Hi,
I just want to chip in here that I'm one of those people who went for top surgery alone (more-or-less; I'll explain in a minute) so it can be done, though every time I read about someone's process of healing, I'm reminded that everyone's different. I'm going to give you a day-by-day breakdown of what my experience has been like, so you can think about what parts you think you might need assistance with, ways you can plan in advance, etc.
Before I left, I did some serious prep. First, I bought a plane ticket with a flexible return date so that I could stay longer if something went wrong. It also came with the benefit of a free checked bag and choosing ANY seat I wanted for free, so on my return-flight I booked the aisle seat in the front row of the plane to minimize jostling. I bought about a week's worth of HEALTHY groceries, including heavy stuff like ultra-pasteurized milk and bottled water, and made sure I was set for when I got home. I also bought vitamins, some books and DVDs and stocked up on OTC pain meds. Next, I did all my laundry and changed the sheets on my bed so that I'd have clean clothes and linens. I started to clean my apartment, too, so that I'd come home to a clean house, but I admit didn't get quite as far as I would have liked. I went out and bought two button-up shirts (I don't normally wear button-up shirts) that were HUGE so that I made room for the drains. I packed a bag that put minimal strain on my pecs: what I'd read online was that the best thing was a bag that you drape over your neck and shoulders and carry to the side, like a big purse. I packed it as lightly as I could: my two big shirts, a pair of shorts, boxer/t-shirt combo I wear for pajamas, an extra t-shirt, toiletries, my ipod and a book, and enough underwear to last the week. I wore a t-shirt and sweat pants (nothing tight or required dealing with buckles or draw-strings) and flip-flops so I wouldn't have to fiddle with my shoes. (Clearly I was the pinnacle of fashion). Right before I left I walked around and moved everything I anticipated needing in the week after recovery lower than shoulder-level; a cup, plate, eating utensils, pans, soap and shampoo, medications, took clothes on hangers out of the closet and put them on doorknobs, moved clothes from the top drawer to the middle drawer and left the drawers open a little bit. For whatever reason, the sockets in my house tend to be up high, so I also went around and plugged in my TV, washing machine, etc. Then I informed my landlady I'd be gone for a weekish aaaaand I left.
The pre-op days were jittery and it would have been nice to have somebody for moral support but I wasn't entertaining any thoughts of canceling, so that was fine. The scariest moment for me came when I was hooked up to an IV and being wheeled into the operating room by about 5 different nurses and I suddenly thought to myself, "I am about to undergo major surgery on a perfectly healthy body. This is nuts." - but of course, I wasn't about to back out then.
Day 1 post-op I wouldn't have been able to do it myself. Period. My surgery was around 10am and a night in the hospital was part of the surgery package. Thank god, too, because I had a really rough recovery from the anesthesia. I vaguely remember waking up to take pills and yell for more anti-nausea medication, but the world was spinning horribly so I basically slept through the day and into the next morning. I'm glad no one I knew was there with me because I would have felt pressure to entertain them somehow when all I could do was sleep to keep from puking.
Day 2 was when I started to feel the pain, but it was completely manageable with Tylenol, so I didn't have to deal with the side effects of any narcotics. I managed to crawl out of bed to use the restroom by myself in the morning (this involved stretching my IV as far as it would go, untying and carrying along my little pot of blood/drain - ugh). In the late morning I even washed my own hair in the sink. I was weak, still vaguely nauseous and it took probably 72 hours for the head-fogginess from the anesthesia to completely leave my system. In the early afternoon my surgeon came in to check on me and took out the drains (yes, really early - why, I have no idea...) Then I packed my things, turned down the offer for wheelchair-assistance and walked out of the hospital by myself with my luggage in a side-carry bag. From there a driver from the surgeon's office took me to my hotel.
Within an hour of arriving at the hotel (still Day 2), my friend arrived. I hadn't asked her to come, but when I said I was doing this she insisted on coming as soon as she could to monitor my recovery. I was up and walking around, head mostly clear, in good spirits and not much pain. She was actually shocked at how well I was doing. We left the hotel and walked about a half-mile to the main road where we found a Subway restaurant and 7/11 convenience store and stocked up on food. I could slowly walk up and down steps with no problems, but the *bump* from going down hurt, so I learned to clutch my chest (and tried not to feel girlish). That night I sponge-bathed myself.
The next day, Day 3, I felt a little more pain than before but I just downed more Tylenol. Since I obviously didn't need a nurse, my friend and I made a little vacation out of the weekend. We walked to the main road from the hotel and took a taxi to a tourist area, walked around there and bought some souvenir t-shirts and sat at a restaurant and people-watched through the afternoon and evening. It felt kind of surreal. Whenever I'd start to hurt I'd take a Tylenol and within about 45 minutes it'd be fine.
The next day, Day 4, I felt stronger pain (from overdoing it the day before, I assumed) and wouldn't have felt up to the activities from the day before, but my friend left me alone to attend a meeting with an old colleague. That evening, even though I still wasn't feeling that well, my friend had kinda assumed that I was healthy so I felt obligated to meet up with two more mutual friends at a restaurant after a long walk, but we took a cab back to the hotel. My friend left that night, so then I was alone.
I had my first post-operative appointment with the surgeon on Day 5, at which point he gave me the all-clear to fly. I told him the pain was manageable but that it was INCREASING from day-to-day, which alarmed me. He told me there was no sign of infection or inflammation so just keep an eye on it, and it should be fine. His drivers picked me up from my hotel and brought me back again. I appreciated a quiet afternoon and then I met one of the two friends for dinner again that night at the same place.
The morning of Day 6 I packed my bag and checked out, just utilizing the help of the receptionist to help me close the bulging seams. I had meant to ask my friend to take some of my clothes back with her it reduce the weight of my bag, but I had forgotten. However, there was a quiet moment of reverie as I deliberately draped my only bra over the hotel chair and walked out. I caught a cab from the hotel to the airport. Once at the airport, I quickly grabbed a cart for my bag, well-aware that the sight of a young, seemingly healthy person hobbling along with a tiny bag on a big cart must have looked kinda ridiculous. I was grateful for the checked-bag benefit so as to not have to strain to drag it around the terminal. When I arrived in my home city I took a cab back to my apartment and effectively exiled myself for the rest of the week. I took my first real shower that night but avoided letting the jets spray the stitches directly. I still had to wash my hair with my neck strained downward and my elbows locked at my sides. For whatever reason, the first night home was really rough - I couldn't sleep longer than a few hours when I'd wake up from the pain. I was glad that I had another post-op consultation with my GP the next day.
Day 7 I took a cab to see my GP and she recommended leaving the stitches in for a few more days. She cleaned up the incisions and taught me how to do it myself. She told me to switch from Tylenol to ibuprofen to manage not just the pain, but the inflammation (BEST.ADVICE.EVER) She also recommended I start doing some light stretches/exercises to improve circulation and so later I found some post-mastectomy exercises online and started doing them each day. I walked to the pharmacy to buy the supplies and then the rest of the way home.
Day 8-10 I mostly spent relaxing/recovering/bored at home. After switching to the ibuprofen and starting the exercises, the pain became much more tolerable and it, as well as my range of movement, got a little better each day.
Day 11 my GP took out the stitches. I began wearing a tight t-shirt in place of the bandage, except when I was in transit when I needed the extra support. If I had someone to help me, I'd try wearing my pre-op chest binder since it provides the best compression of anything, but I can't get my arms through the holes without straining my chest muscles. Told myself to give it another week.
Day 12 I went back to my desk-job. I had only told them I was going on "personal leave;" nobody knows that I had any kind of medical procedure, so I took care to hide my discomfort. It was kind of a tough first day because I couldn't lie down at all. By the early afternoon, my chest was really starting to ache and there wasn't much I could do about it. At home I began facing the water jets directly in the shower now that the incisions were scabbed over, but I still avoided scrubbing them.
Day 13 was a national holiday so I stayed at home again. Heh. After the strain from the day before, I appreciated the time to rest, though.
Day 14-15 I was back at work and things were fine (with ibuprofen). By the end of Day 15, though, after only two days of easy work, I was deeply exhausted. I also had a follow-up with my GP on Day 15 and she told me there were signs of infection and inflammation, so I had to step up my daily routine of cleaning, which adds an extra hour to my morning routine.
Day 16 (today) and 17 is the weekend, so resting at home, continuing to do the exercises, and taking lots of time to clean the incisions 3x/day.
On Day 18 work will kick into high gear as I have to start teaching part-time. I'm a bit nervous about maintaining the energy as I'll have to wake up at 5:30am. I have another follow-up appointment with my GP on Day 20 when I will inquire about driving my motorcycle again, which is my only form of transportation.
Other random, last-minute advice and observations:
#1 Don't underestimate the psychological strain of keeping this a secret. Even if the only people who know are online, make sure you have someone you can talk to about this. Ideally, someone who's been through it before and can give you tips and advice and reassure you that this and that is normal.
#3 Remember that even when you're not *hurting,* your body is still undergoing a massive reconstruction, which takes a lot of energy. Try to give yourself ample time to take it easy and, if you can be somewhat open at work, I suggest talking to your boss or at least thinking about how you can lighten your workload for awhile, to ease back into your routine. You'll also feel physically weaker and have a limited range of upper-body motion. Hiding these deficiencies takes even more energy.
So, in summary, basically if you have the money, you can pay people to make your life a lot easier. I strongly recommend having someone - hired strangers, if necessary - be your nurse for those first 24 hours, at minimum. Longer if you have to rely on mind-altering medication. After that you'll randomly need other people to carry things, drive things, open things, clean things, reach for things, etc., but if you've planned well in advance and don't live in the middle of a forest or something, you can probably rely on the kindness of strangers to help you with random favors. I strongly recommend having emotional support available - friends, ideally, followed by a good therapist if you can afford it, but at minimum, support from people online.
Good luck and best wishes.
V
