Tag Archive | bleeding

Mistaken for the Bride of Frankenstein — Part II

[May 6, 2013]

breast cancer thirties 30's 30s skin cancer mohs surgery

So I had the Mohs Microsurgery / Chemosurgery last Tuesday morning.  I was grateful for all of the kind comments on Mistaken for the Bride of Frankenstein and Skin Cancer, Too?  Really?!  You really gave me the courage to face another surgery and another type of cancer.  Of course this surgery was nothing compared to the others and this cancer was just a bump in the road, but I think I would have continued to push this surgery out even further if it weren’t for all of you.

I have been meaning to post about what the experience was like, but it was such a difficult week that I just couldn’t manage it.  And then I thought the Frank and Nancy post was much more important. I will begin with what has happened to my face since the surgery.  Quite simply, my face has swollen beyond recognition.  I wish I were exaggerating.  On a positive note, they say it will get better — but that it will take a week or two to do so.  I’ll take it — I’m just glad this won’t be permanent!  And so are the kids, who looked horrified when they saw me this morning and told me that it was getting worse! Back to the procedure.

As you know, I was quite nervous about this one!  Fortunately, my lovely friend jme was here and she not only made me feel better about going, but she got the boys ready for school so we could leave at 7:40 a.m. for the hospital.

H (husband) dropped me off in the hospital loop and I made my way up to the Mohs Surgery Department.  I haven’t mentioned it before (this is another post I haven’t gotten to!), but we have had a photojournalism student (Jennifer) following us around for the past couple of months to document our lives as a family dealing with the effects of cancer.  Jennifer met me just outside the doors and began taking photos as I walked to the check-in desk and made my way to the waiting area. H met us in the waiting area about 10 minutes later.  He promptly found a magazine and took a seat.  When they came to collect me to prep me for the surgery and asked if I would like to bring someone back with me for this part since I had skipped out of the pre-op / question-answering appointment, H didn’t look up from his magazine.  Apparently, reading about the life and times of Billie Joe (Green Day’s frontman) was more riveting than what was about to happen to my face and asking questions about the cancer growing on my forehead.  Normally this wouldn’t bother me.  But this morning it did because I was so unenthusiastic about the surgery that I think I was visibly shaken.  So when Jennifer asked if she could follow me back, I did not object.

We were taken to a large, bright room with a special chair — it looked like one of the birthing chairs from Star Trek: The Next Generation — positioned in its center.  Jennifer asked the nurse if she would be allowed to take photographs, so the nurse left to see if the surgeon would allow this.  When she came back with an “okay” for photographing everything but the surgery, the prep began.

A second nurse arrived, and after asking me some questions and cleaning my forehead, they began injecting my forehead to anesthetize the area. After massaging the anesthetic in, waiting, and testing the area to see if it was truly numb, the nurses left to get the surgeon.

When Dr. B arrived, he discussed the procedure, used a black marker to outline the area he’d be cutting, and described what my scar would look like. Then he asked if I had any questions.  At jme’s urging, I asked if he could make my scar look like Harry Potter’s.  He smiled, said yes, and walked out, promising to return when my prep was finished. After he left, the nurses draped my head with sterile cloths, rechecked the numbness of the area, and asked Jennifer to leave.

When Dr. B returned, he looked at my online chart and said that he thought it was safe to say that I had been through a lot.  So he then assured me that he would do his best to get as much as he could in the first round so he wouldn’t have to put me through anything more than necessary.  I thanked him and then tried to go to my happy place as I felt the cold instruments touch my head. I’m not sure how much time passed before he said that he needed the cautery.  I asked if I had forgotten to mention that I was on blood thinners.  Yes, I had.  I could smell burning flesh.

Then he continued, and cauterized more because I continued to bleed. And eventually he was done.  He cauterized some more, and then they put a pressure bandage on my head, and escorted me to the waiting area so we could see if he had taken enough to get clean margins.

While I waited, my surgeon, who is uniquely qualified to double as a pathologist, looked at slides of the tissue he had taken to determine whether he was able to get clean margins. As I waited, before and after my surgery, I watched as a nurse came to the waiting area to tell several other patients their results.  My surgeon had managed to get clean margins for each of them.

As I read an issue of Coastal Living, I couldn’t help but notice that I was the youngest patient in the packed waiting room.  By far.  I think I could safely say that most of the people there were double my age.  This fact wasn’t lost on Dr. B, either.  He told me that it is not uncommon for people to develop skin cancer.  It’s just fairly unusual to develop it at my age.

Now it was my turn to get my results.  I was told that he had also gotten clean margins for me.

The nurses brought me back to the surgical room.  They asked Jennifer not to follow. They whipped out the needles to numb me again.  When this was done, Dr. B came back in, reiterated that he had managed to get clean margins around the cancer.  Then they draped me with blue sterile cloths again.  And Dr. B undid my pressure bandage and began cauterizing me again.  Then he started to stitch me up.

When he was through, he apologized for everything I was going through and wished me well.  He told me that I had a much higher risk of developing future skin cancers and asked me to schedule a full skin check in 6 months.  He said that I would always need to do this now and that I would need to be more vigilant about checking myself and being protected in the sun.  I neglected to tell him that being more vigilant would require staying indoors entirely, even in our grey city.

After he walked out, one of the nurses asked if I’d like to see it.  Of course I did!

She handed me the mirror and “That’s big!” was the first thing I said.  Dr. B could have made a nice Harry Potter scar and it would have been the same length!  The nurses reassured me that it wouldn’t be that noticeable one day and they wrapped me up with a pressure bandage and went over the care instructions.

It wasn’t long before I was finished and had an appointment scheduled to remove my stitches in a week (tomorrow).  I was there about 5 hours, but it didn’t feel like it.  It really wasn’t as bad as I had anticipated.  And I am glad that I did it.

Or at least I was until the swelling began.  It began to appear on Day 3.  By that evening I was so swollen that even H thought I should call the surgeon’s office after hours.  When I did, they gave me a few instructions and scheduled me to come back to the hospital in the morning.

At the hospital I was told that the swelling was a result of an excessive amount of bleeding.  My surgeon said this was pretty unusual.  He seemed to feel that my “young” age and skin were partially to blame.  He said that it would get worse before it would get better and that it would soon look bruised (and give me a set of black eyes).  Lovely!

March 5, 2010

Sweet Mattie

 

*Though today is June 28, 2012 and it has been more than two years since I received my breast cancer diagnosis, I believe the early days of this story are important, so I will do my best to recount them based on my notes.  Welcome…and thank you for reading…*   

 

So, today is the anniversary of Mattie’s death.  Mattie was my miniature schnauzer, my first baby, my closest confidant.  She was 10 ¾ and was with me most of my adult life.  Through jobs, four homes, births, deaths and everything in between, she was by my side.

I came home a year ago today and she wasn’t quite acting like herself.  And when I went into the bathroom, she lay on my feet and looked up at me.  Her gums were white–a sign of blood loss.  Her breathing quickly became labored and everything went downhill from there.  The rest of the night was a nightmare.  I called the vet, scooped her up, and we rushed off to the veterinary emergency hospital.  Almost $700 and just a few short hours later, I would walk out of the hospital not with my vibrant and beautiful dog panting in my arms, but with a small cardboard casket containing the body of my special girl.

Unbeknownst to me, Mattie had cancer.  Hemangiosarcoma, to be exact.  Her spleen had ruptured and she was bleeding to death.  Our only options were to let her die or consent to a  surgery costing thousands of dollars in which they would attempt to stop the bleeding and save her life temporarily so she could undergo chemo.  Before discovering this last chemo detail, I quickly said yes to the surgery, even though I knew that paying for her surgery (they required instant payment) would mean we would lose our home.  I had to try to save her.  It was only after I called my mother and told her what was happening that she encouraged me to ask whether the surgery would even save her life and what this cancer diagnosis would mean for her.

It was after this conversation that I asked what Mattie’s prognosis was.  The news wasn’t good.  She had a large tumor in/on her spleen.  Once these malignancies rupture, it is very difficult to control the bleeding.  They told me that they probably wouldn’t be able to save her because she had lost so much blood, and that if they did, she would require hospitalization and chemotherapy, likely for the remainder of her life.  Even with those measures, she would only have a month, at best.  I was shocked and devastated.  Did I want them to attempt the surgery and bankrupt our family so that she might have a chance to survive and be put through terrible cancer treatments until she succumbed to the disease?  Or did I want to let her continue to bleed to death until she was gone that night?  Or did I want to euthanize her and end her pain?

It was one of the worst decisions I had ever faced.  Horrible options, no happy ending.  After questioning them repeatedly about her chances for survival and about her prognosis if, by some miracle, she made it through the surgery, I made a decision.  With a heavy heart, I told them that I would let them put her to sleep.  They brought her out to me.  She was clearly suffering.  She was too weak to lift her head or to bark, her favorite pastime.  I knew she didn’t have much time even if I didn’t choose to put her down.

They told me to say my goodbyes.  I told my little boys that Mattie was very sick.  They asked if she was going to die and I said, ‘yes’.  They were just 4 years old, but they knew that Cancer was bad, and they knew that when you were very sick, you could die. I was unclear as to what their understanding of death was at the time, but I thought it was important for them to be able to say goodbye to her.  I didn’t want them to look back one day and wonder why I hadn’t let them see the special family member they had spent their whole lives with before she died.  I also thought it was important for Mattie to hear their voices and know that they were there with her.

After lots of hugging and tears and “I love you’s”, I asked my husband to take the boys out so they wouldn’t be there for her last moments.  They had wrapped Mattie in blankets and said that she would likely urinate and defecate when she died, so I might want to position her accordingly.  Through tears I said that this was the last thing on my mind and I held her close so she could feel my warmth.  They injected the medications into her and I was filled with a sense of panic.  I told her how much I loved her and how I would always be with her and how sorry I was that I couldn’t have saved her from cancer or from death.  It was horrible.  I told her it was okay to go and that I didn’t want her to suffer anymore.  She went peacefully and I sat, shaking and sobbing.  I had tried desperately to hold it all in until she was gone so I wouldn’t scare her.  I was successful at waiting, but when I let the emotions go, it was overwhelming.

As I carried her cardboard casket into the house that night, I could barely make it through the door before I set it down and removed the lid.  I lay down next to the box on one of the two blankets she had been wrapped in when they euthanized her.  I stroked her soft white fur and told her how sorry I was and cried until I couldn’t cry any more.  I felt like a shell of the self I had been that morning.  I felt as though I had lost myself and that I’d never be whole again.  Even a year later, I still can’t believe she is gone.  Or that she died in such a sudden and unforgiving way.

I still remember that night with such pain and sadness and guilt.  It was not the first time I had lost I someone I loved desperately to cancer.  And I knew it wouldn’t be the last.  I hated the disease.  I hated cancer.

And, at 32 years old, I had it growing inside of me, too.  I just didn’t know it yet.*

[*And, to be fair, I still didn’t know it for sure on March 5, 2010]