Details (Part Two)

So, yesterday's post was about the wire localization, which was the first thing I had to get done on surgery day. Because the tumor couldn't be felt or seen, they had to insert the wire to give the surgeon a clue as to where he needed to be to remove the cancer. Once this was done, I had to report to UMC's Ambulatory Surgery for the actual operation.

I think we got there at around 9:30 and the waiting room was already pretty full - of people and of signs saying "Please, no food or drink in the waiting area" - a sign that was rightly ignored by almost everyone (for the life of me, I can't figure out why such an injunction would be necessary; I thought it was kind of insensitive to the poor people waiting for their loved ones to come out from under the knife). The waiting room was small and there wasn't much room for us. One area was filled with about six people, some wrapped in blankets and sleeping across several chairs (I thought that was rude). Another area was filled with about 15 people all packed into a space like a cubicle. We had a job of finding a place for the four of us to sit (me, Mike, Mom, Dad), but Mike waded in and not only found a space for four, but commandeered a table and moved the chairs about so we had a space to play cards. We'd brought UNO with us to kill time. My surgery wasn't scheduled until noon so there was plenty of waiting. But we had fun of a sort and I think we provided entertainment for others (there were definitely envious looks at our cards and sotto voce discussions about the game and its rules). Mike kept leaning over to sneak a look at my hand (I ask you!) and when I tried to do the same, he'd make it impossible - until I realized his cards were reflected in the window behind him! Aha! Take that, you scoundrel!

We played for about 40 minutes and were interrupted mid-game by a nurse who was ready to take me back for prep. Ack! Okay, I guess it was time. We made a small flurry as my mom and dad gave me a hug for luck (mom was looking teary) and Mike and I went back to the pre-op room. The first thing they did was sit me down to take my vitals, ask me who I was (another check on my identity in case I had bribed someone to take my place), and some other questions. While I was sitting there my surgeon came along with his usual gaggle of ducklings trailing behind - read residents, medical students, interns. When he saw me he started to apologize that they were not ready for me. From what I gather, I was supposed to be the second surgery of the morning but because they weren't finished with me at the Tucson Breast Center, he made the call to operate on someone else instead. As they'd actually brought me back earlier than he'd expected (it was 10:15 or so), I guess he was thinking that I thought I was going to be operated on right away. I reassured him that I'd been told noon for a surgery-time and that made him feel better, although he still kept apologizing and even made a call to see if they could switch things back. They couldn't, so we were in for more waiting. He joked with us for a bit (more comments on my hair) and then I was escorted by the nurse to what would be my bed (ha! a glorified cot, of course) for the next several hours - on which were waiting chic and trendy hospital clothes just for me: one well-worn smock, one pair of blue booties and one cap to cover my hair. I changed out of my clothes, dumping them all on Mike, and balked at the hat. Nope, wasn't going to put that on until I had to.

The best part came next, which was the warm blankets they pile on you (as many as you ask for). As you already know how I feel about blankets (see previous post), this made me feel a little less anxious (but not much). Pretty quickly after that various and sundry medical staff came over and introduced themselves, asked questions, and started doing things to get me ready. One woman was putting tags on my right wrist - one for my allergies, one for my name and hospital id, and one for the type of surgery I was having. This last one spooked me as this was clearly a step to make sure that they do the right surgery on the right person. On the one hand, this was comforting since this appeared to be all in a day's work for the people there. I was just one more person going through the surgery mill and it was all routine. On the other hand, I was just one more person going through the surgery mill and it was all rather impersonal. Who in this group actually cared about me and was going to take care of me?

At this point, I reminded myself that my surgeon was going to take care of me. I had to put my faith in him and believe that all would come out well. I simply had to. Plus, I thought of the many people who were rooting for me, including most of all the man sitting by my side, and had to believe that all those positive thoughts can only make good things happen.

I took a deep breath as the young doctor with the IV paraphernalia came over to my little nook. He was clearly a very very shy person who looked most uncomfortable having to actually talk to us and explain what he was going to do. But I only got good vibes from him despite being terrified of the stupid vein-finding expedition that was soon to come. I warned him about my veins, he asked when was the last time I ate or drank. Apparently when they say you can eat and drink up 'til midnight, they really mean you should. Having food in your tummy is apparently good for finding veins. I'll have to remember this and plan a slightly-before-midnight snack if I have to go through this again. He looked at my veins and proceeded to tourniquet my arm really tight (alas, this is always the case). I made a fist, I hung my arm down and while he was smacking my hand in the hopes of scaring up a vein, I asked if heat would help (a trick my mom reminded me about that they do for many chemo patients). He said yes and asked a nearby nurse for more warm blankets (score! I got more!). I got two blankets, one for each arm in case they had to use my right arm despite its lymphedema.

While he waited for the blankets to lure veins to the surface of my hand, a medical student doing an anesthesia rotation came by to say she'd be watching the procedure. She wasn't exactly mean or nice, just no bedside manner to speak of. The IV Shy Guy started smacking my hand again, as she instructed me to open my mouth as wide as I could, tipped my head, shone a flashlight down my throat. She made me do this several times and I admit I started to feel a tad cranky with her because it seemed to me that she didn't know what she was doing (I've actually never had anyone do this before in previous surgeries). My suspicion that she was a little out of her element was confirmed when she asked Shy Guy to also take a look. He did and she said, "So, what do you think, a 2? or a 3?" Shy Guy said, "2". At this point I asked what this meant and she didn't really explain it all that well. I asked the question later to the actual anesthesiologist (who looked as if she were about 12), who said it's an estimate of the distance from where your chin meets your neck and your thyroid cartilage - in terms of the number of fingers they can lay there. For me, she can lay only two and I gather they like to have three at the least. They use this as a measure of what size tube they'll need and to get some idea of what to expect as far as intubation.

Back with No Personality Woman, she asked whether I had been difficult to intubate before and I said no. She made a half-hearted swipe through my chart and then said maybe they just never told me. I started to feel a little nervous about this intubation thing at this point. I've never had an anesthesiologist worry about this before as far as I know, and I wasn't getting a good feeling about these two anesthesiologists, although 12-Year-Old was really nice and certainly seemed competent (but how long can she have been practicing, I asked myself? Okay, maybe she wasn't twelve but she was certainly not out of her 20s yet; ack!).

While I was fretting about this, Shy Guy began prepping my hand for the needle-stick. Mike got up and walked around the bed, away from this procedure because it was stressing him out. Shy Guy put some numbing stuff in first (Yay! That meant if he had to poke around in there, I wouldn't feel it so much) and then got the vein on the first try. I was looking away but looked back when I thought it was in. I asked if he'd gotten in, at which point he pulled back on the flushing syringe or whatever and blood started to drip rather rapidly out of my hand onto my fingers and all over the floor. I guess it was in! I told Mike not to look at the floor, while Shy Guy taped the IV down with a LOT of tape and then cleaned the blood off the floor and tried to get it off me, the latter with not so much effect despite his well-intended efforts. I think he was afraid of jarring it, not wanting to go through that all over again. Me either, so I was okay with icky fingers.

To be continued...