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| 4 Months Post Bilateral Mastectomy Photo by Eric Von Bargen |
Keep in mind that every surgeon, every body and every cancer is different so your experience may not mirror mine but certainly some things will. Below is the list of how things went for my Skin Sparing Total Bilateral Mastectomy with Immediate Reconstruction preformed on April 4, 2012.
THE PRE-OP APPT WITH SURGEON
This is the appointment where your surgeon should finalize all
details of the procedure with you and give you instructions for surgery. Find out if your surgeon will be sewing Alloderm to your chest wall ( human tissue sling type apparatus that will hold your tissue expanders) If so, there will be some pulling and pain from where these are attached.
You will also possibly
leave with some prescriptions to fill so that you will have them when you get
home they might include:
1.
Pain
Killers – They gave me Oxycodone but it made me hallucinate and feel terrible.
About two days in, I had them switch me to Vicodin and when I couldn’t take the
way that made me feel anymore, they switched me to Tramadoll which I had no
trouble on and could easily drive with.
2.
Anti-Nausea
Pills – Sometimes the anesthesia cocktail they give you along with all of the
pills that will be in your system will cause extreme nausea. They will not want
you to throw up because it will pull on the chest muscles. What they gave me
was Zofran. But make sure to get the tablets that dissolve under your tongue.
If you are as nauseated as I was, you will not be able to stomach another pill
to swallow.
3.
Antibiotic
– This will mess with your stomach royally so make sure you take with food
4.
Stool
Softener – the beauty of all of these pain meds is they are constipating.
(warning TMI) I did not poop for 1 month after my surgery and was MISERABLE!
5.
Xanex
– If you are having trouble sleeping or with stress, they will prescribe you an
anti-anxiety such as Xanex or Lorazepam but you have to ask. I highly recommend
having it as my panic attacks increased as I got closer to the surgery date and
sleeping was out of the question.
THE SURGERY
1.
They
will want you to shower the morning of the surgery with an antibacterial soap
taking care to wash well around your breasts and your chest. They will not want
you to put on any lotions or deodorant. I advise you to shave your underarms here, this will be a luxury you may not have for a while due to the drain location and the limited mobility in your arms.
You will be going into surgery without
underwear on (something I would have never dreamed or else I might have groomed
better!) If you care about this. Take care of that in your shower too.
2.
When
you check into the hospital, they will get you undressed and in bed and
possibly start your IV. My nurse gave me a shot of Lidocaine before inserting
the IV and it was the best one I’ve ever had. The anesthesiologist will come in
and make sure that you are well enough to go under and clear you to start any meds
they want you to have. In my case, I was so nervous, that gave my an
anti-anxiety through my IV called Versed. I was relaxed and calm.
3.
The
surgeon will come in and check the surgery orders with you again and then mark
up your chest for his/her guidelines during the surgery. Then you will be ready
to go.
4.
Once
you get into the operating room, they may be performing a chest nerve block on
you. I highly recommend this. They have to do it before they put you under
because you have to sit up while they do it. It is a series of about 6
injections in your spine not unlike an epidural. With the Versed on board, I
barely remember it. But it kept me comfortable for about 24+ hours after the
surgery.
5.
They
put me out with a mixture of Propofol (Yes, the Michael Jackson Drug) and it
worked well.
6.
Off
to la la land you go. Once you are out you will be intubated, which will cause
you to possibly wake up with a sore throat. You will also probably be
catheterized so don’t be surprised if you have that I cant pee and it feels a
little strange feeling when you wake up.
My surgery from mastectomy to rebuild was just under six hours.
GOOD MORNING SUNSHINE IN RECOVERY
1.
You
will slowly come to in the recovery room which will be quite a blurr. Unless
like in my case the woman next to you is screaming hysterically. There will be
others all around you and it is a little scary and disorienting but once they
have monitored you for a bit they will send you back to your room where your
family members can join you.
2.
More
than likely, you will have a pain pump that will be attached at the base of
your new biggerJ breasts to deliver pain meds directly to the
chest. It is a simple contraption that you will be able to remove yourself once
you get home.
3.
The
dreaded drains, I had two, will be stitched into the side of your
chest and will at worst be annoying. For the first several hours, output will
be monitored by the nurses. This is a good time for your family to watch and
learn because depending on your output, you will have these drains anywhere
from 7 days to 3 weeks. They are a pain but once you get how to pin them to
your gown you should be fine. The hospital will probably send you home with a chart so that you can continue to monitor the output and report to your surgeon. My surgeon took out the drains when the output was less than 30ccs on each side per day. Your surgeon may have a different goal in mind so ask.
4.
If
you can, bring a colored pillowcase pillow (so they don't get confused with the hospital pillows) from home that makes you
comfortable. A little comfort can go a long way. You will need to be propped up
on your back to sleep.
5.
You
will need help to get out of bed to go to the bathroom because you will not be
steady enough to do it on your own. Visitors may come but you will be kind of
out of it so it may not be as welcome as you might think.
WHAT YOU WILL NEED WHEN YOU ARE RELEASED
1)
A
pillow for the ride home to put under your seat belt. Your driver will need to
drive slow, every bump in the road will add to your discomfort. I could not drive myself for about 1 to 2 weeks. Not only was it painful but I had too many narcotics in my system to be a safe driver.
2)
Nausea
Bands – Any drugstore, the kind you wear during a cruise or while pregnant. I
swear by them.
3)
All
of your meds, ready to go and take them on time. Do not worry about addiction
and back off. Trust me, stay ahead of the pain. If you
do have a chest block the pain is deceiving and will not hit you hard until day
2. Trust me, I was facebooking on day 1 like a champ and the next day was like
WTF?
4)
Surgical
Gloves – You will not want anyone to
touch your drains or your bandages without surgical gloves. This will save you
from an infection down the road.
5)
Extra
Gauze Pads – Large size, these will need to be taped to your drain sutures to
stop leaking.
6)
Surgical
Paper Tape – To attach the gauze to the drain output.
7)
Shower
Chair – I had to be showered by someone for 1 week. I could
not lift my hands to wash my body, much less my hair. A shower chair is an expense but goes a long way when you are managing drains and woozy from drugs in your system.
8)
Tons
of pillows. You will need to sleep on your back with tons of pillows for about
a month. The
problem is actually the drains. Any movement you make will tug on the drains
which is very uncomfortable.
9)
Food
for an upset tummy. Bland Cheerios, dry toast, saltine crackers. You may even
need to keep a little Gatorade on hand in case you get dehydrated. I chewed on
a lot of ice chips due to my nausea.
10) DO NOT buy the
$80 drain top the hospital recommends. I found it incredibly uncomfortable and
useless of course if you have to go right back to work, that might be different. My husband's over sized button down shirts worked just fine. Whatever clothing you get, you will want a soft, no constricting fabric. I found this great short cotton robe from target and that is what I wore most of the time.
11) Someone to
provide meals for your family for the first week. You will not be able to sit
up on your own for days. Your caregiver will need to figure out a way to gently
push you up from your back. Once I was a few days in, it was easier to roll on
my side and have my mom pull me up. Your caregiver will need to wake every 4
hours to make sure you take your meds religiously. Neither one of you will be
sleeping so someone needs to plan meals and bring them to you. A great resource for organizing meals for your family is www.mealtrain.com. I had meals delivered to my door for over a month and I can't tell you how helpful that was.
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