What will surgery actually be like?

What will surgery actually be like?  What exactly do they do? 

For me the morning of surgery is going to start in the Nuclear Medicine department.  I am going to have a radioactive tracer injected near the suspicious areas found during my last MRI.  It will take 2 hours for this injection to go through my body and be ready to do its job. 

During this 2 hour wait I will get all prepped and ready for surgery including IV antibiotics, getting drawn on by both doctors, and consult with the anesthesiologist.  I'm fully prepared for this to be the longest 2 hours of my life.  I'm going to be hungry, nervous, super-emotional, and just an all round basket case.  I will take any suggestion you have on how to spend this time and get out all of my nervous energy.

When they tell me it's time, I will walk into the operating room.  I find that quite empowering.  No one is pushing me to do this, I'm walking there on my own two feet.  The anesthesiologist will work their magic and I will be out.  A breathing tube and catheter will be inserted because of the length of the surgery.

Dr. Colette will handle the first part of the operation.  She will make a 6-8 inch incision on my infra-mammary fold, meaning right under the breast where it will be conveniently hidden later.  She will scrape out all of the breast tissue and pass this tissue onto pathologists.  They will slice the tissue like a loaf of bread into manageable sections and further exam each section.  Dr. Colette will also perform a sentinel node biopsy on both sides at this time.  Using the nuclear injection that I had earlier in the day, she will find and remove the first one to three lymph nodes that my breast cells drain into. This part of the surgery will take about 4 hours.

Once all of the tissue is removed, Dr. J will begin his part of the surgery.  He will make an incision low on my pectoral muscle.  He will insert an implant behind the muscle.  He will use alloderm tissue matrix to create a pocket large enough of the implant to sit in because there really is not a lot of space behind the muscle as is. Alloderm is cadaver tissue that has had all of the cells removed out of it basically leaving behind just collagen framework that will be a patch of sorts for me.  My body will work over the following months to weave it self into the alloderm.  At 6 months post-op if you were to exam in original alloderm tissue,  it would be completely made up of my own cells and would be unrecognizable.

Dr. J's portion of the surgery will take about 3 hours as he works to perfect the position, size, and shape of the implant with my remaining skin.  Dr. J might be able to start his portion of the surgery early working on the side Dr. Colette has already finished while she continues working on the opposite side.  The total length of time is expected to be 5-7 hours.  He will insert 2 surgical drains and close up the original incisions Dr. Colette made.

At this point, my breathing tube will be removed and I will be moved to the recovery room.  The amount of time I have to spend here will be dependent upon how long it takes me to wake up probably between 1-2 hours.  The catheter will remain in place until I am able to walk on my own.

When I am somewhat coherent I will be moved into a general hospital room where I will stay for 1-2 days.  While in the hospital, I will learn how to handle my surgical drains and sleep a lot.  The drains will need to stay in until they are draining less than 30cc in 24 hour time period, probably 1-2 weeks.  Mitch and my mom plan on rotating staying with me at the hospital.  I will probably not be up for any guests.  I've read about women saying or doing things in the hospital that they have no recollection of later.  It could be something like insisting a guest brings me a Dairy Queen blizzard and then falling asleep mid-spoonful or major over-sharing of the new goods.  I think I'll be safe just assuming I won't invite any guests, including my kids. I know that I'll miss them, but it's probably for the best that they don't see me like this.

After 1-2 days, when I show that I have pain management under control, reasonable movement back, and all bodily functions back to normal, I will be discharged from the hospital.  I'll be home to sleep in my own bed (or recliner) and shuffle to my own bathroom.  I'll be able to see my kids and give them gentle hugs.  I'll be on the other side at this point.