Post-Operation Guides – The Importance of Saying What You Mean

Every operation comes with instructions about what to do after. The lumpectomy instructions told me to bring a sports bra or similar for support. It also said you must have someone drive you home because of the anaesthetic. (The sentinel node biopsy meant I had to have a general anaesthetic since apparently armpits don’t freeze well – who knew? If I hadn’t been having the node biopsy, then the lumpectomy could have been done with local freezing. I was glad to be ‘out’.)

Here’s what I wished they’d said in those post-operative instructions (note – this is specific to my experience):

  • wear clothing that opens in the front (I wore a t-shirt)
  • bring a bra that opens and closes in the front, and has good support (I brought a sports bra that pulled on over my head. I ended up cutting this off at the specialty bra store that I went to the day after surgery to get a special mastectomy bra that provided  support and closed in front. I’d be wearing it 24/7 for the next month or so as my incision healed, so best to have something that I could put on and take off easily)
  • your arm will feel tight – keep it moving to the best of your ability; follow these lumpectomy-specific physiotherapy exercises (here’s some I found that worked for me – I started them the day after surgery)
  • go for walks to help your circulation
  • if you had dye injected, your urine and bowel movements may change colour as the dye is excreted – this is normal and may take a few days
  • you may have swelling in both your arm where the node were removed and your breast incision – this is normal
  • measure the circumference of your arm where the nodes are to removed before your operation so that you have a baseline of what’s normal for you (that way it’s easier to see if you have any lymphedema effects)
  • get some Moleskin tape and once the steri-strips come off (on their own) put a fresh strip of Moleskin tape across the incision each day to support the skin on either side of the incision. (It was three weeks after my operation when I met my surgeon again and she saw my incision. The steri-strips had come off the week before, so it was open to the air. I thought it looked fine – it was healing well. She said it was healing well, but that they’d learned a trick from the plastic surgeons – to put that strip of Moleskin tape over the incision to support keeping the edges together.)

I found a few sources of physio video exercises I could follow along with during my first week of recovery. The one I liked the best that was easiest to follow was at Memorial Sloane Kettering. It was tough to do those first few days. My left arm was really tight. What I learned later, when I met my physiotherapist a week post-operation, was that the lymph string down your arm is likely inflamed from the ‘trauma’ inflicted during the sentinel node extraction. That made sense to me. They had to dig around in my armpit to pull out those nodes and the surrounding tissue, so there would for sure be some inflammation. That’s not lymphedema. It’s recovery of the lymph string as it heals – remember, it has three less lymph nodes to take care of all that lymphatic fluid, and it has to learn to cope. Fair enough.

She also explained why my arm felt so tight. She described it like a wool sweater that’s been thrown in the wash and shrunk. When it comes out, you have to ‘block’ it – pull it in all directions to bring it back to its original shape. You have to do that gently, multiple times, to not over-stretch the wool and damage the sweater. Same with your lymph string. That made sense. I’d have to gently tease my left arm lymph string back to shape. I could do that.

She also gave me good advice – have patience. It takes longer to heal as we age, so give myself the time to do that. Wise words.

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