DIEP 2014

mary625

Having a possible small set back.  A small area of abdominal scar is red and raw.  I think I rubbed off the scab accidentally with panties and compression garments going up and down.  Am going to be doing wet to dry dressings this weekend and going to a wound clinic next week...in the abundance of caution.  Drats!  Hoping this is a small or non-existant bump in the road.

MEG2

Wowza you ladies have been busy here in the past few days.  Just received my surgery packet from PS in the mail...Oy the forms to sign for the DIEP are scary!

I've been instructed to stop taking Tamoxifen for 2 weeks prior and 2 week after surgery date, is this common?  I am not so anxious about the surgery (yet) but the idea of stopping the Tamox scares me...if it's doing it's job and stopping the cancer from recurring what happens if I stop taking it??   Has everyone stopped hormone therapy temporarily for surgery? 

Welcome to the newbies and boobjrny I have two posts I've saved when I had the same questions, I'll send them to you in a PM.  Have a restful and healing weekend y'all! 

Ridley

MEG -- I stopped tamox 2 weeks before each surgery -- I think that's fairly common based on what I have read (due to the risk of clotting) but I understand the worry re: keeping cancer at bay.  I was able to start back on tamox once I was released from the hospital (day 5) for diep and the day after outpatient surgery for revisions.

Mary -- I hope your abdo scar stays closed!

I think our summery fall weather is coming to an end this weekend -- cooler days ahead.

Take care all -- Ridley

Donna2012

Going to see Vinnie next week!  So excited - I made my appt 6 months ago, back in April!!  Hopefully it will be worth the wait.  

MartyJ

Mary - up your protein, it will help.  Nothing's no fancy needed - meat, fish, chicken.  Go for 80+grams a day.  Will help with the healing problem.

GwennyMD

I agree with Marty about protein helping with the healing.  For those of you who are scheduled for surgery, you may want to start increasing your protein a few days before the surgery and continuing until you have fully healed.

JMB - I have not had a mammogram.  My insurance required a CT scan for my one year anniversary.  MO said that future scans would not be required unless other signs indicate recurrence.

Congrats to those of you with tattoo appointments.  I hope to finish my journey by the end of next year.  Fortunately, I live about 1 1/2 hours from Vinnie so I will not have far to travel. 

Kb33

a few days shy of 6weeks post diep today and I can't hold out any longer... Must get to the gym.  Lol. For those of you that started back on a work out routine... How fast/slow did you jump in?   Having my stage 2 in 6weeks so I guess I don't want to start anything major... Thinking running and strength.... But I have been staring at weights in gym for weeks and I have to say I miss them a bit and my boot camps and high aerobic strength training.  I would like to drop about 10 more lbs before surgery.... Sigh but don't want to be overly aggressive...

On a side note... Did anyone else have those lovely stitches/sutures that just will not absorb in their body?   At 6 weeks I can still feel them under my skin and I worry that scar tissue will surround them in healing.  Yesterday, about 6inches of thick suture pulled out in two areas.  Ugh

MartyJ

Kb33-go slowly.  Some docs won't let you do much/any strength training at 6 weeks.  dr. M was not in favor at all.  There is still lots of healing going on that can't be seen.  Use the treadmill, spin.  My abs were screaming at me when I began working out - and that was 8weeks after Stage 2.  For the first several months I got funky cramps in my abs.  My PT suggested laying backwards over a stability ball to stretch them out and relax them.   I would set the timer for 5 minutes, grab my iPad and read while I stretched.  

I know you want to get moving, but ask the doc how much and what you can do.  Really remember that this time will be a small blip in your life and dedicating to healing gives the best long term outcome.  Our Integrative doc told us last week that he felt that doing 20 minutes of high intensity interval training 3 times a week was the best way to rev up the metabolism to drop a few lbs.

BoobJrny

Thanks Debiann and Tan for your replies.  That eases my mind to know I won't need to bring much to the hospital with me.  When I had drains from my mastectomy, I think for showers I strung a robe belt around my neck and pinned the drains to it.  Now that I think of it, I might just crochet myself a thin cotton belt for that. 

I like the idea of using a light housecoat inside out to hold the drains for the rest of the time.

ChrisInPA

Hi all,

On Monday, I will be 2 weeks out from free TRAM and I am still in a mountain of pain.  They had me on Dilaudid and pulled me off Friday, so spending the weekend on Advil (which isn't doing anything).  Dilaudid is an interesting beast - sends your brain to Mars while not doing anything for pain here on earth.  How helpful (sarcasm).  The pain isn't from the procedure - it is all because of the drains.  My body doesn't do foreign objects real well and even partially expelled a breast drain on its own last Wednesday.  They pulled both Wednesday when that happened and I feel like a new person up top.  PS was like "wow - do you want to see this before I remove it?"  Er, no - thanks but just get the alien out of my body and shoot it dead, please.  LOL

Hopefully the last 2 in my abdomen come out on Monday.

Healing uptop like a gold medal champ according to all of the medical professionals that have checked the last two weeks.    Now just need the bottom two to come out so that I can breathe without catching my breath.  Lordy, I hate these drains.  I saw a suggestion a few posts back about taking Benadryl to sleep and think I am going to try that tonight since I don't have any other options.

Hope all is going well for everyone!  Will check back in when my head is back in the game.  (((hugs)))

Ridley

Chris - drain free day is a great day - sounds like it will be extra special for you.  Hang in there.

Ridley

debiann

Chris, I couldn't agree with you more about the drains. They were awful! 3 of mine were removed 11 days after surgery, but I had one bottom one for an extra week. I had a real love/hate relationship with it. I was happy it was draining so well, keeping my belly from swelling, butI also felt like I couldn't really begin to heal until it was out. Hope your last two come out soon!

enjoyevrymoment

Hi all,

Had my MRI which onc ordered, insurance paid for it, was NEGATIVE hooray hooray!  Also had an ultrasound of abdomen which was negative.  So grateful.  

I too was told to use Bacitracin rather than Neosporin.  

Teacher, glad your friend is ok!!!  Sorry to hear about the other one having some infection.  

Janet wow I was asleep for my stage 2, you are tough.

To those recently having surgery, at 7 months post surgery it is a wonderful place to be.  My only complaint is I cannot seem to tame the overweight beast.... but that is not related to my surgery.

Healing hugs to all.

Cindy

Janet_M

Cindy - Ha! Thank you for the compliment - but I feel like a fraud. I may have stayed awake for my stage 2, but I'm anything but tough. 

I'm actually a big fat hairy chicken. And, I have a tendency to fall apart. There was a time where I didn't think I could make it through one surgery let alone four - one of them while I was conscious. I could write a book about overcoming my surgery fears,(including Reiki, Guided Mediation, Yoga Breathing, Ativin)  And the reason I'm telling you this is because I don't want any of my BC sisters to think that it's something they can't do. I didn't have any fat grafting - so my procedure (90) minutes was relatively simple. And as usual, my mental gymnastics were far far worse than the actual  reconstruction itself. The dog ear removal was particularly simple. 

But like I said, thank you! And am glad you're doing well. 

And far anyone undecided about nipples vs no nipples...it's SO nice to have something back. Happy Sunday everyone,

Janet

edukes1002

Janet, so happy to hear everything went well for you.  I can imagine how nice it is to have them back!

Chris, I hope things get better for you.  I am not looking forward to the drains either!

Terrified of the entire process, but BMX with DIEP is scheduled for 1st week in December.  Its the right decision, even though I am not looking forward to it.  Here's to making it the next month and a half without loosing my mind.

Kb33

can someone explain... Dogears... Thnx

Janet_M

Dogears are the excess flesh at the ends of the abdominal scar. Mine looked sort of like the corners of a pillowcase and stuck out a bit. They're fairly common and are easy to hide under clothes. They're also easy to get rid of during stage 2. 

But - when I first heard that I might have 'dogears' I almost fainted. I thought that I'd have excess skin like my own dog's ears - and I have a basset hound. 

Teacher64

kb33 - my PS allowed treadmill and cycle, no weights. My trainer, who has worked with BC patients, had already told me we wouldn't be doing weights until he was satisfied I was stretched enough and had good ROM. It was worth doing as he said because I went into stage 2 stronger than I thought I'd be. Getting antsy to be working out again Can be a challenge, but we are worth doing it right.

Kb33

so... I can run... But real slow... Happy with that.  Tried to do a sit up or crunch... Nope, not going to happen.  Listening to my body and not my head.... Stick with running and stretching for next few weeks.   Lol

Teacher64

kb33 - I had to wait to do sit ups til week 10 and they were incline sit ups. Every other day incline was reduced so I was doing "real" sit ups week 11 in reps of 10. I didn't have stage 2 until 4 1/2' months after DIEP. It was 8 weeks after stage 2 and I started with incline again. By week 9 I was doing regular workouts. The best thing is that after stage 2, there don't need to be anymore "comebacks!" It will all happen. Remember...marathon, not sprint.

ChrisInPA

All,  I really need to understand these drains.  My BS insisted they came out at 7 days post BMX because of the risk of bacteria even they weren't below fluid levels.  I ended up with a seroma in my left (cancer) breast that he had to expel with a needle twice in 2 months.  Once at 150cc and once at 90cc.  It was not painful AT ALL - just annoying me.

What is the difference between pulling drains when they are at the borderline (30cc in 24 hours) and risking a seroma - knowing that the seroma was WAY(!) less painful than the drains staying in?

I feel the drains staying in are hindering my healing, but afraid I am missing something and should probably know the whole story before having the discussion with the PS about it tomorrow as he refused to remove them Friday.  Is there a risk to them staying (or being pulled too early) that I am missing?  I feel like someone has a blow torch to me in spots 24/7, but don't want to be insistent on something if there is a worse outcome possible.

Help!?

Teacher64

I had the last drain out at day 26 after bmx. PS re upped a scrip for antibiotic and said that last drain would be out on day 28 no matter what. Thrilled to get it out even a couple of days ahead of the deadline. Out too early and it can result in seroma, as you experienced. In too long I guess there could be infection if not monitored. Certainly discuss with your PS.

naiviv

Hello to all,

Bit antsy, can't sleep. Surgery tomorrow at 2 pm. Looking forward to it, but I'd much rather have early am. Its phase 2 for lat flap lefty and symmetry for Diep righty. Some fat grafting for both and bye-bye to doggie ears.  Belly Button may also be done. Still not sure if wish to attempt again.  It basically closed up, no hole, just a small indent.  I wonder why the midnight ban on fluids for a 2 pm surgery?  I can understand 7 am.

Will check in with an update as soon as able

Vivian 

The1toC

naiviv thinking of you and sending good wishes that everything will go super smoothly for you.

ChrisInPA

Thanks Teacher.  26 days makes me feel a little better, but I just hurt so much.

Naiviv, will be thinking of you today.

debiann

Chris, I have no answers for you but lots of sympathy. One week after surgery my top drains were so painful and producing less thsn 20 cc of fluid a day. I called the PS office begging to have them removed, but the receptionist said the doctor wouldn't even consider taking them out that soon. He did remove three of them 3 days later, and the last one a week after that. It was such a relief! Teacher, I don't know how you endured  26 days of drains! I would have removed them myself, lol.

wintersocks

I am due to have my DIEP on 24th November.  A month or so ago I had an acute attack of cellulits on my right arm following a minor gynae op. I had to have 6 days of IV AB's. I was very ill.  

Has any one else had cellulitis,  I am wondering what is the likelihood  of this happening again after the DIEP.  

Did anyone take any special precautions?

I am seeeing the plastic surgeon early November to discuss the DIEP. To date he does not know I had to go into the hospital. 

Any advice please?

sky78

I thought I would summarize my recent DIEP experience while it's fresh in mind...

I had bilataral DIEP 18 days ago. I had a double mastectomy last September, so this summary is strictly DIEP related. 

I was very nervous about nausea after surgery as I had a fairly hard time of it after my mastectomy last year (even using the patch and other tricks). The anesthesiologist listened and said that because I am in good health otherwise, he was able to focus less on keeping me alive and more on reducing the liklihood of nausea (my words not his) and he succeded! I had ZERO nausea.

I spent 4 nights in the hospital. They took the catheter out on Day 2 and I was up an using "bath clothes" to clean up as soon as they'd let me. I was fortunate enough to get my period a few days before surgery, so I was highly motivated to get cleaned up and into some underwear and shorts! I think I got to take a shower on Day 3. I had to sit the whole time, but it felt GOOD! Then I needed a nap.

I had no compression garments or bras or anything.   I do not use any sort of ointments. 

I started with 6 drains. One for each hip and two for each breast.  One breast drain on each side came out on Day 7.  Another breast drain came out on Day 14. Two more came out today, Day 18. I am left with one hip drain that I have a feeling is going to be there a while. The PS office provides a camisole that has pockets inside to hold the drains, as well as a neck lanyard to clip the drains to for the shower.

I have been sleeping in my bed since I got home. I have pillows all around me and under my knees. I was quite surprised at how well I have done with sleeping this way. I guess it's because of dealing with sleeping with the expanders for almost a year.  Those things are no picnic for sleeping either.

I had sort of an uncomfortable feeling when urinating. I think it's because of them pulling up on the lower part of the abdomen. I think this feelings is getting better, or I am just getting used to it.

I had a small scare a few days ago when I had a low grade fever.  Of course it was at night and a Friday. I called the nurse and she said to just keep an eye on it.  Luckily, she was right. It went away and today the doctor was unconcerned.  I hope that is the last of that.  Last year I ended up with a fever and a small pink patch on one breast. I had to stay four nights in the hospital on IV antibiotics. I'd rather not have to do that again!

As far as pain goes, I stopped taking the narcotics on Day 14.  I felt a little pressure from the nurse and doctor to get off of them and maybe it's for the best. I've done fine without them. I would say the major pain I have/had is from the drain sites.  One of them, the one I have left of course, hurt quite a lot recently when the scab around the site came off when I sneezed! I must have been laying on the tube a little!?!?  That was not pleasant. I think a new scab has formed so it's quieted down a little.  Another uncomfortable feeling is the abdomen. It's not really pain, it's just this full feeling.  I'm trying to eat less at one time, but that's not my best skill.   Lastly, I would say that my sternum/chest gets sore. Apparently this is from the part of the rib that they shave off to get to the veins they need.  After sleeping on my back all night, my chest hurts quite a lot. Thankfully, once I am up and about, it subsides. Until I sneeze! Ugh.

The itching has been a small problem as well. I take a benadryl at night now most of the time.  I have sensitive skin so I think the glue makes me itch, plus just the itchiness that comes from healing incisions.

I think my energy perked up around Day 14...which could also be because of stopping the narcotics.  I haven't needed a nap in several days and generally wake up earlier in the morning now.  

I had my first physical therapy appointment on Day 12. It was mostly just stretching my arms up and around. I will be going once a week. I was told no abdominal exercise allowed until Week 6.

I have been trying to focus more on healing and feeling good, than what things look like.  I guess I am not thrilled with the shape of the breasts at this point, but honestly I had large saggy breasts before the mastectomy and these probably look better than that.  But, I was a little disheartened today when I looked down and saw what look like little course hairs coming out of my incision on my breast.  Last year, my breast surgeon was basically trying to talk me out of DIEP. I think she's a very skilled surgeon...but how she handled the reconstruction part of my process was not great. She said one day, "some people end up with pubic hair on their chest!"  I thought, oh she's just trying to scare me and let it go.  Now today I am wondering what these little pokey hair-like things are?!??!  I am hoping they are stitches or something?!?! Thank goodness someone on these boards mentioned laser-hair removal for something else. I will just do that if I have to.

Well, I guess that sums it up.  Sorry if that was long and boring! 

annieb4

Sky,

Thank you for letting us in on your surgery experience...I like hearing the play by play...Sounds like you didn't have to bad a time with it and you are healing quite well.  But pubic hair on your chest..Oh man...so now we gotta start shaving our boobs !!!

edukes1002

Laser will definitely take care of that situation.   I am actually getting tons of laser before my surgery.  I just touched up my underarms because I am afraid shaving and lymphedema.  Is that crazy?  It might be, my mind is going everywhere.