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POD
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Post-Op Date
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Comments
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Comments Not Bold
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Feeling
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Accompanied by:
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Normal first week
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Normal second week
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Normal first month
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Normal 3 months
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Normal 6 months/Year
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Followed by Oncologist?
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Current Bra Size
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Specific Findings
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Afebrile
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Activity
• • •
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Comments
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Scars
• • •
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Comments
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Breast Contour
• • •
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Breast Contour
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Tissues
• • •
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Seroma cc aspirated
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Symmetry
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Flaps
• • •
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Nipple
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Comments
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Breast Capsule
• • •
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Comments
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Drains
• • •
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Fat Graft
• • •
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Tattoo
• • •
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Brought Neg studies?
• • •
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Comments
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Pending Patology
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Pathology
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Pathology Report
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Clinical pictures taken?
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Pictures Taken
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Breast Diagram Measures
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Free Draw
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Treatment Plan
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Follow-Up Appt
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F/U Reason
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Follow up comment
|
Comments
|
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General Instructions
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First week F/U
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First 2 weeks F/U
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First month F/U
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Normal Rec for follow Up
|
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Recovery period
|
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Recommended Procedures
|
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Future Procedures
• • •
|
and Additional Proc
|
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Rec Proc Detailed
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Comments
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Possible Procedures
• • •
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Possible Proc. (Detailed)
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Specific Instructions
|
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Activity as tolerated
|
Ambulate
|
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Avoid crowds
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Bactroban
|
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Avoid driving for next week
|
Massage
|
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Resume driving
|
Moisturizer
|
|
No Heavy Lifting
|
Papaya
|
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Avoid Sunlight
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Intimacy
|
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Resume exercises
|
Implant Massage
|
|
Continue Exercises
|
Nipple Shield
|
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Work release
|
Wash with soap
|
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Arnica
|
Comments
|
|
Keep surgical area dry
|
May Travel
|
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Bra
• • •
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Binder
|
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No limitations
|
Other instructions
• • •
|
|
BIA-ALCL Discussion?
|
Comments
|
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Prescription given for
|
Comments
|
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Radiology Orders Given
• • •
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Radiology Pre-Op
• • •
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Medical Follow Up
• • •
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Ready for Radiot?
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Radiology
• • •
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Radiology Orders (detailed)
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Diet
|
Diet Comments
|
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Consults
• • •
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Consults comments
|
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Labs
• • •
|
Lab Comments
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Education
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