Diep 2012

Beckers

Gotoell,



Dr. Sharon Lum was my BS and she gave me two business cards for PS, one for Dr. Cody and one for Dr. Miles from Redlands. I picked him because he is head of plastic surgery for the VA and also associate professor at LLUMC. I saw him first and made my decision. I had the surgery at Loma Linda. Overall, I am very happy with my team of doctors.

Beckers

Goetell, after reading post, it's not clear that Dr Miles is who I ended up going with, not Dr. Cody.

gotoell

Have you heard anything about Dr. Cody? I am going for the abdomen scan soon to see if I am a good candidate. I had failed implant reconstruction on one side due to radiation and I am fairly thin so not sure about the potential outcome. Thanks for your quick response

Beckers

I think Dr Cody is a good choice given he was recommended to me by Dr Lum who is the medical director for the breast center. Dr Miles told me he could only do DIEP and Tram flaps so if I had a failure, I would have to go to another PS.

gotoell

Thanks so much for your input

Beckers

You are welcome. Good luck and let me know how it goes!

howhm02l

Ladies - I am 5 weeks post bilateral DIEP and have a couple of questions for the veterans:

1.  Most of the time, I feel like someone is trying to pull my new boobs off my body.  Is this a nerve issue - have others experienced this.  It is really annoying because it is constant.  I have been wearing light support camis or nylon bras that Rebecca (Beckers) recommended.  I wonder if maybe more support would help?  I go see PS next Monday.

2.  I have not had a period since the DIEP.  I am 41 and have always been very regular.  I am not on any hormonal treatment and no chemo.  I had a period a couple of days after the mastectomy, which was 2 weeks before the DIEP so it has been 6 + weeks.  Just wondering if anyone had a similar experience.  I have a appt with gynecological oncologist on Friday and will ask then.  Since I am BRCA2+, I will need a hysterectomy.

 Thank you all so much,

 Heather

Hoya03mom

howhm021

9 weeks out and I don't have the pulling feeling as much as boobs are way to heavy.  Not sure if it is swelling that will go down, or just overfill but I feel top heavy!  Hoping they go down soon.

As far as # 2...it has been almost 15 years....don't miss them!!

fredntan

Packed up and ready to go to texas in am for diep Monday with PRMA docs. As usual think I over packed. Can't wait to see the new girls. Think I will name them left and right

bdavis

Heather... I did not experience that but I have heard of it. I have also heard it passes.About the period, mine stopped with chemo, so I don't know... perhaps the lose of breast tissue affected your hormone levels?

Beckers

Good luck Fredntan!!!! Let us know how it goes.

howhm02l

Thinking about you Fredtan! The first few days are rough so do not be alarmed.



Thanks for the responses to my questions. That is what I was thinking Bdavis. I will talk to the doc on Friday.

fredntan

I think I am going to call the new twins left and right. Anyone else naming there's?



Heather I bet loss of period is from all this bc stress.

Anonymous

Good luck Fredntan!  LOL....I love the idea of naming the new "twins".  Maybe I'll name mine, Chips and Salsa!  

Galsal

An interesting question - would one be considered a good candidate for Diep if they were positive for a blood factor associated with blood clots?

J-Bug

Galsal: That is hard for a layperson to know the answer to that one. I was on a blood thinner at the hospital and then on baby aspirin for several weeks after. My PS insisted even though I am allergic to NSAID's (anaphylatic allergic!). I didn't like it, but I also didn't have a reaction. So if a person got blood clots more easily, if that is what you are describing, couldn't they raise the level of Coumadin or whatever they are using a bit? I know it would have to stay in a particular range though, too thin is dangerous too. My daughter was on it as a baby for about a year.

Jennt28

I have been wearing Teds stockings and having daily Clexane shots while in hospital to prevent clots. Not sure about if you are susceptible though.



Jenn

Galsal

Turns out that I'm positive for Factor V Leiden blood mutation which sets me up for blood clots.  That's why I was wondering about waht makes a good candidate.  Primary Dr was supposed to have run the test in 2006 but for some odd reason this one specific test wasn't run although other thrombotic risk tests were.  It was to be run because we knew my Mother is positive for it with clots and her Mother had clots, etc.

Fast forward to 2012 and my Diep procedure.  Right now I'm just trying to get some tthings straight in my head.

Thanks!

Beckers

Galsal, does this pose a threat to your reconstruction even now? What about Tamoxifen's risks of blood clots?

mommaof4

Today is 9 days since my DIEP and I feel a little better each day, especially now since I'm back in Chicago.  I found out at my follow up appt that my Stage 2 on Feb 1st will actually be a stage 2a...  Because of my vessel placement and not as much abdominal fat as the Dr had expected, I will need a whole stage 2 for lipoing, shaping, revising and lowering the scar etc...  So nipples/areolas will have to wait until that's all done and he thinks it might be a bit much for one surgery.  Honestly, I was a little dissapointed...  I just want to be done!  I also had to go to the dermatologist and have the rash I have around the right side checked out.  They think it's just contact dermatitis.  I hope everyone else is feeling well ...  Speaking of periods, I was lucky enough to get mine the night before surgery lol (Nothing surprises me anymore  It seemed like more of a nightmare than the surgery itself! 

cg1234

Good luck Fran! We'll be thinking of you.



Heather, I bet the stress of everything has caused you to be off schedule. Although I was about 41 when I started getting more erratic/peri-menopausal. I'm so hoping that i don't start my period during surgery too!



I have my prep-op appts in about a week. Anything I should be asking? I'm most concerned about post-op vomitting. It's always awful for me.

Galsal

Beckers, this was discovered after my attempted Diep during which blood clots occurred.  I was just one of those unlucky ones.  I thoroughly believe that for most people it's going to happen.

howhm02l

Cg - have you had the patch in the past for nausea? I think throwing up would be very tough after the DIEP so I really hope they can get that under control for you. If you have a preop with the PS, I would ask about ow they will be monitoring your flaps. Mine was manual checks with a doppler every hour for the first 48 hours, which was pretty brutal. I have a friend who is having a DIEP next week, and her surgeon/hospital have automatic monitoring as with other vital signs.



Momma-sorry you will not be finished at stage 2. I know what you mean by wanting to get things finished.



Gal - I wish I could help.



I met with new GO today, who was fabulous. She said very normal that I would not have ovulated with the stress of the DIEP so not to worry. She also said we could do ovary/tube removal (due to BRCA2+ status) the same time as Stage II of the DIEP. I hope PS agrees. I would love to combine them.

cg1234

Heather, glad you had good news with GO! I plan to ask about the patch, zofran, and phenergan but with 12 hrs of anesthesia I'm not sure how much it will help. Good advice about the monitoring. I was thinking they'd do Doppler but will check. What was brutal about it? Was it painful or lack of sleep? I dont know what automatic monitoring is though. Thanks for the advice!



And this may seem like a dumb question but has anyone had good results post op and didn't need stage 2 or revisions? Since I'm doing bmx and am not too big I was half hoping I wouldn't have to go through a second surgery but maybe that's just being naive.



Healing thoughts to all this week!

Jennt28

My new breasts (after skin sparing BMX with immediate free TRAM 8 days ago) are looking very well shaped and the only follow-up planned at this point is nipple and areola reconstruction.



Breasts are pretty symmetrical and nicely shaped :-)



Jenn

Beckers

Galsal, you said attempted....did your flaps fail then? I can't remember what exactly happened.



Jenn, so glad you got nice, symmetrical results.



Unfortunately, my left is tight and almost too firm or feels hard in some areas. Also end is flat. So... They will do fat grafting during stage 2 in Dec. Right one is perfect. I wonder if it's necrosis in there? Does anyone know? I had nipple and skin sparing and my nipples don't look alike so my PS will work on that too. Almost lost one but they made it. Yay!



Howhm, it will be good to have ooph out of the way. I'm kind of glad I got it over with 4 years ago. Still got BC!



Is anyone else on Tamoxifen? My PS said it's ok to start (MO was worried due to flaps and risk of blood clots) so...Monday I will start. I'm doing Tamoxifen for a few years and then AI.



Cg, good luck with preparations. Questions to ask....can you get pain meds filled ahead of time, will you need any equipment, such as commode or walker? Do they provide mastectomy bras? The first night they rolled me side to side for sponge bath and tried to prop me on my side. I tried my best to protest. My PS said "No, no, no!" and he will make sure he changes orders for future patients.

Galsal

Yes Beckers...attempted.  The surgery was aborted after several attempts to connect up the arteries and clotting happened with the arteries and veins.

This is not a reflection for others waiting on Diep to dwell on - I have a hereditary specific blood factor mutation which pre-disposes me for what happened.  We all thought I'd been tested for the ones my Mother has, but this one was never tested for when factor tests were run.

I did wind up with the tummy tuck part out of all it, just no breasts from flaps.  Flaps started having problems while still in the operating room.

Recover well Beckers....I'm doing fine and have decided to do no reconstruction at all.  Still not smoking either!

cg1234

Thanks Rebecca! I better make a list of Qs....I hadnt thought of getting scripts early. The sponge bath sounds terrible! I'll be on a unit experienced with diep so I hope that doesn't happen.



Jenn, that's great to hear. I hope healing continues well. I want to stay an A cup so here's hoping!



It's all worth it, right? As hear about everyone's journeys with open wounds, phantom pain, thrush, necrosis, and flap failure, I have to keep reminding myself that most of you would do it all again, right? As you can tell I'm nervous as the date gets closer. I did get doughnuts and meds last week though! Lol!

cg1234

Galsal, I'm sorry to hear about all that. I'm sure it was hard waking up to the news. It sounds like your trying to understand why the specific test wasn't run and if that would have changed the recommendation for you? have you talked to the ps about it? I have some friends with factor 5 but dont know as much in the context of bc. it's great that you stopped smoking though! I hope you get your answers.

Jennt28

I'm not even out of hospital yet but can already say I would def do this again :-)



Due to go home in the morning - it's Saturday night here in Australia.



I have before and already some after photos I will be putting up on the BCO private photos site run by TimTam. I just started the thread today but have to wait to get home to my laptop to be able to upload my photos as it doesn't work from my ipad.



Jenn