DIEP stage 2 and lymphedema

vlnrph

Getting a little nervous as the date for this out-patient procedure approaches. Neither the plastic surgeon or my LE therapist seem concerned about the nipping and tucking that will take place.

I am looking forward to having the "dog ears" around my abdominal scar reduced by liposuction but the nipple reconstruction has me worried since that area is closer to my problem zone(s). 

Wrapping every night for the past 6 weeks has maintained a degree of reduction in the arm but it is still swollen. I wear a sleeve when doing stressful activities and have a new glove on order because the gauntlet gives me chubby fingers.

Also, I plan to be back at work two days later so hope I recover quickly! Advice from anyone having been through a similar situation would be appreciated...  

carol57

On another thread, I just posted a similar question. Today I saw a doc for LE evaluation, at an LE evaluation/treatment clinic.  (I'm a 'maybe' for truncal, it seems). I asked during our consult if he had any reason to believe that lipo to be done in stage 2 (in my case, from midriff) would increase my risk for what he says 'might' be truncal LE.  His opinion was that the dermal lymph flow would not be affected, and that the midriff is not a major lymph thoroughfare, so he thought the added risk to lymph flow is truly minimal and not to worry about it.

My question on the other thread was just: does this coincide with what others have been told?

Vinrph, thanks for asking here.  Are you getting some fat transfer to fill in any areas?  I have a few odd-shape spots, so I want the lipo/fat transfer if it really is safe from an LE standpoint.

Carol

vlnrph

Had the work done last week under conscious sedation. Wierd to be able to hear and respond to what was going on.

The abdominal binder seems to be helping relieve the sensation of truncal edema that was present previously. My arm is not any worse. I took acetaminophen and was back on the job 2 days later.

Fat removed from the ends of the scar was injected into a hollow near the center of my chest (not that I'm planning to display much cleavage!) This area is still tender and makes doing the full range of manual lymphatic drainage massage more difficult. 

It was cute to see your picture - our miniature white poodle died last month. His heart condition was diagnosed at the same time as my cancer but veterinary cardiac treatment only extended his life by half a year. I'm hoping for a better outcome! 

carol57

vlnrph,

I'm four days out from stage 2, and wearing compression over the lovely bruises! I was worried about lipo making more mischief with my LE, which to date has been mild upper arm and truncal. PS was able to avoid that quadrant while still harvesting fat to inject in my dents and divots. So far, so good!  I have always had a tingling sensation in my SNB/LE upper arm hours before I can see swelling, so I am taking it as a very good sign that I have felt absolutely none of that....so far.  Am doing MLD three times a day, extra gently over the revised incisions and the bruises, of course.  My LE therapist assures me that MLD can help with post-surgical swelling--I certainly have that--so I'm hoping that knowing how to do MLD gives a little back-to-normal speed bonus.

Our standard poodle is the household clown with quite the personality and very, very sensitive. He amazes me with his seeming awareness of when I'm feeling off and in need of some attention, and although he's normally quite the rough-and-tumble fellow, he's been spookily conscious of taking care not to bump me in all the places that would hurt, after my original bmx/diep and now.  And you can see from the photo that he's our kayaking buddy, although a bit of a freeloader 'cause he just takes in the scenery while we paddle!  Dogs are sooooo therapeutic.  Sorry you lost yours and yes, you'll have a better outcome!!

Carol

kcshreve

Sounds like you are doing well.  Congratulations!  I love your description of your dog.   

vlnrph

I posted a summary on the reconstruction forum, describing how the Bali compression garments found at Kohl's have been my constant companion the past several weeks. The high waist option has extra strong lycra panels and seems to really help the truncal edema. I even sleep in one!

carol57

vlnrph, I have what I think is the identical Bali garment, wearing a 'genie' bra above (one that is sized smaller than I would normally wear, for added compression. What a get-up, but it works. My only complaint on the Bali garment is that at the top it's compressing right over a very sore spot, ouch.

This morning I measured myself just below the breasts and at the belly button, same places I was measuring months ago after recon, to gauge progress in swelling reduction. I took the measures before stage II, for a baseline, and I have identical measurements after lipo as before lipo. I really thought the post-lipo swelling would be worse than it is, that I would be larger post-surgery than just before, so am encouraged.  Can't wait to see how things settle down as the post-op swelling subsides, which my PS has told me will take months.  I am taking bromelain and arnica, but of course have no clue what things would be like without those, so it's hard to say if they are helping much. 

You're a few weeks farther along in healing than I am: are you seeing any noticeable progress in edema reduction?  Especially in the waistline area, which would help keep the pants up? 

Carol

carol57

Today marks four weeks since my stage II lipo/re-shape/scar revision surgery, so I thought I would report that so far, I notice no change to my lymphedema symptoms. 

The lipo has caused a good amount of swelling through the midriff and one breast where a fair amount of reshaping took place, but these are not areas where I have had LE swelling, and probably more telling, the new swelling does not include the tingling and heaviness I feel when my LE areas give me trouble. 

I did ask my LE therapist to suggest ways to extend my MLD to help with the post-surgical swelling, and she agreed that MLD can help with that. I tend to get post-surgical swelling in the late afternoon and in the evening, despite wearing compression shirts or camis nearly 24/7. The added MLD does a great job of reducing that swelling--at least that's what I think is doing the job! Unfortunately, like LE, the post-surgical swelling keeps coming back, but my PS (and reading) tell me that I should expect post-op swelling for some months.

I was worried about stage II making my LE worse, but I am fairly certain that it has not.

Carol