How to Prepare for a Mastectomy

It's been a few weeks since my mastectomy. I am still healing. I am not 100%, but each day I am slowly getting better. While I sit here and heal, I have thought about putting a post together to try and help other ladies who may be facing a mastectomy and answer any sort of questions that they may have. One thing one has to remember is that every one is different. Everyone heals a certain way. Everyone has a different pain tolerance. But here are a few things that I thought were very helpful and wish someone had told me... or they did tell me.

Pre-surgery
* It's okay to cry. Going into surgery is and can be a frightening experience. It's okay to shed your big girl panties (literally, you have to). There's lots of things that can go wrong while under anesthesia and it's okay to be a little or a lot freaked out.
* If you go to OHSU, be prepared to take a shower the night before and the morning of with this putrid smelling "soap." It's an anti-bacterial wash to get all the germs off of your body.
* Change the bedding the day before your surgery. When you get home, and you want to lie in bed, it's nicest to do it on fresh sheets.
* Packing - pack light. Pack a pair of pants that are easy on and off (think elastic, yoga pants). You don't want to be buttoning and zipping up a zipper. My sister-in-law got me a great shirt from Heal in Comfort. The shirt was nice and comfortable and I wore it for days. Pack some socks and a pair of underwear. Bring a book, iPod or something to do in your down time. Unless you like daytime TV, TV sucks. Pack a shirt that buttons up or zips. Wear easy on/off shoes to slip into while you're in the hospital. Toiletries too.
* Pack a few snacks, easy on the tummy. When you order room service, it usually takes 45 minutes to an hour.
* Pack one of those neck things that you bring on an airplane. You'll be sleeping sort of upright for a few days.
* Shop. Make sure you've got your fridge and pantry stocked up.
* Make plans to have help with you the first week.
* Leave that toe nail polish on! They didn't say anything about my red toe nails. I also had on clear polish on my fingers. No one said a word.
* Ask your surgeon if you will see any bandages on your chest following the surgery. My surgeon used dermabond which goes over the incision and makes it waterproof. In addition, my surgeon doesn't use any "bounding" or bandages. However, if I wanted to be put into a camisole or something, she would have done that.
* Make your post-surgery check up before surgery.

Surgery
* Yes, they will intubate you - put a tube down your throat to help you breathe.
* They will most likely before you wake up from surgery drain your bladder. That means a catheder.
* You'll meet your surgeon again, the anesthesist, nurse anesthesist, head nurse of the OR and more. It's a bit overwhelming.

Post-surgery
* If your at all modest, throw it out the window. They've seen it all!
* Have an advocate with you. When you get out of surgery you're weak. I could barely press the "Nurse" button on the bed and when I got one, they could barely hear me because I could barely talk because of the tube that was down my throat.
* If you have to use the bathroom, try your hardest to do it yourself by getting out of bed. But do it slowly. Get help from everyone you can. I went about 8 hours after surgery. It took about 10 minutes for me to get from the bed to the bathroom about 10 feet away. I first sat up, rest, swung my legs over the side of the bed, rest, stood up, rest, walked a bit, rest, walked more and got to the toilet. I did tell everyone to give me privacy so I could pee. I don't pee well when everyone is watching me. And yes, they do measure the amount of urine output. (This is where having easy on/off shoes works great)
* Expect drains to be annoying. They are stitched in place. Pin them to your hospital gown.
* Expect to be sore - as in you just bench pressed your max about 100 times.
* Expect not to be able to take a deep breath in. Shallow breaths are all you can do until the swelling goes down, and if you had immediate reconstruction the pectoral muscles will be sore.
* Don't worry about wearing underwear. It's over rated after surgery in a hospital.
* Get up and walk as much as possible.
* Don't expect to get lots of sleep. Nursing shift change and vitals to be taken every 4 hours makes sleeping a pain.
* Keep a barf bucket nearby.
* Make sure you have water handy at all times.
* You may get a cough. This is a result of the intubation. I coughed a lot and got a lot of phlegmy stuff up.
* Fill your prescriptions at the hospital pharmacy.
* Expect the male CNAs to ask if you need any help with hygeine. I had to laugh because all the male CNAs asked if I need help. None of the women did.

Going home, I wore the same elastic pants I came to the hospital in. I also wore a mastectomy camisole home with the drains attached to it. The cami zips in the front. I didn't velcro the drains to it, but rather pinned them to the camisole itself. I tried, but it was too uncomfortable. If you get a bra or cami specifically for the drains, make sure your cami is roomy around the chest because it will be swollen. Also in the car, I made sure the seatbelt didn't touch my chest. You can put a pillow or something where the belt goes across the chest to pad it.

At Home
* If you had a double mastectomy, you won't be able to lean on anything in any direction because of the drains.
* Use lots of pillows.
* Don't forget to move around. You are at a higher risk for blood clots following surgery.
* Rest
* Do your exercises to get your shoulders working again.
* If you had axillary dissection, watch for cording or axillary web syndrome. If you suspect you have it, then tell your surgeon and have them refer you to a physical therapist who is certified in lymphedema.
* Get a lanyard to hook your drains on when taking a shower. Your first shower will feel great but take it very slow.
* Driving - my doctor said I could resume driving after I stopped taking narcotics and could turn my head left and right without pain.
* Drains - My surgeon said that the drains can come out when it stopped draining over 30mL in a 24 hour period for 48 hours. Again, the magic number is less than 30. For example: Day 5, in a 24 hour period, my drain collected 29mL cummulative. On Day 6, I measured 25mL of fluid in a 24 hour period. That means I can get the drain out. Now if on Day 6, I measured 33mL of fluid in a 24 hour period, I would not get the drain out. It has to be 30mL or less in a 24 hour period for two days straight. Mine came out one drain at a time.
* Stay on top of your pain medication.