I Don't Remember Signing Up for This

Bo and I arrived at the hospital on Wednesday two hours before my surgery was scheduled, as instructed. Dad and Jeff followed us there. Before exiting the car, I carefully applied "Fire Down Below" on my lips. Bo said that they would probably me take it off (the pre-op brochure instructs you not to wear lotion, makeup, or nail polish) and that I should wait until after the surgery to put it on. I told him the book was not called "Why I Wore Lipstick After My Mastectomy" and proceeded to walk into the hospital, face naked and pale except for the bright beacon of color painted on my lips.

Betty was already in the waiting area, and we managed a quick hug before I was immediately ushered to the pre-op area where I was converted from "civilian" to patient in the 30 seconds it took to remove my clothing (and dignity) and don the infamous hospital gown, opening in the back. A nurse began the process of taking my vital signs, obtaining signatures on required paperwork, inserting the i.v., and explaining the day's events to me.

Since I had already been through the pre-op process for my porta-cath insertion back in May, I was somewhat knowledgeable of the protocol. This was a good thing since I found myself needing to be a more active participant in the process than passive. (Seriously, this had nothing to do with my control freak tendencies. The staff seemed busy or distracted or something. I was really, really nice about it though, of course.) For example: Dr. Hoeffer wanted the i.v. on the arm that was not undergoing lymph node removal (left side), but the nurse was getting ready to insert it on the right side, mistakenly thinking that the total mastectomy occuring on the left side was the more comprehensive procedure. I set her straight - no reason to subject my body to any more assaults than absolutely necessary. Also, for some reason, my paperwork did not include the porta-cath removal, so I had to remind the staff several times to correct this omission, and I was finally given corrected paperwork to initial. (I was not leaving that hospital with that thing in my chest!) Then, as they were getting ready to wheel me out, I pointed out that I hadn't received my Jiffy Pop hat yet. (It is a silver metallic chef looking cap that keeps your head warm during surgery in the chilly operating room.) They had forgotten both the cap and the slippers for my feet.

While I was supervising the pre-op procedures, I was also visiting. I was allowed two visitors in my "suite" at a time. Bo stayed with me the whole time, and Jeff, my Dad, Betty, and Jodie also came in one at a time to wish me well. Jodie brought me a coffee cup containing a big bag of gummy bears. She was afraid I would find the mug too irreverent under the circumstances and almost didn't buy it for me. I am glad she did. When I read it, I burst out laughing. It said "I don't remember signing up for this." The sentiment and the timing were perfect. When she left, I almost tried to sneak out behind her, but the tell-"tail" (pardon the pun) hospital gown distinguished me as a patient and prevented any escape.

Dad came in next, and he was very quiet and solemn. I know how hard this must have been for him - to be forced to relive what he had experienced with my mother 25 years ago. Also, I think when someone undergoes the transformation to patient, it almost seems to diminish the person and make them appear more vulnerable and weak. When you see someone lying on a hospital gurney, in a gown, with an i.v. stuck in hopefully the correct arm, you can't help but experience them a little differently from the night before when they were fully dressed sitting across a table from you engaged in a conversation about say, the latest political scandal... Plus, I am his little girl, and I am sure it has been painful for him to watch me deal with this diagnosis and its attack on mind and body, helpless except to love and support me. Nonetheless, he has been there for me every step of the way, babysitting the boys, spending time with me, listening to me, offering financial support if needed, helping me navigate through this latest challenge in my life, steadfast and unwavering in his role as my Dad and one of my greatest and most constant sources of strength.

Jeff was next, and he hung out for awhile. (Pre-op is an excruciating two hours of waiting for the inevitable.) While he was there, the anesthesiologist, Dr. M came in to introduce himself. The first time I caught a glimpse of him, I thought he must be fresh out of med school, but upon closer inspection, I was relieved to see some gray hair in the sideburns poking out from under his surgical cap. He said that Dr. H had reserved the operating room for three hours and 4o minutes, and that knowing, Dr. H, the surgery would take three hours and 40 minutes. "Dr. H. is very thorough," he explained.

I advised Dr. M that I believe in the power of the subconscious and that even though I would be under anesthesia, my mind would be able to hear what was being said. Therefore, would he please say only positive things during the surgery such as, "You are healthy" and "You are going to feel great when you wake up"? I told him that he could even throw in a couple, "You are beautiful"s, that Bo wouldn't mind, under the circumstances. I also informed him that my hypnotist had suggested I hear the message, "You will wake up feeling a little bit hungry." (She had explained to me that you can't feel hungry and nauseous at the same time.) He was very good natured about my request.

After Jeff departed, Betty came in, but she didn't stay long. She wanted me to have some alone time with Bo before they took me away. She assured me she would be there when I woke up, even if it was midnight.

Dr. H stopped by to see me. One of the pre-op nurses told me that if any of them (the nurses)needed surgery, Dr. H is who they would choose. This was reassuring to hear, although at that point, it would have been a little late to change surgeons. I had the power of the subconscious mind conversation with Dr. H during my last surgery when he "installed" my portha-cath, but I reminded him today and asked him to communicate positive messages during the surgery. He agreed that he would tell me that we had kicked the cancer's butt.

The three nurses who would be assisting in the operating room also came by to introduce themselves, and I advised them of my subconscious mind beliefs. They were all very nice, and one of them even said she absolutely agreed with me. The other two smiled at me kindly.

During the interminable waiting, I went ahead and signed the Living Will and Medical Advance Directive document. I selected Bo as the primary decision-maker but asked him to please get a majority vote before pulling the plug. I have never heard of anyone dying during her mastectomy, but the thought crossed my mind, "What if I don't wake up? I will never see my boys grow up. They will never know how much I loved them. Life will go on without me." These thoughts didn't really consume me, but when the nurses said it was time to go and administered a drug to relax me, I began to cry as Bo kissed me and I was wheeled away.

Evertyhing got fuzzy after that. I remember someone asking me to hoist myself up on the operating room table, and I had to stretch my arms out on these boards on each side of me. Then either the last thing I remember before going under or the first thing I remember when I woke up was feeling someone putting anti-embolism socks on my feet. Time and reality blurred for me then and there.

I woke up up in the recovery room. It was about 6:45 p.m. I asked how long I had been in surgery, and it was just about 3 hours and 40 minutes on the dot. Talk about precise! I stayed in recovery until about 7:30 p.m. The nurse observed that I was in pain, and I agreed with this assessment so she gave me something through the i.v. It flushed the pain right out of my system but only for a couple of minutes, and then the pain moved right on back. It was mostly under my right arm where the lymph nodes had been removed. I asked her if I could have more pain relief medicine, and she said that I could but that I would have to wait another 15 minutes in recovery to make sure I was okay. I was anxious to see everyone so I asked if I could just get something for the pain once I was in my room. She said "yes".

I asked if my family had been notified that I was done, and she said that Dr. H had already been out to talk with them. The nurse said that I could be released to my room as soon as Dr. H finished the notes on my case. I could see Dr. H sitting at a desk talking on the phone. At some point, he began dictating notes. I was trying to hear everything he said, but I was too far away and caught only the occasional word. Finally, he walked over and told me that everything had gone well.

The nurse had already called down to the waiting area, so Bo, Jeff, Betty, and my Dad were waiting outside my room when I was wheeled into the... maternity ward! (How appropriate. After all, I had just delivered... a tumor.) I was so thrilled to see them. I had a big smile on my face, and I waved as I approached them. I felt like I was on cloud nine. I don't know if it was the anesthesia drugs or just the sheer joy of knowing the cancer was out of my body, but I was exuberant.

Betty asked me what brand of lipstick I applied as it was still on my lips. I am sure I was quite a sight with the jiffy pop aluminum cap, bright red lipstick, and my round moon face, swollen and puffy from the i.v. fluids. I was oblivious to all that. I was euphoric! I was just so happy to be alive, happy to be back with my family and friend, happy to have this leg of the journey behind me, and happy to be on a maternity ward without having had gone through childbirth again!

The recovery room nurse advised Charlene, my night shift nurse, of the pain meds that had already been administered to which I responded, "and I am still waiting for something that actually works." (I was really, really nice about it though, of course.) Charlene advised me that I would have to wait until midnight before I could have anything else. Thought bubble: Hmmm.... wonder if they will let me go back to the recovery room for that dose I just passed on....

Tthe doctors and nurses must have honored the request to advise my subconscious that I would wake up feeling hungry because I was in the mood for food (or it could have been the fact I hadn't eaten in nearly 24 hours.) Dr. H hadn't left instructions for my diet, so Charlene called him. He said I could have clear fluids that evening and a regular diet in the morning. She managed to track down one popsicle for me which I promptly devoured. She advised me that if I didn't urinate within six to seven hours, I would need a cathether. I promptly began drinking water, juice, and ginger ale in quanitities sufficient enough to deliver the desired results. Whew! Another indignity averted.

She had also asked Dr. H about meds, and he authorized her to go ahead give me Oxycontin and Percocet. Thank you, Dr. H. I was wired and even with the medication, I couldn't fall asleep. I decided to call my friend, Ann. She had called me earlier in the day, before I had left for the hospital and was very worried about me. (She had been at the hospital when my Mom had her mastectomy, so she was having to relive the past with the next generation too.) I wanted to let her know that I was feeling great. She didn't recognize me at first because my voice was hoarse from the i.v. tube, but she was thrilled to hear from me, and her tears that night were prompted by relief, I hope, and not by worry, as the morning's tears were.

By this time, Bo was snoozing on the couch beside my hospital bed, my new pain meds still hadn't kicked in, and it was too late to call anyone else, so I resorted to the television, which less than a week before election day can be very annoying. The campaign ads were actually making my pain worse. The room was wired for e-mail and internet access, and I considered updating the blog, but the B on my keyboard was stuck, and I couldn't gain entry to the website.

Sometime after midnight, the pain fianlly eased up and I was starting to drift off to sleep when the nightly routine of hourly vital sign readings and other sure-fire slumber prevention techniques were employed. The morning was no better. First there was the shift change at 7:00 a.m. and three new nurses or aids to meet, and Anna, the nurse practicioner came by, once with Dr. H and twice without. Then Donna, the other nurse practicioner came by, breakfast was delivered and retrieved, the home health care advisor came by, followed by the actual home health care rep, and the cleaning lady.

Dr. H offered to let me stay in the hospital another night, and I appreciated this offer, but I decided I would take my chances at home where I only had to contend with three rambuctious boys. (Seriously, how does anyone heal in a hospital between the lack of sleep and the quality of the food??) Dr. H said he wanted to make sure I could keep food down and that I was able to get up and walk around before he would release me. He asked me to stick around until after lunch to see how I was feeling.

Dr. H told me that the surgery went well and that everything looked normal. He said it would be five to seven days before the pathology results would be back and that these results would tell us is if we needed to do radiation. He said that even though he had been advising radiation from the beginning, we would make that decision upon learning the results. I am not sure if he saw something (or didn't see something) that made him reconsider the need for radiation, but Bo said Dr. H had mentioned the same thing to him the night before. I had been planning on radiation, and I really want to do everything I can to ensure the best long-term outcome, so I am fine if radiation is the next step.

I ate lunch and then got up and walked around. I started feeling a little dizzy and nauseated, so I laid back down and was miraculously able to get in 1 and 1/2 hours of uninterrupted nap time. I tried walking around again and felt much better this time. My goal was to get back home to greet Cole and Clay at the bus stop, and we made it just in time. We actually followed the bus into the neighborhood, and I hopped out of the car so I could hug them as they stepped off the bus.

To be continued....