Tag Archives: surgery

Pre-op stuff

NoteThe countdown to my PBM has hit single digits! Less than a week away.

I have done/gathered almost every single thing on my checklist with the exception of the recliner. I’m borrowing one from a friend, because I don’t want to buy it just for the occasion and he has six.

Here are some of the pre-op instructions I received from both doctors.

DON'TsDON’Ts

  • Don’t use any aspirin or any products which may contain aspirin (acetaminophen/Tylenol is OK), vitamin E, fish oil, herbal medications, or diet pills within 14 days of surgery
  • Don’t smoke, exercise, or drink any alcoholic beverages for 24 hours
  • Don’t eat or drink ANYTHING, including water, after midnight
  • Don’t bring valuables (jewelry, excessive amounts of cash/credit cards)
  • Don’t wear makeup, perfume, or nail polish

DOsDOs

  • Do take your blood pressure, seizure, breathing, heart condition, or thyroid (but not diabetes) medications with small sips of water
  • Do bathe either the morning of or the night before surgery
  • Do wear proper clothing (top that opens in the front)
  • Do have a responsible adult with you to drive you home
  • Do bring your eyeglass case or contact lens case and solution, if needed

I’m anxious and scared, but very excited! Still feel that this is the right decision for me and that I am doing the right thing. Can’t wait to be on the other side.

Last details

  • 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 EischenBS, 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

Wonder Woman

Wonder Women

The first item on my list of Resources is: Find a SUPPORT GROUP. I think this is critical to keeping sane, among many other things. I have had the opportunity to participate in all three kinds – traditional, online, and communication with former patients.

A huge thank you to all of the Wonder Women out there that take time to offer their stories, experiences, photos, and support. It is just absolutely invaluable!!!

As I prepare for my mastectomy in January, I spend a lot of time thinking about it all. It has completely consumed me and can be overwhelming at times. If I have a question or just want to vent or want to see some pictures, I just pop on FaceBook or into the FORCE message board and do it. It’s so easy and convenient. I don’t feel like I’m bugging someone when I call them just as they’re putting their kids to bed.

The ladies I came across truly are my heroes! I mean it. In one way or another, they have all been touched by breast cancer. Whether they are like me, considering (or have already gone through) a prophylactic mastectomy, have watched a loved one deal with the disease, or those that have “been there, done that.”  Unless you have had the unfortunate chance to be in any of those shoes, you can’t fully understand how the experience affects every single facet of your life. It is not PINK and fluffy … it is completely devastating. Yet, these women continue to fight and move forward with a positive approach and unwavering determination. Thank you Wonder Women! Keep strong.

Preparing for surgery

I have seen many different lists outlining what you should do before surgery, what to take to the hospital, and how to make your life easier through recovery. Check out the Mastectomy Surgery Checklist from FORCE, a prep guide and a checklist from MyDestiny.

Here’s the list I kept for myself (after-surgery updates included) .

NotePreparing your body:

  • Get in the best physical shape you can manage before the surgery. The healthier the body, the more tolerant it is to trauma and the faster it recovers. ¤ YES! But lay off the push-ups and focus on core and legs. Note: I chose reconstruction via tissue expanders/implants, which directly impacts the pectoralis major muscle. Your doctor may offer different advice based on type of recon (or no recon). 
  • Constipation can be an issue after pain medication and anesthesia. Two weeks pre-surgery start getting more fluids (avoid caffeine), fiber, flax seed, prunes, or prune juice in your diet. You can also purchase an over-the-counter stool softener. ¤ Colace was the only medication that made me nauseous. I stopped taking it. Sunsweet prune juice did the trick. I went #2 on day five.

Preparing your home:

  • Rent a recliner or a hospital bed. Alternatively use lots of pillows, buy a wedge pillow or get yourself a BedLounge. Because of drains you will not be able to sleep on your side and obviously can’t sleep on your stomach. Pillows are crucial if you don’t normally sleep flat on your back. Most women report that sleeping at a 45 degree angle seems to be most comfortable. Buy one of those c-shaped travel pillows to help support your neck. ¤ I borrowed an electric recliner from a friend. Covered it with a vinyl sheet and a sterile white one. BEST THING EVER.
  • Buy or borrow a TV tray type of table on wheels. Have it next to your recliner or bed.
  • Get a Tiddy Bear or a travel-size pillow for the car to keep the seat belt off your chest. ¤ Tiddy Bears are great! The key is to have two of them – one up high on the shoulder and one under the boobs.
  • Have a set of clean sheets ready for the day the you return from the hospital.
  • Move everything you will need during the day to waist level.
  • Buy paper plates, plastic cups, straws, food in/on smaller and lighter containers. ¤ Yes on the straws, but all the other stuff I didn’t really use.
  • Prepare and freeze meals ahead of time or have someone as the designated cook while you recover.
  • Buy or rent a shower chair or have a cooler handy. ¤ I sat on a small cooler.
  • Get a back brush for showering. ¤ YES!
  • Place bottles of hand sanitizer everywhere.
  • Buy a personal digital thermometer if you don’t already have one. Monitor your body temp (keeping infection in mind). ¤ Yup, this is important. Take temp daily.
  • Things for the nightstand:
    • Medications (track when and how much taken) ¤ Set an alarm clock/cell phone to wake up at night and take on a schedule, rather than wait for the pain to hit.
    • Gauze, tape, scissors
    • Rubber gloves
    • Hand sanitizer
    • Tissues
    • Chapstick
    • Snacks
    • Water
    • Note pad and pen
    • Books and magazines
    • Tablet/eReader and charger
    • Phone and charger
    • Camera ¤ This is important. I took photos every single day from multiple angles. They helped me keep track of the necrosis and were my go-to when I thought I developed a seroma.

Other handy items to buy before surgery:

  • Lanyard or a special bra with drain pockets (insurance may cover) or make your own drain pockets if you have a sewing machine (see vid below) ¤ A lanyard worked well for me.
  • Button down shirts
  • Dry shampoo
  • Alcohol wipes
  • Non-child-proof medication bottles
  • Tylenol

For the hospital (if staying overnight):

  • Button down top
  • Lanyard/drain pockets
  • Head band and ties
  • Toothbrush and paste
  • Face wipes
  • Throat lozenges
  • Chapstick
  • Eye mask, ear plugs
  • Back scratcher (meds will make you itchy)
  • eReader/tablet and charger (check if hospital has wi-fi)
  • Headphones
  • Tiddy Bears or small pillow for the seat belt during the ride home

You’re doing WHAT?

January 22, 2013.  Seems so far away, but I know it’ll be here before I know it.  That’s the day I’m having a prophylactic bilateral mastectomy (PBM) and start the breast reconstruction process.  A PBM is an elective, preventative procedure which surgically removes breast tissue (see more details under WHAT IS A PBM?).  You’re doing what with WHAT?  Ya, I am doing it.  I have thought long and hard about what this really means.  I have discussed this with family, friends, and doctors.  I have done hours of research, almost ad nauseam.  After considering all of the factors, the risks, the benefits, the uncertainties, the consequences, I know this is the right decision for me.