Tag Archives: ROM

Post-op resistance training

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Level 3 exercises are here!

I’ve mentioned in a couple of previous posts, that I began doing simple range of motion exercises while still in the hospital bed on the day of the prophylactic bilateral mastectomy. I was following Casey Eischen’s program. Casey is a fitness expert and nutrition coach that is certified in training women who are recovering from breast cancer and related treatment or surgery.

If you have not yet seen Casey’s first video or want to learn more about her, see: Post-op exercises or Foobie Fitness.

Here is the next video in the series with level 3 exercises. It is for those that are at least six weeks out from their mastectomy and includes more stretches plus a great resistance training routine.

As with starting any diet or exercise program, always consult with your doctor.

They’re growing – first expansion

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WARNING: NSFW / graphic content below.

Goodbye ugly scab, hello first fill!

The scab that has been living on my left boob has finally fallen off! Can I get a “woo hoo”? It has been two full months since my prophylactic mastectomy on January 22 and the start of my adventure with resulting skin/nipple necrosis. Today I had my first fill. 50ccs of saline were injected into each tissue expander, bringing the total to 150ccs/side.

Tissue expanderWhat are tissue expanders, you ask? The type of breast reconstruction I chose is two-staged: tissue expanders first, followed by silicone breast implants. The tissue expanders, which were implanted underneath my pectoralis major muscle during the mastectomy, get filled with saline on a regular basis to stretch said muscle and the skin that covers it, until the desired volume is reached. They are like “pre-implants.” Similar shape, but more rigid, unnatural, and uncomfortable. They have a round magnetic port in the top half, which allows for insertion of a needle, without compromising the expander.

Breast Reconstruction Guidebook Figure 7.1

The process of filling the tissue expanders is pretty quick and uneventful. First the nurse uses a little plastic contraption with a metal pin at the end to find the magnetic port in the tissue expander. Once the center of the port is identified, the nurse sanitizes the area and injects the needle attached to a syringe holding the saline. She then slowly pushes the plunger until all 50ccs of fluid have been injected into the expander. This takes less than one minute. After completing the fill, she places a little round band-aid over the injection site. Same story on the other side.

This procedure is overall painless (based on just the first fill). The only sensation was a brief sting as the needle was inserted into the port through the skin.Three hours later, I feel a little bit of that now-familiar pressure on the muscle and skin stretched over the expanders. As soon as I got home, I popped an ibuprofen, did some stretches, and smeared my chest with Palmer’s cocoa butter oil.

As I look down at my chest, I can see that my foobs are bigger. It is a small difference, but it’s there. It will be interesting to watch these things grow. I can already tell that it won’t be pretty. The expanders didn’t settle exactly the same way: one sits higher and the other one is a bit twisted. The asymmetry seems to be normal based on my plastic surgeon’s feedback and the photos other women have shared. Enjoy the visual!

Fills 2013_3_29

100 + 50 = 150ccs

The fills will continue every two weeks at 50ccs/side. At this point, I have not yet decided how big I want to go (one of my friends joked: “go big or go home!”). However, I did find out that my breast surgeon removed 184 grams of breast tissue/side, which translates to roughly 184ccs, so one more fill and I will be back to pre-op size. Next appointment: April 12.

Source of Figure 7.1: Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.

Shower time

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Taking a shower after a prophylactic bilateral mastectomy can be a challenge. For the first few days after the procedure, it is not a good idea, because of limits on mobility/range of motion, weakness, and the presence of surgical drains. Some doctors instruct their patients not to shower until the drains have been removed. Until that time, sponge baths are the way to go. I got clearance from my doctor to take a shower four days after my procedure. I almost hugged him when he uttered those words.

The magical day was Saturday (surgery was Tuesday). I waited until about 30 minutes after taking a dose of pain meds, so they had a chance to work their magic. My equipment:

  • Someone to help
  • Shower chair or a small cooler with a towel draped over it
  • Antibacterial soap
  • Shampoo/conditioner
  • Regular pouf
  • Back brush/pouf

The whole process took somewhere around 30 minutes, with most of it spent on undressing and then putting clothing back on in what seemed like slow motion. I wore my underpants and clipped my drains to them (washed my butt last:)). An alternative is to wear a shoestring or a lanyard around the neck and clip the drains to that.

Yoshi

Yoshi: my fav t-rex

I sat on the cooler facing away from the shower head and let the water run down my back rather than directly onto my incision sites and boobies. I insisted on doing the washing, including my hair. It was tough to reach up and scrub – taking it slow and noting when it was too much was the key. The back bush helped with the hard-to-reach places. It was a much needed extension of my t-rex arms. I put antibac soap directly on my hands and gently washed the incision sites, the armpits where the drains exited, and the rest of the chest. After showering, I patted the chest dry with a clean, sanitized towel. This was a much needed refresher!

Sasquatch xing

Sasquatch xing

In one week, I progressed from the sit-down shower or a bath (water level below the chest) to my first real, solo, stand-up shower. The day I wrote this post, nine days post-op, I felt limber enough to shave my legs. Someone release the marching band! My armpits are still a bit sasqutch-esque, because the drain tube holes haven’t completely healed, so I’ll hold off shaving them.

Post-op exercises

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Check out this awesome video from Casey Eischen, BS, CSCS, CPT, CES, Health/Fitness Expert and Nutrition Coach, providing levels 1 & 2 of a great exercise program for women who have undergone a prophylactic bilateral mastectomy. More to come!

Exercises to Recovery from Phophylactic Mastectomy/Reconstruction

2/1: Check out a more recent post about exercise and nutrition: Foobie Fitness

Last details

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  • Insurance pre-authorization: confirmed
  • Disability and FMLA forms: completed
  • Consent forms: signed
  • Pre-op instructions: received
  • Pain medications: prescribed

All that’s left to do now is to get through the items on my Preparing for surgery list, think positive, and avoid getting sick! It just got real. It’s the final countdown.

Went to see the plastic surgeon for the last pre-op appointment. We discussed a few last details:

  • QuestionsSome ladies are told not to shave, as it may increase chance of infection. Is shaving OK before the surgery? Yes, it’s fine.
  • Will I get a pain pump implanted or IV-type pain medication while at the hospital? The pain medication will be administered via IV, not a pump. Implanting the pump creates additional surgical/wound sites and isn’t necessary for this type of procedure.
  • How soon after surgery do I start follow ups? I will meet with the surgeons before leaving the hospital. If there are issues after leaving, may see the plastic surgeon every day, may not see him for a few days. Depends on how things go. Will keep in touch.
  • How soon will the first MRI need to be completed? The MRI is done two years after the implants are in, so nothing to worry about in the immediate future (especially since this will be a staged reconstruction, which means the final exchange of implants for expanders will not take place until about six months after mastectomy). These screenings will be monitored by the plastic surgeon. Breast cancer screenings will continue via clinical exams from the breast surgeon/OB-GYN/PCP.
  • Is physical therapy recommended? Not typically. Some women are back to normal fast, some take a few weeks. Try to do things without help from others (within reason). Brush your own hair the day you get back from the hospital. When you can shower, wash your hair yourself. Do some range of motion exercises. If not making progress, PT may be recommended to help with the recovery.

Added 1/19: Check out this awesome video from Casey Eischen, BS, CSCS, CPT, CES, Health/Fitness Expert and Nutrition Coach, providing levels 1 & 2 of a great exercise program for women who have undergone a prophylactic bilateral mastectomy. More to come!

Exercises to Recovery from Phophylactic Mastectomy/Reconstruction