Breast cancer treated by day surgery inhumane and sexist?

[Toadlover]

Due for this in 3-4 weeks. Not a tiny lump, a humungous one with lymph nodes.
In my case, a distant hospital (Haywards Heath - and I live in Brighton)
I am 79 and with many comorbidities. I also had keyhole surgery to repair a mitral (heart) valve in May. It seems a good few people vomit after surgery due to the anaesthetic.
I really don't think that I should be sent home the same day. In fact, I don't think ANYONE should !
Any experiences please?
My plan is to demand a night in hospital after the op.

Unfortunately you cannot demand an overnight bed unless their is a medical need. You will need to stay overnight after a GA if you have nobody that can stay with you overnight or that you could stay with. Make sure the team know this before your surgery date to plan for you needing an overnight bed as they may cancel on the day if there is no bed available and they don't know that you will need one (unlikely in a cancer case but not unheard of). Have you had your pre op?

If you are unwell and vomiting after surgery then you would not be discharged anyway, they would keep you in overnight until you feel better.

Many surgeries are done as daycases now, including those to treat testicular and prostate cancer. It is not a sexist principle but about utilising resources effectively- I appreciate it is daunting and it is not appropriate for everyone.

With respect OP, Haywards Heath is barely 10km from Brighton, so hardly distant.
Day surgery is an aim.
I had a similar surgery but ended up staying overnight, due to sickness after the anaesthetic.
You won't be sent home on the same day unless it is deemed fit to do so.

Most countries would not automatically keep you in unless it's a service you are paying for.

Every country is dealing with more patients than they know what to do with and has put as many ops to day surgery as possible. The NHS isn't an outlier on this. Even in the USA mastectomy is generally a day case surgery.

OP I understand you being nervous about surgery but, honestly, hospital is a horrible place to spend the night. I begged to be allowed home the same day I had my hysterectomy and was devastated I needed to stay in for two nights, I had no sleep at all. I was exhausted. It’s hard to recover when you are knackered from a sleepless night!

I’ve had half a dozen (at least) general anaesthetics and have never vomited. DH has also had several GA’s and never vomited. I know several people who have all had GA’s and only one of them has vomited, so please don’t worry about that. You really would be better at home in your own bed.

You maybe need to speak to someone about your worries, but an unnecessary stay in hospital isn’t the answer, neither is ‘demanding’ a stay.

Contact hospital now and explain circumstances. You will need transport and at home nursing care.
Beds can't be magic up. You may end up on a trolley in a corridor

I was sent home 10 hours after mastectomy in 2016. District nurses called daily. It was far more comfortable than hospital.

I used to work on a day surgery unit. We did breast surgery, which is seen as quite minor as it’s not really invasive.

If you need to be admitted afterwards, you will be. If you are fit to go home then home is definitely the best place for you. You will recover so much more quickly at home. Sleeping in your own bed is definitely better than being on a hospital ward. Hospitals are full of germs and sick people. Studies show that day case patients recover more quickly and have considerably fewer complications.

Your anaesthetist can give you an anti emetic to prevent vomiting.

I had a hysterectomy and went home the same day.

As long as medically you are fit and well and have someone over 18 in the house personally I’d prefer sleeping my in own quiet house than a hospital ward.

However if you aren’t happy you can speak to them.

Im sorry for your diagnosis.

In relation to the day surgery they will only send you home that day if you have someone with you all the time for the first 24 hours so if you are living alone and at 79 with other health concerns then they should keep you in overnight. Just have a conversation with them. I don’t know hospitals in your area at all but I’ve recently had treatment for a much more minor breast cancer and all the NHS staff I came into contact with were very helpful.

FWIW I had no problems with sickness after the anaesthetic but I would imagine I was under for less time than you will be, plus I’m younger and no other health conditions. The first OP I had, they sent me home around an hour after I came to, which I thought was a bit soon (afternoon surgery) but I was told to rest and stay at home the next day, with my husband there. It’s important for you to share any worries with the hospital staff and particularly that you are worried as you live alone.

And it isnt a woman only thing with BC. Mh male college had BC surgery and was also done as a day case.

He has also been so good at promoting staff (woman heavy workplace) to do checks.

Kind of envious tbh. For both of mine, I had blood pressure cuffs strapped to both arms and legs that took my blood pressure every 15 minutes for 12 hours post surgery. It was tortuous!

I had a wide incision lumpectomy that was day surgery. What I will say is that I would not have been allowed to go home that day had I not had somebody who could stay the night. I am a lone parent and my child was 8 at the time. If you have nobody to be with you for 24/48 hours after surgery, indeed also able to collect you in person from the ward, it’s unlikely you will be sent home. I was grateful to be able to go home with the help of my lovely friend who stayed for a few days. It was much nicer being in my own bed with my own home comforts.

Well they are hardly going to give her major breast surgery under a local anaesthetic are they? 🙄

WTF is wrong with people on this thread ? ‘Taking up a bed that others need?’ The OP is 79 years old with heart problems and lives alone. I agree the thread title is a bit click-baity but have some empathy folks!

You shouldn't be sent home if you live alone and have nobody who can stay with you OP - or at least you wouldn't be anywhere that I have ever worked. You need a competent adult to look after you for 24 hours after a general anaesthetic regardless of the surgery. It does sound as if there are a number of factors in your particular situation that might make an overnight stay a good idea and you need to discuss this when you have your pre-op assessment.
But for many people day surgery is perfectly safe and is preferred by many. And there's nothing sexist about it. More and more surgery is being done on a day case basis across all surgical specialties, not just those where the patients are women, and across the world not just in the NHS. Improvements in both anaesthetic and surgical techniques have massively reduced the need for post operative hospital stays over the course of my career. Operations which used to require a week or more's hospital stays when I gave my first anaesthetic in 1990 are now commonly done as day cases or overnight stays perfectly safely. It is more cost effective of course, but also better for most patients. However, people are individuals and whilst day surgery may be the norm for a particular procedure it doesn't mean that it is right for every patient. The decision making process includes each person's medical and social situation as well as what they're having done and of course even some people who are planned as day cases need to stay in hospital if they're not well enough to go home after their surgery.
Discuss your situation with the staff - you won't be the first or last person with concerns such as this.
I hope all goes well for you and that you make a good recovery.

To add, I had no sickness after the GA and was in recovery with several other women who had had similar operations. None of them were sick either. Obviously not everybody is the same but it’s not a foregone conclusion that you will be sick. It was my first GA too!

Why should you stay in hospital if you don’t medically need to be there, it’s not a hotel. Why is it sexist? The last place I ever want to be is hospital

Remember that hospital transport can be a bit of a Cook’s tour, taking several times the length of a car or taxi.

My two lumpectomies have been day cases, as was my gall bladder removal and ovaries issue. I prefer to go home same day although as I live on my own I had a family member stay overnight

if you can’t get anyone to stay then tell them and they will either cancel the op or you stay in overnight

If I was nearly 80 with other issues, living alone etc. I would also demand to stay overnight, IF I felt I needed it. The big issue here is going home on the day with no one around to keep an eye.

Honestly the tone of some of your posts is just ridiculously callous and dismissive. Alright to have the surgery and go home on the day if you're say under 40 and otherwise well I suppose. Have some kindness and walk in someone else's shoes now and then.

I agree with pps that you're better in your own home, or as you live alone, could you stay with a friend or family member for a couple of days?

If there are any complications they will keep you in. I've had a couple of procedures under GA, and both times was day surgery, so it is standard now. I wasn't sick after either.

By avoiding a night in hospital, you're avoid a risk of infection, and haveva much better chance of getting some sleep.

Please don't feel awkard about asking friends or family to put you up - you need support going through cancer treatment, people are generally delighted to be able to do something practical to help.

I hope the treatment goes well.

on your own, with no support, a few hours after major survey, at almost 80? I mean really????

I dont see how it is sexist? I have had 3 day surgeries i dont see the issue?

I live close by and am under the same trust as you @Toadlover .

I didn’t have my surgery at HH, but some of my appointments are at the the Sussex Cancer Centre, as I suspect yours are.

I had a lumpectomy and lymph nodes removed as day surgery again with a GA. I gladly went home that night and was fine.

However, when the surgeon visited me in the evening before my discharge, he was clear that if I wanted to stay overnight I would be accommodated, so I’m sure you’ll be advised the same.

Hope all goes well.

My mother in law spent her last 15 weeks of life in hospital she barely got a wink of sleep during the night because there are still ward rounds and well lit up hallways and people going to the toilet and looking for additional support. I wonder if there is a step down care that you could look out for in this instance that would give you a better chance at recovery. I would speak to them about not having support at home after the surgery because you are correct no one should be completely unsupported after surgery. Everything crossed for you that it all goes well.

Another anaesthetist pov….you may be pleasantly surprised by the actual procedure compared to what your imagining it to be. Even big lumps are fairly unstimulating surgery and post-op nausea is pretty uncommon these days, particularly in your demographic and for this sort of surgery. If you’re having a complex reconstruction/will have drains in & whatnot then staying in may be the plan anyway. It there is a medical reason to stay in then of course that will be planned. Most people prefer to go home (where there will be fewer bugs/fewer disturbances to sleep/ better food (hopefully!). If that’s not practical/ you don’t have support then it’s better to let them know ahead of time. There is nothing sexist about any of it - men with breast cancer are also routinely done as day cases.