get dressed. I wear that turtleneck because it looks good on me and I won’t be able to wear one for awhile. You have to be able to step into tops or to button them up. I try to stay away from button up tops in honor of my sister. I won’t be able to get the recently washed clothes put away before I leave. Oh well.

I’ve never had surgery or a baby before, so perhaps you can empathize with my trepidation a bit. I don’t care to visit hospitals, let alone get cut on and spend the night there. They are the best places in the modern world to get infections that you don’t go in with. You must be thinking "chicken", but I’m a nurse - I know about some of that stuff.

We drive in to the hospital, sometimes silent, just a little chatter. Not much. What is there to say that we haven’t already said? Park the car, find the purple elevators and go up to the admtting area. More questions, fill out papers, remove jewelry, and go to my pre-op room. More papers. No, no meds, no health care conditions. I take my vitamins & supplements when I remember. Yes I have my Advance Directives – please make a copy for my chart. Incentive Spirometry -  yes I have taught people how to use it in the past, but lets take a look at modern technology. (Takes a little bit of coordination these days - not just sucking in the air and letting it out.) You will have compression leg wraps on your legs to prevent clotting. Move your legs and feet anyway. You will be taken to recovery after surgery, and when stable you will be moved to one of the units, not sure where. Scott can leave if he likes and return when we call him after the surgery is finished. 

Advance Directives? Do you have yours completed? It doesn’t matter if you are well, anything can happen at any time. If you’d like to have a say in the measures that are taken to continue your life at any cost at any quality, I encourage you to complete a copy. Here’s a link – each state has their own form. http://www.medicalert.org/join/advance-directives.htm?selected=MedicAlert+Membership_Advance+Directive&gclid=CJX10ZjdwKkCFQY-bAod6lGSNg

I have a television with cable in my little room. Couldn’t find much, but what we did find was a channel with nature photographs and soothing music. I couldn’t have asked for a better option. More quiet time inside.

Blood gets drawn, IV gets started. The nurse from the breast clinic comes in. She has seen my chart and though I do not have cancer she thought that she would come and visit me anyway and gives me a breast pillow. She tells me a little about their service and that I can come in anytime.

I have the nurse put my note on the chart for Dr. C to get a candid shot with his cell phone camera of Phyllodes. She says she’ll also tell the OR nurse just to be sure.

Dr. C comes in. I didn’t think I’d see him until my first follow-up visit as I’d be sleeping, of course, while he works. Ahh, he wants to make sure, after talking again to Dr. I, that the incision is in just the right place. If we do it like Dr. I is thinking, my nipple might be pointing in the wrong direction from the wrong location. So he sketches his idea on my breast to make sure that he gets his say in. He will talk with Dr. I. I am grateful for the thought that he is putting into the design phase of my reconstructed breast. Still hoping for single stage reconstruction, and at the worst, nipple/tissue sparing anyway, with multiple stages of reconstruction involved.

I haven’t seen or talked to the anesthesiologist yet. He will call 30 min. before he comes over to see me – and get me, I think. No call. I’d better get up and go to the bathroom. I do so, carrying my IV bag in my hospital slippers (I didn't put it in my hospital slippers, I was wearing the slippers on my feet, carrying the bag in one hand.). Eek, I’ve stepped in water (?) on the bathroom floor and there is quite a stream, maybe a river, of it – oops, looks like the toilet is going to run over - again. Go find the nurse, need new slippers, and I need another restroom. Didn’t get to finish my business.

I’m waiting, it’s now 3. Looks like the afternoon surgery case is taking longer than anticipated. No anesthesiologist.

If I remember correctly Dr. C II, anesthesiologist came in about 4:30, asks a few questions, pushes the Verced or some other sedative and rolls my gurney down the hall. I had hoped for a glimpse of the OR, but alas, I’m sound asleep before we even get there. General Anesthesia coming up. Cutting, cauterizing, scooping out that alien growth that doesn’t belong, and the initial stages of redesign begins. Here's where they put the expander in behind my pectoral muscle.