After surgery care

What can I do to ease the pain from surgery?

• You will be given a prescription for pain medication before you leave the hospital after your surgery. Please take the pain medication as you are told by your health-care team.
• You can also use Tylenol (acetaminophen) Extra Strength.
• You can also use Advil (ibuprofen) in addition to the Tylenol.
• DO NOT use Tylenol or Advil if you are allergic to them.
• DO NOT take Tylenol Extra Strength if you have been prescribed Percocet (oxycodone) or Tylenol 3 by your doctor.

How do I take care of my surgical incision (cut)?

• Leave the outer bandage on for 48 hours. You can then take it off.
• The incision is covered with adhesive paper tape called Steri-Strips.
• Leave these Steri-Strips in place for 10 days after your surgery.
• After 10 days, you can take off the Steri-Strips while you are in the shower (the water makes it easier to remove them). They may come off on their own before 10 days. This happens to many patients and is not something to be concerned about.
• There may be one stitch at the end of the incision. It can be removed by your surgeon at your follow-up appointment.
• A small amount of blood on the bandage or Steri-Strips is normal.
• Wear a good supportive bra (day and night). This will help reduce pain and swelling.

I hear a sloshing noise in my breast. Is that normal?

• Sometimes after a lumpectomy surgery, fluid may collect where the breast tissue was removed. The collection of fluid (called seroma) is a normal body process to heal the area. You may “hear” the fluid. It may sound like a “sloshing” noise. This is normal.
• If the area gets very swollen and you have a lot of pain, call the breast nurse between 9 a.m. and 4 p.m. Monday to Friday at 416-480-5000. This is not an emergency. Some of the fluid may be drained and this may make you feel better.

Is there anything I cannot do after surgery?

• DO NOT drive a motor vehicle for 24 hours after surgery as it may be dangerous with all the medications from the anesthetic.
• DO NOT drive while you are taking your prescription pain medication as the medication may affect your ability to drive safely.
• DO NOT drink alcohol while taking prescription pain medication because taking both together can be dangerous.
• DO NOT lift anything weighing more than 10 pounds for 4 weeks after the surgery as it may damage the incision.
• DO NOT do repetitive shoulder movements for 3 weeks after the surgery as they may damage the incision. Repetitive shoulder movements include ironing, sweeping, mopping for extended periods of time.

When can I shower?

• You may have a shower after the outer dressings are taken off which is usually in two days.
• DO NOT scrub the incision.
• DO NOT soak in a bathtub and DO NOT go swimming in a pool, lake or ocean until at least 4 weeks after the surgery.
• DO NOT use soaps, creams or lotions over the incision until it is fully healed.
• Gently dry using a clean towel.

When can I start my normal activities?

• You can do most of your normal activities 1 to 2 days after surgery, except for heavy lifting or repetitive movements with the arm that is on the same side as the surgery.
• You can go back to your normal diet when you feel hungry. There is no special diet after surgery.

When can I go back to work?

• You can go back to work 2 to 4 weeks after a lumpectomy surgery.

What can I do if I am constipated?

You may be constipated after surgery. Constipation can result from the medication used to put you to sleep for your surgery, certain pain medications, a change in diet and/or reduced physical activity.

If you have trouble having a bowel movement, the following may help:

• Drink lots of fluid after your surgery.
• Use a laxative such as Senokot, which stimulates the bowels so they move. Senokot is available at a pharmacy. Take 1 to 2 Senokot tablets twice a day as needed.
• Eat prunes or drink prune juice.

If these things don’t help, call 416-480-5000 and ask to speak to the nurses on the breast team.

Deep breathing and coughing

Do deep breathing exercises as soon as possible to help your lungs recover after surgery. It is best to do these exercises while sitting up in a chair. But they can also be done lying in bed.

• Take a slow deep breath in through your nose, filling your chest and stomach like a balloon.
• Try to hold your breath for 1 to 2 seconds.
• Slowly blow out through your mouth, like you are blowing birthday candles.
• Repeat 5 times.
• After the last breath, cough to try to clear any phlegm or mucus from your lungs.
• Do these deep breathing exercises 4 to 5 times a day in the first 48 hours after surgery.

Movement

• You should move your arms soon after your surgery.
• DO NOT cradle your arms against your chest.
• For the first 4 to 6 weeks following surgery:
  • DO NOT lift anything over 10 pounds.
  • DO NOT do any heavy pushing, pulling or repetitive movements with the affected arm(s).
• The exercises that you need to start doing 24 hours after surgery are shown on the next pages of this guide.

What can I do to ease the pain from surgery?

• You will be given a prescription for pain medication before you leave the hospital after your surgery. Please take the pain medication as you are told by your health-care team.
• You can also use Tylenol (acetaminophen) Extra Strength.
• You can also use Advil (ibuprofen) in addition to the Tylenol.
• DO NOT use Tylenol or Advil if you are allergic to them.
• DO NOT take Tylenol Extra Strength if you have been prescribed Percocet (oxycodone) or Tylenol 3 by your doctor.

How do I take care of my surgical incision (cut)?

• Leave the outer bandage on for 48 hours. You can then take it off.
• The incision is covered with adhesive paper tape called Steri-Strips.
• Leave these Steri-Strips in place for 10 days after your surgery.
• After 10 days, you can take off the Steri-Strips while you are in the shower (the water makes it easier to remove them). They may come off on their own before 10 days. This happens to many patients and is not something to be concerned about.
• There may be one stitch at the end of the incision. It can be removed by your surgeon at your follow-up appointment.
• A small amount of blood on the bandage or Steri-Strips is normal.
• Wear a good supportive bra (day and night). This will help reduce pain and swelling.

What side effects might I have from the blue dye?

• If your doctor used blue dye to find your sentinel lymph nodes, you may have some side effects.
• Some people may have an allergic reaction to the dye. This is very rare and occurs in less than 1% of patients who have this injection. If this reaction happens, it will occur during your operation.
• The blue dye is absorbed into the blood stream. It leaves your body through your kidneys and urine.
• Your urine may be a blue or green colour for 24 to 48 hours after the operation. Your urine will return to a normal colour.
• The blue dye may also cause your skin to change colour, especially around the injection site. Your breast will return to its normal colour.
• Don’t be surprised if your face or body also looks a bit blue or grey in colour as a result of the dye. This effect will disappear in 24 to 48 hours.
• Drinking water will help flush out the dye through your kidneys and urine.

I hear a sloshing noise in my breast. Is that normal?

• Sometimes after a lumpectomy surgery, fluid may collect where the breast tissue was removed. The collection of fluid (called seroma) is a normal body process to heal the area. You may “hear” the fluid. It may sound like a “sloshing” noise. This is normal.
• If the area gets very swollen and you have a lot of pain, call the breast nurse between 9 a.m. and 4 p.m. Monday to Friday. The phone number to call is 416-480-5000. This is not an emergency. Some of the fluid may be drained and this may make you feel better.

What is lymphedema?

• Lymphedema is swelling caused by fluid collecting in your arm and your chest.
• There is a very small chance of developing lymphedema after a sentinel node biopsy. The risk is 2-3%. That means only 2 or 3 out of every 100 patients who have a sentinel node biopsy will get lymphedema.
• This type of swelling may develop months or years after surgery.
• Signs of lymphedema include swelling, heaviness, aching or tingling in the arm or chest on the side you had surgery.

Tips to help reduce your risk of lymphedema:

• Let your health-care team know if you develop swelling that does not go away.
• Maintain a healthy weight. Obesity is a risk factor.
• Try to avoid bloodwork (blood being withdrawn) on the side you had surgery.
• Protect your skin on the side you had surgery. Apply antibiotic cream to cuts, scratches and insect bites.

Is there anything I cannot do after surgery?

• DO NOT drive a motor vehicle for 24 hours after surgery as it may be dangerous with all the medications from the anesthetic.
• DO NOT drive while you are taking your prescription pain medication as the medication may affect your ability to drive safely.
• DO NOT drink alcohol while taking prescription pain medication because taking both together can be dangerous.
• DO NOT lift anything weighing more than 10 pounds for 3 weeks after the surgery as it may damage the incision.
• DO NOT do repetitive shoulder movements for 3 weeks after the surgery as they may damage the incision. Repetitive shoulder movements include ironing, sweeping, mopping for extended periods of time.

When can I shower?

• You may have a shower after the outer dressings are taken off which is usually in two days.
• DO NOT soak or scrub the incision.
• DO NOT use soaps, creams or lotions over the incision until it is fully healed.
• Gently dry using a clean towel.

When can I start my normal activities?

• DO NOT lift anything weighting more than 10 pounds (4.5 kilograms) for 1 month after your surgery
• You can do most of your normal activities 1 to 2 days after surgery, except for heavy lifting or repetitive movements with the arm that is on the same side as the surgery.
• You can go back to your normal diet when you feel hungry. There is no special diet after surgery.

When can I go back to work?

• You can go back to work 6 to 8 weeks after a lumpectomy surgery that included a sentinel lymph node biopsy.

What can I do if I am constipated?

You may be constipated after surgery. Constipation can result from the medication used to put you to sleep for your surgery, taking certain pain medications, a change in diet and/ or reduced physical activity.

If you have trouble having a bowel movement, the following may help:

• Drink lots of fluid after your surgery.
• Use a laxative such as Senokot, which stimulates the bowels so they move. Senokot is available at a pharmacy. Take 1 to 2 Senokot tablets twice a day as needed.
• Eat prunes or drink prune juice.

If these things don’t help, please call the nurse at 416-480-5000.