Enhanced Recovery After Surgery (ERAS)

1. What is Enhanced Recovery After Surgery (ERAS)?
2. MICHELE LEY, MD, FACS
3. The level of care is excellent.
4. Contact Us Today
5. ABOUT US & EDUCATIONAL INFORMATION
6. CONTACT US

One aspect many patients wonder about is what to expect during recovery from a breast surgical procedure. The recovery process is an extremely important part of your breast surgery journey. At Tucson Breast Health Specialists, we support Enhanced Recovery After Surgery (ERAS).

What is Enhanced Recovery After Surgery (ERAS)?

Enhanced recovery protocols are proven to help with the physical recovery following surgery. Typically these pathways include a combination of methods and medications to reduce pain and minimize nausea while using fewer opioids. The goal is to reduce the amount of pain and speed recovery as well as minimize infection and other complications.

Before your procedure, it is vital to speak with your surgeon and anesthesiologist regarding sensitivities, medications, and allergens that may affect your pain management plan.

Board-Certified Surgeon

MICHELE LEY, MD, FACS

Dr. Ley, a breast surgical oncologist in Tucson since 2006, delivers compassionate and personalized care to create tailored treatment plans based on the latest research. Specializing in surgical care for breast cancer and high-risk patients, she employs minimally invasive techniques and practices oncoplastic surgery to optimize outcomes.

More About Dr. Ley

ERAS may include the following components:

Pain Control

Some enhanced recovery protocols include prescribing Gabapentin, a nerve medication that can reduce pain and discomfort when started the night before surgery. Some healthcare providers will have you continue this medication following surgery for several weeks to reduce chronic pain and nerve pain following mastectomy. While gabapentin is not a pain reliever, it reduces the nerve signals from the surgical site to the brain and helps reduce the need for other pain medications. Side effects include drowsiness, brain fogginess, dizziness, and mood changes. If you experience side effects that concern you, please contact your surgery team.

Opioids, a type of narcotic medication, may be given as part of your anesthesia during surgery. While opioids may help reduce pain, they can be highly addictive and are associated with a wide range of adverse side effects. Drowsiness, dizziness, constipation, nightmares, or mood changes are common side effects. If you need opioids it is not wrong to take them for a short time around the surgery, and when used properly and as part of an ERAS plan, they can be safe. These medications have been found to be more effective when taken with anti-inflammatory medications.

Anti-inflammatory Medications

Anti-inflammatory medications reduce the inflammation following surgery, therefore reducing pain and helping with the healing process. They are even more effective when taken as part of an ERAS plan. These anti-inflammatory medications may include celecoxib, ibuprofen, and acetaminophen. Your surgery team will recommend medications that are right for you. You should take them on a scheduled basis, starting the night before surgery, and for at least one week after the surgery.

Regional Anesthesia

A local anesthetic will be used to numb the nerves responsible for sensation at the surgery site. This can be achieved with a nerve block before surgery or a long-acting local anesthetic injected at the time of the procedure. If you are undergoing a mastectomy, you may be discharged after surgery with a pain pump. The pain pump automatically releases the numbing medicine into the surgical site. It will be removed in the office after surgery.

“The level of care is excellent.”

Dr. Ley is extremely good at explaining your breast cancer, treatment options, and everything she is going to do. She is a masterful surgeon and uses plastic techniques to close incisions, leaving minimal scarring. In addition, she is warm, pleasant, and a lovely person. I am so happy that I found her based on a friend’s recommendation. I can’t say enough about her and the practice’s excellent care.

Dr. Ley is an excellent doctor who cares about her patients. She takes the time to explain everything and provides all options. The level of care is excellent.

I have no words to express my gratitude for Dr. Ley! I was diagnosed Feb. 2020 and Dr. Ley besides being the best in her field and doing an amazing job on my double mastectomy she was even able to save my nipples. She is also a remarkable human being, patient, kind very clear in explaining everything and making you feel heard and safe in her hands. I 100% recommend her and her very helpful, kind and amazing team! If you have recently been diagnosed this is the team you want to have your back!

Nausea Prevention

Nausea following surgery is more common following breast surgery than other forms of surgery. Because of this, a scopolamine patch containing anti-nausea medication can be placed behind your ear before surgery. If you have had nausea during prior surgery, please tell your surgeon as placing the patch the night before can be even more effective. During your procedure, you may also be given a steroid known as dexamethasone and/or an anti-nausea medication called Zofran to prevent nausea. If you still experience nausea after your surgery, you may be prescribed (Zofran) ondansetron or a different oral anti-nausea medication to take at home. Proper hydration before and after surgery is also key to helping curb nausea.

Reducing Surgical infections

There are several things you can do to reduce your risk of wound infection. These include washing with antibacterial soap before and after surgery, washing hands before and after handling drains and dressings, controlling blood sugar if diabetic, and quitting smoking before surgery. You will also be given a dose of antibiotics before surgery and possibly after to reduce the risk of infection.

Activity After Surgery

One very important aspect of ERAS is getting out of bed the night after your surgery. Moving early after your surgery results in less pain and a quicker overall recovery. While it is important to avoid lifting more than 10 lbs. for a few weeks after surgery, moving your arms and shoulders is important to prevent lymphedema and stiffness.

Contact Us Today

If you are seeking more information regarding Enhanced Recovery After Surgery, please contact Tucson Breast Health Specialists in Tucson, AZ today. We will be happy to discuss your recovery plan options with you.

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