Aftercare for breast cancer surgery patient….

On the day of surgery:

Food after surgery: Patient may initially take clear liquids and preferably water 6 hrs after surgery i.e. after full recovery. If tolerated and patient desires, soft diet may be given as per patient’s wish.

Position after surgery: Better to remain 30- 45 degree head and back inclined up till full recovery.

Post op treatment: Nurses will give the IV fluids as per instruction and sugars will be timely checked as ordered. Antibiotics,anti acidity and pain medications will be given on day 1.

Patient’s previous medicines for comorbidities like blood pressure or diabetes etc can be resumed after the physician’s advice.

Dressings: Dressing will be changed before discharge. It is advisable to actively learn and follow the dressing technique so relatives can do it at home as required.

Post anesthesia recovery symptomes:

You may feel drowsy and have minor side effects after your procedure or surgery with anesthesia. These side effects include:

• Sore throat • Headache • Muscle aches • Dizziness off and on

• Nausea • Vomiting (rarely)

Some of these symptoms may be from the pain medicine you are taking. The side effects from anesthesia usually go away quickly in the hours after your procedure. Still, it may take several days for your body to recover from the stress of surgery and anesthesia.

Urinary retention (not being able to urinate) may occur after some procedures. If you are unable to urinate within 8 hours of going home after your procedure, or if your bladder feels painful and full, call the duty doctor or inform the nurse. In some patients, temporary insertion of a urinary catheter may be required.

At home care:

Dressing: it is desirable to change the dressings at home daily. Patients can take showers, especially if plastic coated dressing is applied. After a week, soap and water can be applied to surgical site as well. Always dab it dry and clean the wound with propranolol [cutasept] or chlorhexidine based solution. Apply mupirocin ointment on the suture line. Keep a thin layer of sterile gauze pieces dressing and secure it with micropore tape or use ready made tegaderm with pad dressings.

Wound inspection: it is important to note any collection, discharge, redness or pus from the wound. In doubtful circumstances readily click a photo and send across to the clinic number or doctor, else meet the doctor in the clinic.

Patient will be given pain medications and antibiotics which can make the patient constipated. Increasing fluid, fiber and fruits in your diet may be helpful in avoiding this problem. You may return to a normal diet immediately following surgery.

If you notice swelling in your hand or arm, it is expected at times post surgery:

Use 2 to 3 pillows to raise your arm higher than your heart. Do this a few times a day. You can raise your arm while you sit, lie on your back or lie on your side.

Raise your arm and slowly open and close your fist 10 times. This acts like a pump and helps drain fluid out of your arm.

Return to your daily activities as tolerated.

You will return to the clinic a week following surgery. At this appointment, we will remove your dressings and you will receive pathology results from your pathologist. Further action plans can be sketched out after that.

Suture removal is usually done after 2 weeks.
NEVER EVER TO USE THE UPPER LIMB ON DISEASE SIDE FOR BLOOD PRESSURE MEASUREMENT, DRAWING BLOOD , INJECTIONS OR iv CANNULA
Drain care and removal: the tubes coming out from the operated area have a vacuumised box attached. It needs to be emptied daily at a fixed time so that the fluid in each 24 hrs can be measured. Date Wise charting of fluid output helps us in determining the time when the drain pipes can be safely removed. Details of drain care are given later separately. It is advisable to learn the emptying and recharging of drain while the nursing staff is doing.

When should I call my doctor?

You have bleeding that soaks your dressing;
Temperature taken by mouth between 38-38.2° C (100.4-100.8°F) for one hour or more, or a temperature that is 38.3°C (100.9°F) or above; or temperature taken under the arm between 37.5-37.7° C (99.5-99.9°F) for one hour or more, or a temperature that is 37.8°C (100° F) or above;
If you have chills;
You have any sign of infection: redness, increased pain, swelling, foul-smelling drainage, or increase in the amount of drainage from your wound;
You notice an increasing fullness of your skin where your drain site was;
You have concerns that cannot wait until your follow- up visit.

In case of severe emergency, reach out to the nearest specialist or hospital if your doctor is not available or reachable.