You must have a mastectomy? My observations, my tricks, my experience, the more neglected elements and the general advice before a general anesthesia with hospitalization. In short, what you need to know to properly plan the mastectomy day and convalescence in order to live this period as best as possible.
Before the mastectomy
Your surgeon asks for exams to see the evolution of the situation. He wants to make sure that cancer has regressed and that there is nothing else. I have a magnetic resonance imaging ( MRI ) breasts and a positron emission tomography (PET scan). The hospital calls you for a preoperative check-up in the 3 months preceding the intervention. In the program :
- Blood and urine tests, electrocardiogram and lung x-ray
- Meet with a doctor to discuss your history, ongoing treatments, allergies and a brief physical examination to anticipate possible obstacles that may arise during the operation.
- For some, there is a teaching session where they learn more about breast surgery, lymphedema and post-mastectomy exercises. li>
The hospital can provide you with documentation. Keep it preciously!
According to standards of care for CIS , the modified radical mastectomy takes place 4 to 6 weeks after the end of chemotherapy. Ask your surgeon to confirm the type of surgery. It needs to remove all the skin. It’s very important. Ask him how long you will be hospitalized and if he has any special instructions other than what you staff said during the preoperative checkup.
Make sure you can continue to take your medicines and natural products , whether prescribed or over-the-counter. Check with your surgeon and / or the pre-admission clinic. You may have to stop certain substances up to 2 weeks in advance . Avoid smoking, drinking or using drugs for at least 24 hours before surgery. Discuss with your surgeon if you are a user of any of these substances. All this is to avoid drug interactions, reduce the risk of complications (respiratory, cardiac, infectious, etc.) and promote healing.
What to expect
Do you have all the items you need at the hospital and when you leave? See the list of what to bring .
As long as you have a drain, you can not lift the arm higher than the shoulders. So you need tops that button or clothes that you can go through the feet for at least 7 to 10 days. It is relatively easy to think of having blouses. But you also sleep … Do you have night clothes (pajamas, dress or nightgown) that you do not have to go over your head? Not me at the time. I went shopping … If that’s your case, go ahead because you will not want to do it when you get out of the hospital.
In the days before the operation, I wash the clothes I need and I wear only tops that I will not be able to wear for the beginning to avoid having to wash immediately after leaving the hospital. ..
Transport and accompaniment
With the painkillers and reduced mobility of the arm on the operated side, you are not able to drive back from the hospital. In any case, you are not allowed to drive within 24 hours of general anesthesia. Have you planned a person to accompany you on the day of the operation and when you leave the hospital? It does not have to be the same person.
Arrange prepared meals in individual servings at least for the first few days of the first week, especially if you live alone. On the other hand, are the objects you use the most all stowed at a height where you do not have to raise your arm too high? If necessary, move them temporarily. This helps to be more autonomous.
During the first 2 weeks it is forbidden to lift any object weighing more than 5 pounds with the arm on the operated side. Thereafter, it will be 4 additional weeks with a limit of 10 pounds. In addition, it is forbidden to raise the arm higher than the shoulders on the operated side in the presence of a drain. These constraints limit you more if it is your dominant side or if you are operated on both sides at the same time as me.
You do not need to be always in the presence of someone, especially if you have a non-operated side. Nevertheless, plan in advance who can help you, how and when. I plan to be 2 weeks with my parents after leaving the hospital because I have a bilateral mastectomy and I live alone.
Obtain post-mastectomy prosthesis and underwear
Between the end of chemotherapy and mastectomy, it is time to get what we will be wearing for the next few months. In most stores, it is best to make an appointment to meet with a counselor.
Several locations with post-mastectomy products offer a temporary trans-operative textile fiber prosthesis that you can wear when you leave the hospital until you are ready to wear a standard silicone prosthesis. Some hospitals have an associated foundation that offers transient prostheses. There are also the Knits Knitted Knockers that you can order free of charge. These various prostheses are of various shapes and sizes according to the models. Do not hesitate to try another one if the first one does not suit you.
Also, it’s a good idea to get a bra or a post-operative camisole. They are designed to be more delicate on the skin so more comfortable. They incorporate pockets to hold the prosthesis in place. Small bags to hold the drains are sometimes integrated. Otherwise, they can be used separately.
For my part, the counselor gave me the Prosthesis postoperative upholstery fibers of Amoena during my visit. I do not like this prosthesis. I think it’s too wide, it’s going too far to the side. It slightly interferes with the movement of my arm. Amoena has other models that look better.
Your hair under the armpit is back? Do you want to be as glabrous as possible during the mastectomy? Schedule a hair removal session 8 days before it. You should not epilate the armpit on the operated side in the week before surgery. The purpose of this precaution is to minimize the risk of infection.
The day before the mastectomy
What to bring
If you have not already done so, prepare what you are going to take with you to the hospital.
- The valid health insurance card;
- The hospital card;
- Information about your hospitalization insurance, if applicable;
- Information about the person accompanying you and the person to contact in case of emergency;
- Documents to be completed (eg form, medical certificate, etc.)
- List your medications;
- Medicines in their original containers
- Clothes to wear when you leave the hospital, including a button-down top (eg, a blouse) since you can not lift the arm from the operated side higher than the shoulders;
- Anti-slip slippers;
- Toilet kit kit: deodorant, toothbrush, toothpaste, dental floss, soap and comb or hair brush
- Tissue paper;
- Sanitary towels, if applicable;
- Protective containers, if any: hearing aids, contact lenses, glasses, dental prostheses;
- Walking aids, if applicable;
- Two pillows or pillows (three if it’s bilateral) to use in cars after you leave the hospital. The person who picks you up can wait for you to leave before bringing them.
- Depending on the length of your stay, it may be useful to bring something with you to distract you. Attention! You do not need to lift more than 5 pounds with the operated arm . So nothing heavy or with which you can not cope mainly with the arm not operated. Examples: magazines, crosswords, sudokus, pocket radio & headphones, paper and pencils, etc.
- Do not bring in objects of significant monetary or sentimental value. So no large sums of money, credit cards, jewelery or valuables, computer, tablet and telephone. If you do, the hospital is not responsible for any loss, breakage or theft.
There are actually people walking around the corridors looking for things to steal. Do not take chances!
Preparing for fasting
Here’s a little trick: take 2 bottles of meal replacements the night before. Even if the mastectomy is scheduled for 8:00 am, I’m afraid of being hungry even before I get into the operating room and / or wake up and not be able to eat right away. It’s because I’ve had a very good appetite. Having to be fasting from midnight on, I take the first bottle halfway between supper and midnight and then the second bottle at the end of the evening.
In the evening and / or in the morning, it is time to take a bath or shower and to wash your hair. The hospital asks for a question of infection prevention. In addition, it will be less easy to wash for a while. Under these conditions, it is better to do a deep cleaning … On the other hand, no nail polish, perfume or cream. If you have received specific instructions, follow them.
Day of the mastectomy
You should not eat or drink, even water. A small sip of water is allowed if you have medications to take and you have the right to take.
If you have not washed the day before, it’s time to do it. See the Personal Hygiene section on the day before the procedure if necessary. You can not wear makeup, jewelry or piercing or contact lenses.
Non-menopausal women should undergo a pregnancy test. The hospital may have given you a bottle to allow you to do it at home. Otherwise, you will need to do so when you arrive at the hospital.
Finalize your luggage and you are ready to leave for the hospital. Review the list of items to bring as needed to ensure that you do not forget anything.
My bilateral mastectomy is delayed due to an emergency. While I wait for someone to come and fetch me, my neighbor is eating. The person bringing the meal tray tells him it’s his breakfast. The curtain between the two beds prevents me from seeing it but does not block the smells. It’s not too hard to resist.
I finally entered the operating room at 10:35 am and left it at 3:20 pm. I am brought back to my room more than an hour later. I am not impatient to eat and I do not suffer from hunger contrary to past experiences. When “supper” arrives (liquid diet), I “eat” because it is time and not because I am hungry. I’m much more sleepy than hungry … The 2 bottles of meal replacements were therefore effective. (See Preparing for fasting the day before if necessary.)
Leaving the hospital
Do not play the strong woman. Do not hesitate to ask for help and take a wheelchair to get to the car. You need all your energies to recover.
Transport and accompaniment
Depending on the side where you have been operated and the seat you are in, the seat belt could press the wound more or less directly. It is also possible that you need help to catch and tie your belt. If you do not have both pillows with you, the person who picks you up must bring them. Place one between the seat belt and you to dampen friction. Fold the other and place it along your leg so that your arm rests on the pillow.
Postoperative care and follow-up
The day after your visit, you will be visited by a nurse who visits you to check your dressings, change them if necessary, check your wound and your general health. The nurse will also ask you for the amount of fluid collected by the drains and can help you if they run poorly. If you do not go to your residence when you leave the hospital, tell your surgeon. He will then send his request to the CLSC near this place.
You have a postoperative follow-up appointment with your surgeon 7 days after the mastectomy. Drains are removed when the amount of liquid over a 24-hour period is 30 ml or less for 2 consecutive days. One or more additional follow-up appointments may be required for the removal of drains, staples or non-melting sutures (if applicable) and give you the results of the pathology report. Depending on the situation, staples or stitches may also be removed by a nurse on the prescription of the surgeon from the local community service center.
I forget something? You do not agree ? Does it suit you ? Feel free to share your point of view in the comments!