• What kind of injection is given the day before surgery? Will I be able to manage the drains myself?

    Asked by suzyq on Thursday, May 23, 2013

    What kind of injection is given the day before surgery? Will I be able to manage the drains myself?

    Just got my pre-op appointment schedule for the day before my mastectomy, which will be on the 31st at the Mayo Clinic. I am scheduled at Nuclear Medicine for an injection on the afternoon of the 30th. What is that about? And are the drains and dressings after surgery difficult to manage? I'm having the surgery done 400 miles away, but once I get home I'm wondering if I should take advantage of my local hospital's Home Health Care services.

    19 Answers from the Community

    19 answers
    • leepenn's Avatar

      These are great questions for your health care team... First - will you have a single or double mastectomy? Second - will you have reconstruction?

      It depends on how things go for you... But, my guess is this.... If you are having a single mastectomy with no reconstruction, you are likely to be able to manage quite well on your own at home. If you are having a double mastectomy with no reconstruction, it's definitely still possible to manage on your own at home, but it will really depend on you. How much pain you have and how much mobility you have. I had a double mastectomy, and I had no problem managing my own drains and bandages, much to the annoyance of my better half who simply wanted to be helpful. But, being the stubborn human being that I am... I said - I can do it myself!

      The drains themselves are easy as they are rather long tubes... and it doesn't require much twisting or turning to reach them and empty them out periodically.

      If you are having reconstruction (I did not), then more pain is expected, according to others I've talked to about this. Hopefully, some folks who did reconstruction can weigh in here. With reconstruction, there are mobility restrictions about how high you should raise your arms and so on. So, you might need assistance at home due to those restrictions.

      The injection at nuclear medicine is for determining which of your lymph nodes is the FIRST node for lymph drainage from your breast. That lets the surgical team minimize the number of nodes removed from your body. The goal is to keep the number of nodes removed as small as possible as lymph node removal can cause future problems, like lymphedema.

      So, they inject a solution containing a marker that they can then image... and where you get a high concentration of the marker - that is your "sentinel node" - that is the first (and hopefully ONLY) node they will remove during surgery. Then, they will examine the lymph node right then and there to see whether they can detect the presence of cancer.

      During the surgery, they may also use a blue dye to doubly confirm which node is the sentinel node. By the way, don't be surprised if your pee after surgery is blue...

      So, there are some additional questions you should consider asking your health care team.
      If the lymph node is positive for cancer, what will be the next step?
      Options might include a full axilliary node dissection (removal of many lymph nodes) or radiation treatments after healing up from the mastectomy.

      Another thing - the nurses should be able to teach you how to handle your drains and bandages. Ask loads of questions.

      Did they tell you how long you should expect to be in the hospital? Seems like non recon folks stay 1-2 nights... and recon folks stay like 2-3 nights. I think that's mainly due to differences in pain management.

      Well, I think that's about all I have... I hope this is helpful. Ask more questions!!! I'll do my best to answer according to my own experience and what folks have shared with me.

      Good luck!

      over 4 years ago
    • suzyq's Avatar

      Thank you so much for your very helpful information! My mastectomy will be single, with no reconstruction, and so far there is no evidence of invasion anywhere else....but the cancer is high grade, and your explanation of the injection makes sense. I'm thinking we will be able to handle the drains just fine--will play it by ear, and call for help if we need it.
      I'm sure I will get lots more information at my surgical consult. My medical team has been nothing short of amazing.
      Thanks again!

      over 4 years ago
    • HearMeRoar's Avatar

      Be WARNED - the injection HURTS LIKE H-E-L-L!!

      over 4 years ago
    • Cactus49's Avatar

      You can ask to have the nuclear medicine injection after you are already under anesthesia. They do have equipment that can read the nuclear tracer right in the operating room. If not, insist on a local and some "happy juice."

      over 4 years ago
    • MarianneT's Avatar

      I had a bi-lateral with tissue expanders. I had no problem managing the drains. I had a surgical bra so there was no bandages to manage. They checked the incisions during my 2 night hospital stay and that was it. They healed very quickly as well. I took pain killers at home as needed. The first few days were painful. I had trouble getting up from a laying position without help since I was told not to use my arms to get up so I just had my husband help. some tips I appreciated were having button down shirts and PJ's ...much easier to dress and undress. Also I could not shower until drains were out so I bought dry shampoo. Some days my husband washed my hair at the kitchen sink (less bending) and others we used the dry shampoo.

      over 4 years ago
    • DianaL's Avatar

      Hi suzyq, I was 65 when I had my lumpectomy with wire localization--that is a wire they put in to the marker where you cancer is located. Then I went to the Nuclear Medicine Department and they gave me the shot--since I had been deadened for the wire I felt no pain so ask for some lidocaine when they give you the shot. The information below is correct but it took almost two hours for the contrast to reach my sentintal nodes so my surgery was pushed back twice. I did not get good news with my lumpectomy so my husband and I chose to go with the bilateral mastectomy for peace of mind. I had no dressing at all when I woke up and just used 4 x 4's at home. The drains were not bad, I could do them but usually my husband would come home once during the day to drain and measure. Pain not bad. I did sleep in a recliner for about two weeks because laying flat just was not comfortable for me. Good luck with everything, hugs and prayers!

      over 4 years ago
    • Myungclas' Avatar

      Ok...while the injection DID hurt more than anything else I'd experienced before surgery, it only took a few seconds. I think the pain was mostly in my head because she was putting a needle in my BREAST! I wasn't offered anything local, probably because that is also an injection in the breast and wouldn't have saved me much in the way of discomfort. Hang in there.

      over 4 years ago
    • busymom0413's Avatar

      I had bilateral with tissue expanders and was able to manage my drains and everything by myself. The hardest fir me was getting in and outbid the bathtub. I was not allowed to get then wet so I had to bathe and not shower. Unfortunately I had them for 4 weeks. The shot was not so bad if I recall I had 2. I got them the morning if surgery. They rolled me down about an hour before. She put alittle cream on the nipple and waited about 5 minutes and fit the shots. I have more painful procedures done. Not so bad and it is quick. I am sorry you have to go through this. I pray all goes well for you

      over 4 years ago
    • Mel's Avatar

      Hi!. they did my shot like hours before surgery.. Ouch!!... I believe its to light up your lymph nods for them to detect if cancer there. I hated having drains they are just in the way and I couldn't stand to mess with them now that's just me personally. My mom came over everyday and hung out from time my boyfriend went to work till he came home she would take wet ones (wipes) and pulled them down my drains just made it more slicker then those tools they give or just your hands, also they gave me special bras to wear my mom to pins and pinned drains to the sides of bra so that they were more out of the way than just hanging there. And actually my boyfriend stepped up to plate and drained me also became a natural haa haa figured he'd be grossed out as much as I was. Best of Luck!!..

      over 4 years ago
    • debco148's Avatar

      The shot you describe via Nuclear medicine is a radioactive dye used to light up sentinel lymph nodes. This is important, because during surgery they will remove any that light up and review them in the OR for possible cancer cells. This is another step in the final pathology review and staging of breast cancer. It will also help to determine what type of treatment is needed after surgery. I would take advantage of the home care, just in case. You won't have a ton of pain per se, just uncomfortable and drains to manage and monitor. Not that tough to manage, but I felt more comfortable having a few home visits just to make sure I was on the right track. Also, bring a few pillows with you for the ride home. I had one shaped like a half moon that a local store gave me (one that caters to breast cancer patients). I put this under my arms for a few days just to prop my arms away from the breast area. Also, you want to wear your seatbelt on the way home, but the belt may hit an area of the breast that is sore. So, use some cushioning. Best of luck, you will be amazed at how quickly you'll recover!

      over 4 years ago
    • Nonnie917's Avatar

      I didn't receive any injections before surgery. Don't know what that is all about. As for the drains are easy to handle, but I did have to have my husband changed the dressings. If you need to take advantage of your local hospital system do so. Don't be afraid to use them that is what they are there for. What I did for my showers and containing the drains is I had a cloth belt and I put that around my neck then hooked the drains to that belt so I could take a shower and not risk pulling on the drains while they are hanging loose. You can use almost anything that can go in the water to put around your neck. A piece of scrap material, tear up a old sheet stuff like that. As long as it is not heavy on your neck and the drains can clip to it you should have no problems. When I wasn't dressed, which was most of the time while I had those drains in and I didn't go anywhere, I hooked them to the inside of my p.j.'s or underware so they were not just hanging loose. You don't want that so make sure you always have them clipped to something. Hope this helps you?

      over 4 years ago
    • suzyq's Avatar

      You are all so helpful--thank you for the injection explanations and the great tips for after surgery and going home. Much appreciated!

      over 4 years ago
    • peachpoppy's Avatar

      Hi Suzyq - I just had all this done and it's not terrible, so don't worry!

      I had a double mastectomy on Wednesday and came home that night. I have 2 drains that are manageable since the tubing is long (as leepenn said). I do have a nurse visiting today who will help me with cleaning the site - that I haven't done yet.

      I had an axillary dissection about 3 weeks ago since the cancer was found in 2 sentinal nodes. For me, the dye injection wasn't that bad. It had a burning feeling that lasts about 5 seconds. Then they did the second shot, then the third. It was like a 30 second procedure. I could still feel a little ache after the shots which they told me would slowly go away. They said I should gently rub the area to get the dye to dissipate.

      Good luck to you, you'll do fine.

      over 4 years ago
    • Honeypot's Avatar

      The injection which was worrying me, barely hurt and it was a blue dye that goes into the
      nipple so sounds awful but isnt and the dye goes to the sentinel node so that the surgeon
      can do a biopsy to check if the cancer has got into your lymph nodes. Honeypot

      over 4 years ago
    • pressinfwd's Avatar

      I had bilateral mastectomy with immediate expanders. The injection to mark the lymph nodes before surgery does hurt, I wont lie, but the pain only last for a few minutes. The drains are easy to managed, my family took turn emptying them. Getting in and out of bed or a sitting position was a challenged because you can't use your arms. The Occupational therapist will give you some exercises you can do to rebuild the strength in your arms.

      Wishing you the best!

      over 4 years ago
    • Nancebeth's Avatar

      I had bilateral with imeediate reconstruction with silicone gel implants. I have no family and my surgery was done about 90 minutes from my home. I was released from the hospital after 2 days and was fully able to manage my drains myself. I had friends come over and help me cook food and stuff but that was mainly because I was so tired, not so much from pain.

      over 4 years ago
    • Bug's Avatar

      Hi, suzyq. I had the injection, too. It was no party but totally do-able. I was laying down. The doc was on my right. I had heard that the injection really hurt so I had my husband on my left holding my hand. Yes, it stung but I don't recall that the sensation took that long to subside. Please don't be anxious about it. I'm a chicken so believe me if I say you don't need to be anxious you really don't. : ) I had a lumpectomy and did not have drains so I can't address that issue. Best of luck to you for all you're going through.

      over 4 years ago
    • Snooks' Avatar

      Nuclear Medicine will inject a dye into your breast. Fair warning - it hurts like XXX! As to the drains, they are very easy to maintain and you really will not need home health care services. Your doctor will want you to measure (and document) the amount of fluid in the drains, and it's really very easy. The dressings after surgery are not difficult to manage; you will want to check periodically to make sure the wound is not leaking. Just don't strain your arm and don't lift it above your head. Good Luck and God Bless.

      over 4 years ago
    • laurie2025's Avatar

      I still have 2 of 4 drains following my mastectomy. My husband helps me when he's home, but I really can do it alone, it is not difficult, even when I had 4 drains. They should give you 'instructions' before you leave the hospital on how to do it. Make sure they let you know when you can shower and how to handle the drains then. I hung mine on a lanyard with safety pins. ( I am having reconstruction later ).

      over 4 years ago

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