Monday, August 29, 2011

Three years

August 27th, was the three year anniversary of my first surgery -- six lymph nodes removed from my arm pit.  In June of that year, my annual mammogram showed a the edge of a suspicious lymph node, kicking off a series of tests.  One biopsy showed that node was malignant, but cells that were indicative of lung cancer.  One doctor fired.  The next biopsy showed no cancer at all, but that doctor wanted to remove ALL of they nodes from my underarm and my breast just to be sure.  Two doctors fired.

The third doctor said she wanted to open up the armpit area and look around.  This is from my writing project and I've been feeling weepy about it again...

August 27, 2008, two months and three days after the original mammogram, I had outpatient surgery at the hospital under full anesthesia. I had that questionable axillary lymph node removed along with five of its suspicious-looking friends. They were able to deep freeze the troubled lymph node on the spot. It contained a 1.7 centimeter tumor of HER2+ Invasive Ductal Carcinoma; an aggressive but common form of breast cancer. Since this gave us the final answer, a breast biopsy was unnecessary. These surgical results turned out to be exactly what the surgeon had expected, so she placed a medical port under the skin by my left collarbone. I remember coming out of the heavy fog of anesthesia, Dr. Runk telling me the results. I remember crying. Again.
How can this be happening to ME?

A drain to remove the buildup of blood and lymphatic fluid from the surgical site was installed under the area of the lymph node removal. A long rubbery tube extended down my right side. Several inches of tubing were inside my body, emerging just below my armpit toward my back. Sewn in place on the outside, the tube terminated by my hip with something that looked like a clear rubber hand grenade. The technical term is Jackson-Pratt Drain. When the grenade was empty, I took the cap off and squeezed all of the air out of it. I replaced the cap and this created suction to pull the fluid out of my body.
Twice a day the drain needed to be emptied, stripped and measured. After uncapping the grenade, the contents are emptied into a small measuring cup, like the kind that comes with children’s medicine. Then, starting at the underarm, we had to milk the tube with our thumb and forefinger, squeezing the contents of the tube into the grenade, then into the cup. After the line and drain were empty, we squeezed air out of the grenade again, recapped it and let the process begin again. We had to record the amount in milliliters and the color of “output.” Because of the awkward position of the tubing, I was not able to strip it myself. I had to enlist the aid of my husband, telling him I was activating the “in sickness and in health” clause from our wedding vows.
Every few days I called my surgeon’s office with the results of my tracking. Once the fluid output dropped below a certain level and contained more lymph than blood, I could have the drain removed. One thing I learned online – you don’t want to impatiently rush through the drain process or cheat in your measurements. If they remove the drain too soon, you can get a fluid buildup called a seroma. The only way to drain that is with a needle, so properly maintaining the grenade was the lesser of two evils despite finding the whole process humiliating and a blow to my overly-developed sense of independence. My husband and I followed the instructions carefully and in about a week the surgeon’s office yanked the tube out of my armpit.
My Summer of Test-a-Palooza, with its angst and uncertainty, was over. I had my answers and even if they weren’t the answers I’d hoped for, I had a team of doctors that I trusted and a treatment plan. Two weeks after surgery, I would start chemotherapy. No more frantic running around, it was time to focus on healing which turned out to be about a lot more than getting rid of cancer.