Boobies Go ByeBye, Mastectomy Time

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I check the fluids on mom’s IV pole—Lactated Ringers, or breakfast in a bag, as we nurses call it. “That’s your morning omelet and coffee,” I tell my mom. She grunts from hunger, since she has not being allowed to eat since midnight last night. 

As she lies on the gurney, her light blue surgical cap gradually slides down her forehead, eventually covering her eyebrows. She wears no makeup, except the outlines of red lips on either cheek, where my aunt and I gave her kisses.

Covered in blankets, she’s still cold. Aunt Janice and I rub her feet to keep her warm. 

It’s now noon, and she’s already had a long day.  At 8:30 this morning she “checked in” in multiple locations, seemingly getting a tour of the entire Cedars Sinai Medical Center. Then radioisotope, a blue dye, was injected into the area of the two tumors of her left breast. After a couple hours, the dye is supposed to be carried by her lymphatic system to the sentinel lymph node so the surgeons can remove and biopsy it to see if the cancer has spread, in which case they would remove all lymph nodes in and around the armpit.

In the main OR pre-op room at this time of the day, most surgeries have already been completed, and we, the cheerleaders—my dad, aunt, uncle, and myself—fill the nearly empty pre-op area with laughter. The waiting room receptionist, whom we profusely bribed with smiles and kind words, allowed all four of us back to visit Mom, exceeding the two-at-a-time policy. 

I had been worried that Mom would be nervous, but as she explained last night, she had done all her grieving in the first week, and now she’s cracking jokes, taking everything in stride.  

At 12:15pm a tall, handsome nurse pulls the curtains and shyly introduces himself. “He must be new,” I think, remembering being that sheepish as a new nurse. Going through the final checklist and instructions, he tells us that we will see my mom in six to nine hours in the recovery room, after which she would be admitted to the hospital for two to three days. 

mastectomy timeDad, ever the comical historian, reenacts my great grandfather’s goodbye to my great-grandmother before she went in for her mastectomy, some 30 years ago. “Can I cop one last feel?” he whispers, the classic Timmons smirk on his face. She sweetly smiles and kisses him. We all say our goodbyes, and silently watch as Mr. Cute Nurse wheels her down the hall and rounds the corner.   

Now out of sight, we still stand there in the stark hall for a moment, staring at the empty floor where she was just a second ago. “Don’t do that, Aunt Janice, or I’ll start too,” I say. She daubs her pretty hazel eyes and we walk to the cafeteria, hoping they’re still serving breakfast. 

Just after devouring our meal in the hospital cafeteria, Mr. Cute calls from the OR, as promised, to notify us that everything is right on schedule. “We will continue to keep you posted every hour and a half to two hours.” We all take a deep breath and go back to the waiting room. None of us want to leave the hospital.

Back in the OR waiting room, we settle in to padded chairs, which remind me of the rows of connected chairs in airport terminals. I find the only free outlet in the area, which is in the hall, next to the men’s restroom. It’s quieter here, and I can focus on taking notes. 

After mastectomyHours later, the surgery is finished without complications, and the nurse lets me in to see Mom. I see her from across the recovery room, still as a rock. As I approach, I notice an orange stain on her skin, from her mouth and down, all over her neck as if she’d spilt curry and let it dry. It’s Betadine, a surgical solution used to sterilize the skin surrounding the operative site. 

Ever the nurse, I quickly scan all the monitors, making sure her vital signs are within the normal limits. Looking down, I notice her flat chest. Interesting, how breasts automatically give women an older appearance. She’s always looked young, but lying here now, without makeup, flat chest, mom resembles a teenager.

She’s dizzy from all the anesthesia and pain meds and gingerly greets me. I kiss her forehead, as she asks for ice chips. The PCA (patient controlled analgesia) pump, which delivers Dilaudid (6X stronger than Morphine) every time she pushes the button up to a certain maximum mg per minute, will keep her pain at bay. 

She drifts in and out of sleep as I massage her feet. “They have a foam pit here,” she softly says, sounding like a little girl. “Really?” I ask. “Yep,” her eyes still closed, “So people can jump in and play.” 

“Where are we?” I ask, testing her to see if she’s oriented. She slowly cracks open her eyes as if it’s painful, blinks slowly a few times, then whispers. “Oh, we’re in the hospital,” sounding confused. Apparently every time she closes her eyes, she sees “an empty warehouse,” describing Sky High Sports in Woodland Hills, an indoor trampoline park, where I recently took she and my dad. It must have made quite an impression on her, to be recalling it in such a way now. It’s normal to go into a dream-like state while on IV pain meds like this.     

About an hour later, the nurse permits Dad to come it to see her too. Now that she’s more awake, and he sees that she’s doing well, his playful side shows, and he props her blue barf bag on her head and takes a picture. Mom is not amused.

Once she’s admitted to a room and we’re all settled in, the long night begins. As I expected, I don’t get any sleep, from the constant monitoring from the night nurses. Taking vitals, checking incision sites, drain output, catheter output, vitals, and pain level, the nurses check in about every hour on the first night of post-op. But I’m happy to be there, and feel more secure with her having me in the room the whole time. 

show you care cancerThe next day I pamper her with a sponge bath, leg and foot massage, and clip and paint her toenails. She’s making progress faster than anyone expected. Immediately after breakfast her foley catheter is ordered to be removed, she walks for the first time and does great, and the PCA pump is removed.    

The next few days fly by. My dad takes the second night in the hospital, and as the doctors make their rounds, the surgeons appear amazed at her progress. The resident even tells her she’s recovered faster than any other mastectomy patient he’d ever seen. 

It’s now a week out, and she has a follow-up with her breast surgeon and plastic surgeon. Great news from the breast surgeon: Lymph nodes were officially negative, tumors were only stage one and removed with clean borders; so no more chemo required; just an anti-hormone pill for five years.

Her plastic surgeon removes two of her four drains; the rest will go in another week. I’ve been emptying and measuring them twice a day, and she’s glad to have that much bulk removed from her abdomen (the drains are pinned to her bra, looking like grenades attached to her waist). 

It’s now 6 months after the “Big Double M,” and Mom reports feeling like she’s got a new lease on life. She’s cancer-free and more energetic and inspired than ever. She jumps on road trip opportunities, is a regular at the gym, is back into making her famous veggie smoothies, and is planning a summer vacation cruise. She’s only got two more surgeries, and we’re glad to put the “C” word behind us, but it hasn’t been an easy road. 

Getting fills has been the most painful part of reconstruction, far worse than the actual surgery recovery, according to Mom. In the mastectomy surgery, the surgeons placed expanders between the pectoral muscles and the ribs, as temporary implants, and they’re basically thick, empty plastic bags. A “fill” means slowly adding saline to the expanders, until they are the desired size, at which time they are surgically replaced with permanent implants. Every two to three weeks she gets 50-100 mL of saline added, to give the skin time to stretch slowly. 

The process is very uncomfortable and causes major muscle spasms in her chest and all down her back, which take up to a week to dissipate. Valium and Vicodin help, but leave her drowsy for days, pinning her to the couch and keeping her from enjoying life. 

Along with going for fills and modifying her workout regimen, she has a strict routine of weekly physical therapy, where she jokes that she should take her female physical therapist out to dinner or offer her a cigarette after each one of her boob massages. These often painful but intimate massages help increase blood circulation to the skin and manipulating it to stretch more.  She’s also expected to do three-times-a-day Vitamin E baths, where she lathers her skin surrounding the surgical site with E oil to help the skin recover faster. 

Now we wait for the last act, the final surgery where the expanders will be replaced for permanent implants, still three months off, then a smaller procedure after that where nipples are made and areola are tattooed on. Mom wants her life back, and the clock isn’t getting her there fast enough.

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