I have never been good at following doctor’s orders. I question everything, research medication side effects and decide for myself what’s best for me. I can not tell you how many prescriptions I have refused to fill. But when it came to my doctor’s instructions about activity after surgery, I really wish I had followed their advice.

By the third day after my lumpectomy, I felt so good that I decided to take my daughter shopping for her first school dance. During cancer treatments, I tried really hard to maintain a sense of normalcy for my daughter. I did not want her to miss out on anything, and I did not want to miss out either. I was not supposed to drive until day four, but it was my girl’s first dance! Without thinking, I got in the car and hoisted myself up on my elbow to reposition in my seat. That simple movement, one I have done thousands of times before from sheer muscle memory, shot pain through my breast immediately. I knew I had popped a stitch, but I preferred not to think about it at the moment. We had shopping to do!

Over the next two days, I developed a large, painful hematoma (bleeding inside my surgical site). By the evening of the second night, a Sunday of course, I was in the emergency room. My breast was swelling and bruising rapidly because of the blood thinners I was taking to manage the blood clot in my heart. Blood thinners prevent clotting, which in this case, meant that I was bleeding freely into my surgical site. I wanted to stop taking the medication, but my doctors advised me against it until I could be examined. So I sat in the ER, waiting for them to tell me what I already knew. I needed to stop the blood thinners, and I needed another surgery.

The ER doctor confirmed the hematoma, took me off of my blood thinners, and gave me IV pain medication. I have spent most of my life trying to avoid pharmaceuticals. I did not even use the pain medication prescribed to me after my original surgery. But that night, as my breast continued to swell, I finally acquiesced. Within a half hour, I honestly did not care about the hematoma, cancer or anything else.

The next day my surgeon scheduled me for a hematoma evacuation. But before they could operate, I had to make sure my blood would clot properly during and after surgery. My chemo angel, Vicki, took me to Tacoma to get an IV drip of Vitamin K, which would help my blood to clot. The doctors and nurses were not sure that the Vitamin K drip alone would be enough to get me ready for my surgery the next morning, so Vicki made it her personal mission to make sure I ate as much Vitamin K as we could find. 

Leafy greens are a great source of Vitamin K, so we started there. We found a health food store with a salad and smoothie bar and got a heaping plate of spinach. I washed down the spinach with a green smoothie including every green vegetable they had on hand. She also talked me into eating natto, a fermented soy product that was really high in Vitamin K. I love soy in almost every form, but natto was disgusting. It was sticky, stringy and tasted nasty. As much as I wanted my surgery, I could not choke down more than one spoonful.

The next morning, I arrived for my surgery and my blood clotting factor was perfect. (Thanks, Vicki!) My surgeon told me that even if I had not had a hematoma, he would have called me in for another surgery. While the surgery margin was clean around my original tumor site, there was a new DCIS (Ductal Carcinoma in Situ) adjacent to my original tumor. He had removed the entire DCIS in the original surgery, but wanted a larger margin around it to be on the safe side. As it turned out, my hematoma did me a favor by getting me in for surgery promptly.

My second surgery was a complete success. I did not wake up during surgery, there were no complications, and my surgeon got the clean margin he had planned. In the days after surgery, I adhered strictly to his advice about activity to prevent popping stitches, and we delayed the start of my blood thinners to allow my incisions to heal. 

My hematoma taught me a valuable lesson about my behavior during the healing process. After each phase of cancer treatment, I was itching to get back to my “normal” life. And each time, my body smacked me down. I was forced to rest and recover. I think I’ve finally learned my lesson.

Let’s hope it sticks.

Melanie Kallas Ricklefs is a mom, wife, daughter, sister, and friend. She is also a breast cancer survivor. She was diagnosed with Triple Negative Breast Cancer in April 2016. She underwent chemotherapy, a lumpectomy, and radiation to find her way back to health. Melanie has always enjoyed working and playing outdoors. You can find her and her family hiking, biking, kayaking, backpacking, and camping throughout the Pacific Northwest. She holds a Bachelor of Science in Forest Biology from the University of Vermont, and a Master of Science in Forest Pathology from Colorado State University.  To read more of Melanie’s articles related to cancer, click here.


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