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After breast surgery you will have a heavy strapping and dressing across your chest and 1 or 2 drainage bottles attached to the operation site. These will remain in place for 1 to 5 days.

Day 1 onwards

To reduce the effects of a general anaesthetic do the following two exercises hourly throughout the day until you leave hospital.

1. Deep breathing

Sitting up in bed or in a chair, take a deep breath and sigh the breath out (repeat 4 times)

2. Coughing

Be sure that you can cough strongly and effectively after your operation and cough as needed to clear any excess secretions. Coughing will not damage your stitches.

If you have any problems with your breathing pattern or difficulty clearing any secretions please tell one of the nursing staff. They will ask the doctor or ward physiotherapist to come and see you.

Use your affected arm normally from the elbow down to the hand. You may use your arm to manage your personal care, eg –

• washing your face

• brushing your teeth

• using a knife and fork

• brushing your hair, if you can

7-10 days after the operation

Repeat each of the following exercises 4 times. Try to do all of the exercises three times a day until you regain full movement in your affected arm. If any exercises cause you pain, stop doing them and seek advice from your GP.

Exercise 1

Standing or sitting with your hands clasped together, slowly raise your arms above your head as far as possible. Lower slowly.

Exercise 2

Standing or sitting, place your hands on your shoulders and lift your elbows sideways until they are level with your shoulders. Lower slowly.

Exercise 3

Stand facing a wall. Start with your fingers at shoulder height on the wall and walk them as high up the wall as possible. Slide your hands back to shoulder level before repeating the exercise.

Try to increase the height you reach each day.

Exercise 4

Standing or sitting, clasp both hands on top of your head with your elbows out to the sides. Slide your hands down to rest at the back of your neck. Release your hands to start again.

Exercise 5

Standing or sitting, clasp both hands behind your back. Slide your hands upwards reaching gently towards bra level. Release your hands to start again.

Reducing the risks of lymphoedema

If the lymph glands in your armpit have been removed during surgery, or you receive radiotherapy to this part of your body, there is a risk of lymphoedema (swelling of the arm or hand). This is usually mild and may develop gradually a few months or even several years after surgery.

If lymphoedema occurs, the arm and hand are more vulnerable to infection. Listed below are some simple tips to help you care for your skin and reduce the risk of infection –

• Treat even small grazes and cuts with antiseptic and keep them clean until they heal. See your GP at the first signs of any infection, eg. if the cut is inflamed or feels warm and tender.

• Wear gloves for washing up, DIY and other household tasks.

• Try to avoid being scratched. Wear gloves and long-sleeved clothing when handling animals or gardening.

• If you sew, use a thimble.

• Avoid getting sunburnt.

• To avoid cuts, use an electric razor if you shave under your arms.

• Keep your skin clean and dry and apply moisturising cream daily to keep it supple.

• Use nail clippers instead of scissors to cut your nails and use hand cream regularly. Never push back or cut the cuticles – use cuticle cream instead.

• Do not have blood taken, your blood pressure measured or have acupuncture on your affected arm.

Advice on discharge

Exercises

Continue with the exercises until you regain ‘normal’ movement in your arm.

Rest

Take a short daily rest if necessary.

Work

You should not expect to return to full time work until after your post-op appointment.

Sports

Avoid all sports for 10 – 14 days and check with your Consultant or Breast Care Nurse.

Driving

Do not drive until you can perform an emergency stop without experiencing pain. You may also want to check with your insurance company.

Gardening

Avoid gardening for a few weeks, then begin again gradually.

Household activities

While you are recovering -

• Maintain your personal hygiene

• Do light housework, eg. dusting, making drinks, washing and drying dishes, preparing light meals

Until you are fully recovered, do not –Decorate

• Lift heavy objects or cook a large roast meal using the oven

• Shake the duvet or heavy bedding

• Carry out any heavy housework

• Use your affected arm to vacuum

Further information

The Breast Care Nurse will be available at your follow-up Outpatient appointment. If you have any problems before then, please contact your GP or the Breast Care Department on Telephone 01271 349115 and answerphone 01271 311632.

PALS

The Patient Advice and Liaison Service (PALS) ensures that the NHS listens to patients, relatives, carers and friends, answers questions and resolves concerns as quickly as possible. If you have a query or concern, please visit them in the Information Centre on Level 2 at North Devon District Hospital or contact them on 01271 314090.

Have your say

Northern Devon Healthcare NHS Trust aims to provide high quality services. However, please tell us when something could be improved. If you have a comment or compliment about a service or treatment, please raise your comments with a member of the ward staff in the first instance.

Please also take the time to complete a comment card 'Tell us what you think', so we can make improvements.

If you would like to make a formal complaint, please contact the Customer Relations Manager on 01271 322334 or put your concerns in writing to the Chief Executive, Northern Devon Healthcare Trust, Raleigh Park, Barnstaple, EX31 4JB.

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