Lumpectomy, Hands Down

I’m home from my lumpectomy and intraoperative radiation (IORT)! Tom drove me to the hospital this morning in a City CarShare car. I felt kind of scared when I stepped out of the car, but Tom told me to remember all the people who love and care about me, and once I entered the building and was sucked onto the surgery conveyor belt, I felt perfectly calm and remained so.

At this place, you have your regular yearly mammogram on the first floor, your follow-up mammogram and biopsy on the second floor, and you report to the third floor for surgery. I hope not to find out what happens on the fourth floor.

I registered, sat in the waiting area, was shown to a room, changed into a gown, and had an IV successfully and painlessly placed on the first try by a nurse named Juanita, which has not necessarily been the case prior to other surgeries, so I appreciated her expertise.

Then there was yet another mammogram, this one part of “needle localization,” in which a needle is used to place a wire in the area where the tumor is so the surgeon knows exactly where to cut. (The mammogram is to help guide the needle to the right spot.) When the needle localization is complete, there’s a wire sticking out of the breast.

Then I walked down to the operating area, passing Surgeon Number Two on the way; I said hello to her. I sat in a room near the operating room for a while and was visited by a nurse or two, and then by my radiation oncologist, Dr. L, which was good, because I still hadn’t made up my mind about IORT.

I asked if the other major medical center here does IORT for DCIS and he said they do, but currently only as part of a study. I asked if my health insurance carrier had approved it, and he said they had, and about 20 minutes before surgery, I decided to go ahead. Dr. L. told me the dose of radiation would be 20 gray, formerly known as 2000 rads.

Surgeon Dr. P. came in briefly, looking very different in his scrubs. Besides the change of attire, he seemed much more relaxed and at ease than he does in his suit behind his big desk. Next was the anesthesiologist, who was very, very nice. He reminded me a little of the actor Geoffrey Rush.

Then I walked into the OR and hopped onto the table and had my limbs arranged. The anesthesiologist said he’d given me something that might feel a bit strange, and was about to give me something else. I didn’t feel the first thing at all, but certainly felt the next thing, very briefly, and then I woke up in a different room, just me and a lone woman by the side of the stretcher.

(IORT, by the way, employs plain old X-rays, and so can be delivered in a regular room, but a room other than the OR is used, for reasons unknown to me. I was told that once the applicator is in place, everyone but the patient leaves the room, and the anesthesiologist watches the patient on a monitor, and the IV line runs through a little opening at the bottom of the door in case the anesthesia needs to be adjusted.)

The woman who was there when I woke up told me she’s on a quest to choose a religion and is starting by reading the Bible, though she doesn’t think Christianity will end up being the thing for her. I told her about my hospice volunteering and she said she could never do that, which surprised me.

She wheeled me back to the room where the IV was placed earlier in the day, and I changed back into my clothes, hung out, and had water and juice and a few crackers, all of which tasted good, unlike after the hysterectomy, when everything, even water, tasted terrible. Tom picked me up about 6 p.m.

Food aside, I also feel much, much better than after the hysterectomy. There’s a big dressing over the incision, and I feel a bit tired and headachy, but there is really no pain to speak of. I took two Tylenol, just in case.

Today's lesson: If you get to choose between having a hysterectomy or a lumpectomy, have the lumpectomy.