Surgery

Karen is out of surgery. Although the doctor expected it could take up to 2 hrs., the doctor calls me in the waiting area after just an hour. The outcome is encouraging. The lump was relatively small, about 1.5cm, which is what they estimated. More importantly, the tumor was not attached to the chest muscle. Very good news. They also removed four "sentinel" lymph nodes from under her armpit. The sentinel nodes are the primary nodes that collect fluid that drains from the breast. If the cancer has spread to lymph nodes, it will show up in these nodes first. A biopsy of the lymph nodes will be performed and results will come back in about a week. If cancer has spread to any of these nodes, the doctor will need to perform an additional surgery to remove more nodes. A pathologist will also look at the tissue that was removed with the tumor to make sure that they have "clean margins" all around the tumor. This means that the outer edges of the tissue that was removed must be clear of cancer. If there are cancer cells on the outer edge, the doctor will have to reopen the incision and remove more tissue until she is sure that she has all of the cancerous tissue. So, the possibility of more surgery in the next couple weeks remains. For now, we wait.

Though the surgery itself went well, Karen had a nasty reaction to the tracer dye used to locate the lymph nodes. Only 0.2% of patients have an adverse reaction to the dye. Guess who was in that 0.2%? When I came back to the recovery room to be with Karen she looked like she just ate a Volcano Double Burrito from Taco Bell. She was red...or maybe, orange. Or maybe red like a fire truck. More red than me...and I'm pretty red. And covered from head-to-toe with hives...big welts. She was a mess. (So much for that mini-facial exfoliation moisturizer thing she did this morning). They tried Benadryl, Hydrocortizone and a bunch of other drugs, including morphine. Nothing seemed to work. But, in time -- over 3 hrs -- it did start to improve. The redness slowly faded, but the hives were still driving her crazy. Exhausted and the last patient in the recovery room, she was wheeled to her hospital room at 8:30 p.m. What they expected to be an outpatient procedure ended up as an overnight in the hospital.