"Sentinel lymph node dissection"

Yesterday, (Wednesday) I had an outpatient surgery called a sentinel lymph node dissection. They make an incision in your armpit and take out 1 or more lymph nodes. They test these lymph nodes to see if cancer is present. If there is no evidence of cancer - this is good news. If cancer is found, this means that I would need radiation. This also means that even though I can go ahead with the double mastectomy, I would have to postpone the beginning stages of reconstruction (boooooo). I am really hoping to start reconstruction immediately after the mastectomy (for one thing, that means one less surgery to have to endure).
So, the surgery went down like this: I was not allowed to eat anything since midnight the day before. I was allowed to drink water that day, but only water, and had to stop that and be NPO (nothing whatsoever by mouth) 2 hours prior to my arrival. I cheated a bit, as I (gasp!) drank water on the way to the clinic. (Did I mention that the surgery wasn't scheduled until 3pm!?) I knew that without eating anything all day (even though I was POUNDING water down the night before and all morning long), there was a good chance they would have a more difficult time finding a vein for the IV (ouch!).
**I wanted to mention this as well, in case no one else has heard of it. There is a document called "Five Wishes", kind of like a more detailed "advanced directive". It is a way to let your caregivers know your "wishes" in the unlikely event that something went wrong during surgery, I was in a coma, etc. You have to identify people (1-3) whom you would like to be in charge of making medical and "end of life" decisions for you, and you specify how you would like to be taken care of if you were unable to speak, unconscious, etc. As awful as that document was to fill out, it did give me a bit of peace of mind, going into surgery (especially when general anesthesia is involved). This was something that I got from my primary care physician when I went to see him last week. You can also get a free copy of "Five Wishes" here: http://www.agingwithdignity.org/five-wishes.php

So, I arrived for my surgery appt. (with the hubby) and waited a bit for my "buzzer" to go off. They showed Adam a computer screen that he would be able to check on my progress during surgery (isn't that cool?!) Then they took us back to a curtained off area when they had me get undressed (totally undressed), and put on a gown (ahem - "wrap dress"). They came back and took my vitals, had a few people (resident surgeon, anesthesiologist, researcher, nurses) ask me a bunch of questions to make sure I was feeling alright, teeth were not chipped, get medical history, blah, blah, blah. Then...THE IV. This was one of the more uncomfortable parts to the day, actually. The lady first was slapping the heck out of my hand (I guess trying to get the vein to "pop out"), but geez, ouch! Then she gave me a local injection (ouch), that was supposed to make the IV insertion easier (it wasn't). They took some blood (about a 1/2 a vial, for a research study that I agreed to be a part of). The research is supposed to be something about pain management (I agreed to give them some blood and fill out a questionnaire or 2, that's it on my part). Back to my IV...She was not able to start an IV in the 1st vein, so she proceeded to continue slapping the back of my hand again in another area (I never would have thought about that being painful, but I tell ya, it was), then another injection that was supposed to help with the pain of another IV insertion. This time, she got the IV to take - thank goodness, cause I felt like slapping that lady back at this point! My hand is a lovely shade of blue today - Grrrrr.

 

I told them how I had issues with nausea and anesthesia and the nurse said that they would be sure to load me up on anti-nausea meds in my IV and after the surgery. They also said that they would tell the anesthesiologist to use the least amount of narcotic possible (in the IV) and use more local injections if possible to ward off the nausea. They also gave me a script for some anti-nausea meds I could use with pain meds at home if needed. They had me say goodbye to the hubby (seeing the look of concern on his face was tough - even though I am sure he thought he was hiding it pretty well). They gave me some kind of relaxing med in my IV then wheeled me off to the operating room, had me scoot to the operating table. That's about all I remember, until I was back in another curtained off area (the recovery room). They went and got the hubby, and offered me some juice,water and a nutrigrain cereal bar. I gobbled it all up. I was still feeling a bit nauseous (but not as bad as I was feeling after the Upper GI on Monday), so I am guessing the meds were working. My pain was about a 6 on the 1-10 scale. I wasn't feeling the pain so much in the incision area (in my armpit), as all over the L breast (esp. the nipple), and it was a continuous sharp/burning pain. They gave me more meds for that, which helped. Honestly, I felt like I was in the recovery room forever. I just wanted to get home to see my kids. They said that they wanted to get more fluids in me (from the IV) before they let me get up. So, I waited...and waited. I was having a hard time keeping my eyes open, but I didn't want to close them either, because if they thought I was zonked out, they were going to make me stay longer. I remember thinking to myself "KEEP YOUR EYES OPEN". When I had to rest my eyes for a min. or 2, I had the hubby on lookout, and he would nudge me when my nurse was coming so I would quickly open my eyes - so sneaky, LOL.

The surgeon had come in for a quick visit, but I have no idea what was said (good drugs). Eventually we got to go home. Adam (hubby) hadn't eaten all day either (the big dummy said he was not going to eat if I didn't get to eat - not his smartest decision). So, he was starving and we stopped and got some greasy cheeseburgers, fries (and of course a vanilla malt for me! :)
I came home and laid on the couch for a while. It was so sweet...when it was time for my girlies to go to bed (they are used to me tucking them in at night, and they usually have a bit of a hard time if I am not here to do it)...this time, Adam asked the girls to tuck me in instead (on the couch). So they both came over, gave me a kiss and said goodnight - without batting an eye...(Zoe came back out and adjusted my covers to pull them up over me. It was the sweetest thing. I told her that I thought she would be a great Mommy some day).