Sunday, January 2, 2011

Not All Surgeons or Hospitals Are Equally Created

My positive word came to me in the middle of the night when I was mostly half asleep.  But still, I was aware that the dreamy message in song was meant for me.  Where had I heard this before?  The words were so perfect.  Over and over they rolled through my fuzzy brain.  I was so glad because I knew that I'd wake up this morning and remember.  I'd have my perfect mantra to get me through the day.  Only I didn't remember.  I couldn't.  I only remembered that the words were from a song from the part of Mary Magdalene in Jesus Christ Superstar.  Dwain tentatively suggested the title, I Don't Know How To Love Him.  No.  That was not it.  Good try though.

Thankfully, Dwain has the Jesus Christ Superstar Rock Opera by Andrew Lloyd Webber & Tim Rice box set from 1970, which includes the songbook with all the words of the entire cast.  He dug it out and found exactly the words I was looking for --

Mary Magdalene
Try not to get worried, try not to turn on to
Problems that upset you oh don't you know
Everything's alright yes everything's fine
And we want you to sleep well tonight
Let the world turn without you tonight
If we try we'll get by so forget all about us tonight

So my positive words for today: ... Everything's alright, yes everything's fine.  But I mean, how perfect and how strange that those exact words, ... And we want you to sleep well tonight, Let the world turn without you tonight...  would come to me as if in a dream.  And I did sleep well and sound. 

Now on to the subject of my post for today, surgeons and hospitals. 

This past Thursday I was hospitalized in our local hospital for an outpatient procedure to have a port installed.  You can read about this (click here) if you missed it. 

What is Chemotherapy Port?
A chemotherapy port is a relatively simple and painless way to deliver chemotherapy drugs into the body. Chemotherapy is a medical treatment for cancer, which can have many harsh side effects. A chemotherapy port can be a more comfortable way of administering chemotherapy and also prove safer for the patient’s overall health.

This is not a picture of me, but an image I captured off the world-wide web that accurately depicts what a chemo port looks like right after it's been surgically implanted.  I've already removed the surgical tape that covered mine.  But oh wow, is it ever sore and bruised. 

Like I said in my post about my most recent surgery, it felt rushed and hurried and not very personal.  Let me delve even deeper.

My double mastectomy was scheduled after a long and deep consultation with my breast surgeon/oncologist Dr. Dana Abraham at the Abraham Breast Clinic in Little Rock, who could not have been more compassionate and caring, as was her entire staff.   She told Dwain and me that our consultation about what came next would take time.  In fact, it took about an hour.  Dr. Abraham had done my lumpectomy about a week prior and was prepared to give us all our options.  She went over each option step by step and the consequences involved, including breast reconstruction. She could put us in touch with a plastic surgeon, if we wanted.  Believe me, breast reconstruction for a mastectomy patient is not like getting a Hollywood boob job.  It is a very painful, painful process that takes about a year to complete.  Dr. Abraham said that the pain level for a double mastectomy would be about 2 to 3 on a level of 1-10.  If I had opted to have breast reconstruction after mastectomy she said it would have been about 8 out of 10.  Our heads were swimming.  Dwain finally asked her what she would do if it were her.  She simply said, I have a special needs child.  I have to live as long as possible for her sake.  So if I were in your shoes, I would have a mastectomy, which would offer me the best chance for a long life.  She said the only thing she would do differently is she would have to have breast reconstruction because of her husband.  She smiled weakly.  You should have seen the look on Dwain's blazing face.  I thought his eyes were going to pop right of his sockets.  He blurted out, NOOOO!  I knew immediately that WE had already opted NOT to have breast reconstruction.  The State of Arkansas has a law that says a mastectomy patient can make that decision at any point, even 10 years later if they want.  But I guarantee you, that will never be an option for me.  But the decision to have a double mastectomy was a total thumb's up.  Why a double mastectomy? Because it was only a matter time for the left neighbor breast, the one with the atypical cells swimming around in there.  We did it as a matter of prevention.  Believe me, I don't want to go through this twice.  Dr. Abraham told her scheduling clerk what we wanted to do, and to schedule it for November 22, 2010 for 10 a.m.  She knew we had a three hour drive, so she put us as late in the morning as she could. 

That's Dr. Abraham, front and center. Her loyal staff surrounds her constantly, and they are as calm and nice and helpful and available as can be.  Isn't that what you want to see when you are scared to death? 

This is a picture of the entrance to the Arkansas Surgical Hospital in North Little Rock, where both my lumpectomy and double mastectomy were performed.  I was informed up front that Dr. Abraham is a part owner in this hospital.

This is a picture Dwain took of me just prior to surgery.  I was saying, Go Go Go MEEEE!  And I wasn't even high on anything

The nurses treated me like I was the only patient.  Was I warm enough?  They had a machine that gently blew warm air under the covers.  Hospitals, I found, are always freezing cold because they want to discourage the growth of germs.  How about that?  My vital stats were monitored constantly. How was I?  How was I?  How was I?   But one random question took me completely off guard.  In fact, I thought it was a joke;  Does your husband mistreat you or beat you?  I said, no, but my cat does.   The questioner did not seem in the least amused.  I mean, I thought the guy was kidding.  By the way, he did not ask this question in front of Dwain.  He asked a whole series of questions before Dwain was allowed in pre-op. I wonder if they ask the same questions if the patient is a man?

Here is where surgeons part ways, I guess.  Both times I was at Arkansas Surgical Hospital, Dr. Abraham came into the pre-op area to check on me.  She smiled reassuringly and told me everything would be okay.  She asked if we had any questions. She told me that my pain would be managed.  She even initialed my boobs with a Sharpie. 

My port surgeon on Thursday did not bother to come in to see me pre-op and say diddly squat.  I mean, I honestly felt that he should have.  It wasn't a life or death thing, but surgery is surgery.  He could have come in and said something.  A smile and a nod would have helped a little.  I never saw him once.  The only way I know he actually performed the surgery is that he came out and talked to Dwain afterward. 

Dwain's friend, Jeanne, who is a surgical nurse at UAMS in Little Rock said this is called the ET finger.  

Dwain said it was the only thing I was hooked up to when I was wheeled into my patient room after the double mastectomy -- no IV, no nothing.  All I remember is when I woke up in recovery I was in pain like you would not believe.  Someone said, how bad do you hurt?  Bad, I said.  Really bad.  She did something, then said, how's this.  The pain was letting up but still I could feel it.  She did something else.  How's that?  Suddenly, I felt no pain at all.  In fact, I felt all warm and deeply comforted, like being enfolded in a blanket.  The next thing I knew, Dwain was whispering something in my ear.  What?  I have no idea.  But I knew it was him, and that's all that mattered. 
Before surgery, he had given me a strong whiff of his cologne. He said I would recognize him by that smell.

He must have said "smile" and I reacted because I had no idea that Dwain had taken any pictures of me at all, post surgery.  I told him this is my happy morphine face. He said that between naps I said some of the funniest things he'd ever heard.  Well, at least I'm a happy drunk, right? 

All I can said is, Dr. Abraham has never lied to me.  She told me the truth from day one.  And she never, ever hurt me, unless you include the time she told me, you have to stop taking my bio-identical hormone replacement therapy.  How long? I said.  Forever, she replied.  You can never take them again.  You have estrogen receptive cancer.  She gave me one month to taper off my hormones.  She said, you have till the end of November to be completely rid of them. I'm the mean, bad doctor, but I'm here to save your life

So many life-changing circumstances in such a short period of time.  Dwain and I have learned not to say, what next?  But we  have also learned, choose your doctor, your surgeon and your hospital very, very carefully.  Any other major surgeries to come down the pike will not be rocket science for this family -- we know where we're going, even if it is a three-hour drive south. 
We really shouldn't have to tell doctors or nurses what we expect.


  1. That mantra is beautiful perfection. How amazing is it that when we ask for something we really need, it is provided? Ask, and ye shall receive.

  2. Those are perfect words to use as a mantra...My Mother's favorite song while going through Chemo was "One Day At A Time Sweet Jesus". She sang it all the time. Your Dwain is the sweetest man are so lucky to have him.