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Discharge
Instructions After Mastectomy/Lumpectomy
Care of the Incision
After the surgery, the mastectomy/lumpectomy incision will be covered
with a gauze dressing. This dressing may be removed after 48 hours
and does not need to be replaced.
Under the dressing
you will find several thin paper tapes (steri-strips) covering the
incision. The steri-strips should be left in place. The stitches
are underneath the skin and will dissolve. It is normal for the
breast to look bruised (black and blue) and swollen after a lumpectomy.
The swelling will go down and the bruising will fade after a week
or so.
Drain Care
You will be instructed how to empty your drain(s), strip or milk
the tubing, and measure and record the amount of drainage before
you are discharged from the hospital.
The drain(s)
will need to be emptied between one and three times a day depending
upon the amount of drainage. Initially, the drainage will be dark
red (bloody). It will change in color over the next few days to
a week, becoming a clear red and then a clear yellow. There may
be a few small blood clots in the drainage. This is normal. If the
drainage should become cloudy or look like pus, please call the
office as this could indicate infection.
The drain(s)
will be removed in the office when the drainage decreases to one
ounce (30cc) a day or less. A Visiting Nurse may see you in your
home to change the dressing, assess for infection, and monitor your
progress after surgery.
While the drain
is in place, you will find that it is easiest to wear loose fitting
shirts that button down the front. The drain bulb can be pinned
to the underside of your shirt or pants.
Medication
Antibiotics
You may be given a prescription for antibiotics when you are discharged
from the hospital or asked to apply an antibiotic ointment around
the drain site when the dressing is changed. It is very important
to follow this therapy to prevent infection while the drain(s) is
in place. Some patients develop diarrhea or abdominal cramps while
taking antibiotics. This can usually be prevented by eating yogurt
on a daily basis. It is also not uncommon to develop a vaginal yeast
infection while you are taking antibiotics. This can be treated
with an over-the-counter medication such as Monistat.
Pain Medication
Most women have pain or discomfort for a few days up to a week after
the surgery. You should take enteric-coated aspirin (Ecotrin) or
ibuprofen(Motrin, Advil), two tablets three times a day with meals
for one week after your surgery. You will probably be given a prescription
for narcotic pain medication when you are discharged from the hospital.
These pills should be taken for any pain that is not relieved by
the aspirin or ibuprofen. Common side effects of narcotic pain medication
are decreased appetite, constipation, and feeling tired or "blah."
Vitamins
We also recommend that you take a multivitamin (any brand) once
a day to help with healing. You may be asked to take iron if you
are anemic after your surgery.
Usual Medication
You should continue to take any medication that was prescribed before
your surgery, for example, thyroid medication, high blood pressure
medication, etc.
Activity
Limit your activities and pace yourself for the first few weeks
after surgery. Your body needs rest to help heal and recover from
the surgery. You should not be doing any heavy housework - laundry,
vacuuming, etc. You may go out to eat, visit friends, or go for
a drive in the car. Taking a walk at least once a day will also
help to speed your recovery along. Sexual relations may be resumed
when you feel comfortable enough.
Arm Care
You should limit use of your arm on the affected side to eating,
brushing your hair and teeth, and bathing, until the drain is removed.
Do not raise your arm above the level of your shoulder. Elevate
your arm on a pillow when you go to bed to prevent swelling for
the first three months after your surgery. You will be given information
in the hospital about special precautions that must be taken after
the removal of lymph nodes from your axilla (armpit). This information
will be reviewed with you in the office after the drain is removed.
Pathology
Results
Information about your breast cancer and whether it has spread to
your lymph nodes will generally be available within five business
days after your operation. You will be called at home with the results,
usually in the evening.
Follow-Up
Office Visits
You will be seen in the office once a week until your drain(s) is
removed. After you are discharged from the hospital, call the office
to schedule your first post-op visit. Remember to bring yourdrainage
record with you.
Hygiene
You may not take a shower while your drain is in place. A sponge
bath is preferred. It is very important to keep the drain site dry
to prevent infection. Do not wash around the drain site until after
the drain is removed.
Diet
You may resume your normal diet. It is not unusual for your appetite
to be decreased for a few days after the operation. This is usually
due to side effects of medication, especially the pain pills. Drink
plenty of fluids and eat lightly until your appetite returns to
normal. Eating a well-balanced diet with extra protein will help
with healing at the surgical site.
When To Call
The Office
Do not hesitate to call the office if you develop a fever (temperature
greater than 101), shaking chills, nausea or vomiting, diarrhea,
dizziness, bleeding or pus from your incision or around the drain
site, persistent or increased pain, or with any other problem that
concerns you.
Genesee Surgical Associates, PC
Linden Oaks Medical Campus
10 Hagen Drive, Suite 240
Rochester, NY 14625
Phone:(585) 383-8830
Fax:(585) 383-8901
Christopher
B. Caldwell, MD
Robert J. Tripp, MD
Victoria U. Nugent, N.P.
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