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The shocks & strategies of surgery recovery
A Series of Shocks
I was blithely unaware of the long-term effects of cancer when I was diagnosed with invasive breast cancer in July 2018. I was confidently told by my consultant that I would ‘just’ need a lumpectomy and radiotherapy. In a few months, I would be finished with this nasty cancer business and able to resume my normal life as if nothing had really happened.
So when my first and then second lumpectomies failed to get clear margins (i.e., margins of tissue around the original tumour that were free of cancer cells) and I was told that actually I’d need a full mastectomy instead, it all came as one huge shock.
From expecting to be clear of treatment in a few months, I was suddenly confronting major, life-changing, body-altering surgery. And when I opted to have the DIEP flap breast reconstruction (which takes fat and skin from your tummy to rebuild a breast shape) I knew I was also staring down the barrel of many months of post-surgery recuperation.
Now, over a year after my surgery, it’s felt like one shock after another. As I confront the visible and psychological scars it has left me with, here’s my top five pieces of advice I would offer anyone in post-cancer surgery recovery.
Don’t judge yourself against anyone else’s recovery
Just as everyone’s bodies are different, everyone’s recovery from surgery is different. There are always a few people who have made apparently miraculous recoveries from their ops and are out running marathons while you’re still in your pjs, bingeing Netflix boxsets.
After my mastectomy/DIEP surgery, I could barely stand up straight at the three week mark and I felt like the most awful failure of a human being when I read of the progress others were making.
But I soon realised my recovery was exactly that – mine. Comparing myself to others was only undermining my own physical and psychological progress. We tend to be our own harshest critics so it’s worth reminding ourselves that we don’t need to be the supermen and women who often fill up our newsfeeds. We just need to listen to our own bodies, be kind to ourselves and acknowledge that there will be good and bad days ahead as healing happens.
Top tip: Start a post-op diary charting your personal progress, with little landmarks like how far you’ve walked that day, how much rest you’re getting, what your pain levels are like and what sort of mood you’re in. Recording even little improvements will help you see that you’re going from strength to strength and give your positivity a boost.
The ‘New Normal’
It can be difficult to accept that the long-term effects of cancer treatment might mean that your body, your energy levels, your wellbeing never quite return to the way they were before cancer. There might not be a route back to the ‘normality’ of pre-cancer life.
It’s not true for everyone of course, but for many there’s a need to acknowledge that instead, there’s a ‘new normal’. This is especially true if cancer surgery has left behind visible reminders such as scars, missing body parts or permanent medical devices. Seeing yourself in the mirror is a constant reminder of the trauma you’ve endured.
When these scars are hidden under your clothes, it’s easy for those around you to assume that you are ‘fine’ now, healed and back to normal, the cancer firmly in the rearview mirror. But learning to acknowledge, accept and adapt to the new normal can be key to physical and psychological recovery. This isn’t a lesser you, just a different you who may need to prioritise activities in order to lessen fatigue, learn some new recipes to manage dietary needs, or ensure your day includes even a few minutes of self-care.
Top tip: the breast cancer psychologist I saw before my surgery told me that the brain has developed a ‘map’ of your body over time and that when cancer surgery makes changes to that map, the brain needs to learn the new contours. Looking at scars and missing or new body parts in the mirror, and touching them, can help the brain the adjust to the changes, accepting them as part of the new ‘map’ of your body.
When you’re diagnosed with cancer, you tend to lose a lot of control. Your diary is full of hospital appointments you can’t miss. Treatment stops you from working or doing fun things and hobbies. How you spend your days no longer feels like something you control, as if your life is being managed by some unseen force, manipulating you like a puppet on a string.
When you’re dealing with the effects of cancer surgery, both in the immediate post-op recovery period and in the longer term, there are some aspects of your life where you can wrest back control and which will have a positive impact on your recovery. Diet and exercise are a good example. Packing your meals with protein rich foods to aid speedy healing and cutting back on those things we crave but which don’t really benefit us, such as sugar and booze, can be a great boost to your recovery.
Healthy, balanced nutrition is the best fuel to help rebuild strength. And getting out into the fresh air for some exercise, even if it’s just to hobble five minutes up the road and back again, also helps you regain your mobility and fitness. When feeling rubbish after surgery it is so tempting to hibernate, curl up on the sofa with the TV remote and the chocolate biscuits (and that’s ok some days, you do need to rest too), but it’s amazing how even a short walk outdoors can lift your spirits and boost your energy levels. Just do what you can, increasing a little every day, and you’ll feel so much better for the exercise and knowing you’re in control of some parts of your life again.
Top tip: Take some company when you go for walks – be it a friend, a pet or even a podcast. Some form of distraction and/or entertainment will make the walks so much more enjoyable.
Ask for and accept help
As a fiercely independent single woman who lives alone and has always provided for herself, one of the scariest things about cancer treatment was suddenly realising that I wouldn’t be able to do everything for myself. My mastectomy and DIEP reconstruction surgery has an expected initial recovery time of at least 12 weeks, during which you’re not allowed to do any heavy lifting or repetitive tasks (such as emptying washing machines, lifting heavy pans, vacuuming etc.). Even getting out of bed is a painful and difficult process, and the basics, such as pulling on your socks, is tricky as well.
I was so terrified of how dependent on others I would become during this time that I almost refused the surgery, until my family made it very clear that they wanted to help.
We are often so determined to be ‘strong’, resilient, independent and self-sufficient while going through cancer treatment, that we can forget that our loved ones feel unable to do anything to alleviate our suffering and worry. They can’t administer the chemo, perform the surgery, irradiate the cancer cells, so they can feel powerless. Asking them for help, and letting them provide it when offered, can be of benefit to everyone. You get someone to change your bedding, take the dog for a walk, cook a meal, while they get to support you and feel they’re doing something positive towards your recovery.
Asking for help is tough – we get embarrassed, feel like we’re burdening someone else, being an inconvenience. But just ask yourself, if the shoe was on the other foot wouldn’t you want to offer help and support where it was needed? Taking the step of admitting you might need some help as you recover from surgery isn’t a sign of weakness. It’s just about the bravest thing you can do.
Top tip: When friends/family/loved ones pop over for a visit after your surgery, ask them to help out with one or two simple tasks – unloading your washing, putting the hoover round, getting some shopping in. It’s easier to ask lots of different people to do one thing, than ask one person to do everything.
Focus on the next small step, not the entire staircase
Recovery from surgery can be a daunting prospect, especially if you’re also still dealing with the after-effects of previous treatment or have more treatment still to come. Being fully physically and emotionally recovered can seem like an impossible dream in some far-off future. But we can only live one day at a time, one small step at a time.
We often expect recovery to be a linear progression from sick to well, but sometimes the path takes dips and curves back into being poorly and it’s important to not think of that as a step backwards. It’s a small blip, a hurdle to overcome the next day or the day after that. Every step, every small bit of progress, every moment of feeling a little better than we did yesterday, or an hour ago, is a building block to recovery. We don’t need to sprint towards the finish. Sometimes recovery is a marathon and we need to preserve our energy for the longer haul. Focus on the next small step forwards and upwards, rather than looking all the way to the top of the staircase and being daunted by the distance left to travel.
Top tip: Set yourself small goals (i.e., walking a set distance, getting out to do some shopping,) and reward yourself when those targets are hit. Buy that extra cake or watch an extra episode of your favourite TV programme. But don’t beat yourself up if you don’t hit that goal today. There’s always tomorrow.
Karen Myers is a blogger, baker, knitter, traveller, theatre-goer and escape room addict. She was diagnosed with invasive breast cancer in July 2018 and has blogged about her experience at atozeeofbc.com
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