DIEP 2013

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  • peacelovedogs
    peacelovedogs Member Posts: 57
    edited January 2013

    Heavenschild- glad to hear you're home and doing ok!!



    For those of you that know more about this...why do I have an othropedic surgeon as an additional doctor? Just wondering.



    The hospital thing, I agree. I feel grateful that I live within 5 miles of Mayo Jacksonville. They got me to this point in NED so I didn't even look anywhere else.



    There are amazing surgeons, nurses and caregivers around all of us. I'm so hopeful that we all get the reconstruction that makes us feel great about our breasts again!



    ...um...sorry for the strang post!

  • MartyJ
    MartyJ Member Posts: 1,859
    edited January 2013

    Nihahi, you are so right.  This is about trust and positive outcomes.  It is very good to spread the word about great surgeons and offer info on all procedures (particularly personal experiences).  Each of us select doctors for different reasons.  If I want a facelift, I want to go to a doctor that specializes in that procedure and does several a week.  When I looked for a surgeon for DIEP, I wanted to be sure that surgeon preformed the procedure frequently.  When I began my research, I found many local doctors who advertise DIEP, SGAP, TUG on their websites along with lots of body and facial procedures. When it came down to it many only preformed the reconstructive procedure once a month or less.  The frequency of procedure is often the best method to prevent negative outcomes.

  • nihahi
    nihahi Member Posts: 3,841
    edited January 2013

    Orthopedics doesn't really have a role in breast reconstruction??? It would be a good question to ask, and really good to let us know what the answer is. 

  • MartyJ
    MartyJ Member Posts: 1,859
    edited January 2013

    Peacelove - I would also love to know why you have an orthopod involved.  Doesn't really make sense.  Enquiring minds want to knowCool.

  • peacelovedogs
    peacelovedogs Member Posts: 57
    edited January 2013

    I have a full day of pre op on Feb 4 so I will let you know. Actually, I'm calling the nurse tomorrow to ask about another thing so I will find out.



    I'm nervous tonight. I have a million appointments on the 4th. After that time is going to fly. I have to find clothes. I have very little that fits now and I have been holding out on buying much since I knew this was coming up. I guess tomorrow (today since it just hit midnight) will begin my quest to get started on my to-do list.



  • faith729
    faith729 Member Posts: 244
    edited January 2013

    Wondering if this has happened to anyone else? I went for my pre-op CT scan to view the blood vessels etc. A few days later I get a phone call explaining that the couldn't see what they needed to see so they wanted me to come in for an MRI instead.

    Friday when I went for my MRI and asked the woman if she would just be taking pics of the blood vessels. She looked at me very confused and said no we are only looking at the liver and the surrounding area??? I see my PS Thursday so Im sure he will have answers and test results by then. Just wondering in the mean time.

  • nihahi
    nihahi Member Posts: 3,841
    edited January 2013

    Is there anyone who's surgeon doesn't ask for imaging of the vessels pre-op?

  • gotoell
    gotoell Member Posts: 29
    edited January 2013

    For my doctor, it was the deciding factor whether I was a candidate. I had my initial consultation with dr. Cody from Loma Linda and he ordered the test and said we would talk about the surgery based on the viability of my vessels from the CT scan.

  • seagan
    seagan Member Posts: 166
    edited January 2013

    My PS hasn't said anything about pre-op imaging. I understood that he was going to make decisions about blood vessels (and specifically whether I had sufficient ones for a DIEP vs. a muscle-sparing TRAM) during the surgery. I've OK'ed either type of recon, and while I'm hoping a DIEP will work (so I don't have to lose any muscle), I also don't want to risk insufficient blood flow, etc. so am willing to go with a muscle-sparing TRAM if he determines that's the best route.

    My surgery is scheduled for Feb 19 and I have one more office visit with my PS on Feb 7. I suppose he could still order imaging at that point, but I think he would have mentioned it already. I'll ask about it, though, as I'm curious about the diffferent practices. I ran across a study concluding it didn't make a big difference if they did pre-op imaging as opposed to assessing things intra-operatively, and that it might even be better to rely on the latter, but I don't have that cite handy. I'll try to find.

    So grateful for all the continued stories and info, including from the gals who've had their surgeries -- my best wishes to you!!

  • heavenschild
    heavenschild Member Posts: 212
    edited January 2013

    i don't understand the pre-op imaging either, unless there are other medical considerations.  What they did in my case is get a *sonogram* of the vessels located in the surgery area at the time of SX to identify which ones they were going to use.

    Peacelovesdogs - when is your SX, I don't see you on the countdown. 

    Blessings to all on this journey.

  • faith729
    faith729 Member Posts: 244
    edited January 2013

    My plastic surgeon did mention that the pre op imaging was just for him to get a better idea and wasalso a deciding factorfor me as well. He did however mention that it is a possibility that durinh surgery the blood vessels may not be as good of an option as originally thought. So he has prepared me for the possibility that we may need to take another route. I am just trying to stay clear of implants personally it doesn't seem like that's for me. But the liver comment had me very curious.

  • gotoell
    gotoell Member Posts: 29
    edited January 2013

    I think that is absolutely correct. He did not promise me a stacked diep based on the test but was able to do that once he got in there. Good luck Faith! I am one week out from this surgery and feel really good, this is amazing stuff and feel grateful that I was afforded the opportunity to go this route.

  • nihahi
    nihahi Member Posts: 3,841
    edited January 2013

    Gotoell..so glad to hear you're doing so well so soon after your surgery. My doc isn't one who has any pre-op blood vessel assessment either. He says they are not always what they seem, and makes his decisions based on what he actually finds intra-operatively. My priorities too are for complete flap viability vs. complete muscle sparing. I also have stressed to him that breast symmetry is more important to me than "cup size". He has done lots of diep/free tram surgeries, and has tons of microvascular experience, same for the other plastic surgeon who partners with him in the OR. He is known for his attention to detail, so I am putting my trust in him to make the best decisions for me. 

    The waiting for surgery is tough, but I'm trying to use the time to get as fit as I can. 

  • nihahi
    nihahi Member Posts: 3,841
    edited January 2013

    Bleugirl, hope your recovery is going well. When you get a chance, please add my name and date to the list. Thanks

    Nihahi - April 12

  • MartyJ
    MartyJ Member Posts: 1,859
    edited January 2013

    I had a CTA with contrast the day before my surgery, but it didn't show good vessels.  My doc used a pocket ultrasound prior to surgery to determine the best possible options.

  • curveball
    curveball Member Posts: 3,040
    edited January 2013

    I had an ultrasound and CT angiogram today to locate vessels for surgery in April. I think I like that the surgeon will have some idea what he is going to find in there prior to cutting. Also if my vessels are in any way not suitable for the surgery I think I would rather my surgeon found out now and told me now, rather than going all the way to April and waking up with reconstruction still undone and being told, "we got in there and found the vessels were not usable".

  • peacelovedogs
    peacelovedogs Member Posts: 57
    edited January 2013

    Heaven and Bleu I hope you're both feeling better everyday!!



    Orthopedic mystery solved. He is also an extremly skilled micro vascular surgeon. I guess it works for them. It's a long procedure so I'm sure they are both busy.



    I have several pre surgery images scheduled. I will list them when I'm not on the phone and can type easier and view my schedule. My memory still hasn't recovered from chemo brain.



    I'm so thankful I found this site again.

  • nihahi
    nihahi Member Posts: 3,841
    edited January 2013

    Wondering what people have gotten "clothing wise" for the early weeks post diep surgery? Does anybody use a light, support type garment for the ab incision area once the drains are out?

  • MartyJ
    MartyJ Member Posts: 1,859
    edited January 2013

    I found a bali panty with really good front support that I still wear.  I also wore the full compression with open crotch after drains were out til incisions healed.  That way I wasn't pulling things up and down every time I needed the bathroom.  Beyond that, yoga pants are great.  I found comfy pants without a tight waist on sale on the J Jil website that look great.  Button front tops were perfect for the first 4 weeks, but I could get my arms up easily to put on a pullover top.  Just not fitted.  There generally is abdominal swelling that comes and goes for quite a while and you need to be able to accommodate easily.

  • nihahi
    nihahi Member Posts: 3,841
    edited January 2013

    Marty, your postings are always so positive and informative. Just want to say Thanks. Did you use the compression garment after Stage 1? I am not planning on doing any lipo, unless the ab donor site really doesn't settle out on me, but I am going into this surgery knowing I already have a "fragile" lower back, and may end up with a muscle sparing Tram instead of a Diep. I'm thinking once the drains are out, the feeling of support (front and back) would be a good feeling, especially until I am comfortable with being "upright" again. Also, I do know that compression helps to minimize scarring.

  • heavenschild
    heavenschild Member Posts: 212
    edited January 2013

    First post-op visit today - and the breast drains came out, woo hoo!  She said that I am healing nicely and would feel *human* in about three weeks.

    No mammos, no more worries about CA, worth it?  Yep. 

  • nihahi
    nihahi Member Posts: 3,841
    edited January 2013

    That is wonderful news, heavenschild!

  • peacelovedogs
    peacelovedogs Member Posts: 57
    edited January 2013

    Heaven...so happy to hear that!!

  • lilyun
    lilyun Member Posts: 54
    edited January 2013

    There is no feeling like being "drain-freee!"

  • MartyJ
    MartyJ Member Posts: 1,859
    edited January 2013

    Yeah, Heavenschild!  Great!

    Nihahi - No lipo at stage 1.  I, too, have a questionable lower back.  Problems with it come and go.  I liked the support that the compression garment gave me.  Very comforting.  I did take flexeral ocassionally for my lower back (maybe 4 - 5 times) during the first 8 weeks.  Then we took a trip, walked a lot, sleeping in strange, but comfy bed and my back just said it was done - took flexeral and was fine.  I have a wacoal panty that is a particular favorite (more than bali) and wear it often, still.  I will begin the lipo at Stage 2.

  • jjl
    jjl Member Posts: 68
    edited January 2013
  • faith729
    faith729 Member Posts: 244
    edited January 2013

    Wahoooo! Heavenschild and lilyun you two must be feeling pretty good!



    MartyJ the full.compression that you wore after your drains were out did the PS provide you with that or a name of a good one?

    Im totally lost when I start thinking of what to pack for the hospital and where to begin with preparing the house for recovery..my mind just goes blank probably cause Ive never stayed in the hosp for that long ;) help ahh! where do I begin lol my goal is to get most of this stuff done on Fridays when my kids are at school and Im not working.

  • MartyJ
    MartyJ Member Posts: 1,859
    edited January 2013

    Faith - the compression garment was given to me by my PS.  You should talk with yours to see what they recommend.  Not all docs use compression.  I am glad mine did.  She issued me a Design Veronique and then I later bought a Marena to switch off.

    Packing for the hospital - we all over do this one.  Actually they give you everything you need and it is much easier for you and the nurses if you stay in a hospital gown.  A light bathrobe is good to put on when you walk the halls.  A pair of flip flops or comfy slip on flat shoes, too.  There is a packing list at the top of the NOLA in September thread you might want to look over.  I really didn't need most of what was suggested, but it is well thought out and very helpful.

    Food - I made lots of things that were easily kept in the freezer (my DH is great at defrost and heat).  Chili, beef stew, crab cakes, portioned hamburgers.  Since you have kids, freeze serving portions of their fav stuff so your DH can feed them easily.  I had a grocery list for him for when we got home (my surgery was not in the city in which we live and I didn't return until 10 days after surgery).  Several of my friends scheduled meal deliveries, but I had to ask them to stop as we had too much.  We are a big breakfast house, so I had canadian bacon in the freezer.  My dh picked up our grapefruit, eggs, avacado.  I really did not want to eat a lot, but wanted to be sure he did.  The antibiotics that my doc gave me tend to change the sense of taste, smell and vision (yes, weird, but they are really good).  I only wanted bland stuff that involved white products (mashed potato, white bread, pb&j) - very strange because I do not usually eat any of that.

    I guess what I am saying is don't get overwhelmed by the preparations.  Whatever happens, happens.  And you will be better for it.  Preparing the house for recovery - I just did regular cleaning.  Have your DH put clean sheets on the bed the day you come home.  Made sure that the wash was done.  BTW - since most of us have some lift restrictions - I bought a bag of the detergent pods so I could be independent and do wash without having to lift a heavy container.  You can juggle this if you can juggle a family - just don't let it take over your life (mind).  Just be sure that you allow yourself the time to recover and rest.  You will be fine!

  • Downey30
    Downey30 Member Posts: 337
    edited January 2013

    Faith,  Marty is so right.  I overpacked, overdid, and over prepared before surgery.  It's just amazing how things fall in to place.  Try not to worry and just listen to your body and rest.  The other "stuff" will follow.  Before you know it will all be a distant memory.  Jamie



     

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  • faith729
    faith729 Member Posts: 244
    edited January 2013

    Thanks so much ladies :) I am visiting my PS tomorrow morning to follow up and get my CT scan and MRI results hopefully he will confirm that we are moving forward with the DIEP fingers crossed. Might sound a bit strange but Im getting used to the idea and sort of have a peaceful feeling about the surgery.

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