Bi-Lateral Mastectomy Day

November 16th 2017 – almost exactly a month from my initial diagnosis, this was the day of my bi-lateral mastectomy. The day I would lose both of my breasts and have them replaced with fake ones, or as many call them “Foobs” which I actually find endearing. Somehow the day came up so fast, yet so slow all at the same time, and I was surprisingly calm walking into the hospital….probably because I was more than ready to get rid of the tumors that were slowly taking over my body.

I had never had a major surgery before, let alone one that is 5 hours long! I had been under minor amounts of anesthesia for routine tests like an endoscopy and a colonoscopy (yes – I’m like 60 years old and had to get one when they were trying to figure out what was causing my GI symptoms about 4 years ago – ends up it was Celiac Disease. That’s a whole other story…). Both of those procedures were all of 20 mins max, so 5 hours was a bit intimidating to say the least. I tried to distract my mind from thinking about the length of time and kicked into survival mode saying over and over ““ok Danielle, we’ve got to just do this and get it out, so don’t worry, we’ve got this”.

I vividly remember the night before the surgery, I had gone out with friends and family for Pizza because 1. It’s my favorite and 2. I knew I wouldn’t be able to eat come midnight for about 24 hours, so I was preparing myself by eating as much as I could. That’s reasonable right? That night was full of stories, laughter and fullness both literally and emotionally. When we got home I took a shower as directed with the special medical grade soap I bought and I went to bed somewhat early.  I remember turning to Phill and telling him that I finally felt nervous knowing I would be going under for 5 hours and feeling like it was only 5 mins. It all was a bit hard to wrap my head around. There wasn’t much anyone could do to take away those nerve, but i did find one thing helpful. A technique that my therapist and I had discussed the week prior. Setting my mind at ease by visualizing myself waking up with the people I love by my side, and being sound in my road to recovery. I would think about this over and over. It helped get me to sleep, though I’ll be honest I didn’t rest well that night. My mind continued to race, mainly because of the unknowns. How would I feel when I woke up? Would I be in a lot of pain? Would I be nauseous (a big anxiety trigger for me)? What would the preparation for the surgery be like? Especially the nerve block, would that hurt? All of these questions were answered that next morning…

Like I mentioned before, as I walked into the hospital I felt calm. Even though I had these bouts of anxiety during the course of the night before, there was some kind of calming energy that came over me when we got there. I’m not sure if it was the faith I had in my doctors and a strange sense of knowing I would be okay especially ridding this alien inside of me. Or was it the fact that the MSK outpatient facility was like a friggin hotel mixed with a spa when you walked in. Upon entering there was a small lobby and a man who greeted and ushered us to the next check in area. We were shown around and informed of all the amenities for the friends and families who would be waiting long hours for their loved ones to come out of surgery. There were games, books, a café and a digital board that showed you exactly where your loved ones were in the process of the operation. AMAZING! Seriously they put every thought into how to make it a seamlessly comfortable experience for both the patient and their squad. It helped ease the nerves for sure.

It wasn’t long until we were brought up to the pre-op floor in which I was placed in a small waiting room with a mobile hospital bed. At this point I was prompted to change into a gown and hair net, plus grippy socks which are weirdly my favorite. I definitely kept them and asked for some additional pairs to take home…guilty. I was only allowed to have one person with me while they put in the IV and briefed me on the next steps in terms of the nerve block and pre-op meds. My sister stayed with me and I was so proud to watch her being so supportive. It was a really special moment for me to have her there especially since I know her overall fear of needles.

The nursing team explained to me that I had the option to do what they call a nerve block which is essentially like an epidural that pregnant women can receive. It’s injections into the spine to block the nerves in a certain area of your body so you are left numb. In this case it was my chest area. I was told the main benefit of doing this would be post operation with pain management. That way I would require less pain meds afterwards and I was all for that. Of course there are certain risks that come with this type of procedure, like nerve damage for example, but I was willing to take that risk because the benefits outweighed them.

The next discussion was with the anesthesiologist. For anyone reading this who knows me well you will probably laugh at this next part. For those who don’t here’s a quick explanation- one of my second biggest fears (the first being Cancer which I faced head on) in life is throwing up. Out of all of the things I had to go through with this surgery, it was a mission of mine to let my nurses and doctors know of this fear and to try to eliminate me having to deal with both of these high anxiety triggers at once. I made that very clear to the anesthesiologist who left the room and I overheard him say to the nurses “ok so she’s not nervous about anything BUT the nausea”. I had completed my mission. My family and I had a good laugh about that one.

The interesting thing I wasn’t aware of since I had never had a major surgery before was that every single medical professional that walked into the room repeated the same questions over and over to make sure you were the correct person and to confirm you understood what was going to be happening. They asked me my name, date of birth, what were both of the procedures that were going to be happening and if I had any allergies. In my case for the second part of those questions, I had to continually answer “bi lateral mastectomy of my breasts both right and left. The Cancer is on the right side. I am allergic to penicillin and gluten”. I kind of wished I had counted how many times I had to say that in one day.

Once everything was sorted – I was given a pill to help with nausea which would effectively work throughout the process and I was prepped for the nerve block. I had to lay on my stomach and they put surgical dressing cloths over me until I was completely covered in a thin paper like blanket. I couldn’t see anyone around me. The nurse talked me through a “cocktail” she was giving me in my IV which would help sedate and relax so they could work their magic. I am SO thankful for that sedation med. Man did it work. In about 30 seconds I felt like I had about 4 Gin and Tonics without the annoying spins and upset stomach. Though I was sedated I surprisingly remember the nerve block procedure. It felt very much like someone was bruising my back badly. It didn’t hurt too much but I remember audibly saying “ouch”. It maybe took all of 15 mins from start to finish. Once that was done my family was allowed to join me and from that point on I was not allowed to get out of bed. Here’s a fun TMI image – I wasn’t able to get up to go to the bathroom so I was treated very much like a large adult baby….

You can enjoy the video below of that first encounter after the sedation and nerve block. My mouth was extremely dry afterwards (which is common) so they gave me what I thought was a lollipop but to my disappointment ended up being a wet sponge on a stick. That’s what I’m holding in the video below….I hope you get a good laugh out of it like I did:

I had to wait about an hour ½ after the nerve block until I was wheeled up to surgery. I remember saying goodbye to my family and went up in an elevator directly to the operating room. My breast surgeon greeted me there so warmly it makes my heart happy thinking about how amazing she is. They lifted me onto the surgical table (since I wasn’t allowed to walk on my own due to the nerve block) and draped a warm blanket over me. This was actually an incredibly comforting touch. There was a lot of commotion around me as the doctors and nurses all prepared for the operation. My breast surgeon who knows I dance in a company in my spare time started distracting me with questions asking how dance was going. I started telling her about the company show I had just watched the previous weekend and how one of my best friends choreographed a piece and they wore pink Breast Cancer ribbons during it – I barely got the full story out and I don’t remember the rest…

I woke up in the recovery room before I was really aware that I was awake. The doctors had conversations with me that I reiterated to my family once they were allowed in. I can’t remember these conversations at all aside from what they told me. It’s so crazy to think your mind can function without you consciously knowing….or remembering. I digress….the great news which I promptly told my family was that my lymph nodes tested clean when they were operating! When they do any sort of Cancer removal of the breast the process is to remove the sentinel lymph nodes which drain the breast and chest area checking those to see if any Cancer cells are present. If they are clean they do not remove anymore, but if they aren’t they move onto the axillary nodes which are located in the arm pit. These nodes help drain the arm. I was fortunate to have caught my Cancer early enough that the Sentinel lymph nodes had no sign of the disease therefore they did not need to remove anymore. This is a very positive sign which I was happy to share with my family when I was reunited with them.

My sister told me that some of my closest friends came to visit me and were waiting to come in. I was only allowed 2 people in the room at a time so they took turns coming in and helping me with mundane things like eating and going to the bathroom. They are some of the best friends a girl could have. You can see their amazingness below. I’m so glad they captured this because I don’t remember everything after surgery. A lot of it is blurry even going into the following day which I would say is even harder to remember than the initial surgery day. Regardless of how specific my memory of that day is, there is one thing I can’t and won’t forget, is how incredibly loved I felt.

To recap on what I woke up to post operation – both of my breast were removed completely. All of the breast tissue, milk ducts and nipples were removed during surgery. I was left with an incision that goes straight across both breasts. It resembles the little yellow face emoji with the straight line for the mouth, but my breasts don’t have the eyes obviously. Sometimes I look at the scars now and want to draw the little eyes above each line. Waking up after surgery I was fully dressed in a compression bra, bandages and two drains. The lines for these drains came out right below my arm pits on either side. These are placed in to make sure my body expels the buildup of fluid so you don’t get an infection. The drains were certainly the most shocking thing for me. Having a foreign object sticking out of your body is not something anyone is ready to wake up to.

Once my breast surgeon had removed all the tissue and tested the lymph nodes she handed the baton to my plastic surgeon to go in through the same incision and place in tissue expanders. Think of these like deflated breast implants. They insert them under the muscle and skin and fill them just a little bit with fluid during the initial surgery. Overtime I had fluid put into each expander to help stretch out the skin and muscle to make room for the permanent implants. The permanent implants require another surgery which I will have once I’ve completed chemotherapy treatments.

So how did I feel after right surgery both physically and emotionally? The right after is a bit fuzzy, but it was definitely taxing in both ways. Emotionally it was tough to realize that I couldn’t do simple tasks for myself, like go to the bathroom or open a door. I had to let my guard down and allow lots of help. It’s less of a pride thing for me and more of a “I don’t want to be a bother” though I quickly learned that when people care about you, that’s the last thing on their mind (if it’s even there at all). Physically I was the weakest I have ever been. I don’t think I realized how much it would set me back. Like I mentioned before it was nearly impossible to perform simple things like just sitting up from a reclined position. And sleeping – forget it. I had to sleep on my back and that was so hard given I had never been a back sleeper before. It tested my physical and emotional strength a lot and I will talk about that more in a recovery post coming soon.

It’s a bit surreal writing this blog post after what seems like so much time has passed but its barely been 6 months. It feels really good to be able to lay it all out so I can look back and remind myself of where I’ve been and how far I’ve come. Thank you so much for reading.

XOXO,

Trops

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