The Day After Surgery

I’m already home and feeling great.

It’s hard to believe that surgery was yesterday. I have an incision about the length of my index finger on my left breast, about where you would put your hand on your heart if you were swearing an oath. It’s sealed with dissolving stitches and covered with a waterproof dressing so I can shower. My post-surgery instructions are to wear a bra, night and day, to prevent drag on the wound, to do some simple arm exercises twice a day and to go for a walk. The other instruction is ‘nothing strenuous’.

My husband has made everyone repeat this last one. When the Breast Care Nurse told me to ‘take it easy’ he asked her to repeat it three times!

I’m a ‘doing’ kind of person. I do not rest easily. Fortunately, typing is allowed so expect a blog-surge over the next ten days!

Although I was supposed to have a private room the hospital is very busy in early January catching up after all the Christmas breaks. If you have the choice, avoid this time of year. The poor woman in the bed next to me was in a lot of pain and spent the night either groaning or discussing her pain with the nurse. She was in a bad way. This meant I didn’t get much sleep so I spent good chunks of the evening hooked up to my iPod shuffle listening to yoga music and meditation recordings. It was one of those situations where I could have lay there being distressed and grinding my teeth, wondering what on earth I could do to help her, so I was pleased to be able to be peaceful and relaxed. I’ve probably only had about four hours sleep, off an on. In spite of the lack of sleep I’m feeling well rested.

I love lists and find them very useful so I thought this would be a good time to record my list of surgery-related things. Hopefully it will prove useful to those of you facing the same treatment.

BEFORE SURGERY

1. The time to start planning for surgery is the minute you discover you’re going to need it, even if it’s weeks or months away.

2. You cannot be too fit. Keep up your fitness routine or start one if you don’t have one.

3. Your food is your fuel. Rubbish in equals rubbish out and I’m not just talking about digestion. Particularly in the weeks leading up to surgery it’s worth paying a lot of attention to what goes in your mouth. If you drink, give up alcohol. Eat plenty of grass fed organic meat (higher in omega 3) and lots of fresh fruit and vegetables, preferably organic. I had oysters the night before because of their high zinc content. Seriously. The fact that they’re also delicious was just a bonus.

4. Follow your doctors instructions. Don’t pay them all that money and then ignore what they tell you to do. That’s stupid behaviour.

5. Decide how much you want to know about the procedure and then learn more if you want to. Ignorance really is bliss for some and that’s okay, but I really like to know what to expect.

6. Decide if you’d be better off staying close to the hospital the night before. This is the only option for a lot of rural people but even if you live in a city it can save you the stress of worrying about an early morning appointment.

7. Avoid injury and illness. Don’t go throwing your body at new and risky adventures just now. This is not the time learn knife juggling. I also made a point of avoiding prawns and chicken when I ate out because I’ve had food poisoning from both in the past. You can’t be too careful.

8. It’s a great idea to drink a LOT of water just before your cut off time the night before surgery. You’ll be well hydrated which will help with recovery. These days they typically give you a ‘nil by mouth’ direction from midnight the night before. The nurse told me they used to say ‘clear fluids until four hours before surgery’ but too many people thought milk was okay (!) or soup was okay (!) so now they just give the midnight cut off. If you’re really thirsty then ask when you check in if you can have a drink of water. Depending on your surgery time they might be okay with this. If you can’t drink water you can still rinse your mouth and spit it out. Good to know.

WHAT I PACKED FOR HOSPITAL

1. Clothes that are easy to get in to and out of. Front opening tops. Pull on pants. Remember you’re best to wear separates rather than a dress because that way you only need to remove your top for any pre-surgery procedures. I needed an ultrasound, followed by a procedure to have radioactive dye injected into four points on my breast and then I needed two lots of imaging after that. Remember hospitals are notoriously cold so front opening, long sleeved pyjamas are a good idea, along with a soft scarf for your neck/head and a jacket or dressing gown.

2. Shoes that are stable and easy to get in to and out of. See above. I wore my Birkenstocks. They’re super stable and double as slippers.

3. Toiletries. You’re not allowed to wear makeup, nail polish or jewellery into surgery so I didn’t pack any, but I was also only in overnight. If having a bit of makeup for afterwards will make you feel better then go ahead and pack it. I did pack perfume and put a bit on before I went off to sleep. It makes me smile and masks that hospital odour. I also packed rose hip oil for my face and hands and some tiger balm in case I had cramps.  I packed a nail file, nail clippers, lip balm and dental floss just because I don’t leave home without them. I packed toothpaste and a toothbrush. I threw the toothbrush away when I got home. This just seems sensible after hospital, radioactivity and all those germs. I also packed flushable wipes. There’s a rule that says you will always need to go after you’ve showered and before you go into surgery. Flushable wipes are the next best thing to a shower.

4. I packed my trusty fold out fan. Great for hot flushes. I didn’t pack a hand towel for my pillow but would recommend it. As it turned out the Mater were happy to supply one. I cope much better with night sweats if I’m not sleeping in a puddle.

5. I wish I’d packed my Biotene mouth spray. I’d forgotten that having a general anaesthetic leaves your throat sore and your mouth very dry. This would have been great. Drinking lots of water was the next best thing. I also forgot my mouth ulcer cream and I woke up with an ulcer on my lower lip, probably friction from the tube down my throat. I’d recommend that too.

6. I did pack a drink bottle full of water. I had great advice from friend that’s been through a double mastectomy about the importance of water during chemo and surgery. It really does make a huge difference. As soon as I woke up I started drinking water and I kept drinking it all through the night. Yes, I did need to get up and use the toilet about five times but I wasn’t sleeping anyway and it was great to see my urine transition from radioactive blue to very pale green. Surely the sooner my body is rid of that stuff the better. I called the nurse a couple of times during the night to refill my water jug. Don’t be precious about bothering nurses. Yes, they are seriously underpaid and overworked but sometimes you’ve just got to put yourself first.

7. Bras. I packed a selection including the free bra provided by the Breast Care Nurses (pause to comment on how amazing they are!), an exercise crop top, an underwire bra and the wireless bra I usually wear everyday. In the end I slept in the exercise bra because it was high enough not to cut across my wound. I came home in the underwire for the same reason. There is no ‘perfect’ post surgical bra. The most important thing is to be well supported and comfortable. Seamless bras (like ‘Ah-Bras’) are fine but I think I’ll need to wear two to get enough support. Yoga tops with built in shelf bras are also an option and I’m probably going to be spending a lot of time in those. I find my main issue with bras is rubbing under my breasts and it helps if I tuck tissues under the bottom edge.

8. Book. I packed a previously read and greatly loved book called ‘Mavin Manyshaped’ by Sheri S Tepper. Reading something I know means I don’t have to concentrate too hard or worry about missing anything. It’s like having the company of an old friend.

9. iPod or something else to play music/meditation. Mine was already set to go because I used it during chemo. Music has an amazing ability to shift your mood and it’s often overlooked in therapeutic settings. I was told the Mater have their own relaxation channel but in a shared room this isn’t really an option. My favourite music comes from an Australian group called ‘Sacred Earth’. My recommendation is to find music that lifts you out of yourself. Some people love recorded meditations and some people find them annoying. There’s a huge selection on YouTube and it’s worth at least giving them a try. Any choice you make will be better than listening to someone else in pain, traffic, nurses discussing patients, someone else’s television, someone else’s visitors…….you get the idea.

10. Sports earphones for your music. These have a coil over the back of the ear so they don’t fall out. You can wear them while you’re laying down and they stay in when you move around. Do those little white ones stay in anyone’s ears?

11. Communication devices. Most hospitals are now fine with laptops, phones and everything in between. The Mater even has free wifi for patients. Check before you pack and remember that hospitals are sometimes a target for thieves. You can lock your phone and wallet in a small safe but not your iPad or your laptop. I packed my laptop but I stored it in a shell, inside a zipped, locked bag, inside a cupboard.

12. Any forms, test results, films or reports that you’ve been asked to bring.

13. Your medicare card, your health fund card and a credit card for paying any excess. Consider putting these and just enough cash for incidentals into a special wallet and leaving everything else at home (unless you need your licence to drive but you really should not be driving).

14. Finally, pack the whole lot in a small carry-on bag with wheels. Much easier post surgically to carry out of the hospital.

OTHER TIPS FOR SURGERY

1. Tell the truth. You’re going to be asked about your weight and whether or not you use illegal drugs. Answer both questions honestly. Weight and height are used to calculate your anaesthetic and if you lie yourself thin you’ll get less. Not a good idea. Letting staff know about any drug use is important because reactions and interactions can be misdiagnosed if staff don’t have all your information.

2. Ask questions. This is your body and your health. Don’t feel rushed just because staff are. If you’re not understanding something, not sure about something or need more information about something then let them know.

3. A good friend who works as a nurse gave me this advice; when you first wake up after surgery say ‘pain’ and they will top you up with drugs. I did this. It’s 24 hours later and I’m still not feeling any pain.

4. Have someone with you. Someone that loves you. Have them there when they wheel you in and there when you wake up. Have them there the next morning to get you really good coffee instead of hospital coffee and maybe some raising toast.

5. If you know you’re not going to feel like visitors then let people know before hand. There’s no rule that says you have to entertain everyone. If you are going to feel like visitors then have someone marshall them for you.

6. Write down your post surgical instructions or have someone else write them down. You WILL forget them!

7. Keep drinking lots and lots of water when you get home.

8. Consider taking a probiotic to repopulate your digestive system. I like kefir drinking yoghurt.

9. Take all your pain medication as prescribed. Don’t wait to decide if you need it. Pain is not good for you.

10. Take it easy, take it easy, take it easy. (Yes, yes, I get it!)

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