May 29, 2013 05:47PM - edited Jun 28, 2013 06:29PM by nyama
OK, so this is what I discovered in having this surgery. I didn't actually make all of the preparations I'm mentioning....but wish I had!!! Which is why I'm making the list for anyone else who might be interested.
As I said in the last post, the surgery requires a joint team of BS and PS. My PS has been the one responsible for most of my physical follow-up (post-op visits, etc.) except for one follow-up with the BS. For the actual surgery, the PS made the initial incisions, based on our planning visit when I got to "choose" my ultimate breast shape, and then the BS stepped in to remove the cancer and do the sentinel node dissection/biopsy. It was a
long surgery--about 3-4 hours. (Side-note: I just realized as I wrote this that that planning visit finally gave me a sense of control over a situation that, so far, had seemed so far OUT of my control. Never thought of it like that before, but it's definitely true. A plus.)
Recovery from this surgery is a little different than from a regular lumpectomy. Some things are the same and some are different, so I'll just speak to my experiences even though some overlaps with that of a lumpectomy and some with some kinds of reconstruction and you'll find references to a lot of these things in one thread or another.
When I woke up after surgery, I had a large compression bandage over my chest -- looked like a big, gauze, bra--and two drains, one on each side. I've read that some doctors use either ace wraps over a dressing or a surgical bra with dressings, but this was what I had. I wasn't draining much, so had the drains out and got to leave the hospital the next day, and kept that initial bandage on for a week, after which it was removed at the PS's office. I then had to wear a bra night and day for the next 2 weeks. Try to buy a good, COMFORTABLE, supportive bra (no underwires). I've had a terrible time finding one that works for me, mostly because of the way it rubs my incisions under my breasts. I'd recommend one with a wide band. I know they're out there, but I just haven't been able to get one that works for me. Should've done it from the beginning or used the hospital breast center for that!
Plan on at least one week of doing almost nothing. Or, as my PS said, being a couch potato. That means no trips to the store, no going out to dinner, nothing. Technically, I was told not to drive for 3 weeks (!!!) since it pulls too much on the incisions, but I simply couldn't last that long and drove after a little over 2 weeks. Just a little (emergency trip to the store 1 mile away). I could see why I wasn't supposed to earlier, though. I basically set myself up a little nest with laptop and books in my bed and stayed there most of the time.
So be prepared with plenty of food, including pet food, pre-prepared meals, and friends and family willing to help and act as chauffeurs.
You will also be unable to raise your hands above your head for about 3 weeks, other than bending at the elbows to brush teeth, hair, etc., so prepare the house accordingly. I live alone, so took a supply of dishes & non- perishable food down from the higher cabinets and placed them on the countertops so I could reach them (who cares if the house looks like a mess, right?). The biggest unprepared-for problem for me was how to use the microwave, which is above my oven. I actually ended up using a step-stool so I could still reach the microwave without lifting my arms so I could zap my tea-water and some of the meals I'd prepared and frozen ahead of time.
Wash your hair the night before/morning of surgery, since no showers for a week post-op, until the big bandage/dressing is removed. It's still difficult for a couple of weeks after that since you basically have to keep the operated area dry as you can in the shower and only bend your arms at the elbow to reach your head. And baths. I--finally--got the OK to take my first bath this week (6 weeks post-op) as long as I don't soak the breast area yet, since I'm still healing. So a half-bath, really, but it felt SO good!
You won't be able to lift much for a while. Almost nothing the first week, and then up to around the weight of a milk container for the next couple of weeks. This presented a problem for me in a couple of unexpected ways. For instance, pouring the cat-food out of the ten lb. bag. (Solution - measuring cup inside the bag.) Also, things like opening/closing car doors or trying to open a lid from a jar or a child-proof medicine bottle cap presented unanticipated difficulties. The first week is especially rough.
Needless to say, no laundry, no housework, no vacuuming for about 3 weeks (good excuse, right? ) And front-closing bras and tops are a big help in the first weeks. The hardest part for me was not being able to babysit my two, rambunctous little grand-baby boys. Can't lift them plus they have too many elbows and knees. But I suppose if I had to it could be done, with some planning, and there are some moms out there for whom this might be an issue, too. Something to plan ahead for and figure out a way to make it work.
Pain and healing. I actually haven't had too much pain, nothing unbearable anyway. I stopped the pain pills the day I left the hospital and just used tylenol for a week, and then ibuprofen. However, it's now 6 weeks post-op and I'm still sore and tender. Some parts of the surface area of my breasts are actually numb due to the cut nerves, which is a weird feeling. Others are hypersensitive. Sometimes I feel sharp, shooting pains or a feeling like chills as nerves regenerate (or that's what it feels like they're doing). Sometimes the incision lines under my breasts feel like they're pulling...all part of the healing process I guess. I still have a little bit of scabbiness on a couple of the incisions. And I still have scabs on my nipples, which is not typical but a result of my particular procedure.
As I mentioned in the last post, my tumor was right under the nipple, so the decision was made, because of the location and since I'm past my childbearing years (so no need to breastfeed) to actually remove my nipples during surgery as full-thickness skin grafts and then re-attach them after the tumor was out. (Ewwwww, right? I stopped reading the op report about the time it said they were "properly labeled and placed on a moist sponge...."). This is NOT the typical procedure, though, but specific to my case. However, it's not too bad, in case someone who is reading this will have to go through it. They will look nicer, eventually, as the PS made the areolar areas smaller. ( Mine were too big to start with and would've looked even worse on smaller breasts.) He was also able to place them higher on my reduced breast so they look nicer in that way, too. The first set of stitches around the nipples, holding on the pressure bandage, were removed after the first week. The second set, holding the nipple on (talk about Franken-boobs!) at about three weeks post-op. The drawback is that, as of now, they have no sensation and it's likely they never will, although I do notice some response to cold. Not that I can feel it, but I can see it. And it takes a while to heal.
So. Like I said, it's kind of a mix of procedure and recovery issues to have this done. Hopefully listing some of the particulars will help someone contemplating/preparing for this surgery, not that I'm any authority or anything but I just didn't see another place where it was all combined so as to pertain specifically to oncoplasty. Despite some of the added difficulties compared to a lumpectomy only, I'm happy with my decision. Everyone is different, though.
Feel free to ask any questions, or if anyone else has gone through this and has a diffierent or similar experience, please chime in and add your two-cents.
Whew, this is a long post!