Air travel after masectomy

Old Nov 22, 14, 10:11 pm
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Air travel after masectomy

I want to ask this on behalf of my wife. She will be having surgery late winter to remove breast cancer. There is a fair chance she will have to do a masectomy (hoping for a good chemo outcome and a lumpectomy though).
I know her doctor will be the final call on this, but I wanted to get a sense on healing after such a procedure and how long after surgery you should wait to do air travel? Our family always does an early spring vacation and we really don't want cancer to mess with our plans
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Old Nov 22, 14, 10:21 pm
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http://www.nhs.uk/chq/Pages/2615.aspx?CategoryID=69

Above are some reccs from the British NHS.

Two weeks would likely be safe, but ask the surgeon.

I think a lot more is going to have to do with the chemo schedule and side effects. Will she really feel up to traveling?

This may be a year to concentrate on resting and healing.

Last edited by Doc Savage; Nov 22, 14 at 10:40 pm
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Old Nov 24, 14, 6:14 am
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Originally Posted by Doc Savage View Post
http://www.nhs.uk/chq/Pages/2615.aspx?CategoryID=69

Above are some reccs from the British NHS.

Two weeks would likely be safe, but ask the surgeon.

I think a lot more is going to have to do with the chemo schedule and side effects. Will she really feel up to traveling?

This may be a year to concentrate on resting and healing.
This, chemo is a killer, no matter how small the dose is. She really needs to rest and take it easy. She won't be enjoying anything or feeling anything for a long time.

If the trip is that important, maybe you should schedule all her treatment for after your yearly trip.
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Old Nov 24, 14, 2:15 pm
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Originally Posted by Yahillwe View Post
This, chemo is a killer, no matter how small the dose is. She really needs to rest and take it easy. She won't be enjoying anything or feeling anything for a long time.

If the trip is that important, maybe you should schedule all her treatment for after your yearly trip.
You are absolutely right that our family's health comes first. However I found it interesting that my wife recently asked 'so, where are we considering going on vaca this next spring'

One thing I should have mentioned is that she is doing her chemo now and is over 1/2 done with it. Her surgery will come after completion of chemo.
That is the way Mayo Clinic rolls with breast cancer.
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Old Nov 25, 14, 7:44 am
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I had brain surgery to remove a large tumor at Mayo in Minnesota and was quite surprised to learn that I was able to fly home to Seattle one week after the surgery. My surgeon said as long as it was a pressurized commercial aircraft, I was good.

One word of caution - I once traveled the day after a breast biopsy, and mentioned the biopsy site when asked by TSA, which earned me a very painful close check of that area. At Mayo that isn't a problem, as the airport employees are used to travelers with recent surgery.

All the best wishes for a full recovery for Mrs. Hawkeyefan!
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Old Nov 25, 14, 8:50 am
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Travel after Mastectomy

First of all why such long delay if breast ca is suspected?
Secondly, the aggressiveness of the tumour decides its outcome.
Chemotherapy certainly is VERY helpful despite its awful nature.
As another poster mentioned, make this a year of rest and recuperation.
Technically you can fly soon after the doctor feels the bleeding has stabilized but the body is in a low immune state and airplane flights or young children are not the best choices for an immune suppressed person.
Best wishes to your wife in this struugle against this disease, it is not a local disease as people think, it is a systemic, hormonally inflenced illness, so aggressive therapy brings good results.
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Old Nov 25, 14, 9:18 am
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Best wishes to you both for a complete and speedy recovery.

I am an oncology massage therapist who has worked with many breast cancer patients (all stages from 0-IV) during and after treatment. While your wife might be able to fly much sooner than this, speaking very generally, in my experience, people feel about 80% recovered about six weeks after surgery--six weeks is what most surgeons will tell you for just about any procedure. Chemo sucks, but it can shrink the size of the tumor, so surgery can be much easier. The last 20% of getting back to normal in terms of energy, range of motion, etc, can take a while--more like 6 months to a year.

One consideration no one has mentioned so far is the risk of developing lymphedema after surgery, and this will depend on whether and how many lymph nodes may be removed during the surgery. The more nodes removed, the greater the risk. Air travel does increase lymphedema risk, even though the cabin is pressurized. Wearing a compression sleeve or garment during the flight is a good idea--and your wife should definitely ask her doctors about lymphedema, and for a referral to a therapist who can perform manual lymphatic drainage therapy--a specialized type of very gentle massage that reduces edema and is actually quite pleasant and relaxing to receive.

The Society for Oncology Massage maintains a website with a locator service for finding therapists with the advanced training needed to work safely and effectively with people living with cancer, and educational information for patients and other health care providers at: www.s4om.org.

Again, best wishes for you and your wife on your journey.

warm regards,
Martha Menard, PhD
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Old Nov 25, 14, 9:22 am
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Originally Posted by Hawkeyefan View Post
However I found it interesting that my wife recently asked 'so, where are we considering going on vaca this next spring'
Mental state can be very helpful in recovery. Your wife might want assurance that life is going on as normal after surgery. And the pleasure of knowing she is going somewhere enticing might give her a focus other than hospitalization.

So I would carry on. Book something. Be sure that it can be canceled if she lacks the strength to go. Mention that but don't focus on that in discussions with her.

Hopefully a couple of the FT women who have had mastectomies will stop by and give real life experience as to their recovery time.

(Came back to add: Thank you, mbmenard, for such a helpful post. We're glad to see you posting.)
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Old Nov 25, 14, 9:28 am
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I had a lumpectomy back (both breasts) in April on Thursday and was back at work by Monday....actually by the next day I felt fine....all depends on how invasive the surgery is, reaction to anesthesia, etc., but I would have been ready to go away in a week
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Old Nov 25, 14, 11:08 am
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Originally Posted by mbmenard View Post
Best wishes to you both for a complete and speedy recovery.

I am an oncology massage therapist who has worked with many breast cancer patients (all stages from 0-IV) during and after treatment. While your wife might be able to fly much sooner than this, speaking very generally, in my experience, people feel about 80% recovered about six weeks after surgery--six weeks is what most surgeons will tell you for just about any procedure. Chemo sucks, but it can shrink the size of the tumor, so surgery can be much easier. The last 20% of getting back to normal in terms of energy, range of motion, etc, can take a while--more like 6 months to a year.

One consideration no one has mentioned so far is the risk of developing lymphedema after surgery, and this will depend on whether and how many lymph nodes may be removed during the surgery. The more nodes removed, the greater the risk. Air travel does increase lymphedema risk, even though the cabin is pressurized. Wearing a compression sleeve or garment during the flight is a good idea--and your wife should definitely ask her doctors about lymphedema, and for a referral to a therapist who can perform manual lymphatic drainage therapy--a specialized type of very gentle massage that reduces edema and is actually quite pleasant and relaxing to receive.

The Society for Oncology Massage maintains a website with a locator service for finding therapists with the advanced training needed to work safely and effectively with people living with cancer, and educational information for patients and other health care providers at: www.s4om.org.

Again, best wishes for you and your wife on your journey.

warm regards,
Martha Menard, PhD
Thank you for providing such good input.

Cheers.
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Old Nov 25, 14, 12:03 pm
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Sleeve may not be required

Check with your surgeon. In NYC the view/data is that sleeve may cause more problems than prevent if used BEFORE/absent a concrete lymphedema diagnosis. Your surgeon will have opinion/protocol for her/his practice and will be able to further explain her/his thinking. There are exercises that surgeon or staff will give your wife that may be especially useful when flying.

Other thoughts:
Radiation - you did not mention but with lumpectomy radiation usually starts 6-ish weeks post surgery - a bit longer for mastectomy - and is M-F for up to 6.5 weeks. Since you can't subject recently radiated skin to sun/sand/chlorine might be best to fit holiday btw surgery and radiation.

Chlorine/Ocean/Immersion: Some surgeons restrict swimming for longer than others out of fear of contamination. Also keep all scars/incisions covered from sun if having scars fade is important. Also - remember she will remain photo-sensitive for a year-ish after chemo so lather on the SPF and stay in the shade where possible.

Expander - if your wife does opt for mastectomy and reconstruction she will have an expander in when you go on holiday. At the 6-week mark it will probably not be 'full' so not the same size as the other side. Some women won't care but some would be very self-conscious about this in a swimsuit. Your wife can think about that and let you know where she falls on the issue. In addition the expander can be a little uncomfortable. Anecdotally it seems like women with a slim build find this to be the case more often than others. Your wife may want to reach out and see if anyone in her BC treatment cohort knows anyone with personal experience flying with an expander.

Activity - do not let your wife even pull a suitcase, never mind lift, on the BC side. No bags, no weight, no stress on that side - especially after a mastectomy. Also - consider that some people do have pain/range of motion issues after mastectomy. Surgeon/PT will let you know if swimming is advised if there are range of motion issue.

You seem like a very supportive husband. I recently hurdled BC and having a partner who could roll with the punches and look forward to a fun future helped. Free advice (not applicable if you have already weathered AC portion of chemo): your wife should be drinking plenty of water now - but if she is doing the AC at the end she should start drinking water 'like its her job' - about 3 liters a day if possible - the week before and then all the way through till 2 weeks after last infusion. Again - run by your Dr - but this advice I got from someone who had been through it helped me stave off the worst of the side effects. Also - be proactive with anti-nausea meds - no prize for suffering through without them and easier to pre-treat than make go away once it starts.

Wishing you a great outcome and many, many years of fun travels.

amsNYC
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Old Nov 25, 14, 12:40 pm
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Ski, I am sorry to hear you and your wife are going through this.

I agree with others here of the need to balance something to look forward to/return to 'real' life with being aware that not everyone follows a pre-determined path in recovery. I've seen a lot of women go through the process of having mastectomies with reconstruction, being one of those high-riskers due to family history and hanging out with a lot of others like me. It never ceases to amaze me how variable people's recoveries are and how no two journeys are alike.

First thing is, though, mastectomy (on its own, without reconstruction) is apparently one of the more 'simple' surgeries . There's no going into body cavities, and it's a relatively quick procedure. So much so that a tactless former nurse friend just couldn't understand why I was in any pain at all after mine. So all going well, it can be at the straightforward end of things, physically speaking. Emotionally...another story.

It's also really important to consider what can (in the unlikely event of...) go wrong. I was like your wife, ready to briskly move through this messy and annoying point in time to get to the other side and get on. My one big surgery (Mx plus starter implants) followed by one more planned one (to get permanent implants) turned a standard 6 week recovery into a 2 year ordeal of infection, more surgeries and some sort of weird allergic type reaction. All the will in the world couldn't have got me on a plane for anything but work travel over that time. I don't recall how long it was before we holidayed - maybe a year after the first surgery, and nine months after the third or fourth?

Four months after the one that went wrong and the one after that and a couple of months after the one to remove the implants I was able to travel domestically for work with a PIC line in and carrying my own little pouches of antibiotics that they taught me to change myself. But medical staff were wary....said most people in my situation were quietly at home waiting for the district nurse to come each day. And yes, it was exhausting and probably stupid....I did notice a lot of swelling and redness at the end of a long day when I was tired, and I am sure it impeded my recovery.

Two years on and eight weeks after a 14 hour surgery to rebuild my breasts again we took a trip to NY with friends (a twelve hour + 6 hour flight) and I flew down to Florida for a conference (so another 5 - 6 hours?) and back across to LAX. Flying no problem, though I did have lymphedema concerns and the redness and swelling (that is something to definitely check out before you travel) again.

It was a trip planned from my hospital bed the day after surgery and eight weeks seemed like ample time. But this time I had fluid buildup that required syringing out most days, right up to a week before we left and I had pulled the stitches trying to hoist myself up out of a chair too fast so had a lot of pain. Still, we went. I couldn't get travel insurance (and still can't for anything breast surgery/cancer related). It was a miserable trip for me - I was exhausted, couldn't keep up with my husband and friends, got a raging UTI and felt like a flake for not being able to get through the days. Again, all the will in the world...

And then again, all the people I see who sail through like text book 6-weekers and life goes on without a blip.

So things to consider:

Travel insurance - you might find it hard to get coverage for any post surgical issues so be 100% that things are as stable as they can be before you leave, if it's an international trip.
Best laid plans - whoever, whatever, however your wife is pre-surgery may not be who she is for a time, post- surgery. As a normally strong, independent, capable person I was shocked at how much it slowed me down and even stopped me for a (longer than usual) time. My interests narrowed accordingly. At times I was happy just to be able to walk to the letterbox, a walk down an airbridge was the last thing on my mind.
Goals matter - it's great to plan a return to real life and have something to look forward to, but make sure it's 100% flexible or things could get very expensive...
YMMV - medical 'estimates' on time for recovery etc are sort of predicated on a normal person leading a normal life. They certainly didn't account for the sort of high octane life I live on a day to day basis, and they don't account for every kind of holiday (lying on the beach is very different to racing around NY, Florida and LAX like the energiser bunny.)
BC surgery specific concerns - like Lymph. really need checking out, pre departure. Mine never came to anything major, but boy, I've seen some horror stories. You don't want to aggravate that monster any more than is absolutely necessary. Also, lingering pain and discomfort issues are worth thinking about. I ended up requesting an extra mattress for the flat bed flights (back then the mattresses were thin) because the surface just felt too hard in places. Had never been bothered by mattress thin ness in the past.
Plan for the worst case scenario, hope for the best - I don't know if your wife is anything like me, but it really knocked me to be in NY and not be able to really enjoy it or even participate for a whole day. I would def. have chosen a different sort of post surgical trip - or taken a shorter hop (maybe to Melbourne for a long weekend) first as a sort of a trial, to check I was up to it. Or gone for a beach holiday first off and worked my way up to the big time.

Anyway - hope some of that helps. Please feel free to PM me if you want, more than happy to answer any questions. All the best with the surgery (I'm the 1% where everything goes absolutely wrong - I am sure it will all go swimmingly) and I hope for a swift and uneventful recovery for your wife.
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Old Nov 25, 14, 12:46 pm
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Just to add having read AMS post...there are some great sites online where you can buy post mastectomy bathing suits. Getting a well fitting prosthesis is important if your wife is concerned about having one flat side (some people couldn't give a hoot and more power to them). You can swim in the good quality ones no problem and they are good for every day wear. The better the quality, the longer they last and the more comfortable they are.

On the issue of flying with expanders (the 'first' implants they put in to stretch the skin in a 2 step recon.) - never heard of this being a problem *except* from personal experience, because the port they inject the saline into is metal and can set off the metal detectors so good to warn the TSA...
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Old Nov 25, 14, 4:14 pm
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I concur with pretty much all the info above.
Planning and feeling normal are critical, so if your wife wants to plan travel, go for it. Buy travel insurance, plan away, and just see what happens.

The issue with the surgery, as you may have picked up, is whether she is going to do reconstruction. The mastectomy is not nearly as hard on your body as a cesarean (if she had one of those). I was back home playing on the floor with my kid within two days of the mastectomy. Reconstruction on the other hand, wow. Serious surgery. Drains. Expanders. I would not have wanted to travel. Even driving was uncomfortable.

So, while YMMV, I was only overnight for a mastectomy with 16 lymph nodes removed, traveled during chemo, taught summer school during radiation, traveled the day after radiation ended, and took care of two kids under three while doing 6 months of chemo and 6 weeks of radiation.

However, those reconstructive surgeries. That's a completely different matter. These are the most painful and hardest to recover from things I've had done.
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Old Nov 25, 14, 7:01 pm
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So sorry for your wife. If you do make plans then do purchase travel insurance. I was able to travel after a mastectomy/lymph node involvement. My kind doctor coordinated my chemo treatments with a clinic in another state so I could travel. Later, I flew to Mayo for a breast expander/implant and flew back home to Fairbanks,AK. All went well. However, please encourage your wife to not do this. I insisted and everyone accommodated me. In retrospect, I know I would have fully recovered so much more quickly if I had stayed home. It was a really long time before I felt like I had any energy. Again, in retrospect, not worth it. Your wife does not have to be a super woman and carry on as though this is an everyday occurrence. It isn't. Acknowledging that truth is great. Stay home and you, husband, take your family vacation at home with her. Make everyday special. A year from now she, and you, will be glad you did. Best wishes.
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