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What to Expect After a Mastectomy · Flourish- A Prisma Health Podcast

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  Caitlin Whyte (Host): This is Flourish, a podcast from Prisma Health.
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  I'm your host, Kaitlyn Whyte, and with me is Dr.
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  Brian McKinley, a surgical oncologist and general surgeon from Prisma Health.
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  Join us as we talk about recovery after mastectomy, what to expect, what truly
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  helps, and what you can likely skip.
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  Doctor, what should patients know about the first few days and weeks
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  of recovery after a mastectomy, and what can they expect physically?
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  Dr. Brian McKinley:
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  Yeah.
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  I think they should know that, first off, it's not the most
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  pleasant experience, right?
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  It's not something you would choose to do, but that it's a surgical procedure that
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  has a very long history and is very safe.
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  and it's something that they're gonna be able to get through, right?
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  and that all the questions they might have about, the specifics,
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  that we will have answers for them.
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  Many people are concerned about their level of pain afterwards, and we have
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  a plan for managing pain afterwards.
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  lots of folks are concerned about the drains and what that will mean
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  to them, and we have a plan both preoperatively, while they stay
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  overnight in the hospital, and then postoperatively to manage that as well.
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  So while there are lots and lots of unknowns, I think the most important thing
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  would be that they can rest assured that we have a really comprehensive plan for
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  them that's based on a long history with this procedure, which itself is very safe
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  Caitlin Whyte (Host): So what are some of those must-have items to have at
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  home before surgery to make recovery more comfortable and manageable?
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  Dr. Brian McKinley:
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  So I think, must-haves are relative.
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  I think that in general, you would want to make sure that you have an environment
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  that you can get around in easily.
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  And so if you generally sleep on a top bunk, that might
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  not be the greatest thing.
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  If you have to close a sofa bed, that's not a great thing.
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  so make it so that getting in and out of your bed is very easy.
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  and for most people, the standard bed would be fine.
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  I think that because we use drains after a mastectomy, we wanna make sure
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  that those drains are well-supported, they don't hang and pull on the skin.
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  And some sort of, clothing device that can support the bulb or collection end
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  of the drain, a little pocket is nice.
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  And in our practice, we provide patients with a little zip-up
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  camisole that they can use to tuck the drains into in an inside pocket.
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  I had one lady who just…
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  she was a do-it-yourselfer, and she had a Home Depot belt, and she
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  came in post-operatively, and she had that around her waist, and the
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  drains were in the Home Depot pocket.
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  So that's, something.
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  And then there's lots of stuff to be sold and bought in this country, there are more
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  extravagant things, camisoles that have built-in ice packs and things like that.
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  Those I, I would certainly say aren't have-to-haves, but something to support
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  the drains, an assurance that, you're gonna be in environment where you
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  don't have to do an army crawl to get through your life and your days.
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  And then the other thing is a nice water bottle to always have around
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  'cause you wanna stay hydrated in this post-operative period.
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  a water bottle or a big water cup that you can be sipping on throughout the day
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  Caitlin Whyte (Host): Absolutely.
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  Well, you kind of touched on my next question here, but what are some of those
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  extra items or products that are not necessarily essential but nice to have?
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  Dr. Brian McKinley:
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  Yeah.
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  there are various kind of zip-up garments that can support a
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  woman who's had a mastectomy.
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  and one of those which is nice, especially if you're only having
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  a one-sided operation, women still want the support of a bra.
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  So there are devices that, have the support of a bra, but in the other side
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  you can put some softer padding, so you could even, wear a shirt over it
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  and still have the sense of, having two breasts, while out in public early on.
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  as I said, there are some kind of more, animated type devices where
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  you can, either a cold pack that's electric or just ice packs that you
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  can have, that can help you as well.
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  and then there's other things like you could have like little massage guns
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  that, you know, 'cause you tend to not move in a normal limber way when
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  you have these operations, so you can get stiff in the neck and/or, back.
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  And so a little massage gun is nice for some folks, to keep those areas loose.
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  'Cause the other thing is we don't really want you doing lots of
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  stretching exercises and movements with your arms until the drains are out
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  Caitlin Whyte (Host): And are there any other types of pillows, props,
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  clothing, things that maybe people don't really think of that could
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  make a difference during recovery?
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  Dr. Brian McKinley:
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  I'm glad you reminded me because part of what we give our patients too is a
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  little pillow that can either go under the arm in case, the underarm is sore
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  because of lymph node surgery, so that as the arm and the elbow kind of come
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  back toward the chest, this pillow can go right in that little space and keep
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  the arm from coming all the way to it.
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  And then there are pillows that you can place across your chest so that when
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  you're getting up and down, you can use that to support your chest wall and
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  buttress it as you move around and get up.
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  So those pillows, they're not high-tech, but just simple pillows
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  would work to that extent too.
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  there are some devices where you can have a little strap and the pillow can
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  hang from it and things like that too.
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  Caitlin Whyte (Host): Then what are some practical changes that patients could
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  make at home before surgery to make their daily activities like sleeping,
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  bathing, cooking, just getting dressed easier during that recovery period?
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  Dr. Brian McKinley:
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  this is a great question because it really speaks to the importance
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  and the helpfulness of preparing for getting back home, right?
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  So one of the big questions a patient has to ask herself is,
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  " Who's gonna be home to help me?
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  How much support do I have?"
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  And if it's a 55-year-old lady whose husband and three, adult-ish adolescent
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  kids are around, and they're gonna be able to do lots of stuff, she's
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  gonna be pretty well taken care of.
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  But if it's a single mom with younger kids or someone that lives alone, then
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  you're gonna wanna really go through and make sure that, as I said, the bed is
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  not, a tough bed to get in and out of, to make sure that the fridge is stocked
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  with pre-prepared foods that only need to be heated up a simple way, either with a
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  microwave or an air fryer or with an oven.
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  that any items that you would normally want to get out of the
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  shelves are down at counter level.
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  So if you wanna make yourself your cup of tea, you don't have to
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  reach up and get the tea bags and the sugar and, things like that.
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  So you have to really do a good walkthrough to make sure that the house
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  is ready for, the timeframe when you come home, when your mobility and your
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  ability to lift things and reach for things is gonna be a little more limited.
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  And again, it comes with that preparation is what is important
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  to getting that, part of it right.
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  Caitlin Whyte (Host): Of course.
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  Well, are there any common mistakes or things that patients should totally
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  avoid doing too soon after a mastectomy?
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  Dr. Brian McKinley:
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  Yeah, I would think that, most of the time, people are, well-calibrated
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  in their kind of expectation that they're gonna be, impacted by this.
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  I think some people have in their head that they're gonna have
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  to go to bed for three days.
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  I think that's a mistake that some people make, that they're not gonna
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  be able to get out and do stuff.
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  And so we try to get those folks to understand that you will have these,
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  things that you need to do, but with help you'll be able to get out and do them,
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  and even get out of the house and go to church and walk in the neighborhood.
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  On the other hand, we do have some very ambitious and driven people
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  that want to know when they can swing that tennis racket or golf club.
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  And for those people, we have to just say, good.
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  Good that you're ambitious, but make sure that you temper your enthusiasm to get
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  back to things until you get a feel and a sense for how you're doing afterwards."
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  So I think the big mistakes are being out at the either extreme of kind of
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  what this is gonna be like and what I won't be able to do, on the other
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  hand, what I will be able to do.
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  Caitlin Whyte (Host): So as we close up today, doctor, what are your best tips
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  for making the recovery process just as comfortable and successful as possible?
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  Dr. Brian McKinley:
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  I think the most important thing is the preparation phase for the mastectomy.
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  And so that means ask all the questions you could possibly think of to ask so
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  that as you're approaching the surgery, which is an unknown, and then into the
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  recovery period, which is an unknown, you fill in as many of those gaps as possible
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  with things that might be, you know, not in the center of the bullseye, but will
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  definitely be on the dartboard, right?
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  You'll get some sense for where it's gonna be, and I think that's important
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  to try to dispel any wild uncertainty on your part, 'cause that would
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  drive anxiety, which can make pain control worse and things like that.
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  And then once you're home, I think, after you've gone through your home
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  and kinda set it up the way you want, just, always be mindful of the fact
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  that the plan that you've been given is one that generally works, but if you
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  don't think it's working, you can always check in with us and find out about it.
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  the pain medication plan that we give people is given because it's been
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  proven to be effective, and if it's…
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  As I said, if it's not working, then let us know.
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  The management of the drains is pretty low tech, so, get a lot of
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  instruction, to take home with you.
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  But if, again, if there's questions, then call us
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  Caitlin Whyte (Host): Well, that leads me into my last question: When
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  should a patient contact their care team about a concern during recovery?
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  Dr. Brian McKinley:
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  any time there would be unusual swelling, if you had fevers, if the incision
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  started to turn color, got pink or red, or it became more painful with time.
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  Those are kind of danger signs for infection, and that would be
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  something that we would wanna know about sooner rather than later.
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  but even when there's not those specific things, sometimes, the drain
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  just doesn't seem to be working the way you thought it should, or the
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  prescriptions the scheduled medications doesn't seem to be quite taking care
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  of you as well as they could be.
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  So any time there's something in the road that wasn't quite what you thought you
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  had been expecting or that you've been told, then by all means, you can call.
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  we have someone available, all day, every day to answer questions.
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  And whether those questions, need to come at night or whether they can come
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  during the daytime during office hours, we're always available to answer them.
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  Caitlin Whyte (Host): Thank you so much, doctor.
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  That was Dr.
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  Brian McKinley.
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  For more information, go to prismahealth.org/podcast.
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  If you enjoyed this podcast, please share it on your social channels.
• 10:13
  I'm Caitlin Whyte, and this is Flourish.
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  Thanks for listening