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PHYSICIAN REFERRAL POST MASTECTOMY REHABILITATION PATIENTS NAME: DIAGNOSIS: PRECAUTIONS: Evaluate and Treat Exercise Program (i.e. home, gym) Functional Conditioning Therapeutic Exercise Manual Therapy
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How to fill out post mastectomy rehabilitation:

01
Consult with your healthcare provider: Before starting any post mastectomy rehabilitation program, it is important to consult with your healthcare provider. They will assess your specific needs and develop a comprehensive rehabilitation plan tailored to your condition and goals.
02
Begin with gentle exercises: Gradually introduce gentle exercises to improve range of motion and muscle strength in the affected area. These exercises may include shoulder stretches, arm raises, and chest stretches. Start with low impact activities and gradually progress as tolerated.
03
Practice lymphedema management techniques: Lymphedema, a common side effect of mastectomy, occurs when fluid accumulates in the arm or chest area. Your healthcare provider may recommend specific techniques such as manual lymphatic drainage, compression garments, and self-massage to reduce swelling and maintain proper fluid balance.
04
Incorporate scar tissue management: After a mastectomy, scar tissue may form around the surgical site. Proper scar tissue management can help improve flexibility, reduce discomfort, and enhance overall healing. Techniques such as scar massage, silicone sheets, and topical creams or gels may be recommended.
05
Address physical and emotional well-being: Post mastectomy rehabilitation is not only focused on physical recovery but also on emotional well-being. Seek support from healthcare professionals, join support groups, or consider counseling to address any emotional challenges you may be experiencing during the rehabilitation process.

Who needs post mastectomy rehabilitation?

01
Individuals who have undergone mastectomy surgery: Post mastectomy rehabilitation is specifically designed for individuals who have undergone mastectomy surgery. It aims to address the physical and emotional challenges that may arise as a result of the surgical procedure.
02
Those who experience limitations in range of motion and strength: Mastectomy surgery can result in limitations in the range of motion and strength in the affected shoulder, arm, and chest. Rehabilitation can help improve these limitations and restore function.
03
Individuals at risk of developing lymphedema: Lymphedema is a common complication after mastectomy surgery. Post mastectomy rehabilitation can help manage and reduce the risk of developing lymphedema through exercises, lymphatic drainage techniques, and other preventive measures.
04
Anyone seeking support and guidance: Post mastectomy rehabilitation provides a supportive environment and guidance for individuals who may be struggling with the physical and emotional aspects of their recovery. It offers resources and techniques to help improve overall well-being and quality of life.
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Post mastectomy rehabilitation is a program designed to help patients recover physically and emotionally after undergoing a mastectomy.
Post mastectomy rehabilitation is typically filed by healthcare providers or physical therapists who are overseeing the patient's recovery.
Post mastectomy rehabilitation forms can be filled out by providing details about the patient's medical history, treatment plan, progress, and any challenges faced during recovery.
The purpose of post mastectomy rehabilitation is to improve the patient's physical function, emotional well-being, and overall quality of life following a mastectomy.
Information that must be reported on post mastectomy rehabilitation includes the patient's medical history, treatment plan, progress notes, and any challenges faced during recovery.
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