Preventive Mastectomy: Pre Op Appointments

Posted April 11, 2016 by Prairie Wife - 4 comments

The clock is ticking and we are getting closer and closer to my surgery…it’s less than 20 days away! Last week I drove down to Denver for all of my Pre Op Appointments. The Cowboy was unable to go with me due to work commitments so, I traveled down on my own. Those of you that follow me on Instagram know that I took advantage of my kid and husband free time to go for a nice long run (it was in the mid 60’s in Colorado), buy a milkshake, and curl up in my hotel room and watch hours of trashy television. For me, this is the ultimate bliss! I got a great nights sleep and even had time for a shower AND a trip to Starbucks before I met with my plastic surgeon.

I’m not going to lie, it would have been nice to have The Cowboy with me for a bit of moral support but, really I was surprised at how fine I was on my own. I knew the doctors and the medical facility already from our last visit, so I felt comfortable navigating the buildings on my own and asking questions. I am well aware, that as much as I love The Cowboy, he wouldn’t have remembered any of the care instructions that I received anyway…I’m thankful for all the handouts they gave me for this very reason!

What is the purpose of the PreOp visit?

This visit is where you and your doctor make some final decisions about your surgery. In my case, I was still nursing when we last met so we weren’t entirely sure if I could A. Save my nipples and B. Possibly do a Direct to Implant surgery (this would allow me to have only two surgeries instead of three). We decided that it was best for me to have expanders first, and then replace them with implants. While this means I will have three surgeries instead of two, I think it’s the best choice for me. Good news, I WILL be able to keep my nipples. Not only will this save me three more surgeries but, it will also help my reconstructed breasts to look more like the “old” me.

You will sign a ton of consent forms (seriously get ready for even more paperwork) and receive a bunch of handouts about before and after care, medications, and your procedure in general. Keep all of them in a safe spot, there is a lot of information that will be very useful to those that are helping to care for you in the first few weeks after surgery.

This is when you will receive your prescriptions for all your medication. From pain meds, to anti-nausea pills and antibiotics…and in my case physical therapy. They will also talk to you about the purpose of the medications and when and why you should take them. Keep the handouts on these in a safe spot so that you caregivers can check them when you’re too doped up to be responsible for yourself! I filled all my prescriptions and put them, and the informative paperwork, in a big ziplock bag so it was all together.

This is also when you will schedule your post op appointments so make sure you bring your calendar!

Question and Answer Time

Over the course of the last two months I’ve spent a lot of time thinking about my surgery, talking to others that have had a Preventive Mastectomy, and reading about this process. Add to that some issues I had with my surgery earlier this month (extreme nausea from the anesthesia) and I had a notebook full of questions. When I sat down with my Plastic Surgeon and his amazing staff I let them know I had tons of questions. They didn’t bat an eye and asked me to fire away. An hour and a half later we were done and not only did I feel better but, they knew that I was well informed and ready to be the best patient I could be. I thought about writing down all my questions and all the answers they gave me but, I’m learning that every surgeon is different. It’s really best to talk to your doctor and do what they say. I am going to list the questions I asked to help others that may be on this same journey and a few answers but, please remember if you are on this journey, I’m not a doctor and your doctor may have different rules.

How long will the drains be in?
Usually 10 days but, it may be longer if you are still draining more fluid than they feel is safe.

When can I shower again?
When the drains are out.

When can I lift anything, what are the weight restrictions?
What I really wanted to know was, when can I lift 25lb LittleMissH again and start taking care of my family? Technically at four weeks I can start lifting heavier objects but, due to four weeks of restricted movement I probably won’t be able to safely take care of my kids for six weeks. My doctor has me set up to begin physical therapy at three weeks so, if I do this I may be able to shorten that time a bit.

When will I have my first fill?
During the first surgery they plan to fill the expanders with some saline. Then, when I get my drains out, I will get a second fill. The process will continue every few weeks, with a fill of 50-100cc each time until we feel that my breasts are expanded to the size that the Plastic Surgeon and I want.

When will I have my second surgery (exchanging the expanders for implants)?
Three months after the last fill.

What kid of bra do I need to wear, how often do I need to have it on, and how tight?

How should I take care of the incisions/scars?

What medications do I need to take before and after surgery?

When can I exercise again?
Nothing that gets your blood pressure up, face red, or out of breath for four weeks.

Do I need physical therapy?
As I stated above, my doctors feel that I should have physical therapy starting at three weeks post op, so that I can get back to the physical demands of my life more quickly (and safely).

How should I sleep?
Plan to keep your body 45 degrees for the first two weeks, and then it’s however you feel comfortable.

How long will I be in the hospital?
One day. Because we live so far away from our doctor (4.5 hours), we will be staying in a hotel for an extra night in case complications arise.

What things will I need help with for the first week (or two)?
Moving around in bed, getting out of bed, walking, bathing, going to the bathroom (including wiping), eating and drinking (buy straws), washing hair and face. NO cooking or cleaning for the first three weeks…maybe four. Like I said to the Cowkids, I’ll be a T-Rex Mommy  for the first two weeks, and no lifting my arms past my shoulders for week three.

Rather than feel overwhelmed by all the information I received at my Pre Op appointments, I feel empowered and ready to go. I know that my doctors will be available to answer any questions I have at any time, and I feel even more confident with their quality of care than I did before.

Frankly I’m just ready to get this all over and done with so that we can all move on. That being said, I have a big to do list that I hope to get done before my surgery!

What do you think? Is there anything I forgot to ask, or that surprised you?

Read about my surgery and week by week updates including pics here.

Copyright: michaeljung / 123RF Stock Photo
Copyright: dedivan1923 / 123RF Stock Photo

Categories: Mastectomy Surgery, Preventive Mastectomy

Tags: , breast cancer, direct to implant surgery, expander, filling expanders, mastectomy, phophylactic mastectomy, pre op, preventive mastectomy, questions for doctors