DIEP 2011

WOO HOO!  Have had >30 cc drainage the last two days.  Emailed the nurse and she told me to go ahead and take them out.  Went to do it and the stitch had broken and it was partially out anyway so just yanked it.  Freedom!  (Except for the binder, of course.)  Now I can sleep on either side.

 For those who have mentioned it, don't sweat the marking.  It was very business like and actually made me feel like the process was finally beginning.  The waiting and appointments, tests, etc.  were over.  I was in a teaching hospital and there were a few other Dr's there but they do these all the time and I figured they had seen better and worse. 

 I am back in for consultation on the next step in two weeks but may try to put it off until Nov as I love gardening, summer and fall and we have kids and grands coming in the summer.   The next generation has taken over the holiday responsibilities so II can just concentrate on sleep and work from Nov to Apr.

Next week is my first visit to the oncologist.  I am sweating that one a little but guess it pays to know what you're dealing with.

I am so glad I have this place to come to.

XRAYestInMA:  WhenI get questions or opinions about "why" I chose reconstruction or "why" I am getting nipple tattoos I either then them a) I need them if I'm going to be the most famouse 50 year old stripper in the world or b) I like to change my boobs out every 10 years or so....It keeps my marriage exciting as my husband thinks he's got a new sex partner every time.

I don't usually get many more questions after that (probably because they are dumbstruck at what I just said, but that's they're problem).

@ brigadoonbenson - omg you pulled out your own drains?!?!?  Wow, that is hardcore!  Mine were like a foot long it seemed like.  EEOOWW-za!

I have been lurking rather than posting, but I've been busy and missed a ton. Wow what great updates. The marking reminded me of my reduction surgery at 19. I was actually anxious when my mastectomy surgeon DIDN'T mark me up. (And I think it would have been tidier if he had. The incision is tighter than the rest and makes a groove, almost.) But pulling your own drain? awesome. Mine was removed by a nurse with dirty gloves, so I spent a week on keflex. One good dose of Tylenol 3 and pulling my own drain vs. a week on the stinkiest antibiotic, qid -- so hard to choose. But seriously, thanks to everyone for the upbeat and realistic updates. I don't have the DIEP consult until June and in a perfect world would be going into battle in the Fall but won't really know much till June. I'll be sustaining myself with reassuring war stories from you gals in the mean time.

If I stop by the hospital over the weekend to say HI.. how do i find everyone.. maybe you should have DIEP 2011 or BC.org on your doors with your user name... LOL

Hi just a lump update, bs said it was a enlarged LN and he biopsied it . He said to him it didn't look like any cancer and he is pretty sure it will come back neg. Yeah !!! Prayers answered again !!!

I'm preparing for my big ol' surgery this coming Tuesday. Got my Rx all filled. You;re right! The Keflex stinks like sulphur. At least the pills aren't the size of my big toe! I think I can swallow those suckers. Now the pain killers are another story. Huge. Strategically huge, I think. I have a hard time swallowing pills. Forgot to ask for the the NON-childproof caps. My kiddo can open them anyway, so maybe I can ask her to open mommies pills for me.

Just ordered the post-surgery bras my NP recommended. I hope I got the right size, because I really goofed up on the larger than usual granny pants. I don't remember when I last bought underwear, but I thought a size 12 would be bigger than usual and comfortable, etc. I think, if I sew the leg holes shut, I can use them for grocery bags! LOL! They are GINORMOUS!!! Soon to be a gag gift item.

Don't know what else to do to prepare at this point. Cleaning house (as if I'm going on vacation. Ha!) Any tips at this point would be appreciated.

Good night.

Lady Lois Marjorie Mish Finley 

Charlottesmamma  Good luck to you on tues.  I will be thinking of you and saying some prayers for a very speedy recovery.  I am 4 weeks out and mowed the lawn yesterday My wonderful sister bought me some BurtsBees lotion yesterday, cause once the hair started growing on my legs and "down there" Iam itching like a mad woman.  Lotion is paraben free and very nice stuff although I noticed very expensive.  The sun is finally shining so I am headed outside, have a wonderful day everyone.

Betsy, that's what I said, yeah!! I will be there from 9-19th.  somone mentioned putting our screen names on our doors, so we can recognize each other. Do you know if they will be able to place my port? I wasn't sure if that was something they would do or I would have to do it at my local hospital (which would stink)... Jerusha, I will be looking for you too!! Hopefully we will be able to meet up with everyone after.

I did my first craft fair today at 4 weeks, 3 days after my 2 surgeries.  I did great, wasn't tired at all throughout the day (I am now!), only took 2 advil and had fun being around all of the BC girls.  The event was a fundraiser for Breast Cancer Angels who provide support for women (and men) who have great financial need as a result of BC.  They provide housing, money, food, clothes - whatever they can and whatever is needed the most.  It is a very inspiring organization and it was great to be a part of this event - especially now!

While Ihate this disease, I really love the amazing way it brings people together. 

Alexanjb-  I am in-between Roch and Syr but am nore familiar with Roch through training as a nurse.  Through the wonderful internet I found Dr. Caldwell as my surgeon and Dr. Vega as my PS and they were wonderful!  I have a friend that is a Dr. here in the FL and he recommended Dr. Caldwell.  I gooogled "NY  surgeon with most experience in breast surgery" and I got Caldwell, so I just kept asking around to get confirmation about my decision as I was petrified!!!  If your Docs came recommended then you did your homework and you should feel confident that you made a good choice.  I also did the same with the PS to make sure he had done several Diep and was proficient.  Good luck to you, what procedure are you doing?

Thanks Carberry,  I think I am having the DIEP flap, but my surgeon didn't actually use that term.  He did use the word perforator though....it felt like a good consult but shortly after leaving I felt confused and overwhelmed over what was said and the fact that I had an appointment for surgery so fast after one consult appointment.  I am hoping that the paperwork I was told they were sending would help me to regroup and absorb the information.  I have read the Breast Reconstruction Guidebook several times and I have been read the posts here and elsewhere.  I know that the PS is qualified for the DIEP.  And the way he explained it sounds like the DIEP, except he did throw in there using mesh if he needed to and something about possibly using a small bit of muscle (which means free tram flap, right?)  From reading these posts it seems like they can't always be sure until they get in there, and I can understand that, if they can't get good vessels for transfer it won't work.  I think he was going over all possibilities and sometimes I was still stuck on the last thing he said while he was on to the next thing.  He didn't say anything about a stage II other than eventually he has a woman come in to do a tattoo for the nipple, and that the other breast might need a lift for matching.  I am very encouraged that you could ride the lawn tractor at 4 weeks out, how did you feel afterwards?  I feel very scared and alone about this surgery.  The PS said it was a 6 hr surgery, the day of surgery and the next in ICU for monitoring the blood flow, 4-5 days in the hospital and 6-8 weeks recovery.  I asked if I would be able to work from home part time before the 6-8 weeks and he said yes, I could probably do computer work from home.  I have my work laptop set up so that I can access the company network from home and basically do anything from home that I can do at work.  Since I am a support person for technical software it should work out OK.  I hate to lose more time at work and I hate to spend another summer in recovery.....but I do want to feel whole again, and say goodbye to the prothesis.

Alex... It sounds like your surgeon knows how to do DIEP, but doesn't do very many... I would ask exactly how many DIEP flaps he does a year, and what percentage turn to TRAM...

btw- On my docs website there is a place to send questions. 

 I sent the following: 

I was in last week for a consultation and made an appointment for a breast reconstruction on June 8. Is this scheduled surgery the DIEP procedure? I feel confused right now as to whether I am to have the DIEP or a free Tram Flap. I thought it was a DIEP but I remember he said something about using mesh and a small part of the abdominal muscle. It sounds like the recovery is harder for the free Tram flap and I am getting cold feet. Thanks

My PS responded himself within the hour: 

The decision to perform a muscle sparing free TRAM flap (which takes a very small piece of muscle), vs a DIEP or SIEA (both perforator flaps, which take no muscle) is made in the operating room, based on the size and quality of the vessels in the abdominal tissue.  I always go into the operation with the plan to perform a perforator flap, if it is appropriate.  That being said, I will not "push it" and perform a perforator flap if the vessels are very small, or of poor quality, as the liklihood for flap failure increases in that scenario.  Even when a surgeon is very confident that a DIEP will be done, both he and the patient need to be willing to accept a free TRAM id it appeares intraoperatively to be the best choice.

Having done a large number of both free TRAMs as well as DIEP/SIEA flaps, I can tell you that the recovery from a free TRAM compared to a DIEP flap is almost identical.  In the DIEP procedure, the muscle is split and the recovery is very much like a free TRAM.  Recovery probably has more to do with the individual patient, than which of the procedures is done. 

I will call you to discuss this over the phone with  you tomorrow.  Hopefully, I can answer your questions, and assure that you are comfortable with whatever your decison may be.

I am encouraged!