The morning started as expected. We left Preston's at 7 and were at the hospital turnoff super early so we decided to stop by Krispee Kreme's along the way. Pulling into the hospital parking lot, my dad was already there waiting. I was so glad he was going to be there with me. Mike and Suzie came down the night before and were with us as my support team as well. We walked into the imaging center, the place where this all started with the biopsy just a few weeks ago. Pam, the super friendly receptionist who had first helped me, was there. This was the fourth time I had talked with her as she had been a starting place and a reliable source of information on all of our other visits. She cheerfully greeted me by name as I walked in. As she started the paperwork, I handed her a present. I made cute little snowmen with earmuffs out of wrapped candy bars that I brought to give out to the nurses and doctors. I figured bribery couldn't hurt :) and would keep the spirit light. She was so surprised and grateful.
Pam had me sign tons of paperwork. She was able to check me in at the hospital for the actual surgery later in the morning, which was nice to have it all done. Of course, she handed me a pile of the infamous labels identifying who I was which matched my arm bracelet. I laughed and told her if I had to do this again, I was making my own sticky labels with my signature and every time I had to sign something I was going to hand them a sticky label. She laughed.
It wasn't long before they called me back. The nurse checked my vitals--my first scare they would discover my cold and postpone the surgery. She put the thermometer under my tongue and kept it there a long time. I was sure that was it, I was caught, but she reset the machine and I was clear to proceed. Whew.
After changing into a robe, I went into the mammography room--surprise number one. I assumed this procedure was going to be exactly like the biopsy which used ultrasound. Never assume. I was completely wrong. The doctor was different than the one who did my biopsy. This doctor was older and enjoyed my sense of humor and giggly attitude. He explained the mammogram provided a much more accurate picture when inserting the seed. Okay, how in the world was this going to work? I was definitely curious. How were they going to be able to have my breast squished in a mammogram and inject a seed?
In the room there was a nurse, a mammogram technician, the doctor, and a nuclear medicine technician--that was interesting. I guess I really was going to glow. After asking me to confirm my name, birthday and which side we would be working on, and comparing that to my bracelet, the mammogram technician invited me to sit in a high rolling chair and rolled me up to the mammogram machine--the chair should have been clue number one, but I missed it. The doctor came over. He asked the same questions, my name, birthday, and which side as he compared my answers to my bracelet. I guess they wanted to make sure I hadn't switched places with someone along the way. The doctor started reviewing previous pictures of my mammagram before while the technician got started by setting my breast onto the machine and the machine squeezed it tightly. "Are you okay? Tell me if it gets unbearable." Like all of us do, we let them go a little tighter than we should so they can get a good picture because we can take uncomfortable for 30 seconds, right? It's only 30 seconds to take the picture then it releases, right? Incorrect assumption number two. After she took the first picture, the machine didn't release. "Okay, you are going to stay compressed for the whole procedure," she announced. What! A 45 minute mammogram! You're kidding, right. Needless to say, with this bit of news I told her she had to release a bit of the tension, which she did and took a new first picture. So now the need for the chair made sense. I was going to be clamped there for almost an hour.
As I sat in my high chair, my breast compressed, the doctor and nurse were reading numbers and preparing. I began questioning the nuclear medicine technician about his role in all of this and his education and what made him go into that field. He seemed surprisingly shocked that someone acknowledged him. I figured we might as well all be friendly here and talking certainly took my mind off the pressure on my breast. Soon the nurse began lining up a light grid shining on my breast to match the grid the doctor was reading on the picture. The top of the mammogram paddle was a square but open in the middle where she lined up the grid. She cleaned the area with iodine and then moved away and the doctor came over. He was much older than the first radiologist who did my biopsy. Though his hands shook a bit--not so reassuring considering he would be inserting all of the needles--he did have a great smile, good energy, and a good sense of humor to match mine. He talked about one seed, and I told him the surgeon thought they might need two since the size was so large. He agreed two would be best and was glad I mentioned it since that was not what the paperwork said. He explained he was going to place some long needles into my breast. When I saw them, they looked more like skews for shish kebobs, thick and long, so I decided not to watch. There was no numbing medicine like they had done with the biopsy. I guess they figured the pain from my breast being compressed that long would numb it. With a pinch and a poke, the first needle went in followed shortly by the second. "Are you okay" he asked. "Piece of cake," I answered. More pictures. He adjusted the needles a bit, then more pictures. I looked down and realized these long needles were much thicker than I expected and very tall. These were what they would use to drop the nuclear seeds down once he had them positioned correctly. Next they released the compression, which you would think would be a relief, but with the pressure off, I could suddenly feel the needles. Just breathe I told myself. They carefully held my breast as they rotated the machine sideways. Now they had to compress it from the sides to know how deep to embed the needles. Once the machine was sideways, the machine once again compressed my breast from the side this time. More pictures. When they were all satisfied and in agreement, the doctor brought the seeds over and dropped them down the needles while I was still in the machine. "Opps," he said. "Okay," I said, "Opps is one thing a doctor should never say when doing a procedure, especially with nuclear waste!" Everyone laughed. He assured me he had just missed setting the empty container down on the tray. Once the seeds were set in place, he pulled out the long needles and released the machine. I looked down and told them, "It looked like I've been bitten by a vampier." They laughed again and I sighed a breath for relief. Whew. That was way harder than a biopsy, but we were done, well, at least I thought.
He rolled a tray over with about seven more needles, these attached to syringes. I forgot that they still had to inject the radioactive dye to find the sentinel nodes. He explained he would be doing injections all around the nipple so the dye could drain into the node and turn it blue. "Great. So now I'm going to be a glowing nuclear smurf!" I said. He laughed. As he started each of the shots, I tried not to notice his shakiness. The shots were not comfortable and stung quite a bit, but it was bearable. They were all impressed with my toughness and positive attitude. I told them we might as well make a party out of it. I told them I was supposed to be at the Gallup Balloon Rally chasing balloons this weekend so I was just pretending to be there. The doctor told me he used to live in Albuquerque and loved watching the balloons. He soon left and the techs were left to clean up me and the machinery. The nuclear medicine guy had to check everything for nuclear contamination. The nurses asked the other technician, "Were his gloves clean?" "Wait a minute," I said. "That is another question that should never be asked in front of a patient especially AFTER a procedure." They all laughed again trying to explain their questions in relevance to the nuclear waste. I assured them I was just kidding.
In the room there was a nurse, a mammogram technician, the doctor, and a nuclear medicine technician--that was interesting. I guess I really was going to glow. After asking me to confirm my name, birthday and which side we would be working on, and comparing that to my bracelet, the mammogram technician invited me to sit in a high rolling chair and rolled me up to the mammogram machine--the chair should have been clue number one, but I missed it. The doctor came over. He asked the same questions, my name, birthday, and which side as he compared my answers to my bracelet. I guess they wanted to make sure I hadn't switched places with someone along the way. The doctor started reviewing previous pictures of my mammagram before while the technician got started by setting my breast onto the machine and the machine squeezed it tightly. "Are you okay? Tell me if it gets unbearable." Like all of us do, we let them go a little tighter than we should so they can get a good picture because we can take uncomfortable for 30 seconds, right? It's only 30 seconds to take the picture then it releases, right? Incorrect assumption number two. After she took the first picture, the machine didn't release. "Okay, you are going to stay compressed for the whole procedure," she announced. What! A 45 minute mammogram! You're kidding, right. Needless to say, with this bit of news I told her she had to release a bit of the tension, which she did and took a new first picture. So now the need for the chair made sense. I was going to be clamped there for almost an hour.
As I sat in my high chair, my breast compressed, the doctor and nurse were reading numbers and preparing. I began questioning the nuclear medicine technician about his role in all of this and his education and what made him go into that field. He seemed surprisingly shocked that someone acknowledged him. I figured we might as well all be friendly here and talking certainly took my mind off the pressure on my breast. Soon the nurse began lining up a light grid shining on my breast to match the grid the doctor was reading on the picture. The top of the mammogram paddle was a square but open in the middle where she lined up the grid. She cleaned the area with iodine and then moved away and the doctor came over. He was much older than the first radiologist who did my biopsy. Though his hands shook a bit--not so reassuring considering he would be inserting all of the needles--he did have a great smile, good energy, and a good sense of humor to match mine. He talked about one seed, and I told him the surgeon thought they might need two since the size was so large. He agreed two would be best and was glad I mentioned it since that was not what the paperwork said. He explained he was going to place some long needles into my breast. When I saw them, they looked more like skews for shish kebobs, thick and long, so I decided not to watch. There was no numbing medicine like they had done with the biopsy. I guess they figured the pain from my breast being compressed that long would numb it. With a pinch and a poke, the first needle went in followed shortly by the second. "Are you okay" he asked. "Piece of cake," I answered. More pictures. He adjusted the needles a bit, then more pictures. I looked down and realized these long needles were much thicker than I expected and very tall. These were what they would use to drop the nuclear seeds down once he had them positioned correctly. Next they released the compression, which you would think would be a relief, but with the pressure off, I could suddenly feel the needles. Just breathe I told myself. They carefully held my breast as they rotated the machine sideways. Now they had to compress it from the sides to know how deep to embed the needles. Once the machine was sideways, the machine once again compressed my breast from the side this time. More pictures. When they were all satisfied and in agreement, the doctor brought the seeds over and dropped them down the needles while I was still in the machine. "Opps," he said. "Okay," I said, "Opps is one thing a doctor should never say when doing a procedure, especially with nuclear waste!" Everyone laughed. He assured me he had just missed setting the empty container down on the tray. Once the seeds were set in place, he pulled out the long needles and released the machine. I looked down and told them, "It looked like I've been bitten by a vampier." They laughed again and I sighed a breath for relief. Whew. That was way harder than a biopsy, but we were done, well, at least I thought.
He rolled a tray over with about seven more needles, these attached to syringes. I forgot that they still had to inject the radioactive dye to find the sentinel nodes. He explained he would be doing injections all around the nipple so the dye could drain into the node and turn it blue. "Great. So now I'm going to be a glowing nuclear smurf!" I said. He laughed. As he started each of the shots, I tried not to notice his shakiness. The shots were not comfortable and stung quite a bit, but it was bearable. They were all impressed with my toughness and positive attitude. I told them we might as well make a party out of it. I told them I was supposed to be at the Gallup Balloon Rally chasing balloons this weekend so I was just pretending to be there. The doctor told me he used to live in Albuquerque and loved watching the balloons. He soon left and the techs were left to clean up me and the machinery. The nuclear medicine guy had to check everything for nuclear contamination. The nurses asked the other technician, "Were his gloves clean?" "Wait a minute," I said. "That is another question that should never be asked in front of a patient especially AFTER a procedure." They all laughed again trying to explain their questions in relevance to the nuclear waste. I assured them I was just kidding.
After it was all done, I asked if I could see the pictures they took. The technician said she would show them to me once I got dressed. Up until then, I had tried to make light of the situation, but my heart dropped a bit when she started showing me the pictures. I asked her if I could bring Greg back and she said yes. As we stood there looking, a sense of uneasiness came over both of us. First, the cancer was much larger than either of us expected. I've known from before the biopsy that is was large, but the surgeon felt I was feeling the swelling from the biopsy. But I knew it was more than that because I felt it had gown significantly since I first barely felt it back on Oct. 14th. Even more alarming was, when they did the biopsy, they left a tag where they took the sample. We both noticed the tag was more on the perimeter of the cancerous area, quiet a ways from the main part of the cancer. Greg and I had the same worry. If the biopsy was that far away from the main part of the cancer, and the report on that sample showed suspicious of micro invasion, what if the biopsy had been actually in the main part? Was this probably a sign that this was bigger than even the doctor realized? The rest of the pictures were interesting. They showed the needles and then the seed placement. I was glad Greg got to see them so he would have some idea of what the procedure was about.
We both went back into the waiting room to wait for the annotated pictures so we could take them with us over to the hospital. Suzie had put pink ribbon tattoos on Mike, Greg and my dad earlier that morning. As we went back to the waiting room, she was putting one on Pam, the receptionist, who was thrilled. I had taken pictures on my phone of the pictures as the tech showed them to us. I shared them with my dad and Mike and Suzie. As we sat there, I looked at Greg and he at me. We were both thinking the same thing. The reality was setting in. It had been quite the procedure.
We both went back into the waiting room to wait for the annotated pictures so we could take them with us over to the hospital. Suzie had put pink ribbon tattoos on Mike, Greg and my dad earlier that morning. As we went back to the waiting room, she was putting one on Pam, the receptionist, who was thrilled. I had taken pictures on my phone of the pictures as the tech showed them to us. I shared them with my dad and Mike and Suzie. As we sat there, I looked at Greg and he at me. We were both thinking the same thing. The reality was setting in. It had been quite the procedure.
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