It has been a bit of a roller coaster ride

It has been a bit of a roller coaster ride; but, our hopes are high. 

Yesterday was surgery day.  We started out the day with feelings of hope and apprehension.  Upon arriving at the hospital at 10:15 AM, we began with the typical check in, pre-op IV, blood draws, and etc.  By 2:00 PM Nannette was ready for surgery with pain meds in her system, an epidural type block (paravertebral block), a low level radioactive dye injected into her left breast to detect any lymph node invasion (investigated during surgery); and, discussions with the anesthesiologist about her uvula and pain control, and both surgeons about the procedures (single left mastectomy & preliminary breast reconstruction/expander placement). 

Within an hour, the great news that there has been no lymph node invasion!!!  What a relief!  We had been under the impression that this meant no chemotherapy would be necessary, with the exception of Tamoxifen (an oral, and less invasive form of chemo); however, when Dr. Neumayer completed her part of the surgery, we found out that until the pathologist can check the actual size of the tumor, and the "margins"/how far into the breast tissue the cancer has spread, we won't know whether chemo and/or radiation will be necessary.  Those findings won't be available for another week!  So, we are waiting again.  We also found out that there is no way to save the nipple; because, this surgery was so close to the breast lift, and the nipple hasn’t had the time to recover. 

After Dr. Neumayer completed the removal of the breast tissue; taking extra tissue to insure all of the margins were clear, Dr. Agarwal took over to place the expander behind the pectoral muscle, and start the preliminary breast reconstruction.  After 4 hours of surgery, they were done, and were pleased with the results.  By 8:00 PM we were into the VIP suite (how did we get so fortunate?), and settling in for the night.  A long, but successful day, at one of the best cancer centers around.  They have taken good care of our girl. 

 This morning has been a flurry of activity; with visits for nurses, residents/interns, and doctors.  Nannette is recovering well.  She has had the paraverteral block removed, the IV’s & monitors removed, and we are working on managing the pain.  If we are able to get the pain managed we can leave the hospital this evening.

We look forward to the pathology report; and whether chemo and/or radiation will be needed.  If chemo is required, they will start as soon as the surgical drains have been removed (2 – 3 weeks).  They will also start the expansion process; where they inject a saline solution into the expander, a little bit at a time until the pectoral muscle has been stretched enough to insert the permanent implant.  If radiation is also required, they will wait until the chemo is complete, and the expander has reached the desired volume; the implant would not be inserted until the radiation is done, and a portion of the latissimuss muscle is brought up to the breast area to bring a new blood source to the radiated area.  If radiation is all that is required, they will have to complete the expansion before the radiation can begin.    

We are very hopeful for good news, and appreciate all of the support, thought, and prayers.