question about sentinel node injection

Yes, I looked at the ultrasound screen.  I was too curious to keep my eyes closed, but I knew looking directly at the breast would scare me.  Of course, the pre-op folks gave me an ativan before they sent me down for the wire localization.  That helped a lot.

I hate to admit it, but I'm still kind of obsessed with the SNB injection thing - three months after my surgery. My experience turned out to not be bad at all, if you don't count the almost crippling anxiety leading up to it. Still makes me mad - they gave me next to no information. I had to do my own research and ask for pain meds. Had a couple of valium before the procedure and used EMLA a couple of hours prior. That worked for me. This was for the radioisotope injection. They did the dye part when I was under.

I asked for lidocaine in the injection. They said they would not do it because some studies said it interferes with the tracer. But it sounds to me as if several very reputable hospitals have a conflicting opinion and routinely include lidocaine. It would have given me huge peace of mind if I had known they would include lidocaine - even though it turned out I didn't need it. Needless pain and stress make me really mad.

Ok - it's out of my system - again. I think I might just have to write a letter to the hospital's nuclear med dept. to make it a little more official since it is still bothering me. Sigh.

Be your best advocate, ladies and get all the info you need/want to be prepared. Best wishes to all!

My hospital used lidocaine in the injection too but I still insisted on the EMLA. There is no reason ,in this day and age, for anyone to have to stress over pain regardless of how "minor" others might think it is. Caryn

Well, I survived it all!  Yesterday I had the SNB, wire loc and lumpectomy!  What a relief that it's over.

I had to exert a lot of self-control to not slather the EMLA all over my boob!  I layered it on thickly and wrapped it very carefully.  When the tech saw it, she said, "Oh my, you did a good job."  LOL  Meaning, "I can tell you're just a tad nervous about this!"  We laughed, but all day long I made sure I told everybody how nervous I was and that I would like "a lot" of whatever anesthetic they had on hand.  Everybody treated me very well.

The tech said that EMLA doesn't really penetrate the skin, so I'd still feel a "bee sting" with the tracer injection.  (No lidocaine was used).  And it was really a very minor sting, thankfully!   Oh, I'd taken 2mg of Ativan prior to arriving at the hospital, so that probably helped, although I didn't feel sedated at all (normally that much Ativan would be very noticeable).

On to the wire loc ... the radiation tech said he'd use a little lidocaine (I suggested "a little more") and I felt a minor sting and then mild pressure when the wire went it.  It was much more weird than painful.

Also, I was glad I spoke up initially about exactly where the wire was going to be inserted (I have one large palpable lump and one spot that can't be felt) ... turns out, he didn't even know about the little spot, and had to call my doctor.  Result: two wires.  If I hadn't said anything, it would have been done incorrectly.  He actually shook my hand and thanked me.

I also asked for anesthetic for the IV and got lidocaine.  After the IV was in, the nurse said, "You can stop clenching the bed rail now."  LOL

So ... I'm really glad I was vocal and honest right up front about my stress and pain levels.  I think it really helped. 

Thanks so much, Joan!  I'm glad to see your nodes were clear!

I got my results yesterday afternoon.  Clear margins, but 1/2 nodes positive.  So now I'm in the chemo club.  I guess next step is more tests to see if it's anywhere else.

Etherize,

Oh so sorry to hear about the positive node.  Was that the sentinel node area that was positive?
I won't find out until October if chemo is in my future.    I asked about further testing but was told that it is not indicated.  I keep wondering, what if the next little node was positive and it wasn't taken? 
Well, we can't look at what ifs or look too far ahead.  It doesn't help anything.
It is good news that the margins are clear so you can move forward with treatment. 
The waiting can be stressful.
Best wishes for continued recovery.
Joan

"Sentinel lymph node" is sort of a theoretical term. The goal in a SNB is to find the nodes into which the tumor first drains. The radioactive substance is injected into the breast so the surgeon can use a geiger counter to see where it goes, and it's assumed that the nodes that took up the radioactive substance are the ones into which the tumor first drains. However, as I understand it, the doc isn't really looking for "THE" sentinel node. S/he is looking for whatever nodes are likely to be the ones into which the tumor could be draining. 

As I say, it's more of a hypothetical thing than a real thing. So to say they found cancer in "The" sentinel node, or in a node other than the sentinel node, isn't really meaningful. 

Cycle - I agree  -  I never felt that the SN was the magical node - and I feel a bit insecure about the zero nodes since there could be others.  Am realistic about this.
Etherize - I have a change in plan - my oncology appointment has been moved up to this Friday.  There was a cancellation and I took the opening.  I have to see a different doctor but I researched her and decided it could work for me.  So, I may have a plan soon.
Hugs and prayers for good results for any tests you have.  Let's hope your Stage doesn't change.
It amazes me how fast BC can change our lives.

Joan, I wouldn't worry. What I trying to express was that there is no such thing as "The" sentinel node. If you think it's possible there was cancer in other nodes, talk to your doctor. Ask how your treatment would be different if cancer had been found in one of the nodes. 

If the answer is "no different," then I think you should stop worrying. If the doc says, well, I would have done thus and such, ask whether thus and such might be done, and decide whether you want those treatments.

It looks to me from your diagnosis that you had a very small tumor that, while it had invasive characteristics, hadn't invaded anything outside your breast. If I were you I'd be celebrating!

Go ask the questions you need to ask so you can celebrate more and worry less. 

cycle path,
thanks for your reply last week.  I got my onco score (13) and chemo was left up to my decision...I am having a hard time dealing with this decision since my onco group considers low to be under 11.
I'll figure it out.

Joan, I think that's terrific news!  If I had a choice, I'd definitely skip chemo!