Pre op - what to expect

Good news: lumpectomy on my right boob and sentinel lymph nodes will be removed as planned on Wednesday 3 October.

Not so good news:  I have to wait up to nine months before my left boob can be operated on to make similar to my right boob.

I spent Wednesday morning in the breast unit at Guy's Hospital.  First up was an appointment with the lovely Vanessa, my Clinical Nurse Specialist (CNS).  This was when I first learnt that my right boob op wouldn't be in December but next year - up to nine months after radiotherapy, depending on how my right boob responded to it (healed and shrunk).  We then discussed comfy's (cushion type padding for the right breast to make it similar in size to the left) and getting a silicon insert for my bra.  

If all goes according to plan, 7 - 10 days after my lumpectomy I'll come back to the breast clinic to have my dressing removed and get the results of surgery.  That will then determine whether I need another operation or if we can start planning radiotherapy.  Radiotherapy is likely to start w/c either 5 or 12 November and last for 3 - 4 weeks.

For my lumpectomy on Wednesday, I need a needle localisation.  To help guide the surgeon, I'll have two needles that stick up out the skin like flag poles to act as markers for the surgeon so that he takes out enough tissue.  Pre chemo I had a clip put in to mark where the cancer was and as it's shrunk so much it will be difficult for the surgeon to know if he's taken out enough tissue without the needle markers.  I'll also have a needle flagpole for my lymph nodes.

We discussed lymphoedema.  After I have some of my lymph nodes removed, I have to be super careful about any scratches or cuts on my right arm/hand to make sure they don't become infected, which can lead to lymphoedema.  I can no longer have my blood pressure taken or have cannulas put on my right arm.  Once you get lymphoedema, you've got it for life and it's something I want to avoid at all costs.  

Following on from my appointment with Vanessa, I met with a couple of researchers who wanted some tissue and blood for the Research Biobank and for the 100,000 Genome Project.  I had no problem consenting to this - the more research we can do into cancer the sooner we can prevent people from going through the suffering the disease brings.

I was supposed to go on to pre-op assessment clinic however as I had treatment on Wednesday afternoon, they advised me to come back first thing Thursday morning to jump through the pre-med hoops.

I turned up at pre-op at 0845, hoping to be first in the queue as I'd been advised they were short staffed and I could be waiting hours.  I couldn't believe how grim and soulless pre-op was.  I felt like I was in the basement of a 1970's communist block, all artificial light, old, worn lino & chairs and a stale must in the air.  After completing a form, a medical assistant took my height, weight, blood pressure, temperature and MRSA swabs.  I then waited before being seen by a nurse who went through my form, making sure I was fit for surgery and that I had someone to take me home after surgery and stay with me overnight.  As the pre-med team weren't trained to take blood from a PICC line, I had to head over to the Cancer Centre and ask them to take the bloods for me.

I then headed back up to the breast clinic for my appointment with my surgeon, Mr Douek.  I'm not exactly sure why I needed the appointment as I was in and out within 5 mins with nothing new being discussed.  
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