Ok - so after the needle biopsy confirmed the presence of cancer cells in my breast, my surgeon scheduled a surgical biopsy for a few days later. Problem was, he was heading out of town on holiday so a locum would be doing the procedure.
I arrive at the hospital on time and, after getting robed and prepped by the nurses, settle on the bed and wait. After 20 minutes of harried phone calls and under the breath muttering from the nurses, the locum is located and asked politely (told) to get over because his patient is waiting! Turns out it is his first day at the surgical practice and the hospital and he is having trouble getting everything together, parking pass, id etc. to check in at the hospital himself.
So finally he gets here, introduces himself to me, shakes my hand as I lie flat on my back (get used to this - you will shake lots of hands while half nude and on your back) and says "How are you, darlin?" before getting started. No sedation, just local freezing and away we go. For the next, I don't know, half hour, I lie there, head turned away, looking at the wall while he slices into my breast and begins removing chunks of the tumour and my skin.
After a few moments, the nurse takes my hand, smiles at me and suggests a little music on the stereo. Nurses are really good. So now the procedure continues to the tune of a little light rock from a local station. Now I am not a huge fan of light rock. But I would have listenend to a selection of Bobby Vinton's greatest hits at that point.
Ok -so the first song up is Can't Fight the Moonlight. Now add in the sporadic interruptions of the surgeon's cell phone ring tone - which I think must have been a sample from the soundtrack to Kung Fu Hustle. I'm not joking. Every five or ten minutes, off goes the phone. Swish...swoosh...aaaah...dada dada dada da da da. Ok - can you put it on vibrate or something, please?
Once he gets up close to the tumour he starts talking to the nurse about what he is seeing. He isn't happy. The tumour is big. And many blood vessels are involved. He starts taking pieces and placing them on slides for the pathologist. After he has taken several samples of the tumour, he announces he will be taking samples of the skin. I don't know if this is standard with all surgical biopsies, but it is certainly necessary if Inflammatory Breast Cancer (IBC) is suspected because they are checking for the presence of cancer cells in the skin.
Finally he cauterizes the tissue, sutures the incision and finishes me up. He asks the nurse how long it should take for the pathologist to prepare a report. "Ten days or more." He doesn't like that. "Can we put a rush on it?" he asks politely. My heart stops. "We can try," is the response. More smiles for me from both the surgeon and the nurse. And then he is out the door. He is a kind, if distracted, man. But I know he is making an effort to be positive and attentive. She is a pragmatic, empathetic nurse who sees a lot. I feel cared for, but dazed.
I am a little shocked by the abruptness of the procedure, of how aware I was going to be of every little slice, every off hand comment. During the procedure, be prepared to hear your surgeon discussing what he or she is finding with the nurse or with you. Do not be alarmed. Your surgeon's observations are going to help your medical team determine the best way to fight your cancer. Information is good. The more your doctors know, the more effective the fight will be. I really wished someone had warned me that I would be both awake and aware during the procedure (I never asked). I would have been in a better frame of mind to process it all.
The pathologist did rush the report and within the week my oncologist had received it.