A Little Off The Top…a.k.a. Surgery Day

Morning – or what would pass as morning as early as it was – came quickly. The plan was to be on the road between 2:30 and 3:00 am. We would be on the highway and well on our way before most people were even thinking about getting out of bed for the day. There would be no morning coffee or breakfast for me since I’d been given strict orders for nothing after midnight in preparation for the surgery.

The drive was uneventful and the sun was just waking as we pulled into the hospital parking lot. It was early so I was able to get rock star parking. I looked at the time. Having no traffic on the roads made the drive quick and easy. I was almost an hour early for my surgical prep check-in, but went inside and registered with the receptionist anyway. He informed me that someone ahead of me had not yet arrived, so it was likely I would be called back early. I sat down in the extremely quiet waiting area – there were only three others there and they seemed barely awake at that hour. As speculated, I didn’t have to wait long.

Once called back I was directed to a small curtained room. It looked no different than any other hospital facility, so it was familiar to me. I was given a heavy cotton gown and the expected instructions to undress and put the gown on before climbing into bed to wait. The nurse took my blood pressure, pulse and temperature. She asked if I’d had anything to eat or drink since midnight. She gave me a quick overview of how the morning would go – the same checklist of activity that I’d heard several times just a couple of weeks before during my pre-op exams.

It appeared that everything on the agenda was going as expected. Despite the early call to prepare for surgery, there was no speeding the rest of the process. The doctors had their schedule and were sticking to it. My surgeon arrived about an hour before we were expected to go into the operating room. She greeted me then spent some time reviewing what would happen next and checked in with me to see if I had any questions. I was having surgery in a teaching hospital so her resident also had specific questions and conversation he needed to address before they would put in my IVs and start the anesthesia.

The surgeon used a purple marker to draw on my chest where she would be cutting and explained how each step of her work would be managed. She also reminded me that some work may be performed by a student, but assured me that the finished work would be up to her high standards. She would not allow anyone else to handle any part of the surgery if she was not 100% convinced that they knew what they were doing. After one last ask if I had any questions, it was time for her to go check on the operating room and time for the nurse to stick me with the needle.

There was a delay getting into the operating room. Apparently the previous surgery ran long and it was taking longer than usual to turn over the room for my procedure. The doctor voiced her displeasure and lit a little fire under the staff to speed things up. In the meantime, the nurse had dimmed the lights for me and I was able to rest a bit while I waited.

Once it was time to take me to the operating room, things moved quickly. I remember rolling down the halls and into the elevator, then through the wide double doors into a brightly lit and quite cold room. I’m not sure how many people were in there, but everyone was busy doing something that looked important and necessary. I climbed onto the table and after the doctor spoke to me briefly, they put me to sleep and we all did what we were there to do.

The surgery, as I knew it would be, was pretty extensive. When I woke hours later, I had already been taken to my room and was in my bed under pre-warmed blankets. The surgery had taken a little over six hours and I was told all went exactly according to plan. My doctor was just outside my room when I woke and stuck her head in to see how I was doing. I was groggy, of course. I just wanted to sleep and wanted everyone to leave me alone so I could. I guess the people in my room thought I was joking when they asked if I wanted anything and I responded by asking them to leave. I’ve never understood how people can ignore a direct request from someone when they aren’t feeling so good. Not everyone recovers the same or likes to have people around when they’re feeling crappy.  I am someone who prefers to be entirely by myself when I’m sick. It isn’t that I don’t want to be a burden or that I’m just downplaying my illness. I flat out do not want people around. I am fine with my dogs because they just let me rest until I feel better; but people are a different story. I know I was instructed to have a person there with me, but I cannot get comfortable if people are lurking about trying to be helpful. So I sent her on her way and asked her not to return until it was time for me to go home. I turned off the television because I wanted nothing but quiet. I would have sent the nurses away, too, but unfortunately that was not an option – although, they did leave me to get a little rest, assuring me they’d be back to check my surgical drains in two hours. I was ready to hit the morphine button and fall asleep; but not before I put both hands on my chest and it struck me that I’d actually had the surgery. My breasts were gone! All I could think at the time was, “I’m a boy, I’m a real boy!

As promised the nurse returned in two hours and woke me to check and document the output from the drains. He disconnected the pulsing leg wraps that were meant to help keep my circulation going so I could get up for a minute. I was able to walk myself to the restroom with all the IV tubes trailing behind me. I was helped back into bed and everything reconnected and checked and left alone for the next two hours. This was the pattern for the hours leading into evening. Around 8 pm, the nurse introduced me to the resident doctor on call. My doctor had asked him to stop by and make sure the drains were working properly. They told me that the nurse was concerned by the lack of output from the drain on my right side and had called the doctor. The doctor and nurse removed the compression vest that I was wearing, undid the surgical padding, snipped the stitches holding the right side drain tube in place, and flushed the drain a couple of times; then they reinserted the tube and stitched it back in place. They took a couple of photos of their work to text to the doctor before bandaging me up again. They were confident all was fine and let me return to sleep.

Around midnight I found myself awake and fairly coherent. I wasn’t in much pain and after the nurse helped me up for a bathroom break I decided to check my phone messages. I had just enough morphine to mess with my ability to focus on much, but I was functioning well enough to respond to an email my therapist had sent that afternoon. I gave her a quick update on how surgery went and how I felt and signed off. I pushed the morphine button and was soon again sleeping.

The rest of the night was uneventful. Before the night nurse left at his 7 am shift change, he informed me that the doctor had called and would be by to see me after she’d finished with some other surgeries she had on her schedule. He also said they would not be releasing me until she was able to see me in person as she wanted to check my drains herself. So I spent the day sleeping and being roused every two hours. The only break in the routine was when they brought me chicken broth for breakfast and again at lunch. Yum. 

The doctor woke me around 4 pm. She looked at the drain output log that the nurses had been keeping and commented that the right drain was really not showing any significant drainage. The left drain seemed to have slowed significantly as well and she was concerned. Normally there is quite a bit of fluid after surgery and the drains are monitored for a full week as it generally takes at least several days before any reduction in fluid output. She decided it best to have a look so I was unwrapped again and she examined me and the drains. She determined that I was done draining. This was certainly not expected! There was no fluid there and that was why the drains were no longer functioning. She gave me the option to leave the hospital with the drains in place – if I personally would feel more comfortable doing so. But she said there was no need for that and even though she’d never before removed surgical drains before discharging a patient, she didn’t see any need for the drains to stay in and cause any unnecessary discomfort. She removed the drains and was ready to sign off on my discharge.

At the same time the doctor and I looked at the nurse’s face. She was assisting the doctor with unwrapping me and suddenly looked confused. The doctor laughed. She had figured out that the nurse was trying to figure out what was missing. I had no nipples! We all had a good laugh as the doctor explained that not everyone gets the nipple grafts.

As she explained to me that for the next week I was not to remove any of the dressing or the vest the doctor took a few photos of my chest for her file, asked for my cell phone and snapped a couple for me. Then she applied fresh bandages and put me back into the compression vest. I could leave the hospital and head to the hotel.

I was free to go begin the first week of rest and recovery and I’d purposely only taken two days off from work so I could avoid going stir crazy and prevent untold hours of boredom. I would be working from the hotel nearest the doctor’s office for the next week. Off to recover I went.

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