Face of hope

Face of hope
Courtesy: TIffany Kay Photography

Saturday, April 6, 2013

Expect the Unexpected - Part 3: Surgery

Well after switching surgeons and waiting for what seemed like eternity, my surgery date finally arrived yesterday.  It couldn't have happened at a better time, it turns out.

Just for a brief summary:  I had found a small bump behind my right ear.  I forgot about it, and then rediscovered it after Christmas-time.  It seemed larger so I had it checked by my primary care doctor, who referred me to an ENT.  The first ENT I saw did the ultrasound and saw a tumor sized just under 1cm. They also did a fine needle biopsy which showed certain salivary cells but was inconclusive.  They said most of the time these were benign so we could just watch it. Upon my own research though, I also found that #1. These particular types of mixed cells have a high occurrence of degenerating into malignancies if left alone, and #2. These particular type of tumors, even if benign, can continue to grow and increasingly threaten facial nerve bundles that run right through the same area.  I had asked about having it out and the ENT was ok with that but I wasn't comfortable with how they would do the surgery and where, so I went to a second opinion.

The second ENT surgeon I saw was amazing.  To recap, he said he wouldn't watch it, but definitely have it removed (for the reasons I stated above), and he also would try to remove it a different way so he could completely avoid my facial nerves, something important for my musicianship, and also just to me as a person.  He was booked and then out of town so we had to wait until this past Friday to have the surgery.  But boy am I glad I waited for him.

Fast forward to this past week.  I went to my pre-op Tuesday.  Dr. P went through all the usual paperwork and talk-through about surgery, what it would entail, and the possible outcomes.  He was confident everything would go well. Based on the scans the tumor looked relatively small and easy to navigate.  I got a call later that day that surgery would be Friday morning so to arrive early to the hospital.  I was told to pack a bag because he may want to keep me overnight depending on how things went.

My in laws had been helping me the entire first part of the week to help me with all my pre-op obligations, and so I could easily pop in and out of Meagan's GI appointments..etc...We had a mini birthday celebration on Wednesday night since they would be leaving the next day.  My father in law cooked Fajitas and my sister in law made the most incredible Margaritas.  My mother in law helped with the kids and we had a great night of fun, talking, eating and spending time together. I got some nice gifts and some good family time.  Overall it was a really nice night.

Birthday celebration #1.....

My parents came in on Thursday to trade off with my in laws.  My in laws left and I spent most of Thursday prepping by doing laundry, cleaning and organizing, packing my bag and getting things ready for the weekend while my parents held down the fort with the kids.  Of course we had another smaller birthday celebration that night since it was my actual birthday.  I didn't want to eat much the night before surgery but my parents had brought a small cake for me. Brian lit the candles, the family sang to me and we had fun opening a few presents and eating a little bit of cake.

Birthday cake with Brian and my parents...

Hello 33!

The next morning came quickly, which I was glad about.  We drove to the hospital and checked into the outpatient center.  The pre-op nurses were so incredibly nice.  I must say it felt very strange to be laying there and have something about to happen to me - I was so used to being the support as something was about to happen to Meagan. A very strange feeling indeed.  Once all the pre-op signing and testing was finished I got my IV.  Like mother like daughter - I also needed the IV team to come and find a vein. I guess some of Meagan's tendency of being a hard stick is genetic :)  Anesthesia came in and talked to me about how it would all go - I was listening to him closely as I had never been under before. He told me I may have a sore throat for a few days from the breathing tube and warned me of the nausea possible when waking up.  Next another doctor came in to talk to me about nerve monitoring.  He explained that they would be putting needles all over the right side of my face to monitor my nerve function in real time during surgery.  If Dr. P got close to any facial nerves, the needles would send off immediate signals that would tell him he was near nerve centers and it would help them to preserve nerve function.  Pretty amazing stuff!

Pretty nervous about the anesthesia

Finally I got wheeled down to the OR.  The nurses asked me my name and what I was having done, and then that's the last thing I remember.  Next thing I knew I was waking up in my recovery room.  I kept hearing my alarms go off and nurses would come in and shake me, or Brian would reach over and push on my shoulders.  Apparently I was forgetting to breath as I was coming out of the anesthesia so they kept having to stimulate me somehow until I woke up a little more.  Once I was more awake the pain definitely set in.  I could feel the whole right side of my neck, face jawline just throbbing with pain.  I had a small drain also coming out from that side and my ear was numb.  ( I was warned about having a numb ear before the surgery as a nerve in my neck had to be severed).  Finally Dr. P came in to talk to me about surgery and what they found.

He said once they got me opened up, he knew it would be a longer surgery.  He said the tumor was actually quite a bit larger than they had anticipated.  They were expecting a mass under 1cm, and instead found a tumor that was over 2.5cm large.  He said it also had uneven borders on the back and was growing aggressively into my surrounding lymph nodes and tissues.  He said the initial frozen section did come back benign, but, because of the way the tumor looked and its aggressive growth pattern, he decided to not only take the tumor out, but also some lymph nodes, and a large margin of surrounding tissue. He also ended up taking about a third of my entire gland.  Dr. P said we should have full and final results in 5 days but he was hopeful since the frozen section was benign the rest of it would be too. That's the way I'm feeling as well - I'm just glad he did what he did in the OR.  The type of tumor it was, although mostly benign, have the highest rate of degenerating into malignancy, and also the way it was growing it would have soon impacted my facial nerves.  I'm so happy I went with a surgeon who was not only experienced, but who also made the best split second decision for me and my long term health when faced with a little different scenario than anticipated in the OR.  He said because of the large margin he is sure he got all of the tumor, and for a tumor that has a normal recurrent rate of 20-40% he feels my recurrent rate has been cut to 4-7%.  All good things to hear when you come out of surgery, especially considering what the consequences could have been if I had stayed with the first surgeon who wanted to "watch and see."

My lovely drain

Incision site 

Because of my little breathing issues, I had to stay until 5pm surgery day, but once my vitals stabilized, Dr. P said I could go ahead and go home.  He said that I would be pretty sore from the surgery as it was more invasive than they originally thought so to make sure and take my pain medication.  He also said my throat would be sore from the breathing tube and that my face may start to feel bruised over the next few days from all the nerve monitoring needles they inserted.  He also gave me instructions on how to care for and empty my drain and said I can come back on Monday to have the drain removed. Dr. P said I was to be on a two week liquid diet.  He wants to minimize to eliminate any chewing because it will stimulate saliva production which could lead to cysts being formed as my surgical site is trying to heal.  The nurse then wheeled me out to the car we headed out.  Of course in true "Molly" fashion, Brian and I made a stop at Walgreens for some cold drinks and my medication.  Anyone who knows me knows I have a big problem with just laying around in bed for prolonged periods of time. :)

Maybe a liquid diet won't be so bad?

Since being home things have gone 'ok.'  I feel bad complaining as I know there are things MUCH worse people go through, including all our Hydro kids who endure so much.  However that said, I think I earned a little bit of a right to whine a little bit. My jawline is definitely painful and really hard to move.  There is no way I can chew anything - matter of fact I've probably even been talking too much over the last day because today my incision site is absolutely on fire with pain.  My throat is still a bit sore and face still bruised feeling, but the most sore area is the site behind my ear where he had to dig for the tumor.  I can feel pain from the back of my jaw all the way deep inside my inner ear area and back out to my face.  I know it will get better with time, but for now it is really annoying.  I'm trying my best to stay on top of the pain and rest because Meagan has surgery coming up in 3 days so I want to make sure I'm strong enough to be there for her.

I am so so thankful I decided to listen to friends' and family's advice and go get a second opinion. Dr. P truly knew what he was doing, and knew in that instant what he needed to do to protect me from the tumor doing any further damage down the road.  I will feel completely at peace in a few days once I have those final results in hand, but, for now I feel pretty good that no matter what he did a great job and we are rid of that awful thing.  It is still so random this happened, but, I am better for it. If I could tell anyone a lesson from this it would be to know your body - and if something doesn't seem right, by all means get it checked.  Further, if you aren't comfortable with one doctor's answer, go to another until you have your answers. It could very well save your life.

 Now I look forward to healing, some final good news from pathology, and turning my focus back to Meagan where she will need me most.  Thank you all for the prayers, support and love.

 My favorite place to recover

No comments:

Post a Comment