Pre-Op For Breast Cancer Surgery

The following post was written on a blogger app on my phone during my pre-op appointment on February 13th, 2013 -- which is exactly 1 week prior to the actual surgery date of Wednesday, February 20th, 2013.

I'm now at my one week countdown stage to surgery -- 3 hours into my Pre-operative appointment.

In hindsight I should have asked what to expect at this appointment, how long it would take, and if all parts of the Pre-op would be in same location. Luckily I'm in the same clinic building for all parts. And, I brought two 32 ounce containers of fresh squeezed juice from home to keep me hydrated. But I'm getting hungry and wanting a warm, crunchy, yummy lunch like grilled salmon or chicken with salad.

The reason why this pre-op appointment was lengthy was due to the following:

• They took blood pressure, temperature, and a baseline of lymph fluids through a machine called LDEX. They informed me that the lymph fluids are then every 3 months for one year. This is to prevent complications of lymphedema. Apparently one runs this risk post mastectomy which is why fluids must be monitored, physical therapy exercises will gradually be increased.

• They explained a post-op separate machine, called a DVT, that will be hooked up to me while I'm sleeping, reading, watching tv in order to monitor and prevent blood clots. This is roughly for a week. It's portable; they gave me the device and gave me instructions on how to FedEx it back to the office.

• They also talked to me about drains that will be hanging out on my sides, under my arms, after the mastectomy. These drain fluid and are done at intervals I'll soon learn more about. My husband will learn how to do this. I'll have these for roughly 1-2 weeks. Once this was explained, they gave me a 'drains camisole' prescription which costs about $54, but is covered by insurance. They gave two of these so it's nice it's covered. These are like regular camisoles but with pockets for drains and what was described as a grenade that hangs at the end of the drain. And since on this topic, they talked about having loose clothing on (I can't imagine anything otherwise)in order to encourage healing. Tight clothes restrict blood flow, causes a blanching effect, and can increase risk of infection. The following PubMed Health link has more info on lymphedema. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002106/

• They explained an antiseptic cleanser that I'll need to start using two days prior to surgery. So for my Wednesday surgery, I will use this in the shower like a liquid soap starting on Monday. They gave me this cleanser during the appointment.

• They talked about a pain medications prescription that I need to fill prior to surgery. These include Valium, Percocet, doxycycline. These are for me to continue taking once I leave the hospital.

• They explained that during the mastectomy they will be removing one sentinel lymph node in order to test if cancer has invaded the lymph system. This is the gold standard test for nodular cancer. Once my tissue is removed, they will place the node on a slide. The pathologist will be there to test it next door. It's about a ten minute test. If it's cancerous, more nodes will be removed and it's a guarantee for chemotherapy. If no cancer is found in the node, then the only thing I may feel is numbness for a while. But I definitely would prefer the numbness over having the cancer invade the nodes, having these removed, then having more treatment.

• They took X-rays and did lab work.

• They told me of yet another lymph test I will need to do the day before surgery. It's called a lymphatic mapping test. It's roughly a 90 minute test in which they inject a contrast into my lymph nodes.

Aside from these routine things they had to do, they answered all my questions which is probably another blog post. But basically for an 830 am surgery I need to show up at 630. No water, other fluids, vitamins, food etc after midnight going into surgery. It's roughly a 2.5 hour surgery per breast -- so roughly 5 hours. I'm there for 2 days. Then a series of appointments happen starting that following Monday.

They asked me how I was feeling about my upcoming events. I told them that if this keeps me alive, healthy, strong, then I feel good about it. I'll do anything I need to do and accept it in order to avoid the alternative.