The first week few days home from mastectomy surgery aren't bad. Medication controls the pain. Nine well placed pillows prop me and I am, surprisingly, able to sleep on my back. Two of these pillows are little flannel hearts that fit comfortably under my armpits to prevent chafing. God bless the hands that sewed them. I am wearing an ingenious garment. It is a camesole of the softest cotton knit with thoughtfully constructed interior pockets to hold drain bulbs, tubes and prosthetic breasts(which are empty). The bulbs attach to tubes running from each under arm acting as suctions siphoning off body fluid until the lymphatic system kicks in and takes over. Twice a day my husband removes each bulb and squeezes the murky contents into a measuring cup to record the amount collected. He manages this task with great attention to detail and a deft touch for my comfort. It's the way he approaches everything. One day as he was absorbed in these ministrations my mind flashed back 35 years ago- I was a flight attendant and my husband was the captain of our DC10. Upon descent into to Boston's Logan Airport we lost an engine. The older flight attendants assured us we had nothing to worry about, Captain Yamauchi was at the helm. His reputation as a skilled airman dispelled all fear and he gently set our big old bird down, passengers none the wiser. These are the same hands that care for me now I am thinking.
We saw my plastic surgeon three days ago. He removed the bandages and we got our first look at my massacred chest. From my vantage point, I can't see too much which I'm sure is a blessing. I prefer to investigate later in private. For now, looking down I can see the outline of the tissue expanders creating little malformed mounds. I check out my husband's expression. He wavers between curiosity and horror. I love him for trying to control this transfer of thoughts to expression but his heart is clearly broken for me. We are entering a whole new kind of intimacy.
Dr. Mosharrafa points to a place on my left, heretofore healthy "breast", and explains,"this is a burn where Dr. Corn was cauterizing" outlining 4 square inches and two 1/4" holes of skin damage. Its said matter-of-factly and I'm too stunned to respond. Considering the rest of the devastation, it seems to makes little difference now. I'm not up to assessing this new information and neither is my husband. We are two weary warriors and this information is more than we can deal with right now.
There is a lot more pain the second week because twice a day Shoyei has to change my dressings. I realize now that I'd never thought this far out. It's a nasty job and seems too much to ask. But this too he does with love. Did I mention he was a child prodigy - he played piano with the San Francisco symphony, he played for the king and queen of Norway. He has a feather touch and my skin is numb anyway so I can't feel the wiping or stinging. Unconvinced, he continues his gentle ways. What I feel a is a deep aching pain that has me sucking in air and concentrating on my diaphragm breathing.
This new regimen has me doubling my pain pill intake but Shoyei's stingy with my meds. For one thing he's afraid I'll become addicted. Yesterday afternoon he tried to get me to hold out between doses. "On a scale of 1 to 10, how would you describe your pain?". Like the hospital nurses would ask. I tell him I am a 4(10 being childbirth). I know perfectly well he doesn't want me to suffer. He plunks a heavy naturopathic tome on my lap and points to the paragraphs he wants me to read. It states that narcotics(i.e. my Percoset pain pills) may actually contribute to the spreading of cancer. Two of my doctors have already poo pooed this. I feel caught in the battle between traditional, heavily documented medicine and the naturopathic approach which sounds good but what about pain? Right now I vote for the route of pain relief. I've become hesitant to call Shoyei for a pill only to have him look at me like a junkie. My prescription says 'take 1 to 2 every 4 hours as needed for pain'. I take 3 to 4 a day but my nurse Ratchet would like to see that down to 1 or 2. So I guess it's obvious I'm growing grouchier by the minute.
Finally we agree to call the doctor who tells us both if I hurt, I get a pain pill. But they also agree to alternate my medication between Percoset and Valium, the latter is a muscle relaxant. Perhaps muscle cramps are a partly responsible for my pain. I'm happy to report, 24 hours later, it's already making a difference.
There has been a wonderful highlight to this week. We have been blessed with meal after meal provided by some women from my church. Flowers and gifts and cards have helped me through some of the toughest days. I keep reminding myself how very blessed I am.
Kathleen
"O Joy that seekest me through pain,
I cannot close my heart to Thee,
I trace the rainbow through the rain,
And feel the promise is not in vain,
That morn shall tearless be."
-George Matheson
Showing posts with label surgery. Show all posts
Showing posts with label surgery. Show all posts
Wednesday, January 28, 2009
October 30th 2008, Surgery, Hospital stuff and Home
THURSDAY. Home again. One sleepless night in the hospital is enough. My husband is beyond exhaustion. His task is difficult. He feels so responsible for my care and I suppose he is.
TUESDAY. Today we met with Dr. Mosharrafa, my young blue-eyed plastic surgeon in Phoenix. He specializes in mastectomy reconstruction and is gifted with the necessary manner to deal with women faced with this option. I'm so grateful I've found him. He draws lines across my chest as I stand naked before him, my husband looking on with keen interest in the details. Shoyei asks the questions of a detached medical student and Dr. Mosharrafa enthusiastically responds. I feel like a class project. The lines are for my oncology surgeon, Dr. Corn, to follow when performing my double mastectomy tomorrow. It's like laying pattern pieces out on the fabric of my skin. A few bold pen strokes and he has marked out a plan for the new me. Like a visit to my tailor. Reconstruct - to build up, as from remains, an image of the original. Perfect. When Dr. Mosharaffa inserts the expanders and sews me up, I think to myself, I will be well along in the process of rebuilding Katrina(Spanish for Kathleen) after hurricane Cancer. I smirk at my private little joke while the boys are discussing the procedure as if I'm not there. Shoyei inquires as to his chances of being in the OR to watch. I raise an eyebrow knowing he can't stand the sight of blood. Fortunately, for all, its not an option.
Afterwards, Shoyei and I meet a dear friend who happens to be in town. We wander in Old Towne Scottsdale and find a great little restaurant where we dine on elegant salads and catch up in the intimate manner of old friends - a delightful diversion which takes my mind off tomorrow.
WEDNESDAY. I've slept well but Shoyei has been up since 3AM. We get ready in silence and then we are off to Thompson's Peak Hospital, a new hospital with state-of-the-art equipment and patient comforts. I was there for my port implant and have almost looked forward to another visit. I'm quickly ushered into radiology where the male attendants are disappointingly cold and impersonal despite the fact they refer to me as "dear". I overhear enough to know they are afraid of a chewing out by the radiologist. "Where are your mammograms?" I'm queried in a you-forgot-your-homework-again tone."My mammograms? What? No one asked for them. Why? Nothing showed up on my mammograms," I explain. "The radiologist is going to want to see those mammograms" I'm told."The ones that show nothing?" I ask. "He's here," they say softly. I hear him ask to see the mammogram and their whispered response. He marches to my side where I lie in undignified repose. "No mammograms." He says. I'm not sure if its a question or a statement but I explain their uselessness. Nonplussed, he seguays to the subject at hand, leaving me wondering at the twittering techies.
"I'm going to inject four shots into your right breast. We don't anesthetize for this because that would still mean four stings," he says. After the first injection I tell him I didn't feel a thing. "I'll try harder next time," he says. I appreciate his effort at humor in this humorless place. The injections are radioactive isotopes. This is a "sentinel node" procededure to locate which lymph node guards the path to the whole chain of nodes under my right arm. The table I'm on glides feet first into position for pictures. Turns out I have two sentries. No one says if this is a good thing or bad. The radiologist runs a geiger counter over the nodes and adds two more marks to my tattooed chest. I later learn Dr. Corn is annoyed by this over stepping of her power. Apparently politics abound even in hospitals.
I'm taken upstairs to Pre-Op by wheelchair, my husband taking over the sentry role. What is the deal with hospitals not letting you walk on your own volition when you're able and then making you amble about when you don't fell up to it? My assigned nurse here is a gem. She's exudes warmth and competence and I find myself relaxing. I'm outfitted in my hospital gown, socks, an IV is started and Shoyei and I settle in for a two hour wait. Dr. Corn, the OR nurse and anesthesiologist stop by one at a time to check in with me. I'm amazed at the peace I feel. When noone is looking. I take one last peek down my gown at the part of me about to be cut away. "Farewell," I whisper wistfully. I glance at my husband. He looks afraid and I pray for him. I'm so sad he's refused all offers of company for his waiting but he's adamant about preferring to going it alone. The anesthesiologist is ready to take me. "Now's the time for the hug and kiss" he tells Shoyei. I'm surprised to feel my face crumple as we cling to each other. It's the last I remember until I awake in recovery.
Recovery is the hard part. They are under staffed today, they tell me. I'm in pain and unable to position myself for relief in the bed. The nurses are overwhelmed and impatient. They are in the ninth and tenth hours of their twelve hour shifts. Its unrealistic of me to expect the best of them. I'm given a pain killer which quiets me down. I'm kept waiting and waiting because there are no rooms ready (because they are short handed there too?) which for these nurses means double the patient load. I can hear another patient coughing and the distress is is causing her. They are comforting her. Suck it up I tell myself but the drugs render me weak and selfish. I seek the comfort of my Lord and He is there but I am concerned about my husband and anxious to see my daughter. It has been hard for Shoyei to let me out of his sight. My protector. I hear a recovery room nurse taking a call. She is explaining to my husband why I am still here where he cannot be with me.
Finally, I'm wheeled to my room where my husband, daughter and son-in-law are waiting. I am so happy to see them so why am I still so irritable. It took me so long to get into a semi-comfortable position my room nurse wants to make me "more comfortable". I just want her to leave me alone. Actually I want her to leave completely. Shoyei is all the nurse I need. I'm "under the influence" and behaving badly. I hear my daughter apologizing for me. "Did you know my mother before?" she asks, "because, this is not how she normally acts." "I'm embarrassing you," I say. Shoyei makes a stab at a joke and I tell him to drop the jokes for a while. They're annoying me. Later I'm mortified, tearful and ashamed apologize to everyone.
Shoyei shares the doctors post-op reports. They are both giddy with excitement at how well I've done. It's good to know I behaved during surgery. Dr. Mosharaffa has inflated my tissue expanders halfway already which had not been his intention "because her muscle is so strong". Must be all that protein I've been eating. It also explains why I feel as if I have a rubberband around my chest. The expanders are under muscle.
.The new nurse, Shelli, seems on guard, as if she's been warned. But I start off by telling her how out of control I feel. "It's normal," she says, "the anesthetic does that". She's beginning her shift and appears to be conserving her energy. She gets me settled. I eat a little but fail to keep it down. My husband holds the bucket. For better or for worse, he's pulling his end.
I feel myself again, my alter ego has thankfully gone missing. The pain is under control and I'm sleepy. The nurse helps my husband convert the couch into a bed, gives him sheets, blanket and a pillow and he collapses for about 3 hours. I smile with gratitude for his soft snoring. I try to doze off but there are pressure "socks" alternately massaging one leg then the other every 10 seconds to prevent blood clots. My "vitals" are monitored throughout the long sleepless night. At 3AM I need to use the bathroom and call for Shoyei's help. He calls for the nurse to help us with the tubes. She comes to help, instructing me to put my weight on the bed rail, which collapses sending pain up my torso and her tripping past my husband. No harm done, we all laugh. Through the night she forgets to restart my pressure socks, put on my oxygen tube and re plug my IV drip after I use the bathroom. She's annoyed at first when I call each time to ask about these things then acknowledges "we" forgot to reconnect you. She's lovable but I'd like to go find that pre-op nurse. I finally sleep from 5:15 to 6:15 when an attendant attempts to slap a blood pressure cuff on my arm after loudly announcing "sorry to wake you". He missed the big sign on my board saying no blood pressure readings from either arm. "Oh yeah," he remembers, "I saw that on your chart". I ask for a pain pill. "I'll let Kelly know,"he says. "Who's Kelly?" I ask.
My husband is getting breakfast I'm told. I'm hungry and wonder when breakfast is served. I turn on the flatscreen TV and discover the coolest thing about this hospital. I hit menu and order oatmeal, brown sugar, milk, berries and an english muffin.
Dr. Corn pops in, loosens my bandage(I finally take a full breath) and signs my release. My delicious hot breakfast arrives and I am thinking about staying one more night. Until Kelly shows up. He's not mean but right up until I'm released no shadow of a smile attempts to brighten his face. I am so anxious to get home.
HOME. Shoyei gets me settled experimenting with the right pillows to make me as comfortable as possible. I absolutely cannot imagine a gentler, more conscientious nurse than Shoyei is being. He is grouchy but mighty short on sleep. His is a volunteer position. I take in the beautiful view out my window and the two vases of flowers each of my children have given me. My daughter and her husband are here to help. My mother is here. My family has called and friends email their love. I feel cherished and very grateful.
TUESDAY. Today we met with Dr. Mosharrafa, my young blue-eyed plastic surgeon in Phoenix. He specializes in mastectomy reconstruction and is gifted with the necessary manner to deal with women faced with this option. I'm so grateful I've found him. He draws lines across my chest as I stand naked before him, my husband looking on with keen interest in the details. Shoyei asks the questions of a detached medical student and Dr. Mosharrafa enthusiastically responds. I feel like a class project. The lines are for my oncology surgeon, Dr. Corn, to follow when performing my double mastectomy tomorrow. It's like laying pattern pieces out on the fabric of my skin. A few bold pen strokes and he has marked out a plan for the new me. Like a visit to my tailor. Reconstruct - to build up, as from remains, an image of the original. Perfect. When Dr. Mosharaffa inserts the expanders and sews me up, I think to myself, I will be well along in the process of rebuilding Katrina(Spanish for Kathleen) after hurricane Cancer. I smirk at my private little joke while the boys are discussing the procedure as if I'm not there. Shoyei inquires as to his chances of being in the OR to watch. I raise an eyebrow knowing he can't stand the sight of blood. Fortunately, for all, its not an option.
Afterwards, Shoyei and I meet a dear friend who happens to be in town. We wander in Old Towne Scottsdale and find a great little restaurant where we dine on elegant salads and catch up in the intimate manner of old friends - a delightful diversion which takes my mind off tomorrow.
WEDNESDAY. I've slept well but Shoyei has been up since 3AM. We get ready in silence and then we are off to Thompson's Peak Hospital, a new hospital with state-of-the-art equipment and patient comforts. I was there for my port implant and have almost looked forward to another visit. I'm quickly ushered into radiology where the male attendants are disappointingly cold and impersonal despite the fact they refer to me as "dear". I overhear enough to know they are afraid of a chewing out by the radiologist. "Where are your mammograms?" I'm queried in a you-forgot-your-homework-again tone."My mammograms? What? No one asked for them. Why? Nothing showed up on my mammograms," I explain. "The radiologist is going to want to see those mammograms" I'm told."The ones that show nothing?" I ask. "He's here," they say softly. I hear him ask to see the mammogram and their whispered response. He marches to my side where I lie in undignified repose. "No mammograms." He says. I'm not sure if its a question or a statement but I explain their uselessness. Nonplussed, he seguays to the subject at hand, leaving me wondering at the twittering techies.
"I'm going to inject four shots into your right breast. We don't anesthetize for this because that would still mean four stings," he says. After the first injection I tell him I didn't feel a thing. "I'll try harder next time," he says. I appreciate his effort at humor in this humorless place. The injections are radioactive isotopes. This is a "sentinel node" procededure to locate which lymph node guards the path to the whole chain of nodes under my right arm. The table I'm on glides feet first into position for pictures. Turns out I have two sentries. No one says if this is a good thing or bad. The radiologist runs a geiger counter over the nodes and adds two more marks to my tattooed chest. I later learn Dr. Corn is annoyed by this over stepping of her power. Apparently politics abound even in hospitals.
I'm taken upstairs to Pre-Op by wheelchair, my husband taking over the sentry role. What is the deal with hospitals not letting you walk on your own volition when you're able and then making you amble about when you don't fell up to it? My assigned nurse here is a gem. She's exudes warmth and competence and I find myself relaxing. I'm outfitted in my hospital gown, socks, an IV is started and Shoyei and I settle in for a two hour wait. Dr. Corn, the OR nurse and anesthesiologist stop by one at a time to check in with me. I'm amazed at the peace I feel. When noone is looking. I take one last peek down my gown at the part of me about to be cut away. "Farewell," I whisper wistfully. I glance at my husband. He looks afraid and I pray for him. I'm so sad he's refused all offers of company for his waiting but he's adamant about preferring to going it alone. The anesthesiologist is ready to take me. "Now's the time for the hug and kiss" he tells Shoyei. I'm surprised to feel my face crumple as we cling to each other. It's the last I remember until I awake in recovery.
Recovery is the hard part. They are under staffed today, they tell me. I'm in pain and unable to position myself for relief in the bed. The nurses are overwhelmed and impatient. They are in the ninth and tenth hours of their twelve hour shifts. Its unrealistic of me to expect the best of them. I'm given a pain killer which quiets me down. I'm kept waiting and waiting because there are no rooms ready (because they are short handed there too?) which for these nurses means double the patient load. I can hear another patient coughing and the distress is is causing her. They are comforting her. Suck it up I tell myself but the drugs render me weak and selfish. I seek the comfort of my Lord and He is there but I am concerned about my husband and anxious to see my daughter. It has been hard for Shoyei to let me out of his sight. My protector. I hear a recovery room nurse taking a call. She is explaining to my husband why I am still here where he cannot be with me.
Finally, I'm wheeled to my room where my husband, daughter and son-in-law are waiting. I am so happy to see them so why am I still so irritable. It took me so long to get into a semi-comfortable position my room nurse wants to make me "more comfortable". I just want her to leave me alone. Actually I want her to leave completely. Shoyei is all the nurse I need. I'm "under the influence" and behaving badly. I hear my daughter apologizing for me. "Did you know my mother before?" she asks, "because, this is not how she normally acts." "I'm embarrassing you," I say. Shoyei makes a stab at a joke and I tell him to drop the jokes for a while. They're annoying me. Later I'm mortified, tearful and ashamed apologize to everyone.
Shoyei shares the doctors post-op reports. They are both giddy with excitement at how well I've done. It's good to know I behaved during surgery. Dr. Mosharaffa has inflated my tissue expanders halfway already which had not been his intention "because her muscle is so strong". Must be all that protein I've been eating. It also explains why I feel as if I have a rubberband around my chest. The expanders are under muscle.
.The new nurse, Shelli, seems on guard, as if she's been warned. But I start off by telling her how out of control I feel. "It's normal," she says, "the anesthetic does that". She's beginning her shift and appears to be conserving her energy. She gets me settled. I eat a little but fail to keep it down. My husband holds the bucket. For better or for worse, he's pulling his end.
I feel myself again, my alter ego has thankfully gone missing. The pain is under control and I'm sleepy. The nurse helps my husband convert the couch into a bed, gives him sheets, blanket and a pillow and he collapses for about 3 hours. I smile with gratitude for his soft snoring. I try to doze off but there are pressure "socks" alternately massaging one leg then the other every 10 seconds to prevent blood clots. My "vitals" are monitored throughout the long sleepless night. At 3AM I need to use the bathroom and call for Shoyei's help. He calls for the nurse to help us with the tubes. She comes to help, instructing me to put my weight on the bed rail, which collapses sending pain up my torso and her tripping past my husband. No harm done, we all laugh. Through the night she forgets to restart my pressure socks, put on my oxygen tube and re plug my IV drip after I use the bathroom. She's annoyed at first when I call each time to ask about these things then acknowledges "we" forgot to reconnect you. She's lovable but I'd like to go find that pre-op nurse. I finally sleep from 5:15 to 6:15 when an attendant attempts to slap a blood pressure cuff on my arm after loudly announcing "sorry to wake you". He missed the big sign on my board saying no blood pressure readings from either arm. "Oh yeah," he remembers, "I saw that on your chart". I ask for a pain pill. "I'll let Kelly know,"he says. "Who's Kelly?" I ask.
My husband is getting breakfast I'm told. I'm hungry and wonder when breakfast is served. I turn on the flatscreen TV and discover the coolest thing about this hospital. I hit menu and order oatmeal, brown sugar, milk, berries and an english muffin.
Dr. Corn pops in, loosens my bandage(I finally take a full breath) and signs my release. My delicious hot breakfast arrives and I am thinking about staying one more night. Until Kelly shows up. He's not mean but right up until I'm released no shadow of a smile attempts to brighten his face. I am so anxious to get home.
HOME. Shoyei gets me settled experimenting with the right pillows to make me as comfortable as possible. I absolutely cannot imagine a gentler, more conscientious nurse than Shoyei is being. He is grouchy but mighty short on sleep. His is a volunteer position. I take in the beautiful view out my window and the two vases of flowers each of my children have given me. My daughter and her husband are here to help. My mother is here. My family has called and friends email their love. I feel cherished and very grateful.
October 29th 2008, Day of Surgery
I awake after a good night's sleep and begin praising the Lord for my peace and joy. I am fully prepared, buoyed on the prayer of the saints - thank you! Only the grace of God can account for the incredible excitement I feel! Thank You Lord for the gift of wisdom and skillfulness you've imparted to my doctors. Thank You for this incredible opportunity for healing through medicine and prayer!
On Monday I woke upon seeking God and not sensing His presence. Where are You? I need You now. I went to His Word. "I am not alone for my Father is with me" John 18:32. There You are! I picked up my Blackberry and a friend encouraged me from His Word, "Blessed shall you be when you come in, and blessed shall you be when you go out... The Lord will command the blessing on you in your storehouses and into all to which you set your hand... and the Lord will grant you plenty of goods, in the fruit of your body...." I went to work and friends there prayed for me. There You are! I opened my mail from an elder. Sweet and tender words tell me You are pleased with me. There You are! A woman from my new church whom I've never met called to arrange delivering a meal. There You are! Another calls in the evening to pray with me. I've not met her yet either. Family an friends call and send me morsels of Your Word. I smile. Lord, thank You. I saw you everywhere!
This is the most wonderful journey. You are my trail guide and my eyes are upon You.I praise Your Holy Name - my sweet Lord.
On Monday I woke upon seeking God and not sensing His presence. Where are You? I need You now. I went to His Word. "I am not alone for my Father is with me" John 18:32. There You are! I picked up my Blackberry and a friend encouraged me from His Word, "Blessed shall you be when you come in, and blessed shall you be when you go out... The Lord will command the blessing on you in your storehouses and into all to which you set your hand... and the Lord will grant you plenty of goods, in the fruit of your body...." I went to work and friends there prayed for me. There You are! I opened my mail from an elder. Sweet and tender words tell me You are pleased with me. There You are! A woman from my new church whom I've never met called to arrange delivering a meal. There You are! Another calls in the evening to pray with me. I've not met her yet either. Family an friends call and send me morsels of Your Word. I smile. Lord, thank You. I saw you everywhere!
This is the most wonderful journey. You are my trail guide and my eyes are upon You.I praise Your Holy Name - my sweet Lord.
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