A woman who has a mastectomy often asks herself: “What to do? How to live after this operation? How to wait for breast reconstruction? “. Specialists have an answer: “To live fully, better, more brightly than before the disease. All the difficulties associated with surgery are temporary.”
While mastectomy is considered to be a risk-free operation, nevertheless, in some cases complications may occur and you should be aware of them.
- lymphorrhea is a natural post-surgical process associated with the release of lymph in the surgical area. A drain is required for 7-10 days.
- a seroma can occur after the removal of the drain. A puncture is required to remove the fluid.
- shoulder stiffness.
- lymphedema may appear after a long period of time. Swelling of the arm on the side where surgery was is a sign of lymphedema. As a result violation of the lymph circulation takes place.
- violation of the skin sensitivity in the breast and armpit area as a result of incision of nerve fibers during mastectomy surgery.
- psychological complications.
- post mastectomy syndrome.
- skalenus syndrome is compression of scar-altered formations of the nerve tissue and blood vessels with violation of blood circulation of the upper limb and brain.
You should understand what post mastectomy syndrome is.
Post mastectomy syndrome is a combination of clinical symptoms that manifested after mastectomy surgery. They include:
- Breast reconstruction after mastectomy. Cosmetic defects in the surgical area.
- Shoulder adduction contracture as a result of scarring in the armpit area.
- Psycho-emotional disorders: depression, anxiety, sleep problems.
- Sexual disorders.
Most people who have a mastectomy recover well after the procedure and don’t develop complications. In most cases, it takes three to six weeks to fully recover.
Before you leave the hospital, your surgeon or nurse will provide you with information about recovering at home:
- Taking medications: Your surgeon will probably prescribe some meds. You might want to get it filled on your way home or have a friend or family member get it filled for you as soon as you are home so that you have it available.
- Caring for the bandage (dressing) over your incision: Your surgeon or nurse will teach you how to take care of your bandage. You may be asked not to touch the bandage on your own, when you visit the hospital the next time, the surgeon can remove it.
- Caring for a surgical drain: If you have a drain in your breast or armpit, the surgeon might remove the drain before you leave the hospital. Sometimes, however, a drain stays inserted until you see the doctor, usually 1-2 weeks after surgery. If you’re going home with a drain inserted, you will have to get rid of the fluid from the detachable drain bulb several times a day. Listen to your surgeon carefully: he or she will teach you how to take care of a drain in your breast or armpit.
- Stitches and staples: Most surgeons use stitches that vanish over time, so there’s no longer any need to have them removed. But sometimes, you may notice the end of the stitch on the incision. If this takes place, your surgeon can easily remove it. Surgical staples — another way of closing the incision — are removed during the first visit after mastectomy surgery.
- Recognizing signs of infection: Your surgeon should provide you with information about infections that may occur, in case of infection you have to call your doctor.
- Physical exercises: Your surgeon or nurse may show you an exercise routine you can do to prevent stiff arm and shoulder on the side where you had surgery. Usually, you will start the exercises the morning after surgery. Some exercises should be avoided until drains are removed. If you have any questions about physical exercises, ask your doctor, he or she will explain in details. Besides you should be provided with written, illustrated instructions on how to do the exercises.
- Recognizing signs of lymphedema: If you have had axillary dissection, you should be aware how to take care of your arm and recognize signs of lymphedema if they take place.
- When you can start wearing a prosthesis or resume wearing a bra: The site of mastectomy surgery, and especially mastectomy with reconstruction, needs time to heal before you can wear a prosthesis or bra. Your doctor will tell you how long you may need to wait.
General guidelines to follow at home
- Have a rest. When you get home from the hospital, you will probably be tired and exhausted because you experienced a lot. You should have sufficient rest in the first few weeks after mastectomy surgery. Many people experience fatigue after surgery, so you should learn how to deal with it.
- Take painkillers on time. You will probably experience a mixture of numbness and pain around the breast incision and the chest wall (and the armpit incision, if you had axillary dissection). If necessary, you should take painkillers according to your doctor’s instructions.
- Take sponge baths until your doctor has removed your drains and/or stitches. You can take your first shower when your drains and any staples or sutures have been removed. A sponge bath can refresh you until showers or baths are approved by your doctor.
- Continue doing arm exercises every day. It’s important to continue doing arm exercises on a regular basis to prevent stiffness and to keep your arm flexible.
- Ask your family members and friends for help. Mastectomy recovery is a time consuming process. Ask friends and family to help with meals, laundry, shopping, and childcare. As your body heals, don’t feel you should take on more than you can handle.
- When sitting, keep your hand on the surgical side at heart level to prevent swelling. If swellings on the arm do not go away, you should consult the doctor. It is okay to use your arms after surgery. But do not overuse, as stitches or staples are not removed, and you have not visited the doctor.
- You can return to normal activities after 2 weeks. Avoid actions where the arm on the surgical side is required and try not to raise your arms.
- You are able to move freely and drive a car, if it does not cause pain and you do not take painkillers.
- Ask your doctor when you can return to work, whether any changes in your job are needed, depending on the kind of work you do.
- Wear loose bras, they will be more comfortable.
- An icepack may be helpful to decrease discomfort and swelling, particularly to the armpit after a lymph node dissection. A small pillow positioned in the armpit also may decrease discomfort.
Important things to keep in mind
- You may have “phantom sensations” or “phantom pain” in the months after mastectomy: As nerves regrow, you may feel a weird crawly sensation, you may itch, you may be very sensitive to touch, and you may feel pressure. Your discomfort may go away by itself, or it may persist but you adapt to it. Analgesics and NSAIDs such as acetaminophen and ibuprofen usually can address the pain related to this type of nerve injury. Opioids also can be used to treat this type of pain.
- Continue doing regular arm exercises: Stay with your arm exercise routine to keep your arm limber.
- You may experience fatigue from time to time in the early months after surgery: If you’re having trouble with fatigue, ask your doctor about things you can do.
Call your doctor or nurse if:
- Your basal body temperature is 38 ° C and above.
- You have swelling of the arm on the side where surgery was (lymphedema).
- You notice any discharge (blood) from the surgical wound or you have thick, yellow, green or cream-colored pus in a surgical drain.
- You have pain and painkillers do not work.
- It is difficult to breathe.
- You have a cough that does not go away.
- You can not drink or eat.