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.

They did this to my mum who had a mastectomy a few weeks ago, sent her home the same day, she's in her 80s! I thought it was awful, my dad is incapable of looking after her, she booked herself into a nursing home and stayed there over a week before she felt able to go home. Is that an option for you? It's expensive but maybe if you just did a couple of nights?

@Sachakan

most countries charge you for your bed and food (some expect a family member to help with care too) systems vary!

most western countries have day surgery just like us and keep you in overnight only if medically required, if you need care for social reasons they contract to a care facility to provide care whilst you recover. That said if the op wasn’t fit to go home they will not hesitate to keep her in - they cannot magically know her home situation, she needs to tell them she lives alone and cannot arrange for family or friends to stay to look after her, social services may be able to help too

If you're well enough you'll go home, if not you'll stay in hospital. Many surgeries are day case now as GAs are safer with shorter recovery time. I've gone home 3 x after GAs on the same day - inc an open groin hernia repair (that was probably the hardest). Prob had the op around early afternoon and was home by about 8.30pm. You will need someone to stay with you for 24 hours after GA as well.

It sounds like the biggest issue is that you live alone rather than that you have a medical need for hospital care. I had cancer surgery a bit over a year ago (not breast though) and I was pretty poorly afterwards and had to stay in for definite medical reasons. However, as soon as I was allowed to leave because it was medically possible for me to leave, just getting home made a huge difference to my pain levels and how unwell I felt. Hospital is not a great place to be, you only benefit from being there if you have medical need and actually have to have highly trained staff on-hand. Being at home, in your own bed and away from the noise and lights and bustle of the ward, your tension/stress levels reduce and your whole body relaxes, and you can start focusing on actual recovery. Don't demand to stay in any longer than is medically necessary (they will not attempt to discharge you if it is medically necessary of course - any planned day-surgery may end up with admission to a ward if needed). Instead, make plans to ensure you have proper support and care around you - paid for if you can afford it, or accessing social care if you don't have your own funds.

OP's MDT would have discussed all this - including her age and comorbidities - when scheduling her surgery. If they, particularly OP's consultant (not to mention the hospital Registrar) felt there was a risk, she would not have been booked in for day surgery.

A plus of this surgery (as well as OP's) is the amount of morphine they inject into the area before they bring you round. As a result, it's pretty incredible how little pain most feel after breast surgery. Discomfort yes, pain no.

And yes, the drain removal is a whole other horror! Sympathies!

OP, if you haven't yet been told, be sure to take front opening/fastening clothes with you and to ensure you won't have to reach up for things when you're back at home. You will probably find it more comfortable to sleep sitting up/against a lot of piled up pillows for the first few days/week. It is good to think about and prepare your bed/house a few days before surgery.

This is fundamentally to do with NHS cuts and low bed numbers/staff, imo.

I’ve had many surgeries. I’m in the 0.5% of people who do not handle anesthesia well at all and have to have alternative plans worked up before surgery and even then it doesn’t always go well. I’m always desperate to get home and get actual rest so I can recover.

YABU to think you have the right to demand anything in hospital and for claiming sexism. Playing the sexism card with no reason diminishes your valid concerns.

YANBU to not want to be sent home alone after surgery.

I worked in a day surgery unit decades ago that involved people having procedures under full incubated GA. They will discharge if medically fit. It isn’t sexist in the least, your issue is after care alone at home. My MIL had a lumpectomy 2 months, DH went to stay with her for about 10 days after. Can you get anyone to come and stay?

This. It's better to be at home.
I had a mastectomy and lymph clearance. I'm in Spain and they keep you in here. It was horrible. It's much better to be at home where you can get proper rest without other patients and their visitors bringing their germs in and eat food you like

Surely they won't let you home if you are too unwell to go home. I'd not be demanding anything but if I didn't feel well enough to leave then I would speak to the Dr.

Haywards Heath is less than 15 miles from Brighton and a very good hospital

I travelled double that distance for 3 months to visit my DD when she was in Haywards Heath without being ungracious to the NHS who have saved her life twice

My other DD had to travel further than that to give birth and will shortly do so again

Many people have to travel a lot of miles to get the specific care that they need whatever their condition/illness

Not sure why you think it's sexist.
My DH has had 2 ops involving GA in recent years. Both times he came home the same day and was glad to.

i have had a lumpectomy with sentinel node biopsy and it’s standard to be a day case, unless you are too unwell
to go home after. I went home at 5pm after a mid morning surgery. I then needed my nodes clearing a month later which would also be day surgery but I was in a lot of pain and I stayed overnight so we could get on top of that and went home the next day. A day case is not a bad thing. You may not rest as well in hospital. You do need someone with you for 24 hours after a general and so you need to discuss what support you have with the hospital. You can’t lift anything remotely heavy or do housework for a couple of weeks after the op so do make plans for easy food and seek/accept help from others. I wish you all the best for your op and your ongoing treatment x

I had a lumpectomy some years ago and was due to be day surgery but ended up staying nearly a week as wound kept bleeding and had to go back to theatre for revision surgery and also needed blood transfusion. Be careful what you wish for!

I agree it seems ludicrous, but my sister recovered far better and quicker from her day surgery than she did from a week in hospital a few years earlier for the same operation (mastectomy.). The hospital did say they would keep her overnight if she had nobody at home.

Honestly I can’t imagine anything worse than having to stay in the hospital. It’s hot, unsanitary and loud. I should imagine you’d be much more comfortable (and safer from infection) at home. Have you got someone in your life that could stay with you for a few days?

Hi. I had my lumpectomy at Crawley as a day case. Unfortunately, I was the last patient in so didn’t get done until after 6. Pm. Therefore didn’t get home until after midnight. I mentioned to the anaesthetic chap that I vomit so he made sure to give me anti puke stuff and it was fine. Unfortunately my margins did not clear so I had another surgery the month later as a day case, then another one a month late and then a final one a month after that. After all of them I was up and pottering around. After the third one, I flew back down to Cornwall to continue my holiday. As long as you have someone at home who can make you tea, etc, then it is fine.

The problem is that if people need an inpatient bed after an operation they are much more likely to be cancelled. The hospitals are full to bursting much of the time and if they don’t have a bed you will be cancelled. At least by making these procedures day surgery it keeps the lists going and the procedures completed.

I work in ICU and we often have people that have been cancelled 4 to 5 times due to the lack of an ICU bed being available.