August 31, 2014 - Milky white propofol

As promised, here is another re-visit for those of you that joined my journey late. Warning, It's rather emotional. I teared up reading back through it just now. This tells the story of the 24 hours around the actual mastectomy. You may have read this if you have followed me from the beginning. If not, here you go! (Note: it used to be 2 posts, but I've joined them together for one). 

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Day 0 Part 1: 

I realize I never captured the actual day of the mastectomy. Early on, I didn't yet know if I could commit to going public with this specific journey. I wanted to advocate, but was I truly ready to put it all out there, particularly something so very private by most standard? It seemed all to personal a topic. It seemed foreign. It seemed unreal. Well it quickly became very real when we got in the car that morning to go to the hospital. I don't even recall what we talked about in the car. I do recall my saying everything is going to be different when I wake up and I warned Ron I didn't know how I was going to react. I'd pictured it a hundred times by now and I knew it would be not so good but reality is powerful. This part made me very nervous. 

When we got there and walked in, there sat my mom, dad, sister, in laws, and sister in law. That got me! Just to know they came out of support for this decision we had made. It made my moment. It got me through the waiting room doors. 

"Mrs. McCollum, please come to the registration desk." I had put off signing in to the very last minute. I didn't want them to know I was there early for fear they would take me back earlier than planned. Delay, delay, delay.  There sat the kindest looking lady at the registration desk. She asked my name, address, etc. Then verified I was in for a double mastectomy. Well, darn it! Hearing that word "mastectomy", and I busted out into blubbering tears. The precious lady responded with "you're beautiful now and this won't change anything." And she had this watery look in her eyes as well. She knew to treat me as fragile. I could have kissed her cheek had I not been wiping my face so frantically. I knew that revelation that mastectomy wouldn't change my beauty, but boy was that kind for this stranger to say to the girl crying at her check in counter. Angel, I tell ya.

I had to go back by myself at first. I left everyone, including Ron in the waiting room. I was crying the whole way down the stupid cream colored hallway. They're always cream you know. Hospitals adore cream! And then there stood the poor intake nurse. She must have not even known what to say to me, the girl obviously all messed up in her hallway. She just shined her kind smile at me and held my arm. Another angel. Then, we are at the cubical room. Get changed into the lovely air conditioned gowns I adore. The scrub cap. Get my vitals. Start the IV line (it only took four attempts. I'm an iv line nightmare.) Then wait...By myself...While my mind wanders...Wait some more...Wait...Look at the monitors...Notice my super high blood pressure...Wait...Count the heart beats...Make up a song to the rhythm... Wait....Curse the iv line that is killing my arm...Curse Hodgkin's Disease that got me here...Curse medical literature...Curse me reading the stupid literature.....Wait.

Finally, there I see Ron smiling at the cubical curtain. He gets to come back so we can have our final consult with the Lead Breast Surgeon who also just walked in. Off comes the gown I so pain stakingly had just put on fashionably tying it in three places. Out comes her lovely black magic marker to start her art work on my chest. By the end of this, I look very much like a tattoo artist's playground who was testing every pattern available to a wishy washy client. Dots here. Lines there. X marks the spot. She even signed her initials on her handiwork. This is a requirement for all surgeries to verify patient and MD agree what is happening. She is amazing, but really there is NO dignity in this journey. Next, a chat with the anesthesiologist (she knew I was a medical clinicial) and in the end a spinal block would be my best friend and fate along with another arsenal of inhaled agents. 

Then, they ask Ron to leave. Now, why did they have to go and do that? Here come those stupid tears again! I'm a sap. A true sap. For the record: I didn't cry even once with my knee surgeries. If he leaves this room I'm going to lose it.

Lights, camera, action! I'm in the OR with about 12 clinicians all doing this and that. It's like an ant farm! Last thing I remember is the syringe of the eye catching milky white propofol being hooked in. They know I detest the taste and smell of milk, right? Wonder who that lady is that is holding that tubing? There are those cream walls again. Wonder what Ron is thinking.

Day 0: Part 2: 

Cream colored ceiling. Strange lady sitting next to me writing in some blue binder. Weird tight feeling on my chest. IV line hooked to a clear bag above my head. Awful sore throat. Beep. Beep. Beep. Must-sit-up. Super bad idea. Lady leans over to guide my head back to the pillow. Faint realization.... I must be in recovery and this strange lady must be my surgical nurse. More realization...Oh no, it really happened! Where is Ron???? I really needed him here when I woke up. That was so important to me. Where is he??? (you can see my flight of consciousness as I am coming out of anesthesia and realizing what is happening).

Glancing down, I can see every bit of my abdomen. My pelvis. My leg. My foot. But NOT my breasts! They really are gone. What in the world happened to those two humps! They don't just get up sprout legs and walk off! My thoughts were not of how great this is to no longer be at risk for breast cancer. Nor of how great it is that we have these medical advances available to women like me. Not of God's unfailing provisions. My thoughts were instead of my selfish human perspective of "they truly are gone." Under this surgical vest, there lie absolutely nothing. Nada, zilcho, zero. Instead, scarred leftover tissue that made the cut for use later in reconstruction. Deflated pouches of nothingness. 20 years of development gone in a poof! Abra cadabra. Zippity Zam. 4 surgical hours. Gone! Fast shallow breathing. "I need you to get my husband!!!!" "Please, I need Ron!" It wasn't frantic, just a super strong request that got her attention.

There is a lot of grey here. I remember bits and pieces. Some of this, some of that. Rolling down to my hospital room for my overnight stay. Climbing out of bed to go to the bathroom with four nurses helping my transit (I was super groggy and wobbly). I honestly didn't fully know where we were. That grogginess had an intense hold on me. Then, the unthinkable...vomiting. Nothing like vomiting while walking. Vomiting after chest surgery where every movement can be felt down to your toes. Vomiting on someone else's shoe. Vomiting when you haven't eaten in 12+ hours. Now, desperately wanting to make it to that bed two feet away without face planting myself in a drunken stupor on the not so soothing cream color vinyl floor. Why is my backside so cold? Please don't tell me I walked down the hallway with my gown wide open. Please, I know some of these people! I did NOT just flash these nurses! Tell me that! Chick-fil-A. Wonder if someone can get that for me? Can someone PLEASE make that beeping sound stop! (See, anesthesia really messes with your mind).

We made it through the evening with my thoughts slowly returning to rational with each passing hour. I did get my chicken sandwich, but I guess the airway tube scratched up my throat so much I couldn't really eat it. But, not for lack of trying. Then, it got dark. I have no idea what time it was, but Ron was sacked out in a recliner beside my bed. A faint yellow light trickled in under the door and blue lights from my infusion pump making the room an odd greenish hue. It's funny to me that I remember that so vividly. I lay starting at the ceiling wide awake feeling pretty lonely...and weird...and different. (Recall: I'd had a lovely four hour drug induced surgical nap earlier in the day so I felt no need to sleep.) Once again groggy from the repetition of pain meds every three hours. Because the continuously infusing IV fluids, I was ringing the call bell every 2 hours or less for yet another wobbly shuffle back to the bathroom. Surely, I was becoming a high maintenance patient nurses talk about out at the front desk. "Oh no, there's Old Lady McCollum's bell again. How many times can one person need to go to the bathroom? All she says is 'Get me this, get me that'. Rock, paper, scissors. Karen loses and heads to my room. But those nurses were oh so kind when they crossed my threshold. Happily getting me ice chips, or meds, or escorting me back and forth for the umpteenth time. Always smiling despite it being three in the morning on a super long shift with all rooms full. Grateful was I. Grateful. And I tried to consciously remember to thank them at every turn. I wanted to be low maintenance. But those stupid IV fluids...

Then, at six a.m, in came the surgical fellow and I lit up like a Rockefeller Christmas tree. See, I knew that surgical fellows meant morning rounds and that was the only thing standing in my way from a paid ticket out of here and a car ride home to a comfy cozy no more wide open surgical gowns, IV lines, loud beeping noises, too tight compression stocking living room! Come in, say what you need to say. Blah, blah percocet every four hours, blah blah sponge baths, blah blah this and blah blah that. Surely Ron was getting all of this down. Come on very nice fellow, can't you be any quicker? My couch is calling my name.

Fellow : "Mrs. McCollum, I need to take off your vest so we can check the surgical incisions..." SCREECHING halt!!!!! Slam on the brakes! Hold all your stinking horses. Wide eyed terror filled expression (Me, not the fellow).

Me thinking: Huh? What??? Where's my lead surgeon who told me not to even THINK about opening it and looking? You are doing what and why? This very minute?

Background: Lead surgeon was brilliant in instructing me not to open it for any reason. She knew nothing good could come of me seeing her master piece (it's common knowledge surgeons love to show off their work.) Yet she, being the heart felt clinician that she was -as you would have to be working in breast oncology- wanted to save me from seeing the aftermath. She knew from my very first consult appointment that I was overly grief stricken about the period between surgeries. She had seen the tears as she described the before and after. She even got watery eyes with me. So she brilliantly disguised the true intent (salvaging my sanity) with medical lingo and reasoning to camouflage the plan. "Sally, do not look under this bandage".

Fellow: "It's policy for me to check the incision sight to ensure you are safe for discharge."

And there in lie my quandary. If I want to go home, I have to let this 20 something young man, fellow in training might I add, open up this surgical vest for him, myself, and Ron to view it's content. You see, I had absolutely no plans to let ANYONE see this handiwork. Surgery #1. Stay all bandaged up for two weeks. Surgery #2. Voila! Normal chest again! This silly surgeon wanna-be is destroying my brilliant, sanity saving, well devised and lead surgeon approved master plan. What-is-he-doing???

The unmistakable sound of Velcro. (Insert the now famous fast paced shallow breathing.) Right side off. Left side off. All I could think was Holy Moly! That looks awful. More than awful. Devastatingly awful. Unrecognizable. Not of this world. Embarrassingly horrible. First, one tear down this cheek, then their watery salty friends join in for good measure because they hate to be left out.

Super delightful fellow in training closes the vest back up, hands me my paper work with last minute instructions and quietly walks out the door with well wishes floating in the air behind him. I, however, sat dazed and speechless staring at my now closed vest. What once was a well concealed package with mysterious and only faintly imaginable contents now became a fully discovered, undeniable, messed up reality. The image now burned into every single memory cell of my brain ready to cause me anguish for some time to come. Don't get me wrong, Fellow was delightful and under any other circumstance extremely likeable. Professional and thorough. Rule follower. But at this very second, he was Judas with a shiny new coin in his hand after the last supper. And now my heart, my positive demeanor, and master plan sat crumbled on the hospital floor. And there sat my amazing Ron, who had just seen the unfolded package himself, holding my hand.

Afterward: As irony would have it, 15 minutes later the lead surgeon walked in with her trade mark friendly smile to check on me. "Sally, don't forget to just keep it all bandaged up until our next appointment. There's no need for you to ever open it or look at it. It will heal best if you just leave it alone until our next appointment." - She had driven in super early in attempt to beat the rule following fellow to my room. I tell her it's too late. She had just missed him. Her face falls when I told her he checked the incision. Now her well intended thoughtful master plan for me lie crumbled next to my pieces on the hospital floor. She, too, stood holding my hand.

In hindsight, I imagine God even had a purpose for this expecting unveiling and for this Judas. I'm still sorting what that might be. Maybe I needed that experience. Maybe, I require a true vision of the mastectomy leftovers to better prepare other women that might struggle with the emotional adjustments of delayed reconstruction. Or just maybe that event wasn't even for me, but rather for something in the kind Fellow's journey. After all, I've always thought a Christian's life is rarely for the benefit of self but more about becoming a vessel focused on impacting the life of others. I may never know the true why of that morning. But I do know God has purpose. He has a strategic kingdom impacting plan. He sees my big picture and he sees your big picture. Even in the "awful".