DIEP 2015

Ridley

Hi all -- I've been following along and now have a date for what will hopefully (fingers crossed) be my last surgery -- March 25.  We are going to try fat grafting on the left side one more time (had it done once, but most of it reabsorbed) and will do nipple reconstruction at the same time. 

Sending healing thoughts to all those who are in their early days with this surgery.   Although my results are perfect, I would make this same decision again in a heartbeat.

Morwenna

Welcome Neta

Wow, you really don't have long to plan/panic!

Welcome Ridley

Fingers crossed that fat grafting works for you this time. It's good to know that you have no regrets, even if you are not entirely happy with the result as yet.

I'm looking at myself just 2 weeks post op, and reserving judgement on what I will look like once the swelling settles down, but already can say I am so happy I have done this! I have at least some shape on my original mastectomy side, and my right breast is gone so I don't have to worry about that any more. When I turn sideways to look in the mirror I am seeing a tummy profile of me 30 years ago, pretty much!

Violetphisch

hi everyone-

Home from the hospital as of yesterday. Came home with 4 drains ( 2 were removed yesterday). Had visit first visit from nurse today. Very helpful.

Trying to get pain meds sorted. Dilaudid makes me burst out sobbing. Yuck. Oh, and I am having auditory hallucinations. THAT is interesting. Nurse is trying to get th switched.

Still can't stand up straight. Don't know how long I'll be walking all hunched over. It is making my back miserable.

Going to take a shower for first time today. Wish me luck!!

Nurses and doctors all say that my surgeon did a beautiful job ( some with that hushed sound of admiration in their voices), but I have nothing to compare it to, but they all, (even visiting nurse), talk about her as the best they have ever seen and that working in her OR is "intense". We shall see!

Good luck to all if you coming after me...:)

WalleGator

I'm so thrilled to read how well you guys are doing after surgery. I'm a month out from mine, and I'm having trouble moving from anxious/nervous to excited. Not sure how to be more thrilled? This is the surgery I want, found a great doctor I like...maybe it's the long recovery time making me nervous? Any ideas?

It reminds me of the two weeks after I was first diagnosed, where I couldn't move myself from crazy upset to no nonsense facts, figures and get this crap out of me and moving forward. That was a switch that had to be flipped, too. Thankfully, a nurse gave me some good advice then.

Morwenna

Violet

Welcome to the other side!

The back pain was crippling to me, but started to subside about 9 days post op. It's way better now!

Now I can stand and walk fairly/almost straight, at times, but my tummy tightens up like a Braxton Hicks contraction (if you ever had kids), and makes it hard to take a deep breath. I can't stay upright for more than a few minutes, but played my piano this morning AND cleaned a toilet cos it was bugging me. I was pleased with myself cos up to a couple of days back I really struggled to pick something up from the floor!

I'm just taking occasional tylenol now. I am quite swollen under my arms, and looking forward to that subsiding!

I wish I had a nurse to visit me at home!

study411

Hi Ladies, help me to get through this... I am nervous about next week's surgery, even my family doctor don't think I need to remove the left normal breast,

she said since I am on tamoxifen and no family hx, just monitor yearly should be enough.  I start to feel am I making a mistake ??? 

Violetphisch

Morwenna-

I am so GLAD it has gotten easier . I feeling like it is never ending right now . Do you still have drains ?

The visiting nurse is great . My insurance covers it and she checks drains and incisions and got my pain meds switched . All the help I can get and peace of mind that she is looking at everything with an educated and experienced eye .

Feel like I just need to get rid of these drains and I can start to really do better ....

Morwenna

Violet, one of my drains was removed before I left hospital, 5 days post op. The remaining 3 were removed 3 days later. I didn't have any issues managing them at home, but was pleased to get them out, as especially the abdominal ones pulled and irritated. The back pain settled gradually over the next few days, and is pretty much resolved now. I walked (slowly) on my treadmill for 10 minutes this morning as it's too icy to walk outdoors! I might do that again later!

Study, what can we say? It's horrible that you are finding yourself second guessing at this point.

It is an individual decision of course, and I know the medical profession feel that too many "unnecessary" mastectomies are performed, but it comes down to peace of mind.

In my case nobody really tried to argue with me, although a couple of doctors muttered something about my risk of developing a new cancer in the other breast was "only slightly elevated". Also I had lived with the large uniboob for 2 years and knew I hated it (the remaing appendage!)

If you feel confident that your risk is low and are happy with that decision then that is the way to go.

Sorry, I don't feel I am helping much, but you do have my every sympathy! xxx

LAstar

Glad to hear good healing stories! Violet, hopefully you'll turn this corner soon. Morweena, you make scrubbing a toilet sound like a small victory! Bravo, gals - keep it up!

IndigoMont11

Evening everyone! I had my consult today, and PS says I can have DIEP or free TRAM! The session went really well, and I feel good about going ahead. The way he explained the free TRAM, they don't take but a very small bit of the muscle, so that if the blood vessels are especially small, the risk of damaging them by dissecting them away from the fat tissue is much lower. Morwenna, is that what you had done? Anyway, I am okay with that, especially because he said the use of the muscles after healing from either procedure is about the same regardless of which procedure I end up having. No SGAP, but he explained how that is more complicated and more uncomfortable later on. OK with that, too; it would have been nice to have a butt lift, but I'll just have to do it the hard way. No tissue expansion (yippee!).

I will go back to see him in May or June, and schedule for September or October.

If anyone else who is with Kaiser in Denver is interested, the PS is Dr. Royal Gerow.

Morwenna

Yup Indigo,

My PS routinely does muscle sparing TRAM rather than DIEP, and I'm fine with that. They only take a postage stamp sized piece of muscle, and he says the incidence of fat necrosis is higher with DIEP.

The vessels they use are the same, actually, but in DIEP they dissect the vessels out of the muscle rather than removing them with the scrap of muscle, so the muscle is still cut, even in DIEP.

The only surgery that doesn't affect the muscle at all, if you happen to have suffiently sized superficial vessels, is the SIEP, but this is rarely available.

mefromcc

Glad to see our first surgery sisters are recovering nicely.

My surgery is in 20 days and all I can say is ARGH!!! I have to admit it's not the surgery itself that I am not looking forward to, it's the healing process, the pain and discomfort, the physical limitations, the needing help from others, the ...... Need I go on?

Morwenna

A tip when showering/bathing: several small (hand) towels are much easier than a larger towel for drying, whether someone is assisting or you are doing it yourself!

SheriCola

Just wondering:

Has anyone, with a set date for "phase 1", scheduled the phase 2 surgery date in advanced? I don't know if that is even an option to do this early. Or is it something that's discussed at your first pre-op appointment?

Violetphisch

ok ladies-

Just heard back from surgeon about path results yesterday.Most of my team were advising me to go for lumpectomy and radiation. My instincts were to take them both, and do re con .

Well - they found non invasive in the original breast (right) that hadn't shown up on orgonal scans. The left breast had " a lot of different things in there". Fibroadenomas, polyps, and a cluster of a-typical cells. I asked the nurse if that meant if I had opted for the lumpectomy and rads if I won't have been right back in their office looking at the same damn thing, or worse, having missed it once, maybe not catching it until it was a stage III or IV. She said yes, most likely.

Trust your gut.

Morwenna

Good for you Violet!

I haven't actually had my path results yet from removal of my "good" breast. I get them next Friday at my follow up with the BS.

I wasn't actually expecting to go back to her, but her nurse phoned to make the appointment, and mentioned that she would review the pathology at that time.

Funny thing is, I wasn't that bothered when she said that, but this morning I woke up wondering if she had something to tell me!

You're right. Trust your gut! xx

How are you feeling today btw?

mefromcc

SheriCola,

My PS has never mentioned there is more than one step involved. In reading this site's explanation of the various reconstruction methods available, it was not clear that there were stages, either. I only found out about stages by joining the DIEP 2014 thread.

Violetphisch,

Good for you for following your gut. I feel your relief, as I felt when the path report for my "good" breast found all sorts of stuff going on in it, but no cancer yet.

The count down continues: 18 days to go. 😐

OVienna

Hello everyone, I am new to this group and very happy to have found you. I am approx two weeks post-op (Uni MX with immediate Diep). Tomorrow my drains come out. I am counting the minutes!

I have been very happy about the procedure generally. Today I am cranky though because I am substituting Tylenol for some of my Oxycodone dosages, which made me feel slow and stupid. I think 3 regular strength Tylenol may be the sweet spot.

Wishing all the post-ops a good recovery

websister

It is good to read and see how well everyone who has had surgery this month is doing.

Morwenna - it will be interesting to hear how your appointment goes on Friday.

I know it's still farther out there than most of your surgeries but my date was moved up from June 9th to May 22nd on Friday.

Appreciate the tips being shared by those going through the postop period now, thank you

Morwenna

I've updated the timeline Websister

I forgot to do it before and meant to go back through our conversations to see when the new date was!

spookisgirl

Don't forget me !! I will be "August 2015" for a little bit, Although I did get a call from my PS saying they wanted to do it in two weeks! I had to point out that my oncologist might not agree with that since I am doing chemo and all....They are going to call back in July as I finish my chemo. Glad to know I am on the radar though!

Jenn

jmb5

Indigo, I also technically had a free tram, even though I still tell everyone I had a DIEP. The DIEP is what was planned, but during the surgery, the PS decided to take a little muscle because the blood vessels were thin. I didn't want to explain to everyone the difference, so I still say I had a DIEP. It's really pretty much the same in my mind anyway. On Saturday was the one year anniversary of my surgery. Crazy!

Violet, glad you decided on the BMX. I was first diagnosed 5 years ago and had the lumpectomy and rads, which is the standard of care for DCIS. Four years later (Nov. 2013) I had a recurrence, and was told my only option was a mastectomy. I opted for the bilateral, thinking I would be done and wouldn't have to worry when some calcifications showed up on a future mammogram. The next decision for me was whether or not to do nipple sparing on the right "healthy' breast. I couldn't do it on the left breast, because of previous radiation. The BS told me the nipple would just die, and didn't even give me the option. So in my thought process, I decided I would also have her remove the right nipple so that they would match. Not sure if that is logical thinking, but it was to me. Pathology came back after the mastectomy, and can you believe I had Paget's Disease? Cancer cells in the nipple of the "healthy" breast! I was floored! I had no symptoms at all, so it was found very early. I can't even imagine what might have happened if I had done the nipple sparing mastectomy and that cancer had a chance to grow. By the way, the BS told me before I made my decisions that I had a less than 1% chance of having cancer in the healthy breast.

 

Morwenna

Not forgetting you, Spookisgirl

Just let me know when you have an actual date, and I'll add you to the timeline. How's the chemo going?

spookisgirl

Thanks Morwenna!

It's going great I guess for a first infusion. Burst of energy on day 2 and crashed day 3 and 4. Today is starting with a headache, but I hope it goes on it's merry way. All things considered, I have nothing to complain about. I see my surgeon next week, so hopefully she can fill in some details for me

Jenn

Morwenna

Good to hear Jenn,

I did AC/T as well, and remember the post steroid crash! Look for your hair starting to fall about day 16 ..... I see you have it short already

I used to sit with a bowl in the mornings and pull out handfuls as it came loose. My 20 yr old son caught me at it one morning and was fascinated! He asked if he could have a go!

Stay well xxx

Dlia

Hi Ladies, Initially I had a lumpectomy, and after I found out that I had Her2 breast cancer and that my sister had passed away from it after spreading to her liver, spine, lungs and brain, I decided to do the double mastectomy. Now I have lumps in both breast that are so close to the implants that the plastic surgeon is concerned about infection so he recommends that I take the implants out and do the diep flap but before he will do it I have to lose 35-40 lbs. So far I've lost 10 lbs but still not sure I want to do the surgery since I dont know anyone who has had the surgery and what the side effects or complications could be. Also, not sure why I have to lose the weight. Although getting rid of that stomach sounds good just need info from those who have had the surgery.  Does anyone know if taking the tissue from the stomach will cause lymphedema?

Dlia

Hi Ladies I read in one of your post that there are stages to this diep? Or am I mistaken? I hadn't heard anything about it. I also see that it can cause fat necrosis...

Morwenna

I have mild lymphedema to my arm on my original post mastectomy side.

I was concerned about the TRAM flap surgery exacerbating that, even though my PS said it wasnt likely to. I am staggered to find that I have almost NO swelling in that arm since surgery 3 weeks ago. So , I guess my PS was right!

Oh, and I tend to get swelling in my right leg since my dvt in 2013, but right now both ankles are looking great! I don't think there is any suggestion that removing skin and fat from the abdomen would lead to lymphedema.....

As regards fat necrosis, I don't think it is a way big deal, but small areas of fat tend to shrivel into little lumpies as they don't get adequate blood supply for a while. These tend to gradually reabsorb over time, and are not really anything to worry about. But women with our history get nervous about lumps!!

About staging. Not everybody goes through more than one surgery, as I understand it. But often the main drive of the initial surgery is to implant the flaps and have them establish a good blood supply. This may result in a reasonable shape for some women, but commonly some "nip and tuck" procedures may follow to achieve desired shape, size, and or symmetry. Nipple construction is commonly done as a later procedure also, if a woman chooses to have that.

The number of surgeries or stages may be determined by a combination of how good the original result was, plus how exacting the subject is about how she wants to look and/or the surgeon's satisfaction, plus of course finances, if insurance is involved etc.

So my PS has never mentioned stage 1, 2 or whatever, but he did mention he might improve my port scar "later", so presumably he has further surgery in mind!

I might find out more when I see him for my follow up next week.

Sassy01

Dlia, I had the DIEP done in two stages. Stage 1 in August and Stage 2 in December. I'm a bit biased but it looks pretty amazing. My husband agrees. I have not had any necrosis on the breasts, but had two small spots on the donor site that was cleaned up and removed at Stage 2. They did not want me losing a bunch of weight prior to surgery- they used it all for the new girls. I'm quite pleased. It was completely worth it. I don't know where you are but do your research on the the procedure and surgeons. Check out The Center for Restorative Breast Surgery. They are amazing. Their website is pretty informative and talks about the different procedures.

OVienna

Hello all, can anyone give me advice about weaning off Oxycodone? I am only 13 days post-op but I just had the worst nightmare and it was too vivid and 3-D... I do not like this stuff. I feel so mentally dull.

I have reduced my dosage to 4 per day from 6 per day. Now I'm ready to halve pills and add Tylenol, which the NP said I could do. I tried substituting Tylenol by itself but it did not work..I must have used too little;everything fell apart that day.

Thanks!