Wednesday, April 15, 2015

Surgery day. April 9.

You all remember this adventure started out with such a small colored piece of skin, in the shape of Saturn. A little round spot with 'edges' that resembled -to me- the rings of the planet. 
After my 'punch biopsy' the area slowly healed.  
The general surgeon I met with explained there is a nerve that runs right along the toe in this area, and that is why it had been a painful recovery from the punch biopsy.

The surgery was pushed out a little bit for several factors doctor's  schedule, my schedule, hubby schedule, and with the OK of the general surgeon.  

One of the last "hurrahs" of springtime toes.
I used my Jamberry wraps (2013 ones) that just scream summer.  
Also, I enjoyed wearing my Born sandals as much as I could in the chilly spring air.  It doesn't seem like I wore them as much as I wanted.  It'll be a while before I can wear them again. 

Since surgery was pushed out an extra week, it was convenient for a sibling:  I spent a week in the D.C. metro area, hanging out with sibling and watching her son for his 'spring break'. My fee was spending time with nephew,  food, and trips to thrift stores :-)  
I scored a brand new pair of Fidji shoes with the sticker still on from Nordstroms---for $25!  

While the planes traveled through some turbulent clouds, when I got back to Iowa, the clouds were moving on in a perfect line.  Gorgeous skyline.
It reminded me of ocean water meeting the sandy beach. 

The Mike and I spent Easter with his parents. He drove back on the 'back roads' and we found a nice river overlook.  We usually travel the roadway/bridge that is in the far background. 
My sister in law's church made a prayer shawl for me--
and she got one for me in my signature purple (for pancreatic cancer)

All the fun out of the way and it was time for surgery. EEK.   One of the hospital nurse's called the day before to run through my medications, vitamins, and allergies.  Reporting to the hospital time was changed from 5:30am (GASP) to 11am. I still couldn't eat past midnight (sigh). 
Surgery time itself was changed from 9am to 3pm.  

Last Hurrah of toe socks for weeks to come. 

Pre-Op
The hospital intake was interesting and different.  Most of my colonoscopies have been in the doctor's ambulatory room.  The only surgery I can recall 'checking' into a hospital for was my breast reduction and that was a different hospital.   The intake person was fairly new, and she kept reiterating that.  I was told to bring copies of my Living Will and Durable Power of Attorney, and she apparently had never had to scan a document into the file for this.  
She then sent us down the hallway to the surgery wing.

In the hospital room I had an intake nurse  who promptly started getting things ready. First, I let her know I had brought food for the recovery room/post surgery when they always try to get a person to eat crackers.  She said just to leave those with The Mike as I'd get those when I came back to the same room after surgery.  Next, she verified medication/vitamins and then tried to get me to give a 'water' sample (which I wasn't told of and couldn't give for at least an hour).  

Before she even had me in a gown, transport was there to take me to nuclear lab for the lymph node mapping.  Even though they said there was no rush, the fact that these transport folks waited by the door while the nurse was doing her work was annoying to me, and must have been to her as well. While this was going on and the nurse was verifying info, an older nurse came in and just "had" to see my cancer spot on the toe as she thought it was a misprint. [okay, maybe she was a heavy smoker and had aged skin, but she seemed about 60].  I honestly have no idea if she was a nurse, I remember her saying her name, but for all I know, she probably was the busy body at the reception desk.

To my intake nurse, I verified that no I.V. can go in my left wrist due to scar tissue from my very first I.V. experience in August 1993. Most nurses don't believe me on this. Today I had medical tape with "NO I.V." written on it slapped on to my wrist vein :-)  My intake nurse believed me and tried to get the I.V. into my right wrist, under and around the name badge and allergy badge. It didn't go well, The vein blew. This means the vein got a hole in it and they would have to go in another place. It doesn't really hurt when this happens, but it is inconvenient.  Another nurse was called in -who apparently can do I.V.s under extreme pressure, and my IV was put in the inside elbow vein.  
I was quite impressed to get an allergy band that had not only Ibuprofen on it, 
but also gluten and soy!

Lymph node mapping. 
Mapping is . . . interesting.  I was taken down to the nuclear med floor and left in an actual waiting room which was vacant except for yours truly.  After about five minutes I was rolled down the hallway to the mapping room. The surgeon was there and he and I confirmed together where the Melanoma spot was located, he marked it for surgery, and then another spot (also between the toes) for the tech to inject the mapping dye. I was asked if I was pregnant.

The tech injected the dye, which was just a little twing, and then did a preliminary scan. After that, I was taken to have a chest X-ray performed. I assume this is because I'd be intubated for the surgery.  The technician there came out to verify my bracelet ID, even after I stated my name. As she was looking at it, she said I looked 25. WOOT!   Probably had something to do with the ponytail on top of the head and the Lululemon headband :-)  I was asked again if I was pregnant. Ah! Maybe this is why they wanted me to give a urine sample up in the intake room!

After a few chest xrays, I went back down the hall to the mapping room.  This whole time I just tucked my gown around my body to prevent a show. After 20+ years of showing myself for colonoscopies, I wasn't concerned with having my legs exposed, nor interested in more laundry for the hospital with extra gowns--but I did want to maintain modesty for the hospital workers. 

In the mapping room I was set up on a skinny table/bed/tray with warm blankets and there was a tube/machine I'd be fed into for scanning where the dye was in the body as it worked its way up from my toes to the pairing lymph nodes.  It was possible for these to be behind the knee, or by the groin area.  Eight photos were taken over a period of about 40 minutes.  During the second or third photo, the room was called by someone to see if I was done. HA! I'd barely been started upon!  A computer screen above the scanning area showed the starburst of the dye as it moved through the body. As each photo took about a minute to process, the starburst effect would be concentrated in a certain area for the nodes. 

After the photos were taken, the tech then had to mark on my body the locations of the three main lymph nodes that were marked with the dye.  I had no idea what was really going on, but it tickled and felt like a marker.  She was using a skinny marker to mark three locations on the groin area and then the doctor would take from each area.  The tech explained the nodes are basically a string of pearl like items and the surgeon would take out some from the three marked areas.

After this was done, I was taken back to my hospital room. I was able to give the sample they had wanted, and I got to wait until surgery time. While all this was "hurry up, hurry up, hurry up" time, now it was "wait, wait, wait".  Time was now just after Noon and I wouldn't be called back for surgery until 3:15pm.  

The Mike and I  were in the room together for a little bit when a nurse came in and asked if the doctor had been in yet. Well, I saw the doctor down at lymph node mapping, and he had been in about the same time to see my husband, but haven't seen him since then. My understanding was he was suppose to come in with both of us here. The nurse was just very terse and asked , "So he hasn't been in".  He was in to see my hubby about an hour ago, he saw me down at the lymph node mapping. Terse Nurse: (harumph/sigh) and sort of huffed out of the room. 
The Mike and I thought that was quite strange. 

tried watching tv, we tried reading magazines, and we generally just sat there and held hands, waiting for them to come and take me away for my cancer surgery. Even though it wouldn't be as invasive or as scary as my sister's mastectomy the next day, it was still cancer surgery for me, in an unusual location.  

For surgery, this is what I remember. We were taken out of the hospital room. The Mike was informed of the waiting room for family members, and they have a television screen to show my initials, color coding where I was (in surgery, in recovery, in hospital room).  The nurse transport team wheeled me past the cleaning/scrub stations for medical personnel, I was taken into the surgery room which was cold for me, but I'm sure it would be warm with the spot lights lit up for surgery.  I repeated my name, birthday, why I was there, which foot would have the surgery. I was transferred from the moving bed to the surgical bed, laid upon it, warm blankets given, and I exposed my thigh/groin for the techs, I breathed into the mask and that's it.

The next thing I know it's 5pm in the recovery room and I'm being fed ice chips in between quick naps.   After so many ice chips I'm taken back to the hospital room where The Mike is waiting for me and my foot is bundled as below: 
All this bandaging covers the fourth/fifth toe area/surgery location. 


Hanging out with my prayer shawl --which was perfect for the chilly room--and my Kinnikinnick graham animal crackers and Snyder GF pretzels.  (both of these have soy lecithin, but that is one thing my body can tolerate, it's soy oil and protein that I can't). 

Another nurse was caring for me when I returned to the room. I enjoyed a small orange juice, water, and my crackers and pretzels.  Then we had to wait for my RX to be filled at the pharmacy hospital. Normally I'd take it to Target ---especially in April for double points month--but it was going on 6pm and I couldn't remember when the pharmacy there closed 6pm or 7pm).  After twenty minutes the nurse comes back to say the fax RX didn't get sent.  She gave me a pain pill while we were there, and then I had my RX delivered about 20 minutes later. After this, it was discharge time!  

Finally, we were heading home. No plastic boot or shoe for the foot. . .nope, just the bandage wrapped foot that I'm not suppose to walk on for 3-4 weeks!  

First, a wheelchair ride to the entrance, followed by hopping one footed into the car, and then we were on our way :-)   The Mike pulled up as far as possible to the sidewalk and I one foot hopped (with his support) into the house and to the couch.
The comfortable couch is where I'd be for the next couple days. The Mike set up my phone charger, electric blanket, and beverage station, along with a small end table with my magazines and note pad to keep track of when I took my medication. I highly suggest this for anyone who has surgery and has to take sleepy time pain medication. Otherwise, the hours seem to blend together the first days.


Disclaimer: My apologies for any misspellings or grammar mistakes.  I'm still on pain pills :-)  

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