Surgery Date

My surgery date is July 30th. My surgeon said my oncologist told her he was giving her until the end of the month to get the surgery done. Sounds like Dr. Barth its pretty much his way or his way. So the 30th was the earliest she had available and it is before the end of the month.

I have an appointment for the 22nd for pre op work. Already had a chest x-ray the during the stay at the hospital during round one of chemo. So that's done don't need another one. Brenda, my surgeon's scheduler was looking through my test that are in the hospital's data base and she sees the x-ray so that's taken care of. Then she asks me have you had any recent blood work done. Oh I just laughed. Yes before each round of chemo and tons of it. She finds the one done on June 6th. That was the start of round three and she says holy moly Dr. Barth tested you for everything under the sun! I said oh is that the test that 5 or 6 pages long. She says yes! I don't think you need anymore blood work. So I tell her that I have blood work orders from Dr. Barth for next week to have my iron checked from when I had the iron infusion so I asked her if I could bring those and if Dr. Guerra (my surgeon) does need anything else could those be done at the same time. And she said yes to bring the orders because even if Dr. Guerra doesn't need anything else I can go ahead and get the blood drawn for the iron while I'm there. So one less trip somewhere. So, the last thing is an EKG. So pre op instructions, post op care, bunches of release forms to sign, blood work and EKG scheduled for next Thursday.

So here's details of procedure (warning for the squeamish) I have to be at the hospital at 5:30am. Yikes. I register and then they will be taking me to get my wires put in. Yep. It called wired guided breast surgery. If a tumor can be seen on a scan but not felt or in my case there are just metal clips left, then they toss you in a mammogram machine, numb up the breast and then insert needle threaded with a wire into one end of what was the tumor bed and then another one on the other end of the tumor bed and then pull out the need. The wire will be threaded from the tumor bed to the outside of the breast where it will be taped down. Why? this is the guide for the surgeon to know where to make the incision. Yep. Best way they can do this. They will also be injecting the tumor site with a radioactive isotope. Nice. This is part of the lymph node identification. I'll explain in a minute. The I will go to surgery where my surgeon will inject blue dye into the tumor site. The blue dye and isotope will be taken up by the lymph node(s) this is to identify which one or ones of the lymph nodes the tumor was draining into. A pathologist in the operating room will take a peek and see if there is any obvious cancer cells. No one seems to fee that there will be since I had chemo first and such a good response. Then she will remove the tumor bed using the wires as guides. Ok the blue dye and isotope they know used alone doesn't get taken up 100% by the lymph nodes so using both mediums helps insure that this happens.

Bottom line I don't want the tumor bed left because we know something bad happened there. I don't want the lymph node or nodes (we are talking about one to five being removed)that the tumor was draining into to be left either.

The thing that is confusing is that the term sentinel node is used. To me this means one node. The main node. That the tumor was draining into. When my surgeon said I'll be removing the sentinel node so, one to five nodes, I said well, how are you going to determine how many nodes to remove? What is the criteria for removing more than one node inny minny miney moe? Yep and I said it just like that. She said oh no, the dye and isotope will show up in the nodes that the tumor was draining into. Sometimes the tumor only drained into one node, sometimes 2 up to 5. Ok. So its not a random decision. I'm good with it. 1 to 5 nodes being removed is not a big deal. Won't cause major edema later.

The procedure is schedule to be as an outpatient so I can go home the same day. Now I told my surgeon I don't like to be put out. And she says yes, but it's better for you if you are. No kidding. I told her I have a huge fight and flight response and sometimes wake up puking. AND I will need xanax. She told me I could have anything I wanted and that if I was puking they would not be sending me home.

It's a pretty straight forward procedure. Don't want the tumor bed left in and I don't want the lymph node(s) it was draining into either. Those will be removed. So I'm good.

Oh and she told me she could give me a breast lift but of course then we would have to lift the other one for a matched pair. I looked at her and said I think I'll go with the less invasive method and just keep the hanging pair I have. She laughed and said yes I was pretty sure you were going to say that but, it's an option and I just wanted you to have it. I appreciated it and thanked her but, I'm passing on being cut on more than I have to be.