Post-Surgery Suggestions & Oncologist Selection

Hi everyone. This is my follow-up post to What You Can Do To Help Yourself. In this post, I am sharing what worked for me after surgery and before Chemotherapy. Although your major focus will be getting set up for your Chemo treatments, there are two things I suggest you take care of immediate after surgery: 

1. Be sure to get to a physical therapist to work on recovering the mobility in your arm(s). If you had any lymph nodes removed and/or operated on during your breast surgery, you will probably need physical therapy to help heal and activate the full range of motion in that arm(s). Ask you surgeon who he/she recommends, make your appointment and go. I needed to see mine three times. She gave me several exercises that really helped my arm to feel better.

2. Get a therapeutic ointment for the area on your breast where you had surgery.  It will help heal and lessen the scar.  My surgeon suggested Brave Soldier. I also used it on the area where my port was removed (after Chemo) to help heal the scar. It was great with both.

You have a one month window before you must start your Chemo after your breast surgery. It is important to get right to work choosing an oncologist. Get plenty of recommendations, research them and then meet at least two oncologists. I’m pretty sure that most insurance companies cover a second opinion.

Take a friend, all your biopsy, MRI, pet/ct and doctor’s reports and a recording device (with a good microphone). The oncologist meetings were somewhat emotional for me. I needed my friend with me so that we could discuss the information after the meeting. The recording you make will be a great tool to check whenever you need specific information not just what you remember.

Before you have your meetings, write out every imaginable question so that you will have them for your introductory session.

There is so much information and so much stuff going on in your head; it is difficult to get all the information you need to make your decision without organizing yourself in advance.  Here are many of the questions I wanted answers for:

  • After looking a at my biopsy and MRI, pet/ct and doctor’s reports, should I do Chemotherapy? Why?
  • What Chemo regimen do you propose. Why?
  • What are the different “pre-medication drugs” before the Chemo treatment?
  • Explain the drugs in the Chemo regimen. Why these drugs?
  • What are the side effects to each drug?
  • What are the medications you will be prescribing to handle the Chemo side effects.
  • Can I get my treatments on (name the day of the week you want)?
  • What comes after Chemo?
  • In your opinion, will I need to take the Hormone pills and for how long?
  • Which hormone pills and why that one?
  • What if I have reactions to the hormone pills and what might they be.
  • How do you feel about getting a Port put in my arm.

A port is a plastic unit that is in your arm so that during the Chemo injection your veins will not have to be pricked. I strongly suggest you consider a port. It made my injections a lot more comfortable. See if the doctor would be willing to have one of the Chemo nurses check your veins during this appointment so that you will not have to come back for a separate appointment. Then if she approves, you can get the doctor’s recommendation so that you can arrange to get the port inserted asap before the first Chemo appointment. (I think it must be at least 72 hours before.)

Take your time. You will probably not get this much uninterrupted, personal time with him/her again during your treatments.

During the chemo sessions, it was my experience that my doctor was not as attentive as I would have liked. It seemed like he was always in a hurry when I was talking to him. I realized that it was not personal that he did not give me the attention I wanted. As my Chemo Coach told me: “If they have too much time for you that means that they are not a good oncologist. The good ones are in demand.”

As long as he/she is knowledgeable, professional, has a solid office staff and nurses, and is known to be brilliant chemist, they are the perfect doctor for you.

Once you have evaluated the information and the other factors that are key for you, make your choice, inform your doctor and schedule your appointments.  Make all your Chemo appointments before you start so that you get the days you want.  Also, make an appointment to see a Chemo nurse to check your veins if you want to get the port before your treatments start.

I’m looking forward to sharing my next post with you in the coming week. I will discuss the support system you need to build around you before Chemotherapy.

  • Jackie

    Thank you for this information. I will be seeing my surgeon this coming Tuesday and will ask about PT for my arm, and when I see the oncologist, I will take your questions and any of my own.

    • Laura

      As an occupational therapist, and have breast cancer. I would like to inform you that many occupational therapists specialize in lymphedema mgmt after breast surgery, as well with working w/ arm limitations. Either a physical or occupational therapist may be able to help…specialization might be more the focus. Sorry, I can't help but advocate for the occupational therapy that often get overlooked. Many times on the news there will be a special about a “physical therapist”, but realistically it's an occupational therapist :)

      • Bluelaker4

        My surgeon gave me some stretches to do, and I have full range of motion. Still have nerve pain and it feels like I have road rash all the time, but my understanding is that feeling will eventually go away.

        • Lynn

          Hi , Just had 2 ops, one for 2 lumps and 2 sentinel nodes then another 12 days ago for all lymph nodes…get results tonight. Not wishing to be clever ( only to help anyone who is about to have these operations) but I was not looking forward to having the 2nd operation,(and I an ex operating room senior nurse) however for me the problems have been minimal, had to have some fluid removed the other day but I played 18 holes of Golf yesterday and had 20 points on the back nine. Haha ( I don't recommend this and neither does the Doctor and but you will know if you can do it) I have full movement nerve problems yeh some numbness and lymph fluid under my arm but that's sure to go away in time. A friend with the same op told me I couldn't play Golf for a year! I live in Mallorca and there is no Breast Cancer support service (physical or mental) so I'm just making it up as I go along.Having a porto-cath fitted in my chest on Friday -starting chemo next week. Good Luck everyone!

  • Karla Funk

    I have a question, it has been about 2 years now since I had reconstruction and I can't wear a normal Bra, I have to wear a sports Bra because it is the only thing that doesn't seem to irritate my skin… does anyone else have this problem? I just want to feel normal again.

  • laura

    I'm having a hard time coping w/ my breast cancer. I was officially diagnosed 2 days before my 31st b-day. no fam history, not in my genetics. I am hormone+ and her2+. I have to have chemo 1st prior to surgery. I have had one treatment so far and have 5 to go over the next 17 weeks. I'm a stage 2. I just want my mastectomy. I do have an arm port, however secondary to the placement I have 2 blood clots. I was having severe pain in my arm without any other symptoms, it was cutting off nerves in my arm. If you feel pain it's important to get an ultrasound. I am now taking coumadin. Is there other people that have had surgery at a stage 2 prior to chemo?

    • Bluelaker4

      I have stage 2 IDC, grade 3. Triple negative for the ER/PR Her2. I'm age 61. I had a lumpectomy and lymph nodes removed on May 18 of this year. I am having an IV port put into my chest on June 28 and will begin chemo on July 1. After 20 weeks of chemo I will have 6 1/2 weeks of radiation.

    • Mary

      Often, if the tumor is big, or if the skin is involved, or if you want to have a lumpectomy but the tumor is too big, they will do NEOadjuvant chemo – chemo before the surgery, and maybe more after the surgery. The advantage is that you can watch it shrink with each cycle, which is really reassuring. Getting a clot in the portacath is not that rare – coumadin is exactly what you should do, till the portacath is removed. If you had to get it, it's lucky to be hormone receptor positive, as hormones should have a big impact on keeping it away. Also, taking herceptin will reduce the chance of recurrence by 25%, so it's good that we have a treatment for it now, for you. Good Luck!!

  • Dawn Handy

    Where are you located? and do you do reconstructed surgeries?

  • Nancy Dunaway

    I am a year out of chemo and radiation following a lumpectomy and lymph node dissection. I was really lucky that mine was found early. The lymph is the worst problem I have and it is really not too bad but I think that is because I did my exercises and now also regularly go to a massage therapist with oncology training and also a lymph drainage massage therapist. I had to have my wound heal form the inside out so it was open for a long time and created a huge heavy scar. Without the help of my massage therapist I would be miserable. She is able to help the scar not adhere to the chest wall which was causing a dam effect and blocking the lymph from draining. Please after your surgery, research and find a good fully trained and licensed oncology lymph drainage massage therapist who works with cancer patients and has the special training necessary to help you! It wiall make all the difference in the world in your recovery!