ALND recovery question

gb2115

Hello all,

I will be having my ALND in the winter, after chemo is finished. I've mentioned it in other threads, but I'm dealing with a recurrence after already having had radiation to the axilla. Radiation oncology won't touch me, and I had macromets in two lymph nodes on biopsy during the mastectomy (which imaging didn't pick up), so off to ALND I go. I'm not thrilled about it, but I'm also not thrilled with potential tumor hanging out in there running amok. I'd rather not have a third recurrence.

I will have nearly exhausted my FMLA by the time this happens, but my work offers personal leave. Unfortunately you have to COBRA your health insurance if you take this type of leave. I can do this, but yikes $$$.

I <<think>> if I'm not out for more than 2 weeks, I can get away with just using straight combo vacation/sick leave.

My question is, for those who have had ALND done, what is my likelihood of a 2 week recovery being sufficient? I have a medical clinic but mostly office job with coworkers who will help me if I ask. Driving is my main concern. I can probably convince my husband (who works from home) to drive me to and from work for a week or so. I've already asked about work from home, but the person making these decisions clearly does not like me and won't accommodate. Anyway, I plan to call my surgeon soon to ask her about recovery time, but wanted to get some other opinions from those who have gone through it.

Thanks in advance!

SpecialK

I had ALND in a separate surgery five weeks after BMX with bi-lat SNB. In the OR my cancer side SNB looked clear, but was not when examined in the lab. My surgeon and MO both were adamant about ALND because I was Her2+. Is the ALND on your dominant side? How do you generally tolerate anesthesia? My surgery was a pretty short outpatient one in a surgery center, I was in and out and home in half a day. I had significant discomfort in the axilla for a solid week with tingling and pins and needles down the inner arm to the elbow, but the second week it eased up. I did have an axillary drain for the first week also, but I don't know how common that is. I generally don't take narcotic pain meds because I don't like how they make me feel - I was ok pain wise on Tylenol if I stayed relatively still. I did have some problems with skin to skin contact - I recommend wearing clothing that lines the axilla as a barrier if you have that happen. I don't think I drove in the first couple of weeks for sure, but I was also recovering from BMX with expanders as well, and the ALND was on my dominant side. My ALND was also just a couple of days before Christmas so staying home worked out well. It is hard for me to answer whether you would be able to return to work because my ALND was so soon after BMX and several other skin closure/expander removal surgeries, but your surgeon should be able to indicate what would be an expected time until they would clear you to drive and return to work, and what is common for his/her other patients. Wishing you the best!

ruthbru

I had 11 nodes out at the same time as I had a lumpectomy. I was teaching at the time and back to work after a week. I drove myself any place I was going after that week without any problems.

MSWife

my hubby had a complicated ALND just under 5 months after his initial mastectomy - complicated because things were quite matted down, but the surgeon did a great job! He says he could have done an office job if he had to - still had a drain in for 4+ weeks that was more of a nuisance than anything. Barely took anything for pain and has some mild lymphedema (slightly worse since finishing rads last week

Hope this helps - good luck!

MinusTwo

I'm not sure when you had your mastectomy. Was that in 2016? Or was that part of a newer recurrence?

I had a recurrence 2 years after the original BMX & reconstruction. Even though I had chemo before the ALND (I too was HER2+) My ALND was also on the dominant side but I had the time to prep my house & food plans before surgery. My son stayed w/me for 3 days, and I was up & going in 2 weeks. SLOWLY, but functioning. I could have worked a desk job if the office wasn't too frantic. I didn't take pain meds for more than a day or two, so I was driving in a week. Granted - it might be good if your DH could take you for awhile since a car accident wouldn't be pleasant that soon after surgery - but I live alone. Special's comments about anesthesia are right on. Since this was my 3rd breast surgery, I had that fine tuned by then as to what I could take for quick recovery. See what your doc says & good luck. Please do let us know.

gb2115

My mastectomy was in June, part of the recurrence. I would have had the ALND at the time but their quick look at the sentinel nodes in the OR didn't show anything. It was found once sent out for final path, much to my dismay.

It's my dominant side. Anesthesia...well, I do great with twilight. Anesthesia from the mastectomy had me puking all night. But chemo taught me that my body treats zofran and compazine like sugar pills and what I really need is loads of phenergan, so maybe we can prevent the nausea better this time.

For pain meds, I didn't take anything once I left the hospital after the mastectomy and node biopsy. The node biopsy in 2016 did leave me in pain and I did use Percocet for a week. Interesting that it barely hurt the second time around. She's going to do reverse mapping, not sure if that will affect pain levels.

MinusTwo

gb - tell the anesthesia department you don't want that same drug again. I had real problems the first surgery & they switched it up. Also ask for a 'scop patch'. You just pop it on behind your ear & it meant absolutely NO nausea after my last surgery.

scaredme

I had my ALND with my mastectomy, so it is hard to say. They did prescribe Gabapentin helped somewhat. I found the ALND similar to the Sentinel node biopsy, but unfortunately, I developed "axial cording" and have had to do PT for it. Best of luck to youi.