12 ways to keep safe when you recover at home from a surgery that should have been in-patient.

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In all my talks with other breast cancer patients, not one has been sent home directly after surgery, like I have, everysingletime -- excepting, of course, those who have been diagnosed in the pandemic year. Today I want to talk about GOING HOME DIRECTLY AFTER SURGERY.

It's because of COVID-19 precautions that so many dangerous surgeries have become outpatient. In October 2000, my mother was in the hospital for 5 days after her mastectomy. Nurses emptied her drains (plastic balloons that hang off your sides and fill up with blood and lymph fluid and must be emptied every four hours), and they monitored her vitals. They managed her pain. The doctor stopped by to discuss treatment, care, the future. She felt cared for.

Recovering from surgery at home is very, very different. I am glad to be at home, but it can be less-safe too.

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How to keep yourself safe when you are sent home from a surgery that should have been in-patient. **Please remember I am not a doctor. I've just had a lot of experience and have read a lot of medical journals because I'm a nerd like that.**
I had a horrible infection a month after my mastectomy, and while I did what I could to avoid it, I ended up needing 5 or 6 surgeries rather than just the 2 that are usually required for mastectomy with reconstruction. I am not a dirty person, but really just one stray bacteria can get into your body and cause terrible problems. Take what precautions you can. 

  1. Change your sheets the morning of surgery. Fresh, sheets, washed in hot water. Your body sheds a lot of its natural bacteria and if you don't clean your sheets often enough, your pillowcase has more bacteria than your toilet. When you come home, change into clean pajamas and get in that clean bed.

  2. Change your toothbrush. Something we don't think about: the bacteria that collects on your toothbrush could potentially get onto your skin or your wound.

  3. Borrow or buy a Blood Pressure cuff. Watch your vitals regularly. This is a huge one for me. After my emergent surgery in November, I was sent home quickly. I have zero memory of the car ride or how I got up the 28 stairs into my bed. I had Percocet and no other information. Thankfully I know my body, and something felt off the next day. A neighbor loaned us a BP cuff, and my reading was 70/40. Before that reading, I had been on the verge of taking a pain pill and going to sleep, but thankfully I called a doctor friend. She stayed on the phone with me for over an hour while I tried to stay awake, chug Gatorade and stuff my face with Saltines in an effort to get my BP back up. It was during the biggest COVID spike of 2020, so we were trying to avoid the ER. 
  4. If your Blood Pressure is normal, then try to avoid things like Gatorade and Saltines. Overly salted foods and drinks do not promote healing.

  5. Don't let your pets or children into your bed. The amount of bacteria that your adorable little labradoodle or toddler is carrying is ... shocking ... and one doctor even told me it's the leading cause of infections post-surgery.

  6. Wash your body with antibacterial soap at least once a day in the week leading up to surgery. Previous link is Dial, but Hibiclens is even better. It's OTC.

  7. Shower as soon as your are allowed after surgery. It may be a few days, it may be the next day. But clean your body so no stray bacteria jumps in your wound. This is why baths are not allowed -- sitting water = bad. Trickling water = good. Here are some drain begs for showering that I use. That link is a local-to-Louisville small business. I buy local when I can. If you can't, here is a similar product on Amazon.

  8. Get a soft shirt that has drain-holders. They can double as pajamas. Drains involve an additional wound, and yesterday my surgeon told me that getting drains out ASAP really helps prevent infection.

  9. Speaking of drains: you will have them in until your output is 20-40mls in a 24 hour period. Do what you can to get to 20-40/day SOONER by resting. Sit up straight. Good posture promotes better healing. Get up and walking for exercise, but then: rest. Rest. Rest. The harder your body has to work, the more fluid is going to be excreted. Get a wedge pillow to help with your posture in bed. Here's the one I have:

  10. Take wound-care seriously and focus on healing so you can get those drains out quickly. I had my drains in for 3 weeks last time (the doctor's staff did not call me to make a drain-removal appointment grrrr don't get me started on the admin at University hospital), which is highly likely what caused my infection. 

  11. Once your drains are removed, don't be tempted to start doing activities again. Cleaning, gardening, anything that involves repetitive arm movements is likely to increase fluid and since you don't have a drain anymore, it has nowhere to go. REST. Walking is your best friend when it comes to exercise, but don't overdo it.

  12. Change. Your. Sheets. Worth repeating!

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Answering questions from readers: 
-I had my mastectomy almost twenty years to the day after my mom's -- the same surgeon even. It was Dr. Matt Brown in Louisville, and he is phenomenal at both the cutting, the sewing up, and most valuable: communicating. I cannot recommend my initial *plastic* surgeon though. I won't call him out publicly (but I will tell you if you DM me: Instagram is fastest way to connect as that's the only social media I keep on my phone). 
-My pathology reports were identical to my mother's: IDC, grade 2-3, HR+/Her2-. Mom's, however, was Stage III. Mine was Stage IB. 
- I have at least one surgery left, but likely two before I'm whole again.
- Yes, here are some ways to support me (Thank you!)