Diep 2012

basketnut3

All the things they don't tell you ahead of time. These forums have been my best source of information.



Day 3 and I am extremely tired but other than that still feeling good. Gotta get up and go for another walk. I haven't seen the PS since surgery but have seen several wonderful residence ps. Tummy swelling =less appetite for sure. Taking pictures each day so I can go back and see the improvements.

Bogie

Basket can you tell me who did your Diep, I am in Chicago. After 3 failed attempts with Tissue expanders and two cases of capsul contracture time to move on. I had a consult out of University of Chicago for Diep or Tram flap and wondering what kind of complications anyone had and if anyone had a hernia from the donor site in the abdomen, this surgery scares me. I have to lose 20 lbs before surgery. I hate the tight TE can't wait to get rid of the tightness from scar tissue.

cmbear

How long before the abdomen stops being so tight? I feel myself straightening and then my belly just tightens hard again. Beginning to get tired of looking like a stooped old lady!

goldlining

cmbear I was stooped for six weeks. PS said "you were not so fat!" and made it quite taut to get the flaps he wanted. But I forged ahead on treadmill with a mirror on the side view to keep tabs on trying to straighten, and when I went to run at six weeks, I could pretty much pull it off. It's 6 months now and when I am fatigued, I still find myself stooping some. It's still tight, and my physio is pushing the core strength to help keep the upright and fight the stoop.

Snobird

I only remember being stooped over for about 10 days. After about 2 weeks I would lay on a yoga mat on the floor on my back with my knees bent slightly and slowly lift my arms up and over my head as far as they could go with a slight stretch. Then I would try to slowly straighten out my knees. I did this twice a day until I was able to stretch out totally. I really took 3 weeks of this until I could stretch out completely. I didn't force it just went til it was slightly uncomfortable. I found that this also helped prevent cording from developing on my node removal side. It also was relaxing for my back which got tired of being stooped over.

dltnhm

Bogie, I am not Basket, however, Dr. Loren Schechter is my surgeon and he and one of his team of surgeons, Dr. Pavone, performed my DIEP during my left UMX at Advocate Lutheran General Hospital (in January). I have no personal experience with TEs, or reconstruction following failed procedures - implants or DIEP. I can tell you from research and experience with my DIEP that Dr. Schechter is one of the best. It would be worth your time to have a consultation with Dr. Schechter.

Here is a link to the website:

uplasticsurgery.com

So sorry that you have had to deal with failed outcomes and capsular contraction. 

Diana

basketnut3

Bogie. Dr. Michael Neumister and dr. Sommers are in Springfield at SIU school of medicine .plastic surgery. It is about a 3 hour drive for me and more than worth it. I had several PS tell me I was a candidate for implants but from my research if you have radiation a form of flaps is your only choice.



Dr. Neumister was recommended to me by a PS from Nashville whom I went to high school with. She trained under him and he DOES NOT use the tummy muscle. An important point for me since I already have back trouble. Your main points would be to find someone with many under their belt and I would say the part of not using the muscle. Dr. N. has a 97% success rate and I thought that was awesome.



Siumed.edu/surgery/plastics/. Phone 217-545-6314

I've done a lot of research but am still learning. However I never considered implants from the beginning.



He uses Memorial Medical Center and everyone is nice and helpful. If you would like more info or would like to call and talk, pm me and I'll give you my number.

basketnut3

Bogie. Dr. Michael Neumister and dr. Sommers are in Springfield at SIU school of medicine .plastic surgery. It is about a 3 hour drive for me and more than worth it. I had several PS tell me I was a candidate for implants but from my research if you have radiation a form of flaps is your only choice.



Dr. Neumister was recommended to me by a PS from Nashville whom I went to high school with. She trained under him and he DOES NOT use the tummy muscle. An important point for me since I already have back trouble. Your main points would be to find someone with many under their belt and I would say the part of not using the muscle. Dr. N. has a 97% success rate and I thought that was awesome.



Siumed.edu/surgery/plastics/. Phone 217-545-6314

I've done a lot of research but am still learning. However I never considered implants from the beginning.



He uses Memorial Medical Center and everyone is nice and helpful. If you would like more info or would like to call and talk, pm me and I'll give you my number.

Bogie

Thank you basket and dlt. I just went to Dr. Song top microsurgery expert for breast reconstruction in the Midwest. I have some time so I am researching. My current PS talked me into implants through a scare tactic, and now even those failed. I am a candidate for abdomen, wondering what is the risks?

DFOnt

Well I finally got some potential dates for my Diep surgery.  End of July  or 2 dates in August.  Of course my daughter's caregiver is off for the last 2 weeks of August, when the 2 possible dates are.  Wondering how I would be 2 weeks after surgery.  My daughter is severely disabled, completely dependent, weighs 40lb and has to be lifted in and out of bed / chairs etc. Figures.  I might have to wait for a later date.

Del11

Bogie- I think the main risk is having a PS who won't go to great lengths to fix things if a flap should fail.  Even in the best of hands they do fail (partially or totally).  Ask any PS you consult with what their "Plan B" is if a flap fails.  Don't let them put you off the answer with "let's cross that bridge when we come to it".  Find out what they'd do next and make sure you can live with that.

There's a growing body of PSs who do flap surgeries who are known to just walk away if a flap fails (and/or walk away if it just looks bad). Or they'll replace it with Lat Flap or implant.  If you can live with those options, then fine.  But you may want to find a surgeon who has the skills to do another kind of flap if one of your DIEP flaps fail. And you definitely want a PS who wants you to be happy with how you look.  It takes more than one surgery.  Some PSs only do a stage 1, which I find ludicrous.  But it happens.

basketnut3

DFOnt. I believe you will need at least if not more 4 weeks where you can depend om others for the major care of your daughter. It does depend on you and your condition but I would discuss it with your PS. I know right now I'm limited to a milk jug lifting.



This surgery is not something you want to take lightly. If you do it you want to protect it until your healed.



Bogie. Take your time making a decision and do your research. It has taken me 3 1/2 years to decide to move forward. Best of luck.

Chris13

I agree with basketnut....you don't want to take chances with lifting so soon after the flap. You could be seriously jeapordizing it. No way you can consistently lift 40 pounds, in awkward positions, no less. You owe it to yourself to be as safe as possible, just as you must be doing for your daughter. Also,you will be tired and want to take naps.

 My recovery went very well, and I was active about 2 weeks after (short shopping trips, movies, etc.) but still appreciated the meals and rides to the doctors from friends and DH. 

Bogie

Jesk and Basket I will take my time for sure. Do you mind telling who you went to and if you were happy with your surgeon? Feel free to Private Message.



Thank you

cmbear

Has anyone had a reaction to the surgical glue used on their abdominal incision. I am exactly one month out and have developed a lovely rash, itches and hurts and is a pretty red and bumpy looking. Miserable. Have a call in to the doc's office, but just wondered if there was something I could do in the meantime.

CookieMonster

Is there anything new? One month to develop a rash seems a really long time. I developed them a week after surgery (and we determined I was allergic to the surface prep material).

They told me to take benadryl and that it was OK to use the topical cream on it too, those were on breast incisions not abdominal ones, but I imagine the same would apply there.

Beckers

Having a moment of Oh My Gosh after telling my friend what DIEP surgery will entail! Should get my surgery date next Wed. Nervous!

Lavendarlady

I'm 16 days out and feel very well but i feel I didn't do enough research for after my surgery. I wasn't sent home with any exercises like i read so many people do and my sentinol armpit looks to have what I'd call cording. I see my mastectomy surgeon next tues. Called my local hospital navigator and she is sending me a booklet in the mail. I'm close to standing up straight but the skin is so tight. Which is good I guess my abdomen feels great but the breasts are sore...wondering when they will stop hurting? Maybe it's the nerves regenerating...this is certainly a huge operation which is hard to grasp until you do it. But like everyone else I still believe it to be the right decision. I can see past the bruising and the scars and at some point will get nipples made. The enormity of it all is just hitting me now as I feel better....and once again waiting for pathology results.

Beckers

Lavender - I know I thought I had cording in my armpit after my SN biopsy but it's gone now. They told me it was fluid build up but it felt hard. I hope so much I don't have complications and just heal at the normal rate. Did you have DIEP? Tummy is not too painful? That's encouraging. Looking forward to being on the other side of this.

New-girl

Lavendarlad,  I would greatly encourage you to get physical therapy if you can and your insurance pays for it.  I too had lots of cording but asked my bs to refer me to pt.  She gladly did it but would not have offered it if I hadn't asked.  My insurance paid for 8 sessions.  The pt stretched my arms and was able to greatly increase my range of motion.  I am now six months out and have almost all my range back and my cording is almost gone.  I also STILL have nerves regenerating which both the PT and BS said are good because supposedly my feeling in my arm pits are coming back.  I also benefited from finding a massage therapist that specialized in post surgical massages.  Very much helped the soreness as well as just made me feel emotionally better.  I am still learning about this surgery and this site has helped enormously.  Good luck!

bdavis

I had my SNB months bfore my MX and because it is dealing with the nodes, it stays swollen for a while.. I would leave it be for 6-8 weeks... and then see where you are. And also after DIEP, you don't want to get therapy right away and force your arms too stretched... that would not be good for the flap... walk your hands up the wall until you feel you have reached the limit... but don't go rushing into PT IMO.

Cherrie

If I am having DIEP and Hip Flaps when is it okay to do PT?  I like the idea, but don't want to rush into it either.  I don't want to compromise anything.

Lavendarlady

Beckers I had diep using the tummy fat. I didn't find the incision pain too bad but I had a lot of headaches and nausea. Caffeine withdrawal was probably in there too found hospital food offensive. As soon as I got home I felt better within the hour. My appetite increased immensely. It seems to have gone back to normal...neighbours are bringing in food to us...we have three kids...by the time i take my binder off i may have put on weight! I am going to ask my surgeon tues for a prescription for my insurance for physio. I'll see what time frame he recommends. They have said they don't think i'll need any other treatment but can't say for sure yet until i get my results, which they should have tues. Am wanting to go back to work on the 16th. Desk job 9-2...may just do 9-12 and see how it goes. That would be a month recovery. It really is hard not to rush it, but I really don't want to compromise my healing. Trying to take it slow. So far today I'm not getting that "weak, shaky, I need a nap"'feeling. I think my energy is increasing finally! Thanks everyone for your input.

goldlining

I heartily agree with physiotherapy. A good PT knows what you can do at each stage. They will help you ensure you don't wreck anything. Mine did no core exercises until I was cleared for that. I'm at 6 mos, and see her 2x/month. I alternate upstairs / downstairs: shoulder range of motion in one appointment and abs/hips the next. The tummy tuck really pulls the hips into flexion which leads to back pain if uncorrected, and she massages the scar to release scar tissue and it helps a lot. She will work it past the pain point where I would stop. The last visit, she was working on the whole vertical ab muscle that is all bunched and tight in there (and is very stiff and constrains the stomach when I eat and drink) and it helped a lot too. A big +1 on the physio suggestion. Mine is covered through my employee benefits as long as I have a doctor prescription.

Hoya03mom

I am scheduled for bmx and DIEP (or muscle sparing TRAM) on July 25th.  Any pre-surgery suggestions anyone could share to maximize outcomes and recovery time would be greatly appreciated.  19 days and counting!!  Did 2 hrs of aerobics and weight training yesterday (felt good to get back to the gym since I had been slacking off since April due to many surgeries!)  Any foods/supplements that help...or things I should stay away from?

Thanks to all who share their experiences.  I have gotten so many good suggestions from folks on these boards.

goldlining

Hoya03mom: core strength is a big asset before as you can't do much core exertion (no crunches) for the 6 weeks after. The stooping over is hard on the back/hips especially if weak core. 

You're in the home stretch now. Soon you'll be on the other side! 

bdavis

Hoya.. since you are having the TRAM and not DIEP, you may not be able to do core exercises for much longer than 6 weeks... With TRAM , they do take a piece of muscle. My local PS says that with the muscle taken, you may not be able to do sit ups, so I would follow your doctor's suggestions.

cascader

Cmbear, I am 1 month past sgap and have developed a rash also.

Mainly just on the flap but starting to spread a tiny bit to surrounding Area. My doc thinks maybe the surgical glue also, so I have carefully tried to remove what is remaining. Per his suggestion I am going this morning to buy some hydrocortisone cream. Hope your is better? Gone? Let me know

bdavis

My skin definitely had dry patches... not sure I'd call it a rash, but definitlely dry. I used cream, and it did go away.

Iamblessed

Anyone have stage II done while on Medicare?