Bilateral or Unilateral Mastectomy? Implant risks?

Update 1/11/08 post exchange: I did survive the exchange but am more uncomfortable than I expected to be: drains are still in on day 6 post surgery ... and still needed. No major complication so far but more nausea and pain than expected.

Did anyone else recover more slowly after the exchange?? It seems I have read mostly stories of quick and easy recovery and expected the same.

M-mom: thank you for the good wishes and massage input; I am still not clear whether to massage or not and will have to ask my ps again.

Cornelia

Donna: Thank you for your encouragement. I am starting to feel better, thankfully.

I am glad that you got your date. Getting a little certainty in this time of bewildering uncertainty is a good thing. This way you can plan and prepare.

I don't know if I mentioned above the following tips - but they are just fresh on my mind because I am just re-experiencing them after the exchange:

Have the house prepared, groceries stocked, cleaned, laundry caught up, child care arranged .. before the surgery.

Get one or two post mastectomy bras beforehand; your old ones are likely not to fit and you'll need support. Have several front button or zip comfortable clothes and pants that don't require being ‘pulled' up with effort, like tight jeans (you won't have the strength to pull) ... I made that mistake today. Got my husband to help me into my jeans this morning for my visit to the doctor .. and now in the afternoon I am struggling to go to the bathroom by myself. I managed eventually to kick the pants off.  I tend to forget the moment I feel better that I can't do everything as I normally do. In that spirit:

Be kind to yourself after surgery.  Don't expect too much of yourself or others. Do whatever relaxes you in the days before and do what you enjoy; psych yourself up with positive affirmations and visualizations; do empowering activities, and have some fun. I will be thinking of you and I wish you the very best and a quick recovery. I know you are strong and you will make it through this.

Hugs,

Cornelia

M-Mom:

 Thanks for checking in and the good wishes. Today is the eighth day post exchange and I still have my drains in. Darn it!  I'm a bit puzzled that there has been so much fluid; I hardly had any post mastectomy. The ps says that there was so much scar tissue to remove and that is what causes the increase in fluid. Now I wonder if such a build up of scar tissue is predictive of further problems down the road.

It is amazing that you didn't have any drains after the exchange. Hard to understand how we are all so different in adjusting after the surgeries, surgeries that sound all the same to outsiders: mastectomy with reconstruction.

How are you feeling now, 4 weeks after your exchange? How is your range of upper body motion? Are you back to work? Are you happy with your results thus far? What kind of PT does your ps recommend? My best wishes for feeling well and strong in the weeks to come.

Cornelia

Hi Donna,

Great to hear that you put the big day behind you and I hope you are recovering well. Pulling drains will be the least of your challenges; it's brief. Keep the areas dry and clean; no showering before they are really closed. Remember it'll all get better and easier every day, one step at a time. That is very impressive that you don't have expanders. Wow! Where was this done? I haven't seen many references yet about immediate reconstruction without expander. Do you have silicone? Have you seen yourself yet? Report back when you can.

I'm better too. Still with steri-strips but back to work full time. No pain, just limited range of upper body motion. I'll start working on that next week. I'll do a more extensive update when I have more time.

423: Thank you for the note. It is good to know that the posts are helpful to some.

All the best for you.

Cornelia

Hi Donna,

Wow. You are already 4 weeks out from the mx. Good for you! Keep taking it one step at a time; it all will get better. Be easy on yourself. Your body needs to heal and needs the downtime. I know it is easy to get impatient and wanting to be perfect again ... now! (been there). You'll get there ... with time. Do all you can to heal, eat healthy, do PT (I have some ideas if you need them), and to do some happymaking activities .. whatever gives you joy and peace. Now is the time for that. Be proud of yourself for making it this far with a will to succeed; and proud of your body for doing its work to heal. I'm sending you a warm hug.

Below some cording info. Most lymphedema exercises will work too once you are able to move your arm without much pain.

I developed a few days after bilateral mastectomies and SNB in the right side cording: a severe and very painful tightening of the tissue (it seemed to be the tendons although not clear that it was them) underneath the right arm. It started in the axillary area and extended down my right arm, eventually to the wrist. The tightening became tighter over the following days, with actual ‘cords' like violin strings appearing on the inside of my arm. It was very painful to lift the arm or to extend it at the elbow.

This is fairly common, about 15% of people get it (although I was totally unprepared for it). It becomes more manageable with massaging (very gentle) and with time. Do not apply heat! That can agitate or inflame your lymph system. Keep the arm as much as possible elevated to decongest it if cording should occur. Also, do keep moving and stretching the affected arm ... gently.

What to do?

I massaged 2+ x per day with a cream (Traumeel: available on line) which helped. But any light massaging may help. Keep all movements gentle: gentle massage, gentle exercise and stretches, lifting the arm as far as possible so it could decongest (although there was no visible swelling), flexing the wrist. All of it helped. Most of the cording disappeared over the course of the first 6 weeks. 3 months later I still had some tightness but the pain was gone and I had almost perfect range of motion. 6 months later, no sign of cording anymore.

Hi Donna,

I know, it is the pitts to keep up with all the doctor's appointments, PT, self care, etc -- but all so necessary.

I'm relying right on the hope that things won't stay like this. I still feel like I spend way too much time on health issues, but, in all fairness it is so much better than it was months ago. I'm working full time; I go to the gym, and pretty much maintain a normal life now ... I'm just a bit stressed because the remaining health care issues do take time and are a constant reminder (looking at my breasts would be sufficient for reminders). It will get better for you too. That is a sisterly promise! Just indulge in taking it easy. Hey, there is an advantage to that ... before bc I had no excuse for taking walks in the middle of the day; cancelling meetings; catching up on reading good books ...

Keep up your good spirits. Gentle Hugs,

Cornelia