Everyone is different Sally.....and it depends on (1) your own pain threshold, (2) if you have any limitations as to pain meds (for example, I'm codeine intolerant so tend to avoid codeine-based meds, and I have a friend who cant take any opioids at all - but there are plenty of options that have worked for me like Fentanyl - which I self-administered for the first 24 hours after both my mastectomy and my recent DIEP). Talk to your anaesthetist. Tell them you're worried and nervous. There is NO reason for you to be feeling too much pain! Be assertive...and ask for what you need. I found my pain management was much better after my DIEP than after my mastectomy - different anaesthetists! Next time round, I'm going to definitely ask for the second anaesthetist if he's available. He was brilliant.
Share your fears with your breast and plastic surgeons, as well as the anaesthetist. They are there for you. They don't want you to be in any more pain than you need to be and will note it down and do their very best to help out.
I have also had 2 caesars, as well as ovaries and fallopian tubes removed....so know where you're coming from (my big fear is needles!!!!!)
Just realise that you are essentially booked in for two operations: the first is the bi-lateral mastectomies (usually done by a breast surgeon, which also usually incorporates a sentinel node biopsy or axillary clearance.....depending on what they have planned for you) and the second is the insertion of the implant (whether it's saline or silicone or CO2....again - this is up to discussions between yourself and the plastic surgeon). The implant usually goes under your pectoralis muscle because this helps to inhibit any infection - so expect some discomfort from just the expansion of your pec as part of the insertion process.
Like I said, everyone is different. But there is no reason for you to be out of your mind in pain - there are modern meds to help you with this!
I am sure other folk will be able to help as well
Nikki xxx
