Thursday, February 17, 2011

One Moment in Time

I had been warned, told to take the Valium.  People would cringe and squeeze their hands as they spoke about it.  It would hurt, they said.  No way around it. Three needles, one at a time, directly in and around the nipple.  The injections of radioactive tracer used in the sentinel node biopsy the morning of the mastectomy.

Sentinel lymph node biopsy is getting a lot press lately as a better alternative to removing all lymph nodes to determine the extent of cancer's travels into the lymphatic system.  The radioactive dye traces the cells path when leaving the breast.  The sentinel node would be the first stop.  I didn't realize at the time, this wasn't standard practice.  I was lucky to have it.  The side effects of removing too many nodes are well documented and breast cancer patients have more than enough on their plate without adding unnecessary lymphedema.

Well worth the momentary pain I was being told about, but I didn't want to do it.  Who would? The description alone sounded horrendous.  I would do it, of course, but I really didn't want to undergo the procedure that made grown women teary just from talking about it.  I wondered how it could be worse than the core needle biopsy, but I was told from women in my surgeon's office it was.  They were trying to be helpful, to prepare me.

As I've gotten older, it's become increasingly clear we often have to do things we don't want to do and it seems there are varying degrees of enthusiasm, a sliding scale for unpleasant events.

I don't want to get up out of a warm bed to start my day.  That's pretty low on the scale of things I don't want to do.

I don't ever want to go to the dentist.  That's a little higher, maybe mid-scale.

Then there are a few things in life that have topped the scale.  Things that have literally stopped me cold, turned my feet to cement and made it nearly impossible to step forward.   Injections of radioactive tracer to the sentinel node is one of those things.  The best advice anyone could give me, was to take the Valium.

I carried with me the thought that life is made up of moments, for better or worse and though this was certainly "worse," it was still one moment, just the same.  A blink of an eye, a blip on the evolutionary scale. One, single solitary moment in the big scheme of things.  I could endure anything for a moment.  I took the Valium, tried not to focus on the procedure, squeezed the hand of the amazing nurse by my side and thought of the beach I'd rather be on with my husband, as a second nurse began with the needles.

One moment in time, then gone.  The nurses said I handled it well.  Right then I used a phrase I've heard often, but never used before or since.  I had gone to a happy place, one without breast cancer.

Hours later, I was in a hospital bed for the first time in my life wondering how the bilateral mastectomy I just had, would change me.  I was taped up pretty well, so I didn't feel that different.  The pain meds were doing their job and I knew the sentinel node and a couple of its buddies were clean.  I was thankful, but I knew this was not the end.  I hadn't reached the end of anything, but I couldn't contemplate that right then.

There was a clock with a calendar built in on the wall across from my bed and though the television was on below it, I only saw the clock.  I couldn't take my eyes off it.  I watched it click the minutes away until 11:59PM... That changed everything.

At 12:00AM, the date changed to June 23, 2009.  The sentinel node tracer injections and the bilateral mastectomy were yesterday.  Over...in the past. Those things that I had so dreaded, those moments...gone.  I was still here. On the other side of those moments.


What thoughts carry you through the tough moments?




13 comments:

  1. Stacy,

    What a beautifully-done post. And I thank you for this for lots of reasons.

    1) Honesty.
    2) Confronting the "fear factor" face forward with the longer perspective in mind.
    3) Clear writing.
    4) Repeat: perspective. It is everything. Five minutes (at the max) of discomfort to avoid unnecessary lymph node removal? Hello? Talk to me. Worth the discomfort in my book.

    And I pose a question for you from my experience. I had a sentinel node biopsy in 1998 - two years before it became standard practice at MD Anderson. No one told me in advance that the sentinel node biopsy was painful; conceptually, I understood its importance. Let's say -- when I received the injection - I was dismayed. Nothing worse, nothing more. I didn't cry out, fall to the ground, or anything like that. It is amazing that women can bear children but will lose it over a procedure we now understand saved many from long-term consequences.

    The question: did the "it's so painful" warnings make you think twice about having this done?

    Thanks,
    Jody

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  2. Jody, thanks for your words here. I read your article in Oncology Times, so I know how you feel about this. All the press lately brought that day to the forefront of my brain. You ask if I thought twice about having this done, knowing it would be painful and the answer is NO! Not for a second. I never saw that as an option. The only option I had (in my head) was how I would handle the whole thing. You're so right with the childbirth analogy. And this procedure is only minutes, compared to the hours of childbirth. We shouldn't be scared off. As you know, it's worth it in the end.

    I'm sorry you weren't told what to expect, but it's still a biopsy, like all others. You know going in, it's not going to be fun. Thanks again, Jody.

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  3. I've never even heard of a sentinel node biopsy! It must have existed in 1996 if Jody had one in 1998. I did have several lymph nodes removed when I had my mastectomy, but fortunately haven't had any problems.

    One thing I learned with my anxieties about doctor appointments; I think "in 24 hours this will be behind me."

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  4. Very well articulated and honest post Stacey. I was really quite clueless going into all my procedures but was also scared as hell. I just kept telling myself "you'll get through this". It's still a trick I use today. I also use projection as well. This is where I think of some fun activity that I want to do, or something that I want to buy, or I even think about my garden and the projects I want to do. Somehow this helps distract me from whatever is going on and I sort of go into a meditational kind of state. I think I would go mad if I hadn't learned these tricks quite frankly.

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  5. Hi Ginny, I don't know if it existed in 96 or not. I'm surprised it was around in 98, actually. From all the recent talk it sounds as if it's fairly new, but maybe it has to be in use for awhile before "coming out." I'm glad you haven't had any problems.

    Thanks, Anna. Projection is good. I almost wrote about that. I read once to think of the sky, because everything falls right through, nothing penetrates or hurts it. Whatever works to get us through.

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  6. Stacey, What a great post! You raise such a great point in that every moment is just that, one moment in time and it too shall pass. I'm going to do a better job of remembering this and say it to myself at my next procedure, appointment or whatever it is I must deal with. Usually I just focus on a picture or even a spot on the wall. I like this idea better. I was out cold for my sentinel node biopsy since it was done along with my bilateral. Unfortunately, mine was not clear and I had 14 lymph nodes removed on the left side.

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  7. One of my favorite sayings is, "This too shall pass." Nothing lasts forever, which can be applied for the bad times in our lives, but also the good times. Thank you for a beautiful--and very real--post.

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  8. Stacey,
    This a great post. This is exactly the type of thing healthcare professionals often forget to tell us--this is what it's like and oh, by the way, it might hurt.

    I'm curious about the timing--it sounds like they did this procedure right before your mastectomy? Is that correct? Is that how it usually works?

    They sampled my lymph nodes while I was under for my mastectomy and it sounds like they did me a favor. I have one left so who knows, I may need to do this someday. If so I hope to remember it's just one moment (although I will also take Ativan :)

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  9. Nancy, I didn't know you could sleep through it. I'm pretty sure I was given a reason why I shouldn't, but I can't remember what it was. Nice, right? i hope you're not feeling any side effects from having 14 nodes removed.

    Hi Elizabeth, I agree with you. Even the good times come to an end, which is why we need to appreciate them all the more. Thank you for writing.


    Jackie, thanks for your comment. Yes, my sentinel node biopsy was the morning of the mastectomy. I was awake for the injections, then after a while I was taken into surgery. My surgeon was psyched to let me hear the clicking sound his instrument was picking up from the radioactive tracer. It's like a geiger counter, I guess. I was put out right after that. Hard day. Yes, take the Ativan!

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  10. I use tricks similar to Ginny & Anna - I think to myself, in 24 hours this experience will only be a memory, and I focus on things I want to do, buy, or accomplish.

    I had a bilateral mastectomy on 5/14/09, just a couple of weeks prior to yours. I also had a sentinel node biopsy that morning prior to the surgery (awake), with clean results like yours. Honestly, the sentinel node biopsy doesn't stand out in my memory, but my memory cannot be trusted these days. That experience is probably dulled in my memory due to the subsequent chemo & reconstruction surgeries. So far, my least favorite moment of this process was probably the removal of my mediport (although the two weeks it took getting used to the mediport tube running over the top of my collarbone is up there, too). I initially debated whether I really needed a mediport (I did). Those moments have passed, and I'm still here... Thank you for this post.

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  11. Arianne, I love your name! It's so pretty. Thank you for writing and sharing your memories of that day. I wish I knew you then. We could have helped each other through. I don't think I could envision myself two years later, back then. Too much unknown, but here we are. I think it's a better place and I like others to know they'll get there, too. Thank you, again.

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  12. Stacey, the thought of the sentinel node injection still brings me to tears. I can vividly remember each and every needle. I do remember people telling me that would be the worst of it all but could in no way imagine such a barbaric procedure. I wish I had been offered Valium. My best friends hand will never be the same.

    I can laugh now, but the memory of that moment will remain with me forever. Bilateral mastectomy, walk in the park after that test, then again those drugs were better.

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    1. TJ, first off, I can't believe you weren't offered Valium or some other powerful anxiety reducing drug! This procedure is certainly hard enough to warrant Valium. In any case, I admire you for getting through without it. I can only imagine your friend's hand, remembering how hard I squeezed the nurse's. My husband wasn't allowed in, maybe that's for the best. Who can really say? I'm glad you can laugh now. It is pretty crazy the things we're forced to do. Thank you for reading and writing here. I hope you're doing ok.

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