Sunday, July 18, 2010

Preparing for Surgery and Axillary Dissections


NiddyNoddy's comment on my last post made me think back to the first time I had breast cancer surgery in 1994. While I had listened carefully to the surgeon's information, after surgery I was confronted with a lot of new experiences and situations with which I could have been far better prepared.

As I mentioned in my comment to her, one of the biggest embarrassments I had was that I didn't have any button down shirts to wear after the surgery. I am a turtle neck with sweater in the winter and polo shirt in the summer sort of person. After having an axillary dissection (where they remove lymph nodes from under your arm), you are fitted with a drain to carry away the fluid under your arm. This extra apparatus doesn't fit too well under a turtle neck....but the biggest issue is that you can't raise your arm. A button down shirt is imperative. I actually had to borrow some from friends and relations.

The drain is important, and must be kept flowing well. Be very clear on how to flush it and make sure that nothing plugs it up. I had a slight plug the first time around.

As soon as the doctor gives you the go-ahead, start doing the exercises. Make sure you ask about when and what to do. They are simple (wall climbing with your fingers being one) , but the tendency is to treat the affected arm like a broken wing. Failure to move that arm may cause permanent restriction in the movement of the arm. I firmly believe that the reason I don't have any issue is that I HAD to get moving...caring for a 15 month old baby MADE me move and take care of myself.

Be aware that for the recuperation period you will not be able to lift ANYTHING....even weighing as little as 2 pounds. Make arrangements or think about how this is going to impact you.

More importantly, if you have had lymph nodes removed, then your lymphatic system is disrupted. Fluids may build up in your arm and you are more susceptable to infection. Silly things like insect bites or pulls can bring on lymphedema, a swelling of the arm which can be painful as well as dangerous. My sister developed it after the dog pulled hard on the leash while walking. I am very lax in watching what I do, but it is something I should be aware of.

For the same reason, you can't have blood drawn from the affected arm, you shouldn't have blood pressure taken on that arm and you should avoid all types of "sticks" (i.e. needles of any sorts) in that arm. Only under duress should that be done. Medical bracelets with this information should be worn to protect yourself... for the rest of your life.

I strongly suggest that you take advantage of the programs provided to breast cancer survivors by the American Cancer Society. They can send a volunteer out to talk to you about what to expect, what your concerns are, etc. The volunteers are all trained and all have gone through the same thing that you are looking at now. The major program is "Reach to Recovery." In addition, they often sponsor breast cancer support groups. While many people react to the support groups as not being necessarily because "I know x,y, and z who have gone through it, " the advantage in going to a group such as this is that you can hear all of them discussing things at once. In addition, the larger the number of individuals will give you a broader experience. Believe me, while there are times of tears at such groups, there are plenty of laughs as well. My Meriden/Wallingford, CT group was called "The Bosom Buddies" and let me tell you, they were a great bunch of ladies who gave me great advice.

Do not panic if months after your surgery you have pains, often searing, in the area. These are generally nerves regenerating or just doing funky things. While it is worthwhile to mention this to your doctor, it doesn't necessarily mean that you are having a problem. Even 13 years after my last surgery, I sometimes have the searing pain. It comes, then goes quickly...but leaving me a little breathless. The nerves and scar tissue are really odd that way.

Living with cancer is different. Sometimes it seems like a long, steep upward climb...but the sight at the end of the staircase is wonderful.

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