Phase Nine: Surgery

After the long series of chemotherapy treatments, it was a finally the morning of Barbara's surgery, a day she had been waiting for since this whole ordeal began.

Over breakfast - breakfast for Jim actually as she couldn't eat or drink anything - she and her son once more went over the schedule for the day.

"Once they have me prepped and in the OR," Barbara clarified; they'd gone over this before but it had been a couple of days and Jim had been Called to his Trollhunter duties the night before, "it should take just about an hour, maybe an hour and a half. Then I'll just have to recover from the anesthesia, and Laura will drive us both home." As before when she'd had her port placement Jim was taking the day off from school to be at the hospital with her.

"I still can't believe that it's so quick," admitted Jim. "I always thought big surgeries like this took hours."

"That's the joy of medical advancements! Used to, the concept of a lumpectomy wasn't even an option, and then when it was it wasn't always recommended even if it was more viable. "She glanced at her phone to check the time. "Laura should be here soon to pick us up." Jim gulped the last of his milk and was in the process of clearing his plate when their ride in question knocked on the door. Barbara answered it as Jim grabbed his backpack where he'd packed some schoolwork and other distractions.

"Good morning!" greeted Laura. "Today's the big day. You ready?"

"As ready as I can be." Barbara shouldered her purse and locked the door behind them.

Through the drive there Laura passed on well-wishes from Barbara's co-workers and chatted brightly. Jim was rather quiet but somehow his mother thought he would be; though he'd finished his breakfast he'd not made as much as before either. She privately hoped that he packed a snack or two, or that she or Laura could convince him to visit the hospital vending machines at some point.

Arrival and check-in went as smooth as they had for the port placement and soon enough Barbara was called back to get into her gown and wait for the surgery.

"Don't they have to do some other things before the actual surgery?" Laura asked when she and Jim were allowed back into the surgical bay with Barbara where she lay propped up in a bed.

"Yeah," Jim answered for his mom. "I think some kind of guide wires and dye injection."

"That's right," Barbara agreed. "I'll need to go for a mammogram so the guide wires can be placed, and the injection will tell the surgeon which lymph nodes to remove to be tested."

"Sounds like you two have this all memorized!" Laura chuckled. At that moment a nurse came around with a wheelchair.

"Ok," he said, looking at his chart. "Let's make sure I'm about to take the right person. Name and birthday?" Barbara gave both, then was helped into the wheelchair and given a warm blanket to drape across her lap. "We'll be back in a few minutes. I'll bring her back here." Barbara smiled at her son and friend, then she was wheeled away. "Good thing for us," the nurse said conversationally, "there's a way to go from here to the other building without having to wheel you around outside."

"I noticed the skyway," Barbara replied, absently observing some artwork on the walls that they passed.

It's a little chilly in this gown, she admitted privately to herself. Been a while since I had to wear one for anything but a few minutes. Good to see there's some things that never change. They passed by other doctors and nurses, visitors and probably even patients, though Barbara saw no one in a gown like she was. Windows in the skyway gave a glimpse of the outside and its sunshine and blue skies, then they were back in the women's health center and heading towards the familiar machine by a slightly different route. Ah, I think - yes, this should avoid patient waiting areas. I knew we took precautions like that for patient privacy, but never really thought about it before, not really. Though the direction was different on the approach Barbara eventually recognized where they were, the familiar hallway and quartet of little dressing rooms where patients changed into the pink gowns for their scans. Then they were in the mammogram room itself where a female tech already waited. She once more asked Barbara's name and birthdate, then the male nurse left them to it as second female nurse entered.

"Okay, Barbara," the tech said, coming over to help. "Let's get you up and in the machine, then Dr. Sterling will come in and set the guide wires. Then we'll put a cup over them to keep everything in place and secure on your trip back." All of this had been explained to her before in her last visit with Dr. Sterling, but she knew well the importance of repeating the steps to patients. She did it too.

It was only the work of a few minutes to get her in the mammogram machine, which she took note forced her head up and to the side so she couldn't look down at where the guide wires would go, then a nurse briefly left to fetch Dr. Sterling.

"Hello, Barbara," he greeted as he entered. "Today's the big day, huh? Excited?"

"Ready to get whatever's left of this thing out of me," Barbara replied with a smile.

"Sounds good! Ok, I'm just going to confirm the location of the tumor, then I'll inject a little anesthetic into the area, and insert the guide wires." She just nodded, focusing her own part on remaining still and ignoring the discomfort that the machine caused. She felt the sting of the needle that quickly left the entire area numb, and listened absently as nurse and surgeon inserted the wires. Out of medical curiosity she kind of wanted to watch, but unfortunately found her position and the tension in the pressure from the plates made that impossible.

"Almost done," the nurse spoke up. "I'll just get the cup while you're checking the placement." This last was to Dr. Sterling, of course, as he moved away to the monitor behind Barbara.

"Any pain?" the tech asked while they waited.

"Not too bad," answered Barbara. "More pressure now, since everything is numb."

"Good."

"And so's the placement," confirmed the surgeon, even as the nurse returned. "Should be easy to remove in the OR."

"Here's the cup," she said, letting Barbara get a glimpse of it as they moved to secure it in place with a little medical tape.

It was a cup….a literal Styrofoam coffee cup.

Some of Barbara's reaction must've been visible on her face because the nurse giggled.

"I know, so high-tech." Barbara laughed as well, carefully.

"I was expecting some kind of special surgical thing," she admitted as they released the mammogram machine's pressure and helped her back into the wheelchair, covering her back up with the cup making a very prominent and oddly-shaped place on her chest. As she was wheeled back she occasionally heard the scrape of a guide wire against the Styrofoam bottom of the cup. It was strange, as she couldn't feel any vibration or anything.

Soon she was edging back into her bed to wait her turn in the OR. After she was settled and the attendant nurse left Jim and Laura looked with mutual expressions of 'what in the world?' at the concealed adornment she'd gained.

"The cup," Barbara said, trying to sound matter-of-fact, as if this was a normal part of any medical procedure though she couldn't hold in her grin as the finished, "a simple, Styrofoam coffee cup."

"Seriously?" Jim couldn't help but ask. "Like, one you'd get out of a break room?"

"Seems so," his mother laughed. Laura shook her head.

"Well, I've heard duct tape can be used as an emergency band-aid, so why not?"

They continued to chat for a while until Dr. Sterling came in to confirm that Barbara consented to the surgery and fully understood what they were going to do and the risks - which she confirmed on all counts - and Jim stepped out while the surgeon signed his initials on Barbara's left shoulder to mark which side he was to operate on as well as when an attendant nurse who said she would be helping with the operation gave Barbara the radioactive dye injection.

Good thing I'm still numb, Barbara mused. That would've hurt otherwise. They resettled her gown and Jim stepped back behind the curtains.

"It should be only about another fifteen minutes until it's your turn," Dr. Sterling said. "Any questions before we get the ball rolling?" Barbara shook her head.

"Not that I can think of." Jim and Laura both shook their heads as well.

"Then I'll see you in the OR." With that the trio were left alone. Jim briefly pulled out his phone and sent a quick text.

"Just letting everyone know that it'll start soon," he explained as he put it back in his pocket. "They all wanted updates."

"Sounds like you have some great friends, Jim," commented Laura and he nodded.

"The best." he agreed, and Barbara voiced her agreement.

They ended up waiting nearly thirty minutes for Barbara's turn - a nurse told them there was some difficulty with the humidity in the OR - but finally a pair of nurses came to wheel her in there.

"You might want to give your glasses to someone," one of them said as he raised the railing on his side. "Just to be safe. While we have your clothing bag under your bed there's no guarantee nothing breakable won't break."

"Makes sense." Barbara passes her glasses to Jim as well as had him hold onto her purse, then took her son's hand warmly.

"See you when you wake up, mom," Jim said with a smile that to her eyes looked forced. She squeezed his hand, and though she wanted to tell him everything would be fine she knew well that was never a certainty in any surgery. So she said the only things she could.

"I love you, Jim, and try not to worry. I'm in good hands." Jim nodded, then she was wheeled away.

Vision blurry Barbara couldn't see the halls, or the signs and posters on the walls, or the people they passed. It was a surreal, ethereal, and she wondered if any of the medicine they'd given her through her IV was already relaxing her in preparation for sleep. Then through a door and into a room similar to the one where her port had been placed in her shoulder. The only difference that she could see such as it was that instead of just the straight, narrow bed there was a piece that was stuck out on the left side for her arm to rest on.

"Let's get you shifted over," she heard the nurse say and with the help of the nurses and anesthesiologist she was moved over to the operating table. Massagers were wrapped around her legs to protect against blood clots and her arm was secured on place.

"Doing alright, Barbara?" came Dr. Sterling's voice as he stepped into view.

"Yes," she answered with a smile.

"Alright." That was the anesthesiologist. "Breathe deeply for me." The rubber mask was put over her mouth and nose and she began the in and out breathing that she'd been told to do before.

Once more the darkness claimed her.


Her eyelids felt so terribly heavy. Her mind simply wouldn't lift them, but for some reason she thought she needed to do so. A pain under her left arm made her cringe and shift that shoulder trying to ease it.

"Barbara, can you hear me?" The female voice was unfamiliar but kindly.

"Under my arm hurts," Barbara thought she said, and it seemed she did as a moment later the owner of the unknown voice put a little paper cup to her lips.

"I've got some pain pills you can take," she explained and Barbara willingly accepted them, and even more willingly the straw that slipped past her lips a moment later. Oh, her throat had been so dry! She couldn't help taking a few more gulps, but still her eyelids couldn't open for more than a flutter. It was strange feeling like she could think, knew her name and knew she was sitting up somewhat and knew she was safe and could accept those pills without worry, but at the same time her head felt so heavy and her eyes even more so. Perhaps she fell back asleep, perhaps she just drifted in a semi-lucid fog, but after what felt like an eternity her eyes opened and remained so. The attentive nurse at her side came into her blurry field of vision.

"With us again?"

"I think so," Barbara answered. "Felt harder to wake up than when I was last under."

"When was that?" The nurse began checking over her vitals on the connected monitor.

"When my port was put in." With each passing moment her head cleared more and more.

"Ah, probably because you were asleep for a longer time." She typed briefly on the keyboard. "Your surgery went really well. Are you in any pain?"

"Not badly. Mostly under my arm."

"That's good. It probably hurts worse there because it's a deeper incision. You can feel free to lay there until you're fully awake and ready to get dressed. There's no rush at all, and your surgeon should be here in a little bit to talk to you." Barbara nodded and decided to take her up on the offer to doze a little while longer, since she was waiting on Dr. Sterling. The nurse spoke on the phone to someone and the surgeon arrived a few minutes later.

"There's my good patient!" he praised in greeting. "Surgery went well, and we got some good margins. I'm fairly positive we've got it all. I've put a packet in your folder with your aftercare instructions, but I'll go over it with you." He told her about pain management and the care for the sutures, a medical glue more or less, and stressing the importance of resting for several days including not lifting anything with her left arm for at least a week. By the time he'd completed the instruction she felt like she was awake enough for movement after Dr' Sterling had assured himself that she had no questions and departed the nurse came back.

"I think I'm good to get dressed," Barbara told her.

"If you're sure," the nurse inquired, then at the resulting nod reached under the bed to hand her the bag holding her clothes, then closed the curtains around the bed for privacy. "Let me help you with your pants and when you need to stand up; you might still be wobbly on your feet." She helped Barbara sit up more so she could carefully don her upper clothing, then slipped her bottom clothing over her feet and helped her stand to get them up. Thankfully Barbara had the foresight to only wear slip-on shoes. Then the curtain was drawn aside. "Just wait a minute, and I'll get someone with a wheelchair for you. You have a ride here, right?"

"Yes, and my son."

"I'm sure they've been told you're through surgery and in recovery." While Barbara sat there shaking the last tendrils of fog from her mind the nurse made a couple of phone calls and in about five minutes a second nurse arrived with the wheelchair that Barbara was carefully eased into.

"And we can't forget this," the recovery nurse said, slipping the folder into the pocket on the back of the wheelchair. Blurry-visioned, she was pushed through the hallways again and to the front doors where Jim waited, her glasses in hand and once she'd donned them she could see he was smiling. Laura in her car was waiting by the curb and Jim opened the door for his mother, helping her into the front seat then accepting the folder from the nurse.

"Got everything?" the nurse asked. Jim nodded for Barbara.

"The only thing that was with her was her clothes," he said. "We held everything else."

"Okay. Take care, and call or come back if anything changes or you have any questions." As the nurse turned to head back inside Jim climbed into the back seat and Laura looked at Barbara.

"Let's get you home."