I don't know from personal experience, but I believe Dr Susan Love (in 'The
Breast Book") referred to the experience of mastectomy with immediate TRAM
flap reconstruction as "like being hit by a Mack truck".  (Her website is
well worth a read e.g.
www.susanlovemd.com/breast-reconstruction/breast-reconstruction.html.).  I
believe that reconstruction adds quite a lot to the discomfort, although I
guess implant reconstruction would not be as bad.  However reconstruction
does mean additional surgery later, which inevitably means more discomfort.

From what I have read and heard, I suspect that recovery from mastectomy
(alone) is often easier than from a large lumpectomy.

Tim Jackson

I had a lumpectomy, but it was a small area and they didn't take any lymph
nodes.  I had no pain at all - never even needed a tylenol, and didn't fill the
prescription for pain meds.  They made me wait 30 minutes after waking up
before leaving the hospital, and have someone drive me, but I was amazed at how
easy it all was & how well I felt.  I took the next day off from work, which
was mainly because I couldn't shower yet & was kind of gross <g>...but I did
clean up that afternoon and went out to dinner that evening. The surgery area
was tender if I might bang into something, but being small-breasted that wasn't
an issue ;-)

Sue - DivaofDVC   aka WDW1972
DVC '97   OKW, Beach Club, Vero Beach, & Hilton Head

There is a lot of individiual variation with pain, depending on the
patient and on the procedure.  My wife, Jan, opted for bilateral
mastectomy (modified radical on the left and simple on the right) with
no reconstruction.  She was able to do her Tai Chi exercises the next
morning.  She had  some tenderness for several weeks, partly alleviated
by a piece of sheepskin worn with the fleece side in, to keep the seat
belt from rubbing the area.  She had some numbness around the incisions
and extending to the upper left arm.  The is slowly improving even yet,
seven yeas after he surgery.

Tim's cautions re:  pain with reconstruction are worth hearing.  Some of
the reconstruction procedures, notably the TRAM flap, leave weakness
that may outweigh the cosmetic benefit.  If your sister-in-law is afraid
of pain, she might find it easie to accept the idea of using a
prosthesis.  Jan planned to do that but later decided not to bother.
She was never very busty and gets along fine being flat-chested.

Robin wrote: << She has a brain
disorder which makes her a little fearful even on a good day, so she's
worried about this and feels she has a low threshold for pain.<< For those who
have had either, can you give me an idea what it felt like
after anesthesia wore off, and how was it before it wasn't painful
without pain medication ...

Hi Robin, sorry to hear that your sister-in-law is dealing with this.  I had a
bilateral mastectomy without reconstruction (although at the time had wanted
immediate reconstruction but won't get into 'that' story now) along with
removal of first two levels of lymph nodes.  Anyway, several hours after
surgery I lay awak waiting for the initial pain medication to wear off.
Finally,  I thought to myself maybe I should ask for something 'just in case'
since they tell you not to wait until the pain is extreme.  So, even though it
isn't that bad I asked for something that wasn't going to make me feel sick
(nausea) or 'that' out-of-it.  They gave me an Activan.  That was all I needed.
If anything hurt it was the armpit area where the  nodes were removed.  I did
not take any further pain meds for that though.  Instead, I used ice packs
which were very effective for me, and personally prefer that to any pain med.
One thing, though, my surgeon gave me a choice about having a nerve completely
cut or leaving it as is after lymph node removal. She told me that some report
a good deal of pain there as the nerve grows back.  That would result in
permanent numbness in that spot.  Because I also have M.S. and in the past had
had a weird type of synesthesia, I told her to go ahead and cut the nerve.  The
time I experienced a problem from the M.S. was after I had given myself an
injection of M.S. med. (betaseron) in my thigh.  For the next couple of weeks
or so, it felt like someone was ripping a bandage that was about 3 or 4 inches
square off the hair of my legs.  That sensation would happen suddenly and
almost feel like an electric shock or nerve pain (which it was).  I had also
had nerve pain develop on my back after a mole had been removed.  I would also
experience a sudden shock-like pain to that area.  So, because the nerve was
involved and my past experience I told her to cut the nerve.  Interestingly,
though, I am not sure she did--at least completely--or cut another nerve
instead.  I pretty much have some feeling, although it is still somewhat numb
throughout my arm, but there is a small area on the side of my chest that is
numb.
Hope this is not too confusing, but you might have your sister-in-law or
whomever is with her ask about the nerve in the back of the arm that could be
quite painful if partially cut when removing lymph nodes and whether or not it
might be in her best interests to cut it.
In addition, I have one other suggestion.   I found the worst part of surgery
to be that awful, yucky feeling  of horrific nausea one experiences after
waking up from the anesthesia.  Before I had surgery again (hysterectomy), it
was suggested that I have the anesthesiologist use the same anti-nausea
medication that is given for chemo mixed in with the anesthesia.  I asked if
they could do that.  They did.  I was pleasantly surprised how 'good' I felt
when I awoke after 'coming to' in the recovery room---there was  no nausea.
Best of luck to your sister-in-law.  Hope all goes well.
As far as having a lumpectomy---from what I have heard that seems to hurt more
during recovery.  I can't compare though since I never had that although am
sure someone here could who had both could advise.  But, also, for those who
have radiation, it appears to be more uncomfortable for those with lumpectomies
towards the end.  Some who have mastectomies don't need radiation.  I did but
only 25 treatments as opposed to 36.  Those who had the full 36 found it quite
painful at the end, although there are special creams to help with that.  The
group of women I met, though, found the last part of radiation quite
uncomfortable, and because of the mastectomy I did need as much radiation.

Hi Robin,

I had a lumpectomy with  all my lymph nodes removed two years ago.
The cancer was quite far back so there was quite a bit of surgery and
sort of a breast lift involved. I had to stay in the hospital three
days while the site drained.  The anesthesia wore off while I was
still in the operating room but the pain wasn't too bad. They gave me
something for it but I can't remember what - morphine?

The next day I was quite sore and was given a plain tylonal  which was
enough.

After that it only hurt when I moved, so I took an advil every 12
hours just to make it easier to get out of bed and move around.

On the third day I didn't need anything and was walking all over the
hospital, although my arms were protecting my chest for a good long
time, maybe a month.

Marilyn

I had both a lumpectomy and a mastecomy, no reconstruction.  Eleven nodes
removed.  I had no pain whatsoever with either one.

Excuse me, I'm going to get gross here:  the only pain I had occurred a few
days after the mastectomy when I still had my drain in.   Getting up from
the toilet, I didn't realize the drain, which at the time was hanging loose,
had somehow caught between the wastebasket and the toilet.   I got a good,
hard yank--nearly pulled the drain out.  Now THAT was pain!

Shirley K.

As someone else has said pain varies widely both in severity
and individual tolerance.  Gloria was in severe pain after
the general anesthetic wore off.  Nurses these days will
pretty much give you whatever it takes to get rid of most of
the pain.  If she's really worried inquire about a morphine
pump.

The longer term pain is the feeling of tightness in your
left arm.  She should be given some special exercises to
keep that arm flexible.  Then she should do the exercises.

Sorry I can't give you much more information. - Tony

Love & Light
Tony Lima

Hi Robin,

I had a double mastectomy in '99, and 21 nodes removed. Was VERY worried about
the surgery until I learned there are basically no major nerves affecting the
breast, which is essentially fatty tissue, therefore nothing to cause pain,
especially since the scar itself would be numb.

That's what I found to be true. The operation itself was essentially a breeze
for me, and while I've had a few ache and 'zap' like feelings in the area,
nothing I would consider pain, or even discomfort that couldn't be eased with
an Aleve or Tylenol.

I've had friends with lumpectomies who indicate theirs was very uncomfortable
on a continuing or recurrent basis, so figure circumstance gave me the easier
way to travel.

I wasn't overly large, but big enough to realize that had the bilateral not
been required, there definitely would have been a 'balance' problem (which, in
turn, affects the other side of the body as it tries to compensate.) -- Would
definitely suggest bilateral is the better way to go for comfort's sake, both
physical AND psychological.

Good luck and God Bless,
Adrienne

As others have said, individuals differ, sometimes dramatically.  I had
bilateral mastectomies with 9 lymph nodes removed on one side, and have
a hard time even calling it "pain".  "Discomfort" seems more
appropriate.  I took prescription pain pills for a few days, then only
at night with regular OTC tylenol during the day, and probably could've
toughed it out with less without major suffering.

I wrote an answer to someone else recently about post-mastectomy effects
& suggestions.  I hope you won't feel offended if my natural laziness
causes me to point it out rather than repeating.  It's at:

http://www.google.com/groups?hl=en&lr=&ie=UTF-8&selm=bnma17%242u15%241%40msunews
.cl.msu.edu

Best wishes to your sister-in-law!

Ann T.
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Robin:

You may tell your sister in law that they will give her wonderful drugs as she
wakes from anesthesia.  My personal favorite is the morphine pump.  You get to
give yourself a dose as needed.  After 24 hours or so, they move on to fun
things like Oxycodone and Vicodin.  You can get anti-nausea drugs with combined
with the narcotics make you sleepy.

I took Vicodin for a month after a hysterectomy.  I only took it for about 2
1/2 weeks after my Mastectomy w/partial TRAM flap reconstruction (this is major
abdominal surgery).

The great news about modern medicine is that you DON'T have to be in pain.  If
one drug doesn't work, ask for another.

People worry about getting addicted.  In spite of what you read, this rarely
happens. You don't get high when you're really in pain and need the pain
killer.

Sassy

Hi Robin,
I had a lumpectomy of a fairly large tumor in 2000, somewhere between
5-6 cm. And I had some lymph nodes under my arm removed. I did not
have reconstructive surgery and the affected breast is only slightly
smaller than the other one.  My pain was not unmanageable; ibuprofen
took care of it most of the time. A lot of the pain I think was due to
the fluid collecting in the breast after surgery; when it was drained
about a month later, I felt much better. I only took ibuprofen on and
off for about a month.

Almost four years later it is still slightly sore to the touch, but it
does not ache.  My prayers go out for a speedy recovery to your
sis-in-law. Stress is probably the toughest part of this whole
experience, IMO.
kaci