Setbacks – Diagnosis Pink

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# Setbacks

Posted on April 12, 2017April 13, 2017 by admin

Post op day 2.

This morning I woke up in pain. After minimal pain post op day1, I immediately went there- I am worse! I needed to collect my thoughts and I went and examined my wound site where the pain was. The pain was coming from my port. It has been red and I was monitoring it. I rushed to see the area and saw with much relief that it is less red but had a large bruise surrounding it. This is a normal part of healing. Nothing wrong. I let my breath out and sighed. I began to wonder though about set backs that women will go through. I thought about what would I say to my patient that had a set back with treatment. Setbacks can be both emotional and physical (medical). They are normal and it would be unusual if you never had a setback. It is important to recognize that and find ways to help yourself during a setback.

Here are some steps that might be helpful:

1. Understand the course of healing. Remember, sometimes perceived setbacks are part of normal healing. In my case, my increased pain came from my bruising and some amount of swelling. I had not been feeling as much pain and had stopped using pain meds and stopped the cold compress on post op day 1. Along with bruising is swelling of the site. Bruising and swelling should peak around 3-4 days. I was day 2, so increased swelling meant increased pain. My site is not more red nor is it hot. I am ok. I took some Tylenol and got some coffee.

2. Know when to call your doctor
Your doctor should give you an information sheet about what to look for and when to call. In general the guidelines post op are
a. Call your doctor for temperatures 101 degrees F or more. There is sometimes a slight low grade fever post surgery.
b. If you have increased redness that is spreading and hot
c. If you have new redness around the incision or there is pus coming from the wound or drain
d. Bleeding at the wound site
e. Swelling in your arm or hand that is worsening. Small amount of swelling is normal for up to one month post surgery and can be relieved with elevation of arm.
f. Increased pain not controlled by pain medications
g. Increased drainage from surgical drain (greater than 240 cc or 8 oz in 24 hours)
h. Misc problems such as shortness of breath, cough, dizziness

3. Eat healthy: it is important to continue to eat well. Make sure you are getting a well balanced meal. With decreased appetite multiple smaller healthy snacks may be easier than eating larger meals. You can check out my up coming wellness section for ideas.

4. Drink plenty of fluids. Being well hydrated can help with body functions. If you have had GI problems or any nausea or vomiting , replenishing fluids is the utmost importance. The new standard recommendations are to drink to your thirst meaning that you drink if you are thirsty. However, the exceptions are if you are immunocompromised, elderly, living in the desert area or undergoing chemotherapy you should drink 8 glasses of water a day.

5. Have a plan: Make sure you know who you can call if you have a medical or emotional setback. What are the emergency numbers? What are your doctor’s hours and who do you contact on off hours? Who can you call just to talk? Or do you feel better writing or going to a forum? Should you have wellness checks? Schedule someone to check in on you while you are going through treatment.

6. Make small goals. Often times when we don’t feel well, we cannot accomplish things we would like to do. This can negatively impact how we feel. Have some things preset up that can be goals you are happy with. For instance, I had premade individual yogurt servings (recipe in wellness section) and was able to feed myself. I didn’t have to depend on my husband and daughter for everything the first few days post surgery. That was a good goal for me and helped my mood. Find goals that are doable and set them up a head of time to make them possible

7. Use relaxation techniques such as muscle relaxation techniques or imagery.

8. Consider counseling, therapy, or support groups. You do not have to have clinical depression to go to therapy of any kind. Sometimes therapy can help prevent us from become clinically depressed. If you feel you are clinically depressed then please seek help. There are multiple support groups as well as places to get individual therapy. Resources such as the American Cancer Society can connect you with a local group. You can call your church and ask them about counseling services. You can also find local mental health services by calling a hospital near you that has mental health department. The intake for the hospital programs can also give you referrals to other community mental health centers. Therapy can be either supportive therapy (you talk to people for support and listening), Cognitive Behavioral Therapy or Insight oriented therapy. Cognitive behavioral therapy helps to look at our automatic negative thoughts (thoughts that come up automatically when something goes wrong) and helps to change them to be more positive instead. Insight oriented therapy looks at reasons of why your response is causing your mood symptoms and finds ways to change your patterns.

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