First, understand that everyone is a bit
nervous and this is normal. The purpose of this sheet is to familiarize
you with what will happen in the period just before the surgery and
during the hospital stay.
If you smoke, you should have stopped
already. If you are still smoking, stop immediately. Smoking and
nicotine gum increase your risk of problems, and both take time to be
removed from your body.
Often I will mark, in my office, the
incisions for the flap and the mastectomy on the skin the day before the
surgery. If this is the case, then you must shower before coming to the
office. You cannot shower after the marks are made.
Have a light meal the night before
surgery, as most patients do not move their bowels for several days
after surgery.
Bring pajamas, a bathrobe and slippers to
the hospital. For the first few days after the surgery, it is easier to
wear the hospital gown then your PJ’s
If you will be having the reconstruction
at the same time as the mastectomy, then I encourage your loved ones to
go home after they have spoken to the surgeon who has performed the
mastectomy. (Please leave a phone number where they can be reached.) The
reconstructive part of the surgery takes a long time and
"bulletins" will not be issued as to how thing are going. When
I am finished, I will call the loved ones and tell them how things went.
If they would like to visit, it will be at least one hour from the time
of the phone call before they will be allowed into the recovery room.
The decision to transfuse blood is based
on your starting blood count, the amount of bleeding during surgery, and
your overall health. The order of any transfusion is: first, your own
blood (if you donated blood), next, donor designated blood (from people
you asked to give blood), and last, blood from the blood bank.
You will spend the first night in the
recovery room. This is a good place to monitor you overnight. The next
morning, if all looks OK, then you will be transferred to the floor. You
will have an intravenous line (IV). The pain pump is connected to this
line. Push the button as needed. The machine is calculated so that you
cannot overdose on the pain medication. A Foley catheter will be placed
into your bladder while you are under anesthesia. This will eliminated
the need to get on a bed pan. When you are ready to walk to the
bathroom, it will be removed. Special stockings connected to a pneumatic
pump will be placed so that you don’t get a blood clot in your legs.
These can be removed when you begin to walk. The hospital bed will be
flexed. This will take the tension off the abdominal incision. You, and
only you, can change the position of the bed. It is unlikely that you
will put the bed in a position that makes the abdomen feel too tight.
There will be multiple drains from the abdomen and chest. These are
about the thickness of a pencil and go from inside your body to an
outside collection device that looks like a grenade. It’s not as bad
as it sounds. The drains are used to remove any fluid collection. They
are removed when they stop draining which is usually at one to two weeks
after the surgery. You will probably go home with the drains and we will
arrange a visiting nurse to help you empty them.
The first day after surgery, we will ask
you to sit in a chair. Getting into the chair may be difficult, but
sitting there is not uncomfortable. Use the pain pump. You will begin to
eat. You will also feel very tired. Generally, the day after your
surgery, I also feel very tired. You may begin to walk with assistance
if you feel up to it.
The second say after surgery, we will ask
you to begin to ambulate. We will remove the catheter for the urine, the
compression stockings on the legs and later that day the pain pump. Oral
pain medication will be started around the clock. I do not want you to
wait until you are uncomfortable to take the pain medication.
Generally a patient will go home on the
third postoperative day. Going home does not mean that I think that you
are all better. It only means that I think that there is nothing else
that will be done for you that requires hospitalization. You will be
given a prescription for pain medication and antibiotics. You should
also take one baby or regular aspirin per day for one month.
Arrangements for a visiting nurse will be made to help with the drains.
You will make an appointment to see me in the office at about one week
post op.
