Diep 2012

fredntan

Lee I had my rt mast last sept at MSK in nyc.

Woke up from sx, asked where my PCA was, nurse said "those are reserved forbilaterals"

My PS had told my DH-she will be in lot of pain, probably need 2 night stay since i put in 300 mls fluid in TE.

The BS was in charge, took many hrs of my bitching to get pca. So many things went wrong that nght. I just got the hell out of there the next day. Everyone else in my class thatnext am on arm exercizes looked so refreshed.

Lee_S

H,

Your discription of how a little tendering loving care from nurse made me absolutely appreciate what you were saying.  So glad they didn't have to restitch anything and that you are on the mend.  We are going to Vandy on Monday.  I may not be a canidate but have been encouraged by the replies in this thread.  I feel that Dr. Wendel will be my choice if I can go with DIEP.  Hooray! you are finally starting to feel a real difference.  More later...

goldlining

Chris13, some hard spots are likely to be residual swelling around the internal stitches, where they stitch the layers into place to get the shaping they want. I read my OR report and it described it step by step and so early on, I figured those spots I had were in areas where it is reasonable that positioning stitches might be. I have it less now. Not to worry, just ask your surgeon. We're almost always more worried than the surgeon is with these things.

DFOnt

Any suggestions on what to do with the abdominal drains? Managed to get myself dressed in a regular tshirt and track pants with pockets so I have them in my track pant pockets now but I think I only have 1 pair like this. Looks pretty lumpy anyway. Anybody found any creative ideas that work well?

sandpiper1

Dfont.......I had a Velcro piece that all of the bulbs were looped through & attached to binder. When I was not able to wear my binder due to abdominal cellulitis. I pinned them to my clothes or left the pins on the drain loops & put them on a lanyard for me to carry. Loved my lanyards. Made it easy to shower & carry all of the drains together. One of the PS guys remarked about the lanyard to. Wants to make them with their practice name

You can use shoe laces too. I just happened to have a few lanyards from different work places over the years

DFOnt

Ah, I don't have a binder, just underpants! The lanyard idea sounds good for showers or something but I was thinking more about going out in public, looking inconspicuous if possible.

sandpiper1

Dfont you going out to lunch already???? j/k

Honestly just pin or stuff em where u can. The binder really helped for a place to put them but pinned to clothes too. I wore sundresses for appts. I wore lots of large tanks to & had sweaters & jackets to cover. Mostly the lanyard was great for roaming about. Walking & showering. Hopefully they'll be pulled by the time you have your system down pat. Drain1 was out by day 8-9. Drain 2 out by day 13-14. Drain 3 pulled 2 days after drain 2.

ReadingMama

Lee - vary happy with my decision!  But, yes, the breast will gain and lose weight with you, just like your "original" breasts do/did...

Dfont, Mine was in the winter, so I had an old maternity zip up sweater with pockets that I put them in, although I don't remember really going out when my drains were still in...I was in hospital for 4 (maybe 5?) nights.  I can't remember when drains came out and I don't have my notes here...

bdavis

I had drains for 8.5 weeks.. so I think it is totally doable to hide your drains... I used a small black over the shoulder bag.. so the drains were in the bag and I slipped it cross-wise over the shoulder and to the opposite hip. I wore lounge pants or the like and blosson style shirts. No one even knew I had drains. And I had 5 at one point.

DFOnt

Good idea Betsy, I probably have some kind of bag. I an not one to stay at home! I would like to go out for lunch, lol. My taste buds are still kind of off I think. I had the 1 breast drain taken out yesterday, still have 2 abdominals. 1 wasn't draining at all, then it started working when they were going to take it out. Right side isn't draining too much. Have to be under 20ml / day to come out. I have no dressings other than around the drains. Guess I will have to play around with my clothes, bags, see what I can come up with that doesn't look too weird.

goldlining

My last drain was out after the 2nd day at home, but I was also December so I wore loose cardigans and clipped the drain to the back waistband of my Lululemon pants and let the top drape loosely over.

At home, I wore PJ with pockets in the shirt and just dropped the grenade in the pocket. And the conference lanyard in the shower.

The homecare nurse tried very hard to get me to leave the drain another day and I insisted that it come out when it met the criteria on the discharge instructions. I guess they're paid by the visit!

DFOnt

What kind of dressings did you all have? I left the hospital with just one drain sponge gauze taped around the drain tubes where they come out of the abdomen. Nothing over the incision. Home care nurse today changed dressings and I didn't pay attention to what she did at the time. She put about 4 layers of gauze over top of that and taped it right on the incision. I just re-did one side because the gauze was all over the place and the incision started to bleed. Great. I don't think there should be gauze, or tape over the incision if that was how the dr did it, right? Home care also keeps telling me I can't shower until the drains are out when it says clearly on my discharge instructions that I should shower every day! The nurse didn't know what surgery I had either, think she assumed I had a mastectomy, asked me if I was going to have chemo too. I put the discharge instructions in her folder to show her and I will explain how I think the dressing should be. She didn't even empty or milk the drains, just looked at how much was in the bulb, which was squeezed so that wasn't even right. Said they will come daily til Monday then reassess and maybe come every other day. Honestly I think I can do a better job myself! Lol. They do have a 24 hr # and will send someone out if I have a concern, which is good. Didn't really think about all this til I was getting ready for bed.

DFOnt

Goldlining, glad to hear your drains were out that quickly! other than my home care vent I am doing pretty well. Taking tylenol and the occasional oxycodon. Just tight, slow and stiff. My taste buds are off though. People are making me great meals and I can't completely enjoy them! Have family / friends staying with me til next weekend which I will spend at my sisters, which is great! Getting all kinds of stuff done around the house! Hope everyone is doing well! One day at a time!

Beckers

DFont,



I just had a 3 x 3 gauze pad slit on one side to the middle to slip over drain tube. No tape directly on incision. Ouch! As far as showers are concerned, it seems some PS allow it and some don't. I would verify with your PS. Not worth chancing infection in my opinion. Glad to hear you are feeling better. Keep up the good healing work! )

Kd6blk

We showered in the hospital, thank God! I showered most everyday as it made me feel more human. They had us use anti bacterial soap like liquid Dial and wash above the breasts and let it drip over..then wash above the tummy tuck...it worked fine. I had no infections. A wash cloth helped to soak up water and rinse off. They did say no baths. I had one drain that lingered to week 3 or so and we did pad with gauze and we taped to the side of the sutures.

As for that home care nurse..if you don't strip the drains, not only will it get pretty nasty but you will not get an accurate reading of the fluid I would suppose.

I went to PRMA.

goldlining

DFOnt, I assume you talked with Elizabeth at the hospital about the homecare arrangements. You can let her know about your concerns and she can communicate them to the agency. I found it hard standing toe to toe with someone who I thought could cause me pain, even when I knew they were using wrong nursing techniques. (I summoned their bosses to my office after the whole thing was over and I chewed them out, but I could not do it to the RPN in my living room.) Because I had a bad experience post mastectomy 2010, I warned Elizabeth for the DIEP 2011 she needed to pick a better agency than the previous hospital had. (Turns out, in a previous job I worked for 6 or 7 years with the CEO of the agency they sent me this time, but I didn't have to fire up the LinkedIn and pull any strings because Elizabeth ran interference.)

I came home with a clear plastic tape over the ab incision about 6" wide that ran hip to hip, but that came off as soon as the nurse got instructions (she thought it should have come off before coming home). I had a gauze over the drain insertion point (simply changed after showering). I can confirm that our surgeon is 100% pro-shower. I even shampooed my own hair unassisted the day I got home. I was allowed to shower with drains post-mx from the other hospital as well.

If you are not draining over the 20mL, and the discharge orders say the drain comes out at 48 hours post discharge or <20mL whichever is later, you can make the nurse take the drain out. I was 15mL both days after I got home (and before), and she wanted to leave it another day for some reason, and I said call the hospital and speak to the surgical nursing unit if you are concerned. She said "I don't take orders from a nurse. I take orders from a doctor." I said "the doctor wrote 48 hours or <20mL whichever is later, so take the damned drain out and get lost." The drainage is increased by activity, so being relaxed will reduce the drainage. I was already on Keflex so I did not need to worry about infection.

It sounds like you're doing great. Just keep it up and don't push too hard. Looking back, I should have done more relaxing while I could. The exercising was okay, but I pressed my brain back to work too soon, and I am wishing now that I'd relaxed more. Live and learn! 

Hoya03mom

from various posts above....I was told no showering until all drains came out...but then he said ok when only one was left (at 3 week mark...)  I used ribbon to pin drains on in the shower and Hanes sleeveless men's cotton T-shirt to pin on rest of the time. Made do with handheld showerhead  and sponge baths...and several trips to local beauty parlor (and I do mean beauty parlor..like a flash back to the 60's, colorful curlers everywhere!  very visual) where a very nice woman would wash my hair.

 I had very little bandages...nothing on the stomach including no binder of any kind.  Still having leaking from belly button, but other areas are on the mend and some are even fading away. 

My only concerns are that I am still fairly numb around middle of stomach incision and boobs feel enormous and seem very heavy.  Have PS appt tomorrow so will hope to find out more, including "stage 2" options. 

Sharon1942

I am scheduled to have a unilateral DIEP flap reconstruction this coming Tuesday, Sept. 18th.  I am wondering if anyone knows why my "Preparations For Surgery" instructions said, "If you develop a facial sore prior to surgery, please notify us."  Just curious!  I do have a stye on an upper eyelid, so I am worried that the PS may postpone my surgery.  That would be devastating, as my family as made all their arrangements to be off work, etc., to help me since I live alone.  I did call & tell them, but told them there was no pain, redness, swelling, or itching associated with the stye.  The assistant asked the PS, & they said as long as it doesn't get worse!  Yikes!  I am so ready to get this reconstruction surgery behind me that I will be disappointed to postpone even one day!!!

bdavis

DFont... I showered at day 2 at the hospital and everyday after that I had my drains (2 of them) for 8.5 weeks. It was fine and probably good to keep it all clean. I would shower and betadine all drains sites and layer pads over the incisions (just to pad me between incision and compression garment) and around drains sites.

J-Bug

I was told to shower as I had the clear plastic covering over the last two of my six drain sites. I was told not to reach up high enough to wash my own hair though. I had radiation and that skin is very difficult in the healing process (which is why my right breast is hanging open 4-5" waiting to be restitched on Wednesday). Now that that has happened, I am not showering. I am just changing the diapers that I am using as dressings and wiping down somewhat with a washcloth.

My last two drains were the ones in the groin area. Both had the stitches tear through the skin. One drain lost its suction after that and the drain tube finally just came out in my lap. The other one tore through the skin, lost its suction, so I just pulled it out myself. Of course I cleaned up the sites with hydrogen peroxide and put several layers of guaze over them.

I will get a new drain on Wednesday when I get restitched. Oh the joy!

J-Bug

How long did it take you ladies to have your bellies feel "normal"? Mine is very tight, hard and bloated. I am 3 1/2 weeks out of DIEP. I went to put on some dress pants to make sure of what I was wearing to an event tomorrow, and I can't button and barely can zip any pair that I have. I think that I have to wear a loose blouse over them and try to fake it. I lost quite a bit of weight with surgery, but my clothes are all still tighter. When does this start to change?

Also, does anyone have a harder time eating now? I eat very small portions and take simethicone for gas pain every day. Does this go away? I almost feel like my PS zipped everything back up too tight! : )

Beckers

J-Bug,



I am 5 1/2 weeks post and still feel uncomfortable in the tummy. I am just now able to walk upright for most all day. My tummy is very firm and larger lumps...not uniform by any means. Binder feels good when on. I wear stretchy pants even with the weight loss. Don't like to wear anything binding.

I eat less. My appetite is definitely affected. Probably a combination of anesthesia and meds. I am also afraid to eat too much because I think it would be too uncomfortable.



I can't imagine going through all of the problems with drains and the open incision. Try to keep your chin up. Wednesday is around the corner. I wish you the best and much success with the procedure. Hang in there.

J-Bug

Thank you Rebecca. That is very helpful.

cmbear

I'm now 4 days out after stage 2. Much, much simpler and easier surgery. I was suppose to have my nips and areolas done, but the PS decided since he was revising my nonradiated breast up--taking out some tissue to make them more symmetrical---that he would wait on that part of the procedure. Couldn't guarentee that one breast would be perky and the other one would point who knows where. So another procedure in 2 months. So with this surgery, he lifted the non radiated breast(opened up the scar and slid the skin closer thereby tightening it), fatgrafted the radiated breast( meaning he lipo'd on the side of my hips---nice pretty bruises there!) and fixed my abdominal incision that had opened up. The only complication I had was quite a bit of draining the first two days--which to me was frightening because it was blood. But the nurses assured me that is was irrigation fluid and that it would stop. Thankfully it did by day 2. I have been sleeping in my recliner, all my choice because I don't want to roll over on my bruises and also afraid to open up my breast recision. AND I don't want to bother my DH with my weird sleep patterns. The pain is minimal--more discomfort. I go in tomorrow for post op checkup and they will change my dressings. 

As for standing up after the initial surgery--I was a good 6 weeks out before I could straighten out. But then  I had back issues too.Sharon, should be ok with your surgery with your stye, as long as it is not active. With this surgery, they sent me home with a cleanser to shower with the night before and the morning of. For my first surgery, they just said use Dial or an an anti-bac soap. Then when I got there, they gave me these special wipes to wipe down my chest and belly with. They also gave me these swabs that I had to wipe my nostrils with and then a special mouthwash. Guess they are taking this infection stuff seriously!!!

As for drains, I had bought some pockets for my BMX last year that are adhesive and stick to the inside of your outfit. You just pop the drains into the pockets and you are good to go. The adhesive tape allows you to move the pockets from shirt to shirt. This time around, my mom got me 4 inexpensive "dusters"---they button or snap up the front and all had pockets and they were loose. I just made a little slit in the fabric and pulled the bulbs thru and dropped them in the pockets. Perfect for puttering around the house or sleeping in.    

J-bug-- I have been wearing pull up elastic shorts or yoga skirts since June. I have stayed the exact weight and can't seem to get into any of my previous clothes that zipper. My body certainly changed shape. As far as eating, I wasn't terribly hungry for weeks after. Mainly because I felt like I filled up quicker. i still feel that way, which is great cause it helps me from overeating. The gassy bloated feeling does eventually go away. Just keep moving and walking--it'll help. I had an open incision on my abdomen until I had my phase 2--I just kept it covered and clean and they "fixed" it and closed it up last week. Some incisions take FOREVER to close--I am glad they are resewing yours. It'll make for easier healing. Good luck this week and I hope they fix everything so your recovery is easier! 

bdavis

About fitting into clothes... I continued to wear elastic waist pants for the entire period post stage I and right through stage II... After about 6 weeks post stage II I was out of compression and could wear my pants. Now a year post stage I, there are no issues... but it does take quite a while. So 3 weeks, and even 3 months, may be too soon to see results.

Kd6blk

Sounds like we all react differently. I was BMI 37 going into my DIEP Flap, so the tummy tuck, I swear Dr. Nastala worked miracles because it is a LOT smaller and I am at least a pant size smaller. I was able to walk straight up by week 3. I am slower and more creaky than before but at week 6.5 I am feeling pretty good. Tummy is tight and numb some too..but overall I don't think about it too much. I did not have to have chemo or rads...so that may be the difference.

Lisa

J-Bug

This is all very frustrating when I need to be finding a new job. How do elastic pants and another size or two larger fit into looking all corporate and buttoned up?

I have been bordering on plus sized and not, but this definitely throws me into plus sized all the way. So I need new dress pants to get a job, but I have NO money because I don't have a job... I'm sorry. I am very frustrated with life right now.

Beckers

J-bug, I have seen and worn pants that are stretch and made out of a rayon/polyester/spandex that could be used for work. Look at "Woman Within" online. I was just looking in the catalog and saw a couple of possibilities.

J-Bug

Thank you. I have really struggled with dress clothes! I gain at the waist, so by the time pants fit there, they are usually large everywhere else.

I appreciate the help! I will check those out.

betsy7122

Dr. Carty did my DIEP in July. Dr. Caterson assisted him. They do this op as partners.

I don't know if  Dr. Caterson is on maternity leave yey, or who will be assisting Dr. Carty when she is gone.

BUT, I have to tell you, I would recommend Dr. Carty without reservation. I had controllable pain after the procedure, no need for pain pills within a week and a half, was driving two weeks out, and breezed through the procedure.

Dr.  Carty is a great guy, and his staff is awesome.

Don't worry...you will be in incredibly good hands if you go with Dr. Carty.

And I LOVE my new breast!