How it went – Bilateral Wire Guided Wide Local excision and Sentinel Node Biopsy

Wednesday 15th October 2014

(Written Thursday Evening)

I will start writing this post, but if it gets to difficult, (physically) I will stop and carry on tomorrow.

Ray & I arrived at the Day Surgery Unit at Wycombe Hospital shortly after 7 am on Wednesday in good time for my 7:30 admission. There were three other ladies in the same room, all of us having breast surgery of one kind or another, I was the only one having surgery to both breasts. After the usual blood pressure etc checks, the Senior nurse practitioner (I think that was her title but I’m not certain) came to talk through the procedure and sign off the consent forms with me.

(Written Mid-day Friday)

She also made what were the first of many pen markings on me, an arrow on each wrist pointing up, to indicate both breasts for surgery, and notes across both shoulders indicating to what was to be done on each side. After a short wait Ray & I were taken to the Breast Unit. This was for a procedure to insert wires in to each cancerous growth to indicate their location (Wire Guided), as the growths are in ducts they would not be easily located without doing this. I asked for Ray to come in to sit with me whilst this was being done, the nurse was a little reluctant as she explained they have had partners passing out when they see the needles and what is done with them, falling off the chair and needing to be taken to casualty. After assurances that Ray was fine with needles and would not pass out, he was allowed to sit beside me. The Doctor located the growth in each breast using Ultrasound, took measurements, and marked the area, he then injected local anaesthetic in to my right breast and inserted a wide needle in to the growth, again using the ultrasound screen images to guide it to the correct location. Ray watched the whole procedure, he says the needle was a similar size to that used when he gives blood. Then the guide wire was fed through the needle, it has a hook at the end to hold it in place internally, once it was fully through the growth, the needle was removed and the external end of the wire securely taped to my chest. The procedure on my left side was identical but was painful as this growth was larger and located deeper under the skin. I am really squeamish with needles so didn’t watch any of this, when it was all finished and covered up I did sneak a peek 😦 I was glad I couldn’t see any of the wire!

The next procedure was another mammogram –  the dreaded squishing machine >}<   >{< to double check that the wires were correctly located, fortunately they were 🙂

Then we were taken on a trip to Nuclear Medicine for another scan, this time to locate the sentinel nodes under each arm. What happens is that the Radiographer injects blue radioactive fluid in to each breast, then waits five minutes or so for it to begin working its way to the lymphatic system. Then I was taken to have the scan, the machine was the same as the one below:

Image source: http://www.enherts-tr.nhs.uk/files/2013/11/N-medicine.jpg

The machine takes up to 15 minutes to produce each scan image, once the images are displayed, the radiographer uses a metal instrument, like a long pen, and by pressing lightly on my skin could see on the screen where my sentinel nodes were positioned in relation to the instrument and marked them up under each arm. During the procedure I had to have both arms raised above my head and was laying there thinking that I now understand why this position is used to torture people, it was painful! However, using meditation techniques, I was able to cope with it, and at one point actually drifted off to sleep for a few minutes. Towards the end I was able to see the screen showing the radioactive particles moving along and settling in my lymph glands, fascinating!

I had so many scans that I got given a bar-code, beep-beep!

 2014-10-15 23a

Ray & I were collected and taken back to the ward to wait for my operation, it was now the afternoon, we were both tired after such an early start, I settled down on the bed, Ray in the bedside chair, and we both went off to sleep.

Some time around 2 pm I was called to Theatre, Ray was able to walk with me as far as the entrance doors, it was a this point the reality struck me and as Ray & I hugged I could see the emotion in his eyes. Then the nurse and I went in to the Theatre suite to wait for me to be taken off for anaesthesia.

Waking in recovery, I was very aware of discomfort across my upper torso which made breathing difficult, this meant that my stats were not improving quickly enough. The Nurse Practitioner who I has seen earlier came to let me know that they had removed both growths and that they had found no cancerous cells in my lymph nodes which is wonderful news 🙂 The recovery staff agreed that I could have Tramadol to relieve the pain, once this took effect I was able to breathe more deeply and although I still had an oxygen mask, my oxygen saturation scores increased enough for me to be released back to the ward where Ray was waiting for me.

After having some water, tea, toast and a wee I was allowed to leave. The journey home was painful, I felt every bump in the road, and there were a lot of them! We arrived home at 9 pm, Megan, Josh & Liza were pleased to see me and to hear that the cancer hasn’t spread. They have me Lilies, my favourite flowers, Lindor Chocolates – my favourite treat! and get well cards from everyone, I was very touched 🙂

I was weary after such a long and eventful day, and sore from the surgery, so after more tea and toast went off to bed.

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