So by 11 a.m. I staggered back into the house after today’s adventure in the Mayo’s high-powered operating arena. The scheduled surgery did not happen, a conflict of opinion among the distinguished doctors did happen, and I enjoyed a painful but interesting procedure to scour out the inside of my boob.
Here’s what happened.
Bright & early today, we (i.e., me and wonder-surgeon Dr. P, who despite my endless complaints does have a sterling national reputation) had scheduled the third attempt to excise enough boob tissue to obtain clear margins on an encapsulated papillary carcinoma which has proven to be significantly larger than indicated by repeated mammography and ultrasound. Assuming the pathology reports continue to show no sign of invasive cancer, the next surgery, if this fails again, will be a simple mastectomy.
Meanwhile, though, after the last surgery, I developed what appeared to be an infection: redness, heat, swelling, pain. Two (much lesser!) doctors diagnosed this as an infection, but Dr. P felt it was a large hematoma that had filled the surgical cavity. Nevertheless, I’ve been on cephalexin since the 4th, with apparent improvement.
Okay, come 6 a.m. we’re on track to try again. However….
On Thursday I started to come down with a cold. By Friday it felt like someone had stuck a blowtorch down my throat, and I was running a fever ranging from 99.5 to 100 degrees (“normal” for me is about 98.4, so that’s pretty high). Saturday the sore throat cleared, leaving a congested cough and a lot of post-nasal drip (unclear whether the cough proceeds from the chest, or is only a response to the throat irritation from the little nasal waterfall, but it’s probably the latter). Sunday the fever drops into the more or less normal range — 98.4 to 99, up and down). It’s worth knowing that before the virus came along, the temp would spike off and on to 99.5; Dr. P said that was consistent with a surgical hematoma in the breast.
Today I show up to be prepped and of course tell them about this new development..
Nursing staff and her resident believe the procecdure, which requires me to be knocked out with anaesthesia, will be canceled. Dr. P begs to differ. She says we should go ahead and orders her staff to Make It So.
Now one Dr. M, a gray-bearded anaesthesiologist who looks fully senior and wise as the ages, appears on the scene and asks if I’ve had a fever. I tell him about the 100-degree spikes on Friday and Saturday. He thinks about this for approximately three seconds and then says, “It would be foolish to proceed.”
I personally do not argue, because that’s my own private opinion, which as everyone knows is infallible.
Dr. P resurfaces, and she is peeved. She disagrees, but since the man is simply not going to do it, she’s now stymied. She reschedules the excision attempt, but while I’m there she hauls me into the OR to clean out the boob under a local. When she opens the thing up to suction out the fluids, she finds no pus or other indication of infection — just a lot of old, stale blood. She expresses her satisfaction that her diagnosis is now proven correct: not an infection. I think, uh huh… after I’ve been swallowing cephalexin 4x a day for the past week or ten days, and the red areas that concerned the other two docs have receded to the point of disappearance. On the other hand, the incision split open on Thursday; the hematoma has been quietly draining since then, and that also could account for the apparent improvement.
She administered an IV antibiotic, suctioned and cleaned with élan, treated the wound directly with antibiotic, and closed with antibiotic-laced sutures.
The procedure was pretty painful despite liberal amounts of Lidocaine. At one point my blood pressure, which is usually in the 130s/80, went up to 297/120. It dropped fairly quickly into the 150s, which itself is unacceptable but at least not a sign of an impending stroke. The nurse said pain often causes BP to go through the roof. Hope that’s all it is…but now to add to my joy I’ve got to go back to measuring my GD blood pressure twice a day, a pain in the tuchus and yet another source of daily worry.
Temp is 99.6, not good. The cough is nastier than it was this morning. But after an oxycodone and an afternoon of sleep (interrupted by only two phone calls…), the pain is receding some and the swelling is to a large extent reduced, though there’s still some hard stuff in there that feels like the hematoma…I’m afraid it’s probably still bleeding inside.
Given that the cough is now worse and I’m gagging up stuff that’s choking me, I’m glad the anaesthesiologist brought a stop to the craziness. But it means I’ve STILL got two procedures to endure, at the very least. And what do you bet something else comes up to require another one?
We should get a blog pool going on here… How many more fun procedures before this comes to an end? Cast your bets, ladies and gentlemen!
