D-Day: September 30

As September 30 was nearing, I couldn't help but feel like it was a sort of D-day for me. Please know that comparing my breast cancer journey to the day that troops stormed the beaches at Normandy in the fight against Nazi Germany is certainly not intended to minimize or make light of what soldiers went through on that terrible day (more than 9,000 soldiers were either killed or wounded). But that operation was what General Dwight D. Eisenhower called a crusade where "we will accept nothing less than full victory." It wasn't the end of the war by any means, but it was a critical part of the battle that turned the tide in favor of the Allied forces.

The hard thing about cancer is that surgery, while a major undertaking, is really just the beginning of the battle. It's an important step down the road to recovery, but it is certainly not the end. And in my case, it was the beginning of a crusade where I will accept nothing less than full victory.

So I reported to Huntsman Cancer Hospital on September 30 to say goodbye to one of my boobs forever. It's certainly a strange feeling knowing that when you wake up part of you will be missing, but it is a necessary casualty in my own personal war.

After a quick meeting with the anesthesiologist (I had been suffering from a pretty bad cold and cough the previous week, so they sent in the anesthesiologist to make sure it would still be safe to put me under for the procedure), and some time with the plastic surgeon, I made my way to the "Nuclear Medicine" wing of the hospital. Inside a small room, there was a needle next to a container that said something to the effect of DANGER on the outside, and the surgeon explained that it was radioactive material that they were going to inject into me. So, yeah, great. They store it in a lead container and nobody wants to touch it because it's potentially dangerous, and they are about to inject it right into my body. Supposedly it's a low dose of radiation and I'm going to be fine, but once that shot is in, I'm officially nuclear.

The radioactive material is actually designed to travel to my lymph nodes, the same path that potential cancer cells might travel if they had escaped the immediate area of the tumor and decided to go somewhere else in my body. According to the surgeon, there is no specific pathway that they follow, but finding cancer cells present in the lymph nodes indicates that they may have spread elsewhere. The radioactive injection helps the surgeon find the first few lymph nodes that drain from the breast tissue, thus enabling them to do a quick biopsy of those nodes while I'm already in surgery. If they find cancer cells present, they take out the lymph nodes and can either biopsy more, or take out more in the area.

It was supposed to take 2-3 hours for this material to drain into my lymph nodes, during which time I expected to be miserably hungry and thirsty (since it was close to 11:00 by then and I hadn't eaten since midnight the previous night), but it was only about 30 minutes before the surgeon came in to go over a final few notes before the procedure, then maybe another 15 minutes or so before the anesthesiologist came in to get me and take me away. During our pre-op meeting the surgeon also took a few seconds to write "yes" on the right breast in marker, just to make sure he took out the right one, he said. I hadn't really considered the possibility of getting out of surgery to find that they had taken the wrong breast out, but that seems like it would be pretty horrific. I'm glad he gave himself this little reminder.

Once in the operating room, it only took a few minutes before they gave me the anesthesia, and the next thing I remember is waking up in the recovery room around 2:30. Apparently everything went as planned (he took out the correct breast), and after an hour or so in recovery I was taken to a hospital room for the night.

First let me say that I am very grateful for the exceptional care provided by all the nurses and aides who were at the Huntsman Cancer Hospital that night. They really were great. That said, spending the night in the hospital is miserable.

I was exhausted and in some pain, nauseated from coming out of anesthesia, and really all I wanted to do was sleep. That turned out to be impossible because of the constant activity level inside the room. I don't think we were left alone in the room for more than about 60 minutes at a time all night. Between aides coming in to take my vitals, nurses coming in to check if I needed anything, and surgeons coming in to discuss the results of the procedure, check my incision, and give me instructions for when I headed home (they do this before surgery, so they started coming in around 5:30 or 6:00 a.m., and I had several different surgeons and residents visit me because I got both the mastectomy and a tissue expander to start reconstructive surgery), I probably got a total of 3 hours of sleep that night.

There was even a time around 3:00 in the morning when one of the aides came in to tell me that she would no longer be my aide, and introduce me to the new person who would take over. Let's be honest--I'm on pain meds, delirious from lack of sleep, it's 3 a.m., and I really don't care who shows up to take my vitals. Whoever shows up, I'm going to assume they are the right person to do it, and it really doesn't require waking me up in the middle of the night just to tell me someone else is going to do it, then telling me that person will be back to wake me up again in an hour for said vitals.

Fortunately mastectomy surgery only requires a 1-2 day stay in the hospital, and the next morning they encouraged me to try and get out of bed and walk around the hospital wing at least 3-4 times that day. The first walk was just to the bathroom, and the next one was a little shaky, but by walk #4 I felt pretty good and was eager to get discharged. We found the surgeon and were able to get permission to leave and go home for a real night's sleep.