A Path Through

Two weeks ago today I had breast cancer surgery.  Seems so easy to say now but the day was long one.

As much as my surgery was the primary event on this part of my path through this breast cancer journey, the day actually had two additional procedures that were required in order to prepare me for surgery.  These procedures were related to the sentinel node biopsy and a fine wire placement in the right breast.  Both of these steps were unknown to me until a few days prior and made a long day even longer. 

With my surgery, a sentinel node biopsy was done in order to determine whether the cancer had started to spread to the rest of my body.  The sentential nodes are the first few nodes which the tumor would have drained into and as the nodes are basically the body’s drainage system the cancer can hitch a ride through the lymph system to other areas of the body in order to cause chaos and mayhem.  The challenge is that the node can be can be difficult little fellas for the surgeon to find.  So, to support the node hunt, on the day of surgery the breast is injected with a radioactive tracer material that helps the surgeon locate the nodes with a probe that could be compared to a tiny little metal detector…but it beeps for radiation! Then, while in surgery, a blue dye is injected to enhance the nodes further.  The surgeon then uses the small probe to locate the radioactive materials in the nodes and the nodes are removed for biopsy (in my case, three nodes were removed).  Sounds easy right? Well wait…there is another far more entertaining part to this procedure.  That’s right folks, the blue dye turns your urine blue for three days and the breast is a soft blue color for up to three months. Oh the fun!

So, at 7:00 am at the Jim Pattison Surgical Center, I received an injection of a small amount of radioactive material into my right breast. After a 30 minute wait, a scan was taken to confirm that the material was making its way through my system as expected. The first procedure was completed…now on to number two.

The fine wire placement was the more complicated and uncomfortable of the two procedures as it involved the placement of a wire in the right breast.  For me, the reason for this procedure was as was directly related to the success I had with chemotherapy as my tumor was basically undetectable through physical examination.  This poised a challenge to my surgeon who needed to be in the right area in the breast to remove all the remaining bits and pieces and assure that there was nothing remaining.  In order to help her with this, a surgical wire is inserted into the breast to the site where the tumor was originally located in order to guide the surgeon to the area.

A bit of history to share before we move forward.  When I had my biopsy in January to confirm that I had cancer, the radiologist placed a small titanium clip in the area the tissue was taken from.  This clip was intended to identify where the tumor was in the event of surgery.  Again, given the positive outcomes of chemo, this little clip played a very important role in the fine wire procedure.

The preparation for the fine wire placement is very similar to a mammogram with the exception of the breast being released quickly from the machine.  Instead, once lined up correctly, you stay clamped in for the duration of the procedure.  I twigged into the fact that things may be less than comfortable when I noted there was a chair for me to sit in that would be moved to the machine. This was an indication that I would be staying attached for a for awhile. 

In addition to being held in place, unlike a normal mammogram where it is just you and the technician, there is an additional technician and a radiologist involved in the procedure. 

The process starts with getting the breast in place within the machine and confirming that the tumor (or clip) is in the correct place for the wire to be inserted.  Both technicians are involved in the positioning, repositioning, and re-repositioning of the breast. With each move, a mammogram picture is taken to confirm whether the breast is in the correct position. Once the radiologist gives the final “yes” to the breast placement, a small section of the plate holding the breast is removed to allow access to the skin.  A local anesthetic is then injected in order to make the next step more comfortable.  Once the area is numb, a fine surgical wire is insert to the breast to the area where the tumor is or was.  The radiologist then requests additional pictures to confirm the wire is in the place and will make adjustments as needed. Once the wire is in the correct area, you are finally released from the machine, the remaining wire outside of the breast is taped to the skin, the breast is bandaged and you are sent on your way to surgery.  Overall, the procedure takes approximately 20 minutes to complete. 

On a small side note, when the technician left me in the room in order to get the radiologist before we got started, she left my original mammogram up on the screen with the large ugly white mass staring back at me.  I will honestly say that the entire time I sat there I could not take my eyes off the images as every ounce of me was projecting how much I hated that white blob.  I never knew a picture could result in such a level of raw emotion and I don’t think that the tech considered the impact it would have on me.

So….just like that….I was radioactive and wired and off to Surrey Memorial Hospital for the final and main event of the day; the removal half of my right breast with bilateral breast reduction and sentinel node biopsy.  

I have said before that fear was not an emotion that came with surgery. I simply wanted to get things done. The path to get me to this point had been long and fatiguing and the nerves I felt were related to wanting to move forward. I also knew that this would be the point where unknowns such as the cancer stage and whether there had been spread to other areas of my body, would be confirmed.

Just shortly before 2:00 pm I was wheeled into surgery.  As I lay in the operating room with all the buzzing activity going on around me all I could think was that if all went well this unwanted invader would hopefully be leaving me for good and taking all of it’s little cancer cell buddies with it. However, when the anesthesiologist told me to think happy thoughts as he prepared to whisk me off to sleep, my thoughts did not go to being cancer free….rather I thought about my husband and kids and the long life I want to have with them… as they are my happiness no matter what challenges lie ahead.

I have been told that the surgery was “textbook” and I nailed my role as patient asleep on table during procedure (apparently four years of drama classes finally paid off!).   I did have a small sprinkle of drama while in the recovery room that resulted in me being a guest of the hospital overnight.  This was not the intended outcome of “day surgery” and my very clear instructions to my husband to get me out of the place as soon as he could.  However, it was the very best place for me with all that was going on and the nursing team was incredible.

Finally at 8:30 am September 8^th, I was officially sprung free from Surrey Memorial Hospital. I cannot put into words how it felt as my husband and I drove away from the hospital. Yes, my chest felt like a truck had back over it several times ….…..but I was happy….unbelievably happy. I had made it to the top of another hill on this challenging journey and it was as if I could see the end of the path finally in the distance.

And there you have it….surgery DONE.

Over the past two weeks my recovery has been going smoothly.  My drains were removed five days after surgery with no issues.  I am down to minimal (if any) daily pain management (as long as I don’t do stupid things…which I like to do at times)…..and I am starting to become more comfortable with my new “apples”.  I have embraced my inner “cat” and can nap with the best of them.  The fatigue left from chemo is slowly leaving me and I am starting to feel…well….more like “me”.

What is next on the path? Well it is waiting for the pathology report and from there determining the next steps on the journey.  My hope is that the hills left to climb will be fewer and farther apart and with each step I take, the end of this path becomes clearer….and closer.