Modified Radical Mastectomy
You have been found to have a cancer in the breast that has been recommended to be removed. Either mastectomy has been recommended or you have chosen to have that procedure. Reconstruction will not be performed either by choice or because you have been recommended not to have that done at this time. The breast and lymph nodes will be removed. Two drains will be placed to collect any fluid the body makes during the healing process.
Hereís what to expect:
Morning of surgery:
Please check-in at the place and time Patricia has asked on your registration sheet.
Once checked-in, you will be taken to a pre-op room and asked to change into a hospital gown. Your family can stay with you. We ask that you limit the number of family members as the rooms cannot accommodate a large crowd. Your family can keep your clothing or it can be placed in a locker for safe keeping. A nurse will check your vital signs and go over important medical history. You will see me prior to the surgery and have an opportunity to ask any additional questions that you may have.
A nurse or an anesthesiologist will start an IV. In some cases, a sedative will be given to relax you prior to going to the operating room. Once you have been taken to the operating room, your family is to go to the waiting room until your surgery is completed.
In the operating room:
Once in the operating room, you will be transferred to the operating table. In the room, there are key personnel including the circulating nurse, a scrub tech, anesthesiologist, and myself. Several monitors will be connected to watch your vital signs during the procedure. Once all that is complete, you will be given anesthesia to go to sleep. The breast and the lymph nodes will be removed. The average duration of this procedure is 1 Ĺ to 2 hours. Please allow additional time for transportation time and time to get the patient off to sleep. All tissue removed is sent to the lab for complete analysis.
Once your surgery has been completed, you will be taken to the recovery room and I will let your family know your surgery is done. You will spend time in the recovery room, and then be transferred to a room in the hospital. The amount of time spent in recovery often depends on bed availability. Please do not be alarmed if you spend a few hoursÖthat may occasionally happen. Once a room is available, you will be transferred and your family notified about with the room number. In the afternoon you will be able to walk to the bathroom since you wonít have a catheter. That evening, you should be up in a chair for at least 30 minutes. Donít spend the whole time in bed!!!
Day after surgery:
I will come to visit you the morning after surgery. I usually come by between 8:00-8:30 (but donít hold me to that.) I will change your dressings and go over drain care. We can also discuss how the surgery went. Usually (90-95%) you will be able to go home the day after surgery. Upon discharge, the nurses will again go over the drain care and give you the prescription I have written for pain medication. You will have been instructed on when to come to the office in follow-up. You may also resume any usual medications you take on a regular basis (including aspirin or blood thinners).
Once you go home:
The only things you wonít be able to do is shower, drive, or lift anything heavy (no more than 5-10 pounds). You will need to empty and record the drain output twice a day or if the bulb gets full. The drainage may change color from red to orange to even yellow. Please remember that you had surgery, you are not sick nor are you an invalid. Your family may want to baby you a bit, and thatís okay, to a point. You will be able to raise your arm to shoulder level and that should enable you to do most of your own activities such as brush your hair, brush your teeth, groom, eat etc. I will want you to get up and move around the house. You are not going to be confined to your house either. Please sit or walk outside, just donít stay in the sun nor get dehydrated. Your family can even take you to the beauty parlor to have your hair washed and styled!!! You may go shopping if you wish, just be able to rest should you get tired. Ladies, I definitely recommend no cooking, cleaning, vacuuming, etc!!! (smile) Others can do that for you.
Most of my patients experience very little pain. You may take Tylenol, Advil, Aleve, or any other over the counter pain medication if you like. The prescription you will get is for a narcotic and is stronger just in case you need it. If you do not have pain, you do not need to take any prescription medication. Many patients feel more discomfort at night and the pain medicine can help you sleep as well.
I will want to see you in the office after surgery to see how you are healing and to go over the pathology results. Depending on that, your next follow-up visit will be determined. We will also discuss additional therapy if needed, and exercises to improve your arm movement. Once the drainage is down to about 30 cc. per day (in an entire 24 hours), the tubes will be removed in the office (approximately 10-14 days).
Thank you for allowing me to participate in your care. It means a great deal to me and my staff that you would trust us with such an important matter.
Should you have any questions, please do not hesitate to contact the office or staff.
Dr. Arlene Ricardo