Monday, January 30, 2006

being (a) patient

There is nothing like sitting in a cold waiting room, wearing an unflattering robe and your winter boots to test both your patience and your dignity.

The latter part of the week that just ended was filled a gruelling round of pre-operative appointments:

Wednesday, January 25
Location: the hospital where my surgery will take place

I am issued with a green plastic card with my name, address, etc.

the pre-op nurse
A nurse fills me in on the details of my upcoming surgery, what I need to do to prepare and how to follow up. She is very calm and thorough and I remember almost nothing that she said to me. I am grateful for the written material they give me and for my friend, taking notes.

the physiotherapist
I am provided with exercises to regain flexibility and strength in my right arm after surgery (and to ward off lymphedema, painful swelling in the arm that can occur as result of the removal of the lymph nodes). I am expected to start these exercises the day after surgery and to progress gradually until I have recovered fully. I find this appointment very reassuring.

the home care nurse
I remember two things from my meeting with the coordinator of the home care program:

1-A nurse will visit me after the surgery and at least one other time after that.

2-The reply to one of my questions: "Oh you should talk to the pre-op nurse. She handles all of Dr. M's breasts." I refrain from pointing out that I still think of them as my breasts, despite the fact that Dr. M. will be removing one of them.

Thursday, January 26
Location: different hospital, nuclear medicine

the bone scan
I had been told to arrive at 8:15 in the morning, when I would be given a drink to prepare for my bone scan later that morning. Instead, I am injected with "a small amount of radioactive material" and told to return in 2 hours.

Why are hospital robes always too small, no matter what size you are? After cooling my heels for a while, I am ready to be scanned. This process involves lying on my back while a camera passes slowly over me. The five minutes spent with the camera directly on top of my face (not touching but really, really close) are a bit weird but, otherwise, the process is painless.

My oldest son is really impressed with the idea that I have been injected with radioactive material. However, a series of experiments proves that, unlike Spiderman, the experience has not given me superpowers. I don't mind. Those superheroes lead pretty lonely lives.

My friend and I notice a sign in the waiting room, "Please notify us if you are preparing to travel by air in the near future and we will provide you with appropriate documentation." Apparently the stuff with which I have been injected can set off airport security alarms. Scary stuff.

Friday, January 27
Location: a publicly funded private clinic

the abdominal ultrasound
The attire to du jour is a white paper poncho, open at the sides and tied with a blue ribbon. It looks particularly fetching paired with my black Blundstones.

The technician is motherly (actually uses the phrase, "atta girl!"), and like all the others, is very nice. She has me breathe in and hold the breath more times than I can count. I forget to breathe out at one point, as it suddenly occurs to me that although these tests are routine, they are meant to determine if the cancer has spread beyond my lymph nodes and into my bones or internal organs.

the chest x-ray
A run of the mill x-ray, with front and side views. The is the first technician to mention the fact that I have breast cancer.

the heart scan (aborted)
I was told by the woman at the cancer centre who had booked my appointments that this last step would be further blood tests. I am, therefore, a little surprised to be taken through a door with a now familiar graphic and the words "nuclear medicine."

After being seated in a tiny room, identical to the one I'd been in prior to my bone scan, I have the following conversation:

technician: "Are you ready for this?"

me: "I don't know what this is."

technician: "We need to scan your heart to make sure that it's strong enough to withstand chemotherapy."

me: "Is it really safe to be injected with radioactive material two days in a row? Because I just had a bone scan done yesterday."

technician: silence.

She then goes off to check with "the doctor" and, after a short wait, I find myself once again under a camera. The "doctor" (to whom I am never introduced) comes in, and after a brief, muttered conversation, I am informed that my ribs and sternum are still "glowing." A heart scan will be impossible.

This may seem like no big deal but I had really been counting on having three whole days with no appointments prior to my surgery. Now half of Monday will be lost to more waiting rooms and another test.

I am told that it would have been OK for my heart to still be radioactive when my bones were scanned. If the two days had been reversed, I could have fasted before the ultrasound, had my heart scanned and then done the bone scan the next day. While this setback is minor, it is another example of how patients are right to ask questions when something that is communicated to us does not make sense. Even with the most skilled, compassionate staff involved in patient care, these breakdowns in communication seem to happen with a fair amount of frequency.

I had a two hour massage today. It turned me into mush for the rest of the day but did take the edge off my anxiety. I'm fortunate to have this kind of resource at my disposal, as well as family and friends who have overwhelmed me with their kindness and understanding.

I'm also glad that I continue to see the humour in all of this.

1 comment:

Susan said...

I finally have to write. I read your wonderful, smart, strong, gutsy, informative, curious, terrible, personal and even sometimes funny entries and I'm right there, with you. It's a priviledge to be allowed to share this experience with you - to be invited into such intimate moments - I am so moved. We are hearing so many success stories now; everyone knows women who survive and thrive...and you will absolutely be one of them - and get through the parts that really suck along the way. I'm very proud and lucky to be in your family.