Survey
* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project
Download Getting Ready for Breast Surgery - Vancouver Island Health Authority
Transcript
Getting Ready for Breast Surgery $SULO 2016 December 2015 Royal Jubilee Hospital Saanich Peninsula Hospital Victoria General Hospital Getting Ready for Breast Surgery About this booklet This booklet was originally developed by Cathy Parker, R.N., Breast Health Patient Navigator, Victoria Breast Health Centre, with input from nurses, physiotherapists, surgeons, community partners and people who have had surgery for breast cancer. We welcome comments about this booklet. Please contact the Victoria Breast Health Centre at 250-727-4467 or [email protected] with your comments or suggestions. Copies of this booklet can be ordered from the Vancouver Island Health Authority (VIHA) Regional Printing Services by faxing a Printing requisition to 250-519-5332, indicating the title of the booklet, number of copies required, cost centre number and shipping instructions. yregruSReady tsaerBfor roBreast f ydaeRSurgery gnitteG Getting stnetnofoCContents fo elbaT Table ............................................................................................................. ........................................................ noitcudortnI 13 .......Introduction 11 .............Surgery ................................................................................................ ................................................ yregruS erofeB 25 .......Before 22 5 ..........Surgery .................time ..........and .........place ............................................................................................................... ........................................... ecalp dna emit yregruS 2 5 ..........Pre-operative ............................physical ....................................................................................................................... ............................................... lacisyhp evitarepo-erP 2 5 ..........Taking ..............part ..........in .....research ...................................................................................................................... ........................................... hcraeser ni trap gnikaT 2 5 ..........Hospital ..................pre-admission ..............................clinic ... tnem tnioppa cini............................................................. lc noissimda-erp latipsoH appointment 2 6 ..........Length ...............of .....stay ............................................................................................................................... ............................................................................... yats fo htgneL 3 6 ..........Help ...........at .....home ................................................................................................................................... ................................................................................. emoh ta pleH 3 6 ..........Results ...............from ...........surgery ......................................................................................................................... ..................................................... yregrus morf stluseR 3 ..............Ready ............For .......Surgery ............................................................................ ........ yregruS roF ydaeR gnitteG 37 .......Getting 43 7 ..........Preparing .....................your ..........skin .................................................................................................................... ......................................................... niks ruoy gniraperP 4 7 ..........How ..........to ......use ........the ........Chlorhexidine ...........................ssponges..................................................................... egnops enidixehrolhC eht esu ot woH 4 8 ..........Food ...........and .........fluid ..........restrictions ..................................................................................................................... ............................... snoitcirtser diulf dna dooF 5 8 ..........Medications ................................................................................................................................................... ....................................................................................... snoitacideM 5 8 ..........Smoking ................................................................................................................................................... ..................................................................................................... gnikomS 6 9 ..........Packing .................for .......the ........hospital ................................................................................................................... ......................................... latipsoh eht rof gnikcaP 6 ...............to ....Hospital ......................................................................................... ................................ latipsoH ot gnimoC 401 .....Coming 74 01 ........Surgical .................admission ................................................................................................................................ ............................................................. noissimda lacigruS 7 11 ........Fine-wire ....................localization ............................................................................................................................. ................................................... noitazilacol eriw-eniF 8 11 ........Sentinel .................node ............biopsy .................................................................................................................... ................................................... yspoib edon lenitneS 8 ……… ……………………………………………latipsoH ni gnieB 5 5 9..…… Being in…Hospital……………………………………………………………..9 21 ........What ............to .....expect ...............after ..........surgery ....................................................................................................... ..................... yregrus retfa tcepxe ot tahW 9 21 ........Activity ................................................................................................................................................. ........................................................................................................... ytivitcA 9 31 ........Hospital ..................discharge ............................................................................................................................... ............................................................. egrahcsid latipsoH 10 31 ........What ............to .....wear ...........after ...........surgery........................................................................................... ............................................yregrus retfa raew ot tahW 10 ii Getting Ready for Breast Surgery 6 At Home after Surgery................................................................... 11 Effects of surgery.............................................................................................................. 11 Incision care ....................................................................................................................... 11 Bathing ................................................................................................................................. 12 Driving .................................................................................................................................. 12 What to do.......................................................................................................................... 12 What not to do.................................................................................................................. 13 About drains....................................................................................................................... 13 Drain care............................................................................................................ 13 When to call your surgeon ...........................................................................................17 7 Follow-up after Surgery................................................................. 18 Follow-up with your surgeon ...................................................................................... 18 Going back to work ..........................................................................................................18 When further treatment is needed............................................................................ 19 8 Road to Recovery ........................................................................... 20 Physical recovery ..............................................................................................................20 Emotional support ......................................................................................................... 22 Evaluation...................................................................................25-26 Royal Jubilee Hospital Site and Parking Map ii Getting Ready for for Breast Surgery Getting Ready Breast Surgery 1 Introduction 6 This booklet is designed to help you prepare for breast surgery. If you are having surgery to your axilla (underarm), you will receive a breast pillow for comfort after surgery. Bring this booklet and your after Surgery ................................................................... 14 14 6 At Home At Home after Surgery ................................................................... breast pillow with you when you go to the hospital. Effects of surgery .............................................................................................................. 14 14 Effects of surgery .............................................................................................................. Incision carecare ....................................................................................................................... 14 14 Incision ....................................................................................................................... Breast Cancer Information Kit Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. The kit is available on line at www.bccancer.bc.ca/breastkit The Driving .................................................................................................................................. 15 kit Driving .................................................................................................................................. 15will help you learn more about breast cancer as well as other resources for What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... you and your family. Please see insert provided for more detailed What not not to do.................................................................................................................. 16 16 What to do.................................................................................................................. information. About drains....................................................................................................................... 16 16 About drains....................................................................................................................... The Kit includes: When to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... Breast Cancer Companion Guide Nutrition Guide for Women with Breast Cancer Pamphlets: After breast Cancer Treatment-What Next? Follow-up with your surgeon ...................................................................................... 21 7 7 Follow-up after Surgery ................................................................. 21 21 Follow-up after Surgery ................................................................. Follow-up with your surgeon ...................................................................................... 21 My Partner has Breast Cancer-How can I help? Going backback to work ......................................................................................................... 21 21 Going to work ......................................................................................................... Exercises After Breast Surgery When further treatment is needed ............................................................................ 22 22 When further treatment is needed ............................................................................ The Intelligent Patient Guide to Breast Cancer 8 8 Road to Recovery ........................................................................... 23 23 Road to Recovery ........................................................................... Breast Health Patient Navigators 9 Physical recovery .............................................................................................................. 23 23 Physical recovery .............................................................................................................. Emotional support ........................................................................................................... 25 25 in Breast Health Patient Navigators are registered nurses with expertise Emotional support ........................................................................................................... breast health and breast cancer surgery. They assist patients and24 families Sheet ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet ………………………………………………… 23, by ensuring they receive information and support. The navigators sent you this booklet and breast pillow. Jubilee andand Parking ...................................... 10 10 Royal Royal Jubilee Site Parking ...................................... If youHospital areHospital newlySite diagnosed with breast cancer and you have 25 not25 already been in contact with the Breast Health Patient Navigators you will receive three telephone calls: The first call will be before your surgery The second call will be a few days after your surgery The third call will be after your post-operative visit with your surgeon. The navigators recognize that people are unique and understand that individuals vary greatly in their need for information and support. You are welcome to call a Breast Health Patient Navigator at the Victoria Breast Health Centre (250-727-4467) as little or as frequently as you wish! 1 ii ii Getting Ready for for Breast Surgery Getting Ready Breast Surgery 2 Before Surgery Surgery time and place Contact your surgeon’s office at once if you are The surgeon’s office will phone you or not feeling well, 6 6 At Home after Surgery ................................................................... 14 or At Home after Surgery ................................................................... 14have send your surgery time and place a cough, cold or Effects of surgery .............................................................................................................. 14 fever Effects of surgery .............................................................................................................. 14 information by mail. Most breast surgery the week before your Incision care ....................................................................................................................... 14 14 Incision care ....................................................................................................................... takes about one and one-half hours. surgery date. Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. Pre-operative physical What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... a pre-operative (pre-op) physical with your family doctor What not not toArrange do.................................................................................................................. 16 16as What to do.................................................................................................................. early as three months before the surgery date but no later than About drains....................................................................................................................... 16 one About drains....................................................................................................................... 16 week before the surgery date. When to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... Taking part in research 7 7 Follow-up after Surgery ................................................................. 21 21 Follow-up after Surgery ................................................................. Follow-up with your surgeon ...................................................................................... 21 21 Follow-up with your surgeon ...................................................................................... If you are newly diagnosed with breast cancer, your surgeon may ask if you wish to donate tissue from your surgery to the Tumour Tissue Going backback to work ......................................................................................................... 21 21 Going to work ......................................................................................................... Repository (TTR) at the Vancouver Island Cancer Centre. If you When further treatment is needed ............................................................................ 22are When further treatment is needed ............................................................................ 22 interested, your name will be forwarded to the TTR nurse who will contact you with more information or you may contact the TTR nurse 8 8 Road to Recovery 23 23 Road to Recovery ........................................................................... directly at ........................................................................... 250-519-5713. Physical recovery .............................................................................................................. 23 23 Physical recovery .............................................................................................................. support ........................................................................................................... 25 25 Emotional support ........................................................................................................... HospitalEmotional pre-admission clinic appointment 9 Sheet ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet ………………………………………………… 23, 24 The hospital will phone you within one week of your surgery date to arrange a pre-admission clinic appointment. This appointment is usually when pre-operative blood tests, etc., are done. Some people25 do 25 not Jubilee Hospital SiteSite andand Parking ...................................... 10 10 Royal Royal Jubilee Hospital Parking ...................................... need to come in for a visit if all of the necessary information can be obtained over the phone. ii 2 ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG Length of stay The usual length of stay after breast Remember to arrange for surgery is one night with a discharge a ride to and from the time of about 9 a.m. Some patients hospital! are discharged on the day of surgery. 6 41 .....At .....Home ...........after ..........Surgery ................................................................................ .......................yregruS retfa emoH tA 14 6 If you do not stay in the hospital overnight, you must have a responsible 41 .......Effects ...............of .....surgery ............................................................................................................................. ....................................................................yregrus fo stceffE 14 adult stay with you at home overnight. Your surgeon’s office will tell you 41 .......Incision .................care ................................................................................................................................ ...................................................................................... erac noisicnI 14 how long you will be in hospital. 51 .......Bathing ................................................................................................................................................. .......................................................................................................... gnihtaB 15 1 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 Help 5at home 51 .......What ............to ......do ............................................................................................................................... ............................................................................................od ot tahW 15 You may need help with household 61 .......What ............not ........to ......do.................................................................................................................. ..............................................................................If...oyour d ot surgeon ton tahWhas16 chores for a few weeks after 61 .......About ..............drains....................................................................................................................... ..........................................................................................indicated ........sniard you tuobwill A have 16 a mastectomy and/or axillary 02 .......When .............to ......call ........your ..........surgeon ............................................................................................................ .............................. noegrus rdrain uoy llapost c ot noperatively ehW 20 (underarm) dissection. If possible try and you feel you may and arrange for a family member or 7 12 .....Follow-up ..............friend ....after .....to ....be .Surgery ....available .......................................................................... .....as ....needed. ..........yregruS rneed etfa passistance u-wolloF with 21this; 7 please contact the Breast 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... kroHealth w ot kcNurse ab gnioto G discuss 21 whether Home Nursing 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 Care may be appropriate for you. 8 32 .....Road ..........to ....Recovery ............................................................................................ ....................................... yrevoceR ot daoR 23 8 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal Results from surgery Final results will not be known for ten to fourteen days after surgery. Call your surgeon’s office after surgery to book a postoperative visit to review your pathology results. 3iiii Getting Ready for for Breast Surgery Getting Ready Breast Surgery 3 Getting Ready For Surgery Preparing your skin Do not shave under your arm for at least 6 6 At Home after Surgery ................................................................... 14 14 At Home after Surgery ................................................................... two days before surgery. You can purchase Effects of surgery .............................................................................................................. 14 Effects of surgery .............................................................................................................. 14 Chlorhexidine Purchase two Chlorhexidine 4% scrub Incision carecare ....................................................................................................................... 14 14 4% scrub Incision ....................................................................................................................... sponges and use them as directed below sponges15 at: 15 Bathing ................................................................................................................................. Bathing ................................................................................................................................. to bathe or shower the night before AND Wal-Mart Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. on the morning of your surgery. Save-On Foods What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... Hospital gift shops This pre-surgery skin preparation What not not to do.................................................................................................................. 16 16 What to do.................................................................................................................. Some pharmacies procedure helps to: About drains....................................................................................................................... 16 16 About drains....................................................................................................................... (call to confirm). Remove germs on the skin When to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... Prevent infection Promote wound healing. 7 7 Follow-up after Surgery ................................................................. 21 21 Follow-up after Surgery ................................................................. Follow-up withwith youryour surgeon ...................................................................................... 21 21 Follow-up surgeon ...................................................................................... Going backback to work ......................................................................................................... 21 21 Going to work ......................................................................................................... When further is needed ............................................................................ 22 22 When further treatment is needed ............................................................................ Thetreatment evening before surgery: How to use the Chlorhexidine sponges Wash your entire body and hair with your usual soap and shampoo 8 8 Road to Recovery 23 23 Recovery Rinse ........................................................................... Road to ........................................................................... Physical recovery .............................................................................................................. Physical .............................................................................................................. recovery Open one surgical sponge and squeeze to produce lather23 23 Emotional support ........................................................................................................... 25 25 Emotional ........................................................................................................... support Wash body from neck to feet 9 9 Evaluation ………………………………………………… 24 Evaluation ………………………………………………… 23, 24 Sheet DoSheet not wash your head, hair or face with the surgical 23, sponge Carefully clean the surgical area, navel (belly button), under arms, and back Jubilee Hospital SiteSite andand Parking ...................................... 25 25 10 10 Royal Royal Jubilee Hospital Parking ...................................... Then clean your feet and between your toes Clean your genital and anal areas last Do not rinse for at least 2 minutes, then rinse well Do not apply deodorant, body lotion or powder afterwards. The morning of surgery: Repeat the above with the second surgical sponge. ii 4ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG Food and fluid restrictions NO SOLID FOOD after midnight on the evening before surgery. Clear fluids are permitted until three hours before your scheduled surgery time. 6 41 ..include: ...At .....Home ...........after ..........Surgery ................................................................................ .......................yregruS retfa emoH tA 14 6 Clear fluids 41 .......Effects ...Water ............of .....surgery ............................................................................................................................. ........................Popsicle ............................................yregrBlack us fo scoffee tceffE 14 41 .......Incision ...Clear .............tea .care ................................................................................................................................ .................................Jell-O .....................................................Clear erac napple oisicnI juice 14 51 .......Bathing ...Carbonated .............................................................................................................................................. ..............drinks ...............(pop) ............................................................................. gnihtaB 15 51 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 51 ....DO ...What ......NOT ......to ......include: do ............................................................................................................................... ............................................................................................od ot tahW 15 Clear fluids 61 .......What ...Milk, .........not ...non-dairy .....to ......do.................................................................................................................. ............creamer, ....................protein ..................beverages, .........................or ......tomato od ot ton tahW 16 juice 61 .......About ...Alcoholic ...........drains....................................................................................................................... ...........beverages. .......................................................................................sniard tuobA 16 02 .......When .............to ......call ........your ..........surgeon ............................................................................................................ .............................. noegrus ruoy llac ot nehW 20 7 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 Medications 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 2 .......Going ..............back ..........to ......work ................................................................................................................... ..as ......usual .............unless ................told ...........not .........to . kroby wo t kcaanesthesiologist, b gnioG 21 Take all 1prescribed medications your .......When ...........pharmacist ..further ...............treatment ........or ......other ........is....needed ..specialist. ......................................................................................... dedeen si tnemtaert rehtruf nehW 22 surgeon,22hospital Discuss medications is 8 8 3your 2 .....Road ..........to ....Recovery .......with .......your .............................................................................. ......doctor ............at ....least ........10 .....days .... yrbefore evoceRsurgery. ot daoRThis23 especially 32 .important ......Physical .................if recovery ....you ..........take .................................................................................................................. .......medication ..........................for: ................................... yrevocer lacisyhP 23 Diabetes e.g. Chlorpropamide, 52 .......Emotional ......................support ........................................................................................................................... .................................Glyburide, ........................Metformin, ..... troppus laInsulin noitomE 25 Blood Thinners e.g. Coumadin (Warfarin), Heparin 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 Antiplatelet medications e.g. Clopidogrel (Plavix), Ticlid, Acetylsalicylic Acid (ASA, Aspirin). ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal 7 days before surgery, stop taking Vitamin E and all natural health products and herbal remedies e.g. Garlic, Gingko, Kava, St. John Wort, Ginseng, Don Quai, Glucosamine, Papaya etc. Regular vitamins and iron supplements can usually be taken until the day of surgery. Acetominophen e.g. Tylenol for pain may be taken when necessary up to and including the day of surgery. 5iiii Smoking Getting Ready for for Breast Surgery Getting Ready Breast Surgery Smoking increases your risk of serious complications. Do not smoke for twelve hours before surgery. 6 6 At Home after Surgery ................................................................... 14 14 At Home after Surgery ................................................................... If your surgery is planned in advance, plan to stop smoking at least two months before your Effects of surgery .............................................................................................................. 14 Effects surgery .............................................................................................................. scheduled surgery date.of Talk to your family doctor for help to quit smoking. If you are in 14 the Incision care ....................................................................................................................... 14 Incision care ....................................................................................................................... 14 process of quitting on your surgery date, Nicoderm patches are a better option than smoking. Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... Packing What forWhat thenot not to hospital do.................................................................................................................. 16 16 to do.................................................................................................................. About drains....................................................................................................................... 16 16 About drains....................................................................................................................... What tocall bring When to call your surgeon ........................................................................................... 20 20 When to your surgeon ........................................................................................... 7 Your B.C. care card or proof of substitute Medical Insurance Plan, or after Surgery 21 21 7 Follow-up Follow-up after Surgery ................................................................. some form of................................................................. personal identification Follow-up with yourbooklet surgeon ...................................................................................... 21 21 Follow-up with your surgeon ...................................................................................... This Going backback work ......................................................................................................... 21 21 Going to work ......................................................................................................... to Your breast pillow(s) (if you are having lymph nodes removed) When further is needed ............................................................................ 22 22 When further is and needed ............................................................................ treatment Listtreatment of allergies hypersensitivities, medications and vitamins 8 9 Eyeglasses/contacts, hearing aid and dentures with storage case labelled with your name to Recovery ........................................................................... 23 23 8 Road Road to Recovery ........................................................................... recovery Your CPAP, Bi-level machines or dental devices if you use 23 one23 for Physical recovery .............................................................................................................. Physical .............................................................................................................. sleep (even for day surgery) Emotional support ........................................................................................................... 25 25 Emotional support ........................................................................................................... Sheet A small bag with personal hygiene items such as toothbrush, ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet ………………………………………………… 23, 24 toothpaste, comb Slippers Jubilee Sitetop and Parking ...................................... 25 25 10 10 Royal Royal Hospital Site Parking ...................................... Jubilee A Hospital front closure toand wear home from the hospital. What not to bring or wear: Jewellery or body piercing items Personal items such as money, valuables, credit cards Make-up, perfume, deodorant or talcum powder ii 6ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG 4 Coming to Hospital You will be admitted to hospital on the day of your surgery. Your surgeon’s office will tell you: Which hospital to go to 6 41 .....At .....Home ...........after .......date ...Surgery ....and .......time ..................................................................... .....of ....your ........surgery ......yregruS retfa emoH tA 14 6 The 41 .......Effects ...............of ...The ........hospital .................................................................................................................. ..............admission .....................time .................................yregrus fo stceffE 14 .....surgery 41 .......Incision ............... ..care ......Probable .......................................................................................................................... ................length ..............of ......stay. .................................................. erac noisicnI 14 51 .......Bathing ................................................................................................................................................. .......................................................................................................... gnihtaB 15 51 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 Surgical admission 51 .......What ............to ......do ............................................................................................................................... ............................................................................................od ot tahW 15 Check in at the front desk. You will be 61 .......What ............not ........to ......do.................................................................................................................. .................................................................................od ot ton tahW 16 Pre-op Support directed to the surgical admission area to: 61 .......About ..............drains....................................................................................................................... ..................................................................................................sniard tuobA 16 One family member or 02 .......When .............to .. ....call ....Change ....your ..........surgeon ..into ..........a...hospital ............................................................................................. ...............gown ............... noegrus ruofriend y llac ocan t nestay hW with 20 you Sign your Consent for Surgery form until you are taken to (if you have not already done so) 7 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retthe fa poperating u-wolloF room. 21 7 Receive pre-operative medications 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy Provide htiw pu-w ollo F 21 the nurse with and have an intravenous started. 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krowyour ot kcfamily ab gniomember G 21 or Before going to the operating room, you 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaerfriend’s t rehtrufcontact nehW number 22 will be asked to: so your surgeon can call Empty your bladder them when 8 32 .....Road ..........to ....Recovery ............................................................................................ ....................................... yrevo ceR o t daoyour R 23 8 Remove your glasses/contact lenses operation is over. 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 and/or dentures (these items will be 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 kept with your belongings). 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 When the operating room is ready, you will be brought in on a stretcher. After surgery you will be taken to the recovery room. Recovery takes two to three hours. Your surgeon and anesthesiologist may visit you there. ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal 7 iiii Getting Ready for for Breast Surgery Getting Ready Breast Surgery Fine-wire localization 6 If your surgeon cannot feel your breast For more detailed lump, you may have a fine-wire placed in information, refer to your breast a few hours before surgery. pages 66-68 in the Theafter wire will point to the area that needs after Surgery ................................................................... 14 14 6 At Home At Home Surgery ................................................................... book The Intelligent to be removed and is made so that it will Effects of surgery .............................................................................................................. Effects of surgery .............................................................................................................. 14 Patient Guide14 in the not move once it is in place. The Incision carecare ....................................................................................................................... Incision ....................................................................................................................... Breast Cancer14 14 placement of the wire will occur in the Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. Breast Imaging department at the Victoria Information Kit. Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. General Hospital. Your surgeon’s office What to do 15 15 will confirm the date and time of the procedure. The placement of the What to.......................................................................................................................... do.......................................................................................................................... takes about thirty minutes. What not not towire do.................................................................................................................. 16 16 What to do.................................................................................................................. About drains....................................................................................................................... 16 16 About drains....................................................................................................................... SentinelWhen node biopsy to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... 7 8 For more detailed Sentinel node biopsy maps the underarm information, 21 refer after Surgery ................................................................. 7 Follow-up Follow-up after Surgery ................................................................. 21to lymph nodes closest to the cancer site. If pages 112-114 Follow-up with your surgeon ...................................................................................... 21 in21the Follow-up with surgeon ...................................................................................... you areyour booked for this procedure, you book The Intelligent will be work directed to the Nuclear Medicine Going backback to work ......................................................................................................... 21 21 Going to ......................................................................................................... department at the hospital on the Patient Guide22 in the When further treatment is needed ............................................................................ When further treatment is needed ............................................................................ 22 morning of surgery (or on the day before Breast Cancer if requested). Your surgeon’s office will Information Kit. to Recovery ........................................................................... 23 23 8 Road Road totell Recovery ........................................................................... you the time and which hospital to go Physical recovery .............................................................................................................. 23 23 Physical recovery .............................................................................................................. to. Emotional support ........................................................................................................... 25 25 Emotional support ........................................................................................................... Sentinel node biopsy is a two-part procedure: Sheet ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet ………………………………………………… 23, 24 1. Tracing Agent Possible side effects A radiologist will inject a radioactive The blue dye injection tracing agent into the breast. You ...................................... may...................................... Jubilee Hospital SiteSite and Parking 25 10 10 Royal Royal Jubilee Hospital and Parking may cause urine25 and feel pressure and you will be told to stools to appear bright massage the area and to pump your arm blue or green and up and down to help spread the tracing your skin and area agent to the lymph nodes under the arm. around the incision 2. Dye line may appear bluish Once you are in the operating room and in colour. These effects you are asleep, your surgeon may inject a are normal and will blue dye (Isosulfan Blue/Lymphazuran) fade within a few days. into the breast if needed to help visualize 9 the lymph nodes. ii 8ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG 5 Being in Hospital What to expect after surgery 6 41 ...Recovery ..At .....Home ...........after ...room .......Surgery ................................................................................ .......................yregruS retfa emoH tA 14 6 41 .......Effects ...............of .....surgery ............................................................................................................................. ....................................................................yregrus fo stceffE 14 After surgery 41 .......Incision .................care ................................................................................................................................ .................you .........will .......be .......moved ...............to ............................... erac noisicnI 14 the recovery room. The recovery 51 .......Bathing ................................................................................................................................................. ...................................................................................Visitors ....................... gnihtaB 15 room nurses will watch you closely as flexible 51 .......Driving ................................................................................................................................................. ....................................................................................Most .............units ........... have gnivirD 15 you recover from the anaesthesia and ask 51 .......What ............to ...give ...do ............................................................................................................................... ..you .........medication ........................for .......pain ..........and ........................visiting ................ohours. d ot taPlease hW 15 61 .......What ............not ...nausea .....to ......do.................................................................................................................. .....as .....needed. ...............................................................family ........od and ot tofriends n tahW to:16 61 .......About ..............drains....................................................................................................................... ...........................................................................................Keep .......snivisits ard tushort obA 16 If you are staying overnight, you will Limit the number of 02 .......When .............to ..be ....call ...moved .....your ..........to surgeon .....a....nursing ................................................................................................... ........unit. ...................... noegrus ruoy llac ot nehW 20 visitors at one time Respect the concerns of 7 12 ...Incisions, ..Follow-up ..................after .drains .........Surgery ......and ........................................................................ ...dressings ................yregruS retfa pu-wolloF 21 7 the nurses 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 End visits when asked. Depending on the type of surgery, 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 you may have one or two incisions 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 that are covered with steri-strips (small tape-like bandages) and have a light (Mepore) dressing over top. Most surgeons use dissolvable stitches, 8 32 .....Road ..........to .but ...Recovery ...surgical ............clips ............................................................................. ......or ....staples ...........can ......also .......be .....used. yrevoceR ot daoR 23 8 32 .......Physical ...............Depending ..recovery ................................................................................................................................ .....on .......the ........type ...........of ......surgery ..................you ........may ..... yrehave vocedrainage r lacisyhPtubes 23to 52 .......Emotional ...............collect .......support ........normal ................................................................................................................... .......blood .............and .........fluids ............that ..........drain ...........when troppu s lanoisitcut. omEThe25 tissue nurses will show you how to … care for…your of this 9 42 ,32Evaluation ……… …… Sheet …… …………………………………………………… … …… …… ……drain(s). …… te(See ehS pages noita13-15 ulavE23, 24 9 booklet for detailed instructions). For those having lymph nodes removed from under the arm, the breast ..........Jubilee .pillow, ..........along ...Hospital .......with .. gnpain iSite kraPmedication, and dnaParking etiS lcan ati...................................... phelp soHwith eeliany buJdiscomfort. layoR 2501 1052 .....Royal Fluids and diet Your IV will be removed as soon as you are drinking enough fluids. You will be given something to eat when you are ready. Activity You will be up and around with assistance the night of your surgery. 9iiii For 24 hours after surgery DO NOT: Make major decisions or sign documents Drive or work with machinery Take Aspirin – it can cause bleeding Take tranquilizers or sleeping pills Drink alcohol Look after babies, small children or frail elderly. Getting Ready for for Breast Surgery Getting Ready Breast Surgery Hospital discharge Day surgery discharge is one to two hours after surgery. Discharge for overnight stays is usually 9 a.m. Your family member or friend will be told when to pick you up. Before you leave the hospital your nurse will: 6 6 At Home after Surgery 14 14 after Review your................................................................... care instructions with you At Home Surgery ................................................................... Effects of surgery .............................................................................................................. 14 14 Effects of .............................................................................................................. surgery Provide a container for measuring the contents of your drain(s). Incision careWhen ....................................................................................................................... 14 14 into Incision care ....................................................................................................................... you get dressed, put the arm on the same side as the surgery Bathing ................................................................................................................................. 15what Bathing ................................................................................................................................. 15 is the shirtsleeve first. In case of surgery to both breasts, choose Driving .................................................................................................................................. Driving .................................................................................................................................. most comfortable for you. It will be easier to take the arm on15 the15 operated side out of the shirt last. What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... What What not not to do.................................................................................................................. 16 16 What to do.................................................................................................................. toAbout wear after surgery drains....................................................................................................................... 16 16 About drains....................................................................................................................... When to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... After a partial mastectomy (lumpectomy) 7 7 Follow-up after Surgery ................................................................. 21 21 Follow-up after Surgery ................................................................. It may help to wear a support bra after surgery, even while sleeping: Follow-up withwith youryour surgeon ...................................................................................... 21 21 Follow-up surgeon ...................................................................................... Some women prefer a simple cotton undershirt, camisole or tank21top. Going backback to work ......................................................................................................... 21 Going to work ......................................................................................................... These may come with a............................................................................ built-in shelf bra. Some women prefer to When further treatment is needed 22 not When further treatment is needed ............................................................................ 22 wear a bra. It is a matter of choice and comfort. Post-surgical camisole tops and bras are available for purchase from local mastectomy shops. 8 8 Road to Recovery ........................................................................... 23 23 Road to Recovery ........................................................................... Physical recovery .............................................................................................................. 23 23 Physical .............................................................................................................. After arecovery mastectomy Emotional support ........................................................................................................... 25 25 Emotional support ........................................................................................................... ASheet cotton………………………………………………… breast form may be worn in your own bra during 9 9 Evaluation 23,the 24 Evaluation Sheet ………………………………………………… 23,first 24 couple of weeks, if you wish. This helps to fill out your clothes but does not have the weight or shape of your other breast. Breast forms are available free ofSite charge from the Victoria Breast Health Centre VGH at Jubilee Hospital andand Parking ...................................... 25at25 10 10 Royal Royal Jubilee Hospital Site Parking ...................................... 250-727-4467. Post-surgical camisole tops and bras are available for purchase from local mastectomy shops. Prosthesis fittings You can be fitted for a permanent breast prosthesis when the wound is healed to the point that pain and swelling have settled. This usually takes six to eight weeks after surgery. Contact the Canadian Cancer Society Cancer Information Service at 1-888-939-3333 for a list of mastectomy shops. ii10 ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG 6 At Home after Surgery Effects of surgery Numbness in the arm and 6 41 ...Bruising ..At .....Home ...........after .and .........Surgery .pain ............................................................................... .......................yregrbreast uS retfisa common. emoH tA 14 6 Numbness 41 .......Effects ...............of .....surgery ............................................................................................................................. ....................................................................yregrus foinstthe ceffarmpit E 14 and in the back of arm Bruising around the incision is 41 .......Incision .................care ................................................................................................................................ ...................................................................................... erac noisicnIthe14 may linger indefinitely. 51 .......Bathing ...............normal .................................................................................................................................. ...............and .........will ........usually ...............clear ...........up ......in .......................................... gnihtaB 15 seven to ten days. Sometimes this Caution: Hot water bottles, 51 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 takes longer. Pain around the hot bags or heating pads 51 .......What ............to ...incision, ...do ............................................................................................................................... ..........armpit, ...............down .............the ........arm .........and .....................................od ot tahW 15 can burn desensitized or 61 .......What ............not ...into .....to .....the .do.................................................................................................................. ......back ...........is ....normal ................for .......several .....................................od ot ton tahW 16 numb tissue. 61 .......About ..............drains....................................................................................................................... .weeks ..............after ...........surgery. .................If....lymph ..............nodes .....................................sniard tuobA 16 02 .......When .............to ..are ....call ....removed, ....your ..........surgeon ......pain ..........in ............................................................................................ ....the ........underarm .................. nmay oegrincrease us ruoy llseven ac ot ntoehfourteen W 20 days after surgery as nerves heal. Some describe this as a burning sensation or increased tenderness. Some describe feeling “electric shocks”. Should 7 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 this occur, it will pass within a week or two. Take pain medication when 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 needed. 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 22 .....Fluid ..When .............further .build-up ..............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 8 32 .....Road ..........to .Fluid ...Recovery .....build ........up ............................................................................... .in ....the ......breast ..........or ....in ....the ......armpit .... yreafter vocesurgery R ot daisocalled R 23a 8 seroma. There may be a sloshing or gurgling sound in the breast, a 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 feeling of fullness or a lump under the arm. Often the area can feel 52 .......Emotional ...............warm, .......support .......firm .................................................................................................................... .........appear ...............reddened. ...................................... troppus lanoitomE 25 and 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 Seromas are not a problem unless the area becomes heavy, tight or painful. The body will absorb small seromas. The surgeon may remove large ones using a needle and syringe. This is done in the surgeon’s ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal office. It may have to be repeated several times during recovery. (See page 17, when to call your surgeon). Incision care It is not necessary to wear a dressing over your incision(s) after 48 hours unless you prefer to do so, but always wear a dressing over drain sites to support the tubing. Change dressings every one to two days or more often if drainage soaks through. Steri-strips often peel off on their own. If they don’t, leave them until you see your surgeon. Apply a Band-Aid or dry gauze to any weeping areas. If you develop a rash or blisters from your dressings, call your surgeon for advice. If you have stitches or clips, they are usually removed in the surgeon’s office seven to fourteen days after your operation. 11 iiii Getting Ready for for Breast Surgery Getting Ready Breast Surgery Bathing You may shower 48 hours after surgery even if you have a drain (unless otherwise instructed by your surgeon) Remove the outer (Mepore) dressing first, but leave the steri-strips 6 6 At Home after Surgery 14 14your At Home after intact. It isSurgery okay................................................................... to ................................................................... get the incisions wet and to wash gently under Effects of surgery .............................................................................................................. 14 14 arm but avoid: Effects of surgery .............................................................................................................. Incision carecare ....................................................................................................................... 14 healed Incision ....................................................................................................................... 14 Soaking your incision(s) in a bath until they are completely Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. Aiming the showerhead at your incision(s). Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. After bathing/showering, check your incision(s) to ensure that there are What to do 15 15 What to.......................................................................................................................... dosigns .......................................................................................................................... no of infection. Gently pat the incision with a clean towel. Do not What not not torub do.................................................................................................................. 16 16 What tothe do.................................................................................................................. area. (See page 17, When to call your surgeon). About drains....................................................................................................................... 16 16 About drains....................................................................................................................... to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... Driving When You may drive after surgery when: 7 7 Follow-up after Surgery ................................................................. 21 21 Follow-up after Surgery ................................................................. You are no longer taking narcotic pain medication (e.g. Tylenol 3) Follow-up withwith youryour surgeon ...................................................................................... 21 21 Follow-up surgeon ...................................................................................... Your arms have near normal range of motion Going backback to work ......................................................................................................... 21 21 Going to work ......................................................................................................... You feel comfortable and capable to do so. When further treatment is needed ............................................................................ 22 22 When further treatment is needed ............................................................................ What toRoad do to Recovery ........................................................................... 23 8 8 9 Road to Recovery ........................................................................... 23 recovery DO begin the exercises in the Canadian Cancer Society booklet Physical recovery .............................................................................................................. 23 23 Physical .............................................................................................................. Exercises After Breast Surgery: A Guide for Women included the Emotional support ........................................................................................................... 25in25 Emotional support ........................................................................................................... information kit found on line at www.bccancer.bc.ca/breastkit Sheet ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet ………………………………………………… 23, 24 DO place your arm (surgical side) on a pillow if you have had axillary lymph node dissection. The arm does not need to be higher than shoulder level. Do this forParking 45 minutes, two to three times25 per25 day Jubilee Hospital SiteSite and Parking ...................................... 10 10 Royal Royal Jubilee Hospital and ...................................... DO use your arm as normally as possible, within the limits of pain and incisional pulling, for the activities of daily living (ADL) such as grooming, washing and eating DO check with a physiotherapist or surgeon if you have any questions about an activity DO eat a balanced diet with generous portions of protein-rich foods such as poultry, meat, fish, eggs, legumes, milk and cheese. Include high fibre foods such as fruit, vegetables, whole grain bread and cereal, and drink plenty of fluids (six to eight cups or two litres daily) DO watch for signs of constipation if you are taking pain medications with codeine. Increasing fluid intake, exercise and increased fibre can help. Occasionally, laxatives may be needed. ii 12 ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG What not to do In the first few weeks after surgery: DO NOT lift or carry anything heavier than 2.25-4.5 kilograms (5-10 pounds) on the affected side for four to six weeks after surgery or as directed 6 41 .....At .....Home ...........after ..........Surgery ...by ....your ......................................................................... ..surgeon .....................yregruS retfa emoH tA 14 6 41 .......Effects ...............of .....surgery .DO .........NOT ................................................................................................................... ......use ........your ..........arm .........to ......push ...........or .....pull .........yourself ....yregruinto s fo sor tceout ffE of bed 14 or a chair 41 .......Incision .................care ................................................................................................................................ ...................................................................................... erac noisicnI 14 51 .......Bathing ................................................................................................................................................. ......DO ........NOT ...........make ............sudden ................unexpected .........................movements .........................with ... gniyour htaB affected 15 arm 51 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 the arm 51 .......What ............to ......do ...DO ............................................................................................................................ .......NOT ...........use ........deodorant, .......................talcum ...............powder .................or .....shave ......od under ot tahW 15 until the axillary (armpit) wound is healed. Once healed, an electric shaver 61 .......What ............not ........to ......do.................................................................................................................. .................................................................................od ot ton tahW 16 is preferred over a razor with a blade 61 .......About ..............drains....................................................................................................................... ..................................................................................................sniard tuobA 16 DO NOT put Vitamin E on incisions for six weeks. Some surgeons 02 .......When .............to ......call ........your ..........surgeon ............................................................................................................ .............................. noegrus ruoy llac ot nehW 20 believe that Vitamin E can widen scars and irritate the incision. 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 About7drains An inch or more of white 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 tubing visible outside the Some 12 .......Going ..............back ..........to ...surgeries ...work ................................................................................................................... ........require ................a...drain ............................... krow ot kcab gnioG 21 body indicates that the drain 22 .......When .............further .post-operatively. ..............treatment .....................Drains .is....needed .........prevent .................................................................................. dedeen si tnisem taert rehout. truf Contact nehW your 22 coming fluid from building up around the surgeon. incision and under the arm. Each 8 32 .....Road ..........to .drain ...Recovery ....is ....held .......in ............................................................................. ..place .........by ....a...stitch. ..................... yrevoceR ot daoR 23 8 32 .......Physical ..............Two ...recovery .......to .....four .................................................................................................................... ....inches ..............of .....white ............drainage ...................tubing .............. will yrevbe oceinside r lacisyyour hP body. 23 The 52 .......Emotional ..............drain ........support ....is....best ................................................................................................................... ..worn ...........under .............clothing ..................to .....keep ............it. tfrom roppupulling s lanoitapart. omE Pin25the drain under your shirt at waist level. 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 Removing drain(s) If you are unable to empty ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal your drain and do not have The surgeon will remove the someone to help you, please drain(s) when drainage is less than talk with the Breast Health 20-30cc in a 24-hour period. This Nurse about arranging for usually takes seven to fourteen days after your surgery, but can home care before coming in sometimes take longer. for your surgery. Drain care The nurse will show you how to empty your drain(s) before you go home and will provide some dressings and a small container for measuring drainage. Detailed instructions follow. 13 iiii Getting Ready for Breast Surgery G���n� Rea�� f�� B�eas� S�r���� Getting Ready for Breast Surgery 1.2SHQ3OXJ 2. (PSW\Measure 3. Reset 6 6 At Home after Surgery ................................................................... 14 14 At Home after Surgery ................................................................... Effects of surgery .............................................................................................................. 14 14 Effects of surgery .............................................................................................................. Incision carecare ....................................................................................................................... 14 14 Incision ....................................................................................................................... Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... What not not to do.................................................................................................................. 16 16 What to do.................................................................................................................. About drains....................................................................................................................... 16 16 About drains....................................................................................................................... When to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... 1: Figure 2: Figure 3: 7 7Figure Follow-up after Surgery ................................................................. 21 21 Follow-up after Surgery ................................................................. Wash your hands. Turn the bulb over. Push the plug back Follow-up withwith youryour surgeon ...................................................................................... 21 21 Follow-up surgeon ...................................................................................... Hold the drainage Empty the fluid into in while squeezing Going backback to work ......................................................................................................... 21 21 Going to work ......................................................................................................... bulb upright and a container. the bulb. When further treatment is Measure needed ............................................................................ 22 22 When further treatment is needed ............................................................................ open the plug. and record This resets the the drainage. drain’s suction action. 8 8 Road to Recovery ........................................................................... 23 23 Road to Recovery ........................................................................... Physical recovery .............................................................................................................. 23 23 Physical recovery .............................................................................................................. Emotional support ........................................................................................................... 25 25 Emotional support ........................................................................................................... Evaluation ………………………………………………… 23, 24 9DO Evaluation ………………………………………………… 23, 24 NOT rinse Sheet theSheet drainage bulb. Rinse the measuring container with water after each use. Empty the drain when the bulb is half full. Royal Jubilee Hospital SiteSite and Parking 10 10Measure Royal Hospital and Parking ...................................... theJubilee amount of drainage each time and...................................... record it in the Drain 25 25 Record table provided on page 16. Bring your Drain Record to your next surgeon’s appointment. Drainage is often pink, it often becomes yellow or clear and the amount will decrease over time. If the tubing accidently disconnects from the drainage bulb cleanse the connection site with 70% isopropyl alcohol before reconnecting it. Follow the steps to reset the drain. If the drainage plug accidently opens, follow the steps to reset the drain. Tape the drainage plug across the top of the bulb, if necessary. 9 Figures 1-3 Source: Adapted fom J. Rowlands, Multimedia Services, B.C. Cancer Agency 2007 14 ii14 ii G���n� f�� Getting yregrRea�� uSReady tsaerB for roBreast fB�eas� ydaeRSurgery gS�r���� nitteG How to Unclog the drain It is normal for small clots, shreds of tissue, fluid or air bubbles to sit in the drainage tubing, but drains can become clogged with clots or tissue. When this 6 41 ....happens, .At .....Home .......you ....after ..will ......notice ..Surgery ........an ....abrupt .................................................................... .........decrease .............in .yrdrainage egruS rand etfafluid emmay oH tleak A out 14 6 41 ......where .Effects ............the ...of ....tube .surgery .........enters .................................................................................................................... .......the .......body. ............To .....release ...............clots ..........or .....tissue: .......yregrus fo stceffE 14 Support the drain site with one hand and pinch the 41 .......Incision .................care ................................................................................................................................ .......................................................................tubing ..............between . erac noiyour sicnI thumb 14 and index finger close to where the drain enters your body. (Fig. 4) 51 ......With .Bathing .........the .......thumb ................................................................................................................................. ..............and ........index ............finger ............of .....the .......other ............hand ...........squeeze ................the ........tubing . gnihtaand B 15 51 ......gently .Driving ............move ..................................................................................................................................... .........your .........fingers ..............down ............the ........tubing ..............towards ................the .......bulb. ...........This ........is gncalled ivirD 15 milking 51 ......”stripping .What ............to ......do .or .............................................................................................................................. ................the .......tubing”. ................(Fig. .........5) ............................................od ot tahW 15 Repeat 2-3 times 61 .......What ............not ........to ......do.................................................................................................................. .................................................................................od ot ton tahW 16 61 ......Contact .About ..............drains....................................................................................................................... .your ..........surgeon ................or .....homecare ....................nurse, .............if...arranged, .....................if...the ......sblockage niard tuodoes bA not 16 02 ......clear. .When ..........If...you to ......call ..cannot ......your .........reach .surgeon ..........your .................................................................................................. ...surgeon .................or .....homecare ..... noegrunurse, s ruoygo llato c oatwalk-in nehW 20 medical clinic or call your family doctor. If it is after clinic hours go to a hospital emergency department. 7 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 12 .......Follow-up .....Figure ................4: .with .........your ...........surgeon ....................................................................................................... .................... noeFigure grus ruo5: y htiw pu-wolloF 21 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 8 32 .....Road ..........to ....Recovery ............................................................................................ ....................................... yrevoceR ot daoR 23 8 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal Figures 4-5 Source: Adapted fom J. Rowlands, Multimedia Services, B.C. Cancer Agency 2007 15 iiii Getting Ready for for Breast Surgery Getting Ready Breast Surgery Drainage Record Date Time Amount Amount Amount Amount Total 6 6 At Home after Surgery ................................................................... 14 14 At Home after Surgery ................................................................... Effects of surgery .............................................................................................................. 14 14 Effects of surgery .............................................................................................................. Incision carecare ....................................................................................................................... 14 14 Incision ....................................................................................................................... Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... What not not to do.................................................................................................................. 16 16 What to do.................................................................................................................. About drains....................................................................................................................... 16 16 About drains....................................................................................................................... When to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... 7 7 Follow-up after Surgery ................................................................. 21 21 Follow-up after Surgery ................................................................. Follow-up withwith youryour surgeon ...................................................................................... 21 21 Follow-up surgeon ...................................................................................... Going backback to work ......................................................................................................... 21 21 Going to work ......................................................................................................... When further treatment is needed ............................................................................ 22 22 When further treatment is needed ............................................................................ 8 8 Road to Recovery ........................................................................... 23 23 Road to Recovery ........................................................................... Physical recovery .............................................................................................................. 23 23 Physical recovery .............................................................................................................. Emotional support ........................................................................................................... 25 25 Emotional support ........................................................................................................... 9 Sheet ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet ………………………………………………… 23, 24 Jubilee Hospital SiteSite andand Parking ...................................... 25 25 10 10 Royal Royal Jubilee Hospital Parking ...................................... 16 ii ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG When to call your surgeon Contact your surgeon if you have a low grade fever (37.5C-37.9C or 98.5F-101.2F) that lasts for three days. Contact your surgeon Contact your surgeon if you have any 6 41 .....At .....Home ........of ...after .the ......following ...Surgery ............problems .................................................................... ..............with .......your ..yregruSimmediately retfa emoH iftA you:14 6 41 .......Effects ...............of ...drain(s): ..surgery ............................................................................................................................. ....................................................................yrHave egrus afohigh stcefgrade fE 14fever 41 .......Incision .................care . ........The ....................................................................................................................... ........drain ............falls .........off .......and .........cannot ...............be .....................of ..... 38.5C/101.3F erac noisicnI or14 51 .......Bathing ................................................................................................................................................. ..........reconnected ..........................with ..........tape .............................................greater ............... gnihtaB 15 51 .......Driving ................................................................................................................................................. ... ........The ........drain ............does ...........not ........remain ..........................................Experience ................ gnivshortness irD 15 of 51 .......What ............to ......do ............................................................................................................................... ...compressed .................................................................................breath ........od ot tahW 15 61 .......What ............not ...... ..to ......The do.................................................................................................................. .........directions .....................provided ...................do .......not .........................Experience od ot ton tahcalf W pain. 16 unclog the drain(s) 61 .......About ..............drains....................................................................................................................... ..................................................................................................sniard tuobA 16 Drainage increases or is foul 02 .......When .............to ......call ........your ..........surgeon ............................................................................................................ .............................. noegrus ruoy llac ot nehW 20 smelling or changes in If you cannot reach your consistency surgeon: 7 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 Drainage from the incision or 12 .......Follow-up ......................with ....drain .....your ......site .....surgeon ....changes ................................................................................................... .....in .....colour .......... nor oegrus ruoyCall htiwyour pu-wfamily olloF doctor 21 Go to a walk-in medical 12 .......Going ..............back ..........to ..appearance. ....work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 clinic; or 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 Contact your surgeon if you If it is after clinic hours experience any of the following skin go to a hospital 8 32 .....Road ..........to ...symptoms: .Recovery ............................................................................................ ....................................... yrevemergency oceR ot daoR 23 8 32 .......Physical .................recovery . ........Increased ....................................................................................................................... ...........swelling ..................in .....the .................................. yrCall evocthe er laB.C. cisyhNurse P 23Line 52 .......Emotional ......................support ....underarm ....................................................................................................................... .........or .....breast ..............that .........causes ......................... trop pus lanoat ito1-866-215mE 25 toll-free tightness or pain 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teeh S noitaulavE23, 24 9 4700. Increased tenderness, redness, or warmth around the surgery site ..........Jubilee .........Irritation .....Hospital ........from . gniSite kthe raPsteri-strips and dnaParking etiS or lattape i...................................... psoH eelibuJ layoR 2501 1052 .....Royal Swollen leg(s) or achy and red calves. 17 iiii Getting Ready for for Breast Surgery Getting Ready Breast Surgery 7 Follow-up after Surgery Follow-up with your surgeon The day after you get home, call your surgeon’s office to schedule an Effects of surgery .............................................................................................................. Effects of surgery .............................................................................................................. 14 surgeon’s office 14 to book appointment. Your surgeon will want Incision careto ....................................................................................................................... 14 14 Incision care ....................................................................................................................... your post op appointment. meet with you within the first ten to Bathing ................................................................................................................................. 15 15 Bathing ................................................................................................................................. fourteen days after surgery to explain Driving .................................................................................................................................. 15 drain(s) your pathology results, check your incision(s) and remove your if Driving .................................................................................................................................. 15 the drainage is low enough. What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... 6 6 At Home after Surgery ................................................................... 14 14your At Home after Surgery ................................................................... Remember: Contact What not not to do.................................................................................................................. 16 16 What to do.................................................................................................................. Going back to work About drains....................................................................................................................... 16 16 About drains....................................................................................................................... 7 When to call youryour surgeon ........................................................................................... 20 20 When to call surgeon ........................................................................................... Always check with your surgeon before Remember: If you have returning to work. Generally, you may had axillary node after Surgery ................................................................. 21 21 7 Follow-up Follow-up after Surgery ................................................................. return to work when you: dissection DO NOT lift Follow-up with your surgeon ...................................................................................... 21 21 Follow-up your surgeon with No longer have a ...................................................................................... drain (usually more than 2.27 kilograms Going backback to work ......................................................................................................... 21 21 one to three weeks) Going to work ......................................................................................................... (5 pounds) for four When further is needed ............................................................................ 22 weeks When further is needed ............................................................................ 22 treatment Aretreatment comfortable with the basic arm on your surgical side. movements used in your job Recovery Do not........................................................................... have complications such as seroma or infection 23 23 8 8 Road to Recovery Road to ........................................................................... recovery Have the energy and you feel ready. Physical recovery .............................................................................................................. 23 23 Physical .............................................................................................................. Emotional support ........................................................................................................... 25 25 can Emotional support ........................................................................................................... Additional information on returning to work after cancer treatment 9 be found on………………………………………………… the BC Cancer Agency website: Sheet ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet 23, 24 www.bccancer.bc.ca wwwwwwwwwwdsdswdswdcfsdvcsdaz Jubilee Hospital SiteSite andand Parking ...................................... 25 25 10 10 Royal Royal Jubilee Hospital Parking ...................................... ii18 ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG When further treatment is needed After breast cancer surgery (and Adjuvant Therapies sometimes before), you will consult If radiation therapy is with an oncologist (cancer doctor) recommended, it can to discuss the need for further 6 41 .....At .....Home ...........after ..........Surgery ................................................................................ .......................yregruS retfatwo emto oHthree tA weeks 14 6 begin treatment or adjuvant therapies. 41 .......Effects ...............of .....surgery ............................................................................................................................. ..................................................................after ..yregthe rus ffirst o stcvisit effE and 14can These therapies can be one or a 41 .......Incision .................care ................................................................................................................................ ...........................................................................last .........three .. erac to noisix sicnweeks. I 14 combination of chemotherapy, 51 .......Bathing ...............radiation .................................................................................................................................. ..................or ......hormone ...................therapy. ..........................................If....chemotherapy ................. gnihtaBis 15 it can15 51 .......Driving ...............Further .................................................................................................................................. ................tests ..........are ........often ............ordered .................after .......................recommended, ...................... gnivirD 51 .......What ............to ...this ...do ............................................................................................................................... ..............................................................................begin ..............one od oto t tatwo hW weeks 15 appointment. 61 .......What ............not ...The .....to ....BC ..do.................................................................................................................. ....Cancer ...............Agency’s ....................Vancouver ....................................after ......odthe ot tfirst on tavisit hW and 16can months. 61 .......About ..............drains....................................................................................................................... .Island .............Cancer ...............Centre ...............(VICC) ..............will .............................last .........four ..sniato rd tsix uob A 16 02 .......When .............to ..phone ....call ........your ..you ........surgeon .with ..........the ................................................................................................. .date ...........and .........time ......... noegrusIfruboth oy llaare c otrecommended, nehW 20 chemo is usually done of your oncology appointment. You first. 7 12 .....Follow-up ..........will ......be ..after ...seen .......Surgery .four .......to ....six .................................................................. ....weeks ..........after .....yregruS retfa pu-wolloF 21 7 your surgery date. You may ask to 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 have your appointment recorded to help you remember the discussion. 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 8 32 .....Road ..........to ....Recovery ............................................................................................ ....................................... yrevoceR ot daoR 23 8 New patient information 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 9 42 ,32Evaluation ……… …Sheet ……… ………………………………………………… … …… …… …… …BC …… teehAgency, S noitayou ulavcan E23,view 24 9 the To…prepare for your first visit to … the Cancer DVD “What to Expect: A Patient’s guide to the BC Cancer Agency Vancouver Island”. A copy will be mailed to you from the BC Cancer ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal Agency once your appointment has been booked. Copies are available to borrow from the Breast Health Centre at VGH. 19 iiii Getting Ready for for Breast Surgery Getting Ready Breast Surgery 8 Road to Recovery Physical recovery 6 6 At Exercises Home after Surgery ................................................................... 14 14 At Home after Surgery ................................................................... following breast surgery 7 Effects of surgery .............................................................................................................. 14 14 Effects of surgery .............................................................................................................. You will experience stiffness in your affected shoulder and arm Incision carecare ....................................................................................................................... 14 after Incision ....................................................................................................................... 14 breast surgery. The CSS Exercises after Breast Surgery: A Guide for Bathing ................................................................................................................................. 15 15Women Bathing ................................................................................................................................. is included in the information kit. It is very important to do these Driving .................................................................................................................................. 15 15 Driving .................................................................................................................................. exercises to regain full movement and use of your arm. What to do 15 15 What to.......................................................................................................................... do.......................................................................................................................... What not not to do.................................................................................................................. 16 16 What to do.................................................................................................................. Lymphedema awareness About drains....................................................................................................................... 16 16 About drains....................................................................................................................... nodes filter lymphatic fluid throughout the body. Lymphedema is When to call youryour surgeon ........................................................................................... 20 20 When toLymph call surgeon ........................................................................................... swelling caused by the build-up of lymph fluid in the part of the body where the lymph nodes have been removed, or damaged by the cancer, after Surgery ................................................................. 21 21 7 Follow-up Follow-up after Surgery ................................................................. surgery or radiation therapy. Follow-up withwith youryour surgeon ...................................................................................... 21 21 Follow-up surgeon ...................................................................................... Lymphedema is different from the swelling in the breast, armpit and arm Going backback to work ......................................................................................................... 21 21 Going to work ......................................................................................................... areas that can happen just after surgery. Lymphedema can happen soon When further treatment is needed ............................................................................ 22 22 When further treatment is needed ............................................................................ after treatment, months or even years later. It can be a temporary or a long-term condition. 8 8 Road to Recovery ........................................................................... 23 23 Road to Recovery ........................................................................... Physical recovery .............................................................................................................. 23 23 Physical recovery .............................................................................................................. Learn about lymphedema Emotional support ........................................................................................................... Emotional ........................................................................................................... 25 support Read pages 20-22 in the CSS booklet Exercises after25Breast Sheet ………………………………………………… 23, 24 9 Evaluation Evaluation Sheet ………………………………………………… 23, 24 A guide for women on line at Surgery: www.bccancer.bc.ca/breastkit Chapter 33 in the book The Intelligent Patient Guide to Jubilee Hospital SiteSite and Parking 25 25 10 10 Royal Royal Jubilee Hospital Parking Breast Cancer thisand book can...................................... be...................................... purchased on line or borrowed from the BCCA or public libraries. Attend a free information session about Lymphedema: Learn more about signs & symptoms, risk factors, prevention and treatment available. Class held the last Tuesday of each month 3:30- 4:30 PM at Inspire Health, Suite 212- 2187 Oak Bay Ave. Please call 250- 595-7125 to register for the class. 9 ii20 ii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG Physiotherapy after breast surgery After surgery physiotherapy can help to: Relieve stiffness Improve range of motion in the shoulder 6 .....At .....Home ....swelling .......after ......in ...any .Surgery ......part .......of ................................................................... ....your .......arm ............yregruS retfa emoH tA 14 6 41Decrease .......Effects ........tightness .......of .....surgery ........in .....your ................................................................................................................ ........scars. ............................................................yregrus fo stceffE 14 41Relieve 41 .......Incision .................care ................................................................................................................................ ...................................................................................... erac noisicnI 14 If you have been recommended for radiation treatment, and are unable 51 .......Bathing ................................................................................................................................................. .......................................................................................................... gnihtaB 15 to lift your affected arm above your head you may obtain a doctor’s 51 .......Driving .for .......Out-Patient ......................................................................................................................................... ..................Physiotherapy .............................at .....the ........Royal ............Jubilee ...............Hospital. ...................These .. gnivirD 15 referral 51 .......What ............to ......do ..have ............................................................................................................................. .......expertise ....................in .....this ........area ..........and .........are ........covered .................by ......Health ..od ot tahW 15 physiotherapists 61 .......What ......BC ......not .(MSP). .......to ......do.................................................................................................................. .Private ...............physiotherapy ..............................clinics .............also .........have ...........the ..od expertise ot ton tahW 16 Insurance to6provide 1 .......About .......these .......drains....................................................................................................................... ......services .................for .......a...fee. .................................................................sniard tuobA 16 02 .......When .............to ......call ........your ..........surgeon ............................................................................................................ .............................. noegrus ruoy llac ot nehW 20 Scar tissue massage 7 12 .tissue ....Follow-up .....massage .............after .is ...a...popular ...Surgery ..........self.................................................................... ..........Discontinue .........yregruscar S retmassage fa pu-wolloF 21 7 Scar 12 ..technique .....Follow-up .................that .....with ....may .....your .....improve ......surgeon ....................................................................................................... ...........during ......... noeradiation grus ruoyand htiwcheck pu-wolloF 21 help healing 12 .......Going .after ...........breast ..back ..........to ..surgery. ....work ................................................................................................................... ...You .........can ..................with ...........your ...........radiation ...... krow ot kcab gnioG 21 start 22 ...two ....When ....to ......four ...further ......weeks .........treatment .....after ..........surgery, .......is....needed ........................................................................................... d edeen si tnas emto taewhen rt rehtit ruf nehW 22 oncologist when there is no longer any scabbing will be safe to resume. on your incisions. 8 32 .....Road ..........to ....Recovery ............................................................................................ ....................................... yrevoceR ot daoR 23 8 Gently massage along the sides of 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 the scar in circular motions with the pads of your fingers 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 Massage for five minutes daily ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 9 42Use the tips or pads of your fingers along the length of the scar to loosen up the scar tissue 52You a...moisturizing soothing. .....Royal .may .......find ..Jubilee .....using .........Hospital ...... gniSite kraPlotion and dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 10 It is a good idea to continue scar massage for the first year or two after surgery to prevent tethering of the tissues underneath the scar. A massage therapist or physiotherapist can instruct you in the proper massage technique if needed. Consult with your physician (family doctor, surgeon or oncologist) if you feel a referral is necessary. 21 iiii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG Emotional support Vancouver Island Cancer Centre (VICC) The Vancouver Island Cancer Centre is located at 2410 Lee Avenue in 6 41 .....At .....Home .....Victoria ......after .......on ...Surgery .the ......Royal ......................................................................... ...Jubilee ............Hospital ........yresite. gruServices S retfa eoffered moH tinclude A 14 6 41 .......Effects ...............professional of .....surgery ............................................................................................................................. .....counselling, ..........................relaxation .....................group, ..............therapeutic ..yregrus fo stouch tceffEclinic 14and 41 .......Incision ...............nutrition ..care ................................................................................................................................ .......counselling ........................all ......at .....no .......cost. ..........For ........more ............information ....... erac noisor icnto I make 14 an 51 .......Bathing ...............appointment, .................................................................................................................................. ...........................please ..............contact ................Patient ................and .........Family ..............Counselling .......... gnihtaBat 15 250-519-5525. 51 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 51 .......What ............to ......do ............................................................................................................................... ............................................................................................od ot tahW 15 61 ....CancerConnection ...What ............not ........to ......do.................................................................................................................. .................................................................................od ot ton tahW 16 61 .......About ..............drains....................................................................................................................... .The ........Canadian ....................Cancer ................Society ...............offers .............a....free .........telephone ............sniarsupport d tuobAservice 16 for 02 .......When .............to ..anyone ....call ........your ....diagnosed ......surgeon ................with ............................................................................................ .........cancer. ...............They ...... nowill egru s ruoyyou llacwith ot neahsurvivor W 20who match has had similar surgery, treatment and similar life circumstances. Please 7 12 .....Follow-up ..........call ......1-888-939-3333. ..after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 Breast cancer support groups 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 22 .......When .............further ..If...you .........have .treatment ..........been ...........diagnosed .is....needed ........................................................................................... dwith edeebreast n si tnecancer, mtaert you rehtmay ruf nebenefit hW by 22 participating in a breast cancer support group. Members are able to share 8 32 .....Road ..........to ....Recovery .....their ........experiences ............................................................................... ...............and ......feelings .............with ..... yother revowomen ceR ot who daoRhave23 8 travelled the same road. There are several groups in the Victoria area 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 that meet at various locations and times. You are welcome to attend at 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 any time in your journey. Please call the Canadian Cancer Society’s 9 42 ,32Evaluation ……… ……Sheet … ……………………………………………………… ……… …… ……………… to tefind ehS ansupport oitaulavgroup E23, 24in9your Cancer Information Line 1-888-939-3333 area. ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal Dragon boating Breast cancer dragon boat teams participate in strenuous upper body exercise to demonstrate, through dragon boat competition, the benefits of an active lifestyle and to raise greater public awareness about breast cancer. All ages and physical abilities are welcome. Please call the Canadian Cancer Society’s Cancer Information Line at 1-888-939-3333 to find a dragon boat team in your community. Look good feel better program (LGFB) This free two hour workshop provides hands on tips to enhance your appearance during cancer treatment. It can be helpful to attend before your treatment starts. All participants receive a complimentary cosmetic tool kit. In the Victoria area please call 250-592-2244 to register. 22 iiii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG Notes 6 41 .....At .....Home ...........after ..........Surgery ................................................................................ .......................yregruS retfa emoH tA 14 6 41 .......Effects ...............of .....surgery ............................................................................................................................. ....................................................................yregrus fo stceffE 14 41 .......Incision .................care ................................................................................................................................ ...................................................................................... erac noisicnI 14 51 .......Bathing ................................................................................................................................................. .......................................................................................................... gnihtaB 15 51 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 51 .......What ............to ......do ............................................................................................................................... ............................................................................................od ot tahW 15 61 .......What ............not ........to ......do.................................................................................................................. .................................................................................od ot ton tahW 16 61 .......About ..............drains....................................................................................................................... ..................................................................................................sniard tuobA 16 02 .......When .............to ......call ........your ..........surgeon ............................................................................................................ .............................. noegrus ruoy llac ot nehW 20 7 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 8 32 .....Road ..........to ....Recovery ............................................................................................ ....................................... yrevoceR ot daoR 23 8 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal 23 iiii Getting yregruSReady tsaerB forroBreast f ydaeRSurgery gnitteG Notes 6 41 .....At .....Home ...........after ..........Surgery ................................................................................ .......................yregruS retfa emoH tA 14 6 41 .......Effects ...............of .....surgery ............................................................................................................................. ....................................................................yregrus fo stceffE 14 41 .......Incision .................care ................................................................................................................................ ...................................................................................... erac noisicnI 14 51 .......Bathing ................................................................................................................................................. .......................................................................................................... gnihtaB 15 51 .......Driving ................................................................................................................................................. ............................................................................................................ gnivirD 15 51 .......What ............to ......do ............................................................................................................................... ............................................................................................od ot tahW 15 61 .......What ............not ........to ......do.................................................................................................................. .................................................................................od ot ton tahW 16 61 .......About ..............drains....................................................................................................................... ..................................................................................................sniard tuobA 16 02 .......When .............to ......call ........your ..........surgeon ............................................................................................................ .............................. noegrus ruoy llac ot nehW 20 7 12 .....Follow-up ..................after ..........Surgery .............................................................................. ...................yregruS retfa pu-wolloF 21 7 12 .......Follow-up ......................with .........your ...........surgeon ....................................................................................................... .................... noegrus ruoy htiw pu-wolloF 21 12 .......Going ..............back ..........to ......work ................................................................................................................... .......................................................... krow ot kcab gnioG 21 22 .......When .............further ...............treatment ......................is....needed ........................................................................................... dedeen si tnemtaert rehtruf nehW 22 8 32 .....Road ..........to ....Recovery ............................................................................................ ....................................... yrevoceR ot daoR 23 8 32 .......Physical .................recovery ................................................................................................................................ .................................................................... yrevocer lacisyhP 23 52 .......Emotional ......................support ........................................................................................................................... .............................................................. troppus lanoitomE 25 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati...................................... psoH eelibuJ layoR 2501 1052 .....Royal 24 iiii yregruS tsaerB rof ydaeR gnitteG Getting Ready For Breast Surgery Tell us what you think! After 6 4reading 1 .....At .....Home ..Getting .........after .....Ready .....Surgery...................................................................14 ........For .......Breast ............Surgery .........yregplease ruS retrespond fa emoHto tAthe 6 (IIHFWV RI VXUJHU\ Your answers and comments will \UHJ UXV IRusVWFimprove HII ( following statements. help ,QFLVLRQ FDUH HUDF QRLVLFQ, the information. %DWKLQJ JQLKWD% strongly disagree strongly agree 'ULYLQJ JQLYLU' Circle one number for each statement: :KDWWRGR RGRWWDK: :KDWQRWWRGR RGRWWRQWDK: I read allof the information provided. 1 2 3 4 5 $ERXW GUDLQV VQLDUG WXRE$ Comments :KHQWR FDOO \RXUVXUJHRQ QRHJUXVUXR\ OODF RWQHK: 2 .....Follow-up ................is ..after ..easy ........Surgery.................................................................21 ..to .....read. .........................yregruS 1retfa2pu-w3olloF4 The7 1information 57 )ROORZXSZLWK\RXU VXUJHRQ QRHJUXV UXR\KWLZSXZROOR) Comments *RLQJ EDFN WR ZRUN NURZ RW NFDE JQLR* :KHQIXUWKHU WUHDWPHQW LVQHHGHG GHGHHQ VL WQHPWDHUW UHKWUXIQHK: The information is easy to understand. 1 2 3 4 5 8 32 .....Road ..........to ....Recovery ............................................................................................23 ....................................... yrevoceR ot daoR 8 Comments 3K\VLFDO UHFRYHU\ \UHYRFHU ODFLV\K3 (PRWLRQDO VXSSRUW WURSSXV ODQRLWRP( 9 42 ,32Evaluation ……information ………Sheet ………………………………………………………… …helped ………… ……………… teehS noitaulavE23, 24 9 Reading this me 1 2 3 4 5 prepare for and recover from my surgery. Comments 1052 .....Royal ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati......................................25 psoH eelibuJ layoR 01 The information answered my questions. 1 2 3 4 5 I would recommend this information to other patients. 1 2 3 4 5 Comments Comments 25 iiii yregruS tsaerB rof ydaeR gnitteG Getting Ready For Breast Surgery I prefer to have this information in: 6 4A 1 ...book ..At .....Home .....just ......after ....like ......Surgery...................................................................14 ....this ..........one ......................yregruS retfa emoH tA 6 (IIHFWVRIVXUJHU\ \UHJUXVIRVWFHII( Separate ,QFLVLRQFDUH handouts on each topic that Ineed HUDFQRLVLFQ, 'ULYLQJ JQLYLU' :KDWWRGR RGRWWDK: :KDWQRWWRGR RGRWWRQWDK: $ERXWGUDLQV VQLDUGWXRE$ :KHQWRFDOO\RXUVXUJHRQ QRHJUXVUXR\OODFRWQHK: I would have liked LESS information about: 7 12 .....Follow-up ..................after ..........Surgery.................................................................21 ................................yregruS retfa pu-wolloF 7 )ROORZXSZLWK\RXUVXUJHRQ QRHJUXVUXR\KWLZSXZROOR) *RLQJEDFNWRZRUN NURZRWNFDEJQLR* :KHQIXUWKHUWUHDWPHQWLVQHHGHG GHGHHQVLWQHPWDHUWUHKWUXIQHK: What changes would you make in this book to make it better or 8 32 .....Road ..........to ....Recovery ............................................................................................23 ....................................... yrevoceR ot daoR 8 please add 3K\VLFDOUHFRYHU\ other comments: \UHYRFHUODFLV\K3 (PRWLRQDOVXSSRUW WURSSXVODQRLWRP( 9 42 ,32Evaluation ……………Sheet ………………………………………………………… …………………………… teehS noitaulavE23, 24 9 ..........Jubilee ..............Hospital ......... gniSite kraPand dnaParking etiS lati......................................25 psoH eelibuJ layoR 01 I am:1052 .....Royal a patient a family member Thank you! Please mail this evaluation to: Breast Health Centre, CFAU Victoria General Hospital 1 Hospital Way Victoria B.C. V8Z 6R5 26 iiii %DWKLQJ JQLKWD% I would have liked MORE information about: *HWWLQJ5HDG\IRU%UHDVW6XUJHU\ 5R\DO-XELOHH+RVSLWDO6LWHDQG3DUNLQJ 1 ic Er Mar tin Le e A ve nu ! C B Can ce r Agen cy " D & T C Pa vi lio n e n e tr e e R n a l Un it n t e ia lio tre o r i a v "S y a B M em lP a P ti an Ad ac Pavil ion P n e t o R y "a lB a C re r o it Vis e d a rk a P R ic h m o n d R o a d Link to BC Cancer Agency, Level 0 Emergency, Level 1 Medical Imaging, Level 1 Clinics, Level 1, 2 Surgical Day Care, Level 3 Cardiac Short Stay, Level 3 Coronary Care Unit (CCU), Level 3 Cardiovascular Unit (CVU), Level 3 Intensive Care Unit (ICU), Level 5 Patient Care Centre Adult / Senior Mental Health 1, 2 Heart Health / Clinical Teaching, Level 3 General Medicine, Level 4, 8 Rehabilitation / Bone Health, Level 6 General Surgery, Level 6, 7 tre Richmond Pavilion Victoria Hospice, Level 3, 4 West Block Nuclear Medicine, Level 1 Outpatient Laboratory, Level 1 29 25 ck lo e W st B lo ck o C ro n at io n Pav ili o n D & T Centre C e n ic R h m o n d Pav il io n The Victoria Breast Health Centre color scheme and logo are inspired by Ted Harrison’s print “The Poet Who Greets the Sun”. The print was a gift from the Victoria Breast Cancer Support Group to mark the inception of the Victoria Breast Health Centre in 2001. Booklet created by Cathy Parker, R.N., B.Sc.N.; Revisions by Dorothy Yada, R.N. Shawna Bond, R.N. Breast Health Patient Navigators Victoria Breast Health Centre [email protected] www.viha.ca/breast_health_services/ Victoria General Hospital 1 Hospital Way, Victoria, B.C. V8Z 6R5 250-727-4467
