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.

For really high risk people breast surgery can often be done with loco-regional anaesthetic rather than GA - depends on the patient and the lump/operation planned, but sometimes the GA is optional.

Breast cancer also affects men, although not as many as women. My experience of breast surgery is that I had to go back to hospital to have fluid drained after a couple of days, so it’s helpful to have someone on hand to drive you. Otherwise I’d rather go home the same day.

She'd rather have a GA? Eh?
OP has said she's on her own. She's probably scared to be on her own immediately after having major surgery. Have some empathy.

@Toadlover you sound very overwhelmed and frightened by your situation and the prospect of having surgery as a day case. Do you have anyone who can stray with you for a few days post op and to offer you some support?

Have you had your pre op appointment yet? That would be a good time to outline your fears and see if they can be addressed. If you are on a day surgery ward then demanding to stay isn’t really an option as they are closed overnight. Of course sometimes they have to find a bed for someone who is unwell but that’s not necessarily easy.

Id recommend calling one of the breast cancer support lines to discuss your worries and also looking at what you can do to ease your recovery. Could you afford some help in the house for a while?

Good luck, sometimes the things we are most worried about turn out to be fine. In this situation it may be best to keep an open mind.

nb both SIL and a friend have both recently completed BC treatment. Both doing well and hospital stays very minimal.

When was the last time you had a hospital stay op? It's not a very restful experience any more and most people would opt to get out as fast as they can. Obviously that's more challenging if you have no one to care for you afterwards and a hospital won't discharge you unless you are fine to be up and about. You could prepare before hand getting freezer meals prepped, get the things you will need in one place.

I was in hosp after my lumpectomy - got offered no food after op and couldn’t sleep so interminable night and breakfast ,toast I think, at 8.30 - awful -I would have loved to go home

I think day surgery is generally better for if possible. You can try to get comfy on your own bed or sofa. That said you definitely need to drive you home and keep and stay with you for the first few days. Do you a friend who could drive and stay at yours until you are up have managed a shower etc. If not speak to the breast care nurse for putting help in place. Good luck for your surgery.

The hospital isn't a hotel.

Find a hotel/ Premier Inn nearby amd book yourself in for the night before and day of surgery. Rest up. Take it easy the following day. Get someone to take you home.

Best wishes for your surgery.

You should have the choice, though as others have noted, being back at home may be the better one.

I’ve just had a mastectomy and sentinel lymph node removal as a day case and it’s fine. Not sure what the issue is with a lumpectomy as a day case?

do you have several comorbities? do you live alone? are you 80?

OP - in your shoes i would also prefer to stay overnight, do you have someone who can take care of you at home?

crass suggestion.

I am sure the hospital will not just discharge you unless you are clinically fit to leave.

I had right side mastectomy and lymph node removal in January 2024. The plan was day case and to be sent home same day. I had some complications and became unwell and ended up as an inpatient for 2 weeks.

I then had left mastectomy in February this year. The pre-OP assessment nurse booked me a bed for one night just incase the previous problems recurred. This time everything went well, I felt fine afterwards, and had to spend a miserable night in hospital when I just wanted rest which is impossible in a hospital ward. I'm very grateful for the care and the staff were truly angels, but hospital isn't the best place to be unless really needed for medical reasons.

You will have to attend a pre-op clinic where they make sure you are fit for anaesthetic, discuss your concerns with the clinic staff and make sure they are aware of your home situation.

Good luck for your surgery. I hope it gets all of it and starts your road to recovery and that you heal really well.

I know you’re probably quite concerned about being discharged after something that, might not seem like a big procedure when it’s not happening to you, but can be really frightening when you think about being left on your own. Tell them about your worries before the Op and if they have any borderline concerns, they’ll know whether or not you being alone will make a difference to their decision. I’d also contact McMillan nurses and see if there’s anything they can do to help, like pop in to visit you, or even just reassure you and answer any questions. Or arrange to call a friend just before bed time and by 9 am the next morning. Have a bowl next to your bed so you’re not running to the bathroom if you react to the anaesthetic. Keep your phone by your bedside so you can call for help if you need to. All of this is going over the top, but if it’s worrying you then it might help put your mind at rest.

Start thinking about what you’ll wear while you’re healing. You’ll want soft, breathable fabrics. Nothing with lace or buttons or plackets that will rub against your wound. Do you have one of those V shaped pillows? If you can afford one, that might help you sleep more comfortably. If you’ve got time, change the sheets and give the bathroom a good scrub before you go in, so it’s nice and clean to come out to.

My mum was 40 when she had a double mastectomy and lymph nodes removed and it took ages to heal. She eventually cut all sugar out of her diet completely (probably something she’d read in the Daily Mail 🙄😁) and even her consultant was amazed at the difference in healing and the skin growth, so something to bear in mind, especially if you have other medical stuff going on (obviously I am not suggesting that cutting out sugar is a substitute for actual medical treatment because it’s not; she had chemo too and wouldn’t have survived without that, but in terms of healing surgical wounds, it can’t hurt).

Good luck, you will hopefully be home and back to normal in no time at all 💐

Firstly, really hope your surgery goes well.

I'm not sure this is sexism, I don't think they keep men in for very long either. There are good reasons for the NHS to want you home I think, including the infection risk of you staying in hospital.

However, if you have no one to help look after you I think they should consider keeping you in overnight really. Care in the community can be patchy in its delivery.

I know this is a total long shot but a friend of mine who is a similar age and widowed has stayed a retired member of her Trade Union (Unite) and after surgery she applied to them and stayed for a week in a convalescent home in Eastbourne. If you're a member of a Union/ Friendly Society/ Social Group/ Benevolent Fund, it might be worth checking whether they offer any kind of convalescent grant or nursing grant?

She’s nearly 80. She has other serious medical stuff. She’s on her own with no one to keep an eye on her if her heart starts messing about. She’s clearly very frightened.

Can you genuinely not see that?

Its not sexist. Men get breast cancer too.

Kindly though, OP, discuss your circumstances at your pre-op. They will discharge you when it is safe to do so, not before.

If they deem her needing to stay, she will stay - however, if she is healthy enough to go home with support, then.... she should go home

I would much rather go home asap. Hospital isn’t a nice place to test and recover. Hope it all goes well!

Personally I’d rather go home - if you're going to catch an infection, hospital is the place to do it. Plus no sleep, awful food, other annoying patients!
If you’re adamant that you do want to stay, is there a private wing you can spend the night? Our big hospital has a floor of private en-suite rooms that you can upgrade to if you’d like to pay for the privilege. Think you’re only allowed to do book in there if your just needing care rather than nursing though.

that would not be appropriate if the problem (as the OP describes) is that they have no support. Safe discharge post-op does need for there to be a sensible adult present for at least 24 hours whether that's at home or in a hotel. If that isn't possible then the hospital does have a duty of care to the patient that goes on a bit longer than it might otherwise do.

MN seems to be completely clueless about 'social' admissions post-op (saw another thread y'day I think on a similar theme). It really isn't uncommon for people from all walks of life to not have social support and need slightly different packages of care than people who have more involved networks. Equality of care doesn't mean treating everyone the same and kicking them out of hospital because 'the operation's a day case operation', but means that everyone has the opportunity to have the operation they need in a safe way...not much point surviving surgery if you go home, fall over and spend the night on the floor with a broken hip because no-one's there to notice. Perhaps if we lived in a nicer world people wouldn't be so absorbed in their own important little worlds that they'd notice the challenges that other people have...

I don’t think it’s inhumane, nor is it sexist. Plenty of male issues are treated as day cases too.

The sad reality is the NHS has been stripped back to its bones and there isn’t the money there. I was in for an op last week and two women had been treated for breast cancer. They both came out of surgery after me and went home before me! A potential adverse reaction to anaesthesia isn’t a reason to be in all night and they will ensure you’re medicating so that you don’t get sick.

You will be told YABU because people’s expectations in the Uk are woefully low due to the terribly underfunded and not fit for purpose NHS.
You might get a sandwich and a big of fluid in your arm after you come round. An a room to recover in before you are collected. That was my Mums experience anyway.
Its not really good enough

PS my Mum was not allowed to leave the ward unaccompanied- I went and got her and we walked slowly to my Dad who was waiting outside with the car. The nurse when she called was quite clear that my Mum had to be collected. If you have no one to collect you then you should definitely make them aware of this

I went in for a mastectomy with lymph nodes. I arrived at 7am, went down to theatre at 10am. Was out and awake by 11.30 and back on the ward at noon.

It helps that the operation does not involve moving other organs around, as this is what causes a lot of post-op pain and swelling.

I was able to go home that evening with a pressure dressing and drain. I didn't even need paracetamol. I didn't find it inhuman or sexist.

The only painful part of the whole process, was the removal of the drain, a week later, which hurt like hell, but was relatively quick.

Good luck. I hope you are through and home with your creature comforts around you as soon as possible. xx