Diep 2012

Sadie55

I had bilateral diep reconstruction three days ago.  The hardest thing for me has been battling the nausea. I've just stopped taking narcotics because I can't tolerate them.  They have me on Tramodal for pain, and it seems to be doing the trick.  I haven't found the recovery to be too painful.  This has been difficult, but I'm glad I went this route.  From what I can see so far, things look good, although my breasts seem to fall to each side rather than point ahead.  Maybe this is because I'm looking at them while lying down.

Sheila1958

My doc did mention this but I was afraid of it being another big surgery. Did you say it was easier than the DIEP? I would like to know more details. I was just reading a few posts about people who did not like their implants. So many decisions...

bdavis

I'd be happy to talk with you... Yes, the GAP flap is MUCh easier.. I had no pain, quick recovery.. The only down side is that you have drains for 6-8 weeks, but its a small price to pay IMO. I went to NOLA where they do a lot of them... so I had GAP and DIEP.

dressager

i was switched to oral pain meds yesterday, discharged this morning, and sleeping on my sofa by noon. per my surgeon. things are going remarkably well. pain is not bad and i probably have about 95% of regular posture back. my biggest issue is maintaining that 45 degree reclining angle on my sofa... and then getting off the sofa with minimum assistance from my arms. my drain sites are being a little bitchier than they were for my mastectomies--drainage from the insertion site---yuck!

a couple of questions for y'all:

• any tips to help me get off the sofa? my nurses were surprisingly unhelfpul in this regard. if you don't have someone to help you at home, you're regarded as something of a freak.
• how did you handle the caffeine issue? my surgeon never mentioned reducing or eliminating caffeine and i forgot to ask him about it. one of the doctors in his practice rounded on me this weekend so is asked him. he equivocated and said it might be voodoo but it might be useful to avoid caffeine for a few months. gee, thanks. i haven't had any but "a few months" will be challenging. of course, it's a small price to pay but i'd like to hear others' experience.

bdavis

Caffeine... I was never restricted. I don't drink caffeine drinks anyway, so it was never an issue, but the hospital that serves many many flap patients serves coffee all day.

About getting off the sofa, try a roll... The other thing I did was put my hands behind my legs and kind of rocked up. I know it used my arms, but not that much.

julianna51

Off topic....but I'm in a panic.....I just got home from visiting my daughter and picked up my mail from yesterday.  There was a notice in there that my insurance did find evidence the request for approval of my surgery that it is medically necessary!  Seriously???  I know they had already done a preapproval back several months ago when I first scheduled the date...could they change???  I am sure this will get worked out but I do not want any delays.....my benefits change the first of July at which time I'll have to pay 10% on the surgeon and hospital stay.  No WAY!   Has this happened to anyone else?

dressager

thanks betsy---rocking is a great idea. i'll try that next.

julianna, no advice but am sending you jingles. this stress is not what you need. i know there are some coverage experts on this board---one of them will respond.

julianna51

dressager - you're home already!   Wow, that is wonderful.   Sounds like you are doing wonderfully.  Thank you for the 'jingles' - you're right...stress is the last thing I need.

TexasRose

Welcome home, dressager! My PS doesn't restrict caffeine. I was grateful for that! Funny but that is exactly how he worded it when I asked him about it. He said- exact words- "That's voodoo." I had coffee in the hospital.

Chris13

Sadie, I had the same nausea and couldn't stand to eat. After several calls and refusals, one of the PS surgeon's nurses called in an antinausea drug....ondansetorn. I got off the heaviest pain meds as soon as I could, but they are still in your system....plus the antibiotic I had to take twice daily was a main culprit.

Also, a friend used fresh ginger to make me a tea (add honey), plus there are teas, such as the Yogi brand--something like "stomach tea" that have lots of ginger. Ginger ale, BTW, has no real ginger. I also had some lemon drops, but I bet there are ginger candies.

 You will get past this, but it is horrible in the meantime. 

goldlining

dressager, a way I used to get up from reclining postures was to grab around my knee and use my arm strength to pull me up without using my abs. The knee is the fixed position, and the arms can flex to pull towards it. If the knee is too far away, a towel can be used - loop around the knee (or foot) and grab the ends and pull with the arms.

fredntan

Hi everyone, i am just looking ahead again. My PS wants me to wait 12 months after rads now. Per new recommendations fromMD Anderson. Says there is less chance of failure. Sigh.



He said the diep with new mast on left can be close to 12 hrs! I have TE in rt now. Is the sx really that long?



And is everyone pretty much happy with there new breasts? I have only seen pics. I hate looking this saggy left boob and this thing on rt that looks like coconut split in half. Poor dh is squimish. I just want to feel like me again.



I was really looking forward to sx in november, but may be able to make it until feb 2013



Oh and has anyone had experience with dr Rossen PS at johns hopkins & dr Gavin BS same place? I have moved my team closer to home. Unfortunately i woke up in horrible pain with initial mast and was told pca was reserved for BMS. That was at sloan kettering

CookieMonster

Hi fredntan. I had a UMX with DIEP and the surgery was 14 hours. Everyone said my PS is a perfectionist, apparently he is. But it looks great, even in the hospital the nurses oohed and aahed over how good the new breast looked.

I've heard a number of people mention waiting now, must be a new thing, hopefully it means there will be more success to come.

As for the docs, I'm on the West coast, so no help there, sorry.

I too have a saggy left boob, but that will be fixed in July when we do a lift and reduction so that it will match the rt. breast.

julianna51

I'll be about 9 months out from rads at the time of my surgery....here's hoping that it is enough and all goes well!

bdavis

Fred... I had BMX and bilat hip flaps and it took 10 hours.

TexasRose

I had right prophylactic mastectomy (left was already gone) and bilateral flaps and my surgery was 9-1/2 hours.

I also had nausea. I ate very little in the hospital. Once they took the morphine away, I was fine.

rtnyc

dressager, to get out of bed/off the sofa I kind of slid my leggs off first and then rolled off to one side and pushed to a standing positioning through my butt. it takes the pressure off your abs and hamstring (no matter what it still hurt to some degree). I am 4 weeks out from bilateral mx/immediate diep flap recon. Pain was managed when I came home through med's like perco and others but I took it on schedule every 3 or 4 hours no matter what becuase if I waited for the pain to kickin I felt worse.  after a couple of days, I stopped taking the hard drugs as I didn't want to feel loopy all day long. I went on 3 tylenols every few hours. I have to say, the real pain went away but new pain came in. The nerves in my body, literally from my neck to my thighs, started to come back. Weird sensations, like electrical shocks across my chest, pins and needles. You couldn't touch my body at all. This pain was so much worse then immediately out of the hospital.  Additionally, no energy, so tired and insonmia like crazy, up all night.  Try to sleep in bed, the sofa, the chair, sitting up lying down with drugs without drugs.  I have xanax and not working, it's 1 mg.  I also have ambien 10mg...not woking.

goldlining

fredntan The time sounds right to me. I already had one mx and so I had the other umx and bilat DIEP and it was about 10-12 hours (I was really groggy for a long time when I woke up, but I think I went under at 0830 and woke in the early evening but came in and out of awakeness for hours). 

barbsnewlife

If you can afford one I got an electric rocker recliner from recliner land, all I do is push a button that sits me up or lays me back to what ever angle needed. I got it for my mastectomy knowing that laying flat would be uncomfortable and it keeps my from trying to sleep on my side. I paid about $500.00 for mine. Since then I have also seen them at Big Lots for $399.

I noticed you are in Seattle, I am in Edmonds and will be doing reconstruction later this year.Where did you have your surgery ? If I can help somehow let me know

Best of lUCK, Barbara

Ralsper

Barbara - Where are you having your surgery and who is your PS?

rtnyc

my surgery was 11 hours. as my doc's said I won't know the difference of the time but my famiy and friends will....

Jeannie57

I see several Seattle-area ladies on here, and I am one, too.  I am not having DIEP for a year or so, I'm actually just starting chemo, then rads and then more chemo so I have quite the wait.  But thinking about DIEP was scaring me. Your posts are helping me get my head around it.  My doctor is Dr. Said and I meet with him today to discuss how many more fills I need.

dressager

thanks for continuing suggestions on how to haul my useless self off the sofa. it gets a little better each time. a recliner is just an option for me: my house is small and the thought of the work to get it in and out, moving furniture, hiring people, etc, just makes me want to take a nap.

i'm a seattle person. my surgeon is keith paige at virginia mason--he has two plastic surgery clinics: the main VM campus in seattle and an office in federal way. dr. paige performs every reconstruction case with a partner that i never met--kevin beshlian. i was rounded on by a PAC and another surgeon from the practice over the weekend. dr. paige did come see me in the hopsital on friday night, after he finished his clinic hours at federal way--that was really gratifying. if you know seattle traffic, you know it was no small effort to come back to the city.

his office and nursing staff is excellent. i had a rough situation when they found a big ovarian mass during my diep preparation testing. dr. paige and his staff did a ton of out of the box care coordination for me and, as soon as i made it through the detour, they got back me back on track and snugged up the cheduling to the extent possible, given that i had to heal from a giant abdominal incision. dr. paige also consulted with my gyn surgeon so that her work didn't jeoparidze the viability of my abdominal tissue for diep later.

any reconstruction candidate in the pacific northwest should be talking to kevin paige.

bdavis

Jeannie.. if you are getting a DIEP, why are you getting fills? Thee is no need to expand the pec muscle for DIEP, and for those who had a TE and implants and then get DIEP, the surgeon reattaches the pec muscle to where it belongs.

cmbear

Had my pre-op today for next week's surgery. Took photos--ooooh yuck!!!  Otherwise the only testing was a CBC blood test and an EKG. Told to lay off the caffeine now since they won't let me have it in the hospital and the first 6 weeks. She said that the worst thing was how women would be having caffeine headaches after surgery and they couldn't give them any decent painkillers to relieve them. Also told to lay off the vitiman E since its in the aspirin family. Learn something new every day. 

Now my big challenge is my 20 year old has a horrible cold. I have been wiping down everything I can think of with Clorox wipes but the nurses were more worried about the airborne aspect. So I am going to my parents for a few days. I will not get sick!! 

rtnyc

I had major migraine like headaches in the hosptial and they figured it was due to caffeine withdrawal. They let me have coffee and wala, no headaches....even just one cup a day in the morning helped. Also, after 3 1/2 days in ICU they only food I ate in the hospital was a fruit platter which helped on the constipation front in fact no appetite for 3 weeks, it's first coming back now...wish it would go away again. haha

Starfyre

I finally met with a plastic surgeon last week. She trained at UCLA and has done about 200 DIEP procedures.  She said she usually takes a tiny bit of muscle ( about 3" by 3") about 50% of the time she does a DIEP because sometimes the blood vessels are not adequate without the muscle portion.   She said that people do not feel the difference and that I will not noticibly lose any of my muscle strength.  Could this be true?  Did anyone have a bit of muscle cut for their DIEP?

I am starting to feel a bit anxious all over again.  I am in the midst of setting up an appointment with Dr. Tseng at UCLA for a second opinion.  My target surgery date is the end of June.  

I am finding that I am a bit more depressed with this second bout of cancer than I was with my lumpectomy 9 years ago.  I guess it is about losing my breast.  

bdavis

Jannelle... Any time muscle is taken it is no longer a DIEP, but rather a TRAM. And my local PS who doesn't do DIEP said he would never do a TRAM flap because it will forever compromise your core strength. 200 DIEPs is not a lot... your surgeon should be performing 5-10 per week, and should GUARANTEE that no muscle will be taken. If they take muscle 50% of the time, then they are not that experienced. My PS has done thousands and NEVER takes muscle, ever.

Starfyre

Bdavis, that's what I thought also about the muscle.  I originally thought 200 DIEPs was a lot, now I don't.  Sigh. These decisions are so hard to make, it is hard to know who to go with. I really have appreciated the suggestions for PS's.   Hopefully I will get an appointment at UCLA for a second opinion. 

This forum has recommended NOLA very highly.  Maybe that is the way to go.  I have just contacted the Center for Restorative Breast Surgery via email regarding a consult.  It will be a pain to travel to Louisiana from California, I am thinking, but I guess much more of a pain to not have good results for the rest of my life.  I am 50 years old and hope to live a bit longer.   Stupid cancer. 

Chris13

My PS is head of plastic surgery at U. Penn, and he said he may need a tiny bit of muscle. I asked about any chance he would switch to TRAM during surgery and he said no, definitively. I didn't ask if he took any muscle, but I was able to raise myself in about a week using my nonaffected arm. Despite the scar from side to side, my abdomen feels fairly normal. The new norm, anyway.

Funny how I'm compulsively all over the vast amounts of info on possible LE, the SEs from Arimidex, possible chemo (awaiting Oncotype), all the medical stuff. But I didn't really want to know the surgical details.