Diep 2012

Thank you do much Lala63 for your informative observers viewpoint- it is hard to remember things days after an anaesthetic!

I have been lurking and reading everyone's posts and gaining a great deal of strength for the upcoming surgery. I am having a bilateral DIEP soon- within the next month though the exact date is not known (maybe today after I meet with the PS for another expansion ) I have had my preamission clinic appts with the nurses, anaesthetist and so on. I am not looking forward to another surgery after 3 ops in the last year and other TX. I feel healthy and more like my old self for the first time in forever since dx.

I did have TEs in both sides but lost one to infection after rads in November. I had been planning implants but the cratered concave mess of scars and knotted muscle on my cancer side means that is no longer an option.

Wondering ATM how it will all piece together to look like a breast or chest again as everyone is different. I was content with the expander look pre rads so just want to be symmetrical and not sad when I look in the mirror. I get a great deal of comfort from the reports of how happy ladies are after their DIEP and I have a lot of confidence in my PS team here in Melbourne (Australia)

I look forward to posting the exploits of another happy DIEP customer soon!

Cheers Robyn

Four days out she is resting comfortably in her own bed. Trying to keep the boys quiet so she can sleep. She walked up the stairs no problem but has had more pain than in the past few days. She came home with only two drains. PS was very happy with how she looked today and offered to meet her on Friday (DIEP +7) so she can spend the weekend with only one drain. She still having trouble with a BM. Good day because she came home but she is kind of down and in pain. Hoping for an easier day tomorrow. Any tips on what to do about her back pain?

Lala - my PS gave me Valium for my back pain and it was wonderful. It apparently is a medication that can be taken along with our meds. I was totally off narcotics when I left the hospital which was great for me because they made me nauseous. I controlled the pain with a combo of 800 mill of ibuprofen every 6 hours and then after 4 hours I took 600 Tylenol. This staggered med plan worked great for me and was easy to wean off of by cutting the dosage every 3 or 4 days til I was just taking ibuprofen then cutting that back to just nights and then nothing. Check with your Docs on pain meds before you change. Valium was my lifesaver.

Tammy- I'm so glad to see you posting here! I was just thinking about you and wondering how you were doing. I'm so sorry for all that you have been through. I can't imagine how hard it must be to think about another flap at this point, but I think Betsy makes a good point about thinking five years ahead and what result do you want then? I hope you keep coming back and posting with us.

I had terrible back pain too. It was the worst pain I had associated with this surgery. I remember the first week bending over the sink to brush my teeth was just agony, but it didn't last long and as I kept walking and standing up straighter it went away.

To those facing surgery soon- good luck! Won't be long and you'll be on the other side with your brand spanking new boobs!

I am 7 weeks out now and so excited. We have a place down on the gulf coast of Texas. We get down for one long weekend a month, but haven't been since before the surgery. End of January the last time we went. We are heading down today for a super long weekend! I can't wait to walk on the beach and eat some shrimp! I need this so badly! It's been a long recovery, but I am feeling so good now and ready to get back to my life again. It's a 5-hour drive down and I know that will be no problem for me. We drove around the hill country this past weekend checking out the bluebonnets and I was in the car for most of the day without any problems at all. Today is the day we were supposed to leave for Hawaii but that got rescheduled for the surgery. I feel really good but I'm glad we rescheduled that. I'm not ready for a trip that big. I could have done it easily. It's the weeks leading up to today that I couldn't have packed or prepared for a big trip. And honestly, I'm glad I'm not dragging luggage through an airport- especially since it would be DFW and there are still some flights canceled today due to the tornadoes yesterday.

Healing thoughts for all!

I think finding a vessel to attach a replacement flap is one of the things that makes replacements difficult. Our NOLA docs don't talk about it much because they're more experienced in doing it, but many PSs who do flap surgeries are averse to "redoing" flap surgeries, for that reason. 

going back to the PS tomorrow to discuss the different stages and what to expect. Have just read through a lot of  conversations above and got my full list ready...kind of the final reality check for me. I am going to ask about the extended stomack, upper and lower becuase If I'm going through all this I had better have a flat stomach at the end of the day!!!  We have to have some benefit here don't we!   for those you who have said constipation and BM is or might be a problem I've always lived by Starbucks early in the morning and if that doesn't work for you or as an alternative, watermellon, lots of watermellon, it really works, try it!!!!!  Feel good to all,  

Wednesday-DIEP+5



She felt great in the morning but then started to feel pain. She took her half OxyContin and then decided to take a shower. As she was gettin ready (dealing wit drains, guze and clothing,) she got very nauseaus. She finally sat on a shower stool we borrowed from my mother-in-law. She sat for a long time and felt great afterwards. She walked a bit and went to sleep. She woke up ate lunch and went right back to sleep. When she woke up again, we went downstairs and sat in the recliner. She decided to try Tylenol instead in the afternoon but by night, her pain was too much. Back to oxy! Everything is looking great but still painful. She is feeling pain in her chest that had not been there before. Part of healing?

Dutchy... They did lipo on my upper stomach... and mine is still bloated at 4.5 months post stage II... I think it can takes MONTHS. Plication is where there stitch the stomach muscles together to tighten the belly... so if for example my abs can't tighten up on their own and are too manipulated to lay flat, they can go in and surgically pull it tight, This is kind of a big deal... nothing to walk into lightly, but if you look pregnant, it is an option. If the problem is FAT, that is a different less solvable problem. Lipo can only eliminate surface fat, not deeply imbedded fat, so if during DIEP they take the lower belly fat, and can only lipo surface upper fat, you will still have upper deep fat. Does that make sense??

Yikes, so after all this, I will still have my muffin top? I'm working on losing weight, despite a sprained ankle/tendonitis that caused me to stop jogging. So it's S L O W.

 Guess the tummy tuck won't be that aesthetic after all. I was hoping for some sort of a silver lining!

Isn't plication a standard part of any tummy tuck? I looked at my Op Report and my DIEP surgery included a plication. The fat I had above my navel was liposuctioned and used for fat grafting in Stage 2. My abdomen is flat as a board. No muffin top. Ask your PS what you can expect your abdomen to look like post surgery and if your surgery will include a plication.

I'm curious:  did any of you have to use this "Airlife" tube thing to make you take deep breaths when you were in the hospital?  I wasn't allowed out of bed until my discharge day, 4 days after the DIEP.  Meanwhile, starting on the second day, I was supposed to use that machine/device to take deep breaths 8-10 times per hour.  Of course on the 3rd day (after the moprhine bag was empty and they put me on valium as a muscle relaxant and oxycontin for pain), I was so I wasn't awake long enough to do it.

I think it was supposed to help prevent fluid build up in the lungs? 

A plication at Stage 2? I doubt it. Stage 2 is primarily for fix-its, scars, lipo, fat grafting, nipples etc.They should do the plication just prior to closing up following DIEP when they already have the abdominal incision area open. What's 'more invasive' if they are already in there? If they say they are giving a tummy tuck as part of DIEP, I would want the full deal including plication. If they see the muscles need it, they should do it then. Why wait? A long recovery from abdominal surgery is no fun as it is but twice? Not if I could help it.

Nobody told me I was getting a "tummy tuck" with DIEP. I think that's an aspirational bonus and a story we tell ourselves, but it wasn't part of the promise as far as I was given.  We're moving the porch to the balcony, and then we'll close it up. As consumers, we talk about it as being "effectively a tummy tuck" but, at least where I am in the land of public health care, there is no medical objective to do a "tummy tuck", just breast cancer reconstruction. And my OR report makes no mention of any tailoring of the ab muscles at all. I think I probably had/have average ab muscles: one pregnancy, no particular excellence in Pilates. Fortunately, I do now have a very taut and smooth abdomen on the front, which I did not before. I have some visceral fat above the waist that I could stand to lose, but my team really did harvest all the ab fat they could. A bit of pudge I'm saving on the hips, I guess, in the case of a need for filler in a touch-up. Maybe this is one area where people with private insurance can flex their consumer muscles I guess, if they don't differentiate between cosmetic and medically necessary procedures.

A true tummy tuck involves plication. Not all DIEP procedures. My PS told me that once they got in there and removed the flap, that my abdominis rectus muscles had not come back together after pregnancy, so as long as I was opened up he did the repair. Muscles staying separated after pregnancy happens to some women but not others. I'm glad that he did the repair, but he didn't know if he would do it until he was in there to see it needed to be done.

I had stage II today - lipoed the foob (including some on the side - not technically the foob) and revised the abdominal scar. After Stage I, my abdominal area hurt more than the foob, this time the breast hurts more than the abdominal area. I was super cold when I came out of surgery, was shivering enough that they had to give me two doses of med to stop the shivering - the 1st dose stopped it for a little while, but then it came back and they gave me another dose. First time for that medicine. But I skipped the vicodin for the drive home and it was fine and now I'm lying around on the couch at home.

Feel free to ask questions, if I can answer them I will.

My "tummy tuck" was done with the DIEP. No plication was required. I did end up with a very flat stomach but also had "dog ears" at the ends of the abdominal incision. These were taken care of during stage 2 as was a little lipo to the pubic area, fat grafting to the DIEP area as well as a breast lift and nipples on both sides. Most of my fat was located at my waist and below and my PS used it all to build a pair of nice 36 C's. I ended up 20 lbs lighter after all the swelling went away and dropped 2 pant sizes. Now to try and maintain is the next issue. Happy Easter.