Sunday, January 5, 2014

LUMPECTOMY - THE SEQUEL . . . Stories old and new

If I've told part of this before, please forgive me.  The "dancing doctor's" brave video has opened Pandora's box of medical memories and things to be thankful for.

In the 70s, in a then-small California city, my doctor got the idea that there might or might not be a lump in my right breast.   The next thing I remember is sitting in a hard chair in the middle of a large, chilly room, naked from the waist up.  The surgeon was in the room with me; so were a number of male medical students or interns or whoever. If there was a female nurse around, I don't remember her at all.

 I was fairly miserable during the long time it took for almost everyone to palpate my breast and discuss my plight, if there even was a plight.  All that poking and puzzling; no findings.

Although I don't know the standard of care for breast diagnosis in the 70s, the surgeon decided on a combination surgical biopsy and possible mammography method that I now understand had been developed at the beginning of the century at Mayo Clinic.

In this approach, the patient was put under sedation.  The suspicious area was excised and sent to pathology for frozen section -i.e. slicing it up paper thin.  If the pathologists found malignancy, the breast and possibly near-by lymph nodes were removed.  Finally the patient would wake to find out if she still had her breast.

I must have put myself into a sort of pre-surgery denial fog.  My husband, who later became my ex-husband, made a brief, awkward attempt to talk about outcomes.  I was not at all clear on how much to tell my little, grade-school age daughters, and still don't remember what I did tell them.

Finally, I put on my red blouse and was driven off to the hospital.  I should probably inject here that I didn't really like the surgeon.  In those days, women made remarks like "He's not much for bedside manner, but he's good."  Later, he became a client of mine, and we still did not become friends.

When I finally woke, I believe for some reason one of my in-laws was in the room--is that possible?   (We were not huggy in-laws.)  A nurse stuck her head in, said "benign," and vanished.  Someone asked me what I wanted to eat.  There was no sign of the surgeon.   By the time my green beans arrived, I was still too groggy eat them, and went back to sleep instead of enjoying the fact that my husband was in the room.

After so many hours under the anesthesia of the day, I was a little dopey for a while.  Even weeks later I would suddenly get tired when we went for a walk.  Were there pain pills?  How long did I stay in the hospital?  There must have been pain, since the nipple had been removed for the exploration.   The good news is that the scar has been almost unnoticeable.

Just a very few years ago, one of my daughters told me she and her sister had been sure I would die in the hospital.  I wonder if anyone tried to comfort them when I wasn't around.
Through the multi-step DCIS diagnosis, the old scar on that nipple wore a cute little sticker like a wreath, to keep it from looking like a problem on film.

The good news:  I have a surgeon I like, who is as kind and caring as the best family doctor, and who also did a great job removing the affected area for analysis. I am different now than in the 70s; I would not have let him do the procedure if I hadn't trusted and liked him.  

And lumpectomy let me avoid, as many women can now, the long and dangerous surgery to remove a whole breast.

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