Wide local excision and full axillary clearance

Hi all 

I’m booked for a WLE and full axillary clearance on March 3rd. Was diagnosed in early January but due to other health conditions impacting my treatment only just been offered surgery. 

Feeling scared as a HDU bed has been booked for me and will I’ve been told have to stay overnight. 

What can I expect when I wake up ? Thanks

Hi Smudge. 

Sorry to find you’re in this position. I had a mastectomy and full axillary clearance done privately and, after a lot of nagging, they allowed me to go home the same evening so I can only tell you about what to expect from the surgery point of view.

Once I’d come round, a nurse checked I was ok (obviously) but then checked the wound and changed the dressing. You may be attached to a drip if you have underlying health issues and a monitor for blood pressure etc. Do ask if you are going to have a drain under your arm. Some surgeons don’t use them but it was a bit of a shock to me. Hopefully you will be given a sling to carry it in (I wasn’t and had to devise all sorts of strategies for simple things like going to the loo and sleeping).  You will have the drain removed after a specified number of days. 

HDU is good. You have the reassurance of constant supervision but they can’t be expecting problems if you are to go home the next day. You just get extra supervision.

I didn’t experience pain so much as discomfort and didn’t need any pain relief but I was given an injection because of the bleeding. Then came The Socks, probably the worst part. Heel to knee compression socks which the nurse put on but which my husband had to struggle with daily (you can’t pull and yank after an axillary clearance). I had to wear those for 8 days but you have to have time off to give your legs a break - hence the daily struggle (and itch).

I used no pain relief during the recovery time. I did experience numbness in my upper arm but that’s to be expected considering the remove all of the nodes - some nerves must get damaged. You have a programme of exercises you MUST follow to the letter to avoid complications like cording or lymphodoema. Your breast care nurse will talk you through them. They also prevent frozen shoulder. Actually, thinking over 2 years on, I wonder of they aren’t for life! You may feel a little woolly headed so ask them to write down any instructions. You THINK you have understood. By the time you get home, you have forgotten!

Then you have the dressing removed. I chose not to look at my scar until it was healing well and I think that was right for me because now I’m more than comfortable with how I am and don’t try to conceal myself in a gym changing room (in the good old days). I’m monoboobed. So are many others. 

Wear loose clothing and make sure you have front fastening pjs and tops. I borrowed a couple of my husband’s softer shirts till the drain came out. You need to dress for complete comfort but I suspect most people are doing that during lockdown. Have a couple of comfort bras you can slip into, ones that will provide medium to firm support so breast movement is restricted.

I think that’s about it. Hopefully someone can alert you to what to expecT in the HDU but, you know, you can ring your breast care nurse and hopefully she can address all your concerns. That’s her job. Meantime, do what you can to keep anxiety to a minimum: relaxation exercises, mindfulness, meditation, EFT - anything that you find gives you respite from the feeling of dread which we afterwards wonder why we heeded it!

I wish you all the best and hope the results from the node clearance are good.

Jan x