CARING FOR YOURSELF AFTER BREAST SURGERY:
TIPS FROM THOSE WHO’VE BEEN THERE
Many people have called Sharsheret searching for information about how to care for themselves following breast surgery. Speak with your medical team to understand how your surgery can impact you and learn the best techniques to prepare yourself for the recovery process. These are guidelines; however your specific situation should always be discussed with your healthcare provider. Additionally, some Jewish women may have unique concerns relating to laws and spirituality following breast surgery.
Sharsheret is here to help you navigate through this process and provide you with the proper resources and support. Through Sharsheret’s Peer Support Network, you can connect with other women who can share their recovery experience with you. Contact our support staff for more information and help with your individual questions at 866.474.2774 or [email protected].
Lumpectomy, mastectomy and reconstruction surgeries can have both physical and psychological impacts on you. After surgery, it is natural to feel a wide range of emotions, as your body has undergone many changes in a short period of time. Often, women are raised to believe that breasts are a part of their natural appearance and identity, and therefore, mourning and missing them can be a natural reaction. This can be an important part of the grieving and healing process. The time it takes you to feel “back to normal” depends on the individual; each person requires different amounts of time for their body to adjust following surgery.
If you experience any adverse effects from pain medication, speak with your doctor about other ways to manage pain. It is important to create a game plan with your doctors and nurses about managing pain post-surgery, including pain medication and other options.
Many people develop constipation after surgery due to inactivity and pain medication. Prevent this by including plenty of fluids and fiber in your diet, and by moving around as much as possible. Ask your doctor for constipation medication if necessary.
If your drains are causing you pain, try placing a small pillow between your side and armpit; this can reduce the friction and pain you might be feeling.
Consider taking pain medication a full hour prior to emptying your drains to minimize pain.
There are many ways to hold drains, including wearing a camisole or bra with pockets inside, specifically intended to hold your drains post-surgery. Specifically designed drain holder pouches or lanyard necklaces can be another way to hang your surgical drains after surgery, or you can pin them inside your shirt or sweater/cardigan. Holding them with these garments can take the pressure off and reduce pain or discomfort that can occur by having them loose.
Rest is an important part of recovery. You might need to change your normal sleep position to make yourself more comfortable. Finding a comfortable sleep position may be difficult, particularly when you still have your drains and if you have expanders. Many women choose to sleep in a reclining chair for the first few nights or even weeks post- surgery. If you don’t have a reclining chair in your home, you can rent one through a durable medical equipment (DME) company. If you use a recliner, you might want to also use a travel neck pillow for added comfort.
When sleeping in your bed, using a regular pillow may be challenging and put a strain on your chest. Sleeping with a wedge, arm rest pillow, or a full body pillow can help you to get more comfortable. Consider placing a pillow under your affected side or arm for more comfort.
If you’re having trouble sleeping, speak with your doctor. Do not take supplements for sleep unless approved by your doctor. Even the most natural sleep aids might interact with the pain medications you are taking. Sleep meditations are a great resource to try.
Soft and loose fitting clothing, and clothing with buttons or zippers down the front, are ideal because they will be the easiest and most comfortable to put on after surgery as lifting your arms might be difficult the first few days. They also can hide drains and don’t rub against sensitive skin.
Consider shopping for post-breast surgery clothing. Check with your insurance company as to what they might cover and which providers are parts of their plan. Since coverage can vary, make sure you know what your deductible and copay will be. Select a shop that specializes in post breast surgery clothing and products and is an in-network provider under your plan.
After breast surgery, speak with your doctor about whether or not you should wear a bra. It can be beneficial to wear a bra that has: soft seams, a wide under band, deep front and side panels, full cups, cup separation, adjustable straps and no underwire and closure in the front. This will provide you with the most comfort and help the affected areas recover from surgery.
Following surgery, mastectomy bras can be measured to fit you by a professional. A measured fit is necessary after a unilateral mastectomy because the breast prosthesis is worn after a mastectomy to restore balance and symmetry with the remaining breast. I n the case of a bilateral mastectomy, a set of two prostheses can be fitted to recreate the previous size.
Mastectomy bras and camisoles are made of soft and stretchy material which enables easy sizing and complete comfort for sensitive skin and scar tissue.
Women are typically encouraged to wait to shower after surgery; this can vary depending on the woman but can last for several days or weeks. Speak with your doctor if you have concerns about water coming into contact with incisions or drains.
Dry shampoo is a great way to keep hair clean and feeling fresh throughout the time when you cannot shower. Additionally, some local salons will come to your home to wash and blow dry your hair before you are able to shower.
Once you are allowed to shower, it can help to sit in a shower chair or hold onto a bar or ledge, in case of dizziness, muscle spasms or pain.
Massaging may help improve the appearance of scars and may break up deeper scars in the soft tissue and chest wall, which can cause pain or issues with range of motion.
However, in cases where shaped implants and expanders are used, massaging is not recommended right after surgery. Speak to your doctor about massaging and if it is recommended for you. Lymphatic massage is also sometimes recommended to help prevent or treat lymphedema. Your doctor can refer you to physical therapy for this.
Products such as vitamin E oil and topical silicone gel sheets are often used as tools to help scars fade or disappear. It might take a year or two for tissues to fully heal and scars to begin fading.
Make sure that items you will need post-surgery are roughly at your waist level to keep you from contorting your body or needing to raise your arms above elbow-height.
For some, home nursing care is helpful post-surgery. Speak with your doctor about recommended home nursing agencies, and check with your insurance to see if home nursing care is covered. This isn’t necessary for everyone, so don’t worry if it isn’t possible for you.
Movement & Exercise
Speak to your health care team about arm movement and stretches. Doing gentle exercises and arm movement as soon as possible, even with drains or sticks still in place, may improve recovery time and range of motion. It might be helpful to learn about this before surgery, so you’re ready to go once you can begin working on regaining your range of motion. Again, physical therapy can be very helpful with this.
Likewise, walking and exercise is very important. Fresh air and sunshine go a long way to boost energy and spirits. Start with a walk around your home, then around the block to regain strength and promote recovery.
Ask family or friends for help with housework and other errands or chores. Limit housework until you are healed, and do not overexert yourself. If you have small children, speak to your doctor to ask if you can lift them and try to arrange help if needed.
Depending on your location, there may be organizations that can help you with housework, meals or childcare. The American Cancer Society has a vast number of resources available for extra support, many of which are free and searchable by zip code.
Speak with your doctor about when it is right for you to go back to work. Returning to work too quickly after surgery can impact your healing process. Typically, women wait a minimum of 2-3 weeks before returning to work after surgery. Depending on what you do for work and whether reasonable accommodations can be made, it might be longer.
Have a family member or friend open jars and hard to open lids or reach hard to reach items for you before leaving for work or school. It may be difficult for you to open these things by yourself post-surgery.
When traveling in a car, you may want to put a travel sized pillow between your chest and the seatbelt to give you added cushioning and comfort.
For your safety, do not drive immediately after surgery. Speak to your doctor about when you can drive again following surgery.
Communication With Your Health Care Team
Make sure to confirm with your doctor which medications to take and when to take them. Put alarms in your phone to prompt you to take them on time. Don’t forget to set the alarm again once you take a dose. Ask your doctor about arm exercises you can perform to improve your range of motion after surgery.
Keep track of all scheduled checkups and doctors’ visits so your progress can be checked by medical professionals. Sharsheret’s Thriving Again Survivorship Kit is a great resource to help you keep track of everything. Ask your Sharsheret social worker or visit www.sharsheret.org/thrivingagain for more information and to order yours.
Mastectomy/Reconstruction To-Do List
Things to do to prepare for surgery:
- Take a pre-surgical photo (this is optional- only if it’s something that you’ll want to have).
- Get underarms waxed or lasered
- Temporary handicap sign for doctor visits (if possible)
- Remove nail polish
- Designate someone/s to greet visitors and let them know if you’re not available
- Set up an automatic response on your phone, “I’m not available and will get back to you…”
- Set up a night table with all that you’ll need when you get home (easy-to-use water bottle that’s light etc.), remote, magazines, pad and paper etc.
- Unscrew prescription tops or place prescriptions in a reachable dish (can’t unscrew tops)
- Purchase shampoo and soup in a pump bottle for easier access
- Put clothes that you’ll wear (e.g. button down shirts) on low rod that you can reach.
- Put favorite foods/cups etc. on lower shelves that you can reach (no water bottles that are not already opened — top too hard to open)
- Get recliner set up with ottoman so that you can doze off somewhere other than your room if you want (rent seat lift chair, if possible)
- Consider getting a bed rail from a medical supply company (to make it easier to get out of bed)
- Empty your purse and take out what you’ll absolutely need to have to go to doctors appointments etc. or on short walks. Use fanny pack or similar.
- Set up list of people to contact post-surgery
- Set up movies/tv shows/podcasts/music to watch/listen to post surgery
- Collect names of physical therapists for post-surgery. Schedule appointments in advance of surgery, if possible. It is hard to find a therapist who a) specializes in mastectomy patients and b) who isn’t scheduling at least a month ahead of
- Set up chair in bathroom close to mirror
- Arrange for transportation to doctor appointments in the first week or two post- surgery (don’t forget your seat belt protector)
- Reconfirm that your prior authorization for surgery has been approved and sent to the doctors and hospital if your surgery is coming up soon
Things to buy/collect for hospital:
- Favorite throat lozenges
- Favorite Chapstick/lip gloss
- Flip flops for shower (if they let you shower)
- Clogs to wear home/shoes that you can step into
- Fill prescriptions that you know the doctor will prescribe for after surgery (ifpossible)
- Ask doctor if they can prescribe an anti-anxiety medication for day of surgery and fill Rx if so
- Assign someone to take notes on pre- and post-surgery doctor visits (if COVI D rules allow)
- Zip up or snap shirts – alternatively, button down
- Zip up shirts, sweatshirts, robes, pajamas with inside pockets for drains
- A mesh or similar drain holder for the shower
- Roomy sweatpants (with drawstrings) for ease in pulling on and taking off
- Tank tops/camisoles that you can step into or can easily go overhead (e.g. sports tanks that are open in back)
- Extra front opening sports type bras
- Camisoles/Soft non-wired bras for after 6+ weeks post-op
Set up spreadsheets or lists
- Drain fluid removal
- Medication administrations
- Gifts you receive including meals/rides
- Visitors that come by or call that you can’t answer/see (so that you can get back to them)
- Keep a diary, if you want to remember/look back on your journey and/or to share with others
To Buy/Rent For Home:
- Surgical gloves
- Favorite body wipes
- Electric toothbrush
- Dry shampoo
- Small pillows for underneath arms
- A pillow or support for the seat belt that fits across your chest (for doctor’s appointments)
- Wound care supplies (just in case — gauze pads, tape, Neosporin, scissors)
- Easy to use bottle for water that’s not too heavy and easy to use
- Hand-held shower attachment for shower
- Shower bench/seat
- Seat lift chair (for first few days/weeks)
- Benadryl (regular non drowsy for daytime) for itching
- Cream for dry skin and anti-itch
- Dry erase board for keeping track of medications (or you can use your bathroommirror)
- Height and angle lap desk
Do Relaxation Exercises:
- Apps to use:
- Waking Up — Sam Harris
- Insight Timer
- Pre-surgery hypnosis: https://www.voutube.com/watch?v=GnCOELOueNw
This resource is provided for informational purposes only and should not be interpreted as medical advice. All medical information should 6e discussed with a healthcare professional.