DIEP Stage 2

kcshreve

Olivia - why can't you lift your arm?  Is it your shoulder, or a muscle problem, or is it because it feels too heavy?  Is it swollen?  I have developed lymphedema in one of my arm, which makes it quite uncomfortable.  If you think it may be along these lines, go over to the lympedema lines and start asking questions.  They are remarkably helpful over there.

Dutchy

Ladies:

We need information on Stage 2 after the DIEP.

Thanks

Evelyn

kcshreve

What kind of info?  Usually breasts are matched for size, very often the doc does lipo to create a better waist.  I had a reduction and a lift, since my Stage 1 breasts were way too big and too heavy. I was told I'd stay in hospital for one night, but needed 2 due to reaction to antibiotics and high blood pressure. Way better mobility than Stage 1.  Lipo areas were quite sore, like way-too-much-exercising kind of sore, but only for about 1.5 weeks.  My biggest struggle after that was lowered endurance for awhile, but I could DO a lot of things.  I'd just tire a bit sooner for, maybe, 4 weeks.

Dutchy

Thank you.  That was exactly the kind of information I wanted to read.  What about nipples when do those get created?

Dutchy

Bumping

hester

Here's a great article from Sunday's New York Times Magazine.  I'm so happy October is over. http://www.nytimes.com/2010/11/14/magazine/14FOB-wwln-t.html?ref=magazine

Dutchy

Hester, thank you for the article.  It sure does ring of truth, but put a little damper on my having reconstruction.  Although it rings of truth I should not have to feel guilty for reconstruction and it did a bit especially because I dressed up the other day and had some cleavage to show.  Should I feel this way from that...I think not.  But unfortunately the article did because it is so true.

chinablue

 My diep was Aug. 2009.  I am anxiously awaiting my stage II (Dec. 8 pre-op appt., Dec. 21 op.).  I realize stage II requires different procedures for different issues.  I wish that I could contact someone that has had a implant put under a radiated diep breast and a lift on a natural.  I feel like the only one out there that has taken this path.

swimangel72

Hi Chinablue - I'm sorry you feel alone with your upcoming Stage 2 - perhaps if you started a new thread, you'll get more responses from women who went through the same procedure you're facing. I'm sorry for all you've been through - but from reading your other threads - sounds like you have a great PS. Be sure to talk to him to find out what's involved - especially if you'll need drains (I needed drains for my Stage 2 - seems I always get infections from drains, yuck!)

3/3/08 Right-side mastectomy with immediate muscle-sparing free tram; 3/9/08 Developed abdominal MRSA staph infection and hernia;Completed 4 months Navelbine and 1 year Herceptin; Arimidex - 4 more years! Diagnosed at age 53
Diagnosis: 2/5/2008, IDC, <1cm, Stage Ib, Grade 1, 0/7 nodes, ER+/PR+, HER2+

hester

swimangel,

So nice to find another swimmer!  I've been a mile-a-day swimmer for 8 years, but since my DIEP and healing issues on the radiated side I haven't been able to get back into the pool. How long were you out and how did you get back into the rhythm?  I still have open tissue almost 3 months out and I don't know what to expect. 

Dutchy

Swimangel, sorry you are feeling so alone.  Have you checked some of the other breast reconstrution site.  I know there are some good ones out there.

Evelyn

swimangel72

Thanks Dutchy - but I think you meant to address your concern to Chinablue (I hope you're doing OK China).........and Hi there Hester - nice to meet another swimmer. My original free-tram surgery was in March of 2008 - I wasn't back in the water (swimming gently) until that summer (August 2008) - it took that long for my opened abdominal incision to heal. Where is your opened incision? It's best not to rush anything - the pool can wait. Are you increasing the protein in your diet? I helps in the healing process. I was getting back up to a mile in 50 minutes until my last "Stage 3" fipple repair on November 1st - I haven't been in the pool since. I've learned not to rush - but maybe after Thanksgiving I'll give it a try since everything is healing OK.

Happy Thanksgiving everyone - may the love of family and friends surround you now and always! 

Dutchy

Hi I guess I did get mixed up.  How are you doing Swimangel?  I get my Stage 2 January 10 and was wondering how quickly I will be able to return to work as I will not have much sick or vaction to take off.

chinablue

My ps told me that I could go back to work two weeks after stage II (lift with an implant placed under my diep).  The nipple and further touch ups would be scheduled for a later date.

hester

Happy Thanksgiving everyone.  Hope you're all avoiding shopping malls! 

Swimangel, it's reassuring to hear that you were back up to a mile in a reasonable period of time - we swim about the same speed (although I work out at the same club as Michael Phelps so you can imagine  that I don't always feel particularly fast).  My abdominal wound healed very well - the open area is in my right (radiated) breast. I go back to my PS on Dec 7 so will wait till then to get the ok to swim.  I think it will still be some time before my stage 2. She wants the tissue to be healed for 3 months before going in again.

 Chinablue, I hope you're feeling beter.  Here's an old board that I found that helped me understand what Stage 2 really is like: Ready for Stage II DIEP - Need Advice.  Maybe we should start posting there, too.

 Evelyn, you might find somestuff there helpful, too.  I'm thrilled your stage 2 is coming so soon.  Your DIEP was after mine.  You go!

Dutchy

Are you ladies all doing well?  It has been quiet since Thanksgiving.  I asked my doctor how long I'd be out for stage II anywhere from a day to 2 weeks depending on what needs to be done.  So I am going to ask for a lift so I will probably be out for 2 weeks too.

chinablue

Stage II, for me, means:

1. An expander placed under my diep and a lift of my natural breast. The expander is to help balance my bcup diep foob with my natural dcup as well as stretch skin to allow for scar revision to improve a big scar I have due to blistering.

2. Regular fills for 4 months.

3. Scar revision, fat grafting and exchange of expander for a silicone implant at 5 months.

4. Then, comes the nipple and tatoo.

This all is assuming there are no complications.  I have had radiation.  So, I am thinking I should be done with reconstruction in about 7 months or July 2011.  My original mx was August 2009. 

Heavy sigh. 

Dutchy

Chinablue, it sounds like you have a busy schedule with Stage II.  I still do not know what my doctor is going to do,  I do hope I get both of my breasts lifted a bit.  My stomach needs lots of liposuctioning and my scar is not too bad so I do not know if he will need to do any scar revision.  You hang in there.

lollyo

I wanted to post my stage 2 expereince to help other women prepare:

I had a lift on the left good side, nipple construction on the right using flap skin, dog ear revisions on both ends of the abdominal scar and some lipo on each side of the hips (entry through dog ear incision) that was then later injected into the right side.

The surgery was day only. I took pain meds for 4 days and then felt well enought to be driving and doing short errands. Sleeping is complicated because of hip pain, but must be on the back to avoid the sore front. This surgery is so, so much easier than the first. I kept thinking,"huh, there is no sawed in half feeling this time!" I literally feel like dancing around that I am almost done in this process and have been so happy with the results.

chinablue

Today, is the first morning after my lift and te placed under my diep.  So far, so good.  I am just a little sore.  I am up walking around.  I am taking vicodin and an antibiotic.  Sloan is to call me today about my follow up and my first fill.  

nora_az

Hi DIEP sisters!

My PS said I need to get rid of the "dog ears" too and perhaps even things out a bit later on, not yet.

My question being, is this something that insurance pays for? I am quite happy with my results and personally even if I had to stay this way forever it doesn't look bad. However, if insurance pays for it I'd be tempted.

imatthew

nora - i believe it depends on your coverage, from what i've seen stage-2 is typically covered as part of reconstruction.

btw, to report back on my own insurance questions/concerns - our PS is taking our deductible plus whatever above the deductible BCBS paid.   

lollyo

Nora, my particular insurance covered stage 2, I think its generaly included if stage 1 is approved. It doesn't hurt to ask first, though. I really could have lived with the tiny dog ears I had, but my torso is now smoother. I can't believe I'm back in a binder-I picture stacks of these squeeze devices just waiting for us...much easier to take in the winter!

nora_az

Lollyo,

You aren't kidding! I cant imagine being in a binder in the Summer here in Phoenix!  I'll have to plan on mine next Winter if I do it.  I am just so "done" now with surgery after the DIEP and my port placement. Probably in a year I'll be more keen to do something.  This is why I was so thankful I had DIEP to begin with. The thought of having a BMX with TE's or doing nothing till after treatment would be a horrible thought right now. I am so thankful I had my DIEP, I didn't even know it existed until my breast surgeon told me I didn't have to see myself without breasts.

kcshreve

I, too, am thankful to have had a DIEP, and to be finished.  I am the parent/caregiver of an disabled adult child with complicated medical issues.  I decided a DIEP would be the most straightforward and simplest procedure for me with her unpredictable future, since with my dd we never know how she'll be doing.  I had my final surgery 8 weeks ago, and last week my dd destabilized.  She's fine now and we're all home again, but I just got back from spending a week with her in the hospital, sleeping in her room.  I can't tell you how many times I was thrilled that my own stuff could be finished and wrapped up so I could focus on a different crisis.  I have autoimmune issues, so if I had chosen an implant, there is a very good chance I'd have on-again/off-again issues of my own

hester

I've met with my PS about Stage 2 and will wait till late April because I'm a teacher and that's a better time for me.  I know I'll need a reduction/lift on one side and a lift/fill on the other, but I'm wondering about my belly.  Do any of you have a little bulge below your incision?  Like an uneven bubble that when you try to inhale it just doesn't gp away?  What about hard spots along the tummy tuck incision?  My PS said she'd remove the dog ears but we didn't talk about the rest.  And, my incision is pretty high and my belly button reconstruction failed, so I have this funny little hole, which is ok, but my pants slip down to the incision site instead of resting higher where my waist used to be.  Is this normal?  What should I be asking for?  Thanks for any advice.

lmatthew, good for you with the insurance and your PS accepting the payment.  I still remember the $20k bill from my PS for the initial surgery and how happy I was that it was all covered.

kcshreve

I had very little waist prior to the DIEP, and none after it, so my pants fell down, too.  If you tell your PS about your pants, when Stage 2 is done there should be a plan for lipo to create a waist.  Lipo can shape your waist so your pants will stay up.  Some people have no trouble with this, since possibly they are longer waisted or taller to begin with.  I'm short, and I needed all the help I could get at Stage 2 in order to keep my pants up.

nora_az

Hester...

I do have a tiny bit of bulging on the right side just below my incision. Very slight though. I asked my PS about it and she told me it was something to do with internal scar tissue causing it. I didn't press any further, I'm thinking to remove it would only cause more but it's not bad anyway.
I now have a very thin red line as my abdominal incision. There are a couple of areas where it looks a bit sore still, sort of like it was rubbed too much or something and a thicker red to it?
In saying all of this I am still very happy. I have a definite waist. The one and only bothersome thing for me is the abdominal numbness below my incision. It just drives me crazy.

chinablue

Ok, it is two days from my stage 2 (lift/te under diep) and I have gained 6 pounds!!!! Ug!!

swimangel72

Hi Chinablue - I bet it's just water weight from the anesthesia. I find the older I get, the longer it takes for me to get the anesthesia (and weight gain) out of my body. BTW - we live VERY close to each other Chinablue - I'm in Northern Westchester!