[fnlyRNstudent05]

I am a nursing student in my last semester and my mother in law was just diagnosed with DCIS. She has opted to have b/l mastectomy with immediate reconstruction/expanders. She is told me that her surgeon has said it will be same day surgery and she would be able to go to work the next week. I am concerned that she is underestimating the severity of this procedure and i want to help her. I am more than happy to care for her post op and do what ever she needs but she is extremely independant and will push me away or lie about her dependence needs (as she did post hysterectomy). I am not sure how to counsel her and advise her as to what she needs. I don't want her to hurt herself. I wish I could talk to her docs to verify facts but when i went with her to the appointment she did not want me or her fiance to go in with her during consultation.... (personally i know she is sneaky and evades the truth about what they say cuz she used to work in the medical field with them and i have cought her in the middle of a fib before). I need some expert nurse advice on how to help her and how to prevent her from being in denile. she actually commented that she just wants to come home from surgery and take her meds and sleep and heal and doesn't want anyone there. I'm thinking what if she tries to get OOB and starts to hemmorhage? I know i am starting to sound paniky but I am worried.
thanks!



Steph nursing student until May 2007:hatparty:

[KrustyTheNurse]

One thing you'll learn after you become an RN is that patients have specific rights and are responsibile to take accountability for their care. You have to respect her wishes to "come home from surgery and take her meds and sleep and heal and doesn't want anyone there."

Every outpatient surgery settings require a responsible adult to accompany the patient home and whoever is going to be staying with your mother will receive her post-op instructions with patient care and contact numbers for the surgeon. We require the patient to agree to have a responsible adult with them for the first 24 hours. I'm sure this will hold true in your mother's case. Part of the pre-operative process is patient teaching from either her surgeon or his nursing staff. Many patients are not open to teaching and react in various ways to the information presented to them. Processing this information may be difficult for her due to the fact she will be undergoing a life-changing event (look up "Alteration in self image" from your nursing texts). You don't mention her age but from your description of the situation it sounds as if you mother doesn't need a mother and may feel threatened somehow by your comments to her or how you may be treating her - as a child. As difficult as it may seem, she is looking for support and isn't ready to relinquist the parenting role to her daughter. You can't stop patients from being in denial, whether their family members or the patients you care for. It's a process patients have to experience, process and deal with themselves. Be as supportive to her as you can and let her know you'll be available if she needs you. You don't mention her age or your age, or whether she's more comfortable discussing this and getting support from one of her friends, etc. You mention she has a fiance . . . imagine what loosing both her breasts means to their relationship. This is a lot to handle and the possibility that she may eventually succumb to this disease process. As frustrating as it is, you're going to have to back off and give her space but still let her know your love for her and that you're there is she needs anything.

[fnlyRNstudent05]

thank you for responding. My mother in law is in denile and I wrote this post right after she visited and emotions were running high. We have a very good relationship and she says she wants me to be there for her but that denile thing is slippery so i will take your advice and let her lead me. I am resigned to aknowledge that she as the patient has the right to her views and emotions and that i can only listen and comfort her. Thank you for helping me see that.

[Laurel RN]

Originally Posted by fnlyRNstudent05

I'm thinking what if she tries to get OOB and starts to hemmorhage? I know i am starting to sound paniky but I am worried.
thanks!
Steph nursing student until May 2007:hatparty:

I know your worried but she should be okay. Getting out of bed should not cause her to hemorrhage. It is actually good for her to move around some, to get her blood flowing, prevent blood clots, pneumonia, etc.

I know when it's your own family everything you've ever learned goes right out the window. But just be there for her in whatever way she needs you to be there for her. Her strength is a good thing, it will help her get through this. But knowing she has people like you supporting her may be what helps her be so strong.


Good luck to both of you.

[CHATSDALE]

sometimes we need to just hide and heal like a wounded animal'
it is ALWAYS difficult to relinquish contol of our life to doctors or family members
make sure that someone calls or goes by frequently the first few days..i don't know what type of work that she does but i went back to work 4 days post surgery but i didn't have that extensive of surgery bi-lat plus reconstruction is a lot of truma on the body
see if doc/workplace can encourage her to take it easy for a while

[fnlyRNstudent05]

Thanks to everyone for your advice and support! Sorry it's been so long since my last post but with school it gets hectic as you know!
I am happy to report my mother in law did have the surgery as planned and she did beautifully. The first couple days she was pretty out of it but gradually got better and she healed very well except for a minor infection of her suture line on the most affected breast which the doctor said was a common event due to her small bust size and the amount of tissue he removed. I was very worried that she would hurt herself with her stubborness but she proved me wrong and I cared for her, she appreciated the help and she followed all advice to the T. She is doing great and has begun the expansion process. Hope that anyone out there who is facing this finds this post encouraging because it is possible.
Thanks again everyone for all of your kind words.

SIX MORE WEEKS OF SCHOOL AND I'M ON MY WAY!!!!