Monday, February 16, 2015

Surgery Successful. But, Still Waiting...

Browning, MT
It was one of those experiences where you just wish it was a bad dream and you could wake up but you know you're already awake and it's just not good.

We went down to Mayo Clinic last Monday so Kate could get some final blood work and tests done.  In the one at 2PM, scheduled for a 45 minute window, they were going to put a seed in the smaller tumor so it would be easily found during surgery the next day.

They called her back in good time, and we waited.  and waited.  and waited.  (I wasn't allowed to go back with her.)  At five minutes before five, she comes rushing out, running to her final appointment for the day, where the surgeon's nurse was waiting for her to explain her final prep.

I gathered my things and hers and followed her upstairs on the next elevator, still wondering what had happened.  It turns out they couldn't get the seed placed, so left a 10cm wire snaking under her skin for the surgeon in the morning.  Usually, this procedure is done immediately before surgery - people don't generally leave the hospital with the wire in.  There are good reasons for this.  She spent a very uncomfortable night; perhaps it is good that it was short?

We were back at the hospital at 5:45 the next morning for her surgery.  Hers was the first case of the day; they thought she'd be done before 11.  So I waited.  11:00 came and went.  11:30, 12:00.  ???  12:30.  still no word.  The board showed me the procedure had started in good time, at 8:49, but no word.  I kept checking my phone, just to make sure I hadn't missed the call - no word.  The nurses at the desk started to give me sympathetic looks; they knew it couldn't be good, and it wasn't.

The surgeon finally called shortly before 1:00.  He had the defeated tone of a man who'd done his best, but just couldn't make it work.  It turns out the cancer was invasive after all.  And he couldn't get clear margins for the lumpectomy because her entire breast was riddled with DCIS and pre-cancerous cell changes.  He was going to have to do the mastectomy after all; there wasn't enough tissue left to save.

My legs carried me around the corner, then gave out.  It was the family cancer after all.  I sank to the hallway floor in tears.  The friend who had come with me for support came back from a trip down the hall to find me huddled in pain for her.  He put his arms around me.  Then, one of the nurses stopped by and asked if she could help.  I stood up, and started asking all the questions rattling around my brain (whatever they were).  She answered calmly where she knew, deferred what she didn't, calmed me down enough to go back to wait for the next call.

When the surgeon next called back, he had better news - he'd removed all her breast tissue, and her lymph nodes were clear.  The cancer hadn't spread.

A mastectomy is a more involved surgery than a lumpectomy; it's a good thing we'd already planned to stay in town for the night because now she was going to spend the night in the hospital.  (I really felt for the patient who was scheduled for the second surgery of the day - they'd been waiting since ten in the morning - it was after four when they finally began their procedure, whatever it was...)

I went up to her newly assigned room to wait.

There I found a picture of Saccharine Jesus waiting on the wall, watching the room with a poor pity look on his face.  I couldn't stand it; I didn't want Kate to have to stare at that thing all night.  I found a paper towel, drew a smiley face on it, and begged a piece of tape from the ever-cooperative nurses to cover the picture.  (When they saw what I'd done, they just smiled...)

And I waited.  She finally came up after an interminable time.  She was groggy and in a lot of pain - and most of it came from her rear end where she had a deep new muscle bruise.  (from catching her rear on a rail as she was being swung onto the operating table?  I couldn't figure out how else it could have gotten there; she didn't have it when she went in.)  The standard pain meds weren't doing it, and the nurses couldn't reach the doctor to order more.  I hurt to watch her.  Finally, a resident stopped by to see how she was doing - and got her some anti-anxiety meds to relax her muscles, and another type of pain reliever that could be stacked on top of the Oxycodone.  It worked, she finally went to sleep.  We went back to the hotel.

The next morning we went back to find her still unable to eat, still nauseous from the anesthetic.  Regardless, they checked her out, and we bundled her into the car for the 90 minute trip back to Minneapolis.  I drove as carefully as I could, and she did well - made it the whole way without throwing up.  When we got back to her apartment, she promptly fell asleep - the best medicine.

When I left yesterday, she was much on the mend, but the drain was still in place.  (The drain is there to gather the blood and nutrient fluid her body is sending to the breast it hasn't yet figured out is gone.  Painful, but essential for healing.)  Until the drain is removed, she will be in pain.  (speaking from experience here.)  She has friends bring food, to stay with her and to care for the baby until that happens.

I sat in the back seat the whole way home (Joe  drove, his girlfriend kept him awake), still trying to absorb what happened.  The new diagnosis opens a whole new trove of questions - first and foremost, what does this mean for her other breast?  I asked the surgeon when I had him on the phone - he will review all the films and test results and talk with her about it when she goes back for her post-op visit on Tuesday.

And we wait.

As I wait, I am thankful.

For the nurses who took good care of her.
For the medical team at Mayo who took her concerns about the family cancer seriously and had her agree to a mastectomy on a hunch, just before she went under, just in case.  (Can you imagine waking up to hear you needed to go under again as soon as you were medically able?  Yowsa!)
For clear lymph nodes.  For clear lymph nodes.  For clear lymph nodes.

I was right - these next few months aren't going to be easy, but I think she's going to be OK.
I hope.
I pray.

and we wait.

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