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The following are the precautions for self-care and exercise at home after radical mastectomy.

Prevent edema

After surgical removal of breast tissue and lymph nodes, local lymphatic reflux function will be disturbed. If combined with subsequent radiotherapy, tissue fibrosis after irradiation is likely to produce arm lymphedema in the future, which should be prevented early.

• Skin protection and care:
  • Avoid injury to the arm on the affected side.
  • Apply neutral, hydrophilic, moisturizing, absorbent water-based lotion to keep your skin moist and healthy, with several times a day.
  • Wear gloves when doing household chores: avoid contact with chemicals or sharp objects that might cause scratches.
  • Please wear long-sleeved clothes as much as possible to avoid wounds resulting from scratching at the mosquito bites.
  • Careful nail clipping: do not cut your nails too deep or too short to keep your skin intact.
  • If you have cuts, stab wounds or mosquito bites, rinse them immediately with normal saline and apply ointment containing antibiotics, and observe for any inflammation. Seek medical attention immediately if you develop symptoms such as redness, swelling, heat, pain or fever.
• Please avoid medical practices to the arm on the affected side: injection, blood drawing, blood transfusion, blood pressure measurement, etc.
• Avoid lifting heavy objects or sudden overexertion: do not lift any heavy articles 1 to 2 weeks after surgery. After the wound heals, lift heavy stuff step by step at not more than 2-4 kg.
• Do housework in sections to avoid excessive strain on your arms. If you feel that your arms are sagging, sore, and heavy, please take a rest.
• Do not wear accessories on the hand on the affected side such as rings, bracelets, etc.
• Avoid staying in a high temperature environment, such as soaking in hot springs, taking a sauna, take a hot bath, etc., especially receiving a thermal therapy for the arm on the affected side.
• Regular self-examination: undress and check your body at least once a week. Check the two arms for any swelling from bottom to top, any cuff mark. Check whether there is swelling in the axilla, the lateral part of the thorax and the anterior part of the thorax under the clavicle. If swelling persists for more than 3 days, seek rehabilitation.

Home exercise: increase the angles and frequency slowly from 10 cycles each time, 3-5 times a day

1. Proceed with the original rehabilitation exercise:

• Keep a good sitting posture: sit straight with your chest out, your ears straight above your shoulders, relax your shoulders, and don't stoop.
• Shoulder up: hunch shoulders to a tight position and lower.
• Shoulder rotation: rotate your shoulders 10 times from front to back, then back to front.
• Arms up: hands clasped, raised in the front to a tight position and lowered.
• Shoulder joint abduction: bend your elbows, raise arms to a tight position from the side, and then put them down.
• Shoulder joint external rotation: put the elbows on both sides of the body, and turn the forearms outward until they are tight.
• Arms on the back: both hands are at the hip, and then slowly move up to a tight place and then move back.
• Scapula adduction: put your hands down naturally, clamp the scapula inward (toward the spine), and slightly expand the chest with inhalation.

2. Finger ladder exercise: Use your fingers to climb higher and higher on the wall until feeling tight and move them back, and do not need to let your hands linger before removing the drainage tube; after removing the drainage tube, you can let your hands stay in the tight position for 20 seconds and then slowly put them down.
3. General aerobic exercise: most of the mild exercises do not need to be limited. According to physical strength, you can do brisk walking, taijiquan, folk dance, etc., but you should avoid sudden or excessive exertion of strength, swing and pull, etc. If your arms swell and feel heavy after exercise, avoid this movement and seek medical advice.
4. Finger ladder exercise: Use your fingers to climb higher and higher on the wall until feeling tight and move them back, and do not need to let your hands linger before removing the drainage tube; after removing the drainage tube, you can let your hands stay in the tight position for 20 seconds and then slowly put them down.
5. General aerobic exercise: most of the mild exercises do not need to be limited. According to physical strength, you can do brisk walking, taijiquan, folk dance, etc., but you should avoid sudden or excessive exertion of strength, swing and pull, etc. If your arms swell and feel heavy after exercise, avoid this movement and seek medical advice.

Scar massage

After the stitches are removed from the wound, the wound scar can be gently massaged by drawing a circle, pulling the scar perpendicular the wound, gently pulling and rolling, etc., to promote the smoothness and softness of the scar.

Reminder

If you still have a limited shoulder range of motion one month later, please go to the rehabilitation clinic for evaluation and treatment.