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Imagine this situation. Sue Chan, a banking businesswoman and the mother of 2 sons and a daughter, has a cancerous breast tumor. As a result, her health care provider has scheduled her for a modified radical mastectomy in 2 days. She is nervous about the surgery and frightened about her postsurgical appearance.
Ms. Chan has taken pride in her appearance over the years and as a business woman, she is concerned about looking her professional best. Now, she wonders how much the mastectomy will change it.
As a support person and caregiver for Ms. Chan, you have the responsibility to minimize her fears by properly preparing her for her surgery. Do you know how to proceed?
First, find out what Ms. Chan knows and understands about having a mastectomy. Try to be with her when her health care provider explains the surgery. That way, you'll know exactly what has been said.
Afterward, determine if Ms. Chan knows and understands what she was told to her by her health care provider. Sometimes, health care professionals forget to speak in terms and phrases that the average person can understand. Also, when a person is upset about a situation, they will sometimes only hear certain parts of a conversation. This may lead to misunderstandings or misconceptions. It is best to review important information for accuracy and understanding. For example, ask her to explain what a modified radical mastectomy is, immediately clear up any misconceptions.
Encourage Ms. Chan to ask questions and answer them completely and honestly. If you can't answer her questions, tell her you'll find out the information she needs. Then, do so.
Also, recommend to Ms. Chan that she keep a paper and pencil handy, so she can jot down any additional questions she thinks of later. But make sure she knows she can talk to you anytime, even if she's too apprehensive or preoccupied to think of any questions.
PROVIDING SUPPORT
Whenever you visit with Ms. Chan, give her the opportunity to talk about her concerns. Be sure to reinforce the necessity for surgery, if this is the situation, and bring up some of the expected benefits. Emphasize the positive side of her condition; for example, the skill of the health care professionals who'll be caring for her and the advances in cancer treatment available to her. Encourage her to discuss her cancer and what it means to her.
Also, arrange to have an American Cancer Society "Reach for Recovery" volunteer talk to Ms. Chan before the surgery, provided that the health care providers and Ms. Chan seems receptive. Because each volunteer has had a mastectomy, she can honestly say, "I understand what you are feeling. I experienced it, too, and learned how to cope."
Be certain Ms. Chan understands that she may be able to have breast reconstruction surgery after the mastectomy. Describe the procedure and provide her with some booklets on the subject. Encourage her to discuss the possibility of this surgery with her health care providers before she undergoes surgery. (The health care provider performing the surgery may modify the surgical technique so that later breast reconstruction is easier.) But make sure that she understands that reconstructive surgery is an elective, not a required procedure.
SUPPORTING THE FAMILY
Take care to involve Ms. Chan's family as much as possible. Remember, their initial reaction to Ms. Chan after surgery will be very important. Explain the tubes, machines, and degree of disfigurement they should expect after surgery.
Keep in mind that not all family members will deal with the surgery in the same way. Try to identify the family member who's best able to cope with the situation. Explain the procedure to him or her, and inform him or her when surgery is scheduled and when Ms. Chan will return to her room. This family member can then relay the information to other family members.
No matter how much client and family teaching you've done before surgery, Ms. Chan and her family may forget a lot of what you've told them. But if you've relieved some of their fears, you've made progress. And, chances are, your client's outlook after surgery will be positive.
MOONDRAGON'S BREAST CANCER LINKS
Learning About Breast Cancer
Learning About Breast Surgery
Understanding Breast Tumor Staging
Familiarizing Yourself With Diagnostic Techniques
Understanding Fibrocystic Breast Disease
Guide To Types of Mastectomies
Patient Preparation For A Mastectomy
Mastectomy Care After Surgery
Learning About Breast Reconstruction
Selecting A Prosthesis
Applying An Arm Sleeve and Gauntlet
Preventing Complications After A Mastectomy
MoonDragon's Obgyn Information: Breast Cancer
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