You might be the one actually facing the process of a mastectomy, or maybe you are a caregiver to a loved one. Either way, from my point of view as a loving husband and caregiver to my beautiful wife of 33 years, I’m not sure anything can fully prepare you for the impact of a mastectomy. You know the breasts are going to be removed, and maybe you have been told there will be drain tubes inserted for the healing process. You might have seen a picture such as the one above and thought “oh, that does not look too bad”. Those pictures give you an idea of what you will be facing, but they do not actually prepare you for the reality of seeing this up close and personal. The difference in the picture and real life is as stark as the difference between a very slight exposure to pepper spray available to the civilian population and that of 4% OC pepper spray we utilized in the prison when I was a Correctional Officer.
On Sunday afternoon, the day before Loraine’s mastectomy, after I had come off the road from my trucking job I met Loraine at Target to buy her some new pajamas. We knew from her visit with her physical therapist that she would not be able to raise her arms above her head, and pajamas that button down the front would be the easiest for her to put on and remove by herself. We found a couple nice sets of soft button down pajamas and made our purchase. We got the same size as Loraine normally wears and did not foresee any problems with the fit being as her D-cup breasts were going to be removed. These pajamas should be a perfect fit, yet we found out yesterday after she was getting out of her hospital gown the size should have been a bit larger than normal.
Yesterday morning before Loraine’s discharge, her nurse navigator Melissa came by with instructions for going home. Part of these instructions consisted of how to care for the incision drains and suction bulbs. This instruction involved emptying them before the bulbs get over half full, and how to strip the lines should they become blocked by clotting blood. Before proceeding with these instructions, Melissa asked if I was squeamish at all. I’m not, but I can see where this needs to be asked. These drains are long tubes which the surgeon inserts into the breast area or armpit to collect excess fluid that can accumulate in the space where the tumor was. The tubes have plastic bulbs on the ends to create suction, which helps the fluid and some blood to exit your body.
No problem! This is a pretty simple concept.
No hill for a climber!
And then it was time for her to check out of the hospital…
We packed all our belongings that we had brought with us for the overnight stay back into our bags, and left Loraine’s pretty new pajamas out for her to wear home. We wanted her to be comfortable for the ride. Yet, when I was trying to button her pajamas, we discovered that the drain bulbs which are kept in bags that were fastened to the lower sides of the ace bandage covering her chest were not allowing for full closure at her midsection.
Lesson learned ladies. If you are going to go through with a mastectomy, do yourself a favor and buy yourself pajamas that not only button down the front, but also pajamas that might be a size or two larger than you believe you might need in order to accommodate swelling, and the four drain tubes and their carry bags that will be necessary. You cannot leave the bulbs dangling by their tubes. Dangling drain bulbs would cause you problems you can be assured you will not want to experience anytime soon.
Melissa instructed us to monitor the amount of output from the four drains. She gave us a couple of small measuring cups and syringes for doing this task along with a log sheet where we are to fill in the date, time and quantity of fluid from each drain. This record will be brought to follow-up office appointments to help determine when the drains can be removed. Drain removal could be as soon as one week, or as long as three weeks from the surgery.
We have discovered so far, that the drains can be emptied and logged at about 5 hour intervals when Loraine is due for her pain medication. Although your experience could be different, and Loraine’s could change. In order for the drains to work properly, the suction bulbs must be emptied before they become half way full as the fuller they become, the less suction they will provide. This would cause the fluids to not empty from the incision sites as they should. This can also lead to the drains becoming clogged with clotted blood.
Shortly after we got home from the hospital, we decided to try our hand, rather my hand, at draining the bulbs. This went easy enough for the first go round. I removed the bulbs individually from their carry bags, removed the stopper, squeezed the contents into a cup, measured it, and then made my log entry.
I then squeezed the bulbs to create a suction when I reinserted the stopper and put the bulb back in their bags. No problems. Then with the next cycle five hours later, I went about the same procedure, but noticed a little bit of clotted blood in each line. No problem, I have been shown how to strip the lines. This is too easy. Until I discovered to Loraine’s detriment, attention to being gentle is of upmost importance. I grasped the tube as instructed in one hand, squeezed it between my thumb and finger of the other and began pulling down. When you do this, you must take extra care to not allow tension on the drain tube to pass beyond the hand that you are grasping it with. Loraine cried out in pain as the tension from me stripping the line was creating a painful pulling sensation up inside her body. I discovered the best thing to do is to hold the line against the body in a non-painful site in order to keep from putting tension on the tube. By not holding my grip against her body, when I began stripping the line of blood clots, my grip hand had also moved down as the tube stretched downward.
You might feel overwhelmed by the amount of information you have to absorb as the patient or caretaker. However, it is critical that you still pay close attention to all of your instructions. Take notes, ask questions. The only dumb question is the question not asked.
We got through the night alright. At midnight we got up so Loraine could take her pain medication and for me to empty the drain bulbs, then we repeated this again at 5:00 a.m. About 10:00 a.m., it was shower time. You have to steel yourself for the first shower. I thought I was better prepared since I had been doing the drain tubes with no issues other than when I accidentally put internal tension on one when stripping it. When you have had a mastectomy, you will be limited on being able to put your arms and hands above your head, yet this will be somewhat necessary in order to remove the inner compression top that is almost just like a 1970’s era tube top that was popular with all the girls back in the day.
I first unpinned the drain bulb bags from the outer ace bandage that is wrapped around her chest. Then after unwrapping the ace bandage, it was time to get the tube top bandage off. It caused Loraine some pain and discomfort during removal, but we managed without it getting too bad. This is not something you just pull off the body. Once it was removed, we both were able to see exactly what her chest now looks like. My dear wife will always be beautiful in my eyes, even without her breasts. She is the love of my life and the removal of her breasts is not an issue. But, what I found shocking, the sight that made me want to cry for her was how bruised her upper torso was. Where her breasts had been, the tissue is greatly discolored and bruised. It looks as if someone had used her chest for a professional boxers punching bag. It was all I could do to maintain my emotions for my sweet woman while assisting her with her shower. I know the bruising and discoloration is temporary, but feel it is necessary for people to know what they will see the first time you or your loved ones removes the bandages. Seeing my wife of almost 34 years like this was breaking my heart for her. It is things like this that makes me not too sympathetic to people who whine over the smallest of problems in their lives, especially when their petty issues are entirely self inflicted. My dear wife never asked for this to happen, but sometimes bad shit happens to the best of people.
If you are undergoing a mastectomy, here are a few tips to help you during your healing and recovery at home:
- Rest. When you get home from the hospital, you will probably be fatigued from the experience. Allow yourself to get extra rest in the first few weeks after surgery. Read more about managing fatigue.
- Take pain medication as needed. You will probably feel a mixture of numbness and pain around the breast incision and the chest wall (and the armpit incision, if you had axillary dissection). If you feel the need, take pain medication according to your doctor’s instructions. Learn more about managing chest pain, armpit discomfort , and general pain.
- Take sponge baths until your doctor has removed your drains and/or sutures. You can take your first shower when your drains and any staples or sutures have been removed. A sponge bath can refresh you until showers or baths are approved by your doctor.
- Continue doing arm exercises each day. It’s important to continue doing arm exercises on a regular basis to prevent stiffness and to keep your arm flexible.
- Have friends and family pitch in around the house. Recovery from mastectomy can take time. Ask friends and family to help with meals, laundry, shopping, and childcare. As your body heals, don’t feel you should take on more than you can handle. (1)
If there is any positive that can come out of breast cancer, it has been the tremendous outpouring of love and support from family and friends. We are eternally grateful to all who have showed us how much they care. I am most humbly grateful to Loraine’s employers, Geri and Larry Martin of Prestige Home Care in Leavenworth, Kansas. This husband and wife team are committed to providing top quality and compassionate home care to all their clients, and now they have stepped up to help Loraine and I during her recovery. Today, their Operations Supervisor Carolyn Clayton delivered a hearty beef and vegetable stew along with two trays of lasagna which Geri had prepared for us at home in order that we would not have to worry about cooking meals for the next few days of Loraine’s recovery. These are very kind and caring people, if you ever need care for a loved one in or around Leavenworth, Kansas, this is the only home care business I would recommend for the care of your loved one.
Carolyn, we love and cherish your friendship.
God bless and much love to all,