Post Mastectomy and lymph node clearance (Left side) expectations.

[Dolbycat]

Hi everyone, I hope you are all doing well. It's been a while since my last post but I wanted to ask for some advice.

I finished my Docetaxol chemo cycles a month ago and then had to wait until I was well enough for my mastectomy and lymph node clearance on left side. I had the surgery last Thursday and all went well. The surgeon doesn't normally use drains, as she said the body will adjust quicker to the production of fluid if they are not used, saying my body would naturally absorb the extra fluid. I have like a strip of honeycomb padding under a waterproof dressing from the centre of my chest right around to the very back of my left underarm.

I stayed in hospital for just one night as I had sickness relating to the anaesthetic. I was told to expect some swelling and fluid but if necessary I would be able to have the fluid manually drained if it was too painful. I was not told to wear anything in particular, just loose comfortable clothing and no bra until after the scar site had healed. I though I would need some compression on the site to help prevent the fluid build up, but this was not advised. I am not in too much pain, I was given pain relief consisting of paracetamol, Ibuprofen and Tramadol 50mg. I am using the Tramadol at night only and have slept very well with no issues, I used the other pain killer during the day when necessary. I am managing quite well and had expected worse.

My only concern is that the swelling has increased and the fluid now moves along the site of the dressing, there is no leakage or severe pain, but I wondered if this is the normal way to manage the area. I intend contacting the nurse tomorrow for advice, but though some of you ladies might offer suggestions to what I should expect.

[Jennymary]

Not able to advise, but hope it's nothing serious and is easily resolved, and you continue to make a good recovery xxx

[Dolbycat in reply to Jennymary]

Thank you jenny Mary for your support. Take care. xx

[Nixh]

I had drains so not the same but imagine you will get quite a bit of fluid as is natural when tissue has been cut and removed. If it gets really tight or hot to touch or you get flu like symptoms then ring the breast nurse asap as could be a sign of an infection. Otherwise just keep doing what your doing, watch out for the weird pains/sensations when the nerves start trying to knit. Is a combo of itchy, stingy, sore and ticklish all rolled into one... I was told to wear a sports bra but it was too uncomfortable under my arm so didn’t bother. Did you have an expander or just mastectomy and nodes?

Don’t lift anything heavy but do do your exercises as they help immensely.

Good luck with your recovery x

[Dolbycat in reply to Nixh]

Hi Nixh, thanks for your reply. I did not have any expander fitted as I am having Radiotherapy as soon as the scar heals. I was told I will need to wait for reconstruction after all the treatment is completed and my body has recovered.

I have been keeping a check on my temperature and so far so good, no real discomfort yet, just strange having the fluid moving side to side. Feels better if I sit or lie down in a straight position rather than on one side as the fluid flows and pools with the gravitation.

I am resting and not overdoing things but doing the exercises I was given by the Physiotherapist. I have good range of movement with no pain just some numbness in places. It's still early days yet so will keep an eye on the fluid build up. I have a christening event in two weeks time, the consultant said if necessary the fluid can be drained before I travel to make it more comfortable.

I am hoping to get through this stage without too much hassle, I had enough with the chemo, but taking it a day at a time.

Hope you are keeping well, x

[Lainey66]

I had drains in for about 4 weeks and had a lot of fluid drain off, they chose not to take the drains out until my daily fluid loss was less than 25 ml. After that they removed them and the fluid still built up as you describe and I had them manually drained at first it was every second day for a week then we stretched it to once a week for about two weeks, after that I only popped in twice after about two weeks each time. It regulated itself after that. I am glad I had it drained off as I found it very uncomfortable. Good luck with it, perhaps yours might regulate quicker than mine. I hope it does as it is not the most pleasant feeling. The manual draining gave me a lot of relief and was not painful at all. Xxx

[Dolbycat in reply to Lainey66]

Thanks Lainey for sharing your experience, this is what I had expected to happen to me, but my consultant has her own way. She has been very good throughout my treatment and I trust her decision not to use the drains, but hadn't seen anywhere on the forum to give me advice. I hope you are keeping well and enjoying the summer. x

[theahart]

I don't know - I had a drain and my friend, who had a dual mastectomy, also had drains. She had fluid build-up when she removed the drains too soon. I hope all goes well for you!

[Dolbycat in reply to theahart]

Thanks Theahart for sharing. I will keep you updated as to what happens. x

[Linkj]

You sound as if you are managing so well. I had a mastectomy with node clearance in March with drain removed day one. I had the fluid (seroma) drained 5 times in the next 6 weeks, it was almost as if my breast had grown back!! Draining did not hurt but I had 2 breast care nurses and one said her consultant did not drain seromas but my consultant liked them drained as they made the scar neater. Anyway 4 months down the line the scar is very flat and neat and minimal problem. I couldn't cope with a bra initially but Sainsbury do a very cheap crop top with a light padding and I bought a knitted knocker (check them out they are really good) and it was fine until a bra and prosthetic were possible. Wishing you the best for your continued recovery.

Lin

[Dolbycat in reply to Linkj]

Thanks LinkJ. You are the first person I have read who had this experience, I too thought the same with the fluid build up looking like a small breast. It is not uncomfortable yet and seems to have slowed down a little, I am going to check with my nurse today that everything is OK.

My consultant likened the experience to producing milk for breast feeding, where the more the fluid is drained, the more the body produces. By withholding the draining the body adjust quicker and eventually stops producing the fluid. I will have to wait and see how it works out. I am going to buy some comfortable soft vest tops with built in bra support today to make it more comfortable until I can wear a proper soft mastectomy bra.

I have a set of knotted knockers, they are brilliant. I used one to leave hospital as I am quite large busted and felt very lopsided, the knitted substitute was perfect and comfortable. I order a pair as I am waiting for the results from genetic testing and might need to have the right breast removed if the result comes back positive. I had hoped to get the results before surgery, but they take 3 months and surgery couldn't wait.

I will have manual draining when the fluid builds up too much as I don't want the pressure to effect the scar and to be comfortable for my planned Christening trip in August.

Best wishes for your recovery and future health. x

[Linkj in reply to Dolbycat]

When I looked up your response it showed your previous posts and I read your one on docetaxel. I had my first dose 10 days ago and have been so poorly. Bone aches +++ but then at day 5 really unwell with temperatures, borderline for admission but saw my GP instead who was really thorough and diagnosed bladder infection, given antibiotics and today first normal temperature and feeling like I might survive! interestingly my blood tests showed high CRP and white blood count (indicating infection) so GP right. I felt like giving up last week and saying I can't do this anymore (not like me at all) and it is reassuring to hear others felt the same. How did your last 2 cycles go, were they worse? Take care and rest after your op, it is amazing how the body heals

Lin x

[Dolbycat in reply to Linkj]

My first dose of Docetaxel was 200ml and too strong for me, apparently this is common for your first dose to see how you react. The Oncologist reduced the strength by 15% and that helped me get through the next two cycles. I still had a few problems but they were more tolerable than the first time. I too had felt like giving up, but then that is not really an option after getting so far. Persevere with the rest of chemo, it's a great feeling when it is completed. Afterwards you can be very proud of what you have achieved. I had two MRIs done during my chemo and both results were exceptional, so although it is very unpleasant it does the job. Best wishes and take care. You will get through this and soon put it behind you. xx

[Debs1962]

I had no drain in, and had reconstruction at the same time as mastectomy, didn't have any issue with fluid or pain.

I didn't have node clearance so that maybe the reason why I had no problems.

Always best to phone the nurses to check out anything if you are unsure.

[Dolbycat in reply to Debs1962]

Thanks Deb, I appreciate your advice and will contact my nurse. Take care. xx

[jlod]

Hi had aright sided mastectomy 3 months ago did have drain's in same was left in for a week then removed .. Over the next two weeks i had a gradual build up of fluid [ seroma] so much so it was like i had grown another breast i contacted my breast care nurse who advised me to go in and see her so glad i did she drained 1100 mls of fluid , i have since been back twice to be drained i just go to drop in clinic that the nurses run . Dont leave it two long because it can become uncomfortable hope i have managed to help .

[Dolbycat in reply to jlod]

Thank you Jlod this is sensible advise. I plan speaking to the nurse today and arranging an appointment to see her when recommended for drainage. This has helped me to understand my situation. Best wishes for your recovery. xx

[mrsorangecat]

Hello Dolbycat, i had a left sided mastectomy with no drains and i too sloshed about for at least a week if i remember rightly, especially when turning in bed. I ended up going for fluid to be drawn off (seroma) a couple of times by my breast care nurse which really helped. Like another lady said, it did look like my boob was starting to grow back! After that it did all start to reabsorb nicely by itself. I hope you get it sorted soon. Oh and dont worry, the drawing off of the fluid doesn't hurt at all as the area is numb xxx

[Dolbycat in reply to mrsorangecat]

Thank you for your reply, sorry I missed it yesterday. I checked with my nurse who advised to keep with it at the moment until there is any discomfort or pain. She told me the fluid should start to reabsorb naturally but if necessary it can be drawn off to ease the pressure. Thanks for your advice. Hope you are keeping well. x

[Mac99]

I had drains also but I do remember the swishing of the fluid especially if I moved from side to side, not painful but funny sensation. It did take a while to settle but I did notice this week a build up of fluid under my arm so working to move that. Vest tops and long scarfs were great for the first couple of weeks post surgery.

[Dolbycat in reply to Mac99]

Thank you for your reply, it's good to know the swishing is not just me. I am trying to keep up with the exercises to help the arm from going stiff, it seems ok at the moment. I have just bought some soft bras and vest top to keep comfortable until my scar heals. Best wishes for your recovery. xx

[Hidden]

Have you not got a community nurse visiting? I had one come for a week or so every day. the build up of fluid is probably a seroma, they can drain it, but what they drain out can leave space for it To re-fillI. I had drains which took most of the fluid away, but did still get some left when they removed them. My community nurse told me to do special exercises which would help to absorb the fluid naturally into my body, to which I do them religiously every day, also to stop getting a frozen shoulder. Hope this helps ...

[Dolbycat]

Thank you Cash your reply is very helpful. I am waiting to see how the swelling settles as I have some bruising too and hopefully things will settle soon. I am not in any pain and not taking much relief so coping quite well at the moment. I do not have a community nurse visiting, but contact numbers if I need any support. The exercises and gentle massage seem to be working too.

[josiemarie]

I had lumpectomy and auxilary clearance on my right side.. like you l had an adverse reaction to the anaesthetic and went home after two days.. however had to go bk almost daily for the fluid to be aspired with a syringe for 3+ weeks. It wasnt painful.. more of a nuisance and luckily l lived close to the hospital!

Josie x

[Dolbycat in reply to josiemarie]

Hi Josiemarie thank you for your message. I have managed almost a week since surgery with no drainage, but today I have a very heavy feeling of the fluid buildup following a restless night. I am trying to get through to the hospital to have the situation assessed as I think it might need draining. It is not really painful but difficult to lower my arm as the fluid seems to have pooled at my side and the area feels quite numb. I am hoping to get an appointment later today. I hope you are keeping well and enjoying the summer. x

[josiemarie in reply to Dolbycat]

I am very well thanks.. good luck with the rest of your treatment

Josie x

[Dolbycat in reply to josiemarie]

Just had 1.5 litre litres of seroma fluid drained so feeling much better. xx

[BarbRennie]

I had left mastectomy and lymph clearance, and went home with drains, which blocked up after 2 days and had to be removed, so a seroma built up swiftly - like a new boob - and had to be drained twice weekly - about 650mls each time! it slowly stopped producing the fluid over 5 weeks. and stopped as soon as chemo started. Everyone is different post-op. But seroma is very normal.

[123048]

Can any anybody suggest pain management, especially night time. At the moment taking paracetamol regularly and gabapentin two 300mg over 24 hours, but waking early in pain (cording etc) after left arm axillary clearance, seroma settling down