Double Mastectomy: Surgery Day

So many pills.  I recieved my pre-surgery packet from the plastic surgeon's office and it included several new prescriptions -- pain killer, muscle relaxer, antibiotic and sleep aid.  Plus all the regular pills I already take - antithyroid, multi-vitamin, probiotic, claritin, and biotin.  It's going to take quite a spreadsheet to keep all these in order after my surgery.  I tried to label them all so in case I was out of it, Ben would know what each thing was for and when I should take it!

Other pre-surgery to-do items were to get my Covid test (which came back negative), and get my nails done.  Some friends had given me a gift certificate to a new salon and I decided to go ahead and get a dipped manicure and a pedicure right before surgery so that when I felt ugly and sore and beat up after surgery, at least I'd have pretty hands to look at. 

Later, I heard some talk and warnings about not being able to have nail polish on when you go in for surgery, but it wasn't in my pre-op info, so I decided forgiveness was easier than permission.  And having my nails done was really important to me. I don't know why I got stuck on that, but I might have fought someone if they told me I had to take it off.  When you have no hair, can't wear normal clothes, or put on makeup or wear jewelry, and feel completely awful, I just needed something to feel like it looked pretty.  And since it's a dip manicure, it should last me the full two weeks post surgery when I'm least able to do my own nails.

Somehow, I was less nervous about this surgery than my port insertion surgery.  I guess because I'd been through the process once before myself (plus watched both my mom and Ben go through their own surgeries recently).  That took so much of the fear and unknown out of the equation.  Also, I've had over 7 months to get used to the idea of having this surgery, thought I was going to have it in July, and now the time has finally arrived.  I've done plenty of reading and research and ultimately, was just ready to do the next step of this process. 

Certainly I was a little nervous.  What if recovery is awful? What if they find more cancer? What if they can't do reconstruction?  But, mostly I was able to put those questions aside and focus on preparing my overnight bag (which I WAY overpacked, of course) and taking care of wrapping up work (I won't be painting for the next two months while I recover) and getting the house and kids and schedule ready for me to be out of commission for a while.  That all took most of my concentration and focus for the past week, although I was able to slow down about Thursday and just enjoy just hanging out with the family all weekend, participating in Halloween activities and getting Ayla to all of her club volleyball tryouts that were all weekend long.

We had to be at the hospital at 5:30am, showered with antibacterial soap, no lotions or creams, and all my jewelry removed.  Ben was able to come with me and while he did plenty of waiting room waiting, he was able to come into my pre-op area right before I went into surgery and was in my hospital room with me afterward.

Pre-op was very fast, especially since my surgery was moved up from 9:30am to 7:00am.  Both of my surgeons came in and talked to me again about what I was having done (bilateral nipple and skin sparing mastectomy with tissue expander reconstruction), and made lots of sharpie markings all over me.  The nurses asked a bunch of questions, got me set up with an IV, and the anesthesiologist came in to ask his own questions as well.  I think I saw at least 8 or 9 people in this teeny tiny little pre-op area.  

Shortly before I went into surgery, they injected a blue dye into my left (cancerous) breast.  That dye would show what lymph nodes were closest to the tumor and which ones the breast surgeon would need to remove.  We were pretty sure that the cancer had not spread to my lymph nodes, so we were only expecting her to have to take 1-2 sentinal nodes, not an axillary lymph node.  

It all happened so fast, I didn't have time to get nervous (and nobody mentioned my nail polish).  Before I knew it, I was being wheeled into the operating room.  I vaguely remember seeing several people in scrubs bustling around me getting things ready for surgery, but I don't remember being put to sleep at all--just waking up later in a recovery room!

I'm pretty sure I woke up and asked what time it was, which I think I did after my last surgery too.  Wonder if everyone asks that? It was about 12:30pm when I finally came to, and I think the surgery was over around 11:30, because that's when Ben heard from the doctors.  They kept me in the post-op recovery room for a while longer and I was in and out of awareness.  I still felt very woozy, couldn't speak clearly and had a few waves of nauseausness coming out of the anesthesia.  I wasn't in pain, but could definitely feel a tightness in my chest.  

Eventually they rolled my stretcher up to my hospital room, where Ben was waiting for me.  I remember talking to the people transporting me, and asking them how I was supposed to move from the stretcher to the hospital bed (I was able to move over on my own somehow).  I think I even made a couple of jokes.  At least that's how I remember it.  Later, Ben asked me what I remembered from that day and said I was really mean to everyone and especially him!  I felt pretty bad about that, because in my memory and in my head, I was very easy going and charming and witty!  Oops.  I guess maybe I wasn't.

Once I was back in my room, I was still really tired from the anesthesia, and had a couple more waves of nauseausness when I tried to eat or take any pills.  In fact, I threw up at least twice, once when trying to take a pill, and once after I had gotten up to go to the bathroom.

I'll spare you the photo Ben took of me leaning over the toilet and throwing up!  They switched me to IV morphine for pain killers for a while until I was able to eat a little more and the anesthesia could wear off more completely.

My nurses were all really nice and helpful, and eventually I was able to sleep off the anesthesia a little more and eat some food, though very little. I had some applesauce and tried to eat a peanut butter cracker.  My mouth was so dry though that I couldn't hardly get that cracker down!  Plus my throat was really sore and voice was hoarse from the breathing tube. 

 Eventually dinner came and I think I ate a bite or two of alfredo noodles and a piece of broccoli.  But mainly, I just wanted to sleep.

When I was awake and coherent enough to talk, Ben filled me in on the doctors report.  It sounded like everything had gone very well.  The breast surgeon said she was able to get everything out, and the lymph node testing had come back negative, so she only had to take 1 or 2 sentinal nodes. We would have a full pathology report later in the week.

The plastic surgeon said he tried to put implants in directly, but my skin just didn't look ready yet to support them and he wasn't sure about the size, so he decided to stick with the tissue expanders so that I'd be able to give more input in the final size and look.  

When he came by the next morning, I was able to see what had been done.  I've heard a lot of people are very apprehensive about seeing the scars and their changed body after surgery, but since I did a nipple and skin sparing mastectomy and the doctor was able to fill the over the muscle tissue expanders (just with air for now), they actually looked much more normal than I expected.  Not the SAME, but very normal, just taped up and marked up with drain tubes coming out of both sides.  They were very very hard though, and numb in several areas, which was definitely weird!

This photo shows a much prettier version of the awful surgical bra and drains I have. I'll have to empty the drains several times a day and keep a record of how much fluid they're collecting and what color the drainage is...for about 2 weeks.  Maybe longer, but that seems to be about the length of time most people have them.  As long as I'm just laying in bed or sitting down, they aren't a big deal, but when I try to wear real clothes or walk around, it's going to form a very weird lump under everything.  I'll have to carry them in an apron or fanny pack or pin them to my clothes and hook them to a lanyard around my neck when I take a shower.  Fun, huh?

I was able to sleep pretty well in the hospital and found that I was still just really really tired from the anesthesia.  I wasn't too uncomfortable, but would have occasional sharp pains where the incisions were and the surgical bra was pressing on them.  I kept up with the pain meds though and mainly felt pretty good, considering.

By Tuesday afternoon, I'd been seen by both surgeons, my vitals had been taken (what seemed like constantly) and the nurse had brought me my discharge papers and instructions and they took my IV out.  As soon as that IV was out, I got myself dressed (slowly and carefully) and Ben helped me pack up my bag to go home.  I wasn't quite stable enough on my feet to walk out of the hospital, so Ben went down to pull the car around to the front of the hospital and I waited for a wheelchair to take me out.  

As Ben was leaving, he found out that OT was supposed to come by to see me before I left, so I ended up sitting and waiting for a while before we could leave.  When OT got there, she looked surprised that I was already dressed (I think she was planning to help me to do that).  She gave me some quick arm and shoulder exercise instructions, had me show her that I could sit and stand up and walk on my own, and then we were able to head out.

Once we were at home, my main job became to rest, sleep and keep up with my medications.  We got a wedge pillow for the bed that will help prop me up to sleep better on my back, and we borrowed a small recliner to put in our bedroom, which has turned out to be absolutely perfect.  I'm able to walk around the house easily though, and am just moving slowly and trying not to do anything strenuous.  

And one of the first things I did once I realized I could reach my ears with both hands was put all my earrings back in. :) Now I feel like me.

I'll update again in a few days once I go through a week or two of recovery and see how things progress.  But so far, so good.  Just taking it easy and watching lots of television and taking lots of naps.  I feel like a happy old lady in my recliner with my blankets and remotes.   I needed a few weeks of rest, and although it's not the most comfortable way to do it, I'm going to try and enjoy what I can!