Post Mastectomy Drainage Prblems

[lb145]

I"m interested in information regarding a continuous collection of fluid post double mastecomy. It is only occurring on one side (the right side) where radiation was given 1.5 years ago. It is very painful and wondering when the fluid will subside?

[keepontruckin290]

A related discussion, Fluid still draining was started.

[lb145]

Hello everyone who has been so helpful with their personal insight and knowledge,

My Mom is now two months post double mastectomy and continues to have the drainage problems on the right side. This is the side where she had radiation last year. So, the Doctor put the drain back in today. My Mom is not a happy camper. She is in pain and I think mentally felt that things would not drag out this long. She has now been told this is the last effort to get things drained before maybe having to go back into surgery to have the tissue "massaged" so that this does not become a long term chronic problem. The last thing my Mom wants to obviously is go back in for surgery. She is now considering a second opinion. Any suggestions?

[lb145]

Hello everyone who has been so helpful with their personal insight and knowledge,

My Mom is now two months post double mastectomy and continues to have the drainage problems on the right side. This is the side where she had radiation last year. So, the Doctor put the drain back in today. My Mom is not a happy camper. She is in pain and I think mentally felt that things would not drag out this long. She has now been told this is the last effort to get things drained before maybe having to go back into surgery to have the tissue "massaged" so that this does not become a long term chronic problem. The last thing my Mom wants to obviously is go back in for surgery. She is now considering a second opinion. Any suggestions?

[lb145]

Louise thank you so very much for sharing your experience. Interesting that in your situation as well, the docs are saying or suggesting too much in the way of solving drainage problems. My Mom's docs don't seem to concerned either but I might tend to agree that it's a developing area of medicine. My Mom goes into the surgeon again tomorrow so I'm anxious to find out the next step. Today for the first time, my Mom said she thought MAYBE the drainage had slowed up but she was almost afraid to say it out loud! Thinking all good thoughts for all of you ladies that have battled breast cancer. I have learned more than I ever wanted to know about it through my Mom's fight. I am however very thankful that modern medicine has come so far with discoveries and treatment for breast cancer.

[Louise414]

One last thing before I forget just in case it helps your mother.  The physical therapists I worked with suggested that I buy and wear a cheap body shaping camisole.  They said it wasn't necessary to buy an expensive pressure garment.  That seems to help a lot for me.

[Louise414]

I should probably mention too that in my case the right drain came loose a couple days after surgery and was removed early.  Then after a month or two when I continued to have fluid accumulation problems, the surgeon put the drain back in.  That second drain was removed about two weeks later, but I continued to have seroma that hurt and made it difficult to sleep.  The outside wound healed fine, but the fluid continued to accumulate.

[Louise414]

I did not have radiation therapy, so that was not an issue in my case.  In my case, I was surprised at how unprepared/unconcerned the general chest surgeon and oncologist were about the problem.  They both must have known it was a problem and both are competent physicians, but neither of them seemed to know how to handle it.  I mentioned this to one of the physical therapists I worked with and she said it was her experience that a lot of doctors don't seem to know how to deal with these issues.  She mentioned that she had one patient whose primary care physician treated her for heart problems when her real problem was fluid accumulation following a mastectomy.  The impression I have based on my experience is that treatments for this are a developing area of medicine.  In the past, not much was probably done.  Now there are treatments, but you have to be your own advocate to find out about and take advantage of them.  Good luck.

[lb145]

Thank you all so very much for your feedback. I am going to share the information with my Mom. Apparently her skin is healed but it's the tissue underneath where she had radiation that is not healing...sounds similar to you Patty, and perhaps Louise, but Louise I'm not sure if yours was not healing from radiation or if it was the outer skin? Either way, you both bring up really important options; both the specialized physical therapy as well as the VAC. I think what we are hoping and praying for is that there is an end to this. My Mom was lead to believe that she would have the double mastecomy and would take about 3 weeks to recover and she would start to be on her way. Her first week post surgery she had virtually zero pain and now a lot of pain and this fluid issue on the right side...seems to all be going on and on and I know she worries that the tissue will NEVER heal and this will now be a lifelong issue. What I'm gathering from you two is positive hope. Thanks again so much for sharing. I'm so glad I found this site. Glad the the two of you are doing well.

[patty223]

I had this same problem. I had a lumpectomy and radiation in 2003. In January 2010 i had a mastectomy. I had to have the doctor drain my incisions a few times with the needle, it got infected and I was sent to a Wound Clinic. The Wound Clinic attached a machine called the VAC (vacuumed assisted closure)  which helped tremendously. It sucked out the fluid like a vacuum. I had to carry the machine with me and sleep with it because it was attached to my chest. It was only about 6"x 6. It fit into a bag like a small purse or you could wear it like a fanny pack. I also had 23  Hyperbaric treatments. The Wound Clinic said because of the prior radiation my tissue would not heal. I am ok now. Good Luck.

[Louise414]

I had post mastectomy drainage problems also on the right side.  I returned to the surgeon several times over a period of months for drainage.  He never mentioned the possibility of working with a physical therapist, but by coincidence, I decided to consult a plastic surgeon about possible reconstruction.  The plastic surgeon immediately picked up on the drainage problems and recommended that I see a physical therapist who specialized in post mastectomy drainage problems.  He even gave me a referral to one.  Because I have managed care insurance, I had to go back to my primary care clinic to get another referral, but did succeed in getting one.  It was a godsend.  This is a specialized area of physical therapy.  Not all physical therapy clinics do it. Over a series of appointments (two or three a week for about 5 weeks) they massaged the area lightly to stimulate the lymph nodes.  I still remember the second appointment when I actually "heard" the lymph fluid become "unstuck" and start to circulate more.  The therapists  also taught me how to do some simple exercises to stimulate lymph circulation in the breast area. I have not had problems since and have not had to return to them or to the surgeon again.  If the situation does not improve, see about getting a referral to a physical therapist who specializes in this sort of therapy..  

[Cheerpul]

I just had my second mastectomy and had lots of fluid buildup with both.  The first time (Oct, 2009), I had it drained 4 times with a needle and the last time was about two months after surgery.  This second mastectomy was 5 weeks ago.  I was drained at 2 weeks after surgery (almost a pint of fluid) and am still slowly building up.  I'll probably need drained again next week sometime at the rate it is progressing.

If it is painful, I would definitely ask to have it drained.  There is always a risk of infection, but a painful seroma (buildup of fluid) outweighs the risk for most people.  The relief is great and felt as soon as the lidocaine wears off.

As a hint, my surgeon always injects the area with lidocaine before he drains the area.  He inserts the needle either above or below the incision line and withdraws fluid.  Once, his colleague drained my seroma.  He does not use lidocaine (commenting, "It's one needle or the other."  Yeah, but it's a thin needle for the painkiller and a thick needle for draining!) and inserts the needle through the incision, which left a small pucker in my otherwise smooth, beautiful scar.  (No reconstruction for me- I'm having a bra-burning party!)  The added bonus was no pain after the draining was done with the lidocaine, but 2 days of achy soreness which gave me a headache with the no-lidocaine job.  Plus, I have had no infection and no marks left from the lidocaine surgeon.  My advice: Call today about draining this and ask for lidocaine.  

It is pretty common, but surgeons do not want to drain a wound unless it is painful and distressing to the patient.  Don't be overly stoic.  You will feel much better soon.  This drainage thing is annoying, but after everything else, it is pretty temporary and can be relieved.  Chances are very unlikely that the doc would need to put a drain back in.  It is most likely just going to need drained with a needle until the excess fluid production quiets down in the next weeks.  I am thinking of you.

[lb145]

Hi there, thank you so much for your quick response. I'm writing this for my Mom. I should be more clear...the radiation she received was about 1 year ago. She had a double mastectomy about three weeks ago. She had two drains put in. Within about one week, they removed both drains. The side that had the radiation (right side) will not stop draining. Her surgeon drained that side with a needle last week and she goes back tomorrow for probably another drainage as the fluid has built up again and is very painful. Makes sense as to what you are saying that the draining won't stop until the area is kept dry. The surgeon told my Mom that only once in 6 years has she had to put a drain back in. I think my Mom is trying to avoid having the drain put back in as it was very painful for her and she's worried about risk of infection. I guess my question for you is-do you see this as a common problem (draining problems post mastecomy and radiation) and how long do you think before it goes away? My Mom has already gone through so much, lumpectomy, chemo, radiation, Herceptin, followed by double mastecomy and is so ready to move on with her life, now this drainage thing is really bringing her down. Thanks for your help!!

[japdip]

I'm wondering if the area has ever been drained and if so, how? I don't believe that this will cease until the area is kept "dry" so that the tissue can "stick" and not leave a void in the area. This is an awfully long time to have drainage that hasn't been addressed in some manner; replacement of drainage tubes is usually done or sometimes the area is drained with a needle fairly often until the amount is reduced to nearly nothing. When the area is kept dry and not allowed to fill with fluid then the tissues can adhere to each other and there will be no more drainage. Have you see a Surgeon about this problem ? If not I suggest you do so as this should not be happening. It is true that Radiation can impair the healing process but after 18 months seems ridiculous.  Regards ..