Diep 2012

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  • fredntan
    fredntan Member Posts: 1,821
    edited January 2013

    geez you guys are making my PT person look really bad. and she is the mastectomy speciallist in area. Have tried calling in to the new mastectomy specialist in area, but its like trying to talk to pope. 

  • ReadingMama
    ReadingMama Member Posts: 573
    edited January 2013

    Makes me want to find a PT also!  Have not used one at all. I will have to look at my insurance.

  • Linda-Ranching-in-the-mTns
    Linda-Ranching-in-the-mTns Member Posts: 319
    edited January 2013

    I suggest talking to your onc or surgeon (whichever you get along with best) and just ask them to write the prescription, and reccommend the right PT for you. Then your insurance is more likely to say yes. If you just ask the insurance company directly, without it coming from a doc -- the insurance company might think it is unnecessary. 

    There is a subtle art to the insurance end of all this...

    For instance, my hospital stay -- my docs told me do NOT say that I wanted a private room at check-in... that the hospital (at least at the hospital I had my BMX/DIEP) always gives you a private room anyway, due to the seriousness and this type of surgery... but if I ASKED for it at check-in there would be insurance complications because the insurance company would require a whole slew of paperwork to justify paying for the private room, and I might be denied!

    Anyway -- better to get everything you want through the doc/onc/surgeon for the least insurance hassles.

    Linda

  • kimdy
    kimdy Member Posts: 66
    edited January 2013

    Feedback please ladies....

    I was scheduled for bilateral DIEP next Monday, January 14, but due to preop testing revealing damage to my heart...they now believe from chemo I must postpone.

    I am somewhat looking at July if my heart function improves.  

    Where I need your feedback is - If I have surgery June 3, could I be ready to travel to Italy the end of July first of August?  I had hoped to have stage 1 in January so there would be no issues.  I don't have options on the dates to travel to Italy.

    Thanks for any insight you might could offer:)

  • CookieMonster
    CookieMonster Member Posts: 1,035
    edited January 2013

    Much depends on how well you heal. It's all individual. I would have been fine, others might have struggled. I was back to work teaching high school full time at about 6 weeks.

  • cg1234
    cg1234 Member Posts: 181
    edited January 2013

    Kimdy, very sorry to hear about your heart issues and hope all works out. In the best case scenario you might feel pretty good but I couldn't imagine myself making the long flight comfortably and enjoying running around Italy the way I'd like right now. It might depend on how much you have planned. I'm 2.5 months out and still having ab swelling/fatigue if I do too much. Plus, if you were to have any complications (e.g, wound healing) you might not want to be so far. What a wonderful trip to plan though! Where are you visiting? I'm sure it's disappointing to have any delay in your diep but any chance you can go to Italy first?

  • fredntan
    fredntan Member Posts: 1,821
    edited January 2013

    Idk either. Could you switch those? Go to italy first then diep. my boobs arent much to look at after stage one. I consider this part just getting the scaffolding up.



    Are you doing tour? I loked into going but flights from VA to there are arou d 2500. did you find cheaper flights

  • kimdy
    kimdy Member Posts: 66
    edited January 2013

    Thanks for your replies ladies....I must travel to Italy at the end of July.  My daughter is there and will finish her job then.  So it is the only time she is availabe to travel.  

    So I'm thinking a June surgery date may not be the best option.  I am trying to get a 3 phases done in this deductible year.....

    If I can get cardiac clearance, I suppose I can try for April.  Any thoughts on an April surgery date for phase 1 and travel end of July.

    Frendat - flights are about 1500 or so from Tulsa.

    Thanks again,

    Kim

  • sandpiper1
    sandpiper1 Member Posts: 952
    edited June 2014

    I think I would ask your surgeon first. Medical clearance for extensive air & land travel due to many risk factors post op no matter how good one feels. Imho

  • Cherrie
    Cherrie Member Posts: 1,423
    edited January 2013

    It all depends on your healing.  I would have been good to go at 7 weeks. However, I am not sure you want to be out of the country with a complication due to flying or healing.  April would be great if you can swing it, or wait until you get back.  You probably will not get all 3 in this year, even if you start in April.  Stage 2 is 3 mo. later at the earliest, but my doctor wants a longer space before stage 3.  It all depends on your doctor.

    Good luck with all of this.  There never seems to be a good time.  If you have active cancer the sooner the better.

  • fredntan
    fredntan Member Posts: 1,821
    edited January 2013

    I finally got appt with PT in area for US to my scar tissue on the "bad" breast. I was working with the local breast PT person, but all I did was my exercises when I went. I can do those at home

  • Linda-Ranching-in-the-mTns
    Linda-Ranching-in-the-mTns Member Posts: 319
    edited January 2013

    kimdy -- have you discussed this flight with your doctor -- re the 23 removed nodes? It is my understanding that now, when we fly, we need to wear a pressure sleeve, to fend off lymphedema. The trip to Europe is a long one... and some sort of staging might be really helpful... like an overnight stop in Iceland or something... to get that sleeve off and get good rest and circulation back strong before taking the second leg of the trip. Another advantage would be less (or no) jet lag when you arrive... and I would guess that airlines might work with you if you use the breast cancer card!

    I felt pretty good after one month (my BMX/Immediate DIEP was Nov 6). I had relatively no complications. And now, at 2 months out, I think I feel pretty normal again (wow -- is that ever great!). Still -- I would not want to plan a long flight like that for right now... I am driving 10 hours to see my sister next week, rather than flying, for just this reason. I DO feel up to attempting the 10-hour-drive ... I figure if I get tired, I will just check into a hotel and get there a day later. But I have made the trip to Santa Fe (3.5 hours) several times now, and my stamina is improving all the time.

    Maybe it is a silly thought -- but would you have time to make the trip a cruise instead of a flight? Kind of a romantic idea -- who knows what interesting people you might meet on the ship!

    Linda

  • bdavis
    bdavis Member Posts: 6,201
    edited January 2013

    Kimdy... I had a complication after BMX and GAP flap and was back under the knife at one month post op. Once they did my DIEP, I was back at work in 4 weeks. But we just can't plan for complications. You might be great or you may have issues. I would say if you had surgery in April, you would be fine for July even if you had a problem. But June just seems too close.

    I also think planning to have 3 stages in 2013 is a little ambitious. My doc wants at least 3 months between stage I and II, and then wanted many months between II and IIb (I put 14 months between them).

    As for flying, I have flown many times and do not have any issues. With many nodes removed, I would indeed wear a sleeve - but I may not be the best to comment on this as I only had 2 nodes removed.

  • kimdy
    kimdy Member Posts: 66
    edited January 2013

    Thanks ladies for your feedback it is invaluable....with your help..I am leaning towards stage 1 in September after returning from Italy.

    I do have compression sleeves and gauntlets for the flight. Will keep you posted. 

    And any feedback is welcome.

    Thanks

  • MENA1954
    MENA1954 Member Posts: 194
    edited January 2013

    Where in Italy will you be going?  If you need Italian lessons, just ask me!  LOL

    I am glad you decided to wait till Sept. for the reconstruction. Enjoy your time there and when you get back you can fully concentrate on the surgery and a quick recovery?

    Mena

  • goldlining
    goldlining Member Posts: 1,178
    edited January 2013

    I like the idea of the trip first. Waiting for the surgery is just a looming, dreadful thing. Far worse than the actual surgery, many of us would say. If you have your trip to look forward to with excitement and "hide" the surgery behind it on your schedule, you will have less time spent in dread mode. My 2c.

  • bdavis
    bdavis Member Posts: 6,201
    edited January 2013

    I had a vacation planned when I was diagnosed and I had a small window of time to have my surgery. So I literally went on vacation and three days after returning went in for pre-op and then surgery. I enjoyed my vacation fully, did not worry, and could do all the things I wanted to do.. I golfed, went tubing, swimming etc. If I had been recovering, I wouldn't have been able to fully enjoy the vacation. My cancer had already been removed by lumpectomy, so this was in lieu of radiation and post chemo.

  • Katarina
    Katarina Member Posts: 386
    edited January 2013

    Hi Ladies,

    I had my Diep early December. I just started walking straight but notice my abdomen feals hard as rock, is a bit bloated and has no feeling. How long should I expect this? 

    Hugs,

    Kat

  • cg1234
    cg1234 Member Posts: 181
    edited January 2013

    Kat, I find compression really helps but I still have swelling in the eve, esp if I'm stretching and twisting in the day. I'm also trying to avoid salt and too much fiber/gassy foods. I was pulled tight so it might depend on how much room they left you.



    Kimdy, i agree with others about the difficulties fitting all the stages in a year. It really stinks to pay out-of-pocket and deductibles each year though. A September trip would be great and not too hot. How great to look forward to sightseeing with your daughter! I want to go too!!

  • cg1234
    cg1234 Member Posts: 181
    edited January 2013

    And Ronniekay, thinking of you. How did your appt for treatment plan go?

  • RonnieKay
    RonnieKay Member Posts: 2,067
    edited January 2013

    Hi Diep Sisters...good to catch up on how people are!  I'm glad you decided to wait on surgery Kim...best to truly enjoy your trip!  I really am happy with my diep body...although it makes me sad that the port disrupts what I think of wearing now.  For almost a year I had a "double bubble" expander and it was really an odd shape in clothes.  Then, nice toobs and having nice cleavedge for the first time in my life...and boom...now the port.  The fact that it's going to be with me for life makes me just sort of shrug it off. 

    I had my onc meeting on Wed & yesterday (Thursday) had chemo. It grew so fast and large that my onc is hopeful it will shrink quickly.  I've read that's happened with others on the boards.  There was great hope at my meeting...strong heart, lungs and bones.  I'm having herceptin again, along w/another drug that works in tandem w/it, and a 3rd drug.  I'll stay on that combo until it quits working and then move to another combo.  I pray it gives me lots of time! 

    Sending healing thoughts to all...XOXO

  • lilyun
    lilyun Member Posts: 54
    edited January 2013

    Dear RonnieKay, so glad to hear that your meeting was so hopeful, that should set a positive tone for your treatment.

  • cg1234
    cg1234 Member Posts: 181
    edited January 2013

    Ronniekay, we all hope so too! Thanks for updating and hope you stay well!

  • kimdy
    kimdy Member Posts: 66
    edited January 2013

    Ronniekay - you are incredible...praying for GREAT success for you



    Mena - we will be traveling to Arrezzo....the Tuscan region. I think 3 hours south of Rome and one hour north of Florence



    Linda-Ranch & BDavis glad for the input on the sleeves. I had purchased them for my flight to San Antonio...and hadn't even thought about the flight to Italy...



    So grateful for you girls that have gone ahead of me....hope I get to join you at some point with DIEP reconstruction. Hopefully this heart damage will improve in a month or so??? My hope was to start in January so I would have a better chance of completing my reconstruction in 2013....so ready to NOT be the patient.



    With you guys input...I think I"m leaning towards stage one in September and possible Stage 2...but we will see, trying not to get too much set in my mind as things keep changing.



    Anybody have any idea what the cost is for tatooing the areola in stage 3 and is that usually all that is done in Stage 3?



    Thanks again for your insight Ladies & Hope you have Blessed Weekends!

  • bdavis
    bdavis Member Posts: 6,201
    edited January 2013

    I haven't had my tattoos yet, but I think its around $350.

    The Tuscan region is beautiful... but I think you meant north of Rome and south of Florence??

  • fredntan
    fredntan Member Posts: 1,821
    edited January 2013

    I am little confused about what happens next after stage 1.



    My understanding is in next stage, they will lift and reduce my left non radiated breast to better match my radiated breast. I think he will add some fat to the rt side and shape it up. This is also time they would work on abdomin- it seems pretty even to me right now.



    This second stage is where they make nipples? I dont understand that at all. I haveheard they can use extra labia skin? I certainly hope not.



    And what are three D nipples?



    And what happens if you need stage 2b? What is that?

    Tattoos are last?

    I am tentavely planning on my stage 2 in march.



    Will these scars fade? And in stage 2 will they go back in the same scars?



    I will ask my doc all this too. Is there a youtube anywhere that explains some of this

  • bdavis
    bdavis Member Posts: 6,201
    edited January 2013

    fredntan... Stage II is different for everyone and also dependent on the doctor. For me, I had had DIEP and GAP flaps, so my stage II was extensive (butt lift, revision to ab scar to neaten it up, lipo to love handles, outer thigh, inner thigh, inner knees, abdomen, fat grafting to breasts, lift breasts, break up necrosis and build nipple for left side (right side was spared)). I am having a stage IIb this month for more revisions. When I am done, I will get 3D tattoos. So they will be 3 dimensional. And my nipple was made with the skin right there on the breast. My doctor doesn't use paddles of ab skin in the aerola area. He removed the nipple but kept the aerola skin and used that skin to build the nipple. That is why YOUR doctor may have HIS thing that is specific to him... you'd need to ask.

  • Linda-Ranching-in-the-mTns
    Linda-Ranching-in-the-mTns Member Posts: 319
    edited January 2013

    Fredntan - Since each woman's surgery is different (one breast or both -- immediate DIEP with UMX or BMX or later, maybe even years after BMX/UMX...) each stage 2/3 etc are different, too.

    Just depends on what you need. I think the idea is not to over-tax your body by doing too much at once... but getting your money's worth...

    My own deal is I had BMX -- so I don't need my "good" breast lifted -- so they can do a little more in other areas... like create my 3-D nipple (for you they might add a stage 2b for that step... or maybe do it at the same time -- each doc is different).

    I think you had your surgery done with PRMA -- right? I did, too -- and no one said anything about messing around with Miss Kitty... thank goodness! There would be no real reason to use labia skin (as far as I am aware) because I don't think the new 'nipples' are expected to have any sensation at all... they just look like nipples, and all coloration is done via tattoo in stage 3.

    My understanding of my own stage 2 will be lipo from the torso to fat graft into breasts where needed to create the balance, size and symetery we want, and doing a little nip/tuck/sewing to pucker the belly skin (that now exists where my nipples once were) into a semi-erect-looking nipple. They will also re-do the abdominal scar to make it less gnarly... if necessary, and remove dog-ears/re-sculpt the torso to be more fluid/look better.

    And -- my understanding is that I am supposed to lose whatever weight I plan to PRIOR to stage 2 -- to get the best results... in part because some of the weight we lose (from now on) will be from the new belly-breasts... and the only way to have a pretty good idea where the breasts will end up -- is to lose the weight first, then fat-graft the breasts to a little-larger-than the desired size/shape -- knowing that about 1/3 of that grafted fat will dissolve into the body and be re-distributed everywhere...

    Kimdy - for that reason (depending on how much weight you want/need to lose prior to stage 2) that might also afftect your ability to get two stages completed in 2013...

    Since fat creates estrogen... and I have 100 ER/PR+ cancer -- my onc wants me to lose at least 30 pounds... and I have set my own goal at 35-40 pound loss prior to stage 2 -- which I hope to schedule for May of this year. 

    Kimdy -- the Tuscan region is gorgeous -- I spent 2 weeks in Lucca with Italian friends who live there... and then several days in Florence and a couple in Venice... but the beautiful vinyards and cypress trees... fantastic! Oh -- and the pasta dishes with truffles... amazing! OH!! And we went to Il Palio in Siena -- perhaps the most famous (and one of the most dangerous) horse races in the world -- all decked out with Rennaissance pomp/circumstance around the central palazzo... really exciting!

    Maybe you could go a little earlier/stay a little longer... (?) The Palio this year is Aug 10-17... after all, the most expensive part of traveling is always the getting there and back, not the staying longer...

    OK -- off the computer (for me) and out to get some exercise!

    Linda

  • Cherrie
    Cherrie Member Posts: 1,423
    edited January 2013

    I am confused about the weight loss for stage 2. I have never heard this. I am scheduled in 6 weeks and I have 15-20 pounds to lose. I was going to concentrate on this between 2 and 2b. My doctor has never mentioned this.



    Has anyone had success with weight loss after stage 2?

  • Anonymous
    Anonymous Member Posts: 1,376
    edited January 2013

    Kimdy,  I went to Italy one month after my UMX, because it was planned before the BC diagnosis.  I had no problems and enjoyed every moment immensly even though I was waiting to find out whether or not I was going to have chemo & Herceptin.  In fact I got the email from my MO just before the end of the trip that she was NOT recommending chemo.  I don't think one week after my DIEP I would have had as much fun, so I'm glad you're waiting until after your trip.  ENJOY it ALL!!!!

    Fredntan:  I'm just as confused about stage 2....and I think it varies depending on your physician and insurance.  I've been expecting that my stage 2 could be as soon as April (PS says it takes 3 - 6 months for your new boobs to "settle in"), so I'm waiting until May.  Didn't know about the weight loss thing, but it makes sense, so I'm going to try to exercise more to try to lose about ten of those Tamoxifen pounds (not that the chips and dip have anything to do with it :-)

    Reading this thread I was hoping that I could get some fat grafting to improve the flattened shape of my BC breast....but I get the impression from my PS that she's only expecting to do the nipple construction and then tatoo.  Could be my Kaiser insurance....could be my PS thinks the "settled in" breast will be more shapely.  I'm just glad the major part of this is done and I can wear my regular bras again!!!!

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