The Sentential Node Mapping procedure is fairly straight forward. They inject some radioactive crap in the area around where your tumor was removed, give it some time and X-Ray you to see what Lymph Node cluster that area is draining to. They then go in and biopsy the area and send that off to the lab to check for microscopic traces of Melanoma. If its negative then you can consider yourself lucky, if not then you have more choices about treatment to make and the probability of reoccurrence is considerably higher. This was not so straight forward for me and my care team seemed a bit in disarray about what to do. The mole I had removed was on my upper left chest, just below my collarbone and about halfway between my shoulder and neck. The problem was that nobody could decide if I needed a head a neck surgeon for the biopsy or a surgeon who could do the biopsy if it showed positive in my groin or armpit. The biopsy is done about an hour after the X-Ray so there is not a lot of time to make arrangements. There seemed to be a dispute brewing among Dr. G who had originally removed the mole, the Head and Neck surgeon who I will call Dr. W and the chest surgeon who I will call Dr. M. Dr. W felt that the mole should not have been removed before this procedure was done and that Dr. G had not taken off enough skin around the original area. My Oncologist wanted nothing to do with the argument and I was left bouncing between the three trying to figure out what to do next. I loved Dr. W. He is retired navy and his office ran like the USS Enterprise. If your appointment was at 10:15 then at 10:15 you were called back and you saw his nurse first then he followed directly behind. Dr. M was pretty much the opposite. His office always had a million people in it waiting to be seen and you may or may not get called back within a half hour of your appointment time and then you may sit in the room for another extended amount of time waiting to be seen. One thing about all three of them is they are all brilliant men and extremely arrogant about how good they are. I suppose it comes with the territory and you don’t become a surgeon unless you are that way. We finally found a date when I was in town, all the Doctors were available, and the NG could be there to drive me home. The actual procedure was uneventful. I went and got shot up with radioactive crap, did the X-Ray and headed to the surgery center to see which doctor showed up. The NG stopped and got a burger and tried to inhale as fast as she could in a show of mercy for how hungry I was at this point. I understood; no point in us both starving. My sister was also attending the surgery just in case some kind of a decision had to be made while I was under. The NG is an RN so I certainly wasn’t afraid of any decision she would have made but there is something to be said for having family there and so far my sister was the only family member who knew what I was going through. They had never met so this set up a kind of funny situation. The NG was much like me, somewhat introverted and pretty quiet. My older sister would be pretty much the opposite. She is very outgoing and loves to visit with people and has the energy of a thousand people. She is my hero and even as a little kid I always looked up to her. As I was led back to get ready for surgery I had this funny vision of my sister and NG sitting in the waiting room staring at each other trying to make conversation. Not sure why I thought this was funny but I did. Much to my surprise both surgeons showed up and I was getting confused. The X-Ray showed that the drainage had all gone to the nodes under my left arm so that was Dr. M’s area of expertise. Dr. W was there I found out to remove more skin around the original area and to check manually for radiation in the nodes in my neck area with some gadget thing the looks for radiation. The two Doctors came in and gave me the ole pre surgery speech and they made the NG and my sister leave so I could go back and get the show on the road. My next memory is being wheeled out the door and seeing the NG and her smiling face there to pick me up. I will always remember the smile on her face that day and have always wondered if she was just trying really hard not to laugh at me or was she really happy to be taking me home. There was no sign of radiation anywhere in my neck area which was good news and he took about a ½ inch more skin from around the original area. My scar now goes from just about my shoulder to just about my neck. Doctor M removed 5 lymph nodes from under my arm and those samples would be sent to the lab for pathology testing. More waiting for test.
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