Timing of PBMX in Northern USA, when would you do it?

Lea7777

Seriously considering PBMX due to high risk for breast cancer.

Assuming I do it locally, are the warmer summer and early fall months better for getting to the hospital without weather delays, returning home from surgery and going to appts? Or instead, should I just plan to hole up during Feb-March or into April when it is cold out and not waste nice weather (when I like to be out and active) on downtime recovery. Not a skier.

If I were to travel somewhere else in the US for surgery that would require a long drive or a flight, then choosing a time of year other than winter may be best, right? And maybe avoid hurricane season of July-Oct if I chose a more southern spot?

One hint I have been given several times is: do not do elective major surgery at the end of the year. There is a surge of people who opt for procedures at that time of year because they have finally met their deductibles. That means fewer appointments and less availability of medical staff. I personally ran into various appointment problems with that issue at the end of 2017.

Another question--4 months after the PBMX do you think it would be reasonable for me to consider overseas travel that requires long flights to get there and bumpy roads, then when I arrive, moderate hiking carrying about a 15-lb backpack? Of course, much depends on any complications that might arise. I'd follow the surgeon's recommendations too. But I thought I'd throw that out there for those in the know, to help with the timing issue.

Those of you who have been through this will undoubtedly have some thoughts and insights on this "when" question. Thank you for anything you might share.

Lula73

A lot will depend on if you’re planning recon and if so what kind - implants or natural tissue/DIEP/SGAP.

Lea7777

I am planning on natural tissue reconstruction DIEP or if that is not possible, SGAP, at the time of surgery. I thought it was 6-8 week recovery for that.

Rubytoos

I have been told by friends who work in the medical field that July (I think it is that month) is not a great time to schedule surgery because you have a new crop of residents. Nothing against residents . It's just considered a good idea to let them settle in before they start practicing their somewhat newly minted surgical skills.

Lula73

so if you are planning DIEP/SGAP it does take 6-8 weeks for full enough if recovery to go back to work for the average job. I would think you could do the trip at 4 months but we all heal in our own time, so I think I’d purchase travel insurance just in case for that trip. It’s the hiking and backpack part that I’d be concerned with. The flight, bumpy roads and all should be no problem. For the flight, purchasing a pair of compression stockings and getting up to walk around on the plane everybody hour or so will be important to help prevent blood clots,

If you’re traveling for surgery, I’d set it up so you’re scheduled for stage 2 in the fall if possible if you have DIEP. SGAP I’d recommend one stage in spring and the other in fall. This is based on the compression garments you have to wear afterward for 6 weeks and heat factor.) All of this considering flying out of the NE where flights are routinely cancelled/delayed for weather. Typically 3 months minimum between stages.

Where all are you looking at having your recon done?

Lea7777

Rubytoos, what a gem of a hint regarding July! I'll remember that for any elective surgery in the future for myself or others. Your responses show my lack of knowledge so far regarding PBMX. All my research efforts have been focused on my high risk condition to this point. Time to transition the research to action plan, so my questions are not stupid.

DIEP/SGAP is a two step process. I have read a 3-step process if there will be nipple tattoo. Your comment of 3 months between stages makes me think I'd stick close to home for those 3 three months and not venture out until the whole thing is done. Compression garments in the heat, something else to consider, right! Thanks Lula73.

As to where I am looking to have recon done, I have not set my mind on any particular place. Want to keep options open at this stage.

Icietla

I know you are dreadful of your high risk for invasive breast cancer.

If you decide to have the surgery to reduce your risk, I think it would be best to have it done as soon as it can be arranged.

>>and not waste nice weather<<

If it is during a kinder season, you might think of the time not as (to be) wasted, but as (to be) used for your healing.

Lula73

Rubytoos is correct. New crop of residents right out of the classroom in July/August. Mainly in teaching hospitals. This rule typically applies to the ER and inpatient for acute illness though. When we're talking something as specialized as DIEP or SGAP flap the resident situation is far different as those residents just coming out of the classroom typically are no where near the point of microsurgery.

The other thing I'll throw out there is it is not uncommon for women to have to travel for this type of recon for the reasons of scarcity of surgeons who do it and increasing the odds of the best outcome/quality. The groups that do these types of recon typically have travel resources to help you and/or have special rates with area hotels and such. Just a tip when selecting where to go for the recon: You should be able to look at the before and after photos of that surgeons work and say, 'I'd be happy with those results for myself!' And not just happy considering I've had a BMX and it could look worse. If you can't say you'd be happy to have the results you're seeing, keep looking for the right surgeon who does the quality of work you would be happy with. I went to NOLA and I'm thrilled with my results and the care I received. Here's a link to their site:

www.breastcenter.com

Lea7777

Before and After photos, absolutely, Lula73. Sitting outside as part of recovery is a good plan too, Icietla.

NancyHB

I had UMX with immediate DIEP two years ago. I thought I felt fine after a couple of weeks and pushed my activity level (runner and yoga instructor); an antibiotic-resistant superbug (klebsiella) landed me in the hospital not once but twice, and at home with IV antibiotics. I returned to work at 10 weeks and was pretty much okay. Real recovery was a couple months in the making.

I had my surgery in late July and it was perfect timing for me. Allowed me to rest comfortably at home (not cold), walk outside often, and rest in the afternoon sun at the park. I would have been miserable had it been winter and I tried to exercise or recover at the gym, but that’s just me

I didn't realize prior to surgery the extent of potential infections, both hospital-acquired and otherwise. Lots of us have dealt with them, some losing tissue and expanders, some setting us back weeks if not months. Two years later I still haven't had my stage 2 because it's suspected I may have colonized klebsiella. I'm not risking it anytime soon.

Plan for the worst, and hope for the best. I don't mean to sound negative, it's jist important to understand the risks. I do, of course, wish you the best and a side-effect free surgery and recovery.

Lea7777

Not negative at all NancyHB, it's what happened to you. Thanks for the info and the vote for summertime.