Surgery Recovery for Caregivers: What You Need to Know
Caring for someone after surgery for breast cancer — whether it’s a lumpectomy or mastectomy, with or without reconstruction — is not always easy, even if you’re a devoted caregiver. Of course you want to give them physical and emotional care and support when they come home after their procedure and begin their recovery. But you may not know what to expect, or you may not have any experience in post-surgical home care. This can add stress to what is already a stressful time, and that stress — if not tended to — can lead to caregiver burnout.
Good information is key: Research has shown that education goes a long way toward helping caregivers not only provide the right kind of care for their loved one after breast cancer surgery, but also protect their own mental and physical health. Here’s what you need to know.
Managing pain
A key component of caring for someone during surgery recovery is not just relieving pain, but staying ahead of it. Managing your loved one’s pain makes them more comfortable, of course, but it also allows for better-quality rest and a faster recovery.
If the hospital provided the ERAS (Enhanced Recovery After Surgery) protocol, your job may be easier. ERAS is a proactive approach to treating and managing pain, before and during surgery, that often results in less pain after discharge from the hospital, and less need for narcotic pain medication at home.
Be sure you understand what medications your loved one has taken in the hospital, and fill any prescriptions before coming home.
Check you have commonly used over-the-counter meds on hand, such as acetaminophen and/or ibuprofen.
After major surgery, constipation can be an issue, so get a mild stool softener, too.
Handling drains
If your loved one had a lumpectomy, they’re not likely to have surgical drains, but if they had a mastectomy — no matter the type of surgery they had or whether they also had reconstruction — they’ll probably have a number of them.
These drains consist of a soft plastic bulb with a stopper, attached to a long plastic catheter. When the bulb is compressed and the stopper closed, a vacuum is created that draws excess fluid out of the body throughout the day.
Nurses should instruct you how to manage drains. Typically, you’ll “milk” drains. This is done by holding the tubing between two fingers close to the body with one hand, while gently pulling your other fingers along the tube to drain any material from the tube into the bulb. Then you’ll open the stopper and empty the liquid into a measuring container.
You’ll want to keep a log of drain output; when it goes below a certain volume in a day, the drains may be safely removed by the doctor or other healthcare provider. Also take note if there are any changes in consistency or color of the liquid.
The tube is typically held in place to the body by a stitch. A little redness around that site is common and normal. Be alert for swelling and pain, though, which could indicate an infection. If you’re uncomfortable with handling drains, ask the nurse to watch you try it before you and your loved one leave the hospital. At home, be sure to wash your hands thoroughly before and after handling drains.
Managing expectations about the surgical site
After a mastectomy or lumpectomy, the first time that your loved one looks at the surgical site can be an emotional moment. It may be a shock for them to see the breast(s) altered or gone.
You may have a similar reaction, but, as the caregiver, you’ll want to be mindful of your response. Your reaction to seeing the surgical site can have an impact on your loved one, explains Lillie D. Shockney, RN, MAS, University Distinguished Service Professor of Breast Cancer and a professor of surgery at the Johns Hopkins University School of Medicine in Baltimore, MD.
"The expression on the face of the caregiver the first time they see the patient's surgical site can be profound for the patient,” says Shockney. “For example, a look of confusion that might be interpreted as a look of unpleasantness can scar a patient’s psyche.”
Some things to keep in mind and help you prepare:
Ask a nurse or nurse navigator to show you and your loved one photos of people who had the same surgery — taken immediately afterwards, one week later, and six months later. This will help you know what to expect.
If your loved one is having breast reconstruction, keep in mind that it might involve a series of procedures over a period of months or years.
Understand that healing will take time and the area will not look the same in weeks or months as it does now.
If your loved one had a mastectomy without reconstruction and you're looking at the incision together, Shockney suggests focusing not on the breast being gone, but on how the cancer is gone.
Creating a good environment
Take a critical look around your home to see if there are modifications you can make for your patient’s ease and comfort. You may already have done big things, like getting a lift recliner or a set of wedge pillows for the bed or couch to make rest and sleep easier. Other suggestions:
Put commonly used items like drinking glasses, mugs, food, and snacks at counter-height; post-surgery, your loved one may have a hard time reaching into higher cabinets or shelves or bending to retrieve items from low spots.
Clear the floor of tripping hazards like loose throw rugs.
If possible, set up a comfortable area on the ground floor to avoid having to go up and down stairs when not necessary.
Showering
Depending on the type of surgery, your patient will likely be cleared to shower (not bathe) once they’re home but may need assistance getting in and out of the shower. Even if they don’t, it’s a good idea to stay close by, just in case. In most cases, surgical incisions are closed in the hospital with either surgical glue (Dermabond) or steri-strips. The incision areas can be gently washed (but not scrubbed) and patted dry, until the glue or strips fall away on their own.
Coordinating and managing appointments
Your loved one will have a number of post-surgery follow-up appointments and will not be permitted to drive (for how long depends on what type of surgery she had), so be sure you or another responsible driver is available for those times. It may be helpful to ask if your loved one wants to go over questions for their doctors beforehand. That way, you both know what topics are important to them, and you can step in if they forget to ask. Taking notes for them can also lift some of their stress.
For traveling to and from appointments, see about having a mastectomy pillow or just a soft cushion to place between their torso and the seatbelt.
Providing food and nutrition
Good nutrition is important for post-surgical healing. Protein is key; your body heals wounds by replacing damaged tissue with new tissue, and protein is the basic building block for new growth. When thinking about meals and snacks, put protein high on your list: lean sources like poultry and fish are good options. Keep high-protein snacks like nuts on hand, too.
An overall healthy diet — with lots of fruit and vegetables and whole grains — will also aid in recovery. With all that said, there’s always a place for treats while your loved one is recuperating at home. Did someone drop off homemade chocolate chip cookies or send chocolates? It’s all good, in moderation.
Taking care of yourself
Caring for someone who’s had surgery for cancer can be difficult for the caregiver, too, presenting both physical and emotional challenges. It’s obvious but important: you can’t care for your patient if you aren’t well yourself. To avoid caregiver burnout, follow these tips:
Take breaks. As much as you are attentive to your loved one’s needs, they don’t need you around all the time. In fact, it’s probably best for both of you to have space and time apart. For you, it’s a chance to recoup and recharge; for them, it’s an opportunity to do things independently on the road to recovery.
Safeguard your own health. Prioritize sleep, get exercise, and join your loved one in consuming healthy meals.
If possible, enlist help—with childcare, cooking and shopping, and cleaning.
This information made possible in part through the generous support of www.BreastCenter.com.
— Last updated on April 20, 2024 at 7:17 PM