There are two choices in the treatment of DCIS – both surgical. The first is a lumpectomy followed by (prescribed #) weeks of radiation (see lumpectomy page for more information on this option) or a mastectomy. A mastectomy is the removal of all breast tissue in the affected breast. After careful research and a visit to a PS (Plastic Surgeon), my husband and I decided on the mastectomy for four reasons: 1) As a small-breasted woman, a lumpectomy could be very disfiguring; 2) To avoid six weeks of radiation; 3) To make sure we got all the DCIS in that breast; and 4) To speed up the involved period so I could finish my masters degree and graduate that spring.
Below are my personal thoughts from my mastectomy:
PROCEDURE #3: Surgery was quickly scheduled for Wednesday January 12, 2011 – the day after my husband’s 50th birthday. I wanted to get this done promptly for two reasons: 1) to get the carcinoma out of my body, and 2) to give me more time to re-cooperate before classes started. I had resigned my position as the Executive Director of Batavia MainStreet (downtown Batavia manager) effective January 1 to finish my master’s degree full time spring semester. Classes started in a couple weeks, so I knew if I wanted to reach my goal of graduating in May, I had to move quickly. It had only been a month since my ductal biopsy so I knew the routine of checking into day surgery. Dress in hospital garb, get blood drawn, sit and wait and get asked a slew of questions about allergies, pain level and such.
The clock ticked to 9:30 – time to be wheeled to my first procedure… the sentinel node location procedure in nuclear medicine. I had no idea what was about to happen, but they had put a round patch with anesthetic goop under it on my left breast to prep me for the procedure. Upon being wheeled into nuclear medicine, I was greeted by someone not in hospital garb. She was not wearing a hospital badge and told me she would be with me all morning through this procedure and surgery. I remember thinking it was nice to have a face I could look to all during the morning. It became clear she was more than just a volunteer, so I asked her who she worked for – it turns out that she worked for the company that made the device that detects the radioactive material about to be syringed into my breast. Before I knew what happened, the radiologist was sticking four needles around my breast and the “helper” said to squeeze my hand and be prepared for pain. This caught me off guard a bit. I only thought they were taking a “picture” or locating my sentinel node. I guess I was never informed what the procedure was. Before I knew it, the radioactive material was injected and the third needle injection stung like nothing I had ever felt before. I took a deep breath and held it until the pain subsided (since I was a swimmer, I can hold my breath a really long time). They said I did “really well,” so I wonder what the other women did – scream wildly and flail about? I was “photographed” and it turned out my sentinel node was located the first go round. My helper then used what I’ll call a “Geiger counter wand” and ran it across my chest by my armpit. It went off and sounded louder when she located the node and she marked my skin with a black Sharpe mark. She would then accompany me into surgery to assist Dr. Taft, my surgeon, in finding the node to avoid unnecessary incisions and also to save time. I was told the half-life was six hours. I guess at that point I was positively “glowing.”
Back to the day surgery area and time to get ready to go under the knife. The worst part of surgery for me is inserting the IV in my hand. It hurts like a son of a gun for about 5 minutes, and then the pain evaporates almost as fast as the pain and burning crescendos. I put on my “shower cap” and was wheeled into the OR. This time I was awake and they had me shimmy my butt onto the OR table, then my arms were outstretched at 90 degrees. I was starting to feel a bit like I was part of a crucifixion, as my arms were outstretched to 90 degrees. The anesthesiologist pushed “juice” into the IV, I caught a glimpse of Dr. Taft nodding at me with reassurance, then it was lights out. Surgery ran a bit longer than anticipated – my blood pressure did its normal thing and dipped down into the unusual range, so I was told they pushed epi to bring me back up to the normal range. When I woke up in recovery I felt a couple things. First, my heart was racing (from the epi) and my tongue was numb. The breathing tube they inserted down my throat must have caused some damage or I bit my tongue or something. I was told my sore throat would only last a day or two. The nurse pushed morphine, which I was thankful for and I drifted back to sleep.
The rest of my hospital stay was fairly uneventful, except for the unexpected color of my urine – mint green! Although I didn’t get a straight answer (it was after 5 pm and the nuclear medicine staff had gone home), it was my body’s way of getting rid of the injected radioactive dye used during the sentinal node location procedure. It was time to check out of the hospital and figure out what my new ‘normal’ was going to be like living without a breast.
When you’ve had major surgery, you are told to ‘lay low’ for 4-6 weeks. Right. It sounds like a plan the day you are in the hospital and feel awful, but for someone as active as I am it was not an easy order to fulfill. I was a model patient the first week. I didn’t anticipate the extent of affected area from a mastectomy. Breast tissue runs from just offset the sternum horizontally across under the armpit and from the collarbone vertically down to the bottom of the breast/chest area. This is a very large area and I was lucky only to have only my left side removed. It was during my struggles to go to the bathroom, get out of bed, pin my drain on my clothing and more that I sat down at my computer and developed the “10 Tips Pre-Mastectomy.” I simultaneously started the “10 Tips PostMastectomy” as I lived them each day. I simply could not imagine I was the first woman who has felt the way I did – frustrated at the lack of quality information to help me along my recovery path. This is where my ideas started to bubble to create a source of reliable information from multiple perspectives to help future women who will, unfortunately, join ‘the club.” Please visit this page and the “10 Tips Pre-Mastectomy” page as well if you or a loved one is preparing for that surgery.
I babied my left side for the first week while I should have started some gentle stretching exercises, but I wasn’t given any at the hospital, so who knew? Ten days later, I was having real trouble moving my left shoulder and my range of motion (ROM) was very compromised. At my ten-day post-op visit to Dr. Taft, I asked her what I should be doing for exercise and she asked if I would like a prescription for physical therapy. My answer was a quick and resounding, “yes.” After she yanked out my two chest drains (that was an unexpectedly painful experience – (see my top “10 Tips Post Mastectomy”), my friend Sharon drove me home with teary eyes and a light head. I remember thinking, “this is not going to be as easy as I hoped….”