Post-Op Day 6

On Wednesday 29th May at midnight I had my remaining drain emptied again. It had over 100 mls in it and I was so disheartened because the threshold for removal was 50 ml. The nurse caring for me said it could possibly still come out but that the surgeons would decide later.
I saw the surgical team around 7 am and they said it would be up to my surgeon who was in theatre but that they would contact him for a decision and let me know as soon as possible.
I was very restless for the rest of the day. I kept walking around the ward just to get out of my room and see some people. I was feeling pretty well considering how I had been only days before. I still had some persistent vertigo but finally had some tablets for it and I was getting sick of hospital food, a good sign that I was about ready to go home!
The ward seemed to be planning for my discharge because the pharmacist came and checked my medications and they said they would change my bed sheets if I didn't go. I was glad to be able to walk around and I also managed to sit and watch some netflix on my phone but I found I couldn't concentrate on anything like books or puzzles, or even games on my phone.
I video chatted with my family who were all on holiday together (a holiday I had planned to be on) which helped keep my spirits up and I was texting with my daughter and the friends who were looking after her so I knew she was ok.

Post-Op days 4-5

Monday was day 4 post surgery and day 5 in hospital. When the surgeons visited early in the morning I asked again whether I could have the window open and they finally agreed. It was unfortunately a very wet and windy day so the window being open meant it kept banging but I was able to wedge it with some paper. I finally felt more human and they said one of my breast drains could come out. It was a day when I was so grateful to everyone. An amazing HCA washed my hair over the sink and changed my anti-embolism stockings.

The drain coming out was almost painless other than the stitches being removed which was a little sharp but the drain removal was smooth and straight forward. 

Once I was washed and clean I managed to sit out in the chair with a hospital gown on and eat my lunch and dinner. I was able to put myself in and out of bed for a rest when I needed one and I also saw the physio who was very pleased with my mobility and strength. 

All in all it would have been a great day except we had a tremendous thunder storm overnight with sheet lightening. It was so bright it kept me awake for hours but, it cooled the temperature down making Tuesday even better.

Post-Op days 2-3

Saturday 25th May was mixed. I was able to eat for the first time and I got out of bed with help from the HCAs. I felt very awkward as I had so many attachments. I didn’t stay out for long and didn’t eat much at all as I felt so awful. I had a phone call with my family who were all together at my parents 50th Anniversary party. I felt dreadfully sad not to be there but also glad that I had the operation and the cancer was in theory all gone.

I don’t remember much of this day other than trying to keep cool, sleeping and having a quick wash by the bedside. I remember I was still on antibiotics and fluids and that the Doppler of the graft site was every 3 hours. 

However, by Sunday morning things felt a lot different. At around 4 am I asked for some of my own pain relief which I needed to eat with so I had toast and jam which was just amazing. I think I also had tea too. I then had breakfast but needed help to eat as my drip had moved and my hand and arm were swollen like the Michelin man’s. I had to hold my gamgee over me with the other arm which left me with no usable hands. A kind HCA helped me eat some breakfast and get into the chair and have a wash. I felt good in the morning but then I started to feel pretty lousy again. I couldn’t face seeing my poor husband and daughter who came for just a few minutes again before leaving me to rest. 

The consultant came and turned the radiator off but it turned out it was so hot in the room the radiator hadn’t actually been on. I had too much fluid on board and told the Surgeon such. He was very good and just believed me which meant the fluids could be stopped and I could just drink normally.  He approved the glove drain to come out and a dressing change and my catheter to be removed. 

 The nurses came and removed the drain, redressed my wounds and took the noisy fluid pump away. The drain removal didn’t hurt at all and having clean dressings and a fresh gamgee was good as it reduced the nausea.  

I seem to recall eating some lunch and dinner but not much.

After the catheter came out I had to work out how to mobilise around the room to the bathroom and they measured my urine for a few hours just to check it was all normal. 

It was another long night of drain emptying, antibiotics, Doppler checks and ice replacement. 

Monday however was the day I turned the corner.. more on that to follow. 

Post-Op Day 1 24th May

The night of the 23rd was pretty rough. The room was unbearably hot and the radiator was on. I knew that it was important for the room to be warm as it helps to maintain blood flow along the newly connected arteries into the new 'breast' tissues but the heat made everything else feel worse. I was woken hourly for the blood vessels in the new breast to be checked with a doppler (a small hand held ultrasound machine that can detect blood vessels) and the noise of it is almost deafening in the middle of the night in a quiet side room.
I felt nauseated, spaced out and sweaty but my pain was fairly minimal. They gave me IV paracetamol as I did not want to take any more morphine and felt too sick to swallow tablets. I also had a bag of ice that I kept on my head or my feet to try to cool me down a little. I had IV fluids running and the pump noise disrupted my sleep. They emptied my drains at midnight which added to the smell of old blood in the room (which really helped the nausea!)  I found myself thinking in French and Spanish (neither of which I am at all fluent in) and then repeating the name of the operation over and over again trying to remember what the P stood for as the hours dragged by. Finally morning came and I was given IV antibiotics (to prevent infection rather than to treat it) and had my observations done (BP, Pulse, Temperature etc..)
I felt dreadful but tried to sit up to have some breakfast however, I nearly threw up at the first bite and didn't have any more. I managed to drink cold water but other than that I had nothing to eat or drink all day as I felt too awful. I was now down to 2 hourly doppler checks between which I mostly slept and carried on my operation name mantra like a crazy person.

The surgery

On 22nd May I headed into the hospital to have my pre-operation prep. I needed an isotope injection into by left breast to track into the sentinel lymph nodes (2 lymph nodes under the arm that drain from the breast). This was a relatively painless injection undertaken by a nurse. This allows the breast surgeon to identify and remove these 2 lymph nodes for biopsy during the mastectomy part of the operation to check if the cancer has spread into the lymphatic system. It is standard practice to undertake Sentinel Lymph-Node Biopsy (SLNB) when a total mastectomy is performed.

Following this injection I saw the plastic surgery team and my plastic surgeon so that they could mark up my skin identifying the blood vessels, lymph node area, incision areas and correct breast for the surgery. This left me covered in purple marker pen and writing however, I could still shower.  

I had to be nil by mouth from midnight and could have sips of water until 6am. 

I was admitted to the day surgery unit at 7 am on 23rd May from where I would go to theatre and then on to the ward in which I would be staying. The pre-operation schedule included going through my details, medication, last food and drink and confirming the operation to several people. I also met the anaesthetist (a consultant) who would be performing my general anaesthetic and monitoring me throughout the operation.
I was taken to theatre by around 8.30 am where they checked me in and re-confirmed all my details.
I was incredibly anxious but the anaesthetist was great at calming me down and I was out before I knew what was happening.

Tests and reconstruction options

Following on from the diagnosis I had time to wait for my appointment with the plastic surgeon.

Undergoing immediate reconstruction is fairly common, especially in younger patients like myself (I was 37 when I was diagnosed). However, immediate reconstruction means a longer surgery and requires 2 surgeons, a breast surgeon to undertake the mastectomy and then a plastic surgeon to undertake the reconstruction. Whilst I awaited my plastic surgery appointment (which was around a week later) I was to have an MRI of my breasts to check that there was definitely no invasion (the cancer breaks out of the milk ducts). Invasion would have meant a change of plan regarding treatment - probably chemotherapy, mastectomy then radiotherapy. The MRI was only a few days later but was one of the most awful experiences. To explain, you have to lay face down with your boobs in two holes meaning all your weight is on your sternum (breast bone). You have to stay really still whilst the scan is taken which is in a tube and the magnet spinning is very loud. You get ear plugs and I’m not claustrophobic but the pain in my sternum from lying on it was almost unbearable. At one point I had to ask them to stop and put more padding in to try to relieve the pain.

Symptoms to Diagnosis.

In January 2019 I started to experience pain in my left breast. I put it down to hormones as, due to a Merina IUD, I don’t have periods but my daughter was on hers. She finished but my pain continued. After 3 weeks I decided to see my GP and I told my husband who also urged me to go to the GP.
I got an appointment the next day and the GP said there was a ‘lump’. In fact this was a solid mass in the centre of the breast rather than a borderless misshapen lump as is typical with invasive breast cancer. She referred me to my local hospital straight away and within 10 days I was sat in the Breast clinic worrying my arse off.
In the breast clinic I was seen by a consultant who felt the breast and found some small bumps he wanted ultrasound imaging of. He was not concerned by the hard mass in the middle. Then I went for mammogram which was uncomfortable due to the fact that the breast already hurt and was swollen but it only lasted mere seconds.
After some more waiting a lovely radiographer called me in to have an ultrasound with another consultant (a professor this time!)
The consultant told me the mammogram had shown lots of micro calcifications and they needed to take a biopsy. Normally these biopsies are taken under X-ray assisted by vacuum. However they didn’t have a spare appointment for that procedure that day. The consultant was amazing and said she would try to get a sample using ultrasound.
The biopsies were pretty uncomfortable especially the final one. She took 3 in total and X-rayed the samples to look for calcium. By the 3rd sample she managed to get a suitable sample.
By this time I was stressed and tearful, I knew they wouldn’t biopsy without a reason.