The Makings of a Masterpiece

October 25
Surgery day!  Mixed feelings.  I'd put off dealing with this aspect of the process because, frankly, thinking about a surgeon removing anything of any size, and then essentially moving a piece of my body to another area of my body and everything that goes with it is, well, scary.  There I said it.  I knew I had to do this.  The nerves involved here makes chemo seem like a walk in the park.  What I do know is, I don't like to be put under anesthesia.  I don't like people telling me what to do.  I don't like dismissing any amount of pride in any aspect of the process of hospitalization...changing into the gown - open in the front or back.  And then it's the body part in question.  I rather liked both my breasts, even in their less than full, post nursing condition, thank you very much.  And up until now, I liked my lilly white scarless skin, why even the stretch marks from the twins had faded.  I was about to collect some serious merit badges in the test of life.

Still, the clinician in me has a very strong argument:  Um, so you have to do this, because right now this is the only thing you can do to prolong your life.  Right, and so the debate ends here.  It's merely an appendage.  I can do this.  I will do this.  It's just a couple of days cooped up and a few short weeks of rest.  Again, I reiterate to myself, this is really no big deal.  Right?

And so the four of us, girls in the back of the car, rolling down Route 287 shortly after 5:00 am under a cloudless crisp sky.  Strange that the road is empty of the usual traffic backups and typical north Jersey transportation chaos.  The girls enjoying a rare ride in the early morning's temporary blackness while awake.  Sean would drop me at the hospital, let me wait, register, undress, endure the litany of personal questions and needle pokes, continue to manage my jitters while he drives the girls to preschool, then return to the hospital for my very important pre-operative pep talk and good bye smooch.  The routine has become all too familiar.

Out of the blue, Ella, while sitting in the back of the car staring out the window at the sky:
"Mommy, the stars are twinkling."
"Yes, honey."
"Mommy, those are Papa John stars!"
"Ella, what did you just say?"

The girls never met my father.  They only know him by his picture on our bookshelf.  They should have.  Although, maybe there was a secret meeting in a sort of cosmic sense.  A huge cloud of peace and calm followed him.  I'm reminded of the last few words he and I shared before his passing seven years ago.  Of cancer.  And all I'll say about that is, he was right.  I looked out the window.  A warmth - and peace and calm - filled the cabin of the car that is otherwise inexplicable.  He's here.  I'm certain.  And my three year old has just blown my mind.  Again.  There is something at work here, far bigger and greater than me.  In the darkness I let the waterworks release again, the first time in several weeks.

Ella, increasingly annoyed she has to repeat herself, "I said, these are Papa John stars!"
"Mommy," said Gianna, "Ella SAID these are Papa John stars!
"You know, they are."

                                                                       ***

The registration process, in spite of the standing room only waiting area, was rather straightforward.  My data, extensive to be sure, is already in the computer, insurance information has not changed.  There is something to be said for having all your services at the same facility.  I continue to be treated with a great amount of respect and dignity.  People going out of their way to ease my fears.  Reminding me how far I've come on this journey.  I got some strange looks as I am called to the back for the pre-op process, ahead of people who'd been waiting longer than me.

The undress and preparation period moved very quickly.  IV started, Plastic Surgeon slipped himself behind my drape to draw his roadmap and take some last measurements.  Slowly the parade of characters introduce themselves to me.  Anesthesiologist.  Surgeon.  New Doctor Who Will Help.  Head Nurse.  Other Nurses.  Blood drawn.  No, I have no allergies to medicine or anesthesia.  I have one filling.  I am not wearing contacts.  Tap a blood vessel for anesthesia and other things.  Four physicians, at least four nurses and a resident.  In the confusion, my IV slipped and fluid started to fill my hand and forearm.  And I didn't notice until my paper ID bracelet started to rip from the stress of the swelling.  That and I realize I can't close my hand.  Now that after today, I will be less several lymph nodes on the left side, I am down to one arm of usable veins and arteries on the other side, this might be a problem.  Back to the port.  I'll just have to arrange for the port to come out at a later time.  For now, it became a huge time saver.  No need to find another vein through all the extra fluid now filling my one usable arm.  I am wheeled off.  Making jokes about seaweed spa treatments and martinis.  Not bad thoughts by which to fall asleep.  And more amazed that twelve hours seems to have passed effortlessly.

In my post operative haze, I try to count the number of machines attached to me:

• Weird hose thing blowing warm air into a plastic quilt hooked to my gown
• Oxygen up my nose
• Blood pressure cuff
• Oxygen output
• Those chest and abdominal stickers
• Compression boots on both legs, that tighten every minute to prevent clots
• IV for benadryl, anti nausea, pain meds, fluids 
• 2 abdominal drains
• 2 breast drains
• Catheter

Some stuff is lost on me.  Not including the nurse who comes in on an hourly basis to check blood flow of my new breast with a tiny ultrasound device the size of a pen.  And invariably to reset a machine, empty something, or fill something.  So I find it sort of humorous, in spite of all these machines, the first words out of nearly everyone who I meet is,

"Wow!  I really love your toenail polish!"

It's important to pay attention to what really matters.

It became clear very early on that, while all this attention is great, there is no way I'm getting any kind of sleep in this place.  As early as 4:30am, begins the herd of people coming in to check on me.  The Nurse. One or Both Nursing Assistants Assigned to Me.  The Resident.  The Plastic Surgeon.  The Hot New Doctor Who Helped the Surgeon.  The Team of Six Other Medical Students Who Follow the Resident Around.  The Other Group of Medical Students Following the Hot New Doctor Around.  The Breakfast Tray Guy.  The Garbage Lady.  The Head Surgeon.  Some Random Person Who Delivers the Newspaper.  The Person Who Takes Away the Breakfast Tray.  Rieki Specialist.  The Volunteer Who Gives Communion.  The Volunteer Who Delivers Gifts.  Acu-pressure Specialist.  Ironically, one of the last visitors is the Social Worker-Type Happiness-in-the-Hospital Person (no, I really didn't catch her official title) Who Offers to Put a Do Not Disturb Sign on the Door.  (Um, where were YOU at 4:30 this morning??)  And they all ask the same questions.  I felt like making a sign to place on my door:

- Yes, whatever you are asking about, it's sore

- If it's full, it probably needs emptying

- If the machine is beeping, it's probably because I can't find or reach the call button.  Please make it stop
- Even though I've been under anesthesia for half the day, it doesn't count.  So I'm still tired
- Jello is not food, especially the sugar free kind
- No, I can't sleep here
- No, I'm not really comfortable.  You see, my hormones have been shut off, the thermostat is set to 75 degrees in this room and you are blowing hot air into a plastic quilt you insist must be over me.  And I can only have ice chips.  Yeah, I'm a little warm.
- I'm fine, considering what I've been through.  And I know you are only trying to help.  And you are all very kind, and good looking too, Dr. Hot New Doctor Who Helped.  The worst clearly is over.

The non stop attention continued through the week.  By Friday morning, Hot New Doctor Who Helped came to visit.  And out of my drug induced fatigue, I managed to have a short conversation with him.  I mentioned I was anxious to go home and sleep.

"Well, that's not my decision.  We have to leave that up to your plastic surgeon.  He is the one that did the majority of the work.  He would not be in favor of sending you home if it was risky or if it would compromise....his....(gesturing with his open hand and waving it over me) his masterpiece..."

Yes, his masterpiece.  Yes, there should be no disturbing the masterpiece.  Brilliant!  Somehow, that was refreshing to hear.  *I* am an extraordinary work of art.  In progress.  Most of which has nothing to do with surgery.  But, it may be a long time.  The progress might be slower than I'd like.  But I'm coming around.  Every day.  Every day cancer gets further and further away.  And out of the battle is emerging a different, better, stronger person.  Doesn't mean I won't love a long nap, quiet, learning to address my needs as well as I address others' needs, and maybe some more reiki and acupressure at the hospital when I go back for radiation in the middle of December.  

I came home late Friday night.  In the darkness of a crisp fall evening.  And even though a rare fall nor'easter was headed our way, I noticed those stars were still twinkling.