Lain's Log

My schedule

April 20/11

FINALLY got my MRI results this morning! (after bugging the heck out of the poor secretary). Was told they would "expedite" the results and that it usually takes about 5 business days. Turns out, I got the the information a total of 12 days later. (now THAT's what I call expediting...not!)

At any rate - didn't have to go in for an appointment. My surgeon's secretary told me over the phone! She said, "The MRI was FINE". (by fine, she means, not anything other than what they already knew). She then said, "It is NOT multi-focal" - which is good news. I am much relieved to hear this.

The MRI cannot show if the cancer has spread to the lymph nodes. They will only be able to determine that when they do my surgery, which will include removal of two or three nodes, in what the doctor refers to as a "sentinel lymph node biopsy."

I then asked the secretary about the second ultrasound the doctor had requested. She said the MRI people didn't call for one. I told her, no, but the surgeon told me in our consult that he wanted a second ultrasound to be done by the Princess Margaret staff (to add to the results of the one done by an outside lab). She seemed surprised to hear this, but called me back five minutes later with an appointment for tomorrow morning at 10:40. So that's next on my to-do list.

Following that, on Tuesday April 26th, I will go for a two-hour teaching class to learn more about the surgical procedure, after-care and follow-up. Later that same day, I'm scheduled for the injection of dye, which involves four separate needle injections into the areola. Terrific. I've read many personal experience comments about these injections and will definitely be addressing pain issues before allowing them to go ahead with this procedure!

Here are a couple of comments from those who have been through the dye injection, (some of whom say it was injected directly into the nipple. I mean good God!)

1. "I had four injections around the nipple. I have a high threshold for pain and I nearly didn't make it through. I asked for a 20 minute break between shot 3 and 4 to recover a bit. After I was finished, the radiologist told me that the two other women he had before me didn't get past the first injection. They both left".

2.) "When I asked, they said I couldn't have any analgesics at all because it might interfere with the test. The pain was sky-high, out-of-this world, shriekingly unbelievable.

3.) I have to agree, I was not at all prepared for the pain of this injection. (although the doctor did say "this is going to hurt some"-- I should have known that that meant it was going to kill"!!)

4.) "I thought I would pass out from the pain"!

5.) "Can't they conduct this procedure in a more humane manner"?


Several people I read about had GOOD experiences. Here is what they said. (and if anyone else who reads this blog entry has anything to add, let me know!)

1.) "They gave me some lidocaine cream the night before and instructions were to heavily coat the entire areola area, a couple of hours prior to the injection. Then, they deaden with several small injections of (Lidocaine?) and it was just a stinging sensation, sort of like a dentist does - then they waited a few minutes and then injected the dye. There was the stinging, I grant you, but it was over in a couple of minutes. With the dye injection, the area was numb and I didn't feel a thing. I think the secret is HEAVILY coating with the cream before any of the procedure starts. And, again, this isn't pleasant, but it passes very quickly. Good luck"!

2.) "I specifically asked for a certain radiologist to perform the tracer injections. She was the same radiologist who had previously done wire placements (10 years earlier), then the more recent stereotactic core biopsy, and I knew her and felt very comfortable with her. A tech brought in a leaded box containing the tracer material and put it on the counter. While he was loading the syringe, she asked him for the tray with the lidocaine. He said, "You use lidocaine?". She said, "Of course". She gave me a few lidocaine injections in the areola area. They were like any other lidocaine injection she has given me and honestly, nothing to complain about. She is skilled and knows to first inject some lidocaine, wait a second to let it take effect, then go further into the numbed area to inject more so it didn't hurt. Then she gave me the tracer injections all around the nipple area. They did not hurt. Other women have had other types of experiences, however my experience with it was fine".

3.) "I had the dye injection too. My surgeon used a numbing agent but it still stung, but only for a few moments. It was uncomfortable but nothing I couldn't handle. Some ladies say it was awful for them so I think it is different for everyone".

4.) "I had mine the morning of surgery. The radiologist /oncologist was extremely compassionate. It was the least painful part".

5.) "I had my injections the morning of surgery. A nurse applied a numbing cream about 30 minutes prior. The first 3 injections were tolerable. The 4th one hurt like heck. Not sure why."

6.) "Wow, I can't believe how many docs don't use the Lidocaine shots first. I had my dye shots the morning of my right mastectomy surgery. First, I had about 4 Lidocaine shots, and I only really felt the first one, which stung a tiny bit, just like getting a flu shot. After the Lidocaine I had a series of shots with the tracer and didn't feel any of them. I would definitely ask for the Lidocaine shots."

7.) "I had my sentinel node dye injection in pre-op for my surgery. They gave me Versed, and I never felt a thing or remember it either. The nuclear medicine tech who was injecting the dye said that UK Hospital's standard of care was to give Versed, that it was far too painful for the patient to have the procedure unmedicated".


So, what do you think? I find the variety of experiences phenomenal! Why the hell is Lidocaine OK in some places and not in others? Makes NO sense. (note, that final good experience was reported by a woman in the U.K.) I want assurance they will give me shots of Lidocaine (as they did when I had the core needle biopsy test, and I didn't feel ANY pain at all)

Next. On Wednesday April 27th - surgery day, my husband, Sam and I have to be at the hospital at 7:30 a.m. for paperwork etc. After that, I go to get the wire jammed into my boob. Now that should be a true delight. Once again, I'll be dragging out my "proper use of Lidocaine sheet" and discussing it with whomever will be doing the jamming.

Then, between 10 and and 1030 a.m., I'm supposed to meet with my surgeon, Dr. David McCready and the anesthetist to talk about the procedure, allergies, or whatever else I'd like to hit them with. The surgery itself, (wire-guided lumpectomy and sentinel lymph node removal/biopsy), will be done under a general at about 11 a.m. and I'm told it will take about 90 minutes. Then into recovery. I was surprised to hear this is DAY surgery, as I had been led to believe I would be in hospital overnight.

Both Sam, and my sister Carrie will be there when I wake up. (Carrie is coming because she knows "I want my MUMMY!, but she isn't able to be there for me). CARRRRRRRRRIE, I need you!!! WAHHHHHHHHHHHHHHH!

Dr. McCready's secretary told me I can ask for heavier drugs than Tylenol 3 and that I will likely get a prescription for Percocet, which makes me feel a little better. There are many people who have told me to shut-up-already about the pain because I'm obsessing. My response to that is, hmmmmmmm, let me think. Yes. I AM obsessing - and there's nothing you can do about it! As Lesley Gore would sing, "It's my party and I'll cry if I want to." Someday, if YOU happen to be unfortunate enough to go through the above things, it will then be YOUR party and you can do what YOU want to!

OK. Onward and upward. March forth. Into the woods. Ai Carumba! Over and out. Hip hip hooray. Hoo haw! Good luck Jim.

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At April 21, 2011 at 12:32 p.m. , Blogger Camille said...

Good perspective - if you feel like talking about the pain, talk about it. This is your experience and, although there is some helpful advice if you want it, it's up to you to do what you want.

About bugging the heck out of the secretary to get results - keep doing that. Among the top three lessons learned from watching my own mom go through cancer, is "the squeaky wheel gets the grease". Seriously, if you push for more info or better service or another option, you will usually get something out of it. But if you don't, no one offers it and unfortunately you are just part of the line-up. It wasn't always easy, especially since I consider myself a diplomatic, reserved person, but I don't regret any of the times I firmly requested for better for my mom at hospital front desks, with doctors and nurses, in the emergency room, etc. It often yielded results and kept staff on their toes. Everyone deserves equal treatment... But I find people can get lost in the system. So if you have questions or wants a test result or whatever, keep bugging - usually it helps! :)


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