Category Archives: Mastectomy Post-op Medications

A Fellow Breast Cancer Blogger

Occasionally, I visit Word Press’s tag page specifically for articles tagged “breast cancer.”  I ran across a young woman’s post questioning how to prepare for prophylactic bilateral mastectomy Her post begins with:

Now what exactly do I mean by preparing? Mentally preparing. Emotionally preparing. Telling my work that in 2 weeks I’ll be off work for an undetermined amount of time. Telling all of my family. Telling my friends. Telling my rowing coaches. And other smaller(ish) details…

At the time of viewing her post, there were no comments offered, so, I took it upon myself to answer her questions as best I could from my own experience. Of course, everyone’s experience is going to be different, but, all of us who have dealt with breast cancer seem to  seek each other out for stories, support and to offer help. Here are her questions and my offerings of answers:

  • Clean & organize my house (after the surgery I wont be able to reach my overhead cupboards)
    • Prior to surgery, I put things on my counter that I knew I would be using regularly – like my favorite coffee mugs, my jars of instant coffee and creamer, think ahead, you will thank yourself later!
  • Get tops that I can wear post-surgery (i.e. button-up or zip-up tops that are really loose, because a) I won’t be able to pull a shirt over my head and b) to make room for the drains that I will have in for 10 + days)
    • I didn’t feel like getting ‘dressed up’ so I just bought those old-lady-type housecoats that zipped up the front. I wore those for the first two weeks then switched to sweat pants and some old button-down shirts of my husbands.
  • Get small ice-packs to put on my boobs to help deal with swelling?
    • This is a good tip. My hospital sent me home with refillable ice packs, but I didn’t know this prior to surgery. It won’t hurt to have extra!
  • Get lots of food (preferably pre-made meals) so that I don’t have to worry about this for the first little while?
    • Another good tip! I cooked and froze food ahead of time since I don’t like to eat the food my husband cooks, plus, my son was coming in to be with me for moral support.
  • Who can shovel my driveway? There’s no way I’ll be able to do this for a long time, and we’re supposed to get a lot of snow this Feb.
    • Again, check with your hospital or even insurance company, there are volunteer organizations that can help with this, even check with local churches.
  • Who can come with me on surgery day & drive me home?
    • Once again, check with your hospital, they may even have a “pay” service , but, you will REALLY need some help at home at least for the first couple of days… especially if you are taking medications!
  • Do I need to fill any pain prescriptions ahead of time?
    • Your doctor should give you your prescriptions prior to surgery, at least, that’s what mine did.
  • Do I need to get one of those special post-mastectomy bras?
    • Your doctor should let you know ahead of time. Mine measured me ahead of surgery and had the bra with her at the time of surgery. I did have to buy one later, so that I had two – one to wear while the other one was washing. I had to wear my bra for months, day and night.
  • Will I be able to lift the cat food bag in order to feed the kitties? What about their litter?
    • No. You WILL NOT be able to get up off the floor, so don’t even try to get down and sit on the floor for any reason! You will NOT be able to use your hands to boost yourself up!!
    • Again, keep things that you will use daily, in a convenient, reachable place. Insofar as the litter box, I told my husband to clean it out. See if you can ask a friend, or if not, set up another litter box.
  • How long will it be before I can drive?
    • Each person is different.
  • How on EARTH am I going to sleep on my back/sitting up??Seriously, I am a stomach sleeper, and can’t sleep on my back. Legit can’t. And I’ll have to, because post-surgery you can’t sleep on your stomach or side.
    • I am also a stomach sleeper. I literally slept in my lazy boy recliner for THREE MONTHS!!! I got used to it, I had to.
  • Do I have enough movies/books to keep me entertained while I’m bed-ridden?
    • The first little while, depending on your pain tolerance, you may be sleeping a lot with pain medication – I know I did. You might want to look into Netflix – my son bought a subscription for me and believe me, I watched so much television – the entire series of Mad Men, Breaking Bad, Fringe, and movies, movies, movies… It’s worth the cost and you can cancel when you don’t want to be sitting around any longer.
  • What will I do about showering? I’m not allowed to for the first while (because of the drains) -should I buy dry shampoo? Baby wipes? Will someone have to help me with my hair & have a semi-bath/shower/sponge-bath?
    • I have short hair, so I took a towel and folded it up and laid it on the edge of the kitchen sink, where my “boobs” might rest, then, I bent over and washed my hair.
    • I did the sponge baths in the bathroom sink, it wasn’t as nice as a shower, but felt oh so good to be clean!
  • Do I need to buy a shower chair (see above note?)
    • I didn’t and I’m 60 years old
  • Will I be able to keep track of all my meds etc. when I’m all doped-up?
  • Will I be too stubborn to ask for help when I need it?
    • Not when you reach your wit’s end.
  • Will the pain meds even work? (I have an insane resistance to pain medication, itnever works for me)
    • Only you will be able to answer this.
  • When will I be able to return to work? Will I be up to doing some work from home?
    • Again, only you will be able to answer this. Everyone heals at their own pace but I think it’s quicker for young women.
  • When will I be able to get back to rowing? (or at least exercising in general?)
    • Your doctor will advise you.
  • Are there physio exercises I should be doing post-surgery?
    • Your doctor will advise you.
  • Buy extra pillows (to help sleeping on my back/propped up).
    • Unless you have a nice, comfortable recliner.
  • Buy thank you cards
    • Yes!
  • Tell my rowing team (although, I partially did that by posting my blog on facebook and letting people just discover it themselves).
    • Right now, you must put YOU FIRST!!
  • Stock up on cat food, cat litter, toilet paper, Kleenex
    • And frozen food!
  • Buy a thermometer (you have to keep an eye on your temp to make sure you’re not getting an infection)
    • Yes
  • Re-organize my room so that the clothes I’m going to be able to wear post-surgery are easily reachable
    • Yes
  • Purchase a camera? I want to document this entire process, but maybe I’ll just use my iphone the whole time.
    • Since you already have an iphone, I wouldn’t worry about buying a camera unless the new purchase will make you happy!

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Breast Surgeon Post-op Visit

I had procrastinated on making this appointment since I thought there was no need to see her again, after all, she performed the surgery and sentinel node biopsy, informed me that the cancer had not spread to the lymph nodes and I survived, what more did I need to know?  As it turns out, quite a lot.

Fortunately, I had phoned her office last Thursday, the 19th and surprisingly was able to see her today, only 4 days later, including the weekend! Originally, I wanted her opinion/advice regarding possible lymphedema.

Dr. Talbert entered the room with her trademark congenial smile and the surgical report in hand, she asked how I was doing and commented that I seemed to be recovering very well.  She handed the report to me as she reviewed what took place during surgery, which seemed uneventful to my mind until she said, “…there were pre-cancerous cells in your left breast.  It was a very good thing that you chose to have it removed at the same time.”

Those words and time froze in my mind, “..pre-cancerous cells in your left breast…”  I heard nothing else that was being said, I was stuck in that moment of, …of… fear?  disbelief? gratitude?  Dr. Talbert must have realized that I was dumbstruck and gave me a moment to regroup and she continued that she would like to see me six months from now for an MRI to be certain that no cancer remained to spread into the chest wall or skin.  WHAT?  Again, I was dumbstruck.  I thought that “this” cancer was done, finito, all gone, never to be seen or feared again.  Hmm, I’m learning that once you have cancer, the rest of ones life is going to be filled with vigilance.

Moving onward from cancer topics, I proceeded to ask her about lymphedema and to give me the “description” of the type of cancer I had since my relatives can tell me exactly the type of cancer they had, example, Lobular carcinoma in situ,triple negative breast cancer, Angiosarcoma, etc..  But, before I record what she explained about the type of cancer, (I’ll type in directly from the report she gave to me) let’s address the lymphedema concern.

I showed her my right arm of which I am aware that it is slightly puffy, less than it had been several days ago.  I digressed as I asked her to point out from where the three lymph nodes were removed.  She touched the area above where my right breast had been, close to the underarm area but still on the front side of the body and explained that those three nodes were the ones that ‘lit up’ from the nuclear injection.

Back to lymphedema, I asked if removal of the lymph nodes is associated with lymphedema, it makes sense to me that it would.  She agreed that in cases where more numerous nodes are removed, the likelihood of lymphedema is much greater.  Looking at my arm, she agreed that it did look slightly swollen and that she would like to send me for physical therapy but could not do that until the reconstruction phase is completed, at least up to and through the permanent implant exchange and recovery.  While telling this to me, she raised one of her arms and showed me how I might relieve some of the pain by slightly raising my arm, above the heart, and gently massaging from my wrist back to my shoulder, to help encourage the fluid to drain into the larger part of the body.

One final question I posed was whether or not I could start doing more physical things, like, moving and burning our wood pile, weeding the front flower bed, vacuuming, etc..  Her eyes got HUGE and she said, “NO!”  I then learned that it would actually take SIX  MONTHS for my internal wounds to completely heal from the extensive surgery, even though I might be “feeling good”, if I overdo anything, I could end up back in the hospital in worse condition than when I left.  Ok, that warning is good enough for me, my activities will remain to be limited to emptying the dishwasher, doing laundry and computer work.

As we closed out the visit, I wished her congratulations as she was closing her practice at this location and returning to Oklahoma University where she would return to teaching and head the new breast cancer research department.  She will have an office at OU with limited patients, I, fortunately, am one of the lucky ones who can count her as my doctor!

From the report:

Right Breast, Simple Mastectomy (A):

  • Invasive, Well-differentiated ductal carcinoma
  • Tumor location – upper outer quadrant
  • Tumor size – 1.4 x 1.1 x 1.0 centimeters
  • Invasive Tumor type – Invasive Ductal Carcinoma, Usual Type
  • Invasive Tumor Grade – Histologic Grade 1
  • Tumor-Associated Microcalcifications – Present
  • DCIS Component – Present (1/9 Slides)
  • DCIS Type – Cribriform
  • DCIS Nuclear Grade – Low-grade
  • Necrosis – Not Identified
  • Surgical Margins – Free of invasive and in situ ductal carcinoma.
    • Closes Margin – Deep – 1.0 Centimeters
    • Additional Margin – Superficial Skin – 1.7 Centimeters
    • Ancillary Studies – Performed on Biopsy at MWR
    • Estrogen Receptor – Positive (95%)
    • Progesterone Receptor – Positive (80%)
    • HER2-NEU By FISH – Not Amplified (1.2)
  • Right Sentinel Lymph Nodes, Excision (B):
    • Three begign lymph nodes negative fore metastatic carcinoma at levels (0/3)

Left Breast, Simple Mastectomy (C):

  • Mild Proliferative Fibrocystic changes
  • Negative for atypical hyperplasia and malignancy

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