WATERWORKS

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.

RETCH & RECOVER

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.

(Copyright ©2011 Rennasus)

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.

I finally made it to the other side.

SURGERY DAZE

We’ve been up since 4:15 AM, Husband and I, and by 6 AM I’m laying comfortably in a bed on the second floor of the hospital, with an IV taped to the top of my hand (and yes, it hurt going in). My surgery is scheduled to begin in 90 minutes.

I feel very relaxed, considering. For the past four nights before bed, I have been listening to a meditation CD provided by Blue Shield (believe it or not) specifically designed to calm my pre-surgery jitters. It’s working. I employ the visualization techniques I’ve learned as I lay still —  in between the mind-numbing, repetitious medical questioning that’s been going on since I arrived this morning. 

Every person I encounter asks the same questions. What medications are you currently taking? Have you had any surgeries in the past? What are you allergic to? This gets annoying. Really annoying. It messes with my "relaxed" mindset. So I ask: Why the barrage of queries over and over and over again?

“Patients forget to tell us vital information,” the nurse explains. “And sometimes the info you give us gets entered incorrectly into the computer." Oh. So asking each time ensures everything is accurate? "Yes." OK, I get it. This labyrinth of cross checking and questioning is ultimately for my own good. But I don't have to like it. (This surgery is for my own good too; that doesn't mean I have to like that either.)

My anesthesiologist introduces himself. I let him know that Demerol and I are definitely not simpatico (it makes me terribly nauseous and dizzy). He says they don’t use Demerol anymore, but makes note of it anyway.

Finally, I’m wheeled down to a prep area on the surgical floor, where my husband and I wait in a large square queue of sorts with a dozen other patients having surgery this morning. All that is separating us is a thin curtain (like in an emergency room). You can’t see through the curtain, but you sure can hear through it! My hubby and I amuse ourselves by listening to the litany of complaints and problems and conversations on either side of our curtain.

My surgeon, Dr. A., stops by; he’s dressed in his blue scrubs. I make sure he knows how important it is that he take all of my breast tissue, on both sides. (The point in my choosing a bilateral mastectomy is to reduce my recurrence risk as much as possible; I don't want any tissue left behind that could house stray cancer cells.) He tells me not to worry. I like him and I trust him. He reminds me he is doing the sentinel node biopsy — he'll inject a blue dye near my tumor. The first (or sentinel) lymph node that absorbs the dye is removed and examined for cancer cells. If cancer is found, more nodes will be removed. If no cancer is found in the sentinel node, he likely won't remove any others. (In the not-so-distant past, women undergoing mastectomy were stripped of dozens of their lymph nodes, putting a heavier burden on the ones remaining and increasing the risk of complications like lymphedema.)

Major mental note to self: If I wake up from anesthesia and feel pain under my arm, my cancer has probably spread. (Little do I know that I won't be able to even feel my underarm; it will be completely numb — as will my entire chest and part of my back. Maybe for forever.)

As I am filing this shattering thought away, The Prince of Surgery (AKA my plastic surgeon, Dr. C.) arrives. It’s 7 AM and he’s wearing a dark blue suit, a crisp white shirt and a perfectly knotted tie. My initial reaction is to tell him how fabulous he looks. But I’ve got something else I need to get off of my, umm, chest.

  

I want to go a little bigger.

I know my breast cancer sistahs will howl with laughter when they read this; they are the only ones who can truly understand the phenomenon we have dubbed “boob greed.” But I need Dr. C. to know, in case going just "a little bit bigger” will alter what he is about to do right now. He assures me it will not. “There is plenty of time for that later,” he says. “Today, let’s get the cancer out and the tissue expanders in.” 

And on that note, he pulls out his black Sharpe and proceeds to mark up my entire upper torso, tracing the outline of my boobs and marking their position in great detail. When he's done, I look like a grade school art project gone haywire. (Makes me wish I had my camera.)

Dr. C. leaves my bedside and my anesthesiologist reappears. It's time. I kiss my hubby goodbye with tears in my eyes and leave him standing alone in the hallway as they whisk me away on my soon-to-be magic carpet ride.

But I’m not feeling it — the happy juice, I mean. I am completely, 100% lucid. I make idol chitchat with the nurse guiding my gurney as he makes a sharp left and then an immediate right, wheeling me straight into the operating room.

It’s bright, and very cold. A nurse asks me to slide myself off the gurney and onto the (quite narrow, I might add) operating table. This isn’t easy to do, especially since my arm is attached to an IV; then I realize they haven’t yet given me the “juice” — or they wouldn’t be asking me to “scooch.”

They place my arms on narrow extenders that swing out from the sides of the operating table. I close my eyes and visualize myself standing at the top of the hill where I love to hike. I breath deeply. I can hear voices around me. Then all falls silent.