Happy World Anaesthesia Day!

This seems like a fitting day to share all things surgery related: the run-up, the main event, and the immediate aftermath.

One of my goals after turning 40 was to finally focus on my physical health once again. Long-story-short, family stress and aging and the pandemic lead to gaining almost 40 pounds over the past five-ish years. This was gonna be my year to start reversing all that. I lost about 20 pounds last year by focusing on nutrition.  And this year I was excited to add in more exercise and build back my strength. After finding out I was going to need surgery, it only doubled my desire to get stronger. I found Heather Robertson’s home workout videos on YouTube and committed to doing three a week interspersed with my perennial favorite Yoga with Adriene. In 8ish weeks I ended up gaining a lot of strength and flexibility, and I lost 7 more pounds. These pics are from a few days before the surgery. I felt really good about my efforts to go into this in the best shape possible. 

Getting ready for surgery meant a lot of appointments. First I met with a nutritionist through Wellness House, a non-profit that offers free programs and services for people affected by cancer. Did you know 40-something women are supposed to be eating AT LEAST 100 grams of protein a day? That is insanely hard to do without eating 3000 calories unless all you eat is chicken and broccoli for every meal. I wear a Fitbit on and off, but I really don’t like tracking my calories on the same app as my steps because then I see that I burned x number of calories and way over eat to compensate. So I sprung for the paid version of LoseIt! I really like the functionality of this app and the ability to track protein, fiber, and total calories. I highly recommend it if you’re looking for a nutrition tracker. 

I also had an appointment with a lymphedema physical therapist. They measure your range of motion and arm volume before surgery so they can compare it afterwards. Then a physical therapy plan is designed based on what you need. 

MOM SKIP THIS PARAGRAPH

Most of the time I was completely at peace with my decision to have my breasts removed with no reconstruction and couldn't wait for the surgery to come so it could just be over with. I talked about it a lot with Joe to make sure he was also ok with this decision. Yes yes, my body my choice and I was going to do whatever I wanted anyway, but I think it's important to hear and honor your spouse's wishes as well. That's why I don't have a full sleeve tattoo and eight thousand piercings -- Joe isn't a huge fan, and I want him to still like me. So I have a few tattoos and piercings and we're both happy with that. Without getting too intimate, let's just say we both really enjoyed my boobs. The lead up to surgery was rough. I ended up crying everytime we had sex, which made it not fun for anyone. Then I would stay up late reading horror stories in support groups about women whose partners just couldn't handle the change in their body and their relationships ended up falling apart. Joe has always made me feel desireable and sexy, through all the changes that happen from age 21 to 40 and having kids, and deep down I knew that wouldn't change. But man, it was still super scary at midnight. 

MOM YOU CAN COME BACK NOW

I decided to throw myself a party to say Tata to my tatas. Everything was planned and ready for a party in our backyard, and then the village decided they were going to spray for mosquitos that night. My truly incredible friend Julie said screw that, come have your party in my yard. She was the most delightful host and made it super awesome and everyone brought something to share. I posted the invite on Facebook, and women from every corner of my life showed up. Grade school and high school friends, work friends, mom friends, nature-nerd friends, and a few friends of friends who just tagged along. It really meant the world to me. The most gorgeously thoughtful Sol put it in words best, " I saw women pulling threads from their pockets to weave assurance into a wound we all fear."

Finally, August 5th rolled around. We dropped off the kids at my parents' house, boarded the dog, and Joe cleared his work schedule. The surgery was scheduled for 11:30am, but we had to be there by 7am for all the pre-op procedures. I had to fast for 12 hours before arrival, so I hadn't eaten anything since 7pm the night before. I do not do well without coffee and breakfast, and it was a big scary thing we were going to do, so I was not pleasant at all that morning. Similar to the whole summer, there was a lot of hurrying up and waiting. The surgeon popped in to do a final physical assessment, the anaesthesiologist came in to introduce himself, so many nurses, and I had to take a visit to the Nuclear Medicine department to have my lymphnodes mapped. They use a really tiny needle to inject radioactive die all around your nipple, it felt like 8 tiny bee stings that stopped hurting immediately. Then you wait half an hour and they check you with a geigercounter and some kind of imaging machine to see which is the sentinel lymphnode, basically the first one that everything passes through. That one will be biopsied during the surgery to see if the cancer has spread to other parts of my body. 

Then it was time to say goodbye. I am terrified of surgery and anaesthesia, so in the days leading up I had written letters to the kids and hid them in my sock drawer in case anything happened. I also made short voice recordings for them on my phone. I couldn't find the words to write or say to Joe, so I just told him where the letters were. When I was 10 I had an appendectomy, and I remember being given the anaesthesia before going into the operating room, so I was not expecting to be wheeled into the operating room awake. But that's what happened. It was so bright and white and there were so many machines and lights and instruments and people. The surgical staff all introduced themselves again and I had to climb up onto the operating table. Then it felt like as soon as I laid down I was out. 

When you first wake up you're in what's called Recovery 1 where they make sure your vitals are stable, your pain levels are ok, and start to give you some food and water. I was there for about an hour, and then I was moved to Recovery 2 where Joe was allowed to come back. I was SO HAPPY to see him. I didn't really feel any different. You're wrapped in so much gauze and bandages and a compression bra it practically looks like you still have a chest. The surgeon came out and said everything went great, they were able to remove all of the cancer but they did find isolated sells in the sentinel lymphnode so they removed all 14 axillarly lymphnodes connected to that. Thankfully all 14 of those were negative, but it was a slightly more extensive surgery on my left side. They put in four surgical drains, two on each side to help reduce swelling. Everything felt tight and it was hard to move my arms. Then I was discharged to recover at home. Riding in the car was the worst every bump and every press against the seatbelt was nauseating. Not painful, just ooky and made me feel really sick. 

I think me and Joe had pizza for dinner that first night, but I don't really remember. I was given a nerve block that lasted about 24 hours, but when the surgical pain killers started to wear off I put on my big girl panties and took the hydrocodone. I was also to alternate it with ibuprofen to help keep the pain level low and constant, not fluctuating up and down, so every three hours I was taking something. I FaceTimed with the kids, it was so good to see their faces and hear their voices. Hydrocodone turns me into a delightful chatty Kathy, so for the next 24 hours or so everything was great! After the nerve block wore off though, days 2-7 were the worst. I had to set alarms to take hydrocodone/tylenol or ibuprofen every three hours, even through the night, or the pain would get out of hand. Everything hurt. I was stiff, but I had to get up and walk as much as possible and use my arms below the shoulders as much as possible to help facilitate healing. Using cold packs in pockets on the mastectomy pillow really made things feel better, so I would leave them on for like an hour. Definitely not the doctor approved method and when I checked in with a nurse the next week she was like please only do 20 minutes on and 20 minutes off. Those days are blur of Joe taking care of the drains, napping, binging Fallout, icing, slowly walking around the block, and just generally feeling miserable. On Day 7 the kids came home, and the next day the dog returned. 

This post has been long enough, so the saga of the drains and long-term recovery will come next week.