Thursday, September 22, 2011

The Alien - Part Four: Removal

By 7:15 am on Tuesday, September 13th when we arrive at the hospital for my surgery, it is exactly 7 weeks since my first mammogram. The weight of piled up worry over those weeks kept both of us awake last night. It isn’t due to lack of confidence in the doctor or the hospital. I was born at the hospital’s old location and my children were born at the new. My family has been well served by the spirit-centered neighborhood health care institution for more than 80 years. Our insomnia was brought on by general uneasiness about surgery and the outcome of the pathology report. Except for tonsils I’ve never been in an operating room before.

We begin running the gauntlet of pre-surgery preparations. First the admitting clerk who asks me to sign stacks of forms and verifies my ability to pay; the short stay receptionist hands me a stylish hospital gown and tells me to take off all my clothes; a nurse checks for vital signs; and everyone repeats a long list of the same questions. I am fitted with a blue identification bracelet and a red allergy tag. Each person we meet along the way spontaneously praises my surgeon.

The first big obstacle is to place an IV. I know from my experience with child birth that I might be passed around a few times before anyone is willing to place a needle in my tiny, hard to find veins. The first nurse decides not to try and leaves to find someone else. I can tell Janice is experienced as soon as she walks into the room. We exchange some good-natured banter about the difficulty of the task while she wraps my arm in a warm towel to increase the blood flow. After a few minutes, with a little luck and a lot of skill, Janise gently slides the IV into my vein. We both breathe a sign of relief.

A talkative young man tells me about his plans to tour the world after college while he pushes me in a wheelchair down to radiology for the next step - the insertion of an ultra-sound guided wire localization and sentinel node tracer. The radiologist first injects an isotope in four places around my left areola. This radioactive dye will travel from the tumor to the nearest lymph nodes. The surgeon uses a beeping device to find the dye infused nodes so they can be removed and checked for cancer cells. After the tracer procedure the tech quickly finds the alien with her ultra sound wand and the radiologist inserts a 7 cm long wire into the middle of the mass. The surgeon will use the wire, the measurements from this procedure, and the results of the MRI to locate the area to be removed. As the surgeon told me at the first appointment, “I don’t ever want to see the tumor just a clean margin of healthy tissue around it.”

Back up in my room, I knit and Gary reads his book while we wait for transport to short stay surgery on the floor below. A humorless LPN arrives at about 10:30 and wheels my bed down the hall to the elevators with Gary following behind. When we arrive in the empty pre-op area, a nurse with a colorful head covering and a young woman who looks to be about sixteen are sampling chocolates from a locked cupboard in the corner of the room. More questions, more forms. The anesthesiologist although young is not a teenager. She listens intently while I explain my fear of anesthetic induced nausea and dizziness. “You have nothing to worry about. I will make sure you wake up feeling well.” A quick visit with my surgeon, a goodbye to Gary and they wheel me into a brightly lit room where the walls are lined with surgical gear. A nurse is sorting instruments as I roll by. The last thing I remember is sliding onto a narrow table.

I feel a lump in my throat and a low grade burning sensation radiating from my left breast. A disembodied voice is saying, “your surgery is over, you are in recovery.” When I open my eyes, the hands of a fuzzy clock indicate at least two hours have passed. I feel remarkably well. With relief I think to myself, “there was an alien in my body and now it is gone.”

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