Monday, October 26, 2009

The Hospitalization - Sentinal Node Biopsy

I admit to a bit of apprehension about this part of my medical testing.   I'd heard from others who had been through it that it could be extremely painful.

But then again, most people found the biopsies painful too, and I hadn't, so I kept that in the back of my mind as I was wheeled down to Nuclear Imaging.

A word to hospitals:  You really need to do something about your ceilings.  I think you need to lie the head of Maintenance and Operations on one of those gurneys and wheel him around the hospital so he can view the ceiling tiles from the same position we patients do.  Honestly, if you wouldn't put up with those cracks and stains in your house, why should you put up with it in your workplace?

Do you know what we patients imagine that those stains are?  Hmmmm??  Take care of that please.

Anyway, I got down to Nuclear Imaging.  After answering my name, birthdate and what kind of surgery I was having, the procedure was explained to me.  They will inject my cancerous breast with radioactive isotopes, and then for the next hour I will lie under a camera, which will take photos of the isotopes' path through the breast/lymph system.  The first place the radioactive goop will settle are called the "sentinal nodes."  That area will be marked so the surgeon knows which nodes these are, and those will be removed during my surgery and biopsied right away to find any cancer cells lurking within.  If the answer is no cancer, I'm done.  If yes, then they go in and take more through an axillary dissection to see how much spread there is.  The axillary dissection often leads to a difficult lifetime condition called lymphodema, which fortunately is much rarer in those who have the sentinal node biopsy.

I was happy to hear the tech, whose name was "Hai," tell me that he would be injecting lidocaine into my breast first.  Since they inject it directly into the nipple/areola complex, lots of people who had it done had said it was horribly painful.  He assured me that he used the smallest needle possible and it shouldn't feel more than a pinch.

He was right, I felt the first needle pinch which wasn't painful, and after that, nothing.  Hai was a master.  I had to massage my breast to get the stuff to spread around, which was weird because it was numb and I couldn't feel anything.

Then they got me on this skinny little table to position me under the camera.  Now, I don't want to be indelicate here - but I fit on that thing, just barely. It was maybe 15 inches wide and slightly curved up.  My arms could not fit on the table, just my back.  And, I weigh only 43.7 kg.  So, I wonder, how uncomfortable is that table for a person who weighs, oh, say...113 kilograms?  Or more?  Not only did I have to lie on that skinny table for an hour, but I wasn't allowed to move.  At all.  Period.

Well, you know what I did, right?  I fell asleep.

You know me.

When it was over I was awakened by a female tech who said, "You are cute!"  I said, "You are too!" and she totally was.  We struck up a friendship then.  She told me all about her cousin who had a mastectomy but her cancer had come back and this time was going through chemo, and a hilarious story about a fake boob and the ocean.  She also is a big fan of wigs,  she likes to change it up, and gave me lots of tips on wig shopping.  

They have this amazing high tech way of marking the sentinal node for dissection.   The female tech went over to the computer monitor and looked at where the node was.  Hai came over, stuck his finger in my armpit and said, "Here?"   She'd check the images and would say, "Nope, over to the left a little," and he'd move his finger and say, "Now?"  "No, up just a bit."  They did this until she could see the shadow of his finger on my node.  When she finally said "yes, you got it." he took out a pen and marked an X.

I believe that is what is called "state-of-the-art."

Word was sent down that a doctor was looking for me, so they readied me for transport, Cute Tech making me promise to come back and show her my wigs.  Who knows, I might.


  1. someone weighing in at 113 kilograms would be a pretty big person at 249.1198 lbs! :) You can always borrow my mermaid wig! (uh, if I can find it - you can borrow the costume too - it would fit you).

  2. I enoy your blog, my mastectomy was 10/2. My blog is at

  3. I weigh 118 kgs and let me tell you that table was terrifyingly narrow once they jacked it up and kicked the step ladder away. May I congratulate you on having a humane Nuclear Medicine operator and protocols that used lidocaine to numb the area before the extremely, agonizingly painful radiotracer [its antimony in Australia and is basically battery acid] injection. My imagist lied to me and told me the radiotracer injection was the same pain level as local anesthetic. It wasn't. It was so painful it felt like my head was being blown off, and I lost control of my bowels and basically went into shock, shaking uncontrollably and temperature plumeting. When it was finally over and I asked the imagist about why she did not use pain relief the sadist smiled and said my pain only last for a minnute or so and it took longer than that to draw up the lidocaine [lignocaine here] and to inject it and wait for it to go numb. Long story short - it was perfectly acceptable to her to send me into shock and completely anihilate my hitheto positive outlook all because it saved her 3 minutes of her professional time.

