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Now that I am 6 weeks out of surgery (bilateral mastectomy), I can sum up my experience in 4 sentences:
It was easier than I thought.
It was harder than I thought.
I did it!!!!
It’s all true for me. And ohhhhh, am I excited to share more of my story with you. This post focuses on my experience right before surgery and while in recovery for 2 nights at the hospital – Medical City in Dallas.
The day before surgery
It’s the night before surgery, and a complete calm has washed over me. Today, I posted this on FaceBook:
What I find mindblowing is not too long ago, I was absolutely terrified that I would never feel a sense of calm and acceptance around my surgery decision. Remember? Damn, I love when the mind is wrong.
It all feels so simple now. I’m ready on every possible level – mentally, physically, spiritually. I just show up and it’s a complete surrender. A sweet surrender. The FaceBook comments keep pouring in and each one tugs at my heart strings. Such a collective feeling of oneness.
Tonight, my husband, my mom, and I sat in a circle, lit a candle, and listened to a pre-surgery meditation that was gifted to me by the team at CanSurround. When it finished, we sat in silence, tears in our eyes.
I. Am. Just. So. Ready.
On Monday, April 18th, my alarm went off at 4:45am ~ it was pitch black and I could hear the rain pouring outside. Oddly, I felt excitement ~ it reminded me of going on road trips as a kid. My parents would wake us up at the butt crack of dawn; still half asleep and in pajamas, we’d pile into the car. I’d have a rush of “woohoo, a new adventure!” excitement and would then fall right back asleep. Yes, my parents are smart as this gave them a few hours of peaceful silence before the 3 of us started our “are we there yet? I’m bored! He’s bothering me” chanting.
And now here we are, another new adventure. My mom, Travis, and I gathered in the kitchen with our hospital bags in hand…let’s do this!
I felt this same sense of peace/adrenaline/curiosity for each moment leading up to surgery ~ I even declined the nurse’s offer to take a xanex chill pill before the procedure. “Oh yeah, I am so evolved,” I thought, “I don’t need those stinkin drugs.” (Note: future me said YES to every possible pain-killing drug after surgery). There was one exception where I lost my cool…When we first arrived, we all gathered in the pre-op room. The first nurse that walked in said, “OK, Bethany – what are you having done today?” My first reaction was, “Well, uhhh….shouldn’t YOU know that?! Why are YOU asking ME?” Panic, holy shit, they are so flipping disorganized, you have to be kidding me, how am I supposed to trust them with my body and this HUGE surgery if they don’t even know what the F I’m here for!??!!?
Then I learned that this is standard protocol…hehehehe….They are required to ask you this question when you arrive and I would be asked the same question over and over again by each nurse, volunteer, the breast surgeon, plastic surgeon, anesthesiologist, strangers passing by… I then laughed at my mind and realized they are doing this to be helpful, efficient, avoid mistakes, and oh goodie – I know the answer!
I am here for “a nipple sparing bilateral mastectomy. The breast surgeon will also remove the chemo port, and in the left axilla, she will perform a sentinel node biopsy, with a possible lymph node dissection. The plastic surgeon will insert tissue expanders, with a possible allograft.”
Here it is in English:
- Nipple Sparing: I get to keep my nipples. Because the original cancer was a good distance away from my nipple, I am a candidate for nipple conservation. However, this is not a guarantee. The surgeon swipes a sample of the tissue underneath each nipple and tests it to confirm there are no microscopic cancer cells found underneath. If cancer is found, bye-bye nipples. There is also a chance the blood flow to the nipples will not work properly or the skin can die.
- Bilateral Mastectomy: the removal of all breast tissue (and cancer!) in both of my breasts.
- Chemo Port: this is a medical device that was inserted during a day-surgery before I began chemotherapy in October. It’s a small plastic “plug” that goes under my skin, just above my right breast. Instead of sticking me with multiple needles each time I received chemo, the medicine was delivered directly into my bloodstream via the port. It’s completely painless and made me feel like a super hero being “charged up” with special powers each week. And I’m happy to see it go!
- Sentinel Node Biopsy: This is a standard procedure where the sentinel nodes (the first few lymph nodes closest to the breast tumor) are identified, removed, & examined to see if any cancer is present. A dye is injected into the axilla (arm pit area) and it turns a certain color if something is cancerous. Usually 1-3 lymph nodes are removed.
- Lymph Node Dissection: If the above procedure shows cancer, this procedure is done which involves removing additional lymph nodes and some of the surrounding tissue. I believe the typical average is 12 lymph nodes and could result in even all of them being removed depending on what the surgeon sees. (NOTE: my surgeon leans more towards the conservative side as there is a lot of recent research that confirms taking out less lymph nodes leads to less complications and radiation cleans up any remaining cancer cells).
- Tissue Expanders: After the breast surgeon performs the above procedures, the plastic surgeon replaces the breast tissue with tissue expanders that go underneath the pectoral muscle – they are hard balloon-like temporary implants. After this surgery, they will slowly be filled with saline over 6-8 weeks to help stretch the skin and prepare the boobies for the final implant surgery. You literally get to watch your boobs grow and experiment with different boob sizes! They also hold well during radiation which can shrink the skin.
- Allograft: If the tissue expanders do not fit securely underneath the pectoral muscle, the plastic surgeon will add extra tissue (called allograft) to help them stay in place. The tissue comes from donors which sounds creepy, but it’s so deeply cleaned & processed that there is no DNA remaining. Think of it as extra padding.
Going into surgery, I was in complete surrender to the unknown. I love that during my pre-op visits with my surgeons, I asked them what the best ways were to prepare for surgery and they said, “The best thing to prepare is your mind. Trust us. We have your best interests in mind and we want the best possible outcome for you.” So, that’s exactly what I did.
I became child-like a curious. Each person who walked into the pre-op room was smiling, kind. I marveled in wonder while the plastic surgeon drew artistic lines all over my chest with a red marker. He made eye contact with me with a reassuring, “you’re ok. We’ve got this.” My breast surgeon looked so confident and well-rested as she tied her hair up in a bun. This is what they do and they do it well. I watched the fluids enter through my arm. I saw the care and concern in my husband’s and mother’s eyes. Neither wanted to leave my side. My last hug and kiss with each of them was special and intimate, not scary. I loved being wheeled around in a bed! And in a bed in an elevator! The last thing I remember is being wheeled into the operating room under these huge, beautiful lights that looked like colorful honeycombs. I said, “wow…those lights are so beautiful!” And that’s it. Goodnight.
I found out later that right before I started surgery, my breast surgeon went to see my mother. She pointed out a special place to sit in the waiting room. She explained, “your daughter will be on the operating table just on the other side of this same wall. This is where you can be the closest to her.” Wow. The kindness. I also found out that my plastic surgeon wore cowboy boots with his scrubs through my surgery. Gotta love Texas.
I woke up in the recovery room which was full of other patients. We were all separated by curtains. The first thing I remember is a huge intense, painful pressure on my chest; it felt like a giant elephant was sitting on me. I was unable to fully breathe, so I took small, shallow breaths and tried to focus on breathing in my belly. I could tell the nurse was under-staffed and whenever I could get her attention, I asked for ice chips because my mouth was insanely dry. I floated in and out of consciousness and could hear the moaning and groaning of other patients; one woman in particular, “nurse! nurse! It hurts! It hurts soooo much. Help me, please.” Or maybe that was me? The typical amount of time in the recovery room is 1 hour and I was in there for 3 hours – I remember hearing staff members approach the nurse saying, “Bethany’s family is ready to see her now” multiple times. I could picture my mother & husband in the waiting room after 2 EXTRA hours went by saying, “Damnit! I want to see her NOW!” I smiled at the image and went back to sleep.
I awoke to being wheeled into my final recovery room ~ a private room with a beautiful view and this is where I’d stay for 2 nights. I watched my husband, mom, and mother-in-law rush in to see me. Travis reached for my hand, “hey baby, how are you…?!” I smiled and said, “Ok. It’s hard to breathe. It hurts. A lot.” And it did really fucking hurt. Way more than I thought it would, to be honest. I was given a pain pump of morphine ~ they said if I feel pain, I can pump it every 8 minutes when the green light turns on. I thought of some of the other women I talked to who had gone through this surgery, and they said that they didn’t even need the pain pump or maybe used it once. Well…I pumped that shit like it was a hand exercise. And later that evening when it still didn’t seem to relieve the pain, they asked me if I wanted a morphine boost. All of the “I’m so evolved and awesome and don’t need extra medicine” bullshit thoughts vanished and were replaced with:
YES, PLEASE. BRING IT ON.
One unexpected & uncommon side effect of the drugs was that I was unable to pee on my own. I would try and try…I pressed on my stomach, let water run in the faucet, put my hand in hot water, my mom played waterfall noises from her iPhone, I counted tiles to distract my mind…nothing. What’s cool about modern medicine is if you can’t pee on your own – they can do it for you! I had to get catheterized 3 times…each time, they removed about a liter and a half of urine. The mild discomfort was nothing compared to the sweet Jesus relief I experienced when it was done. After the 2nd day in the hospital, I finally began to go on my own which was one of the most exciting things in the world at that time. The simple joys…If you are ever in the presence of someone who can not pee, here are 3 things not to say/do:
- “Just try harder.”
- “We really need you to be able to go to the bathroom on your own.”
- If I politely ask for everyone to leave the room so I can try to pee in solitude, LEAVE THE ROOM instead of standing close enough to me so that my knee is brushing the back of your thigh while you make my bed. This is especially true if we just met 30 seconds ago.
Easier than I thought
All jokes aside, the staff was amazing. And even though the pain level was so much more intense than I expected, there were so, so, so many things that were BETTER than I expected. Examples:
- The moment I saw my new breasts. Before surgery, I dreaded this moment. I imagined it on so many occasions and was brought to tears every time – I saw me standing in the hospital mirror, seeing the first glimpse of my creepy-looking-mutilated-use-to-be-beautiful-and-never-will-be-again breasts. Then horror and regret filled my mind. Well, reality turned out to be pretty awesome. I lifted up my gown, looked in the mirror and thought, “wow – they look pretty damn good! Hey honey, did you see these?” I had adorable little A-cup breasts. The clear surgical tape was wrapped around me like a bra and I could see some swelling & discoloring from bruising, which is expected.
- The breast surgeon’s execution was brilliant. The only incisions she made were along the outer, lower part of each breast. I believe she has magical powers; somehow, she was able to remove the chemo port by my right collar bone AND do a half lymph node dissection in my left armpit through these incisions. The scarring is healing beautifully and is barely visible now.
- The plastic surgeon is an artist and creative genius. He was able to secure the tissue expanders without any allografting and he noticed that I already had a scar on my belly (it was from having a mole removed when I was a teenager). He threaded the tubing for the two drains to exit through this scar so that I wouldn’t have any extra scars on my body. The drains were easy to keep clean and came out in 2 weeks. It did take a little creativity on figuring out how to hide my drains when in public – a sweet fanny pack I bought in Barcelona 9 years ago did the trick.
- I can still feel my breasts. The skin on the inner & upper breast still has sensation! It’s very common for women to completely lose all sensation of their breasts after a mastectomy because sensory nerves are removed with the breast tissue. I jokingly had asked the breast surgeon, “you mean if my breasts caught on fire, I would have no idea?” I could joke but this was something I was depressed and anxious about…sensation meant a lot to me personally and sexually with my husband. I did hear from another woman that yes, she did lose sensation but “other senses are heightened if you know what I mean…;)”
- The food in the hospital was incredible! Assuming hospital food would suck ass, I had called the hospital to let them know I’d be bringing my own food. She asked what my dietary needs were and I explained that I eat all organic, vegetarian + fish & eggs, and no dairy, soy, sugar, or gluten. She said, “sure, no problem – our chef (what they have a chef?) is starting to lean towards using more organic ingredients these days so I’ll make sure he has plenty of items on hand during your stay with us.” For breakfasts, I ate an organic egg omelette w/fresh veggies and a side of organic fruit. Soup & salad for lunch and one dinner was organic salmon, sautéed kale, and sweet potato mash – Travis and my mom ordered a plate too and we all enjoyed it together. I felt pretty darn pampered.
- People are so kind. I have now collected thousands of examples of this throughout the entire journey and there was never a shortage of kindness and love in this part. In fact, I think it amplified. The staff, my family, friends, all of the flowers and thoughtful messages…. everyone and everything was/is here for me.
There are so many more blessings I discovered throughout the recovery process as well as extremely tough moments of physical & emotional pain. Much more to share with you.
Right now, I’m grateful to now sit in reflection of it all.