Having surgery while you’re breastfeeding your little one may not be ideal, but sometimes can’t be avoided. I just had surgery a few days ago for Thyroid Cancer, and I wish I had known some of these ahead of time! This was my first surgery besides my emergency cesarean, and I didn’t know what to expect.
In case this is your first time too, here’s a brief timeline of what happened. First, we checked in and waited in the Family Lounge. When they called me back, I went to a small triage area where they took my vitals and had me change out of my clothes and into a hospital gown. From there, I said goodbye to my husband and was taken to the pre-operative preparation area. This is where I spoke with the Anesthesiologist and the Surgeon. Next was the surgery itself. After the surgery, I was in the Post-Anesthesia Care Unit. And finally, to the recovery area where I saw my husband again.
So here are my ten tips to navigate all of that as a breastfeeding mother:
1. Start a stash early. If you know about your surgery in advance, start pumping and saving milk up ahead of time. I used a Milky Milk Saver during the first couple of weeks post partum to catch my extra milk to save. We were able to use that milk for the two days I was away from my daughter. Pumping once a day can also help to build a stash as well.
2. Have some help. My surgery was a two day endeavor. My Mother in Law came to help with both the baby and the toddler so that my husband could be with me as much as possible the day of surgery and day of discharge. If that isn’t an option, reach out to your friends and community. You can also look at Care.com or Sittercity to find someone to help.
3. Let your doctor know. I was able to speak with my surgeon during my pre-op appointment regarding breastfeeding and pumping. We discussed what kind of anesthesia they usually use and asked her to put a note in my file requesting a breast pump in my recovery room.
4. Make a mermaid bra. This was a tip from the amazingly kind nurse when I was getting ready in the triage area. I was nervous about my milk leaking during the surgery, but I could not wear my undergarments into the operating room due to sanitation reasons. We took four pieces of medical tape and taped my disposable nursing pads on instead. The anesthesiologist was fine with this and it put my self conscious mind to rest.
4. Bring your own pump. Even if you’ve talked to your surgeon ahead of time about getting one at the hospital, bring your own too. I packed mine in a small bag inside of my hospital bag. I was able to pump about an hour before my surgery in the triage room, and then gave it to my husband. I had the nurse write a note in my chart that they should send for it again immediately after surgery- while I was still in the post-anesthesia care unit.
5. Disposable underwear and a pad. If your surgery is very soon after giving birth and you’re still experiencing Lochia, or even if it’s later on and you have some lingering incontinance, don’t be afraid to ask for some of those nice stretchy disposable undies and pads. They won’t allow personal undergarments in the OR, but they can give you some temporary ones. Your nurses might even chuckle and say something about it being the easiest request they’ve had all day.
6. Request a pump as soon as you arrive in recovery. I must have been annoying in my persistence, but I’m glad of it. My hospital pump didn’t arrive until about four hours after my surgery. They had to get it from the maternity ward in another building. I used my personal pump twice during that time. Having the hospital pump was a lot more convenient for overnight for a few reasons: it was on rollers so I didn’t have to hold all the attachments and the machine on my lap whilst getting situated, it was much more efficient so I’m sure I pumped more than I would have with my normal pump, and it’s much quieter which I’m sure room mates in the recovery room appreciate.
7. To dump or not to dump. You’ll hear varying opinions on this depending on who you ask – especially from the surgeon, the anesthesiologist, and the nurses. I decided to only dump the milk that I pumped immediately after surgery – while I was still in the post-anesthesia care unit. I needed assistance from the nurse to attach my pump and get started so I felt there was probably still too much medication in my system to safely keep it. However, I kept all subsequent pumps because I was not on anything stronger than what they give to cesarean section mums. Make the best decision for you and your family. Kellymom.com has some great information regarding anesthesia and breastfeeding.
8. Don’t stress the ounces. Pump when you can and don’t worry about whether you’re keeping up with demand. Post surgery your true focus should be on healing – your baby needs you healthy and strong! Any milk you get is a blessing and stressing about whether it’s enough could steal your joy. Set an alarm to pump every 2-3 hours as a reminder and then try to relax.
9. Bring supplies. Make sure that you bring your other breastfeeding supplies with you as well. I had with me milk bags, a sharpie, and extra nursing pads. It made it much easier to store the milk and label all of them. Don’t rely on the hospital to have enough pump bottles to store everything you pump.
10. Nurses are there to help. If you need help rinsing and washing the pump parts, ask! If you need a cooler with ice to keep it cold, ask! Nurses are great problem solvers and can help to make it easier on you to accomplish your goals. The call button is there for a reason.
I hope that you don’t have to use these tips, but if you do, I hope that they help your experience go smoothly!
If you’ve been following my story, you’ll remember that I’ve struggled a bit with the care that I have gotten thus far for my Thyroid Cancer. The Endocrinologist that I have been seeing put me through a lot during this pregnancy – including taking me off of all of my Thyroid medications for three weeks during the first trimester. I felt like they weren’t listening to me and respecting me as a patient.
Last week, I went for a second opinion appointment with another Endocrinologist based off of a recommendation from fellow mama and Thyca survivor.
After having a week to absorb everything I think I can finally say – I feel so blessed to have found a new provider! I left the appointment feeling that my concerns had not only been listened to, but a plan that met with my expectations has been made! He was extremely concerned about the lack of medication for a prolonged period of time during first trimester, and stressed that they could have jeopardized my pregnancy and caused a miscarriage. I praise God that my baby is healthy and strong and arriving soon!
He has agreed to return me to a natural desiccated thyroid (NDT) medication after the baby arrives, instead of continuing on the synthetic version. We decided that switching medications again during pregnancy is a risk, and although I am not feeling well I don’t want to jeopardize the baby by changing everything again. I was on NDT before we conceived, and felt so healthy and strong while I was on it! I will start NDT soon after birthing, and we will adjust it based on my symptoms – not just the lab numbers. Once I have my Thyroid removed, he will work with me to make sure that the transition to being completely dependent upon the hormone replacement goes smoothly.
I am so thankful that I have been able to find a provider who hears my concerns, and takes me seriously as a patient. I feel so relieved to be supported as we move forward. Having the freedom to switch providers to get the best care for me is amazing, and I want to emphasize again how thankful I am to not have to rely upon a military treatment facility for my care.
It’s been three weeks since we found out that I have Thyroid Cancer. During that time it’s been a bit of a whirl wind of doctor appointments.
I had an hour long appointment with the Endocrinologist where she went over my lab report. The biopsy showed that 98% of the cells gathered were malignant in nature. So there was definitely no grey area of whether it is Cancer or not. Based on the size of the tumor, it is likely that I have had it for 8-10 years. That really took me aback. How could it be that for 8-10 years – at least nine of which I was actively being seen by military doctors for thyroid issues – was this never found? How could so many doctors see me, see my frustration, my desperation, and not do more? Especially when the test that revealed the tumor in the first place is neither invasive nor expensive – a neck ultrasound. My confusion started to burn into anger the more I thought about it.
During the Endo appointment we talked about the road ahead. During the rest of the pregnancy, I’ll be getting my labs taken every four weeks to check my hormone levels. I’ll also get neck ultrasounds every other month to check the size of the tumor, my thyroid, and the lymph nodes in my neck. This will check the growth of the tumor and whether the cancer is spreading. For more answers about my surgery, we had to wait for an appointment with the Endocrine Surgeon.
The week after diagnosis, I went for a follow up neck ultrasound. They were even more thorough than the first, and after the tech had taken all the measurements she had the radiologist come in and double check everything including the lymph nodes. The radiologist said that all of the lymph nodes looked clear to her. The final measurements from the report show that the tumor hasn’t grown since the first scan in June. It was important to get this information before we met with the surgeon.
The Endocrine Surgeon appointment was at one of the leading hospitals in the area, and she is part of a group of endocrinologists that are helping to develop a new type of biopsy for thyroid patients that can increase the probability that they will get the right kind of surgery the first time. Her resident took my history, starting from the beginning. The surgeon herself was easy to talk to. She explained that it’s reasonable to wait until after the pregnancy to have surgery. She said that it would be better to do it in the first three to four weeks postpartum – and that seems extremely early to me. I am thinking about going to get a second opinion on the timing. I realize that it’s important to have the surgery, but it’s also important to me to have a stable routine with my baby before so that I’m not trying to recover from having a baby and having an organ removed at the same time.
So for now, there’s a lot of waiting and watching to do. It’s a little unnerving for me to walk around for six or seven more months knowing that I have cancer. My emotions have been going between relief, anger and determination. Relief to have a diagnosis and know that my intuition about my health during the last few years has been right. Anger because my previous doctors and treatment facilities failed to diagnose me earlier when it could have easily been done if they were more vigilant. Determination to keep living my life as I have been – embracing every moment with my family, staying active and strong, and focusing on having a healthy pregnancy and a VBAC.
I got the call on Monday afternoon. It had been four days since they had done the biopsy and I had been waiting anxiously for the phone to ring. I had just gotten home from work, and hadn’t even taken my boots off. My husband held my hand as the Endocrinologist let me know that the biopsy showed that I have Papillary Thyroid Cancer.
I was suprisingly calm in that moment. Suprising to myself at least. I am sure that my husband expected me to react more than I did. The doctor let me know that we would talk more about what it means and what the next steps are at our appointment later in the week and I could ask any questions then. I could tell that she didn’t like making these calls at all, probably as much as people liked recieving them.
After I hung up the phone we sat in a bit of stunned silence. And then we went about our evening. He made dinner and I played with my Son. We changed and went for a run where we talked about what the treatment plan could be and how we hope that God will use this to his glory and his plan will be made clear to us somehow. We talked about the baby and how we hope that it will be strong and healthy through all of this. I remember telling him that I know I should have been more upset, but I’m such a planner – all I’m focused on is making a list of all the things that I need to do and need to know and need to ask. “I’ll have that breakdown moment evenutally, but just not this second.”
When we got home from the run we snuggled up on the couch and watched TV as a family like any other night. We put our Son to bed and carried on our normal things. We sent a text to our Pastor to see if he could talk. Our Pastor was able to call us around 11:30p. We are so blessed to have found a church family here where we know that we can call them any time of the day or night if we need something. We let him know the news and he prayed with us.
And then I had my breakdown moment, snuggled in my husbands arms on the couch.
On Tuesday, I woke up feeling rested and fresh and normal. I didn’t feel like I had Cancer. Could it really be true? How long has this been inside me? Months for sure, but it could have been years. Years of the doctors telling me that I was wrong and that my intuition was off track. I got ready for the day and went to work like any other day. We had decided that we would keep the news to ourselves until after my appointment on Thursday so that we wouldn’t have to try to answer questions that we didn’t know the answers to. After work I went to an ICAN meeting, and although I didn’t share that night, it felt good to help some other moms that are going through some struggles right now.
Wednesday I woke to a gloomy day outside, made the family breakfast and went to work like any other day. I went about my day like any other. It felt like I was just waiting around for answers though. Only one more day until the appointment. My emotions were definitely on edge, and I let a work situation bother me more than it should have. I was ready for answers.
Thursday we woke up very early and dropped our son off at a friends house so that we could go to the early morning appointment. Traffic seemed extra slow along the parkway, but it could have been my impatience too. By the time we made the hour drive to the Endocrinologists office my stomach was in knots and had a pounding headache.
The Endocrinologist is very good at explaining everything to me. She is, by far, the most responsive, thorough and communicative Endo I have been to in the past nine years. She confirmed that the Fine Needle Aspiration Biopsy showed that I have malignant Papillary Thyroid Cancer. It is an extremely treatable and slow growing type of cancer and we talked about the next steps in the process.
Since I am currently 15 weeks pregnant, and it is such a slow growing cancer, it is reasonable to wait until after the baby is born. We will have to work out the timing, but they will be doing a full thyroidectomy. The tissue will be sent to pathology and based on those results they will decide if radiation, chemo or even nothing else needs to be done. So for now our next steps include getting an additional thyroid ultrasound to remeasure the tumor and compare it to the ultrasound measurements in June. Second, we will be meeting with an Endocrine Surgeon and talking about the surgery itself and the timing. Third, I’ll be getting my thyroid hormones monitored each month for the rest of the pregnancy to make sure that they stay in the right range. I’ll be having a followup monthly with my Endocrinologist as well.
She also talked with me about some other lab results, and diagnosed me with Hashimoto’s Thyroiditis. I still have to do more research about this diagnosis, but she indicated that with the removal of the thyroid this will essentially be irrelevant after that.
While it is not so great to hear that I have cancer, it has also been a big relief. After years of feeling frustrated by the medical system, I finally have answers as to what has been causing so many of my symptoms. I feel like a big weight has been lifted off of my shoulders and we can move forward.
I will keep all of you updated about this throughout the journey. Thank you all for your continued prayers!