Let’s Get Physical

Chemo may be over, but I’m not even halfway through cancer treatment yet. In the coming months I’ve got three surgeries planned, followed by radiation. But the big deal of all that, the big kahuna so to speak, is the first surgery – the Double Mastectomy.

In less than two weeks – on February 14th to be exact – I’ll have the surgery that will remove any residual traces of cancer following chemo, and will reduce my likelihood of a recurrence and a new instance of breast cancer. And when the surgery is over I’ll be able to say I’m “cancer free”

So, on Valentines day I’ll head to the hospital mid-day. At noon I’ll get injected with a blue, radioactive dye that will help the surgeon find axillary lymph-nodes, the lymph nodes in my right armpit that is closest to my breast and thus if the cancer spread, it would spread there first. Then I’ll head down to the pre-op where I’ll meet with my surgical team (nurses, Oncology Surgeon, Plastic Surgeon & Anesthesiologist) and get prepped for surgery (including having the Plastic Surgeon draw the “cut” lines on my boobs so that the Oncology Surgeon doesn’t go rogue and make cuts that will result in unwanted scars) And by 2PM (or thereabout) I’ll be under anesthesia and the surgeons will get the party started.

The Oncology Surgeon (Dr Johnson) goes first. She’ll first make an incision in my right armpit, find the blue lymph node(s) (and if she’s having trouble, will use a geiger counter to find it, since it will be radioactive!) and will remove it. She’ll immediately send the lymph node to the lab for analysis to see if it has or had any traces of cancer. Then she’ll do the mastectomy, removing all of my breast tissue (including my nipples) and leaving behind the skin for reconstruction. Before she tags out, she’ll get results from the lab. If the lymph node is cancer free, she’s done. But, if the lymph node shows traces of cancer, she’ll go in and remove the rest of the lymph nodes under my armpit. The hope is the lymph node is cancer free (duh!). Removing the full set of lymph nodes increases the risk for cording and lymphedema, two nasty side effects that can last the rest of your life.

Once Dr Johnson is done, its time for Plastics! Dr Lemaine will then start reconstruction. She’ll be putting in expanders (like temporary implants), covering them with alloderm (which will act as a second layer of skin, since the remaining skin will be very thin), she’ll install 4 drains (2 on each side) to clear the liquids post-surgery, and will sew me back up. She’ll then bandage me, and put my surgical camisole on (its a tank top that zips up the front and has cool pockets to hold my drains). And then, assuming all goes well, I’ll wake back up and spend one night in the hospital before heading back home.

Once home, I’ll be in recovery for at least four weeks. The hardest part of recovery is the restrictions – I won’t be allowed to lift my arms above my shoulders or lift anything more than 10 pounds for 4 weeks. Oof! Plus, the drains will probably stay in for about 2 weeks. While I’m at home, all of the breast tissue that Dr Johnson removed will be at the lab, being tested for cancer. Hopefully they’ll find no traces of cancer (meaning the chemo got rid of it all) and will declare me “PCR” (pathologically complete response). If the tissue they removed has cancer cells in it, when I meet next with my oncologist we’ll discuss a few clinical trials that I can join to continue treatment and improve my long-term prognosis.

Unfortunately, surgery is going to suck. Its going to hurt and recovery is going to be hard and I’m going to be VERY reliant on others for help while my arms are on restriction

Fortunately, surgery will make me officially CANCER FREE and makes it all worth it.