"The trail has taught me much. I know now of the varied voices of the coyote — the wizard of the mesas. I know the solemn call of herons and the mocking cry of the loon. I remember a hundred lovely lakes, and recall the fragrant breath of pine and fir and cedar and poplar trees. The trail has strung upon it, as upon a thread of silk, opalescent dawns and saffron sunsets. It has given me blessed release from care and worry and the troubled thinking of our modern day. It has been a return to the primitive and the peaceful. Whenever the pressure of our complex city life thins my blood and benumbs my brain, I seek relief in the trail; and when I hear the coyote wailing to the yellow dawn, my cares fall from me — I am happy." –Hamlin Garland (1860-1940), from "Hitting the Trail," McClure's Magazine, February 1899
Before deciding on my mastectomy, I needed an MRI. I'd had a couple of them in the past: one for my left knee, after I abused it running a marathon; and one for my head, following a run-in with a log cabin while mountain biking in British Columbia. But I digress.
The point is, I remember feeling really claustrophic during both prior MRIs. With the teeming anxiety I was already experiencing with my cancer diagnosis, the last thing I needed was to feel trapped like a caged you-name-the-animal in a big 'ole clicking machine.So I tricked myself into thinking I was somewhere else.
You, too, can survive an MRI — or any other uncomfortable procedure (blood draw, chemo, dentist visit, surgery prep, whatever procedure you are afraid of) — while feeling calm and cool and even fairly collected. I've got it down to five simple steps.
Breath deeply while you're waiting, after changing into that cute little gown, and then while waiting some more. Don't let your mind wander into the worry zone. All will be OK.
Don't be overly ambitious when you walk into the MRI room.Keep your eyes and mind focused on walking towards the machine. Try not to think of anything else in that moment. Do not look around the room. Stay focused on walking towards the machine.
Lay down as instructed and close your eyes immediately. This is key. Get comfortable. Listen to the tech's instructions, but whatever you do,don't open your eyes. Wear an eye mask without metal in it (if they'll let you). Or tie a bandana around you as a blindfold (that way there's less pressure to keep your eyes shut).
Think about your favorite placethat is relaxing and joyful to you.For me, it's being at the top of a hill I regularly hike to. I imagine how it feels to stand, feet firmly planted on the ground, arms stretched out to touch the wind. I notice the sun and how warm it feels dancing across my face. With the cool breeze comes the fragrance of eucalyptus. I listen for the sound of birds and hawks in the wind. What's cool is that while you are imagining the details of your favorite place, the MRI will commence. Whatever you do, no matter how many times they ask you to move or flip over, no matter how many times they reposition the machine, keep your eyes shut!Focus on your breathing; it should be slow and rhythmic as you relax into whatever pleasant experience your mind is conjuring up for you. (I used a similar technique as a pre-surgery meditationhere.)
Now sing a song. In your head. This helps counteract the banging and clanking of the MRI machine. Pretend you're in your favorite place and sing to the wind (or the audience, depending). Sing it over and over and over again. With your eyes closed. Before you know it, the tech will be telling you it's over — the MRI, that is. Remember: If you can't see that you are closed in, you can tell your mind you're anywhere.
BREAST CANCER LESSON NO. 213: Don’t let your husband go home the first night you’re in the hospital.
Such is how my evening begins.
After enjoying the requisite post-surgical strawberry jello and juice, my husband heads home to feed the dogs and get some rest. It’s 8:00 PM when he kisses me goodbye, saying only that he’ll see me early the next morning. (We neglect to clarify what “early” means.)
My chest is bound up like a Geisha’s feet, and I have four plastic tubes the thickness of straws sticking out of me — two on either side. The tubes are a foot in length; at the end of each tube is a plastic bulb about 4 inches long x 2 inches wide into which fluid drains from my incisions. A nurse comes in periodically to empty them; they fill up fast the first day. It’s gross and smelly.
I also have a pain pack that automatically releases medication through two very thin tubes under my chest. So I have four tubes, four bulbs and one tennis ball-sized pain pouch hanging off of me. (Anyone wanna dance?)
As a fresh-from-surgery patient, I must rely on the nursing staff to help me do everything. (Thank goodness I have a catheter.) What makes this more difficult is that a nurse, in her infinite wisdom and attempt at kindness, has closed my door so I can get some sleep. There is a visitor’s lounge a few doors down from my room, and in the middle of the night, it turns into Comedy Central. Every graveyard-shift employee is stopping by — laughing, eating, chatting on cell phones… a real hootinanny. (At least that's what my codeine-fueled brain is imagining, anyway.)
My closed door also means I am now isolated. I can’t catch anyone’s attention as they walk by. So my night goes something like this: pain, nurse button, pain meds, BP, drains drained, nap, noise, awaken, lights, thirsty, can’t reach, pillows slip, can’t correct, itchy, can’t scratch, too hot, blanket off, too cold, blanket still off; nurse button, wait, wait, wait. Repeat.
The night nurse's aide — definitely not in the running for Miss Congeniality — is very busy and not very worried about me. I must look like I'm doing well. Her English is also not great. She doesn’t understand what I mean when I say I need her to scooch me back up in the bed. (I can’t use my arms, so it is impossible to move myself; and I’ve slid so far down the bed that my feet are starting to dangle off the bottom.) She is in and out in a flurry. (Again, this is how my brain-on-pain-meds is perceiving it.) I fall asleep with the comforting thought that soon, my husband and sister will be here to help.
Morning comes, as does my breakfast — the first solid food I’ve had in more than 30 hours. I gobble it down. No idea what it was. But my sister should be here soon. I haven’t seen her since before surgery; my husband sent her (and my mom) home when I was having trouble coming out of anesthesia. She’s an early riser so I expect her to walk through the door any minute now.
Breakfast is over. My water and cell phone are nearby. It’s 7:30 AM — too early to call anyone. I watch some television and doze off. I wake up at 9:00 AM and call my husband. He just got up. He says he’ll be here in an hour. I'm bummed. I feel like I've been waiting for him for forever.
That’s when I notice the sign taped to my door: “No BP on left arm.” What? That’s wrong! It’s supposed to be no BP on RIGHT arm! (Because I had lymph nodes removed from my right arm, I can't have my blood pressure taken on the right side.) Oh... so that’s why I had to keep correcting the nurse last night every time she came in and went for my right arm....
These are the details I focus on to pass the time.
The clock says 10:00 AM. I call my sister. Turns out she was intentionally not coming to the hospital this morning to give me time with my husband. Huh? She says she thought my husband spent the night in the hospital with me. I never said that. I ask her to stop by after lunch because hubby will be here any minute. (BC Lesson No. 214: Always ask exactly when someone is coming back before they leave.)
Nearly 11:00 AM now and still no husband. You can guess what I do next. Yup. The tears flow like a swollen stream after the rain.
And of course that is precisely when he walks in. Oh, am I cranky. I can’t do anything for myself! The night nurse couldn’t understand English! There was a party next door! I was completely miserable and hardly slept all night! I couldn't reach anything myself. I couldn't scoot myself up! I couldn't move my pillows! Blah, blah, blah! I pepper him with complaints rather than compliments. But he fluffs my pillow and flips it over to the cool side for me anyway. He gets me my pain meds and some ice water. He fixes the lousy sign on my door. And I start to relax just a little.
My sister arrives. I take my first walk down the hall, notice the visitor’s lounge and put two-and-two together. (So it wasn't just my imagination on drugs!) . My surgeon also stops by to see how I’m faring and is happy with my progress.
That evening, after my husband and sister go home, an absolute angel of a nurse on the graveyard shift appears. She is sweet, she is kind, and she is compassionate. She makes sure I have everything I need and never makes me feel like I am asking too much. She stops by often. She is like a dream compared to the night nurse before her. I actually sleep.
Morning No. 2 dawns, and my BFF arrives at 6:30AM. YAY! I called her yesterday about the mix-up with my husband and sister; thankfully she is an early riser and offered to come visit. After breakfast, we take a stroll down the hall. I’m in a purple robe trailing my IV bag on a hook. We go real slow. I feel weak but I know I need to move. As we round the bend, I see Dr. C., my plastic surgeon, leaning against the counter at the nurse’s station. He’s dressed in street clothes.
“That’s your plastic surgeon?” my BFF asks. I think she is surprised I haven't mentioned the cuteness factor. (She later tells me she would be happy to accompany me to my plastic surgery appointments; she's only half joking.)
Dr. C. walks us back to my room, says I'm doing great and that I can go home. HOME! Yippee! He wants to see me in his office in three days for a follow up, when he’ll remove my drains and pain pack, but for now he is pleased with my reconstruction so far and even offers to show me how I look before I leave the hospital.
Oh no. I’m not ready for that. I want to stay wrapped up in the safety of my bandages a little while longer, thank you very much. I want the “big reveal” to happen in the comfort of home.
My room is ready. (Wish it were overlooking a tranquil sea instead of in a hospital, but I'll take what I can get.) After 4 ½ hours of surgery and five hours in recovery, a room without a view sounds pretty darn good right about now. At least it's private.
A male nurse arrives to take me upstairs (what floor, I couldn’t tell you). Despite my post-surgery brain fog, I find it a little odd that he's the only one assisting in my transfer (besides my husband, that is). As I’m wheeled backwards into the elevator, I suddenly feel emotional. I close my eyes and let the tears roll silently down the sides of my cheeks.
Then BAM! The magnitude of the moment finally hits me. Just. Like. That. Up until surgery, I've been able to focus on a single thing at a time, placing one foot in front of the other. I had tunnel vision, and I liked it. But with surgery now complete, I'm left to face my new reality. And I have absolutely no idea what that looks or feels like.
We reach my room and I'm still quietly crying. Like a leaking faucet. Can't turn the waterworks off. (This time I don't even try.) The lone male nurse raises my gurney so it’s the same height as my hospital bed. Then he asks me to move myself over. Yup, you heard me right — he is not planning to slide me over using a sheet, he is asking me to move my fat fanny from the gurney onto the bed. Myself. After I just had major surgery.
I can’t. How do I do that without using my arms or pulling on my chest? Why can’t someone else help? Where are the other nurses? Why is he asking my husband to spot him? Are they really that short-staffed?
I'm not sure how much of the above I actually verbalize (parts, but definitely not all). And there stands my fabulous husband, encouraging me to "just slide over," saying it’ll take a few seconds and then it will be done. I glare at him. Whose side is he on here? But I haven't the energy to fight. He's right. It will only take a few seconds, but why should I have to...? Before I can even finish my martyr-lovin' thought, I do a one-two-three shimmy off the gurney and onto the bed (with their help), crying the entire time. In part because I’m in pain, natch, but mostly because I’m a freakin' emotional mess. Yet this doesn't seem to faze the nurse, nor my husband. Huh?
I'm caught so off-guard by the wall of rage that is building inside me that I cannot hold it back. (Kinda like retching in the recovery room.) My feelings are overripe. Oh no. Lower your lids, this ain't gonna be pretty.
“Don’t you people understand what I’ve just been through?!” I scream the words, surprising even myself with my ferocity. (The male nurse spins the gurney out of the room so fast I think he left tread marks.) My husband looks startled. He’s never heard me lose my cool like this before. N-e-v-e-r. But the raging isn’t over.
“I just had my breasts cut off!" I continue screaming (and don't care who hears me — so unlike me)."Don’t you get it? Do you know how hard this is?” My voice is horse. All the raw, suppressed emotion of the past two months shoots out of me like loose gunshot, hitting anything and everything in its angry path — in this case, my poor husband.
“You're a very strong woman,” he says calmly. “You’ve been so strong through all of this.”
Lest he think I don't know it, I take the opportunity to tell him. "I am strong!" I yell back. Then, with more than a trace of vulnerability: "But I can't be strong anymore." I'm sitting in a heap of sheets. He leans in to give me a hug (not easy to do given the IV and the pillows and the bandages and my semi-reclined position).
I wish I could say that releasing my emotions made everything better, but that would be a lie. The pain — physical, mental, emotional — has only just begun.
I hear a woman’s voice. She’s calling my name. Everything else is like peach fuzz. I try to bring her into focus but I’m laying on a gurney. In a room much like the pre-operative one, with a nurse’s station directly in front of me. Have I even had surgery yet? I’m confused. Thoughts float around in my head as though lodged in thick, groggy soup. A nurse types something into a computer to the left of my bed. She asks how I’m feeling; she takes my blood pressure. I try to force my eyes open, but a familiar sensation interrupts this task. The nurse quickly grabs a pink kidney-shaped basin. Afterwards, I close my eyes. The room spins. Another tidal wave hits. The pink basin remains at my side.
It seems I’m having trouble coming out of anesthesia. I’m aware — acutely — of how tightly wrapped my chest is. I’m snapped inside an oversized, papery purple gown with white bear paw prints running across it. An ace bandage and a whole lot of gauze compresses my new chest, which is now comprised of two temporary tissue expanders beneath my pectoral muscles (since all my breast tissue on both sides has been removed). Dr. C. has filled each expander with 400ccs of saline. The purpose is two-fold: to hold the space left by my now-departed breasts while I heal completely, and to give me a semblance of a chest, so I am not flat-chested after surgery. Both help with healing — the former with my physical healing; the latter with my emotional. In a few months, after the expanders are filled a bit more with saline, I will have a second surgery to remove them and put in permanent silicone implants.
But for now, somewhere in the cobweb-like recesses of my brain, I remember to check under my right arm to see if it hurts. (Pain means lymph nodes were removed.) Because I can't reach under there, I focus my thoughts on my armpit. But I feel nothing. Yay! Turns out I’m just numb. Dang. I string enough words together to ask the nurse Is there cancer in my nodes? Her response disappoints. “I don’t know, honey. You have to ask the doctor.”
For the next couple of hours, I slip in and out of sleep between bouts of nausea. I can’t have water yet, so my throat is achingly dry. I start to shiver, and a hose is quickly attached to my pretty purple gown. Warm air swooshes all around me, enveloping me, and for a brief moment, I feel peaceful, even cozy. But it’s a momentary respite; my tummy is unrelenting. I'm given Zofran but it does nothing.
I can feel time passing. I fall into an automatic, Lamaze type of breathing — short, quick, rhythmic breaths in an attempt to tame my pain. In actuality, it just gives me something to focus on besides the nightmare I seem to have woken up in. And that’s OK. I’ll take the distraction.
Speaking of distractions, where is my husband? I look around; he’s not here. He’s never been here. Seems the nurses haven’t brought him in to see me yet. OMG. That means he’s been sitting in the waiting room the entire day with my mother and sister. Waiting. Worrying.
I open my mouth but can manage to eek out only two words: “My husband.” The nurse nearby ignores me. So I repeat myself. Still nothing. Oh. I’m only talking inside my own head! I focus hard on saying the words out loud; this time she hears me, and nods OK.
And like in a dream, when I reopen my eyes, my husband is standing beside me. It’s obvious I’ve been going through a terrible time; I look limp and pale as a noodle. (He later tells me that upon seeing me, he went back out to the waiting room and sent my mom and sister home, rather than have them see me like this. Good call.)
My husband asks the nurse what meds I’ve been given so far, then suggests Ativan, an anti-anxiety medication that also has an anti-nausea effect. My surgeon, Dr. A., agrees with him, saying, “Good idea. Let’s try it.” Within minutes, the room stops spinning. My husband explains to me why: Nausea begins in the brain, not the stomach — which is why the Ativan works.
My husband the hero pharmacist strikes again.
My surgery has taken 4 ½ hours. I’ve been in the recovery room an additional five. We arrived this morning in the dark; it is now dusk.
But what about my nodes? They removed several. All were negative. While we won’t know exactly what we’re dealing with until the pathology report comes back in a few days, both surgeons say there were no surprises. They got clean nodes and clean margins. This is as good as it gets. We are happy, despite all the day's drama.