The weekend of 14-15 Jan saw me pretty slow and tired. Trying to get the energy together to clear space in the house to make sure I could get round without crashing into things was proving difficult. And I had run out of vitamin D3. But two days of being a zombie restored me just enough to google the names of the surgical team I had been told would be operating on me. I had not met any of them and was still unclear who would be doing what to me. On the Monday, with just over a week to go until surgery, I found an email address for the consultant breast surgeon who would be doing my mastectomy and emailed him in essence to ask who the sod are you and what are you going to do to me. A good chat to my therapist then settled my concerns about my slow rate in getting ready for the Main Event and a couple of hours later I got a call from the breast care nurses at my second hospital where I would have the microsurgery. I said oo, that was quick, had the breast surgeon told them to phone? No, they said, they realised I was not going to have an opportunity to ask questions before the operation, and my pre-surgery assessment appointment would not involve any breast care nurses to detail what would happen, so this was my chance.
One hour later, I felt a whole heap more informed about the operation and what to expect in the first week in hospital and the first weeks at home. I was warned I would be very grumpy and uncooperative in hospital post op because of the reaction to being hacked around during a 12 hour op (not 7 or 8 as previously advertised), being on morphine and getting over the general, which would take two days anyway. The physios would try to get me sitting up the day after the op, and the breast care nurses would fit me for a front opening support bra as soon as possible. The recovery would be 6 weeks initially with a further six weeks to be back to normal (again, longer than previously advertised). The intial one week and then six week follow ups would be at the microsurgery hospital, not the district nurses or my local hospital, because my surgical team would want to keep an eye on things themselves and relate everything to their detailed post surgery notes on my wounds. Fair enough. There was a lot of discussion about big knickers with lycra and other bits and pieces. I was awash with relief to have some decent facts to go on, but a bit alarmed at the escalation of the timescales for op and recovery. I was also still unclear about homecare once back at my house and still thought I would need home help through the Council, although the breast care nurse was not convinced it would be necessary. In any event, I could finally make the final online purchases that would help with my recovery, like a new bed. My old bed was making loud noises that were waking me up through the night and the memory foam had remembered a hump in the middle of the bed so I was having to roll up hill. Enough of that.
Next day, I suddenly found I was constipated and, I imagine, my hormones had been blocked effectively by the Tamoxifen and instead of having a period, I had started bleeding from a fissure I have had since I was 20 that comes and goes. It was the last thing I wanted to happen before a large surgical procedure that would leave me with constipation anyway. This was a blow and I set about trying to sort things out with an even higher fibre diet than I was already on, drattage. The local surgery then called to say my blood tests were back in and my cholesterol had dropped from 6 to 4.5. This was extremely good news. It indicated, as if I did not know already, that the Tamoxifen was working as well as the lower fat diet and measures I had taken to reduce my cholesterol sensibly. Party time!
Then radiology at the microsurgery hospital phoned. The CT scanner had broken down so I would have to go to a different hospital for the abdominal CT scan they needed to do the next day. They had no idea where. A couple of hours later, they had got me a spot at the third hospital in Edinburgh, for immediately after my pre-surgery assessment in the second, micorsurgery hospital, the next day.
Ignoring the chaos, I went off for a pre-surgery haircut. And very fine it was too. And then had a long chat with my doctoring relation. A good day.
Next morning, it was all aboard the pre-surgery assessment band wagon and getting to the hospital I was sat down to fill in an exhaustive form of next of kins, medical history, allergies, reactions to generals before and all manner of other things. The pre-admissions nurse then ran me through the form exhaustively, did the basic obs, and then tried to take a blood sample. And failed. I seemed to have no veins that would play ball. Eventually she called in another nurse, who dug a vein up quite quickly and the sample was taken. But it was a bit of surprise to have uncooperative veins. This was a first. Anyway the sample was to go off to find my blood group and a second sample would be taken the afternoon before surgery to ensure I had the correct blood on stand by in case I needed a transfusion during surgery, as they would thin my blood out with fluids due to the length of the procedure and I might lose a bit during the knifing.
And that was that, according to the nurse. I needed to have an ECG but otherwise, home time. But I was not having any of it and said I would not leave the hospital until I had actually met one of the surgeons that would be undertaking the long op on me. I felt it was fair enough to clap eyes on them. I was assured I would meet them on the morning of surgery. No, I said, that was too late. I needed to talk about the surgery with them now, in the week prior to my operation, so I had time to weigh up who would be doing what. So the nurse tracked down the main microsurgery surgeon on the floor above, busy with his hand clinic. She also found the supporting breast surgery plastic surgeon in the third hospital, who was prepared to see me once I had done my CT scan later that afternoon.
Now I knew my main plastic surgeon was a hand specialist from googling him but waiting in line to see him in his hand clinic for breast surgery was odd. The nurses at the clinic were quite twittery at my being there. All four of them said in tones of awe, you're the breast surgery lady. And they all tried to cram into the room as I was ushered in to meet the surgeon, to whom I extended a greeting and said my hands were fine it was my breast that needed operating on. He was a fairly quiet bloke so he looked mildly embarrassed by that but he chatted away about the procedure and I was reassured he was very laid back, a consultant (not a registrar as the web had him listed) and he had performed the operation many times before. We discussed fill levels and he was emphatic the new breast would be smaller than the current one. He went through the side effects and the likely problems that might occur. And he then mentioned that of course I would have provided next of kind details, at which I was fairly naughty because I dropped the bombshell that my next of kin was a senior clinical consultant neurophysiologist in England who was now so senior he was above running a department and did more clinical than anyone else put together still, despite technically being retired. He looked slightly stabbed in the vitals at that - operating on a relation of someone in the profession is a bit of a bugger, particularly a clinical consultant who knows a thing or two. But I let him squirm. I had already done enough worrying and felt it was time he did some for me.
I kept the convo short and snappy, whilst making sure I articulated all my concerns for him to rebutt, and kept glancing at the clock because I knew I had to get into the ECG dept before 12.45pm before they closed and it was already 12.30pm. So I basically cut the surgeon off and legged it through the hospital to get to the ECG in the nick of time. Completely out of breath and heart going like the clappers, I settled in for the ECG with a very amused nurse who sympathised that I was doing great getting round everything considering.
Then I had to leg it out of the hospital and drive across Edinburgh at a bonkers speed to get to the CT scan. Again, the nurses had to dig around to find a vein, which was very odd to not have obvious veins to play with, and then I had a massive downer later that afternoon following the contrast/dye injection and had a heart thump which was even more odd. Basically, something must have been used on me at the last op on 28 Dec that had lowered my blood pressure and affected my veins in some way. No idea how but that seems to be what has been going on.
The next four days were a whirlwind of sorting out cupboards, getting things in order, cooking for the freezer, packing, cleansing everything and having the whole place prepared for a return home in a fairly doddery state. Friends helped lug furniture around, do deliveries to the Sally Ally and other amazing bits of support and, critically, a neighbour agreed that she would cook my evening meals for the first week of my being home, and be around enough to keep an eye on me, as well as the cleaners helping out during my entire recuperation. Mercifully my energy levels had picked up just in the nick of time to rattle through the four days. I had even got the constipation under control and things were heading in a really good direction. I was on course.
