22 February 2012

One good surgery deserves another

Every time some bit of me is cut off, an unfortunate soul wearing rubber gloves gets the highly enviable job of examining the piece of me. In case that wasn't stimulating enough, the hapless lab tech then gets to compile all the minutiae into a captivating missive known as the pathology report. Once it's ready, Dr. Surgeon walks into the examine room with my exponentially growing chart and delivers the inevitably bad news.

During the mastectomy, Dr. Surgeon checked visually and tactilely for anything untoward, but did not find anything unexpected. As a result, he merely excised the nipple and areola and left the surrounding skin intact, per the original plan to save as much boob as possible. The pathology report told a different story; there was a tumor in the subcutaneous fat. The size and location of the tiny tumor left me with two options.

The first option was to remove the nearby skin in case of any cancerous invaders. The expander would be deflated so that the remaining skin could be sewn together. The second was to bombard the area with extra radiation. Dr. Surgeon stressed that both were medically acceptable and that it was entirely up to me. For once in my life, I made a decision instantly. I'll repeat that for those of you in apoplectic shock - I made a decision instantly. Everyone resuscitated? Can we move on? Excellent.

When could I be scheduled for further Frankenboobing? Dr. Surgeon wanted to perform the excoriation before any more healing took place, so he managed to squeeze me in for the next morning. In other words, more surgery before I was even a week out of the hospital! And, as Dr. Surgeon put it, it was a shame to ruin the good work that Dr. PlasticSurgeon had done. But he did agree with my decision. After some phone calls, so did Dr. PlasticSurgeon and Dr. Oncologist. With that, everything was set for the next morning.

And that's how Matt and I found ourselves back at the hospital the following morning before even the sun bothered to get up, much less the valets. Mom, who I ever so subtly told to not to go home a few days prior, stayed at home with the leaky puppy and Zero, since the whole mess wasn't supposed to take more than a couple of hours. I think it was just a rouse to stay in bed. Anyway, I checked in and was lead into the workshop within fifteen minutes, leaving me with little time to dehydrate and shrink every vein in my body.

Along with the standard no eating or drinking after midnight, I was told no pills. This included the antibiotics, which I couldn't care less about at the time, and the incredibly important narcotics that made life worth living. I was told I had to wait until the IV was in and a doctor approved the pain killers, so I was thoroughly shocked when the nurse got the IV in my arm on the FIRST try.

About that time Matt was allowed in to see me. Unfortunately for him, I was more interested in narcotics. Shortly after his arrival, the anesthesiologist came over to introduce herself and check for allergies, a standard practice. The IV was in, a licensed doctor was in front of me. The first thing out of my mouth was, "Can I please have some Dilaudid now?"

Clearly that was not the right thing to do. "How do you know about Dilaudid?" was not the response for which I was hoping. Thankfully Matt was there to explain that I'd had a mastectomy the previous week, complete with a Dilaudid PCA, and that I'd been denied pain medicine since midnight. Still not convinced that I wasn't a druggie and apparently incapable of reading the giant binder at the foot of my bed, I had to wait for Dr. Surgeon'sAssistant for relief.

Per normal procedure, Dr. Surgeon'sAssistant confirmed the doomed side and wrote "YES" above the existing bandages. A few minutes later, Dr. Surgeon himself came to make sure everything was ready. When I mentioned that the "NO!" on the right side was fading, he rewrote it and even underlined it a few times. There would be no tormenting of the behaving boob that day.

Instead of general anesthesia, I was given sleepy meds and local anesthesia. As a result, I was much more aware of my surroundings when I was wheeled into the operating room. My attention was drawn to the whiteboard on wall with spaces to fill in all sorts of information. I remember asking about them, but the only one I remember was labeled "FRED." I wish I remember what it meant, but all I recall is laughing hysterically at its existence.

Presumably I woke up in recovery and Matt drove me home, but all I can recall from the rest of that day is feeling like absolute crap. I planted myself on the living room couch and refused to move, eat, or breathe for the rest of the day.

A week later, I was both off the couch and in one of Dr. Surgeon's examination rooms, waiting the inevitable. This time the bad news wasn't nearly as horrible. There were tumor emboli in the skin they removed, which further validated my decision to have the skin excoriated. However, the margins were nice and clean. Oh, and he removed 180cc of the initial 250cc from the expander. But more importantly, no more surgery! At least none involving Dr. Surgeon! I practically skipped out of the office, with Matt trailing behind me. Okay, that was a total lie. Skipping would have hurt like hell. But I was rather elated at the news. Good-bye for now, Dr. Surgeon!

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