After my mastectomy, I am not a candidate for breast reconstruction. What are my options?

Sometimes after a mastectomy, women experience swelling or lymphedema in the remaining breast tissue and are not candidates for breast reconstruction surgery.  Kristen demonstrates how a special breast prosthesis works with massaging technology to actually help remove fluid while you wear it! You can even insert it into your favorite pre-mastectomy bra.

Mastectomy vs. Lumpectomy for Early Breast Cancer: How to Choose

Weighing the pros and cons of two different surgical options.
By Deborah Kotz

Each year more than 200,000 women diagnosed with early-stage breast cancer, the most common kind, must make myriad treatment decisions. Among them: whether to have a mastectomy or breast-conserving surgery known as a lumpectomy.

If you’ve been diagnosed with a stage 1 or 2 breast tumor that’s not highly aggressive, you may have been offered both surgical options and left to decide which is best for you.

“Once we determine that we can remove the tumor with clear cancer-free margins, we generally leave the choice up to the woman whether to have a lumpectomy or mastectomy without recommending one over the other,” says Bonnie Sun, a breast surgeon at Sibley Memorial Hospital in the District of Columbia. “It becomes a personal decision, and the patient will have to decide, ‘what do I really want?’”

A large body of evidence indicates that breast cancer patients who have mastectomies face the same survival odds as those who have lumpectomies along with breast radiation, and for the past few decades oncologists have been encouraging women with early-stage breast cancer to opt for the less radical surgery.

In fact, an expert panel convened by the National Cancer Institute declared in 1990 that lumpectomy with radiation was “preferable” to mastectomy for women with stage 1 or 2 breast cancer – which helped drive down mastectomy rates for these patients from 100 percent in the 1980s to less than 40 percent today.

But the pendulum is starting to swing back a bit toward mastectomies. A 2014 study published in the journal JAMA Surgery – which examined anonymous records from 70 to 80 percent of American women who had breast cancer surgery – found that the percentage of those with early-stage breast cancer increased from 34 percent in 1998 to 38 percent in 2011.

While the study authors could not explain the reasons for the increase, several developments over the past decade may have contributed.

Improvements in breast reconstruction following mastectomy provide patients with more natural looking results than in decades past, says Mehra Golshan, director of breast surgical services at Dana-Farber Cancer Institute in Boston. More breast cancer patients are also getting insurance coverage for the procedure, thanks to a 1998 federal law mandating coverage.

In recent years, oncologists have moved away from strongly recommending lumpectomies toward involving women in a shared decision-making process, which entails a more in-depth discussion of the pros and cons of both surgeries.

Ask yourself the following questions to help determine which surgical option is best for you.

1. How much do you fear annual breast screenings and a potential new breast tumor? Many breast cancer patients opt to have a mastectomy – and even a prophylactic mastectomy on the other healthy breast – because they know they’ll feel extreme anxiety during future annual mammograms and over any abnormal finding, follow-up biopsy and possible diagnosis of another breast tumor down the road. About 5 percent of patients who opt for a lumpectomy will have a recurrence in the affected breast or opposite breast, Golshan says, but it’s rarely life threatening.

2. How much do you want to avoid a painful recuperation? Mastectomy with breast reconstruction typically involves multiple surgical procedures and a painful healing process that can last for weeks or even months. Lumpectomy, on the other hand, is usually a shorter procedure with a shorter recovery time but sometimes also requires a second surgery if a pathologist later finds cancer cells in the tissue surrounding the removed tumor.

 “I give patients the option of speaking with women who have had lumpectomies and mastectomies, so they can get first-hand experiences of what others went through,” Golshan says.

3. Do you have concerns about radiation treatments? After lumpectomy surgery, patients typically need five to seven weeks of radiation therapy, five days per week, to destroy any stray cancer cells. Side effects from the treatments can include breast swelling, fatigue and skin redness and blistering (like a sunburn). Scatter from the radiation can, in rare cases, damage the heart, lungs or surrounding bones.

Some women are now being offered a new option called intraoperative radiation therapy, IORT for short, in which a single dose of radiation is delivered directly into the tumor site during lumpectomy surgery. Those who have IORT do not need subsequent radiation treatments, but only certain patients are candidates. “These are women over age 45 with early-stage invasive tumors less than 2.5 centimeters in size,” says Andrea McKee, chairman of the radiation oncology department at Lahey Hospital and Medical Center in Burlington, Massachusetts. Candidates also must have only ductal breast cancer, which occurs in the milk-producing ducts, with no signs of tumor cells in healthy tissue surrounding the excised lump and no spread to local lymph nodes.

Some caveats: Since the procedure is fairly new, many cancer treatment centers do not yet offer it, and some insurance companies do not cover it. What’s more, about 15 percent of patients who have IORT wind up needing traditional radiation treatments because their final pathology report shows that they weren’t appropriate candidates, McKee says.

4. How much importance do you place on breast appearance? On sexual pleasure? Reconstructed breasts may look great, but they don’t respond to cold, heat, touch or stimulation, which can reduce sexual pleasure, Golshan says. Lumpectomy will retain the sensation of the breast, but may result in a lopsided appearance if a large amount of tissue is removed or if a woman has a small breast. For this reason, breast reconstruction may be offered along with lumpectomy to even out breast size.

5. What’s your life expectancy? Women diagnosed with breast cancer at a younger age may be more likely to opt for mastectomy because their longer expected lifespan means they have a higher lifetime risk of recurrence. “We typically tell patients that their risk of developing another primary breast cancer is about ½ percent per year,” Sun says. A 30-year-old breast cancer patient who expects to live another 50 years will face a 25 percent risk of developing another breast cancer compared to a 5 percent risk for a woman diagnosed at age 70.

Young breast cancer patients are also more likely to carry gene mutations that put them at even greater risk of recurrence, Sun said, which could tip the balance toward having a single or double mastectomy.

How to Wash a Mastectomy Prosthesis

Ever wonder what the best was is to wash a mastectomy prosthesis?  Watch our BOC/ABC certified mastectomy fitter demonstrate:

Study ties breast gene to high-risk uterine cancer

BY MARILYNN MARCHIONE
AP Chief Medical Writer

Women with a faulty breast cancer gene might face a greater chance of rare but deadly uterine tumors despite having their ovaries removed to lower their main cancer risks, doctors are reporting.


A study of nearly 300 women with bad BRCA1 genes found four cases of aggressive uterine cancers years after they had preventive surgery to remove their ovaries. That rate is 26 times greater than expected.

"One can happen. Two all of a sudden raises eyebrows," and four is highly suspicious, said Dr. Noah Kauff of Memorial Sloan Kettering Cancer Center in New York.

His study, reported Monday at a cancer conference in Florida, is the first to make this link. Although it's not enough evidence to change practice now, doctors say women with these gene mutations should be told of the results and consider having their uterus removed along with their ovaries.

"It's important for women to have that information ... but I think it's too early to strongly recommend to patients that they undergo a hysterectomy" until more research confirms the finding, said Dr. Karen Lu, a specialist in women's cancers at MD Anderson Cancer Center in Houston.

She plans to study similar patients at her own hospital, the nation's largest cancer center, to see if they, too, have higher uterine cancer risks.

About 1 in 400 women in the U.S., and more of eastern European descent, have faulty BRCA1 or BRCA2 genes that greatly raise their risks for breast and ovarian cancer. Doctors advise them to be screened early and often for breast cancer, and to have their ovaries out as soon as they have finished having children to help prevent ovarian and breast cancer, because ovarian hormones affect breast cancer as well.

But the role of BRCA genes in uterine cancer isn't known, Kauff said.

His study looked at 1,200 women diagnosed with BRCA gene mutations since 1995 at Sloan Kettering. Doctors were able to track 525 of them for many years after they had surgery that removed their ovaries but left the uterus intact.

The vast majority of uterine cancers are low-risk types usually cured with surgery alone. Aggressive forms account for only 10 to 15 percent of cases but more than half of uterine cancer deaths.

Researchers were alarmed to see four of these cases among the 296 women with BRCA1 mutations. None were seen in women with BRCA2 mutations, Kauff said.

The study was discussed Monday at the Society of Gynecologic Oncology's annual meeting in Tampa, Fla.

Last year, the actress Angelina Jolie revealed she had preventive surgery to remove both breasts because of a BRCA1 mutation. Her mother had breast cancer and died of ovarian cancer, and her maternal grandmother also had ovarian cancer.

Top Tips for Air Travel With Lymphedema

With the holiday season in tow, an increase in travelers will invade airports all over the country.  we've put together a few tips for those with lymphedema and are planning to travel by air this season.

Cabin pressure during a flight in a plane is less than the atmospheric pressure while on the ground. The decreased pressure in the cabin can cause increased swelling of the limb. If you have had a mastectomy, lumpectomy or radiation therapy you should wear compression garments while traveling by air to reduce risk of swelling.

Air travel is sedentary in nature, normally causing blood and lymphatic circulation to slow.  When you have been properly fitted for a sleeve and glove/gauntlet, it should be tight at the wrist and sit one finger width from the arm pit.

A hand piece or glove should be worn with the sleeve in order NOT to push the fluid into your hand. It is recommended to wear your sleeve 2 hours prior to flight and 2 hours after you have landed. Wearing garments applies to other types of long distance travel such as a car, train, or bus.

Travelers Tips:

-Wear comfortable clothing
-Avoid lifting and carrying heavy baggage
-Take a short walk every 2 hours
-Raise your arm and turn in circles several times
-Wear compression garments while on the trip will help prevent symptoms and swelling
-Drink plenty of liquids, avoid dehydration
-Take sunscreen, insect repellent, and extra non-scented lotion such as Eucerin

If you are in need of compression garments, call our BOC/ABC certified fitter, Kristen Knowles at 713-623-4247.  She specializes in creating customized solutions to increase mobility and decrease lymphedema swelling.

Preventative Mastectomy is an Option for Women Who are at a Very High Risk

From the Meadville Tribune

People around the world were shocked to learn that actress and activist Angelina Jolie opted to have a double mastectomy in 2013 to reduce her risk of breast cancer. Jolie, who was 37 years old at the time of the procedure, reportedly learned that she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer. In addition, the actress has a family history of cancer. Her mother, Marcheline Bertrand, died of ovarian cancer in 2007 at the age of 56.

By having a preventive mastectomy, Jolie reduced her breast cancer risk from 87 percent to 5 percent, according to an op-ed piece she authored in The New York Times. Jolie is not the only well-known actress to opt for a preventive mastectomy, as fellow thespian Christina Applegate had a similar procedure in 2008 after learning she had a mutation of the BRCA1 gene. These highly publicized cases have left many women wondering if a preventive mastectomy is something they should consider.

BRCA stands for "breast cancer susceptibility genes," a class of genes known as tumor suppressors, says the National Cancer Institute. Mutations in these genes have been linked to hereditary breast and ovarian cancer. A person's risk of developing breast and/or ovarian cancer is greatly increased if he or she inherits a harmful mutation in BRCA1 or BRCA2. Mutations in these genes could also put a person at increased risk for other cancers.

Genetic tests can check for mutations in BRCAgenes. During such a test, a blood sample is taken, and if a mutation is found, a person may get genetic counseling and work with a doctor to develop a plan of action. It is important to note that not all people with a genetic mutation will get breast cancer or ovarian cancer. The National Cancer Institute's "SEER Cancer Statistic Review" states a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.

Although there is no surefire way to determine if a person with a mutated gene will develop breast cancer, many women who are considered high risk opt for a preventive mastectomy to reduce their risk. Women who have a family history of breast cancer, have received positive results from gene testing, have already had cancer in one breast, or have dense breasts that make testing difficult may want to get a preventive mastectomy.

The decision to get a preventive mastectomy is not one to take lightly. Many breast centers are staffed with breast-health specialists, genetic counselors, breast surgeons, and reconstructive surgeons who can help patients make the best decision. Second opinions are strongly recommended for women considering a preventive mastectomy.

Women should understand the options available to them if they have an extremely elevated risk of breast cancer or ovarian cancer.

What you need to know about BRCA gene testing

What is BRCA gene testing?
Everyone has BRCA genes that produce tumor-suppressing proteins. But risky BRCA1 and BRCA2 gene mutations leave a person more susceptible to cancers, including breast and ovarian cancers. BRCA testing is used to determine whether a person has such a mutation, which can be inherited from either parent. Each child of a parent who has a mutation in one of these genes has a 50 percent chance of inheriting the mutation.

What does the test entail?
BRCA gene mutations are detectable through DNA from a blood or saliva sample. It usually takes about a month to get results once your sample is sent to a lab for analysis.

What does a positive result mean?
A woman's lifetime risk of developing cancer is “greatly increased,” if she has a harmful BRCA mutation, according to the National Institutes of Health. About 12 percent of women will develop breast cancer at some point compared with up to 65 percent of women who inherit a harmful BRCA1 mutation. Other cancers are linked to mutations in BRCA1 and BRCA2, including fallopian tube, abdominal and pancreatic cancers. Men with harmful BRCA gene mutations face higher risk of prostate cancer.

How common are high-risk BRCA gene mutations?
The likelihood of carrying a BRCA gene mutation is extremely low for people with no family history of breast or ovarian cancer. Only about 10 percent of all breast cancers and 15 percent of all ovarian cancers can be traced back to inherited genetic mutations.

Who should take the test?
Because BRCA gene mutations are relatively rare, many doctors agree only those who have specific family patterns of cancer should consider the test. Such patterns include having multiple family members who have been diagnosed with breast or ovarian cancer, especially at a young age; cases of male breast cancer; and two or more cancers in one family member.

For anyone thinking about such testing, experts strongly recommend genetic counseling by someone who is experienced in cancer genetics. Counseling can help assess the need for testing in the first place, as well as facilitate discussion about what kinds of decisions a person faces once she gets her results.

What kinds of decisions should you be prepared to make?
A person who finds out she has a BRCA gene mutation faces some difficult decisions. Some women choose enhanced cancer screening, beginning with regular mammograms in their 20s, for example. Others choose risk-reducing surgeries like mastectomies or the removal of the ovaries and fallopian tubes. People also consider chemo-prevention regimens of drugs and vitamins to delay or reduce cancer risk. Finding out you have a harmful BRCA mutation indicates a higher risk for your siblings, too, so what you learn can affect multiple family members.

How much does it cost?
Some insurance companies cover BRCA testing, which can range in cost from hundreds to thousands of dollars. The National Cancer Institute urges people to contact their insurance companies to discuss cost before getting the test. For those without insurance, some genetic testing companies offer free or discounted pricing for individuals who meet certain medical or financial eligibility standards.

Who can help?
There are myriad resources for people considering BRCA gene testing, including the Cancer Information Service at the National Institutes of Health (NIH) and many nonprofit organizations. Live and anonymous online chatting is available from the NIH weekdays from 8 a.m. to 11 p.m. ET (5 a.m. to 8 p.m. PT at http://livehelp.cancer.gov. You can also call 1-800-4-CANCER.

Walk to Support Breast Cancer Awareness!

Join us for a day of fun for the whole family as we attend the Fifth Annual "Celebrate Your Princess" Breast Cancer Awareness Walk in Fulshear, TX on Saturday October 26th!

Breast cancer is the most common cancer in women in the United States, aside from skin cancer. According to the American Cancer Society (ACS), an estimated 230,000 new cases of invasive breast cancer are expected to be diagnosed among women in the United States this year. Today there are about 2.5 million breast cancer survivors living in the United States. Early detection and prevention are critical. Celebrate Your Princess benefits the CHRISTUS St. Catherine Breast Cancer Awareness Fund, promoting community outreach, health, wellness and education.

We will be showcasing our latest and greatest hair loss, mastectomy and lymphedema solutions and will be available to answer any questions about our products and services.

Join us:

Saturday, October 26, 2013 @ 7:30 AM
Cross Creek Ranch
6450 Cross Creek Bend Lane
Fulshear , TX 77441

You can still sign up for the walk online, or registration is available the day of the walk at the event.

Walk for the cause, enjoy music and food while the kids play in the kid's zone bounce house, decorate pumpkins and much more!

Extensiveness of breast cancer surgery linked to risk of lymphedema

Breast cancer survivors who have extensive surgery are four times more likely to develop arm lymphedema. According to a new study, the extensiveness of surgery to treat breast cancer proportionately increases the risk of developing the debilitating disorder.

According to the lead author, Tracey DiSipio, PhD, from Queensland University of Technology in Brisbane, Australia, women who had undergone an axillary lymph node dissection, which is an invasive surgery to remove lymph nodes under the arm, were four times more likely to experience swollen or disfigured arms compared with women who had received a sentinel lymph node biopsy. The study was published in The Lancet Oncology.

"Arm lymphedema is typically characterized by swelling in one or both arms, causing pain, heaviness, tightness, and a decreased range of motion," DiSipio said. "The appearance of the swollen or disfigured arms provides an ever-present reminder of breast cancer and often contributes to anxiety, depression, and emotional distress in affected women."

DiSipio said the study, a systematic review of the incidence of arm lymphedema after breast cancer, also found that the condition is diagnosed in one in five women (21.4%). She explained, "This is a significant research finding and provides us with the most accurate incidence rate to date. Until now the incidence rate has been reported as anywhere from 0% to 94%. With this information we can explore whether lymphedema rates differ between breast cancer survivors."

The study also pinpointed a number of risk factors linked to arm lymphedema. Risk increased with a lack of regular physical activity and with a high body mass index. DiSipio said, "These factors are potential targets for future prevention strategies or for more effective management of the disorder."

DiSipio said the results of the study added weight to calls to integrate prospective surveillance of arm lymphedema into standard breast cancer care.

"Currently there are no standardized practices when it comes to detection and treatment of arm lymphedema," she said. "Given most patients present with the arm lymphedema within the first 2 years after breast cancer, more frequent surveillance throughout this time is recommended."

If you or a loved one is undergoing breast cancer treatment, call 713-623-4247 to schedule a free consultation with our ABC/BOC certified compression garment and mastectomy prosthesis fitter.  Kristen and our team will develop a customized approach to helping you maintain your mobility and comfort during and after your cancer treatment.

Early Detection & Breast Health Tips

1. Early Breast Cancer Detection – Experts recommend women get to know their own bodies: report any changes in your breast to your medical provider right away and talk to your doctor about your risk of breast cancer and when to be screened. Medical experts also recommend:

• Women age 40 and older should have a mammogram every year 
• Women in their 20s and 30s should have a clinical breast exam (CBE) as part of their periodic health exam by a health professional, preferably every three years 
• Breast self exam: Experts now recommend that women get to know their own bodies and watch for any changes. BSE is an option for women starting in their 20s. You should report any changes in your breast health to your doctor right away. 

2. Reduce Your Risk – Here are some suggestions to help reduce your risk of breast cancer:

• Examine your family history – Your risk is increased if a family member has had breast cancer, especially if a first-degree relative (mother, sister, daughter) is diagnosed before the age of 50. Speak with a nurse, doctor or your medical provider about your breast cancer risk and additional steps you can take to reduce your risk. 
• Get some exercise– Brisk walking for one hour a day can your reduce risk by more than 15%. The American Cancer Society recommends you engage in at least 45 minutes of physical activity at least 5 days a week. 
• Minimize radiation exposure – The human breast is sensitive to radiation, especially if exposure occurs at young ages. Girls repeatedly exposed to radiation before the age of 20 are at highest risk for developing breast cancer later in life. 
• Modify alcohol intake – Regular consumption of one drink a day for women is associated with an increased risk of breast cancer. 
• Avoid smoking and secondhand smoke – Tobacco smoke is a known human carcinogen and is an established risk factor for lung cancer. Exposure to smoking and secondhand smoke should be avoided, particularly during childhood, puberty, pregnancy and when breast feeding. 
• Avoid exposures to exogenous estrogens 
• Hormone replacement therapy – Use only if absolutely necessary; use for as short a time as possible, and discuss alternatives with your doctor. 
• Hormonally active environmental chemicals – Some studies suggest chemicals in our homes, water and environment may play a role in cancer development. 
• Maintain leanness or reduce weight – The relationship between being overweight and breast cancer risk is one of the best understood to date. It is known that women who gain more than 20 pounds from age 18 to midlife double their risk of breast cancer (postmenopausal) compared to women whose weight remains stable. 

3. Lymphedema – Lymphedema is a chronic, debilitating disorder following cancer treatment that can cause arm swelling and chronic inflammation. There are new advances and recommendations for women diagnosed with breast cancer:

• Newly diagnosed women should ask their doctor for a perometry screen or BIS (bioimpedance spectroscopy) screen before they have breast cancer surgery and at regular follow-up visits. Survivors who have already undergone surgery should ask their doctor if BIS or perometry might be helpful in their ongoing care. 
• Exercise and weight training have been shown to help reduce the risk of lymphedema and to reduce the severity of the disorder in already affected patients. Women should discuss exercise and weight-lifting regimens with their doctor or a well-trained or certified lymphedema therapist. 

4. Nutrition – Nutrition plays an important role in your health.

5. Know Your Resources –Don't overlook your own breast health. Survival rates increase dramatically in women who've been diagnosed with breast cancer early. If you are living in a low-income household, or are underinsured or uninsured, there are many resources available, regardless of your ability to pay, that can help you seek out the proper breast care:

• The Centers for Disease Control (CDC) offers an online search tool for women to seek out free and low-cost screenings across the country. 
• For information on breast cancer and tools to help you seek out medical care, visit the American Cancer Society's website at www.cancer.org/Cancer/BreastCancer/index

Women with Breast Cancer Benefit from Personal Website Sharing

Developing and using a personal website to chronicle their experience and communicate with others improves psychological and cancer-specific adjustment in women being treated for breast cancer, according to research published online Aug. 12 in the Journal of Clinical Oncology.

Annette L. Stanton, Ph.D., of the University of California at Los Angeles, and colleagues randomly assigned 88 women diagnosed with breast cancer to participation in Project Connect Online or a waiting-list control group. The intervention consisted of a three-hour workshop to create a personal website and a follow-up call to encourage its use.

The researchers found that, six months later, women in the intervention group showed significant benefit in depressive symptoms, positive mood, and life appreciation compared with women in the control group. No benefit was observed in negative mood, perceived strengthened relationships, or intrusive thoughts. Among women participating in the online intervention, those who were currently undergoing treatment for cancer showed significantly greater benefit in depressive symptoms and positive mood than those not receiving treatment.

"To our knowledge, ours is the first research to evaluate an intervention to teach patients with cancer personal website development," the authors write. "Findings suggest the promise of an intervention to facilitate the ability of women diagnosed with breast cancer to chronicle their experience and communicate with their social network via the Internet."

Tamoxifen Halves Breast Cancer Risk in High-Risk Women

Tamoxifen halves breast cancer risk in high-risk women A global study of women with inherited mutations in BRCA1 or BRCA2 found that tamoxifen could halve the risk for breast cancer in the contralateral (opposite-side) breast in these high-risk women.

Tamoxifen has been used for decades to treat breast cancer and has recently been shown to prevent breast cancers in many women. Until now, there has been limited information about whether it reduces breast cancer risk for women who are at the very highest level of risk with BRCA1 or BRCA2.

This study, led by the University of Melbourne and the Peter MacCallum Cancer Centre in Australia, involved about 2,500 women from Europe, North America, and Australia who have inherited mutations in BRCA1 or BRCA2 and who have been diagnosed with breast cancer since 1970. About one-third of these women were placed on tamoxifen.

Tamoxifen was taken by 24% of the 1,583 BRCA1 and by 52% of the BRCA2 mutation carriers after their first breast cancer diagnosis. Over 20,104 person-years of observation, 520 contralateral breast cancers occurred. The statistical analysis of 657 BRCA1 and 426 BRCA2 mutation carriers with 100 contralateral breast cancers found an adjusted hazard ratio estimate of 0.58 for BRCA1 carriers and 0.48 for BRCA2 carriers. This study was published in the Journal of Clinical Oncology.

"In the past, the only way of reducing breast cancer risk for these high-risk women was to do invasive surgery to remove their breasts and/or ovaries. For women who choose not to undergo such surgery, or who would prefer to delay surgery until they are older, tamoxifen could now be a viable alternative," said the lead author, Kelly-Anne Phillips, MD, of the Peter MacCallum Cancer Centre. Her previous research had found that only one in five Australian women with a mutation in BRCA1 or BRCA2 chose to undergo bilateral mastectomy to prevent cancer.

Co-author John Hopper, PhD, of the University of Melbourne, said, "In light of our findings, it is clear that women who have a mutation in BRCA1 or BRCA2 should review their management plan with their specialist and re-discuss the options available to them to lower that risk."

I Am Scheduled To Undergo Mastectomy Surgery. What Are Some Recovery Tips?

Going through mastectomy surgery can be extremely taxing on both your body and your emotions.  Here are some tips to help you when you get home.

Follow Your Doctors Instructions
Follow all your Doctor’s instructions in regards to wound care, rest, lifting restrictions, driving, surgical bras and garments etc.  Most importantly if your Doctor says don’t do something – listen and don’t do it!

When discharged from hospital ask all your questions (to Doctors and Nurses) no matter how insignificant you may think they are and have contact numbers for when you get home and have another question or concern.

Rest, Rest and then Rest Some More
Take it totally easy the first full week.  Take multiple naps, watch movies, read books and relax.  Have people do almost everything for you to avoid overdoing it.  Be warned it is super easy to overdo it when you first get home.  Even opening the fridge, opening drawers, picking up stuff and carrying laundry is too much!  Also washing your hair is too much in the first week as you can’t lift your arms so book into the hairdressers.  If you do too much you will pay for it that night and the next day with muscle pain and a very sore body.

Fatigue is normal.  Gradually increase your activity and ease back into your ‘normal’ routine.  Remember most women require four to six weeks off work to recover.  A mastectomy is a major invasive surgery and body tissues need rest to recover and repair from the procedure.  By over doing it you are slowing down your recovery and healing.

Remember no strenuous activity or lifting for approximately six weeks following your surgery (your Doctor will tell you when you are ready).

Medication and Pain Control
Get all your scripts filled immediately (with non child proof caps – you will find the push down and turn type difficult to open with limited arm strength) and in a notebook write down what you take and when.  It is easy to lose track of whether you have taken your medication or not and writing it down ensures you have and have taken it at the right time (and haven’t taken a double dose).  Writing down your pain medication is also useful as it allows you to slowly reduce the amount and strength over a few weeks.   

When it comes to pain management take your pain medication regularly.  The job of the medicine is to avoid pain.  If you get in too much pain you will feel miserable waiting for the pain medication to kick in.  Also studies have shown that a patient who has less pain recovers better.

Medical Supplies
It is useful to have the following at home:

• Laxatives as the pain medications/general aesthetic can make you constipated
• Ibuprofen
• Acetaminophen
• Post scar treatment (although you won’t need this until your tape/bandages have been removed)
• Spare dressings (although in some cases you won’t need these as your Surgeon will remove your tape/dressings at your first follow up appointment)

Sleeping
You will most likely need to sleep on your back for at least three or four weeks (definitely the case if you have had a double mastectomy).  This is actually harder than it sounds if you are used to sleeping on your stomach or side and getting sleep is really important for your recovery (and feeling rested and able to cope in general).

Exercise
Follow your Surgeon’s instructions regarding exercise.  Usually you will be encouraged to walk and have been doing laps of the hospital.  When you get home walk a bit further each day.  Listen to your body and stop if you get tired or dizzy.  Resume more physically active exercise, running, swimming etc. once your Doctor gives approval and gradually build back up to your pre surgery levels.

It can be frustrating, for example if you were a runner and feel great but still have bruising and swelling and your Surgeon says no running (raising your heart rate/pulse slows down healing) – listen, grit your teeth and DON’T RUN.

Get Comfortable
New clothes may be necessary to accommodate your surgery.  Specialty camisoles are a great option because they provide a light layer that can hold drains.  Many styles have pockets to hold forms and can be worn under your clothing.  You may also opt for a robe that is made with pockets for breast forms or ice packs and also can support the weight of fluid from drains.

You will want to get a prosthesis or breast form around six weeks after surgery.  Typically at this time the swelling will have reduced.  Make sure that you see a BOC or ABC certified fitter.  These certifications ensure that you are fitted properly.  A certified fitter can also help you find a well-fitting bra to act as a good foundation for style and comfort.

Drink Water
It is very important that you drink plenty of water during your mastectomy recovery.  While having surgery, a lot of blood and other fluids are removed from the body and you will have to reinstate these in the days following surgery for getting the best recovery results.

Eat Well
To assist your recovery each a diet rich in nutrients – in other words eat healthy.  For your cells and tissues nutrients are the building blocks and will assist your recovery.  So eat a well balanced diet of to help your body.

Support and Talking to Others
Regardless of your level of support from family and friends, you may find it helpful to talk to others who have gone through a mastectomy.  Talking to others who have gone through the same decision making process and procedure will give first hand understanding and support.  It is a major deal both physically and emotionally to undergo a mastectomy and it helps to connect with other women who have gone through what you are feeling.

You have just come home from major surgery and most likely haven’t finished your reconstruction so be aware that your chest/breasts/body will not look perfect/normal and you still have recovery and further surgery to go – however you have just achieved something amazing so try to be proud of your body.

Our team at Ricky Knowles Hair and Wellness is here to support you through your journey.  We can connect you with a support group that fits with your schedule, fit you for a mastectomy prosthesis, help you with with lymphedema preventative care, and serve as your patient advocate by untangling the insurance benefit web.  We have a BOC, ABC mastectomy prosthesis fitter and an insurance specialist on staff.   In addition to mastectomy forms, we also carry post mastectomy products such as camisoles, bras and robes.  If you are ready for us to partner with you, please call us at 713-623-4247.