Re: Pain relief for sentinel node injections? Lidocaine

[Guest guest]

Jan:

Good luck with your injections! The (female)staff person handling my

nuclear medicine visit was wonderful, worked there for years, and

said patients at that hospital used to have problems with it, but

very seldom any more because they use local pain killers before

injections....I think they put something on topically, and then also

have lidocaine mixed in with whatever they're injecting so it

deadens the pain caused by the lovely stuff they're really putting

in you to travel from the injection site to your sentinal node. She

said it helped that they got more female staff over time and they

just ultimated insisted on pain relief for the patients; they tried

it and the supervising doctors realized it caused no negative impact

on the actual treatment, so now it's standard, they don't wait for

someone to ask, the pain med is automatic...they tell you what

they're giving you, so you're informed, and I'm sorry I didn't write

it down, but I know they mentioned Lidocaine and one other one I

don't remember. It was Saint 's hospital in Santa , CA if

you or your doctor want to call their nuclear medicine dept and see

if they tell you what pain meds they use for with injections for

SNB. Also, I went through it 2x; for whatever reason, the injection

just wasn't traveling in a timely manner (an hour) to map the node,

so they then injected under the nipple and everything was fine

then. So I had 2x the stuff in me, but no pain due to the pain

killer they mix with the injectible, creating some type of cocktail.

Part of how I got through everything did involved my faith in God. I

prayed, a lot of people were praying for me, I sang sometimes while

I was laying alone on the table in nuclear medicine waiting for

stuff to 'travel,' they let my husband in a for a little visit,

which was good for him, because when things take long and he's

waiting, he's always fearing the worst behind those closed doors,

even with another friend of ours to keep him company! I approached

the day with a positive attitude, that everything they were doing to

me was to help me kick the cancer out of me, and just tried to be

open to it all; I asked questions, I joked with the staff, even

wrote a short, tongue-in-cheek story afterwards, comparing my visit

to the hospital to a celebrity photo shoot or party, with me as the

celebrity! During radiation, I dubbed the Mammosite machine

my " bosom buddy " and had medical staff with years of experience

laughing at my jokes; I thought they would have heard every humorous

thing you could say about this treatment, but I guess not (or maybe

they were just humoring me!). I planned to be and tried to be as

positive as possible. I tried to be grateful for whatever I could

be grateful for: the fact that I was stage 1, caught early, good

insurance, great doctors, etc. Truthfully, I am NOT a medical

person, I had all 3 of my children born at home with no medication,

even my 3rd who was a month overdue and weighed 10 pounds 10

ounces! But I cry when I stub my toe and wasn't the least bit

excited about invasive treatment. But instead of extensively

crying 'why me' I sought the positives, which were plenty and easy

to find, esp in comparison to a very close friend who lost her life

to BC years ago and in comparison to another relative who was DX

stage 4 with very young children; mine are all teens now. I've met

incredible people during this journey; my spouse and I have gotten

much closer, and I hope to also have touched or had a positive

impact on some people's lives along the way that I would have

otherwise not known or met in real life or the cyberworld.

Sorry for the long post; I don't post often, and it's usually when I

do! (Just imagine what my 'short' story is like!)

You may want to see if they let you bring an IPOD (borrow one if you

don't have one) in with you so you can listen to whatever music you

like or have whatever positive messages you want recorded on it to

listen to while they shuffle you from place to place in the

hospital. Helps keep your focus on something positive or what you

want to focus on instead of worrying about the next thing. (I didn't

actually do this, but I asked in advance and was told I could if I

wanted to.)

Suzanne

Los Angeles

Age 43

DX 10/3/6

Lumpectomy 10/26/6

1.1cm, stage 1, SN negative, margins clear

ER/PR +; her2neu negative; lymphovascular invasion

Radiation via Mammosite 11/6-11/10/6

Waiting for results of oncotype test re: possible chemo

> This afternoon I talked with the surgeon's NP -- nurse

practitioner.

> I have talked with her several times in the last few weeks and

always

> found her very empathetic and supportive. Now I have mixed

feelings.

>

> I told her that I had discussed this with the doctor only once,

and

> that the doctor's response was that they are not set up to offer

> anesthesia for the injections. The NP said that this may have been

a

> misunderstanding, and maybe the doctor thought I was asking to

have

> the injections after I'm already in the OR, under general

> anesthesia. I was thinking more along the lines of the stuff they

> give you for a colonoscopy, where you're out of it but still able

to

> breathe on your own and be somewhat responsive.

>

> Anyway, the NP is going to talk with the doctor and clarify that

and

> call me back tomorrow, and maybe I'll get some encouraging news

out

> of that.

>

> There were a couple of things that bothered me, though. At one

> point, when I was talking about how scared I am of the pain, she

said

> that sometimes in life, things just have to hurt. I find that

rather

> patronizing. She also made a couple of statements suggesting that

> there are people much worse off than I am, who have to bear more

pain

> than this will cause. I know all of that is true, but it strikes

me

> as not playing fair on her part. Know what I mean? When I read the

> experiences here, women saying they would do everything they could

to

> avoid going through that again, I don't think I'm being

unreasonable

> to ask for substantial pain control.

>

> I know that medical professionals are kind and caring people, and

if

> they could prevent all pain, they would do so. I also realize that

> in order to do their jobs, they have to develop a certain sense of

> detachment from their patients' pain, or they couldn't do things

that

> they have to do. I think sometimes patients get caught in the

middle

> of those two extremes. Doctors see this all the time and they know

it

> will be over quickly. For the patient, it is a horrible nightmare

> she can't ever forget.

>

> Another thing ... mercifully, most women will go through this only

> once. Several of you have said that if you had to go through it

> again, you would be much more insistent about having something for

> the pain. I think it's going to take that kind of insistence

before

> they DO realize that stronger pain relief needs to be offered.

>

> I guess I'm just venting. Thanks for listening. Please offer any

> suggestions that you can. I'm not giving up yet.

>

>

>

> Jan Koelsch

>

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