Some Advice following Mastectomy Surgery

If you are reading this you have probably just had surgery for breast cancer or are close to someone who has.  If you have had a mastectomy you will know the speed with which surgery is performed after a diagnosis of breast cancer.   This means that you have very little time to come to terms with this life changing news before also undergoing a painful and disfiguring operation.  You no longer feel the same on the inside and you no longer look the same on the outside.  You may be in a state of shock and disbelief. 

However, most women also feel a profound sense of relief when they know that the cancer has been removed from their body and are anxious to know what will happen to them next.   Of course, a lot will depend on what the surgeon found during the operation as to whether you will now be treated with chemotherapy and/or radiotherapy and which drugs you will receive to help prevent a recurrence of the disease.  Developing a good relationship with your surgeon and oncologist early on is very important. 

There will be times in the future when you may feel overwhelmed by the choices you have to make.  Never be afraid to ask questions and to insist in the asking until you understand the answer.  Only if you understand and trust the advice of your doctors can you feel confident in their treatment of you.  Remember, if for any reason you do not feel happy with the treatment you are receiving, you are free to look for another clinical opinion elsewhere.

Coming Home

These days your stay in hospital after the surgery may be quite short, sometimes only a few days!  Before you know it you have been discharged and are back at home.  This can be a difficult time as you discover how much you can manage to do for yourself and how much support and help you will need from others.  Remember that for the people close to you this is also a frightening time.  They are very anxious to help but often feel inadequate and blundering.  You may find it all gets too hectic.  There are hospital appointments, visits and phone calls from anxious friends and relatives, household arrangements to be reorganised etc.   It is a good idea to appoint a spokesperson for your self, someone who is able to be firm when you feel unable to cope.   Choose someone who understands when you need to be protected from calls, ghastly stories and well intentioned but intrusive offers of help, food and weird sounding therapies!  A polite refusal and a warm thank you are usually acceptable to most well wishers.   Another approach is to organise the offers of help so that they are really useful.   Get people to cook a meal for you on certain days of the week.  Arrange for them to pick the kids up from school on the days of your hospital visits.    Give them a shopping list of things you need.   Be clear about what it is you want them to do and when.  Good friends will feel delighted to be doing something for you however mundane. 

Don’t be afraid to be self absorbed and self centred.  Accept help if it is helpful, sleep if you are tired, eat when you are hungry, laugh when you find something funny and cry when you feel sad.  This stage will pass and you will get back in control of your life and your emotions.  For the moment, just do what feels right!

The Road to Recovery

From what I have written above, you may have the impression that you just need to wrap yourself in cotton wool until you feel better.  In fact this is not quite the case!  There are some things you should do to help you get back on your feet and to speed your recovery.  Having positive tasks to do and small goals to achieve can give you a sense of purpose and control over the situation you find yourself in.

One of the most important things you need to do is some gentle exercise every day.  One of the best exercises is to walk.  Try to walk for a few minutes everyday.  Don’t let your affected arm hang down by your side but hold it bent at the elbow.  Walking helps to lift the mood, fight fatigue, promote healing, increase stamina, endurance and well being.   Enlist anyone you can to accompany you.  Going out for a walk is a good way to broach difficult subjects or to get things off your chest.  Walking allows you to talk ‘side by side’ rather than ‘face to face’, it makes silences more comfortable and changing the subject is always easier!

Try to start moving your arm on the side of the mastectomy as soon after surgery as possible, remembering to do these movements slowly and gently.  If at all possible seek out a suitably qualified Physiotherapist to guide you through your recovery.   Knowing what exercises to do and how much or how little to do them is never easy on your own.  Even a few sessions with a Physiotherapist will give you the confidence to do them correctly.   It is important to start moving your arm at the shoulder joint to prevent stiffness.  Although at first it may appear that you don’t have a problem, as the days and weeks go by the scar tissue that is forming will start to shrink and may cause you to develop shoulder problems. 

In my practice I follow a rehabilitation programme developed by Annie Toglia M.E.S called ‘Staying Abreast’.  This exercise programme is designed specifically for those recovering from breast cancer surgery and breast reconstruction surgery.   To visit the site or to order online click on the link   www.stayingabreast.com

A book is a wonderful tool.  It enables you to re-read and digest the information it contains at your own pace and jog your memory when you’ve forgotten what to do.  However it cannot give you answers to questions which it itself doesn’t pose, or get you motivated when you feel down or slow you down when you are just too impatient or enthusiastic! For this reason having professional guidance and practical hands on treatment from a qualified Physiotherapist makes all the diference.

Finally, read up on Lymphoedema and become the guardian of your 'at risk' arm against this complication of Breast Cancer Surgery and treatment.

Here is a list of Do’s and Don’ts to help you get started.

Do seek out a suitably qualified Physiotherapist to guide you through your recovery as soon after your surgery as possible

Do try to start moving the affected arm as soon and as often after surgery as possible, remembering to do these movements slowly and gently

Do practise deep breathing and relaxation techniques to help relieve pain and tension.

Do keep the arm on the side of the mastectomy elevated as much as possible to prevent swelling

Do always use pillows to support the arm when sitting or lying down

Do strive for improvements everyday, but remember that you will have bad days when you seem to be making no progress.  Allow yourself to rest; it takes time to recover however hard you try.

Do try to walk for a few minutes everyday

Do always elevate the affected arm for fifteen minutes after exercising to prevent swelling

Do read the section on Lymphoedema (swelling of the arm) carefully and follow the rules to the letter, now and forever, as Lymphoedema can develop many years after surgery.