When you get home after undergoing an axillary lymph node dissection, you may have questions on how to care for yourself, your incision, and your drain. Here are the answers to the most commonly asked questions. If you find yourself unable to follow these guidelines, please contact Cheboygan Surgical Assocaites at 231-627-4364 for assistance.
What kind of activity can I participate in?
- Do exercises illustrated in the pamphlet given to you by the nursing staff or Reach to Recovery personnel.
- Continue posture, mobility, and strengthening exercises until you have no difficulty moving your arm in all directions.
- Do not lift more then 10 pounds with your affected arm for 4 weeks.
- Do not drive until after your drain is removed or until advised by your surgeon.
- Do not drive while taking narcotic pain medication.
How do I care for my incision?
- Leave the Steri-Strips in place until they fall off or are changed at your office visit.
- You may wear any supportive garment that you find comfortable.
What about bathing?
- Do not soak in the bathtub while your drain is in place. You may take a sponge bath, but do not get the drain site wet for the first 48 hours.
- You may shower 48 hours after your drain is placed.
- Do not shave or use deodorant under the affected arm until your Steri-strips are removed.
What about my diet?
- You may resume your usual diet as tolerated.
How much pain can I expect?
- You can expect to experience a moderate amount of pain after surgery. Your pain will be most noticeable during the first few days after surgery and should then progressively improve, call your surgeon if you experience excessive pain unresponsive to medication.
- Take your pain medication as prescribed.
- Do not drive, operate machinery or make important decisions while taking narcotic pain medications.
- Schedule your pain medication so that you take a dose ½ hour before doing your exercises the first 1-2 weeks after surgery.
When should I call my doctor or nurse?
- If you have increase in swelling or redness near the area of surgery.
- If you have a temperature of 101.0ºF or greater.
- If you have green or yellow drainage from your surgical incision or drain insertion sites.
- If you have bleeding from the incision which is difficult to control with light pressure.
- If the skin around your incision or drain site becomes hot to the touch.
- If you smell a foul odor from any of your surgical sites.
- If you notice that there is leakage around your drainage tube and the gauze dressing is soaked (larger then a 1 inch area).
- If your drain is left in beyond your first postoperative visit, call your doctor when the fluid in the collection bulb is equal to or less than 30 cc's per day for two days in a row or if you cannot relieve an obstruction in the drain tubing.
- Arrangements can then be made for the drain to be removed.
- If you experience excessive pain, nausea, vomitting or any acute change in your condition unresponsive to medication.
Will I require follow-up care?
- Your first postoperative visit will usually be within one week after discharge. Any further treatment plans and appointments will be made at that time.
- If at all possible, do not allow any blood pressure readings, IV's, or blood draws from affected arm(s) for 6 months after surgery.
- Continue with monthly self breast exam, annual mammography and annual physician breast examination.
Who should I call with questions?
- On weekdays (Monday - Friday) from 8:00 a.m. to 4:30 p.m., you may call our office with any questions. The telephone number is 231-627-4364. Fax: 231-627-7758.
- On weekends, holidays, or evenings please call Cheboygan Memorial Hospital paging operator 231- 627-5601 and ask for the Cheboygan Surgical Associates surgeon on call.
How do I care for my J-P (Jackson-Pratt) drain?
- Wash your hands well and clean beneath your fingernails.
- Strip tubing from the insertion site toward the bulb THREE TIMES a day (more often if there are a lot of blood clots). Grasp the tubing close to your body with one hand and secure against your body. With your other hand, grasp the tubing below the first hand. Pinch tubing tightly, sliding your fingers down the tubing and away from your body; repeat this 2 or 3 times. Be sure that the drainage is flowing into the bulb. (It is okay if the tube becomes flat from the suction.) Pinching of the tube may also help to break away clots or tissue blockage.
- Empty bulbs into a small measuring container 3 times a day (more often if there is a lot of drainage or the bulb feels heavy). You may also use measuring levels/numbers on side of bulb. To do this, open the small lid on top of the bulb and pour the drainage into the container. Then squeeze the bulb and hold while replacing the lid. The bulb needs to be collapsed to be effective. Pin the bulb to your clothing so the weight of it will not pull on the insertion site.
- Measure the drainage and record the amount each time that you empty the bulb. Hold the container at eye level to read the numbers on the side of the container. Read the numbers in the milliliter column and record the amount on the attached chart.
- Once a day, clean the insertion site using cotton tipped swabs and a solution of ½ water and ½ peroxide, or mild soap and water.
- Apply a clean 4x4 drain sponge around the insertion site daily. You may change it more often if it becomes soiled. Call if there is a larger then 1 inch area of drainage on your dressing.
- Your drain will remain in place for 1 to 3 weeks. If your drain is left in beyond your first postoperative visit, call your doctor or nurse when the drainage is 30 milliliters. per 24 hours for 2 days in a row. Arrangements can then be made for the drain to be removed by calling our office at 231- 627-4364.
J-P Drain 24 Hour Collection Sheet
Click on the link below to view a printable version of the Jackson-Pratt Drain, Twenty-Four Hour Collection Sheet:
File Download: 1169657179jacksonpratt_drain_collection_sheet.pdf
Printable Version of Axillary Lymph Node Dissection Packet
Please click on the link below to view a printable version of Cheboygan Surgical Associates' "Axillary Lymph Node Dissection" Packet:
File Download: 1169658024axillary_lymph_node_dissection.pdf
