Self-Care Tips for Optimal Healing

Let me share with you my experiences regarding anesthesia. You can then, hopefully, glean some useful information for your situation.

Your consultation with the anesthesiologist usually takes place just prior to your surgery as you are waiting in the pre-op area. He or she will review your medical history and ask about your past experiences, if any, with anesthesia. During this time, I was able to express that after my past surgeries, I had a badly damaged throat that was so raw I had to hold ice chips in my mouth against the area. As my throat healed, I could feel a scab in my throat for weeks. It was quite uncomfortable.

As a result of speaking up about my experience, the anesthesiologist assured me about her approach. She said this might have occurred because the intubation tube that was used was too large for my throat. She said she would switch to a smaller tube. Well, as a result, I did not have a raw throat after my mastectomy! There was absolutely no pain or discomfort in my throat.

Pre-Op Medication: My anesthesiologist was very compassionate. During our consultation, I expressed my nervousness, especially about the waiting period in the pre-op area. Sometimes these waits can seem endless as surgeries get postponed and your surgical slot gets bumped to a later time. Well, she offered me a fentanyl lollipop to calm my nerves. It was such a relief!

The fentanyl lollipop is a narcotic lozenge on a stick that is absorbed by rubbing it against the inside of the cheek. It is a morphine-like drug, so it helps to calm anxiety as you wait. Plus, it helps to be slightly medicated as you walk into the operating room. Otherwise, you are walking in cold turkey, which can be quite intimidating.

If you do not want to ask for a fentanyl lollipop or do not want to risk that your anesthesiologist will not provide one, then you may want to consider asking your surgeon for a prescription for a tranquilizer that you can take the morning of your surgery.

The No-Shower Period
Most surgeons recommend that you not take a shower following your mastectomy until the drains have been removed (usually a seven-to ten-day time frame). During this time, it is essential that you have a supply of pre-moistened bath and face cloths to keep yourself clean. This will add significantly to your comfort while you recover. Freshening up each day helps make you feel better and ready to face the world. Even after you are able to shower, there may be days that you are not up for one. Pre-moistened cleansing cloths are especially helpful during recovery.

During this time, it is also comforting to have a way to help clean your private areas. There are several ways to accomplish this during the no-shower period:

A simple, inexpensive way is to use a squirt bottle that you have designated as the sole purpose for this use. You can fill it with warm water; moisten the area, soap up with a mild cleanser, then squirt to rinse.

You can purchase an inexpensive sitz bath that is placed on the toilet seat whereby you can then wash your bottom as you sit. The sitz bath is filled with warm water, but note that you will need help to do this since you cannot lift something as heavy and awkward as this. The sitz bath gets heavy when filled with water, and it is an awkward stretch to place it on the toilet and then spill out the contents.

The Shower Shirt™ Option:
The Shower Shirt™ is a water-resistant garment designed to be worn in the shower so that surgical drains are protected from water. Although it is a pricey item, it provides invaluable freedom to shower freely with your drains. Plus, the reality is that most of us need follow-up surgeries and revisions, so it would be used for multiple surgeries. Even if you do not need drains in future surgeries, there are still restrictions to not get incisions/bandages wet for a specified time. Check it out at: TheShowerShirt.com.

Washlet Toilet Seat
A cleaning/toileting option that is extremely useful for those after surgery, as well as for seniors and the disabled, is a washlet toilet seat. I installed one of these in my bathroom when we renovated a few years ago, and it is a convenience that I would recommend to all and not just during recovery. The washlet has a heated water reserve that sprays warm water at the push of a button. It does need a grounded electric outlet near the toilet, so you may need a electrician for that. The actual hookup to the toilet is a T-valve that connects to the existing pipe between your water source from the wall and the tank. You would have to hire a plumber for proper installation. This option is pricy, but it is well worth the expense if this is possible for you.

Hair Washing
Prior to showering you can ask a loved one or friend to wash your hair over the kitchen sink. You can comfortably lean over and support yourself against the sink. Lean on a rolled up towel for even more comfort.

First Showers
Once your surgeon has given you permission to shower, you can celebrate the liberation. It feels so great to stand in the shower and feel the warm water! Be careful that you do not apply hard, direct water pressure on your chest. My surgeon recommended that I keep my back to the shower so the water pressure is not directed at your wounds.

Your first showers should be approached with caution since you will be removing your bandages and exposing your wounds. From my perspective, this is a time when you need to adhere to infection control safeguards. I used a gentle, antibacterial liquid soap in the shower. I bring in freshly-opened sterile gauze pads to use as washcloths on the wounds. Place a liberal amount of liquid soap on the clean gauze pad, and then gently wash your wounds with light strokes. Rinse well with the water. Be certain that you use a freshly-cleaned towel to pat-dry your wounds after showering. You will then let then air dry a bit before re-bandaging your wounds.

Hand-Held Shower Spray
A detachable, handheld shower head is very helpful during this time. These specialty shower heads can be purchased for $20 to $30, and they are worth the money. Not only are they helpful after a mastectomy, it helps after other surgeries, as well. Even when you are healthy, a hand-held shower spray is convenient for personal washing as well as for washing and rinsing your tiles, tub and shower!

Shower Chair
If you do not have a bench in your shower, you may want to consider purchasing or borrowing a shower chair. It is soothing to just sit and enjoy the warm water, especially during the first few weeks.

Immediate Post-op Needs
Post-Surgical Tank Top (with pockets for drains): Prior to my mastectomy, a patient navigator at my hospital told me about a post-surgical tank top that had small pockets to hold the drains. This increased my comfort level significantly. Without this pocketed top, you will need safety pins to fasten the drains to your clothes.

After the drains are removed, the most comfortable choice under clothing for me was a cotton tank top. The inexpensive ones that are sold as underwear (either women’s or men’s) are best because they eventually will get stained from healing ointment (if you use this) and incision oozing. It is worth it, though, because using the soft, clean tank tops frees you to just use small gauze pads and paper tape over your wounds. Be sure you buy enough so that you can use a freshly-laundered one each day to reduce infection risk. (See Wound Care for more self-care information on this topic.)

During Breast Reconstruction
Once you begin the expansion process, you will slowly begin to bump out into your clothes. So, you do not need expensive silicone prostheses! That is what I was sold, although the saleswoman knew that I had expanders. They are not needed, because eventually you begin the expansion process, and you cannot wear silicone forms on top of your own mounds once they begin to take shape.

I found out later that heavy, silicone prostheses are not even recommended during the first few months because they put too much pressure on your healing chest. I was furious when I realized that I was sold a bill of goods to the tune of $585!!!

All you need are some lightweight foam pads. You will need a variety of sizes as your needs change based upon your expansion schedule. With each expander filling, your size will change, thus a good variety of foam pads are required. It is helpful to have an actual prostheses bra that has pockets for the foam forms. In the beginning, you may even use two or three foam pads together, so purchase a variety of thin forms.

Here are more details about my bad experience. About three weeks after my surgery, I began feeling depressed. I could sense that my low self-esteem came from wanting to get out and about, but feeling self-conscious about my flat chest. Remember, this was prior to the fill process beginning, so I was flat as a board. Without enough research, I headed to the local corset shop, determined to put Mrs. Humpty Dumpty back together again and shop for breast forms.

I felt that I was hoodwinked at that specialty shop. I was totally ignorant of what I needed, so the saleswoman oversold to me. I hope the above guidelines help so that this does not happen to you.

If not having Breast Reconstruction
Some women who have had mastectomy are satisfied with settling into their revised figure without using breast forms. Others may opt for full silicone prostheses. Check your local area for full-service corset shops, or, even better, ask others at support groups where they would recommend you go for prostheses services.

Prepare a Bra Budget
I must have spent hundreds of dollars on bras over the course of my three breast surgeries. (See My Story for the details.) That is because you morph through so many different sizes during the course of your treatment, especially if you are having reconstruction. Some bras seem like they will be comfortable; then they hike up on your chest and puff out like marshmallows. Others dig into your sensitive areas and are uncomfortable. The bottom line is: prepare to spend a few extra dollars on trial and error during the course of your recovery.

During your recovery from mastectomy or other breast surgery, comfort should be a priority when you choose what type of clothes to wear. Initially, button-down pajamas are in order since you will need easy access to drains and bandages on your chest. A pocket in the top of the pajamas is great for keeping your cell phone handy, especially in the hospital. Of course, adapt the pajamas as needed for the season. A light cotton type with crop pants or shorts is refreshing in the warmer weather, whereas cotton flannels are comforting in colder climates.

Once the drains are removed and you need fewer bandages, it is especially comfortable to wear all-cotton tank tops, the type that is sold as underwear (either men’s or women’s). These tank tops are good for a protective layer under other clothes. They are soft against the wounds and protect them from other materials. In my case, I would sometimes use the cotton tops in place of bandages. I would place ointment on the wounds and let the cotton shirts be the protective layer. This is helpful if you are like me and are sensitive to adhesive. (For more information, read Wound Care.)

Dancing may seem like a frivolous topic, but in order to come full circle in your healing it is important to embrace the fun activities that you enjoyed prior to your mastectomy. Getting back on the dance floor may be part of full recovery for some of us.

There will doubtless be several times when you have the opportunity to dance during your recovery and breast rehabilitation. With certain modifications there is no reason that you cannot get back out there on that dance floor to shake your tail feathers or your booty or however you describe it in your lingo.

Here are some simple guidelines and suggestions that helped me get back into the “swing” of things:

1. As you sway, keep your elbows at your side and your forearms/hands in front of your chest. This will not look awkward if you snap your fingers in front of you. Remember, you need to be able to protect yourself from others on the dance floor. Some rambunctious dancers can be outright dangerous with flailing arms and elbows. I shudder just thinking about the risk involved if you are not cautious. So, do not dance with your arms above your head or away from your chest. You can be just as playful and loose while holding your elbows to your side, but, again, you must shield your body while you are on a crowded dance floor.

2. For the therapeutic effect, keep shoulders back and expand your chest. Open yourself up with the rhythmic movement as you sway your shoulders back and forth. It can be very beneficial to use the opportunity as a rehabilitative exercise treatment!

3. Keep dance sessions to an enjoyable minimum and expect to feel tired. Your endurance during mastectomy recovery and breast rehabilitation may be limited, so don’t be surprised if you need to sit out for a while.

4. Most importantly, enjoy! Get back into the groove and celebrate life!

Visit our award-winning Pinterest page where we created a board to celebrated Dancing during Mastectomy Recovery.

Most women undergoing mastectomy will have drains for seven to ten days following the surgery. It looks somewhat gross, but these tubes do an important job by draining the fluid accumulation that develops after the operation. Without the drains, fluid buildup could cause problems with swelling, infection and pain.

The drainage tubes will extend out of an incision on each breast. At the end of each tube there is a rubber ball with a flip-top stopper that stores the fluid. Do not be alarmed to see that the fluid is bloody. It will begin to get less red as each day passes after surgery. You will need to routinely empty the storage ball and measure the amount of fluid that you are producing. Many doctors will use this information to decide when the drains can be removed. It is expected that the amount of drainage will decrease slowly.

Many times the hospital will give you the plastic measuring cup that they were using for you during your hospitalization. If not, you will need to use a plastic one that can be discarded afterwards. Keep track of the amount of fluid you remove from the drains each day. These measurements need to be given to your surgeon during your first post-op visit. The amount of the drainage helps them determine when the drains will be removed.

Post-Surgical Tank Top (with pockets for drains): A patient navigator at my hospital told me about a post-surgical tank top that had small pockets to hold the drains. This increased my comfort level significantly. Without this pocketed top, you will need safety pins to fasten the drains to your clothes.

My surgeon had recommended waiting as long as possible before driving after my mastectomy. His sensible explanation is one that he preaches to all of his breast surgery patients. You have to remember that it takes time for all those delicate, internal stitches to heal. Although you will be eager to get back into the driver’s seat, it is not worth compromising the integrity of your surgeon’s fine work.

The act of driving seems easy and effortless. However, the reality is that we are all just one swerve away from doing extensive damage to our internal stitching. Think about it. You are driving calmly down the road and all of a sudden you must swerve to avoid another car or an animal that has darted into the road. The sudden jerking movement of your arms and chest could cause damage to your delicate sutures.

Opening/Closing Door: The other consideration is the motion of opening or closing your car door. Ouch! I shudder just remembering how that would feel if I tried that motion in the early weeks. You need friends and family to close and open the door for you. The sideway stretch of pulling a heavy door shut and the jerk of slamming it tight is an absolute no-no! It takes weeks to be able to safely perform such motions.

Seat Belts: You will need to have something to cushion your chest from the seat belt. I used a small baby’s blanket that I rolled up to keep under the belt. On the way home from the hospital, I used a pillow since I needed more substantial protection at that time. During the first two weeks, you also will need help from whomever is driving the car to pull the seat belt across your lap for you.

Be wise and levelheaded. These motions can cause irreparable damage to your surgical sites. It is best to be practical and patient, which means waiting three weeks before driving.

Prior to my mastectomy, creating my home healing environment was top priority. It was soothing to know that my “healing room” would be waiting for me when I got home.

If you share your bedroom with a spouse or partner, you may want to consider setting yourself up in a separate room if you are fortunate to have a spare bedroom. A separate room is helpful because there are some sleepless nights following surgery. You may get a couple of hours of sleep throughout the night, but there are some wakeful hours as well. Watching television helped me during these wakeful hours in the middle of the night. I would not have had that flexibility if I was in my bedroom, because the television would have awakened my husband. That would not have been fair to him since he gets up early for work in the morning.

I went to the extent of upgrading the bedding ensemble in my guest room, including sheets and curtains. The weekend before my mastectomy, my husband and I cleaned and polished the room, making sure it sparkled in the sunlight.

I prepared the nightstand with all I would need nearby during my recovery. Some of these items you may want to keep near your chair in your living room or wherever you plan on sitting during the day.

Handy bedside or chair side items include:

• Tissues
• Phone
• TV remote
• Reading materials
• Lip balm and hand lotion
• Anti-bacterial gel
• An extra side chair in the bedroom
  During the first week after surgery, you may want to recline on the bed while chatting with post-op visitors. Having a kitchen or living room sitting chair in the bedroom is handy for visitors.
• A small pillow
  Hugging a small travel-sized pillow in bed provides great comfort during your recovery. Although you will be sleeping on your back (elevated by large pillows) for one to two weeks, you will eventually be able to get back to resting on your side. Tucking this pillow near your chest and ribs prevents painful sagging of the incision areas.

Medication Bottles and Jars
This is important enough to repeat from another preparation page…

• Ask someone to open screw-top bottles and jars.
  

  Warning!

  You will not be able to open screw-top bottles, which is especially important because it means medication bottles! This is one of the most critical challenges during recovery. Think of the motion of the child-proof medication caps. Just pretend you are opening one in your hand right now; hold the bottle, push the lid down and twist. You can feel your chest muscles contract. That is a BIG OUCH during mastectomy recovery! It is imperative that you have someone loosen the bottles so that they are easy to open. You can also ask the pharmacist to supply your meds without a childproof cap.

Hospital Check-in

When heading to the hospital for your mastectomy or other breast surgery, bring your medication list and medical history notes. Even though you have filled out all kinds of pre-op forms, the nurses and anesthesiologist will still ask you some questions regarding your medical history and medications. Also, be sure to remember your photo ID and insurance cards for the registration process.

What to Wear to the Hospital
The casual outfit that you wear to the hospital will be the same one that you wear home. The hospital will provide a bag for storage of your outfit until your discharge. Wear a boxy button-down shirt, because you will have bandages applied when you are discharged. Wear comfortable sweat pants that are easy to slip on when you get dressed to go home. Most importantly, be certain to wear slip-on shoes or sandals unless you will have someone to tie your shoes for you.

What to Pack for the Hospital Stay
Button-down pajamas are most comfortable in the hospital. This way the nurses can easily check your bandages and care for your drains. You can feel a sense of modesty with the pajama bottoms when you go to the bathroom or adjust bed positions. It will be more comfortable to keep your knees up as you lounge in bed, and this position is must easier with PJ bottoms than a hospital gown. Also, with varying temperatures, you may want to toss the covers off yourself for a while. I used pajamas with a pocket on the shirt to hold my cell phone. (Using your cell phone is much easier than using the hospital landline phone and having to reach for it on a nearby table.) It was so handy keeping my cell phone handy in my PJ pocket. I especially enjoyed texting throughout my hospital stay, and those with smart phones will be able to email as well. Remember to pack your phone charger.

Preparing the Car
Leave a pillow in the car for the ride home. The seat belt can be fastened (by the driver) over the pillow, which will help absorb any bumps in the road or jostling. A blanket in cooler weather will be soothing, too. I adjusted the seat to a slightly reclining position on the way to the hospital so that it was in the correct position upon discharge. It would have been too difficult to adjust the seat after surgery, unless, of course, you have electronic controls.

There are many challenges you will face handling household activities as you recover from your mastectomy, but the biggest obstacle may be your own thick-headedness when it comes to knowing your limitations.

That may sound harsh, but it is because sometimes we are our own worst enemy. The limitations placed on us are for medically sound reasons. Simply put, if you lift something too heavy or stretch too far you will rip apart some of your internal stitching and therefore compromise the integrity of the surgical wounds. Even though your external scars appear to be healed, you still have delicate sutures inside your body that you cannot see and that take longer than the outside wounds to heal properly.

Don’t think you are proving anything if you push yourself to do heavy lifting or chores in the first month. You must be kind to yourself…only you have control over this. You are not proving anything if you ignore the guidelines. You are only hurting yourself and interfering with the healing process. Don’t be a martyr…if you want optimal healing then be a smart patient and respect the healing process!

So how do you compensate for the limitations around the home? Preparation is essential; you can envision your limitations by holding your elbows close to your sides. This will mimic your post-op limitation and give you an idea of your restricted movement as you recover.

Here are some of the main challenges with some tips and guidelines that helped me manage them during my recovery:

Prepare your Healing Perches
Prior to heading to the hospital, you can prepare your healing and resting areas ahead of time. Reaching, bending and stretching will be limited, so simple preparations can ease your recovery.

• Have everything you need placed beside your bed and sofa or lounge chair. Examples are: remote controls, phone, magazines/books, water bottles, etc. Also, a trash can near each area will help keep your perches clean.
• Make up the sofa ahead of time with sheets, blankets and pillows. You may want to recline in the living room in the first week to get a break from your bedroom.
• Have a backscratcher handy; it is a simple but often overlooked item that can bring you great relief! Remember, you will not be able to get to those itches because your movement will be limited.
• Have common grooming items and toiletries gathered together in the bathroom. Toothpaste, toothbrush, mouthwash, contact lenses, make-up, brushes/combs, etc., can be laid out on the bathroom counter or sink area ahead of time. Or you can gather the items in a small basket to transport them to wherever you need them.

Medication Bottles and Jars

• Ask someone to open screw-top bottles and jars.
  

  Warning!

  You will not be able to open screw-top bottles, which is especially important because it means medication bottles! This is one of the most critical challenges during recovery. Think of the motion of the child-proof medication caps. Just pretend you are opening one in your hand right now; hold the bottle, push the lid down and twist. You can feel your chest muscles contract. That is a BIG OUCH during mastectomy recovery! It is imperative that you have someone loosen the bottles so that they are easy to open. You can also ask the pharmacist to supply your meds without a childproof cap.

Kitchen Activities & Cooking
You certainly will be able to putter around the kitchen as you recover. Putter is the operative word here. The secret to your successful puttering in the critical first few weeks is to:

• Keep commonly used items and foods at counter level.
  Dishes that are normally kept on high shelves should be stacked in a corner of the counter area or even on your stovetop. It is not clutter; it is a helpful healing strategy. A basket can be used temporarily on your counter for cupboard foods that you keep on high shelves. You cannot be reaching for things in the upper cabinets. The general rule of thumb is not to reach above your shoulder height. While reaching for a drinking glass at eye level may be manageable, any shelf higher than that poses a problem.
• Purchase smaller milk and water containers.
  Quarts of milk and smaller bottles of water are so much more manageable. Do not buy gallons of milk or water for a few weeks. The pouring motion engages the chest muscles, which makes the heavy gallon containers outright painful to handle. I feel a visceral “ouch response” just thinking about it!
• Ask someone to open bottles and jars.
  As reviewed above about medication bottles, you will not be able to open bottles and jars, so ask someone to open them ahead of time. Once opened, you can store items in the refrigerator. Let other family members know that beverage caps on juice, for example, will not be tight so that they do not shake containers with loose caps unknowingly.
• Use your leg and foot power!
  If you happen to spill something on the floor and need to clean up, use your foot power! Toss a wet paper towel or rag onto the floor and swirl away. Hold your chest still and elbows at your side while you let your lower body do the work!
• Use caution when opening the refrigerator.
  Yanking open a refrigerator door hurts! Be cautious that you so not wrench your chest muscles with the motion. Strengthen your stance while holding on to the handle with both hands (elbows to your sides); then lean back so that the weight of your body opens the door.

Windows, Blinds and Drapes
Opening windows, blinds and heavy drapes will be impossible in the early weeks after surgery. These motions are the worst possible movements for you during this time. When I had my mastectomy, it was early springtime in the Northeast. Opening and closing windows is a daily necessity when warm, delightful breezes turn chilly as the sun goes down in the evening or when it rains.

Here was our solution: my husband would open the living room and kitchen windows about 6 inches before he left for work each day. I would use a blanket in the mornings, but was happy to have the fresh air in the afternoons. There were about five different days during that time period when it got too chilly, so I called my neighbor over to close the windows.

If you have casement windows with a crank handle, then you are in luck. I have those on my back porch and upstairs hallway windows. They are great, and it makes me realize that those are the type we should choose when we are planning for retirement, when our age may make us weaker.

After two to three weeks, you can begin to nudge the windows open, but you must still protect your chest muscles from straining. You can do this by holding the window and instead of your arms, move your whole body by rising up on your toes. This type of motion works for heavy blinds and drapes as well. I have balloon shades constructed of heavy fabric that are raised and lowered with a chain. In the early weeks, my husband would raise these before work. After a couple of weeks, I was able to raise them, but I did not use my chest muscles. Instead I used my body by holding the chain, keeping my elbows firmly at my side and bending my knees for several pulls to get them raised. Improvise…and limit those chest muscle movements!

Cleaning
Heavy cleaning, especially vacuuming is a no-no. You must ask another family member or friend to do this chore or hire someone, even if it is a high school neighbor for temp job. Dusting is fine, especially just using a feather duster for the first few weeks. Any other heavy cleaning you should plan to do before your surgery (if you are reading this ahead of time) so that none of it needs to be done for at least three months afterwards.

Changing bed sheets is another household chore that you should not do for a few months. Again, you will need to ask a family member or friend to help with this.

Another good thing to do is to lower your expectations during your recovery. Your home may not be as clean as usual, but try to ignore it. Be patient and let your body heal.

Laundry
Laundry is a chore that can be managed — providing that you have someone carry the heavy loads to the washer. Loading the washer and transferring to the dryer can be done piecemeal. Items can be loaded one at a time so you are not lifting a heavy batch. When the clothes are dry, they can be removed from the dryer individually and folded into a pile. The key is to ask someone else to carry the pile back to each room, and then put them one item at a time. Another option is to carry a few items at a time and make several trips.

Here is a tip for transporting some small laundry loads after a few weeks. Purchase a tall mesh laundry bag; the type that can stand on its own and has handles. You can drag this mesh bag by yourself and prevent muscle strain by keeping your elbows at your side and your arms stiff (making your lower body do the work). You can also drag the mesh bag down stairs by scooting it with your foot one step at a time. This way you are not lifting it with your chest muscles.

Your surgeon will be prescribing pain medication to get you through the first few weeks after mastectomy surgery. It is important to follow his or her advice on taking this medication, especially keeping to a consistent schedule for the first few days after discharge. If you wait too long in between doses, the discomfort will build up to a painful crescendo as opposed to keeping it tamed with doses spread out evenly, as prescribed.

It is important, however, to be aware of a complication of the pain medications. It is a topic that most feel shy and bashful to discuss, but it is important to be proactive, if need be. We are talking about constipation.

Complications of constipation after surgery are common. There are two factors that contribute to the severity of post-op constipation: anesthesia (especially for long surgeries) and pain medication. Both of these factors combined will sometimes temporarily paralyze the natural contractions and movement of the colon. If the colon cannot be jump-started into action, after a few days you will feel very uncomfortable with bloating, stomach pains and malaise.

This is why some surgeons will recommend getting back to eating fiber-rich foods as soon as possible and they will prescribe stool softeners to help moisten and soften the contents of the colon. Other over-the-counter laxatives stimulate the rhythmic contractions of the intestines to encourage a bowel movement. Glycerin suppositories can help lubricate the anus and prepare it for the bowel movement, which will become hard and uncomfortable to pass after several days of build-up.

When all else fails, though, do not hesitate to use a Fleet’s enema. You will know when you need to resort to this option because you will feel totally blocked and uncomfortable. I was literally groaning with pain. And do not think that this issue should not be addressed. It could lead to a condition called impaction, which is when medical care is indicated. If your colon becomes impacted, the physician will need to use an instrument to manually remove the blocked and hardened stool from your colon. Yikes!

So, you can see why waiting too long with this condition would be worse than a simple Fleet’s enema. Beg a loved one to help with this option. (Offer a reward if you must, LOL…) Or, you can always make arrangements for a visiting nurse. Either way, you will feel like a new person afterwards! Take heed and monitor this situation carefully.

Visit our expanded section dedicated to Breast Rehabilitation for vital information on this topic.

Precautions after Lymph Node Dissection: If you have had a lymph node dissection, you need to take special precautions for underarm care. Using a metal blade to shave under your arms is not recommended. If you were to cut your skin, it could lead to an infection that would increase your risk of lymphedema. Infections sometimes lead to cellulitis, which is a precurser to lymphedema since it often results in swelling of the extremity.

Electric Razor: So, the solution is to use a small, women’s electric razor.  When using an electric razor, it is helpful to apply powder to your skin beforehand. This will help the razor glide more smoothly. The powder absorbs excess wetness so that the razor does not stick to your skin. It protects the skin from irritation as well. The powder is also a useful alternative to harsh deodorants.

Natural Deodorant: Some surgeons advise against the use of harsh deodorant chemicals under your arms during recovery from lymph node dissection. Natural deodorant is recommended because it is free of aluminum and paraben.

This may seem like an obscure topic, but it is a key precaution during your mastectomy recovery. I was reminded of this issue of crowds when I walked through a health care convention of nearly 3,000 attendees. A social gathering, public event or a crowded store is a precarious setting. You always have to be protective of yourself in these types of situations.

Why? An innocent nudge with a stray elbow would be painful and damaging. I felt vulnerable to injury walking at that convention, even though it had been over a year since my mastectomy.

It will most likely be an intuitive response to protect your chest while walking through a crowd, but here is a tip that helped me during my recovery. Carry a clutch purse; it looks very natural to be holding this type of purse close to your chest. If you have a larger purse, place the strap on your shoulder and hold it to your chest.

If you are not carrying a purse as a crutch, then just keep your arms to your side and your hands/forearms purposely in front of you. It is hard to look graceful with this pose, but you get my point. You can never be too careful. The key thing to remember is to be mindful of your surroundings, which is a good safety precaution at all times during mastectomy recovery.

You will be tending to your surgical wounds for several weeks until they are completely healed. It is important to keep infection control strategies in mind as you tend to your wounds. This is a particularly vulnerable time when a wound infection would be a serious complication. Always wash your hands before and after wound care and lay out a clean paper towel to gather your supplies.

Tending to Your Surgical Wounds
You will leave the hospital with gauze bandages taped over your incisions. Underneath those bandages, your incisions will most likely be covered with Steri-Strip™ adhesive tape. Most surgeons recommend that you do not disturb the outer bandaging until the drains have been removed. After that, you will be told to leave the Steri-Strip™ adhesive tape in place. This tape can get wet in the shower (once you are given permission to shower by your surgeon), and it will eventually begin to peel off on its own.

Based on my experience with my numerous breast surgeries, I will describe the wound routine that worked best for me:

Wash with Antibacterial Cleanser:
Once I was given permission to shower (after the drains were removed), I was vigilant about infection control. I would wash my wounds in the shower with a antibacterial cleanser. I would apply the cleanser gently with a freshly-opened sterile gauze pad. Remember that you do not want to rinse with a harsh (full-tension) stream of water. If you cannot reduce tension on your shower, then let it hit your back and shoulders so that the water can gently cascade down your chest.

Dab on Aquaphor Healing Ointment:
I would dry the wounds by patting them with a clean paper towel. This was more comfortable than a towel, plus in the beginning there may be dabs of blood and oozing. After letting the wounds air dry for a few minutes, I would apply Aquaphor Healing Ointment on the incisions with a clean cotton-tipped applicator.

Cover with Gauze Pads:
Use freshly-opened sterile gauze pads to cover your wounds, and secure then with surgical tape. I used paper tape because it is the gentlest on the skin.

If you are like me and get a skin reaction to adhesives there is another, very comfortable way to cover the wounds without tape. Get a supply of inexpensive cotton, tank-style underwear tops to wear under your pajamas, loungewear or clothes. You will need a clean one each day, so get enough to last between laundry schedules. Place a clean top on after you apply the Aquaphor. These shirts will become stained because, although water-soluble, the Aquaphor does leave marks. But, this solution is so comfortable! And you will use the shirts again if you are having reconstruction procedures in the future.