The days of wait between biopsy to surgery can be frustrating. Use this time to prepare yourself for the surgery. If you have been on chemotherapy before surgery, use the days after your last chemo to recharge yourself for the next step.
Taking Care Of Your Body
Diet: Avoid going on a new fad diet just because you have been diagnosed with cancer. There are no particular food restrictions prior to surgery. Maintain a good intake of protein- Milk, egg, meat and pulses are good sources of protein. Have a balanced diet rich in fruits and vegetables. In the days immediately before surgery, avoid eating out and catching an infection. Diabetics should follow a diabetic diet and maintain good control of their blood sugars. Patient's who have been on chemotherapy prior to surgery, should follow advice of their oncology team.
Exercise: Do not start a new gym routine or workout right before surgery. Continue your the exercise regimen you are comfortable with. If you do not usually exercise, start with taking walks. Physical activity can help the mind and body. Breast cancer is no reason to limit activity.
Taking Care Of Your Mind
The time period of waiting for surgery can be stressful. If you have trouble sleeping, ask your doctor if you can be prescribed medication to help you sleep. A good night sleep can help your overall sense of wellbeing. Try not to sweat the small stuff and pick your battles when it comes to everyday problems. Take walks and keep physically active. Practice “mindfulness” in short breaks eg. When you wash your face bring your attention to the water, its temperature, texture of the soap suds. In that moment, focus your attention on the task at hand rather than think about what the day looks like tomorrow. Short mindfulness breaks can bring much relief to the stressed mind.
Preparing For Hospital Admission
You may be admitted to the hospital the day before or the morning of surgery. Here’s a helpful checklist of things to pack.
1) A set of clothes to wear when leaving the hospital. A 2-piece outfit to allow drain tubing to exit on the side. A loose front-open shirt and pajamas are a good choice.
2) A cloth purse/ bag with a long strap that can be slung across the shoulder to place the drain cannister.
3) Comfortable slip-on footwear to wear at discharge- avoid high heels and shoe laces to prevent falls.
4) All your recent and old reports -including lab tests, biopsy reports, mammography and ultrasound CDs and films.
5) Your glasses/ eyewear or contact lenses.
6) Bring your IDs Insurance papers and payment arrangements
7) Regular medicines you take at home. Take these only if and when instructed by the hospital staff once you’re admitted.
Remove jewelry at home and avoid bringing personal valuables with you.
What To Expect On The Day Of Surgery
You will be asked not to eat or drink anything for 6-8 hours before general anesthesia. You can take a shower the morning of surgery. Avoid applying any creams, lotions or talc after the shower. Do not shave or wax any hair near the surgical on the day before or morning of surgery as it increases risk of infection. The anesthesia team will evaluate you prior to surgery and answer any questions you may have about the anesthesia.
When you head to surgery, you will be asked to remove eyewear, contact lenses and dentures. Your family is expected to wait in the waiting area, as you will be taken to the operating room. You will be given a cap to wear as you enter the operating area.
The operating room will appear bustling with team members including the anesthesiologists, surgeons, nurses, scrub techs and other personnel. Expect to be treated with respect and kindness. The anesthesiologist will place an IV if you don’t already have one and have you breathe through a mask. You will fall asleep and wake up in the recovery room, once the surgery is done. After surgery, you will not be allowed to eat or drink for a few hours, until the anesthesia wears off. You will be given medications as needed for pain or nausea. Your surgical team will discuss details of the surgery once you are awake.
Drain Care After Breast Surgery
(see Dr Pranjali Gadgil’s drain care video on youtube or refer to drain care sheet)
If you undergo a mastectomy or axillary dissection, surgical drains will be placed at the surgical site. These are thin plastic tubes that prevent build up of fluid at the surgical site. The drain output looks bloody the first few days after surgery. While in the hospital, the nurses will take care of the emptying and charging the drain. Once you’re home, you or your caregiver will need to empty your drain and measure the output. Use a purse or bag with a long strap you can sling across the shoulder to carry the drain canister.
When sitting or sleeping, place the drains at a lower level than your chest and make sure the tubing is not kinked. Once the drain output is 30 cc or less for 2 consecutive days, your surgeon will remove them in the clinic, after cutting the securing suture. Drains usually stay for a week. The skin holes at the drain site heal without need for suturing.
Dos and Don’ts after surgery
Diet: A health protein rich diet as discussed above. There is a myth in India that one shouldn't eat rice after surgery- there is no scientific reason to avoid rice. If you are diabetic, ensure that your blood sugar is well controlled.
Medications: Take medications as advised on discharge. If you are on aspirin or blood thinners that were stopped before surgery, ask your doctors when you can resume taking them.
Activity: There is no reason to take bed-rest after breast surgery. The more active you are, the faster you will recover. Try to spend some time outdoors. You will be given some shoulder exercises – follow your surgeon or physiotherapy team advice. Be careful with your drains during activities.
Socializing: Involving friends and family in your breast cancer journey is a matter of personal choice. Cancer is not a communicable disease and you’re of no risk to your loved ones. Be careful going to crowded places and avoid sick contacts. Well wishers often give unsolicited medical advice. Rely on your oncology team for reliable information and proper treatment planning. Join a support group if you have access to one.