[2023-07-08] Surgery long note and recovery day 1
A week before my scheduled bilateral mastectomy with immediate reconstruction, I drafted the blog post and social media text and designed the visual that I would publish after getting out of surgery. What I predicted—that everything would go well, that I would be tired and sore, and that I would be home after surgery—came to pass. I'm glad I prepared the post in advance because just publishing what I had created took all the energy I had last night, as I was still feeling the effects of the anesthesia. But I thought it was important to let everyone know that I was out of surgery, doing fine (relatively speaking) and back home.
I promised to share more details today. This post includes the details I would not have had the wherewithal to write and share yesterday as well as an update on day 1 of my mastectomy recovery. I'll get back to my Saturday Synopsis on another day.
On the morning of Friday, July 7, I woke up at 4:56 AM, just a few minutes before my alarm. I needed to drink one more small can of ginger ale (beyond the three I had consumed the day before) by 5:30 AM, 90 minutes before my arrival time at the hospital.
Chris and I left home early in case we encountered traffic, as we had on Thursday when I went to The Ottawa Hospital's General Campus to have Dr. Zhang, my plastic surgeon, mark up my chest.
But Ottawa traffic at 6:15 on a Friday morning is much different from 1:30 on a Thursday afternoon, so we got to The Ottawa Hospital's Riverside Campus ahead of my scheduled arrival time of 7:00 AM. Chris had a lump in his throat when he dropped me off, which reinforces that it's often harder on family members to watch a loved one go through medical treatment than to experience it themselves.
Once I was checked in to the Day Surgery department and had settled in bed #14, Nurse Marla came by to double-check a whole host of details, such as my name, birth date, allergies, prior procedures, the operation. She put in an IV line, set me up with a heated inflatable blanket called a Bear Hug (they're fantastic, by the way) and left me to relax before I was moved to another area for anesthesia.
Michael was my porter. When I asked him how long he had been working at the hospital, he said about 8 years.
— "In fact," he continued, "I was born in this hospital. I like to tell people I haven't gone very far in life."
I laughed at this. Michael went on to say that he had heard that retirement residences would be built around the Riverside Campus, so his association with the hospital might come full circle.
Marie-Ève, a respiratory therapist greeted me next, followed by anesthesiologists Dr. Bould and Dr. Gu. Dr. Bould recommended a procedure called a nerve block, which would help with pain management in the first 24 hours. To me, it was like an epidural I had had before ovarian cancer surgery, except that this time the needles went in my upper back (as opposed to my lower back) and the needles were removed once the medication had been introduced. Dr. Bould explained the risks of the procedure and the steps they take to mitigate those risks.
— "Even though the risks are extremely low, I need to cover them," she said.
— "Of course," I replied, "informed consent."
— She paused at my use of the term and said, "Do you mind my asking what you do for a living?"
— "Well, I'm retired, but before I retired, I was the Assistant Deputy Minister of Communications for Health Canada and the Public Health Agency of Canada."
— "Hmm. That explains the terms you use."
Once the nerve block procedure was done (a relatively painless step), Marie-Ève wheeled me to the operating room. Dr. Cordeiro, my breast surgical oncologist, was there, leading the team. She ran through the planned surgery and someone asked if I had any questions.
— "Just one, for Dr. Cordeiro."
— "I'm here," she said, appearing at my side.
— "Will you biopsy my lymph nodes?"
— "No, because your breast MRI from March was clear."
That gave me comfort, and reaffirmed my decision to have my breast tissue removed before cancer could develop and before it could enter my lymph nodes.
— "Now, I have it on good authority that you hold your patients' hands before surgery," I said to Dr. Cordeiro. She smiled and took my hand. I wasn't at all nervous about the operation, but it was comforting to hold her hand as I drifted off to sleep.
I wouldn't see Dr. Zhang, as she was handling the second part of the procedure—the reconstruction—and would have arrived after I received the general anesthetic.
Hours later, I woke up in the recovery room, where I had started the day. Nurse Marla had been replaced by Nurse Tracey. I don't know whether Tracey had any other patients to care for, but I had the impression that she was caring exclusively for me. She brought me crackers and cheese as well as ginger ale. She helped me to the washroom and stayed with me, as I was afraid that I might fall over. She patiently paused her review of the at-home procedures until I was alert enough to absorb what she was saying. She helped me dress, put on my shoes and tied them up. Like Marla in the morning, Tracey was incredibly kind and gentle. She wheeled me to the car, into the care of my husband and daughter.
I was nauseated from the time I woke up in recovery at about 3:00 PM to 9:00 PM when I threw up for the last time. Anesthesia always makes me sick to my stomach and wipes me out. Fortunately, I was over the worst of it quickly, able to shuffle to the bathroom several times during the night without fear that I would fall.
Before going to bed, I had Chris help me empty the suction cups connected to the Jackson Pratt drains under the skin in each breast. As per the booklet I received on looking after my drains at home, "These drains are used to remove fluid that would otherwise collect at the surgical site. They also help to minimize swelling and pain, and allow for quicker healing."
I slept on a wedge pillow, which helped to ensure that I didn't roll on my side. But as a side sleeper, I didn't get a great sleep. I'm hoping for more restful sleep tonight, or if not then, perhaps when the drains come out in a few days, or when the drainage sites heal, typically another three to four days after that.
I spent a good part of the morning responding to all the well wishes I had received. Your support has been tremendous, and it has meant a lot to me. Special thanks to the women who have had mastectomies and reached out to see how I was doing.
This afternoon, the homecare nurse came to check on me. The first thing Nurse Alexandra said to me was, "You are so beautiful." Perhaps she meant that my spirit was beautiful, recognizing in me a kindred spirit. She checked me over, proclaimed that all was well with my packing and drains, and informed me that my drains would come out once the drainage measures less than 20 mL per day for two consecutive days.
Each day will be better than the previous one. I am happy to be past the surgery. As I said to one of my family members, I was afraid that I might get breast cancer before reaching the front of the queue for prophylactic surgery. As long as my removed breast tissue comes back from pathology with no signs of cancer, I will have beaten the clock.
And that was the whole point of the bilateral mastectomy: to decrease my risk of breast cancer from 50-85% down to 5-8%, less than the general population, whose risk is about 12%. As my family member said, "welcome to your new breast cancer free life."
