Diep 2012

hoppytrigger

Hi there just wanted to post an update.  Had my bilateral DIEP on April 13th and now 3 1/2 months later I still havent completely closed on my abdomen.  I was out of work for 8 weeks then went back 1/2 time for 3 weeks then full time after that.  Apparently that is common for bilaterals but not really sure.  It is a small hole at this time and looks like it should close in the next couple of weeks.  I'm now working on scheduling my second surgery but need to meet with the OB/GYN to schedule his surgery at the same time to get my ovaries and tubes out.  Hoping to get a surgery date in September sometime.  I was hesitant to move forward so fast due to the fact that I'm still not healed.  The breasts turned out fantastic and only have small things to fix.  Was very impressed with that.  Never expected the amount of pain to be so bad.  Mostly in the abdomen now after standing a long period of time or with a full bladder (lol).  I look like I"m 3 months pregnant so was shocked that I felt that I was bigger in the abdomen but the PS says that she will work on cleaning that up in the second surgery by tightening up the abdomen and getting rid of extra tissue.  Does this sound normal?  I just want to be able to go back to my old clothes.  Scar will also get cleaned up at the same time.  Would love to hear what other people's healing times were with the second surgery and if their abdomen was larger than before?

Sabrina

florafarm

Hoppytrigg.

I don't think you should be having pain this far out. I'm at 3 1/2 wks and have no pain at all, except if I bump my drain.

SuzyBlue

Sabrina, It seems that there can be a lot of difference in healing times, pain and complications between women, and it is very difficult to compare experiences.



Generalising here but it's probably not the norm to be experiencing pain in your abdomen still. Having said that, my diep scar is still very sensitive and tender after 4 months. My scarring is raised and red and requires silicone taping for the next 18 months. Hopefully your surgeon is on top of the situation and you will be feeling more comfortable soon.

Galsal

Any suggestions on a tummy shaper for wearing after the compression binder isn't fully needed?

CookieMonster

I got a very basic one at maidenform (they had a minishop at our local mall) it's basically an elastic circle. I also got another one that hooks up the front at Fredricks of Hollywood.

Sharon1942

My breast surgeon & oncologists are in Dallas.  I haven't had my PS consult yet.

bdavis

GalSal.. Marena brand. Just google them.

spicedlife

Sharon, I had mine done at Medical City with Dr Laidley and Dr Antonetti.  I have not heard of your team.  Sorry

Lavendarlady

I had three c sections...no issues for diep. Diep incisions are healing really well...almost 7 weeks out. Another check up with plastic surgeon this week.

sandpiper1

I have been following some of the post here recently. Had my surgery 3 1/2 weeks ago. Healing well for the most part and finally got the go ahead to not be hunched over any more and begin the proces sof "straigtening" up.

I find the drain sites in the lower abdomen peskey. I had an infection in one and that pain was worse than my entire abd incision. The only thing that is bothersome now is some residual fluid accumulation especially above the left drain site-pulled  Thursday before last (noticed fluid accumulation on Sun night after drain was pulled). The infectious disease doc and home care nurse seemed to think it would reabsorb. I called in this past Friday and PS on call did not seem overly concerned at this point. (my PS is out of town). They told me to watch for increased pain, redness or worsening of swelling. I am just going to say it is annoying as heck at this point. For those who had fluid accumulation without it being drained-How long does it actually take to reabsorb?? This seems to be a question I could not get an answer to as yet.

I have been walking a lot, but really just increasing my distance each day, as I have been mobile since less than 24 hours from surgery and have walked every day since. 

I find that I am a bit "stiff" in the lower ab regoin and walking seems to decrease this, but weird feeling with the fluid shifting a little. Binder is on at all times except to shower and clean drain sites/change gauze. 

Thanx ahead of time for any input. BTW, extremely pleased with my recon. Just tickled to pieces with how amazing it looks and feels.

bdavis

Sandpiper.. It will reabsord faster with compression. Is there a way to compress it?? Or you can get it aspirated. I did this for a seroma in my breast. Most you can wait UNLESS the pocket of fluid is near an incision. I was told that if the fluid is putting pressure on the incision, it could pop the incision open. Path of least resistance kind of thing.

sandpiper1

TY BD. I had a restless night of sleep. Couldn't understand why as I had taken 1/2 a norco and ativan to sleep due to the stiffness and discomfort in my lower abd. Finally got up early this am to find my PJs and binder were completely saturated. The dam burst on my left side. I cannot describe the relief of having that fluid completely drained out. I thought that drain site had closed off. Guess my restless night was that drainage finally busting through. My right has a lesser amount which does hover above the incision line to about 1 1/2 in. above the old right drain site. As much as I would like that too to bust through, that drain was pulled on my 2nd admission to the hospital as it was the one that was infected and was causing more problems than was worth keeping it in. So pulled 9 days after surgery. The premise too was that the other drain would compensate and drain both areas, which seemed to be the case until lefty was pulled. Doesn't seem to be the case now as I have massaged the right to see if I could somehow 'move' the right to the left. Looks as if the portal is closed. I have my binder snug around my abdomen and put a peri pad over the gauze this morning to increase the compression and in the event the dam decides to burst again. I do remove that periodically as I do not want to trap too much moisture underneath. My abd incision is completely healed at this point. The fluid doesn't seem to be putting any undo pressure on it. Should that change I will call PS. Wow.......what we go through.

Most days I just have to look in the mirror at my beautiful new breast and know this was worth it. That and my final path being congruent with my origianl dx

I am also having fleeting tingling sensations in my new breast. PS said it was a little early for this, But I know he is pleased. Last night I had some itching sensations across the breast. The itch you cannot itch because the area is numb.  It's all very strange and new. For those far from their recons, what types of sensations have come back in your breasts? I know I will never have full feeling there again, just curious as to what types of sensations everyone has noticed later down the line.

I am so excited to take my walk this morning with at least one side of my abdomen feeling normal. My new normal.

TY for listening/reading. 

Have a wonderful day all

Galsal

How many wound up with highly sensitive skin from the binder?  For an odd reason, when took the first shower at home, found there was a full blister under it that wasn't in an area that wasn't being rubbed overly. 

We already knew I'm allergic to some adhesives so I'm thinking there's more to add to the list.  Just about every where some was got horribly itchy although thankfully this time did not break out in hives.

Thanks.

sandpiper1

Galsal,

My PS et al, had me put my shirt under the binder for comfort and to help with padding against the skin. I am still doing this and wear a camisole underneath with another cami or a shirt/sundress over it all during the day. Pj top only underneath overnight. 

I am highly allergic to adhesives as well and cannot use any type of tape to keep my gauze in place, so I have to lay down and position my gauze over the old drain sites, then the shirt then the binder-if that makes sense. Then I can pull the undies over the binder and don't have to fuss with it when using the girl's room.

Hope that helps. 

Galsal

That makes sense and Thanks, Sandpiper.  Quite an act of dressing you've got going there and sounds difficult.  At least this last drain should be coming out Tuesday, Thank GOD. 

One of the PS team said I'd wear this 24/7 for 8 weeks, then 8hrs daily (my choice of when) for a while after that.  Resident this past Thurs told me I didn't have to wear it unless I needed it.  Nope, not listening to that after what we were told in Preop.  Will ask PS when see him Tues.  Of course, he's the other one of the team so who knows what he'll say.  Unfortunately, the top of either binder I use (two different styles I was given) hits right at the underside of the seroma so I'm constantly readjusting to alieve discomfort.

sandpiper1

Oh goodness Galsal.......I stick with what my primary PS tells me too. He is very particular and his fellow defers to his prefrences. I did not have to deal with any residents. To boot the fellow is absolutely gorgeous and very compassionate. I think the nurses loved having me the extra days as the got to see Dr. McDreamy more often

I am not very tall. My PS had me cut an extra panel off of the binder to accomadate my body so it wouldn't hit me so far up in the abdomen. Not sure where your seroma is, but it might be another question you can ask. I have 2 different kinds of binders also for a total of 4-5. I think I accumulated them through the extra admission. LOL. Which is good because I always have a clean one. I hand wash the ones I wear each day. I have turned into a bit of a nut with respects to cleanliness after getting the infection. Wel.....I am a bit of a clean nut anyhow.

My PS will be having me wear my binder for some time to come as well and has placed a strict weight lifting/pushing/pulling requirement for me. I am at a 5# weight restriction and can move up to a 10# weight restriction within the next week or so. He will keep me on this restriction when I return to work. 

No messing with his work

Which I have come to repsect the heck out of his conservative nature.

Think it has finally stopped raining. I have been on and off the computer all morning. Cannot be too lazy even if it is a Sunday. hee hee Time to get some serious walking in.

Ok slow and steady walking.

Galsal

And here's the rub.  I'm being treated at the VA and the first PS assigned to and met with is on the team but the PS doing the actual microvascular part of the surgery has taken over for the most part.  I'll still see the other one too as I prefer him better in terms of long-term care than the one will see Tues.

Beckers

Having DIEP Thursday. I have 30 min ride home from hospital. How was it riding in a car afterward? Any pointers?

CookieMonster

Beckers - it was recommended that I have a pillow to go home and I did that, I also took the shoulder belt and put it behind me so only the lap belt was holding me. I also took a vicodin before we left. It wasn't the most comfortable time, but it was OK.

cmbear

Pillow is definitely the way to go. I pulled the top belt down around my arm too. I found that climbing in and out of my DH Malibu was a pain--too low to the ground. My Kia Soul has higher seats and much easier to slide into. 

My incision is SLOWLY closing--its only been nine weeks!! Last week at the PS they put Silver Stick inside(?) yuck and that seemed to help.She used a cotton swab to push it in and now the hole is smaller than a swab. FINALLY.

What is everyone using on their scars?? Any lotion that works really well? 

Galsal

Yes, pillows are the way to go.  Agreed that higher seats like in small SUVs are far more easier to deal with than low seats.

Four weeks out.  Last drain should be removed today and a seroma drained as well.

sandpiper1

I used a bath blanket folded up that extended hip to hip to pad/splint my abdomen and pulled the belt snug over it to hold.  Helped greatly. Had a 45 min drive too so I actually used one of those neck pillows (very small) under my shoulder harnes (neck to chest) so I could benefit from the full use of the seatbelt in the event of an accident. I also placed a pillow deep under my thighs and had 2 others positioned under the legs and feet to help give my lower half a little lift as PS wanted me in a continual lawn chair position. This helped to decrease the pull on the lower abdomen. (Left my legs a little numb by the time we got home. I put the seat back down a bit too so I was not sitting straight up but spent some time at lights leaning into my abd splint blanket.

I know, I know, I am a woman of many complicated processes.

I hated going out in a car for appointments, but the cushioning helped for those few times I had to go out. Now driving just 5-10 around my area 3 times so far. Much easier as the seatbelt shoulder harness hits my opposite non-surgical side. and the binder provides enough of a barrier for the lower portion of the belt. I can't place it anywhere else as my drain sites are so low and are still healing

Yeah for drains being pulled, incisions healing and greater strength for all in the days to come.

Galsal...so you will have both PSs doing your surgery-The one you really like and the one specifically committed to the microsurgery?

Cbear...I had never asked if it was ok to put anything on my incision as yet.  Of course with 2 drain sites still healing, PS only wants sterile saline and gauze to those sites at this time. My incisions have been getting a bit itchy lately. sometimes I use a dab of Aquafor, but very sparingly. I am also curious as to what others may have used with their PS consent. My scar has actually healed nicely and is very flat, just those darned JP sites.

Beckers

Thanks for info on car ride. I see you mention saline and gauze Sandpiper. Should I get some to have on hand??

Chris13

I had a thin tape across the abdomen that the nurse pulled off about week 3. The breast incision was soft, not scabbed across for quite a while so they gave me a "burn" cream for that, and I kept a thin guaze on it. After that healed, my PS recommended an antibiotic for after I went swimming in a pool. He did say no "lake" swimming, and I took that to mean until the wounds heal over completely. I was very careful the first weeks after pool swimming to shower right away.

Galsal

Surgery was done 7/9/12 and yes was both of the two I'd spoken of previously.  As of last week, Resident PS had me putting neosporin at the drain entry of the last remaining drain.  She'd already had me putting it in certain areas of the incisions.  Today, Lead PS said to put it along the entire incision.  Based on my very extensive surgery, am to continue wearing the binder as originally planned - 24/7 for at least 8 weeks and after that for 8 hours daily (my choice of when).

Seroma was not drained as expected today, which is most frustrating.  Drain was not removed, also frustrating.  It's thought that there's still draining to occur, despite the continued compression garment since awaking in icu.

Did my good deed today by speaking wiht a young woman (another Veteran) in the waiting room who was there for her one-week post-op from a Tram.  She was an emotional mess, as this had been her bmx/immediate recon surgery.  She'd wanted a Diep but it wasn't being offered for her.  I let her know that it was totally normal to be so emotional following her surgery based on what she'd had done and explained how my surgeries had been separated by months.  Shared with her that I'm just as emotional if I think of future recon surgery for right now.  She was in awe that I was almost upright and I let her know that she'll get there, that it's a day at a time process.   To top it all off, today is her birthday.  This lovely young Veteran had her mother with her through the entire process as they were from the other side of the state.  Before I left, the mother hugged me and whispered her thanks for my speaking with her daughter.  I'd spoken of BCO to the young lady - said she lurks here but never has posted.  I encouraged her to do so!!

SuzyBlue

cmbear, I have been going to a physio at a burns unit to try and get my scars in better form. At the moment they are raised and still red, my reconstruction was in March. I had a bad reaction to the tapes and adhesives they used after the surgery and I think that has contributed to the problem. Anyway I now use silicone sheets that I can cut into lengths (and circular shapes for my breast scars) and wear them over my scars from morning to night and will do so for the next 18 months. Here's hoping it is worth the inconvenience!



She also recommends massaging moisturizer into the scars and de-sensitizing them by tapping on them and rubbing them with the towel after showering.

sandpiper1

Galsal.....that story warmed my heart. I am so happy that you had the strength and compassion to be there for the young vetern (and her mother too).

Hugzzz to you young vetern-hoping you are well and know you are welcome here in whatever capacity you feel comfortable.

(sorry I was a bit confused about your surgery Galsal-I do not think I have scrolled back far enough in these posts. I lost a good 2 weeks in my post surgery haze)

Beckers.......I am quite the minimalist even though I seem very high maintenance with dressing and riding in a car HEE HEE

Every PS has different approaches. Let me say that My insurance covered a home care nurse who brought me supplies. I did end up getting an extra box of sterile gauze at the store, when I ran out of my supplies. I was also supplied with binders from the hospital and used a lanyard for my drains when I showered. I originaly had a velcro strip that I could run through the JPs and attach to the binder. I am highly sensitive to adhesives. None were used. surgical glue to incisions and no dressings other than the jp sites.

I found and still find wearing camis and tank tops to be comfortable and easy to manage for dressing. I don't like button down tops normally so stuck with one size larger in the tanks and camis. I only wear cotton so sliky PJs were not in my realm either, but some find them nice for slipping in and out of bed. I have yet to wear a normal bra. Guess I am a little protective of my new "girl". I found some cami-like bras at Walmart that are comfortable yet not restrictive. I also found the camis to help under a tank and have a cute cami with soft cup inserts that is comfy. I wear sundresses that don't require bras and wear shorts almost all of the time. The hospital will often give you a few limited supplies to go home with, like alcohol pads (for stripping drains) and gauze. I would ask for medicine cups for when the drainage gets lower. Easier to see the volume and more accuarte on the marked med cups when it gets below 30cc.

One of the best things I took was 2 of my own pillows and baby wipes so I could freshen up at random. I also had a make-up bag with my essentials in it-lip balm, travel-size moutwash, toothpaste, toothbrush and hand sanitizer, phone, earbuds and cord. When I could move around, I taped my phone cord to the bed or bedside stand so I wouldn't lose it or drop it when I needed to plug in.

Music via Pandora on my phone helped me relax a lot!

Oh wow it's very late.

Sweet and comforting dreams all

piper

Anonymous

Nervously joining this group with a DIEP scheduled at the end of the month. Would appreciate any PMs or words of wisdom, encouragement, advice. etc.

Chris13

Windlass,you should be fine. It's such a better way to go when the circumstances make losing breasts necessary. Most people are back to some semblance of normalcy in a couple weeks. The time really does go fast. Just plan for help (as possible) in the first couple weeks back home. Let friends/neighbors know (again, as possible) what you are going through, enlist family (DH had list for himself and daughter....LOL no one thought of adding my "adult" son to the To Do list)--and never turn down home cooked meals or rides to the post-op appointments.

 Soon you will be giving others the benefit of your expertise as you come out the other side of the surgery!

DFOnt

I finally have the Diep surgery scheduled for Sept 10.  Nervous about the surgery itself and not sure if I'm going to be able to manage having my daughter looked after. Going to have to read all through these messages soon and decide once and for all if I can do it. Ugh.