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Biopsy Day

biopsy-scalpel

Well, today is the day of my operations.

I’m to have a dual biopsy and an amputation. It should just be an overnight stay in hospital.

Telling Friends & Family

I’ve told everyone who needs to know about my cancer diagnosis and the next course of action. Strangely, it wasn’t as bad as I expected. My siblings took it well. My partner went into a panic state for a few minutes and then calmed down. She’s an advocate of alternative medicine so thinks I should trust myself in their hands rather than with conventional medicine. Unfortunately, my experience has been, well, extremely underwhelming on a variety of alternative treatments.

And when I consider the success rate from surgery, and I’ve no idea what the success rate is from alternative medicine (and neither does my partner), I feel it’s a no-brainer. My daughter cried at first but then gathered her thoughts when I explained what would happen next. I never told my son – there’s little point as he wouldn’t understand anyway and I don’t want to frighten him.

Pre-Op Exam

My pre-operation exam went well. Despite my sarcoidosis, I should survive the surgery and the general anaesthesia. Better still, I was scored good for all of the checklists except, unsurprisingly, for my breathing, although it was acceptable. I do have to stop taking Fuciodan, a supplement I take that’s supposed to help with sarcoidosis as it can interfere with blood clotting. The nurse also went through  in detail what would happen on the day of surgery.

Waiting for the Operation

And suddenly here I am. In what seems like no time at all – and no time to really think about it and the options open to me – I’m at the hospital, checking in. The place is full to bursting – everyone waiting for similar operations.

diagram of a lymph node

Diagram of a Lymph Node

And, yes, it does feel impersonal, like I’m just a number, just another notch on my surgeon’s belt. But I understand. There are increasing numbers of people with cancer or suspected cancer due to lifestyle, genetics and an ageing population. So it’s going to be a bit like some bizarre parade.

They give me a green gown and I’m taken downstairs to have a dye injected into my fingertip so that they can locate suitable lymph nodes for biopsy – known as a Sentinel Lymph Node Biopsy. I’m to drink plenty of water as it can help recovery so I’m downing it as much as possible.

Then I go and meet the team to discuss the surgery and to give my written consent. Professor Powell informs me that I can leave at any time if I want. I can refuse surgery if I want. But the consequences could be fatal if I do.

I do have a few questions for him though:

  1. Why hadn’t he scanned my finger? Answer: he could have and, yes, he would know a little bit more about the cancer but wouldn’t change what the treatment is.
  2. Could I have Mohs micrographic surgery instead of an amputation? It’s a new type of skin cancer surgery which involves removing the cancerous cells in layers until you reach a layer that is free of any cancer. This usually means less damage to healthy tissue. Answer: amputation is best for me as it may have already spread to the bone, I’m relatively young and I probably have a very rare form of skin cancer.
  3. Can I change my mind? Yes, at any time prior to anaesthetic.

I feel I have no choice. I sign. Prof Powell marks my finger with black felt tip pen to signify where the amputation will be.

My partner and daughter, who has the day off from school, meet me to provide support as I am worried sick and anxious – if  suppressed. I’ve never had an operation before of any kind.

CT Scan

CT Scan

CT scanner

I then head to the nuclear medicine department for my CT Scan. This is of my left elbow and left armpit to find a few lymph nodes to cut out and send away to the Royal Marsden Hospital for analysis.

They find four suitable nodes – two in each area. They look normal which is good. Again, out comes the magic black marker to circle each one. I don’t want Prof Powell to cut out anything extra, especially as it’s a conveyor belt of biopsies and amputations for him today. It’s easy to make a mistake.

I then wait an hour or so and have to stop eating – not that I’ve eaten much anyway I’m so nervous. My appetite has gone into hiding.

I feel like doing the same.

Anaesthetic Time

Finally, I say goodbye to my family as it’s anaesthetic time. They look worried and so am I. You hear stories of people dying under anaesthetic. There’s no reason it can’t be me, even though the risk is small.

My two anaesthetists have over 60 years of combined experience so I feel in safe hands. And they’re hilarious. One of them will remain with me throughout the surgery until I’ve come round. They tell me that they are going to give me the same drug that Michael Jackson was hooked on, Propofol, but I’m sure if they are joking or not.

But first they are going to give me a ‘little something’ to calm me down…

 

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