DIEP 2014

thinkpink4ever

Hi cbrenner, and welcome to BCO!  Yes, the info can be overwhelming.  I understand exactly what you mean...

Here's my best shot at answering your questions.  I had so many questions, I created a Word document for the PS consults that I had.  Lol!

1. How is theabdominal pain? How long time you're able to move around the house? How long till back to work?

I've heard alot of women say that the pain was not as bad as they had anticipated.  I have a high tolerance for pain, so I didn't find it to be very painful.  For me, it was more like discomfort.  I was off the narcotics painkillers within 3 days of being discharged after surgery.  I had 800mg Ibuprofen after that, but really didn't take it.  They got me up the very next day in the hospital and started me to walking around.  Once you get home, you should still continue moving around often.  I will be returning to work on Monday, a little over 6 weeks post surgery.

2. How long was hospital stay?  Stage 1 Surgery was on Thursday morning.  I was discharged Sunday afternoon.

3. How many surgeries on average for everything?  For me, it should be three Stages - Stage 1 was BMX and DIEP, Stage 2 will be fat grafting and nipple reconstruction, and Stage 3 will be areola tattooing.

4. Does the tummy tuck also flatten your abdomen above the waist?  I didn't have much fat above the waist, so I'm not really sure.  You are usually pulled pretty tight, so you will definitely be flatter than you are now...

Hope this helps!

One love,

tp4ever

goldie4040

Oh Teacher, you are a much better person than me. I couldn't have held back.  She would have been kissing my rear!!!!!  How insensitive.

Annie and Anna, I had my bmx over a year ago with implants, now I had the diep.  I need the  physical therapy more now than the first time.  I don't know why.  Maybe because my tummy is involved too.  But, I started PT yesterday.

LOL Janet, I do have some blond highlights right now, but usually my hair is blonder. I just don't have the patience to keep up the blond right now.  I get enough highlights to cover the grey...lol

mefromcc

I have not had surgery yet, but I asked my PS about what will happen to the significant bulge I have above the waistline. He told me that it would be pulled down below waist. By the way, I am 5'7" and weigh 177, so I have a significant bulge <grin>.

Andrea623

I would love to lose my bulge too! I'm hoping the muffin top will be gone when this is all over.

I'm going for a CT scan with contrast in the morning so the PS can get an idea how my veins look. I'm really nervous; haven't had one before. A coworker told me when they inject the contrast it makes you feel like you've peed your pants. Is that true? Will I pee for real???

Ridley

Andrea - my ct experience is that I definitely felt a warm flush, like you are going to pee, but thankfully I didn't! I don't think anyone does.  The whole thing was over very quickly.  Much shorter than an MRI.  Good luck!

Teacher64

cbrenner

Abdominal pain is managed. Getting out of bed at the beginning is a challenge but nurses help. I moved around the house from the day I came home. Some sleep in recliners but I slept in our bed with lots of pillows. Movement was limited to walking to and from the bathroom and kitchen but I moved. I'm lucky to be retired so I didn't have to worry about returning to work, but some have gone back to desk jobs at 4-5 weeks. I think most docs prefer 6, even my own primary care is taking 6 after her DIEP.

I was in the hospital Tuesday for surgery, ICU til Thursday mid day and home Saturday afternoon.

One long surgery for mastectomy and placing tissue expanders. The DIEP procedure, which is long, and then the "fine tuning" for any needed fat grafting and nipple reconstruction, which is a couple of hours and usually day surgery.

The tummy tuck pulls the stomach from above and below the navel.

Ask any questions. I kept a binder of my questions and answers from my doctors. I have questions ready for the visit to my PS Monday. He will patiently answer them and I will feel better.

Annajo - SLNB is sentinel lymph node biopsy. Mine was done while I was "out" just before the bmx.

aff

1. How is the abdominal pain? How long time you're able to move around the house? How long till back to work?

I also have a high tolerance for pain, I gave birth to an 11 pound baby boy. I would say the only pain I had was in the hospital. Since coming home it has been more discomfort and less pain. I am still uncomfortable and still wear a tank top with compression even though my PS said I no longer need compression. I stopped taking pain meds after 10 days or so. I was moving around the house slowly for the first week, but moving around. I had a significant increase in movement at about week 3. I am 5.5 weeks post surgery and probably could return to work if I did not have an active job. However, my job is very active so I will be out for several more weeks. 

2. How long was hospital stay? 

My surgery was on Friday and I was released Tuesday morning. 

3. How many surgeries on average for everything? 

I believe I will have 1 more surgery for a nipple and symmetry. Tattoos are optional but would be an additional step. 

4. Does the tummy tuck also flatten your abdomen above the waist?

I was already pretty flat but I believe it  does flatten when it is pulled down. My PS did tell me that if I gain weight after surgery it is possible and likely to gain weight above the abdomen. 

I hope that helps and welcome to all the newcomers that have recently scheduled or are thinking about DIEP. 

Andrea623

thanks, Ridley! Is a CT less noisy than an MRI? 

Anonymous

Question- my crop circle dissolving sutures are being rejected by my body, resulting in puss exuding from the incision line in multiple places. It sounds gross, and it is gross, but apparently it is not unusual. A few years ago I made  three attempts at navel piercing ( had great gold jewelry for it) and each time my body rejected it, with similar results. After that, I gave up...I was 5'4" and 122 pounds and working out regularly. Not into tattoos, but sexy  jewelry I liked.

Anyway, if anyone has experienced this I would be interested to hear how long the process took. I am in touch  with both my PS and BS, though we are currently traveling. I see the PS on 7/24 but thought I'd ask here in the interim. 

aff

Teacher - glad your cording is better. Mine improves while I'm at PT and for some hours after but by evening I am right back to tight and in pain. Tomorrow will be my first rads session without PT first. I will have to do a lot of stretching before to get through rads without pain.

I went out without compression for the first time yesterday. Boy was that a mistake. My surgery was 5.5 weeks ago.I was extremely uncomfortable and very swollen last night. I gave it a shot but obviously not ready to go without it yet. I found these great tank tops by Flexees at Walmart. They are regular tank top on top so no compression on the breasts but they have firm compression from below the breasts down. They do ride up sometimes but it's bearable. I am small enough that I can go without a bra with this tank top so it's been great.

Here is an update on the Mepiform silicone strips. I have had them on since Friday with no issue. I take them off once a day before I shower and put them back on after and they have remained sticky. They are waterproof so you could leave them on in the shower but the manufacturer recommends removing them once a day to clean the incisions. My abdominal incision looks pretty good. I have nothing to compare it to so I'm not sure if the strips are actually helping or not. I will let you know what my PS says after I see him on 7/23.

Ridley

Andrea - honestly, I don't remember the CT being noisy, but maybe it was.  I certainly don't remember any of the banging or pounding sound of the MRI.  

Heidi - I had the same thing re the dissolving stitches not dissolving.  I definitely had some discharge, but don't recall any puss.  I had more areas on one side than the other and in a few places on my ab incision.  My PS removed the offending stitches, and then the areas healed fairly quickly with the exception of one area on my ab, which ended up opening up.  It took the longest to heal (3 months or so)  but it eventually did (was kind of interesting to watch healing, but it kept me out of the ocean when I was on vacation). The crop circle with the most issues has a thicker scar now.  I'm sure my PS can fix it.

My routine was to clean areas with saline, use iodosorb (an antimicrobial) and keep the areas covered until they healed.  I was told not to use polysporin, but like so many things with this surgery, there are likely a dozen different recommendations from surgeons for how to deal with these pesky stitches.  I hope your areas heal quickly.

sollertia

Does make you feel like you want to pee.  But my underpants said I didn't.  

Plus it's a lot less noisy than the MRI, in addition to being shorter.

Andrea623

Thanks Ridley and Sollertia. Glad to know my undies will remain dry!

goldie4040

The wound healing is a drag.  I am packing wet to dry on my tummy twice a day.  I swear there is no improvement, but it's no worse.  I am so tired of it.  I always feel like it could get infected at any moment. No problems with the foobs, though. 

The CAT scans are no big deal.  You do feel warm in the vaginal area.  I liken it to the first few spits of wine...lol.  And, it's all over fairly quickly.  Not a scary test at all.  But, I have been known to fall asleep in the MRI machine. 

Andrea623

does everyone have wound healing issues? I'm getting really nervous!

annajo

SLNB=Sentinel lymph node biopsy.  I know jargon can be confusing!!  

cbrenner, if you have a diastasis, they can repair that during the surgery, which will also help flatten above the waist.  Diastasis is a separation of the abdominal muscles from pregnancy or weight gain.  I had a big one from 3 big babies and PS repaired it.  It will make you a little more sore for a while- it was a while before I felt I could sneeze freely!  Your PS might not mention this in your consult, so you may have to ask about it if you want to explore it.

aff

Andrea - I have not had any wound issues. The silicone strips I referred to earlier are supposed to help with the scar. Supposedly the silicone helps to soften the scar tissue, therefore less scar. It's a great theory. I'll let you know the reality down the road. I'm supposed to wear them on and off for up to 4 months. During the off weeks I'm supposed to massage the scar for 5 minutes, twice a day. 

sollertia

I've just spent the last few days reading the whole of this topic and now feel ready to join the discussion.

At the time of my mastectomy 2.5 years ago, DIEP wasn't being offered in my area and I wasn't sure I wanted reconstruction.  I knew I didn't want implants.  Decided it was time to explore options nearly two years after surgery, as DIEP was being offered in my area.  Moving muscles in a TRAM didn't appeal, as pre-cancer my life expectancy was a good thirty years more and was just doing better at exercising regularly.  

Did do the consult with the PS in town and the perforator CT scan.  Was scheduled for reconstruction locally last week but cancelled it a month ago as I wasn't emotionally ready to have it done here.  The PSs here do one or perhaps two DIEPs a month, and I felt I needed someone with more experience, especially after developing lymphedema around the time of first consult and now after 7 months finally have it reasonably under control. 

Now I'm scheduled to go to San Antonio for a consult on August 19, with surgery probably in October (would like to do a bunch of things already scheduled for September).  Do feel better about a group with more experience, and the possibility of a VLNT to relieve part of the lymphedema symptoms. Realizing I will always have to watch it and take precautions, even if a VLNT relieves symptoms, since the lymphedema didn't flare up until two years after MX

Looking forward to not being concave on top, as both tumors were quite close to the chest wall, and will be happy to lose the pooch, which feels all the bigger for not having as much on top. 

cbrenner

mefromcc

Thx for your reply. I am also 5'7 at 173 lbs so I'm glad to know the bulge will be gone.

goldie4040

No, wound issues are not the norm.  Just a few of us at one time it seems.  No worries. 

About the upper tummy.  I have a friend who just had her diep.  She had a good bit of tummy to give, and she is upset about her upper tummy.  I think her doc will do some lipo on it for stage 2.  I think what most women don't ask from the beginning is about what the tummy will look like afterwards.  They hear tummy tuck and think that's what they are getting.  These docs are much more interested in making sure your flaps take then they are about your tummy. Stage 2 is when the magic happens.  But, I think going in it should be one of the things they should tell us about so we don't worry about it until stage 2. 

cbrenner

Tp, aff and teacher,

Thanks for such detailed answers. I also have a high threshold for pain so it's good to know that won't be so bad. I am also so glad the the upper belly will be pulled down. All I kept thinking was I have a flat lower abdomen with  the bulge on top. Yuck!

aff

cbrenner - please be sure to speak to your PS about your stage 1 questions and expectations. I'm sure you have read all the different approaches and outcomes each one of us has had with the same surgery. I still had so many questions before my surgery. I made an appointment with my PS 1 week before my surgery just to ask the page long list of questions I had. I was not comfortable waiting till my pre-op appointment the day before surgery. 

cbrenner

aff

I do have a list for the PS. It's great to get answers from women who have gone through it. That actually helps me find more questions. Many thanks. 

One last question - how long after radiation did anyone go for the diep? Is it better to wait a while? (How I will live with the TEs I don't know. )

Andrea623

Thank you aff and Goldie for the reassurance.  Sometimes I'm amazed that I'm brave enough to go through with this surgery, and other times I question if I should just leave well enough alone. Then my radiated implant side starts hurting and I just want it out. I want both of them out. Surgery scares me, but having all of you say it's doable is a real help. Thank you to everyone who shares their story.

pollyanna5

Hi all!

I am 5.5 weeks (I should figure out how to add a signature, so I don't have to always state that!) out.  I feel fine mostly, but am really tired this week still.   I can do 2 -3 hours, and then I seem to peeter out.  I've been like that for about 2 weeks it seems.  I have forgotten the binder a few times, and notice a difference that I am more sore and swelling seems to go up.    A few things that I've noticed is that I feel really depressed the last few days with having had to have surgery and lose my breasts.   I've been asked too many times how I am doing with all of this, or am I processing, etc.  I don't think I am yet, it just feels like it was all so fast.  And, some people are irritating me with the "oh it is all done" or some variation of that that underplays it.  I don't know what I want, certainly not a fuss, but when a 12 hour surgery get's dismissed, it just bugs me.    I still have another 6 weeks of recovery per the doctor (this one says 12 weeks), although I'm hoping he will let me start a post surgery water exercise class when I see him Aug 1.  

So......I'm cranky today, it seems .  Lots of others things in life going on, and I think they are all excaberating each other.

Also, my breasts seems to have shrivelled up the last few days.  It looks like a small peach in an envelope for a large grapefruit.  The bras I was happy with last week, I am swimming in this week.  I'm hoping they can be "filled" in at stage 2 if this continues.  I have not a lot of appetite still, but my belly seems swollen (probably because I'm forgetting the binder sometimes).  I want to finish losing weight, but no energy, not eating alot, and not being able to exercise besides walk, are kind of counter productive for that.

A lot could be hormones, I wonder.  I think perhaps my cycle is starting up again, following surgery, although I'm always irregular, so who know.  But, I feel like a crazy lunatic, which is usually a sign!  Plus, it's a year Friday for my dad's passing, my little ones turned 5 (a little of my baby is not a baby now emotions, again hormones)!, $$ tight being off work, ex issues, etc, etc, etc.  It's my perfect storm to turn into a mushy mess.  Which is not like me.

Did you find you were still tired at this stage?  Also, my scars are flame red (not infected looking) and just seem really vibrant now.  I hope they start to fade soon.  

Anyhoow, that's all me right now. 

iowagirl1

I have these large divots where the breast tissue has been stitched in the intramammary fold. This one is large enough I can put the tip of my pinky in it. I am 11 weeks out.  Called my PS office and described it to the NP that called me back.  She said it's very common in DIEP patients and they should loosen up in time.  It feels like the stitch is going to pull right through the skin.  Is this normal?  The most obvious ones are visible from the side.

goldie4040

Ouch, Iowagirl. At first I thought you were showing us your belly button.  I am no expert, but that seems like a large divot to be caused by a stitch.  Did you send a pic to the NP?  I am sure it's going to be fine.  Certainly doesn't look like you've got an infection, or anything. But, that is a divot, for sure.  I have one, but it is very shallow, and only shows in certain light.

Polly, I have been have been grumpy the last few days too.  Maybe it's the Super Moon!  I don't know, but I wish it would pass.  As far as your boobs shrinking, it sounds like any swelling you had went down fairly quickly.  Have you lost some weight? Don't forget, you foobs use to be tummy fat, so if you lose from your tummy first....Just a thought. And, it sounds like you have a lot of emotional stuff going on too.  Sorry.  Hang in there.  It can only get better?   

momofthreeswimmers

Help me decide

I failed Implant once due to infection, I have enough abdominal fat but really scared of a huge surgery:(( is it worth it? or overkilling?

trish01254

Momofthreeswimmers - I too was very afraid of the surgery and even had some remorse immediately after the surgery but today I am extremely happy I went with the DIEP.  My belly is wonderful and the new boob looks just like my original when wearing the sports bra (minus a nipple of course).  My boob is all me. Healing was uneventful and I am heading back to work on Monday.  Still have some ab pain but it is bearable with binder on.

Teacher64

momofthree...DIEP has been worth every moment for me. All that goes with it may not be for all, but it was for me. Radiation, hormones, and implants were out of the picture for me due to other health issues, so I am adjusting to the new me and looking forward to stage 2 in two weeks. 

Pollyanna - I got tired for quite a while. I asked my PS if it was due to my age or other health issues and he said that DIEP is huge surgery, like an assault on one's system, and it takes time. At about 8 weeks was when I really began to feel "normal." My scars, especially crops circles are just beginning to look less like bulls' eyes at 4 months. They are the thing that I have most hated seeing every day. My PS reminded me that my skin seems to be very sensitive and it will take up to a year for them to fade. Also, I started out from DIEP looking like I had porn star boobs, but that is gone. The right side looks pretty good, except for a sunken line on the underside of the crop circle and the hardness along the outer edge has diminished. The left side is going to need a lot more attention in two weeks because it is so much smaller. There is a huge wrinkle of skin in the lower half and it has about half the volume of the right side. Thankfully, I have muffin tops that are going to contribute fat to be grafted there, so my breasts should be closer to the same size. 

Iowagirl - what I was calling divots on my breasts are not like yours. I, too, thought it was your belly button! My divots are more linear depressions along the underside of the crop circles. Keep your NP and PS up-to-date on that site.

As for having the grumpies and lows, they are 100% normal. I've always felt my glass was overflowing until I began this journey. There have been times when I've felt my glass has a drop left and I've felt that the only people who understand what I'm going through are here. I've now met three ladies and we've shared lunch, laugh, and even had show and tell, which has helped so much. It's not that family, friends, my Bible study group, my trainer, or anyone else don't care, they just don't know what this is like from the inside out. And I don't want a single person I know to have to experience this. There have been times I've felt that what I'm going through really can't be happening to me because it all seems so foreign. Indignities, the horrible TEs and drains, surgeries, healing, scars, cording, and starting life over after surgeries have been significant mountains to climb, but soon I (and all of us) will be past these and able to live life. I'm even having my cataracts taken care of this year because next year I'm moving forward, only having copays for check ups. My yard is not going to look neglected like it has been this year. It will be the one all the walkers stop to admire again!

Most of all, I want to be able to reassure women that this is a bump in the road, yep a big bump, but whether crawl, walk, or leap over it, we make it to the other side. We are still wonderful and significant to ourselves and many other people as we were before we started this journey and we will be more gloriously amazing when we are finished. For today, I'm letting the lows go and only doing things to fill my glass. I hope everyone else can, too, so you can see yourself as the strong, courageous, and victorious women you are.