Anyone out there who has had problems healing from a mastectomy?

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I had lumpectomy 11/22, huge hematoma, but it had less than 1 mm margin, and a mastectomy on 12/08/08. I had the expander put in at the mastectomy. I developed what I call cellulitis, hot, inflames, red, fever, swelling along the incision. I was put on Cipro 750mg 2x/day, and after a week 1g of Cephalexin a day. It has been over two weeks and I don't see an improvement. I have been to my family doctor twice, and to my plastic surgeon weekly since the surgery, and the surgeon once following the surgery. Also my oncologist once. I will see the oncologist again monday and plastic surgeon tuesday. I feel hopeless. My soft shoulder pad like prosthetic in the free bras hurts too much to wear and I have been working lopsided since a week after the outpatient surgery. I have reduced self-esteem, increased depression, and weight gain from the Tamoxifin. Am I never going to heal?

Lowengail, I'm so glad to hear that your friend's surgery was less than a month ago. It sounds like she's well within the 3- to 6-week recovery time that a mastectomy seems to require.

From doing some research, it seems like hematoma is a relatively common complication after mastectomy surgery. There's such a large wound inflicted on the body in a major surgery that some blood can get trapped in the wound. Also, many tiny blood vessels are cut during the surgery. In the case of a bruise (which is also a hematoma), the blood is resorbed into the body. In the case of your friend's hematoma, the drainage itself may be keeping her wound from healing as fast as expected. Her doctor may be able to drain it if she or he thinks it would be of benefit to her. But keeping the incision slightly open can relieve pressure and allow any interior bleeding to be absorbed by bandages, also, so some doctors allow this slow drainage to occur.

Here's a general information page about hematomas, which describes heat therapy and pressure therapy:

http://www.healthscout.com/ency/68/677/main.html

And here's a Mayo Clinic page that includes some good information about the drains your friend probably had after the surgery (but has since had removed?)

http://www.mayoclinic.com/health/mastectomy/WO00113

I wonder if your friend would benefit by a Reach to Recovery volunteer? Volunteers are breast cancer survivors who know the territory and also have up-to-date information. There might be one in your friend's area who has experience with difficult healing. Here's a page on Reach to Recovery with a link to the American Cancer Society page where you can enter a zip code and find a volunteer in specific areas:

http://www.cancer.org/docroot/ESN/content/ESN_3_1x_Reach_to_Recovery_5.a...

Signs of infection at a wound or incision site are inflammation, extra redness, being warm to the touch (like it has a fever), pain or drainage of a foul-smelling liquid. If your friend is experiencing any of these symptoms, she definitely should ask for another appointment with her doctor. Otherwise, help her realize that she's well within the healing guidelines for major surgery like mastectomy and to not let stress bring her down. She is in a difficult time right now and she's lucky to have you for a friend.

Diane -- Thanks so much for your help. In her case, a hematoma has formed and the incision is not healing well. She had the surgery less than a month ago.

Lowengail, can you tell us a little more about your friend's experience? How long ago did she have her mastectomy, and what level of recovery -- or benchmarks -- are her doctors waiting on to begin reconstruction?

Was it a "simple" mastectomy (removal of just the breast) or a "modified radical" mastectomy (removal of the lymph nodes as well)?

It's so important to remember that we each have our own timetable for wellness and healing. Hospital stays after a mastectomy can range from 2 to 10 days; the first follow-up visit with a doctor is usually within a week, and then drainage tubes are removed (usually within two weeks) when the amount of fluid draining from the wound decreases enough. Total physical recovery can range from 3 to 6 weeks. Some things it depends on are age, physical condition, weight and the body's immune system.

Has it been longer than that for your friend? What sort of issues is she having? (Healing of the incision? Infection, or physical motion issues? Nerve pain, or stiffness that won't go away?)

Here is a good article on all aspects of breast surgery, including recovery:

http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Surgery_5.asp

Mentioned in the article as things that can slow recovery are hematoma (when blood builds up in the wound) and seroma (when fluid builds up in the wound). Either of these can lengthen recovery time.

Here is a forum where women are discussing hematoma after breast cancer surgery:

http://www.cancerforums.net/about273.html

And seroma is a common complication after breast cancer surgery. Here is some information about seroma:

http://www.medhelp.org/posts/show/261497

I hope this information helps, and please come back with more information, if we need to we can forward it to one of our experts.

Do others out there who have had mastectomies have recovery experiences they would like to share?