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Kalispell Regional Healthcare

Patient Resources

Breast Health

The Bass Breast Center offers several resources for breast cancer patients:

  • Breast Nurse Navigator to guide women on their journey while providing support and answering questions during a very difficult and unsure time.
  • Glacier Bosom Buddies, a group of mentors composed of breast cancer survivors and family members in Northwest Montana who provide a special perspective to patients and families just beginning and continuing through the breast cancer journey.
  • Save-A-SisterTM, a non-profit organization that helps provide access to mammograms and supports post-operative durable goods that often are not paid for by insurance.

The following patient information sections are provided to help patients through their recovery process:

Breast Surgery Post-Operative Instructions

Diet
Resume your usual diet. Stay well hydrated.

Medications
Resume taking your usual medications. If you were taking aspirin, Coumadin or Plavix you will have been given separate instructions about this.

Pain

  • You can expect to mild to moderate amount of pain and bruising after surgery. Your pain will be the worst during the first few days after surgery and then it gets better.
  • You may take over the counter Tylenol as directed on the label OR narcotic prescriptions that were given to you at discharge. BUT DO NOT TAKE THEM WITHIN 6 HOURS OF EACH OTHER.
  • You may take Advil if this is a pain medication that works well for you.
    If you take the narcotic prescriptions, DO NOT drive or operate machinery.
  • The narcotic prescription may cause constipation, so drink plenty of fluids to help prevent it. BUT if you develop constipation (no bowel movement in 24 hours), take a stool softener or laxative.

Incision Care
Remove dressing in 2 days. There will be paper strips (small white Band-Aids called Steri Strips) over your incision/ or incisions that will stay until you are seen in the clinic. If they fall off it is not a problem.

  • You may shower 2 days after the surgery and wash on top of the "paper strips" with mild soap and warm water. Keep your incision clean/ dry.
  • DO NOT apply any creams, ointments or powders to the incisions.
  • DO NOT use deodorant under your armpit if you have an incision in your axilla.
  • DO NOT soak in a tub, hot tub or pool for 2 weeks or as directed.

Activity
You may sponge bathe for 2 days, then after the dressing is removed you can shower.

  • NO driving till you are off all narcotic pain medications, and have your drains out (if drains were placed).
  • NO heavy lifting (more than 5 pounds) till postoperative visit in the clinic.
  • Only light house work-NO vacuuming, sweeping untill postoperative visit. (Finally, some good news!)
  • Your should move your affected arm as you feel able. Maintain a full range of motion of your shoulder on the operated side. Plus you may stretch out any tightness in your armpit.
  • For comfort you may find wearing a bra offers you support while you recover.
  • It is important to progress your activity to your normal level over the first two weeks. 

When to Call Your Doctor
What is a normal symptom?
Numbness or tingling in the arm or incision, blood or pink colored discharge in the drain (if your have a drain), discomfort, slight pain or slight swelling near the incision, especially with activity. Small staining of blood on the dressing. Small amount of clear drainage from the wound for the first few days.

Call Your Doctor If You:

  • Have severe pain unrelieved by medication
  • Develop redness, excessive bleeding, or swelling from your incision or drain.
  • Yellow or green discharge from around your incision or drain.
  • Fever greater than 100.5.
  • Unable to urinate.
  • Unable to eat or drink; nausea greater than 18 hours.
Post-Operative Instructions

Drain Care

What is the drain for?

Your drain is to stop fluid (lymph and serum) from building up under the skin. This helps your incision to heal. Your doctor will take out the drain when there is less fluid coming out.

What supplies do I need to care for my drain?

  • A cup to measure the fluid.The drain chart to document the amount of fluid to bring in with you to your doctor's visit.
  • Gauze and tape
  • Safety pin to secure to your bra or clothing.

How do I empty the drain?

  • Wash your hands to prevent infection.
  • Hold the plastic bulb in an upright position with one hand and take the cap off with the other hand.
  • Empty the bulb into the cup.
  • Squeeze the bulb tightly with one hand and recap it with the other hand. This starts the suction again inside the bulb. DO NOT squeeze the bulb if the cap is on.
  • Record the amount of the drainage on the chart.If the drainage is cloudy or creamy, contact the clinic.
  • Discard the drainage in the toilet.
  • Rinse the cup so it is clean and ready to use again.
  • Wash your hands.
  • Re-pin the drain back on your clothing. The bulb should always be lower than your incision. This will prevent drainage from flowing back into the tube and incision.
  • Once a day, or when necessary, change the dressing after washing the site with soap and warm water.

How often do I empty the drain?

Empty the drain when it is half full. Usually it is about 3-4 times a day.

How much drainage should there be?

The amount of drainage may vary day to day. It should be less each day. Call the office when the drainage is less than 30ml per day from each drain for 2 days in a row, as it may be time for the drain to come out. If you are active, it may increase the amount of drainage.

What color should the drainage be?

The color will vary. It may go from bright to pink then yellow.

How do I strip the drain to keep it unclogged?

Carefully wash your hands.

  • To strip the drain, start at the top of the tube, next to your body.
  • Firmly hold the tube to stabilize in one hand and squeeze the tube.
  • With the other hand, squeeze and slowly slide your thumb and index finger about 2 inches down the tube and pinch
  • Move the hand (closest to your body) and grasp the tube just below where the tube is pinched.
  • Repeat step 2 until you have "milked" the entire length of the tube.
  • Reposition your hands as you move away from the body.
  • Always stabilize the tube with one hand while stripping the tubing with the other. This prevents the drain from being pulled out while you are stripping it.

Strip the tube 2 to 3 times daily.
Note: If you are right-handed, it may be helpful to stabilize the tube with your left hand and strip with the right. If left-handed, stabilize with the right and strip with the left.

Don't worry, we'll show you how to do this and it is EASY once you get the hang of it!

When should I call the clinic?

Call the clinic (406-751-6488) if you have:

  • Temperature greater than 100.5
  • Drainage increased or stops suddenly.
  • Drain stitches break or if drain comes out.
  • The area around your skin around the drain gets red, swollen or painful.
  • The drainage becomes bright red, smell bad or has pus in it.
Bulb Drain Record

Exercises After Breast Surgery

Be sure to initiate an active exercise program only when cleared to do so by your physician!

You are cleared to begin in 1 week 2 weeks 3 weeks after surgery.

Creep up the Wall
Choose an area of wall space which is frequently passed during the day and keep a pencil handy to that area. With both feet against the wall and holding the pencil in your affected arm, begin to "creep" up the wall until your arm feels tight and can go no higher. Make a little mark on the wall with the pencil for future reference. As often as you can during the day, pick up the pencil and try to beat your previous mark on the wall, stretching against the wall to gain distance. Even if your progress is only 1/4 inch per day, you will be gaining a full inch every four days toward your goal of full extension.

One pound lift
Use a one pound hand weight or create a weight by placing a one pound can of food into a sock, tying a knot in the top of the sock. Keep this weight in full view of you favorite chair or wherever you might sit during the day for coffee, to read or, to watch TV. With the weight held in the affected hand and with the arm straight, lift ten times to the side as high as possible, then lift ten times to the front as high as possible.

Hair Brushing or Circles
Keep a hairbrush on your vanity or in a bathroom as a reminder to do this exercise any time you pass that area or any time you may use the bathroom during the day. With your head straight and standing upright, brush your hair ten times creating full circles with your shoulder (if you prefer to do so, use an imaginary hairbrush, making the same motions!).

A handy alternative, if you prefer to do it, is to simply lean toward the surgery side and rotate the arm at the shoulder in ever increasing circles, building eventually to a full "windmill" range for the arm.

Over the door
Pick a door in the house which you pass frequently and hang over the top of the door a piece of rope, and old belt, or an old necktie. Be sure that the rope is in full view as a reminder to do this exercise. Grasp the rope with both hands on either side of the door and begin a "pulley" exercise, pulling one arm against the other ten times as high as you can possibly reach.

**Do two sets of each exercise daily.

These four exercises, will generally lead to a full return of arm motion within three to four weeks. If you find that you simply cannot do this on your own, or you become frustrated by a lack of progress, you should consider working actively with a physical therapist to reach your goal of a full range of motion in your affected limb. Please call the Bass Breast Center and we will be happy to refer you to a therapist.

Remember that modern surgical procedures for breast disease do not remove any of the muscles attached to the arm. With an active exercise program to stretch and remodel scar tissue and rebuild muscle, you should look forward to a resumption of full and normal arm activity.

Please call us with any questions or difficulties you may encounter.

Exercises After Breast Surgery

Survivorship

For a printable version of a brochure that lists all the resources available for breast cancer patients, click on the link below:

Now What? Resources for Healthy Survivorship

Lymphedema

I. Skin Care - Avoid trauma / injury to reduce infection risk
  • Keep extremity clean and dry
  • Apply moisturizer daily to prevent chapping/chafing of skin
  • Attention to nail care; do not cut cuticles
  • Protect exposed skin with sunscreen and insect repellent
  • Use care with razors to avoid nicks and skin irritation
  • If possible, avoid punctures such as injections and blood draws
  • Wear gloves while doing activities that may cause skin injury (i.e., washing dishes, gardening, working with tools, using chemicals such as detergent)
  • If scratches/punctures to skin occur, wash with soap and water, apply antibiotics, and observe for signs of infection (i.e. redness)
  • If a rash, itching, redness, pain, increased skin temperature, fever or flu-like symptoms occur, contact your physician immediately for early treatment of possible infection
II. Activity / Lifestyle
  • Gradually build up the duration and intensity of any activity or exercise
  • Take frequent rest periods during activity to allow for limb recovery
  • Monitor the extremity during and after activity for any change in size, shape, tissue, texture, soreness, heaviness or firmness
  • Maintain optimal weight
III. Avoid Limb Constriction
  • If possible, avoid having blood pressure taken on the at-risk extremity
  • Wear loose fitting jewelry and clothing 
IV. Compression Garments
  • Should be well-fitting
  • Support the at-risk limb with a compression garment for strenuous activity (i.e. weight lifting, prolonged standing, running) except in patients with open wounds or with poor circulation in the at-risk limb
  • Consider wearing a well-fitting compression garment for air travel
V. Extremes of Temperature
  • Avoid exposure to extreme cold, which can be associated with rebound swelling, or chapping of skin
  • Avoid prolonged (greater than 15 minutes) exposure to heat, particularly hot tubs and saunas
  • Avoid placing limb in water temperatures above 102°Fahrenheit (38.9°Celsius)
Lymphedema