ER Visit

I called the oncology fellow on call, and she told me to come to the ER and have them page her.  My son has a learner's permit to drive and I had him drive me there.  We were taken back to a large room with 4 different patients separated by curtains, all talking about outrageous topics.  I called my son's dad and asked him to come pick him up so he wouldn't have to listen to all the crazy talk.

It took a long time for me to be seen, because I had to be seen by the oncology fellow on call, who was busy in the main hospital.  After about 5 hours, the doctor came and did an ultrasound that confirmed that I had an infection.  She gave me a prescription for an oral antibiotic and said I seemed like a "good reporter" so they would trust me to come back the next day if it got worse.  She told me if it was worse I would probably be admitted and placed on IV antibiotics.

I had just enough time to get to the pharmacy to get the prescription filled before they closed.

Complications

The night before Thanksgiving, I started feeling a lot of pain in the sentinel node site, and it wasn't relieved by Advil or Aleve.  I was in Charlotte with my family, and I didn't want to interrupt Thanksgiving.  By the time I returned home on Friday night, it was worse.  On Saturday morning, I called an urgent care clinic. They said they couldn't see me because of my "history" and I would need to go to the ER.  I knew that was the absolute worst place for me to get care, but I really didn't have any choice.

Big Hair and Makeup

I knew I would lose my hair about 2 weeks after my first chemo, 

so I asked my sisters to all dress in 80's big hair and makeup for Thanksgiving.  

My sister Karen teased me up some 80s rooster hair - 

although I have to say, my hair was bigger than this in the 80s! 

Not only did they indulge me in 80s hair, we also sang 80s Karaoke!

Chemo, False Start 3

The drainage catheter met the criteria for being removed, so I went to the infusion chair to begin chemotherapy.  Two nurses tried and failed to insert an IV, so they sent for the IV Team.

As soon as I saw the nurse from the IV Team, I knew he was definitely going to get the IV inserted.  He was bald and wearing black scrubs and I could tell he had a military background and had seen it all.  He did an awesome job and they were able to start the infusion of fluids prior to chemo.  However, after that the nurse told me she couldn't get get "blood return" on the IV and would be unable to safely administer the chemo.

Meanwhile, they called for the nurse navigator to come and remove my drainage catheter.  She explained that I would have to have a port inserted in order to receive chemo.  She scheduled this for the following Tuesday.  Another nurse had asked me several weeks prior if I wanted a port, and I asked her, "Does anyone ever want a port?" She said it was easier and safer than administering chemo by IV and sometimes people appreciate the convenience.  In any case, now it's obligatory, not optional.  It's quite a lot to get psyched up for.

Because of the Thanksgiving holiday, they rescheduled my chemo for Friday, December 6, more than 2 weeks after the original start date. 

Chemo, False Start 2

This morning I was re-scheduled to begin chemotherapy.  However, the seroma had returned so they decided it would be best to insert a drainage catheter and postpone the chemotherapy until Tuesday.  Although this would only be a one week delay, it was agitating to think about dealing with a complication when I was still in the diagnostic stage and not yet in the treatment stage.

Having a drainage catheter is annoying because it has to be emptied and measured regularly, it has to be tied to a string around the waist for showering.  The nurse inserted it and removed 220cc.  She said it would remain until I removed no more than 30cc in a 24 hour period.

Chemo, False Start

I was scheduled to start chemotherapy today, but during the last week the swelling in the area of the sentinel node surgery increased to a golf ball size "seroma" (fluid pocket that sometimes develops after surgery).  They decided to drain the seroma and postpone my chemo to Friday, November 22. The nurse removed 220cc of fluid, which is...a lot.

ER Consult

By the weekend I was experiencing some swelling, numbness and general discomfort (not pain) in the area of the sentinel node surgery.  I hadn't been given any information about normal consequences of this surgery, so I was pretty alarmed by this.  After the surgery I was only given a checklist of signs of infection.

I called the on-call oncology resident and described the situation and she convinced me come to the ER and let her look at it.  She took me into a consult room rather than having me check into the ER.  I had my first emotional reaction to the whole situation, and I explained that this was the first time I started thinking about things that could go wrong.  She had a medical student with her and I told him it was a very good experience for him to see the emotional side of things!  The resident told me that my surgeon is "brilliant," that everything looked fine, and it was normal to have some swelling.

I left there feeling reassured but a little annoyed that I hadn't had enough information to know it was normal.  I really hadn't wanted to do a lot of research because there's a lot of alarming information on the internet.  However, when I got home I spent some time looking for info and found this very helpful document about sentinel node surgery from the UK's healthcare system, which included some recommended exercises.

Sentinel Node Surgery

My sister Karen drove me to the UNC Ambulatory Care Center at 6:00 for the surgery to remove the first 3 sentinel lymph nodes on the my left side.  The assisting nurse told me Dr. Ollila had been her surgeon and that he is "brilliant" and "a wonderful family man."  This gave me a lot of confidence, especially because it was the very first time I had ever been fully sedated for general surgery in my life.  The surgery went fine and Karen took good care of me at home until she was confident I was okay.

Pre-Care

In retrospect, pre-care did not explain much to me about what to expect from sentinel node surgery. The nurse took my vital signs and said, "You have low blood pressure for an old gal!" (I think the term for this is backhanded compliment.) She seemed to be the same age as me and considerably out of shape, so presumably her blood pressure is higher than mine. ;)  She asked me what I do at UNC and when I explained that I am a speech-language pathologist, she asked me for advice about her "artistic" (i.e., autistic) grandchild. We discussed this for a while and then she told me not to eat or drink anything after midnight.