It’s funny now but at the time, we really did feel like we had waited forever for surgery. In truth, it was barely a month after my diagnosis. But as soon as you hear you have a malignant tumor, all you want to do is have it removed. And honestly given how slow the testing went, the scheduling and surgery went fast. It involved a few stages (and therefore three separate trips to the hospital plus my pre-surgery physical and chest x-ray). First I went in and had a blue dye injected into the area where the tumor was. Dr. T would see which lymph node the dye traveled to first, and that would be the “sentinel node” they removed in the first surgery, called a sentinel node biopsy. If the cancer hadn’t spread to the sentinel node, then they wouldn’t need to remove additional lymph nodes to check to see how far it had gotten. This surgery was scheduled for six days before my mastectomy – if they needed to remove more lymph nodes, they’d do it during the “big” surgery on December 12.
(I don’t know what lymph nodes look like, but I pictured the sentinel node as something like this guy or maybe one of the guards at Buckingham Palace.)
We had been told my lymph nodes looked clear on all the scans, but once they took out the three that were judged to be sentinels, they found the first was clear, but the second had a tumor in it and the third had isolated cancer cells. This wasn’t good news and meant they’d have to take out more lymph nodes to see if the cancer had spread any farther. In addition to being problematic cancer-wise, taking out a bunch of lymph nodes in your armpit leads to the possibility of lymphedema, which makes your arm swell up because the lymph nodes aren’t there to help move waste through your system (on the plus side, I don’t seem to sweat in that armpit any more). The presence of cancer in even one lymph node also meant that I was for sure stage 3 and not stage 2 (due to the size of the tumor plus the lymph node involvement).
But, otherwise, we were ready for the double mastectomy now. The plan was that Dr. T would go first and take out everything she needed to remove including additional lymph nodes, and then Dr. K would come in and put in tissue expanders and close everything up. The morning of surgery they both came in and took turns drawing on my chest until they could agree on an angle and length of the incision (again due to previous surgery – Dr. K was worried about my skin so wanted to work with the previous scars as much as possible, but Dr. T needed to be able to get to those lymph nodes she needed to remove). The tissue expanders help stretch the skin until you get the permanent implants – they go in kind of like flat balloons and are filled with saline over time as your skin and muscles stretch to give them more room. I met the anesthesiologist and got my epidural (supposed to work better for pain relief after surgery), told my sister and husband where a good place was for lunch close to the hospital, woke up in recovery and was immediately wheeled to my room.