Thursday, October 27, 2022

Breast Cancer Fight: Mastectomy and Breast Implant Reconstruction Surgeries Part 1

After about 2 months of tests and doctor appointments, my breast cancer treatment finally started with the mastectomy and breast reconstruction surgeries on Thu 27 Oct 2022.

The day before, I received a call from NUH about 2.30pm to inform me about the reporting time and venue, and the time to start fasting. NUH will provide the hospital attire and toiletries, and obviously food during my stay, so I didn't really need to pack anything else other than my going-home clothes and other stuff that I wanted for my own comfort.

I packed like I was going for a short 3D2N staycation hahaha and brought a set of pjs to go home, a fleece hoodie, 2x front zip bras, 2x underwear, 3x socks {because I know it's so cold in the hospital and I like to sleep with socks on}, my own toiletries and moisturisers, an iPad, my chargers, the small bag I bought to put my drainage bottle, my test reports, plus extra snacks like chocolate, protein bars and nuts to the hospital in case I was hungry between meals.

As I had to fast before 6am, I woke up about 5.40am to have a light breakfast. I wasn't hungry but thought I should have something in case my surgery was delayed past the estimated time of 1pm.

The nurse who called told me that for fasting I wasn't supposed to eat or drink anything, even water. For breakfast I could have 2 slices of plain white bread and just black coffee or tea,  no milk or any dairy. We didn't have any bread at home, so I just had a packet of plain Meiji biscuits and about 3 big cups of water.

Throughout the morning I just rinsed my mouth with water if it felt dry, without swallowing. 

Was still feeling a bit sleepy but Lil Pumpkin still had classes so about 6.30am we left home to send her to school then go to the hospital while I slept in the car. Woke up and didn't have anything to do {couldn't go eat breakfast anyway} so went to register early at 8.30am at Ward 2A, Kent Ridge Wing even though I had to report only at 9.30am.

Only had to wait a minute or two before I was called and registration was a breeze. Good thing our insurance agent gave us the Letter of Guarantee and the boy printed a hard copy to bring along, even though one of the nurses said it was not needed if they were going to e-file the cost of my surgeries and hospital stay, as the staff asked for it during registration.

note: a Letter of Guarantee is a letter from your company/ insurer to the hospital stating the amount the company/ insurer is paying for the patient, co-payment required from patient {if any} and other terms and conditions. The hospital will then bill your company/ insurer accordingly. They will need to know the estimated cost from the hospital before they can give this.

I cannot stress how important it is to have good medical insurance, even in times of good health. Really appreciate the boy for his forward-thinking and planning to get the whole family covered early on. Up to surgery day, I think I've already spent about S$4-5k just on tests and doctor appointments. My surgeries and hospital stay is estimated to be maybe S$25k and chemotherapy around S$1.5k per cycle... not including all the additional doc appointments and tests after the surgeries. Of course, insurance won't cover everything but it will cover a bulk of my medical expenses. We still have to pay upfront most of the time though.  

Still had to wait until about 9.30am before I was called into the Pre-Operation Waiting Area, but a few more patients came that time to register as well so at least I didn't have to queue for registration.

A nurse came to verify my identity and confirm my surgery details before I changed into the hospital gown and robe to go to Diagnostic Imaging @ MB1 to inject some radioactive substance into me before the operation. 

They insisted I sit on a wheelchair to be wheeled around wherever I went hehe. 

At Diagnostic Imaging @ MB1, it was really crowded. I sat in the wheelchair to wait a while then a Dr Ong came to talk to me to explain that during my surgery, Dr Mikael will perform a sentinal lymph node dissection and remove the first few lymph nodes under my arm to figure out the extent of cancer involvement. The dye injection I'm about to receive will help him to locate the sentinal lymph node. Once he removes the sentinel node and those closest to it, a pathologist will examine them for signs of cancer and the results can be out during the whole mastectomy procedure. 

The idea behind sentinel node dissection is that instead of removing 10 or more lymph nodes and analysing all of them to look for cancer, remove only the one node that is most likely to have it. If this node is clean, chances are the other nodes have not been affected and do not need to be removed. 

Cancer in the lymph nodes is associated with an increased risk of having cancer cells in the other parts of the body. Our lymph nodes act as filters for the body's lymphatic drainage system. That's why the lymph nodes are likely to "catch" or filter out cancer cells that might be floating in the fluid that drains away from the cancerous area of the breast. 

Sentinel lymph node dissection is a good option for people with early-stage, invasive breast cancer who have a low to moderate risk of lymph node involvement. 

The dye injection for the sentinel node dissection procedure was the more painful than usual, as Dr Ong warned me, even though they use a needle smaller than the usual injection needle because it was at a sensitive area near the nipple. 

It was over in a jiffy then I had to wait about 20 mins for a porter before being wheeled back to Ward 2A. Then, waited about 40 mins before I asked a nurse there what I was waiting for. She checked then said that I was supposed to go to for the dye injection around 11.30am but since I had already done it, now I just had to wait to be called for my operation.

She verified my identity, checked my vitals, explained what I could wear/bring during the surgery {basically nothing, although she let me wear my own socks}, and that the boy could expect a call when I woke up after surgery and be told where my ward room was to meet me. The nurse said the whole operation would take about 4.5hrs and after I wake up, I would be under observation for an hour before I was taken to the ward. 

Then, she let me out to the public waiting area at Ward 2A to wait with the boy. Poor thing he came with me and was lugging my little luggage around while I went to all the different areas. Next time if I ever have to do this all over again *touch wood*, I'd only bring the luggage in after the surgeries as my ward room won't be ready until then and the hospital won't keep your belongings for you pre-surgery while you wait. 

About 12.05pm I was called into the patients waiting area for Dr Jane to make some markings on my left breast and underarm for the surgeries. Then I went out again to the public waiting area, before being called in again around 12.45pm for my surgeries.... finally. 

They verified my identity and confirmed my surgeries with me again before I sat on the wheelchair to go the my operating theatre in the Main Building.

At the operating theatre waiting area, two of Dr Mikael's students came to ask if they could examine and ask me some questions for their learning purposes before the surgery. I was already feeling quite nervous and anxious then so I just wanted to pray, calm my mind and just do what was necessary so I politely declined and said they could come after the surgery if they wanted. 

The anesthetics doctor during my operation, Dr Aileen Tan, came to verify my identity and confirm my surgeries with me, yet again. She was very jovial and friendly. Dr Tan then went through what was going to happen while I was under general anesthetics, and the discomfort/ pain or vomiting I might get when I woke up. I told her that I got really bad vomiting from using morphine last time for my scoliosis operations and she said it's ok, she can use another cocktail of medicine to try and prevent that. She tried to calm my nerves and I told her... "please don't let me not wake up" haha

After that a doctor from Dr Mikael's team came to check that I had my body markings then said I was good to go. 

Going into the operating theatre, Dr Aileen got me ready to go under GA and Dr Jane came in to check on me. Still did not see Dr Mikael yet but it's ok. The OT bed was very narrow but nice and warm. 

I saw the clock and think it was about 1.30pm... soon enough, I drifted of to sleep.

Everything in God's mighty hands now

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Before mastectomy and breast reconstruction surgeries

After mastectomy and breast reconstruction surgeries

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