October 23, 2014
Three weeks to the day following her bi-lateral mastectomy, Anissa was scheduled for a followup visit with her reconstructive surgeon for what would have been her first “expansion” visit…or what we simply called a “fill up.” That visit was cancelled and instead, replaced with an outpatient surgery with Dr. Chang. Based on the pathology results of the sentinel lymph nodes, Anissa would need to have a procedure known as an axillary lymph node dissection. The purpose of this procedure is to ensure the lymph nodes further down the line were not infected with cancer cells. If these come back negative Anissa would have clear margins.
Of course, you’re probably thinking, “Why didn’t they just remove those during the mastectomy?” If the sentinel lymph nodes tested negative after the first surgery then Anissa would have been given the “all clear” and most likely would only have chemotherapy and possibly not radiation. How nice would that be? However, if they test positive (which they did) – this means they need to go back in. The reason for this approach is that with any larger number of lymph nodes removed Anissa would increase her chances of developing lymphedema. With just the sentinel nodes removed, her risk was approximately 25% of developing this condition. A condition which you are at risk of developing for a lifetime. Removing the axillary nodes increased her chances of lymphedema to 33-35%.
So here we are, back at UCLA and Anissa hasn’t fully recovered from her first surgery for yet another one. This was a very different experience from that of three weeks ago. For one, it wasn’t performed at the hospital, but rather at UCLA’s surgical center located on the 6th floor of the medical building that houses the Revlon Breast Center. (or as I referred to it “the red-headed step child of the hospital”. We also didn’t have to be there at 5am – but of course, being LA, we still battled traffic that morning to get there to meet an 8am call time. The staff was nice enough, but no where nearly as comforting as the team Anissa had for her mastectomy.
Even though this was considered “out-patient” we still went through the standard procedures – every nurse and member of the medical team that came in would ask the same questions upon entering the pre-op bay. Name, date of birth, allergies, time of last meal, time of last beverage, list of medications currently taken, etc. Yes, it became repetitive but it was for very good reason. When they don’t ask questions is when you begin to worry.
Once the iv was in and all the pre-op info was input into their computers, Dr. Chang came by for a final visit with Anissa to discuss the details and explain exactly what she would do, how long it would take and what to expect afterwards. Finally, the anesthesiologist entered the bay and could see that Anissa was nervous. He spoke in a very comforting manner which helped and once Anissa gave the thumbs up, he provided her with that same “happy juice” which caused her to break into song before the last surgery. Within 30 seconds, Anissa was flying high and didn’t have a care in the world. Off she rolled to surgery.
As Anissa was wheeled off (not singing this time) I made my way out of the pre-op area where I was greeted by Anissa’s Aunt Judy who would spend the rest of the day with us until it was time to leave for home.
The surgery went well – another text book procedure well executed without issue. Anissa came out of recovery within an hour or so and even after the 4th slowest ride home from a hospital Anissa was home and resting comfortably before the kids walked in the door from school.
We’re now another step closer towards beating this thing. We’re also now having to wait until next week to hear the results from pathology.
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