Cancer log 121: …

Cancer log 121: Lumpectomy report.

So the first thing to know is that I am a fainter. I am not pleased about this -- it conjures up images of fragile maidens too tightly corseted, and since my own self-image is more of the armored sword-wielding sort of maiden, I really don't like it that I faint. But the fact remains that I do, and worse, that I faint when poked with needles.

The first time happen in a high school bio class, where we all had to prick our fingers, squeeze a drop of blood onto a glass slide, and then look at it under a microscope. I was totally fine for the pricking and the squeezing, and I got it under the microscope and started to look, and the next thing I knew, I was falling backwards onto the floor -- somewhat slowly, oddly enough, so that I managed not to hit my head hard on the way down or anything. If you've never fainted, it feels pretty awful; all shivery and weird, and then you lose consciousness; usually I'm fighting that all the way, and then I lose. The teacher got my feet elevated, and I woke up a few minutes later, totally embarrassed -- no one else had fainted. Sigh. But I was fine.

Then, some years later, I was getting blood drawn for something for other, and it happened again. And a few more times during pregnancy, when there were frequent blood draws. It was unpleasant every time, but eventually, thankfully, I learned some techniques to keep it from happening. I don't look at the needle or the blood draw at all; I keep my head turned resolutely away, my eyes closed, and I do deep breathing. I used to warn the phlebotomists that I tended to faint, but I've gotten good enough the last year at avoiding it that I stopped bothering to warn them. And, of course, with the cancer, there have been a *lot* of needle sticks.

So all of that is a preamble to what happened yesterday. I had a procedure early in the more where they were inserting these very thin guide wires (picture stiff black hairs) into my breast, to help the surgeon go to exactly the right spot. It's called needle (wire) localization. Given the location of my cancer sites (two of them), they wanted to insert the wires from below the breast, which meant that it would be easiest to do the procedure if I could be standing for it. I was feeling fine, so said I'd be happy to try.

First they did a couple quick mammogram pictures (not too squeezy) to find the little titanium metal markers that had been left there in the initial biopsies many months ago. Then they had me hold onto the mammogram machine, while standing, and the doctor and nurse worked from a squatting position to first numb the breast with the tiny lidocaine needles (feels just like little pinches, not bad at all), and then insert the guide wires (feels like pressure and tugging, but no pain). This took several minutes, but didn't seem like a big deal, esp. after the previous day's more painful radioactive isotope procedure! I was feeling somewhat sorry for my doctor, who happened to be several months pregnant, but nonetheless managed to stand and squat repeatedly to do the procedure -- what a trooper!

Now, the nurse had told me at the start of all this to tell her if I got woozy, and not to try to be a hero. And suddenly, right at that moment when they finished placing the wires and stepped away, I started to get woozy. So I told her, and then the next thing I knew, the room was getting fuzzy, I was feeling cold and shaky, they were saying something about the pink chair, and then I was falling backwards, with several hands holding me up, and sliding me into a chair, which, it turned out, reclined all the way back and the legs came up and they had an ice pack on the back of my neck and all of that meant that I didn't *quite* faint. But it was deeply unpleasant nonetheless.

All of this is called vasovagal syncope, which Mayo Clinic defines thusly: "Vasovagal syncope (vay-zoh-VAY-gul SING-kuh-pee) is one of the most common causes of fainting. Vasovagal syncope occurs when your body overreacts to certain triggers, such as the sight of blood or extreme emotional distress.

The vasovagal syncope trigger causes a sudden drop in your heart rate and blood pressure. That leads to reduced blood flow to your brain, which results in a brief loss of consciousness." Which mostly sounds like a fancy phrase for your brain being kind of wussy. Sigh. In my defense, I had slept very poorly the night before, and I hadn't been allowed to eat or drink anything that morning.

Anyway, I was basically okay after that. They were able to slide the chair to the mammogram machine for the last bit, where they checked that the wires were placed correctly. It was sort of bizarre, seeing these black wires sticking out of my breast, but then they taped them down and covered them with a bandage and it was all done.

At which point, they wheeled me back to my little room, where Kevin was waiting for me, and I collected a big hug, because I was admittedly feeling somewhat sorry for myself at that point, and then he held my hand and we chatted about other things for half an hour, and then they put an IV in my hand (which I dislike more than all the other places they put IVs, but oh well), and then the fire alarm went off for some unknown reason, and they got it turned off fairly quickly, but it turns out that when the alarms go off, the fans automatically turn off, so then they needed another half hour to re-clean the operating rooms, to reduce any risk of infection, so Kevin held my hand and chatted with me some more.

And then the anesthesiologist came in and said they'd give me something to help me relax, and then I fell asleep and woke up when the surgery was completely over, and then Jed came to pick us up and we went home, where I promptly went back to sleep. No pain, because the drugs are strong, but much sleepiness.

Whew. I think that's all I have the energy to write up right now. More on post-op recovery in the next post.

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