Yesterday morning I woke to find a weird piece of tube in my drainage bulb. So – when they do a mastectomy, it is a fairly major surgery. It’s really an amputation. They have to remove a lot of skin and of course all your breast tissue, plus some lymph nodes.
A couple hours prior to surgery they had injected a blue dye into my breast – three shots, above where the tumor was located- in my case near the nipple. This dye, which contained radio-active isotopes, then flowed through my breast tissue and headed out into the lymphatic system. The first lymph node that it went to is called the sentinel node. That would be the first place that the cancer would spread to if it spread. So that was the one they removed during my surgery, along with the next closest one.
As I said, I was lucky in that the two nodes they removed (the sentinel node and its closest buddy) were both negative for cancer cells, so they stopped at two. If the cancer had been present, they would have taken more and tested them. They keep going until they don’t find any more cancer cells.
Regardless, here is what a mastectomy with sentinel node dissection usually ends up looking like:
Mine looks pretty much the same except my incision is a bit longer- it goes around to my side (because I am not doing reconstruction, the doctor wanted to be sure to remove all excess skin and fat, so he had to go a little farther under my arm to make certain it would be flat). Also, my drain tube comes out under where my breast was, not under my arm. I have an additional incision, approximately 1.5 inches long, where the top arrow in that diagram begins, going into my armpit- which is where they removed the two lymph nodes.
(for extremely graphic photos of an actual surgical procedure – see: http://emedicine.medscape.com/article/1830105-overview#a3)
So, the drain has to stay in place for at least a week or two (I am on day 9 now 😦 ). It is there to ensure that you do not get swelling from excess fluid that has difficulty draining out of the area due to the lymph node removal. Once the drainage amount is much lower, the drain can be removed safely. If you remove it too soon, you may get seroma (accumulation of fluid that causes swelling). Generally the fluid gets reabsorbed by your body, but if it is too much, it may need to be aspirated with a needle.
In the meantime, the suction on the drain can be quite painful. When I shift positions, especially going from a standing to a lying position or vice versae, the suction gets more severe and causes a severe ripping/burning pain inside my chest. I dread lying down at night as it’s extremely painful. I was hoping yesterday morning that when I visited the surgical office to have them examine the drainage bulb to see why there was a piece of latex tube suddenly inside it, they would remove the drain. Once your drainage is below 20 ml per day for two days, it is generally believed that it is okay to remove the drain, and I had been right at 20 ml for two days straight.
It took me a couple hours to finally get through to the surgical office. They had all-staff meetings first thing in the morning and I kept getting their answering machine until after 10 a.m. And of course, this was the day that Tim was accompanying Chris’s class on a field trip, so I knew I would have to drive myself to Lansing. This would be my first attempt at driving since the surgery.
When I finally was able to speak to a nurse and she said to come in at 11:15, I figured I had a few minutes to make some coffee and wash (can’t bathe or shower until the drain is out) before I got dressed to go. I keep my coffee in the freezer and our new fridge has the freezer at the bottom. I already mentioned the extreme searing pain I get when changing position. So, as I reached into the freezer to get out my can of coffee, because I was afraid to bend down too far, I only bent down a little way. Of course, the can came flying out of my hands, lid off, unto the kitchen floor. Luckily for me the can only had about one serving of coffee left in it, but still it was enough to spread over half of the kitchen floor and up under the fridge.
I am not allowed to do anything strenuous at all for about 6 weeks. Definitely not vacuum. Certainly can’t use a broom to sweep. And Tim was gone. 😦 So, yes, I carefully dragged out the vacuum and used the nozzle to suck up the coffee, using my right hand only. After putting the vacuum back in the closet, I quickly made a cup of coffee (very carefully getting the new can of coffee out and opened!) in my “one cup at a time” brewer, and rushed into the bathroom just after turning the power button on so I could wash and change for my appointment.
As I was finishing getting dressed, I heard the coffee maker beeping, signaling that my coffee was done. I smiled in anticipation as I headed into the kitchen, only to find a stream of coffee had covered the counter, ran down the cupboards, into several drawers and across the kitchen floor, leaving puddles everywhere! Yes, in my chemo brain fog of forgetfulness, I had forgotten to put the cup into the coffee maker…
I cried. I grabbed napkins and the kitchen towel and sponge to mop it up as best I could. I cried as I took out the drawer and found it full of coffee. I cried as I pulled all the items out of the drawer to rinse them off and place them in the sink. I cried as I slowly and painfully struggled on my knees to crawl around on the floor to mop it up. And then I realized I would be late for my appointment, so I cried some more.
I drove as best I could, with the pain, and the extreme wind, and arrived 15 minutes late.
Even so, it took them about 20 minutes to call me in. The nurse determined that the latex rubber tip in my drainage bulb was part of the bulb itself. Then she examined my incisions, and determined that it would be best if the drain stayed in for another few days, at least through the weekend. Ugh! So, my visit here had held hope that the painful sucking would be relieved and instead, I would be heading home with a newly replaced drainage bulb and be stuck with this thing for nearly another week. More distressing because the other thing I found out was that my surgeon was out at a conference and would not be returning until Thursday. This meant my post-op appointment would be moved from Tuesday to Thursday. A whole other week to wait for this drain to be removed. 😦 A whole other week of the dreadfully painful tearing and burning every time I move around.