Throughout my cancer treatments, I considered the end of chemotherapy to be a sort of finish line. My lumpectomy and radiation should have been a breeze compared to the harsh treatments I had already endured. But as my surgery date drew nearer, it became apparent that my lumpectomy was not going to be so easy after all.

When the blood clot (atrial thrombus) in my heart was first discovered, my cardiologist prescribed warfarin, an oral blood thinner (and, much to my dismay, basically rat poison!). The warfarin was supposed to prevent the clot from getting bigger, while giving my body a chance to break it down. The downside of thinning my blood was the potential for uncontrollable bleeding, which could be especially problematic during surgery. I had been on warfarin for a month when it was time to prepare for my lumpectomy.

It takes days for warfarin to build up in the body and days to leave the body after the last dose. While I could not stay on warfarin during my surgery, I could also not stop thinning my blood for a week without risking a pulmonary embolism from my thrombus. To bridge the gap, I was prescribed an injectable blood thinner that stayed in my body for only twelve hours after each dose. I gave myself abdominal injections twice a day for several days before and several days after my surgery. By the time all was said and done, my abdomen looked like a nebula of colorful bruises with barely a clear inch. 

The morning of my surgery, I had an ultrasound to locate what remained of the tumor after chemotherapy. They could not even find it! They sent me to mammography in hopes of locating the tumor, but all they could find was the tiny metal marker they had placed months prior during my biopsy. It looked like the chemo alone had completely eradicated the tumor. Woohoo!

Even if the chemotherapy had killed the entire tumor, the affected area would still need to be removed. They placed two flexible metal rods into my breast to guide the surgeon to where the tumor had once been. It was like a surgical version of “X” marks the spot. The metal rods extended outside of my breast and were taped down to avoid jostling while I waited for surgery. 

Because of my thrombus, I was not a candidate for surgery in the outpatient facility where I had my ultrasound and mammogram. I had to have surgery in a hospital equipped for cardiac and pulmonary emergencies. With hours to kill between the rod placement and check-in time for surgery, my husband and I decided to go for a walk and find him breakfast. It was surreal walking along the Tacoma waterfront and sitting in a cute little cafe with rods sticking out of me, but it was better than sitting in a hospital waiting room. I had done enough of that over the previous six months.

Going into surgery, I was more concerned about the anesthesia than the surgery itself. Anesthesia does not usually work well on me. In fact, I have spent more than one surgery fully aware of everything that was happening, but too tired to say anything. I was not surprised to wake up during my lumpectomy, but I was surprised to feel the intubation tube in my throat. Fortunately, by the time I opened my eyes, the anesthesiologist was sending me back to la-la land. The next thing I knew, I was in the recovery room and all was well. The surgery itself was simple, and I went home that night grateful to be tumor-free.

The day after surgery, I felt great! I was two-thirds of the way through my cancer treatments, and I felt no pain. I didn’t even need my prescribed pain medication. I had post-operative instructions to prevent popping stitches, and I adhered to them, for the most part. I was not allowed to drive for several days, or lift anything heavy, and I was instructed to stretch, but not too far. All of that seemed reasonable. The only problem was that I felt so good that I thought the doctors were being overprotective. Over the next few days I would find out that they give after-surgery instructions for a reason. I wish I had followed them.  

To read about the next stage in Melanie’s post-op process, click here.

Melanie Kallas Ricklefs is a mom, wife, daughter, sister, and friend. She is also a breast cancer survivor. She was diagnosed with Triple Negative Breast Cancer in April 2016. She underwent chemotherapy, a lumpectomy, and radiation to find her way back to health. Melanie has always enjoyed working and playing outdoors. You can find her and her family hiking, biking, kayaking, backpacking, and camping throughout the Pacific Northwest. She holds a Bachelor of Science in Forest Biology from the University of Vermont, and a Master of Science in Forest Pathology from Colorado State University.  To read more of Melanie’s articles related to cancer, click here.

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