Mar 25, 2015

Interview Transcript

Interviewer: You just got home after your breast cancer surgery. What should you expect and what should concern you? That's next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists that you can use for a happier and healthier life. You're listening to The Scope

Interviewer: When it comes to getting home and after your breast cancer procedure, what's normal and what's not normal and what should you expect? Hopefully we'll make this next part of your journey a little less scary. Dr. Cindy Matsen is a breast cancer surgeon at Huntsman Cancer Institute. She's going to help give you some idea of what to expect after you get home after your breast cancer procedure. So a woman gets home, what's normal? What's not? Let's start with what's normal.

Dr. Matsen: So what is normal is that regardless of the type of procedure you have, whether you have a mastectomy or lumpectomy, you will have some pain. That's a fact of surgery. So we make sure that we send you home with some pain medication to help with that. You should take the pain medication if you're feeling like you're having more pain than you can handle with something like Tylenol or ibuprofen. If you're ever having a dramatic increase in your pain, we want to hear about that, because that could be a sign that something abnormal is happening and we want to hear from you.

Interviewer: Generally, is it just a couple of different possibilities if you're getting a lot of pain? I mean, what is that abnormality?

Dr. Matsen: So usually if you're getting a lot of pain, it's a sign of bleeding or infection. Early on, it would typically be if you have a lot of swelling and pain we would be worried about bleeding. If you're having a lot of redness and swelling and it's further out from surgery, then we would be more worried about infection.

Interviewer: Everyone experiences pain differently. On a scale of one to ten, I mean how do you even determine if the amount of pain I'm feeling is abnormal?

Dr. Matsen: Right. So what I tell most women if they have a lumpectomy, is that they will probably be sore, not necessarily out of control pain just soreness, for a couple of days. In fact, they will only need the narcotic pain medication for a day or two at most. If women have a mastectomy, especially with reconstruction, they will need pain medication for a longer period of time because that's a much more painful procedure.

Interviewer: Because it's a lot more invasive, you're doing a lot more stuff.

Dr. Matsen: Right, it's a bigger surgery. It's a bigger incision, and it's not necessarily the bigger incision that hurts but just the surface area that is involved. And with reconstruction, especially if it's an expander that's placed behind the muscle, that's quite painful because it's stretching the muscle. So most women, that's where most of the pain is from. It's not actually from the mastectomy, but actually from the reconstruction.

Interviewer: I would imagine that of course, you should always consult your doctor and in this podcast here we're just talking about possibilities, but if there's ever any concern, probably pick up that phone. Is that what you would recommend?

Dr. Matsen: Absolutely, and we always provide women with phone numbers that give them access to someone 24/7, so if you're ever concerned, you wake up in the middle of the night and you feel something really abnormal, we have someone available to talk to you about that.

Interviewer: All right, so we've talked about pain, what are some of the other considerations?

Dr. Matsen: So the two main considerations that we have after surgery are the two things I mentioned with the pain are bleeding and infection. If you ever have an abnormal amount of swelling, we want to hear about that. Typically, if you call us and you say, "I'm having a lot of pain and a lot of swelling," we're going to say come in so we can take a look and see what's happening. If you're ever having fevers and swelling and redness, those are signs of infection and we want to hear from you then too because we're going to have you come in so we can take a look and possibly start you on antibiotics.

Interviewer: And are there differences if you've had a lumpectomy or a mastectomy as far as other things that you should be concerned about?

Dr. Matsen: There are differences. The main difference is that with a mastectomy, you go home with drains in and those drains have to be emptied a couple of times a day and you have to keep track of how much is coming out. If you ever see changes in the fluid, either in what it looks like or how much is coming out, we want to hear about that as well because that could be a sign that something has happened or changed that we need to hear about.

Interviewer: What are some common misconceptions when women get home? Like kind of like false alarms, if you will.

Dr. Matsen: I think the biggest thing is most women with a mastectomy and the drains get very concerned about the drains and the drain output is supposed to go down over time, but they'll be concerned that if it's going down that something bad is happening. And that's actually not, that's a normal part of the process. Your body makes fluid after surgery and as your body heals and those spaces closed down, the fluid will decrease with time.

Interviewer: All right, any final tips or any final thoughts on this topic?

Dr. Matsen: The biggest thing is that for most women, they've never had surgery before. They have no idea what to expect. We try to give you an expectation for the things to look out for, but if there's ever anything that you're concerned about, ever anything that you feel like may not be normal, we want to hear from you.

Interviewer: Better to make that phone call than go on the Internet and try to find out for yourself.

Dr. Matsen: Absolutely.

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