The 5-Hour Blink

For this post, the part of Rosanna will be played by her husband who tends to be a little verbose (consider yourself warned).  Rosanna asked me to write a post about the events of her surgery day since I was awake for or have much clearer memories of those events.  Hopefully I can help describe what the surgery day is like from the side of the loved ones who will be waiting at the hospital when someone has to go through this surgery.

We arrived at the hospital about 11:30, and Rosanna's godparents and two nun family friends were already there waiting for us.  Gotta love big catholic families who all seem to have at least one priest or nun as an old friend. We briefly said hi and then went to the check-in person.  He was nice and even a little bubbly as he handed us our "buzzer" to wait for registration.  Yes, this buzzer is the same one you'd get a restaurant to let you know your table is ready.  After about 10 minutes of visiting, our buzzer went off necessitating a joke with the check-in guy about our table being ready.  He quickly ushered us to the registration lady to sign a few papers and then it was time for Rosanna to get prepped downstairs (~11:45).  One of the hospital staff was to escort her to prep room after some frantic jewelry hand-offs to me for safe keeping.  All I was told at this point is that she would be able to have pre-surgery visitors in about 45 minutes but only one at a time, and the surgeons and anesthesiologist would also come by during that time.  By this point, 4 more members of Rosanna's well-wishing entourage had arrived but did not get to see her before she was escorted off.

The point when Rosanna was escorted off was the moment that this surgery finally felt real.  Up till now, it was just something we talked about but not anything to really worry about as she had great surgeons and the rate of complications was so low.  I had reiterated these things to Rosanna and worried family members many times now, but now I was saying them to myself.  I also started feeling selfish knowing that she only had so much time before her surgery and it had to be rationed out among each of us there.  Thankfully, this feeling quickly faded (or at least I suppressed it) as I greeted and talked with the now 10-person entourage.  The 45 minutes of prep time before visitors quickly became an hour, and we finally got the call that visits could start just before 1pm.  Rosanna's sister L was the first to go down, followed by 2 friends, dad, mom, sister G, and finally me.  My feelings of selfishness came back during this, as I had no idea how long we had.  Turns out we had quite some time, as none of the surgeons had even stopped by when I went down a bit before 2pm.

Rosanna was in great spirits when I got to the pre-surgery room.  This did not surprise me much since several in her entourage had commented on how jovial and light-hearted she seemed, and just about every nurse or doctor that came in also commented on this.  Her demeanor may or may not have been aided by a bit of anti-anxiety medication, but it was good to see her in these spirits regardless.  Shortly after I arrived, the doctors and surgeons started to show up.  The anesthesiologist was the first to drop in, but he stayed for maybe 30 seconds and showed no personality at all.  Next was the breast surgeon who I was excited to finally meet.  She was nice, but had a matter-of-fact and confident tone that must come with the years of surgeries she's done.  She and Rosanna briefly discussed some detail on the surgery, the most interesting of which to me was the machine they would use to measure blood flow to the nipple, determining whether each could be saved.  Other than this and Rosanna expressing her desire for not catheter, the breast surgeon drew two arrows on Rosanna's upper chest, one pointing down to each breast, to indicate that this was to be a double mastectomy.  A nurse came in shortly after and asked Rosanna all the basic details again (no allergies, no she doesn't smoke, etc).  Despite having to ask all the boring questions, he was sociable and we talked about many random things with him, and some not so random such as Rosanna's desire not to have a catheter (a recurring theme at this point).  The last surgeon to come in was the plastic surgeon, who I also was very excited to meet.  He was confident but warm and friendly, smiling nearly the entire time he talked with us.  He gave us some assessments about the length of the surgery, saying it should be fairly quick and they might even be done by 5pm.  Aside from surgery discussion and an amusing conversation about what kind of car he drove, he drew more lines on Rosanna's breasts indicating the edge of the breasts, the incision point, and the alternate incision point if the nipples could not be saved.  After one more quick chat with the nurse and giving them my cell phone number, Rosanna was taken into the OR at 2:30.

With Rosanna going into the OR, there wasn't much for the rest of us to do other than wait.  The entourage broke up at this point, with various people going to work, errands, etc.  Rosanna's mom, sister L, and I went to get lunch.  L and I were hungry for pizza after seeing people carrying several pizza boxes into the hospital.  I let the hospital lobby staff know I'd be leaving as instructed, and I left on my name tag with the number 10 that I had received earlier.  Lunch was relaxing and we didn't talk too much about the surgery.  Rosanna's mom I know was worrying and praying, but she isn't the type to voice that much.  I can only imagine what was going through L's mind due to her first-hand experience with this surgery.  I was of course worrying too but my confidence that the surgery was going to go great had returned.  We returned to the hospital around 3:30, I checked back in with the hospital staff, and then we continued waiting and talking.  The time went faster than I expected it to, and it was 4:30 before I knew it.  I began watching the clock more closely and making sure I had my phone on hand to get the update call from the OR.  4:45 and 5pm passed with still no call.  My worry index was starting to creep up slowly from about 4 up to a 7.  Thankfully conversation with L & G kept me somewhat distracted, and I was also fielding texts sent to both my phone and Rosanna's phone asking for updates.  I finally got the call at 5:20.  The nurse (sounded like the one I had met earlier) said everything was going well and that they finished up one breast and were beginning to start on the second.  Hearing the nurse say everything was going well, the first update at all since she went in, was so wonderful to hear and dropped my worry index down to a 2.  Clearly the surgery duration the plastic surgeon gave us was way too short, and I recalibrated my estimates for when I'd hear the next update accordingly.  I also had a new task as hand which was to send out the first mass text update to a list Rosanna had set up on her phone.

The rest of the wait went reasonably quick as well.  Having Rosanna's sisters and parents to talk to made the next hour or so pass easily.  The next call I got was at 6:05.  I was surprised to hear anything more so early, and when I answered the phone it was a nurse asking whether Rosanna had brought a bra to wear post-surgery.  I knew that she had her planned post-surgery sports bra in one of the bags I was in charge of and told the nurse as such.  I got a good laugh (and odd looks from L & G) out of the conversation because the male nurse was trying to be overly discrete about getting the bra from me, to the point of asking for an alternate location other than the lobby for me to give him the bra.  Made for a fun conversation topic for the next few minutes.  At around 6:45, the hospital staff said that 2 of us could go into a room downstairs to talk to the surgeon.  Kaiser is clearly a little too anal about how many people they let go various places.  As Rosanna's parents were visiting with another friend whose wife was in the hospital as well, L and I went down to the room.  The breast surgeon came in and plopped down in one of the chairs in a way that made the think of an exhausted teenage.  She told us that everything went great, no complications at all.  She didn't have much to say other than that before she asked us if we had any question.  I immediately asked about the nipples and she responded that the blood flow was good and they were able to keep them.  We asked a few other questions about the surgery and recovery, for which it was great to have L's experience there, but overall it was a short meeting.  L had to leave after that to take her babysitter home, with G & Rosanna's mom swapping in before the plastic surgeon met with us.  He seemed very much like he did before the surgery, albeit a little more exhausted as well.  He reiterated that the surgery went great and that Rosanna was coming out of anesthesia as we spoke.  We asked him some questions as well, mostly about the recovery time frame.  He told us that she would likely have the drainage tubes in 2 weeks (though she'd have a follow-up appointment after 1 week) and then would start weekly saline injections into the expanders the following week assuming the incision was healed up.  He also told us about the surgery to replace the expanders with real implants which he described as outpatient procedure that only requires a few days of at-home recovery.  One of the other interesting things he said when G asked about post-surgery meds was that Rosanna would not be given antibiotics.  Instead, the most important antibiotic dose was done prior to the start of the surgery so that the antibiotics could get into blood clots and other bacteria-growing areas before they formed (as they don't really penetrate in afterwards).

Following the consults, we got to wait in the lobby until about 7:30 when we were called down to the post-surgery room.  L and I went and finally got to see Rosanna.  My first impression was that she looked good but very tired, similar to if she was being woken up after just 2 hours of sleep.  She was still very weak and seemed not fully aware of her surroundings (though that may have just been my impression as I tried to hold her hand).  Her voice was very soft and hoarse from the breathing tube, and her body was clammy and sweaty, likely a result of her pulse going at a steady 120 beats per minute.  While she was happy to see us, she seemed most interested in getting some ice chips and anyone fanning her with any papers available.  The nurse watching over her seemed somewhat oblivious, being more interested in giving me two note cards with serial numbers for the expanders though having no idea what I was supposed to do with them or no realization that they would only be in Rosanna for a few months.  Eventually L swapped out with Rosanna’s mom, and we took turns fanning her off and feeding her the ice chips.  I could tell that her anxiety level was up too, but wasn’t sure if it was the cause or effect of her elevated heart rate, and she didn’t seem to notice my gentle attempts to her to focus on talking to us and not on her vitals.  She began to come around once she had gotten half a cup of ice chips in her, and her voice was improving steadily as well.  After 20-30 minutes in this room, another nurse came to take her to her room.  I met up with the rest of the family and we went upstairs to await her arrival.

Once she got in her room, she was very alert and aware, but still with heightened anxiety.  Her pulse was likely high as well, but there were no machines tracking her vitals so I don’t know for sure.  She told the first nurse that came in about the anxiety and it wasn’t long before the nurse came back with IV injections of Dilaudid, Xanax, and an anti-nausea medication.  I was quite pleased for this quick response, and I know Rosanna was too when she began to visibly relax a few minutes later.  During this time, I brought two groups of her entourage into the room to quickly say hi before the visiting hours ended at 8:30pm.  I was happy that everyone knew that they couldn’t all flood her room at once and split themselves up into the two groups; it made it much easier for me as I was definitely winging it with organizing the visiting.   Knowing that I would be staying the night, I just stepped out of the way while everyone else visited.  Special thanks to Rosanna’s friend B for bringing me dinner when she came in.

When everyone left for the night just before 9pm, I finally got to talk to Rosanna one on one.  She told me about her experience through the surgery, especially how it didn’t feel at all like she was out for several hours, rather just like she blinked and nodded off for a second.  She talked to me more about how she felt when we first saw her in the post-surgery room, and we hypothesized that she might have had some adverse reaction to the anesthesia.  I told her all the day’s events and what the surgeons said about how the surgery went.  Some of the information the plastic surgeon had told me about the schedule of expander injections and drainage tube removal was actually new to her as well.  While she was very coherent and conversant during this time, she later didn’t remember large parts of our conversation before 10pm, likely due to either the anesthesia or pain medications.  After another nurses visit from the night staff, me finally eating dinner, and Rosanna playing with her phone, we started to settle in for the night.  Not much eventful during the evening, but I was so glad I stayed for the night (despite getting woken up every 2 hours) because Rosanna had no working method for calling the nurse.  This was especially critical when she had to go to the bathroom and get more pain medication.  The first few times going to the bathroom during the night, Rosanna was still quite weak and needed help from the nurse just to get up and especially to get all the IVs moving with her.  As much as I wanted to help, I just tried to stay out of the way and let the nurse do her job.  As for the pain medication, only the first dosage was of the Dilaudid.  After that, she was given Vicoden orally.  Her appetite also started to come back during the night, and thankfully we had some cookies on hand that B’s mom had made to satiate it.

I’m sure there are other details I’m leaving out, but that is my story of the day of the surgery.  To conclude, I wanted to say that I am so fortunate that Rosanna has had the opportunities and care she has and that she has been recovering so well so quickly.  For anyone reading this that is going through the same situation, I pray that you have similar opportunities and care available and that your recovery goes quickly and easily.