Mastectomy Drain & Fluid Volume

hmr

My mother had her right breast mastectomy performed Thursday night ( 4/15 ). She has a ( Jackson-Pratt ) drain inserted ( tubing exits at base of rt. breast with collection bulb connected ). Could any of you please give me some guidance as to how much daily fluid accumulation is typical over the first several days ? Also, she can feel a hard object running under the skin ABOVE the level of the mastectomy. This area is also giving her the most pain. I felt this hard object and it feels to me like drain tubing. Would the drain tubing be inserted that high on the breast area ? Anything else to keep an eye on ?

 THANK YOU VERY MUCH for any feedback !

sweatyspice

I didn't have a mastectomy but I did have a drain.  I can't tell you where the tubing would be located for a mast, but you could certainly feel mine and it was the area that hurt the most.

Likewise, I have no idea about typical fluid output post mastectomy.  I can tell you that they won't remove the drains until the output is less than 30 (mg? I forgot the unit of measurement) per day.  And as much as you want the damned drains OUT, you'll regret it if they're gone too early b/c you'll have swelling and possible other problems.

My Dr. didn't give me instructions on how to properly care for and empty the drain, and I didn't do it the "right" way.  Maybe someone else will stop by to explain how it should be done, otherwise there are sites online which explain it.  I wish I'd known that, b/c I think my drain was removed a bit too early and I had some problems early on.  It's all resolved and OK now. 

Best of luck! 

Anonymous

hmr-

Everyone's fluid accumulation is different.  As long as she is emptying her drains at least twice a day and the bulbs aren't overflowing it should be fine.  If you have any concerns, though, make sure to call the surgeon's office.

The hard object she is feeling is the drain.  It kind of wraps around.  No one told me to expect this, either, so it does feel kind of alarming.  Mine also gave me a lot of pain where the skin jutted out.  Cocoa butter helps keep the skin smooth.  Try not to let anything rub against it.  Is she still wearing an ace bandage or compression vest across her chest?  Sometimes that can make it more uncomfortable, too.  Once her surgeon says its ok to remove the ace bandage I wore a special camisole that has pockets for the drain.  They sold them at the cancer center I went to but you can also get them online.  It was much more softer.  If she's having the drains out soon you may not want to bother, though.

By the way, I though when they removed the drains it was going to be quite painful since the tubing looped around like that but it didn't even hurt.  Tell her to hang in there.  Everyone hates the drains but that part will be over soon.

Good luck!

Kate 

BulldogluvrBeck

I had a BMX 6 weeks ago. I had 4 drains, 2 on each side. The tubes were located above the incision and below the incision. That is what you are feeling. I had 20 to 30 ml each bulb the first few days. Then it went down each day to finally 5ml. Everyone is different. Keep the suction going on the bulb. The more drainage the better.  When the liquid amount lessens up they will take it out. It did not hurt to remove the drains. Sometimes the tubes get clogged and you need to "milk" the tube.  PM me if you want to know how to do it.

The drains will be gone soon enough, be happy they are doing their job. Taking them out too early sometimes causes fluid build up that then has to be aspirated.

Sleeping in a recliner was the best for me. Lots of pillows for support.  Stay ahead of the pain meds and don't forget the stool softners. Constipation can hit very hard and it can be bad.

Take care and hang in there!

beck 

hmr

Update :

My mother's drain has been in since 4/15. She has been stuck at ~ 50 mls./ day for the last 3 days. Her PS won't remove the drain until volume drops below 30 mls. for 2 consecutive days. He mentioned that physical activity will increase fluid volume. She's doing some household chores, washing dishes, etc. but nothing strenuous beyond that. The drain is painful and irritating to the surrounding tissue. Now she's concerned that at this rate the drain will be in for a prolonged period of time. Any suggestions ?

Thanks much.

hbcheryl

The tubing is what she is feeling.  Is she doing the range of motion exercises as that should help with the drainage.  We all drain at a different rate, when I used to donate blood once I got going I was done in less that 10 minutes and some people would be sitting there for half an hour.  I had my mastectomy on a thursday and the drains out on my tuesday appointment but I know someone who was over 2-1/2 weeks.  Good luck.

Cheryl

mom3band1g

I had my drains in for 14 days.  I hated every minute and towards the end they were very irritating to my underarms.  I was dying to shave and wear some kind of deoderant!  My ps wanted my drain amount to be 20ML or below for 2 days.  I called when I had been at 20 and 21 for 2 days and out they came.  Hope she gets hers out soon.  Does she 'milk' them to help get the fluid out?  Maybe she needs to do a little less for a day or two and see if her level goes down.

pamela35601

Hi, I had four drains.  Two of them came out after three and half weeks and I still have the other two in and it's going on four weeks.... !!  Has anyone else ever had drains in this long ?  My PS won't take drains out until the 24 hour total is 15cc for two days.  I encountered PS problems and tissue necrosis so I'm not sure if this is causing additional drainage or what.  I REALLY want these last two drains out.  I'll feel so much better when these pesky drains are out.

leftfootforward

I konw that drains are a pain in the ass. I hated mine.  what you have to remember is that you need them. If they are still putting out fluid you want them in. If they weren't there, you woudl have to go in for another procedure.  They will come out. I had mine in for about 3 weeks.  Besides fluid levels another indication that you are getting better/healing is the color of the fluid.  Less blood is better.  

I don't konw what she is doing to hold the drains but I found wearing a fanny pack was the best way to have them not pull on me.  I was able to go out and do stuff withouth anyone noticing and my skin and tissue were not irritated by the drians pulling this way.  That and a lanyard and safety pins for showering.

best wishes. 

Anonymous

I had six drains following a BMX with DIEP reconstruction (2 for each breast, 1 on each side of my ab).  The first four drains (2 on my left breast, one on my right breast and one on my left ab) came out 2 weeks post-surgery (14 days exactly).  A 5th drain (final breast drain on right) came out 20 days post surgery.  I just had my final ab drain (#6) removed yesterday (34 days post-surgery).

All of my drains needed to be stripped (milked) morning and evening (they did that in the hospital and those were my discharge instructions), then poured into a little cup that measured their output in millileters (ml).  My docs requested that they be below 25 ml a day total, for two days in  a row, before the drains could be removed (30 is not uncommon, however). 

I used pre-packaged alcohol pads to strip the drains and it was pretty easy.  My drain output really ranged up and down and I didn't really find a big difference in output vs. activity level.  They just seemed to to their thing.  Even my last one was up and down between 32-40 for a couple of weeks and I was already gardening and doing light housework, etc. before it suddenly dropped to below 25.

Could be just my experience, but I found my first five drains to be the most irritating right before they were ready to come out.  It was kind of weird.  There was absolutely no pain in removing them, just a slight tug on the last one and it took seconds per drain.  The drain holes will leak a little afterwards so they were all well-bandaged for me and I was told to wait 24 hours before taking off the bandages.  After that, they healed up just fine.

Some of what I thought was drain actually turned out to be scar tissue and/or fat necrosis causing me pain, btw.  I still have that.  The most irritating part of the drains, for me, was the actual insertion site.

Hope that helps a little.

EDIT:  My fluid eventually was all kind of a yellowish color, btw.  They said that any pure white fluid could indicate infection and I did have to record my temp every night.  I used a wide variety of things to hold the drains, ranging from target hoodies with inside pockets, to camisoles with drain holders, to a drain belt, to some weird harness thing they gave me in the hospital.  Different things worked for different events so I wore whatever worked for the situation.  By the end, I had named my final drain (and drawn a face on the bulb) since it felt like my newest best buddy, and carried it in my pants or shorts pocket.  There are different drain bulb sizes, too... and once you can graduate to the smaller size, it reduces the weight and inconvenience tremendously.

camillegal

Well I have to say the drains really didn'tbother me--but u'r mom should not be movin her arms unles todo an exccercise she was told she can do whie the drains are in. Everyone is different and i emptied mine 3 times a day and before putting the top bavk on squeezed it together for no air. I had mine in for almost 3 months-my Dr. didn't even want me carrying my purse (too big he said) I was just aggrevated having them in so long, but no pain really. i would see the Dr. 2x a week and he still kept them in,but wanted to check for infections. so .......,.

Anonymous

Ooh, camillegal is so correct.  Definitely follow your dr. recommendations for arm movement (I wasn't allowed to do any arm movements above about waist level until the drains were out of my breasts).  I'm still on a 5 lb restriction until 6 weeks post-surgery then it's up to 10 lbs for another 4 weeks....although I can now do exercises they gave me for range of motion.

DEFINITELY squeeze the bulb (I folded it in half) before replacing the top.  The drain works by using suction to pull out the fluid so that's a critical step.

Blessings2011

Ysa is right. When my PS saw me in the hospital the morning after my BMX he was really ticked off that my drains were full.

He called a nurse in right away, and told me that no matter how many times I had to empty them during the day, they should never get more than about 1/3 to 1/2 full. Otherwise, there would not be enough suction to remove excess fluid from the tissues.

I don't know how much I drained per day (2 drains in) because DH was the Drain Man. He's a chart kinda guy, and also ex-medic/firefighter.

He always washed his hands, put on surgical gloves, carefully emptied the drains into the cups and measured them, then flushed the fluid down the toilet.

Once the bulb was empty, I would fold it in half, then roll it to remove all the air.

DH would clean the cap and the opening carefully with an alcohol wipe, and put the plug back in. The PS had told us that the drains were a clear pathway for bacteria to enter the system. So we were REALLY careful!

One thing that helped my drain tubes was the fact that I was completely wrapped in giant Ace bandages from my armpits almost to my waist, so I never saw where the tubes exited my body, and they never moved on me.

When my drains were removed at 2 weeks (PSs policy - says that's the max he ever leaves them in) I felt nothing at all.

SaSa7683

Hi all, 

 First question here. My mother's just had a mastectomy on Tuesday. I emptied her drain last night and it was about 35CCs. This morning (approx 12hrs later) her home nurse came and measured and it was 45CCs. Tonight, I went to empty it and there was barely anything at all. And when I say barely anything, I mean, I could see a little liquid, but no matter which way I turned the drain, the fluid wouldn't come out. But again, it was SO little that I just left it. 

My question is...is this normal? I do know that over time the fluid drainage will decrease, but she had said to expect that by Monday, the drainage should be about half of what it was today.

I'm definitely calling her doctor tomorrow, but I figured that I would ask tonight to see if anyone here has any info.

Thanks!