More Medical Updating

Yesterday, Tuesday 16 April, we had to be at the hospital at 6.30 am to prepare for me to undergo a procedure/surgery : left breast re-excision mastectomy. "Oh, good," thought I on hearing the arrival time, "I bet I'll be the opening act." I was.

Surgery was needed to remove two very tiny (microscopic) spots of potentially cancerous tissue close to the skin, a little way apart, just outside the line of the original incision, only perceptible via microscope. These were discovered during pathology of tissue removed on 2 April during my original mastectomy.

Preparing for the surgery (any surgery at our local hospital, and maybe in all hospitals these days) includes taking three showers using Hibiclens - antiseptic skin cleanser - in a prescribed manner: twice on day before surgery - morning and evening; once on morning of surgery. Freshly laundered towels, washcloths and clothing after each shower. That last shower was fun, timed just before 4 am. I was not playing with a full deck after a mainly sleepless few hours on the recliner, wrangling a dangling drain bottle which kept making a nuisance of itself in the shower! "Using Hibiclens will greatly reduce your risk of developing a staph infection" says the instruction sheet.

No food after midnight, before surgery. That is a direction that doesn't bother me one bit, but it must bother some folks, according to stern warnings on the instruction sheets the hospital provides.

I knew nothing. I was wheeled into the operating theatre, and once shuffled onto the operating table, a nurse applied a mask to my nose and mouth, in preparation for what I think is called intubation, then out I went.

Now...I'm still not 100% sure what was what, but the surgeon had explained that he would need to do a bit of re-aligning of the original incision, from a straight line to a more wavy or angled one, necessitating the move a bit of fleshy tissue from one place to another in order to "pull it all together". I'm still vague about the detail. Later, my husband and other visitors were told by the surgeon that the procedure had "gone well". We were home, amazingly, just after 11.30am. The procedure will probably leave me with a "tight" feeling for a while, but it'll gradually go away with ordinary use of left arm.

Going forward (as they are wont to say in business circles) there will be a few weeks' healing time, with follow-up appointments at surgeon's office, first of which will be on the first of May.

Mastectomy of my right boob is TBA (to be arranged). I'd like to have a few weeks of breathing space, to enjoy what's left of late spring, before summer comes a ragin' in once more, with triple digit temperatures. When it's 103 degrees outside, maybe I'll be glad of the ultra-cold temperatures inside the hospital. Yesterday morn I had 3 warmed blankets atop me and was still shivery cold - 50% temperature 50% nerves, I guess.

Unpleasant Update

I received unpleasant news at my appointment at the surgeon's office on Wednesday afternoon. Pathology shows that there is a little more tissue that needs to be removed where indication of cancerous cells has arisen on the margin of the tissue removed during mastectomy last week. Margins should always be clear. Surgeon will do what he calls re-excision to extract a small amount more tissue and adjust the incision, hopefully then drawing all together. Tricky but doable, he says. Alternative would be to look into possibility of radiation but he'd have to consult others on that. I opted for re-excision.

It'll be an outpatient procedure, on Tuesday, no overnight stay this time.

Here we go again! The incision and drain are still in process of healing from last Tuesday.

More unpleasant news. Surgeon advises having right breast removed, as and when I feel up to it, so that we don't have all these same issues again, a year or so down the line. It isn't a certainty this would happen but it's a clear possibility. I feel this is sensible, and as soon as left-side work is all healed, I shall do as advised. As far as they know, from my mammograms, and breast MRI a few weeks ago, there is no cancer in the right breast at present, so it isn't madly urgent that it be removed, but asap will be preferable, because a few weeks ago these extra cancer cells were not visible on the left side. It'll be for peace of mind as much as anything - and I'll be better balanced when all's done!

(Astrological thought) - I wondered what Pluto and Saturn retrograding over old ground had in store for me - now I know! A few more months of medical hassles still to go!

Glad That's Over!

Having been a "more than a handful's a waste" kinda gal for all of my adult life, the loss of one scant handful is not nearly as traumatic for me, psychologically, as it would be for some naturally better endowed ladies. Small mercies! Anyway, I'm now "One Boob Annie" , with a little drain bottle hanging by my left hip, hopefully hidden by loose shirt and tee shirt. From a distance I might bring to mind Annie Get Your Gun- this is Oklahoma, USA so, "is she carrying?"

It's no joke, but ya gotta larf or you'd cry! I just now did the latter, by the way, after finishing, but before publishing this post, husband's other daughter left a bouquet of lovely lilacs in a vase outside the front door. Tension needed to break and it did!

All went well surgery-wise. We arrived at the hospital at 7.30am, Tuesday. It wasn't long before I was being wheeled in to the operating room . That was a huge relief because waiting is always the worst part of the job for me. Husband tells me that Recovery Time was a longer drawn out affair than expected, but I doubt that was anything to do with my own condition, because I felt amazingly alright when I first opened my eyes, and really for the rest of the time spent in hospital, apart from the last few hours. Husband stayed with me all day and through the night, plus we had visits from husband's daughter, son and their spouses, which proved uplifting - if a tad loud!

I guess it was understandable that hospital nurses, who were all wonderful, seemed to be unaware of my secondary current issue being managed after a colonoscopy a week ago. The lymphocytic colitis. When the nurse suggested that I should take Miralax stool softener, because surgeon doesn't want me to strain on the toilet, and affect the stitched incisions, I had to larf! It worried me a bit until my GP happened upon me during his hospital rounds; the sight of a familiar face, who didn't have to ask the ubiquitous robotic question "What is your full name and date of birth?" , was kinda soothing and helpful.

On Wednesday, during the afternoon and early evening hours, the surgeon's "office day", he had become otherwise engaged somehow, and I couldn't be discharged without his visit and say-so. We'd hoped to go home early afternoon-ish, Wednesday, but didn't get home, after a frustrating time feeling somewhat imprisoned and unsure of what might happen next, until around 8pm, clasping some pain pills in hand.

All's well after a decent night's sleep on my own lovely recliner in our living room.

It's not that I'm a control freak, when it comes to what others do - honest ! I hate, hate, hate though, not being in control of myself. That has been the source of my lifelong "white coat syndrome". Hatred of hospitals has grown over time after heart-breaking experiences when my father, then my mother, then my beloved longtime-partner died - in hospital during the 1990s and early 2000s. During the past two years I've had to fight hard to overcome those feelings. It's a work in progress!

Next stop, tomorrow, will be a visit to surgeon's office for nurses there to inspect my drain bottle, decide if I still need it, and maybe loosen the tight binding around my chest a wee bit. Husband was taught how to empty and measure drain contents (mainly smallish amounts blood and fluid) regularly and to keep a record of date, time and amount of each collection. Not thinking much further ahead than that, at the moment.

I'm off to see the.......

Well...in my case instead of the wizard it's the surgeon. I'll be back soon, probably with a tale to tell.

UPDATE to Weekend's Post

No surgery this Tuesday. I now have a course of anti-biotics to supplement the ultra-expensive medications I began taking last week but which, as yet, have not affected my lymphocytic colitis at all. I can also take Immodium when needed - after giving the anti-biotics a chance to prove effective - allowing a couple of days or so.

Surgery now listed for next Tuesday, 2 April, with an appointment to be arranged for pre-op stuff, Monday - then to see the surgeon later that day to clear any problems....or whatever.

In one way, I'm glad to have a little more breathing space, in another it'd have been good to have it out of the way now - but my diarrhea is just as bad as ever it was, and I'm not eating much - not a good thing, general health-wise!

This thing is following a similar "can-kicking" pattern to Brexit! Brexit hassles are almost enough to give one the s...ts too!

Tales of Woe (mine!)

I have tales of woe to relate. I'm telling them here as much for my own information and record, in weeks and months to come, as for the interest or otherwise of any passing readers.

Last spring, almost exactly a year ago, as any regular readers might recall, I had to undergo a lumpectomy for early stage breast cancer. There are relevant archived posts to which I can provide links, should anyone wish to read them. I've had three-monthly checks of various kinds since then. During the most recent check - at around the one year point - it was discovered, after mammogram, breast MRI and ultra-sound, that another cancer has arisen - still small, and not a recurrence of the old one. I'm now needing a left breast mastectomy, which might be done during the coming week - or maybe not.

There's a second issue. It is not related to cancer, thankfully, but needs to be dealt with. So - chapter two of tales of woe.

Since end of February I've experienced persistent diarrhea. After about a week I saw my GP who checked my blood and declared the cause to be not infectious. After a few more days with no improvement, I sent a stool sample to the hospital. All possible issues came back negative. My surgeon then suggested a colonoscopy, which he did on Tuesday this week. Surgeon took several biopsies of colon tissue. The colonoscopy itself was good - no cancer, no issues to be seen. However a pathologist told surgeon that he had detected evidence of lymphocytic colitis from one of the biopsy samples. Surgeon prescibed meds to manage this problem. There's no actual cure, or so it says online, but how management proceeds will differ for each individual. I guess much depends on the cause, which can range from bacteria, virus, allergic reaction, or taking too many NSAIDs (Ibuprofen and suchlike).

Tales of woe chapter three. After mucho paperwork my Medicare supplementary insurance denied me any help to pay for the 6 week course of meds prescribed - these are very expensive. For 6 weeks' worth of tablets I have paid around $1,400. This cannot turn into a regular thing! In the intervening time, after my surgery, I must find a way around this ridiculous price. The drug's name is budesonide 9mg. But that's a story for another day. I have in mind buying from Canada if and when needed in future (if my GP will provide a written prescription) - still expensive there, but much cheaper than in the USA.

All is at present unresolved. I'm pencilled in for mastectomy on Tuesday, but that won't be confirmed until Monday. If the new meds have not taken effect I suspect I'll be dosed with Immodium for the duration of the surgery and overnight stay.

The next chapter will appear in due course.

UPDATE ~ on Last Week's 9 to 5 Adventure

Yesterday I visited the surgeon's office - the surgeon who performed my lumpectomy "procedure" on 27th March.

The appointment's purpose was for compression bandage and dressings to be removed, incisions checked, and for the passing on of information obtained from investigation of the offending cells and lymph nodes removed or biopsied as part of the procedure.

The office was pretty busy - lots of people waiting. The surgeon, we were told, was currently seeing a woman who was in the same position I'd been, just a few weeks ago. My heart went out to this lady!

After a chat with the surgeon's personal assistant/secretary, who kindly congratulated me on the way I'd handled the whole thing (little did she know the anxieties and obsessions with which I'd tortured myself - or perhaps she did), we then met the nurse practitioner who removed the long compression bandage and dressings, declared all well, healing nicely. Before she began the undoings, though, she told us that the surgeon had given her permission to give us "the good news". Smiling very broadly, she told us that all tests on lymph nodes etc. had come back as "clean", and emphasised what good news this was - could hardly have been better in fact! I started choking up, but called my stiff upper lip into service, and threw my arms around her...

"Thank you, thank you!"

I'm tightly re-wrapped, but not waist-deep this time. Compression is used to help the inner breast cells to come together over the wee hole left by the procedure. I have to return in a week, to have the incisions checked again.

In the meantime, tomorrow I have an appointment to see an oncologist at the Cancer Center - part of the hospital complex, to discuss what comes next. I'm hoping that treatment going forward will be minimal in view of the good news received, and my advanced age, but I'll not feel too cock-a-hoop until we see what this specialist has to say. So far, though, news has been so very, very good!

It was a 9 to 5 Job !

A quickie post just to celebrate finishing the "procedure" I underwent yesterday, 27 March.

The whole event did actually take from 9 to 5! We arrived at the hospital at required time of 9 AM. Not all of the 9 to 5 time span was used for surgery, there was a lot of waiting time to spend, and chunks of tests to establish exactly where "the nasty" is located, and to leave a marker for surgeon as he carried out the small lumpectomy. Some tests were fairly easy, one was a tad challenging mainly due to the length of time it took, while in some discomfort.

After the tests to find positions and direction of lymph nodes, came the inserting of a wire marker to show position of the small tumor, to to assist the surgeon. I was lucky to have a surgeon whose reputation is second to none in the state. The radiologist, also, deserves an Oscar for his skills, enthusiasm, and cheerful support in both my prior biopsy, a week or two ago, and in today's tests. He said, after completing his part of the procedure, "It'll be all downhill from here - you'll have a nice nap and then go home!" True enough, but there was a l-o-n-g wait before the nap, while the surgeon finished a much bigger operation than mine. The waiting time was the worst part of the whole thing, lying, sometimes uncomfortably, on the usual hospital bed-cum-trolley, in a small room. The husband was always with me though - that was a plus! My actual surgery took, I am told, around 45 minutes. I was away from the husband for 2 hours though, due to various additional preparation, plus some recovery time. During surgery husband had much appreciated supporting visits from his daughter, and later from his son-in-law.

I now have "binding" or "wrapping" around my breasts. I'm actually glad of my relatively small bra' size, something I've cursed during most of my adult life. I was given prescriptions for pain medications and stuff for nausea - which I don't have, thankfully. Pain is there but it's quite bearable, I shall not take maximum of pain pills unless it becomes truly essential.

Next appointment: 4 April, to see the surgeon for follow-up talk.

I feel a song coming on: