Go Buy A New Bra! … and other things a woman should do before a surgical ablation

So you’ve scheduled a surgical ablation to cure your atrial fibrillation, but do you know how to best prepare for the procedure?

Make time to do the following things before your surgery:

Go Buy A New Bra.
In fact, go buy a few.  You will want to wash them often to be sure you are keeping your incision(s) clean.

• Choose bras with a soft band and avoid underwire bras.
• Ask your surgeon where your incisions will be and avoid bras with seams in those areas. Even ask your surgeon to mark with pen or marker where your incisions will be to aid in trying on and finding bras that won’t rub those  incisions.

If you are having an open-chest procedure you will need a bra:

• A full band-size larger (the girth of your chest will be larger after surgery).
• With a front closure because if your sternum has been cut, reaching around back just won’t happen.
• A very soft bra for sleeping.  Having support 24-hours per day will help limit pulling on your incision and sternum.  Sleeping with a small pillow or cushion between your breasts for support can make sleeping on your side more comfortable.

Go Buy Some Gauze Pads.
When you have incisions around the bra area, you are going to have rubbing and bleeding. It is important have large gauze pads or bandages not only to cushion and protect the incision, but also to protect your bra and clothing from bleed through as well . “One of the challenges after surgery was getting dressed up — how could I keep the bleeding from coming through and ruining my really good clothes?  Think through that before you have surgery so you are prepared,” advises Mellanie True Hills, who had a surgical ablation and is the founder of the patient resource StopAfib.org.

Even after you heal, your bra can irritate your scars.  Choose your bras wisely. Cushion the band if needed. “I often have a tissue stuffed under the band of my bra right between my breasts,” shares Eliz Greene who had open heart surgery.  “It depends on the time of the month, but it can be irritating and a little cushion helps.”

Schedule a mammogram.
“It is a good idea to have the mammogram before surgery to get a good baseline and then have 12 months to heal before you have the next one.  The thought of having to deal with a mammogram within three to six months after surgery is frightening,” cautions Mellanie.

“But mammograms are even more important after chest surgery as scar tissue can mask a lump.  You need to be even more consistent with mammograms,” explains Eliz.  “Even if you are not at the recommended age, you should have a yearly mammogram anyway to be safe.” You may need to discuss with your doctor how to get insurance to cover it if you are below their recommended age.

After you heal, make sure you discuss your scars and sensitivity with the mammogram technician.  If you have an implanted device, make sure they understand the compression must be done slowly and cautiously so as not to dislodge the leads.

Think about your hormones.
Estrogen can make you feel pain more acutely.  If possible, schedule your surgery right after your period to allow for as much healing before your next period, influx of hormones, and breast tenderness.

Ask What To Expect To See.
It is okay to worry about how it will look! “After your heart is fixed, you will be living with the scars for a long time. That’s the point — to enjoy a long life after surgery,” says Eliz.  “You shouldn’t be embarrassed to ask where your scars will be, what they will look like and what you can do to reduce their appearance.”

Talk about how you feel.
Women are much more open about their emotions.  Don’t be surprised, however, if your surgeon doesn’t quite know how to react to your emotions.  Share your feelings with a friend, loved-one, a peer-support group or professional counselor.

Be aware of depression.
After heart surgery, some women are prone to depression (a good reason to buy at least one very pretty bra!)  Some cardiac medications can increase the likelihood as well.  If you have a history of depression, talk to your surgeon and primary care physician about preventative measures.

Depression can significantly decrease your ability to recover from surgery.  It is extremely important to seek help.  There is no shame in asking for help.  If after several weeks you feel like you are “just going through the motions” and find you are unable to find joy in anything, you need to get some help.  It is not uncommon to get the “bypass blues” as much as six to nine months after surgery.

Get some help at home.
Set yourself up for a good recovery.  If you are the type of person who must have a clean house, arrange for someone to come in and clean.  Paying a cleaning service will decrease the chances you will over-do it.

Talk to your doctor about the medications you will be taking.
Women are more prone to side effects from medications.  Discuss what your doctor will prescribe for pain and be aware of alternatives.
If you are prescribed a medicine which will change the consistency of your blood, such as warfarin, Coumadin® or Plavix®, your menstrual flow will increase (another reason to give yourself some time to heal before your period.)  Discuss with your doctor how long you will need to be on this medication following surgery.  If you are on warfarin or Coumadin®, discuss how you will manage your INR level and whether home testing is an option for you.

Take the time to prepare yourself for a good recovery.  Knowing what is coming will make your recovery more comfortable and make you a more confident patient.

The Patient’s Perspective is a series of recorded teleconferences and articles presented by the Embrace Your Heart Wellness Initiative and hosted by Eliz Greene.  Each teleconference focuses on a specific challenge facing women with heart disease.  For more information visit www.EmbraceYourHeart.com

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Eliz Greene is the Busy Woman’s Guide to a Health. Drawing on her experience surviving a massive heart attack while seven-months pregnant with twins, struggling to lose the 80 pounds gained during her pregnancy, and her background as an adaptive movement specialist, Eliz developed simple strategies and tips to help other busy women be more active, eat better and manage your stress.

As the Director of the Embrace Your Heart Wellness Initiative, Eliz travels the country energizing and inspiring audiences in keynotes and workshops on women’s heart health. She writes one of the top 100 health and wellness blogs. Find more at www.EmbraceYourHeart.com