Pain

You are still very, very early days in terms of healing, so swelling and pain is pretty normal, in general.

The hardness feeling is usually just normal swelling.

Seromas and hematomas usually feel squishy, kind of like water under the skin, and hematomas tend to be sensitive/painful to the touch.

If the skin itself is hard, it may be that it's just dry or, if it's near the incision, that may just be how it feels while healing; the areas closest to my incision scars are 'harder' feeling than the surrounding skin due to swelling and having been pulled tight from the stitches. That should resolve itself in 3-6 months normally. My scar lines and the skin immediately above and below them feel like little ropes to me, but they continue to soften and flatten every day as I heal and due to twice daily massage of the area.

I do have a small dog ear on the right that feels 'hard' due to the fact that it's raised scar tissue AND is still swollen; that, we're keeping an eye on as dog ear revisions are pretty common for people who had larger breasts or who are overweight.

It's also normal for the incision/scar line, and the skin nearby, to feel 'hard' in comparison to the surrounding skin; massage with oil or lotion (I use emu oil and aloe butter on mine) can help and can help the scar from forming adhesions as well, but while it's still early days healing it's always going to feel a bit like a little rope and not like normal skin. For most people that will resolve with time (think in terms of a few months instead of a few weeks), and with regular massage of the scar tissue.

Just something to keep in mind overall: It can take 6-12 months for the swelling from a MX to fully resolve and go away, and you're not considered 'fully healed' from the procedure until about a year out, so at less than 3 weeks out it's perfectly normal to still have swelling and 'hard' feeling spots, and mild (not to mention random) pains while the area heals. At 5 weeks out the space where my breasts were is still 'hard' feeling and a little tender (feels like a deep bruise) if I press on it too hard while massaging the area. I still get occasional 'zingers' where it feels like I've had a small jolt of electricity or a cramp go across the area, which is also normal as things reattach to the chest wall, nerves reconnect, and swelling starts to go down. As a bonus, it's sometimes internally itchy too, which is a very strange feeling.

Most of those sensations gradually get less intense and are fewer in frequency as healing goes on, but for a small percentage of women, they still occasionally have neuropathic pain even years after their mastectomy; for most it's not debilitating and is just an occasional irritation though.

Overdoing it with reaching, lifting, or physical activity early on can cause an increase in swelling and pain as well, so be sure you're taking it very easy, especially less than 3 weeks out. Even if you just had the surgery on one side, doing too much with the side that wasn't operated on can still cause problems as your body doesn't know to just not try to 'use' one side of your set of chest muscles.

What "overdoing it" means is different for everyone as everyone's body heals differently, and for some people it can be something as minor as, "I reached too high into a cupboard to get a glass."

I'm not sure what your surgeon gave you for activity advice, but the advice I got was, for a minimum of 3-4 weeks do as little lifting, pushing, pulling, stretching as possible and just enough to keep from getting stiff shoulders and arms; at 4 weeks, I was allowed to start SLOWLY and gradually doing more, at 5 weeks I'm finally okay to walk the small dog (but not the big one) again and to take short bike rides (you lean on your arms and use your chest a lot in bike riding apparently!) and to lift 10lb "if it's comfortable, if you feel any pulling, tightness, numbness, or pain, stop and lower your weight restriction again for another week". When they say take it easy, they really mean it. I overdid it a couple times early on because I was sick of not being able to do anything, as I'm usually pretty active, and really paid for it the few days following in terms of swelling and pain to the area.

It's really easy to overdo it too, especially if you don't feel pain while doing what you're doing and instead just feel a pulling sensation.

For general pain, after the first week, I just took Tylenol every 4-6 hours and it kept things at a dull ache level. I think I did that from about weeks 2-3, and after that, I found I didn't need it anymore. Advil, for me, works best, but it also increases the risk of bleeding and potentially a hematoma, so I avoided taking it at all for anything until about week 4 just to be on the safe side.

At week 5, I haven't needed it at all, though I do get a little achy by evening if I don't wear my chest binder during the day.

With that in mind, if the area is too painful to even touch, feels hot, swells even more, leaves you with a feeling of 'fullness' sort of like a chest cold might, or if it turns bright red, if it's too painful to function, if the pain doesn't lessen or temporarily resolve with painkillers, or anything like that, contact your doctor as those can be signs of infection or complications, but general, tolerable (even if it's annoying) pain is pretty normal as things heal and nerves start to reconnect and come back online.

Realistically, you'll have some level of swelling and 'hardness' feeling to the area for a good 6 months; if you're having radiation done on the area or chemo, the swelling may take a bit longer to resolve though as both of those things can slow healing a bit in most people.

Yeah, my PS said that too, with the caveat of everything else about not overdoing it. Kind of hard to reconcile those two pieces of advice sometimes as 'back to normal' for me meant being pretty active and, for the first few weeks, that was just beyond the realm of physical ability while I was healing.

That always struck me as a bit strange, because a lot of what I do in my normal routine was beyond my physical capabilities for a few weeks (unless I wanted to injure myself!), but I understand where they're coming from from a psychological standpoint.

It helps you to feel mentally better if you can return to something as close to normal as soon as possible, but phrasing it the way a lot of doctors do makes it easy to overdo it as your mind goes to, "My doctor said to get back to normal ASAP!" and kind of filters out all the stuff about taking it easy and not overdoing it.

It just doesn't always mesh up with what's physically possible during the first few weeks of healing and it can be difficult for some people to deal with the mismatch between "Get back to normal ASAP" and "I physically cannot do this right now, check back next week."

It's super frustrating during the initial healing period; I'm JUST at the point, 5 weeks out, where I can mostly reach over my head and get dishes down from the cupboards without having to grab a dang step stool to reach them (or ask my husband). I'm still not allowed to walk our German Shepherd, who is 100lb, for another few weeks simply because of his size and strength and the 'what if he forgets his manners and pulls while you have the leash? You could tear something!' aspect. They want me to wait 10-12 weeks before walking him again.

Prior to surgery, I was pretty active with biking, yoga, dog walking, all that fun and I've had to basically scale back to walking for the last few weeks; at 6 weeks I can 'very carefully' start bike riding and basic yoga moves that won't require I use my chest muscles for the majority of the balance/hold parts of the moves.

At 8 weeks I can "gradually ramp it up" and even then I have to be careful with anything that requires heavy use of chest muscles for a few months before it'll be safe to just go like I normally do. I know I'll be able to do all of those things eventually, but there's always that part of my brain that says, "But, I want to do it NOW!", just like a bratty little kid.

I guess, on the plus side, I've walked—according to Pokemon Go—119km since July 7th, so it's still possible to get in exercise, it's just slower forms of exercise than I'm used to.

Frustrating, for sure, and I have to force myself to slow down and take it easy as not doing so will just extend my healing time and make it even more frustrating.

Those zingers are normal, at least, it's just nerves repairing and reconnecting; I found mine were worst between 2-4 weeks, and after 4 weeks I rarely get them. It went from multiple times per day to maybe once per day if it happens at all. For most people, they decrease in frequency and go away entirely after a few months.

For me, they're kind of easy to deal with as part of the issue I had prior to my BMX was chronic 8-9/10 on the pain scale breast pain due to fibrous, cyst-y breast tissue so those zingers and aches hardly register to my brain as 'pain' at all after 20+ years of the chronic pain.

As for work, it depends a lot on what kind of work you do. I have a desk job, and usually elect to have my desk in a standing position. There isn't much lifting of anything, the heaviest thing I move around is a 5lb laptop (and even then, rarely), and I was good to return to work after 2 weeks. I did one week off, one week working from home, and really could have probably gone in for that 'work from home' week. At week 3 I was back in the office and it wasn't too bad.

The only thing I couldn't really do, and have only been very recently able to do, is open the heavy stairwell doors with one arm; I had to do a full body push on them or open them with my hip otherwise it pulled too much on my chest. They're VERY HEAVY doors!

I'd say at 5 weeks I feel pretty normal at work (though I still use both hands to open those dang heavy doors just to spread the weight load out), they only oddity I get is that I occasionally become hyper aware of the numb-under-the-skin areas on my chest and it feels strange. Not painful or bad, but my first thought is I have very specific 'tight spots' on my shirt before I realize it's just the sensation of the skin having sensation but the underlying tissue still being numb. Nobody realizes that but me, however, so it doesn't really impact my work.

If your job requires a lot of lifting of things over 10lb, you may need to ask co-workers for a bit of help for a couple of weeks after you return or may have to temporarily have duties rearranged so you're not doing so much lifting that soon, but for regular standing/walking around or desk work, going back after 29 days shouldn't pose a problem. Most employers (and co-workers) are pretty decent about being accommodating to someone who recently had major surgery, so hopefully that's the case where you work as well.

You should get the discharge checked with your surgeon.

Also, get used to the "zingers". For a couple of years after the mastectomy, you will get all kinds of weird sensations in the mastectomy area as nerves that were cut during surgery start to re-grow. Usually the sensation is like having a small electric discharge in a spot inside. To me it felt like there was a little worm wiggling and zapping me.

No worries, it won't last that long. Good luck with the surgeon, I hope it's nothing serious.