Minutiae of PBMX-HELP

auntiems3
auntiems3 Member Posts: 67

Okay, this is for those who have been through skin/nipple sparing PBMX with T/E recon.  I am scheduled for surgery on May 15, and all of my appointments are made, but, I know that there are some things I need to think about and prepare for in advance. 

Things the doctors don't tell you....for instance.  After I had my first biopsy, I had to send my dh and my 10 yr old daughter out to buy a "well-fitting" sports bra for 24/7 support. I know I have read somewhere in one of these threads about a special 24/7 bra.......so what else do I need to know?  Any small detail which for you as an individual, would loved for someone else to tell you to ease the path ahead.

I am a college professor and my semester ends two weeks before the date, but I also have a new job in the labs which will need me until several days before.  I am trying to line up my ducks so they can learn to "Quack" together!

Thanks-Marie

Comments

  • Paula32
    Paula32 Member Posts: 12
    edited March 2013

    Hi Marie.  My bilateral mastectomy surgery now seems like such a long time ago, although it has only been about 18 months since I had a bilateral tram flap reconstruction immediately after mastectomy.  I had skin sparing, but opted to not do the nipple sparing.  After some thought, I felt I just wanted as much of my breast cells removed as possible.  Along with LCIS, my previous biopsies came back positive for a garden variety of abnormal cells, so It just felt safer to me. 

    The best guidance I received pre op came in the form of reading what women had written about their experiences on these forums.  There is a wealth of info about what to expect post op, what to bring to the hospital, and what to expect once home.

    Hospital- my cell phone was very important.  Hospital gowns were easier to navigate the first day or so, then I believe that I wore soft night shirts/gowns that buttoned in the front.  My plastic surgeon had wrapped my breasts in a binder during surgery, and that is what I wore until I got home.  Then, sports bras and a special soft bra that my plastic surgeon supplied.  I had quite a few drains. Once again, the plastic surgeon supplied a wonderful cloth holder for the drains.  You probably will have a few drains, and they will need to be emptied and the amount of fluid drained noted so that your surgeon has an idea about when each can be removed.  I had a notebook which all of that info was recorded in until the drains came out.  We also used that notebook to keep track of pain meds.  A shower seat helped during my first few showers.

    As I am writing this to you, I realize how much my plastic surgeon and his staff facilitated my recovery.  I would recommend talking to your doctor and/or staff, and ask what they suggest.  They have been doing this for a while, and know the tricks of the trade:)

    I am sending you hugs, and reassurance that waiting for the surgery is emotionally more difficult than recovery.  I remember waking up post op, and once I realized that it was finally all over, I felt that I then could concentrate on doing something instead of waiting.  I felt that I finally had some semblance of control.  Just a wee bit, but some just the same:)   Please feel free to ask me any questions, and I will write more as I remember.  Again, I would recommend reading past discussions about surgery.  It was my lifeline pre-op.  Thank you ladies!

  • carol57
    carol57 Member Posts: 3,567
    edited March 2013

    I agree that you'll find lots of preparation advice in the surgery forum.  The single most helpful tip I found there is a very simple one. I bought a package of three large men's cotton T shirts and cut them straight down the middle of the front, from neck to bottom, so I could put them on like a button down shirt. I wore these next to my skin (and over any binder you may be told to wear; my PS did not put me in any binders after my pbmx/diep recon). The idea is to wear something soft (non-irritating) and absorbent, because there are some inevitable oozies for a week or two, depending on how fast you heal. The shirts protect whatever else you're wearing, and if you don't have a special garment to pin the drains to (I did not), you can pin them to the cotton T shirt.

    The surgery is scarier to think about than to actually have, in my experience anyway! I found that doing the kind of planning that you are doing now helped a lot to keep my nerves in check in the time before the surgery. Best wishes to you...focus on the outcome and not the process, because you've got some peace of mind in your future!

    Carol

  • grammietofour
    grammietofour Member Posts: 40
    edited March 2013

    Marie - go to the Before Surgery thread and there are great posts.  One item I never would have thought of but was GREAT was taking an extension cord to the hospital.  Cell phone cords are way too short to reach the wall and sit on your bed and you won't want to be climbing out of bed for the phone.  The nurses even commented on how smart that was. 

  • SimplyAudrey
    SimplyAudrey Member Posts: 242
    edited March 2013

    Marie,

    ASK the surgeons if you'll be staying.   Mi PBMX was day surgery. 

    Re:  Sleep/comfort bras, with tissue expanders my PS didn't see the need, but I found them on ebay (CHEAP) for MY comfort.  I had an ACE immediately after surgery, but that was it.

    Ask about an OnQ pump or the medication Exparel.  Both deliver local anesthetic to the surgical sites so you need less narcotics.

    Those are the hot things off the top of my head....Monday is 6 months for me....and also the day I'm going in for fat grafting (insurance paid for lipo -  woohoo!)

    Best of luck!

    Audrey

  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited April 2013

    My PS was adament that I keep my elbows to my side for 4- 6 weeks, so I bought a grabber that I could use to get the laundry out of the washer, one or two pieces at a time. Also I needed a back scratcher. Also a lightweight stool to kick around the kitchen so you can reach things in the upper cabinets. I'd also work on stregthening your leg muscles so you can get to your knees and back up without moving your arms. Your pecs may be sore for a while, so a heating pad is useful, as is the self heating sticky muscle pain pads. I echo the soft-t idea. I had a compression garment for 4 weeks and the elastic really irritated my skin, but the soft-t was heavenly. I still wear them to this day, but they are no longer cut up the middle :)  Be sure your shower has a sprayer head on it, so you can rinse off without getting your sutures/drains wet. I hooked the drain safety pins to a shoe string around my neck to "shower".  I bought the lightweight zip up sweatshirts at Walmart. They have inside pockets that are great for drains. Also I confiscated a bunch of dry-cleaned dress shirts that my son was giving to Goodwill. I cut the long sleeves into short sleeves and pinned my drains to the compression garment. It looked sort of snappy for going out.

    The leadup to surgery was worse than the actual surgery. I needed help with my dressings which I was to change after 24? 48? hours post surgery and I was to change them twice a day. My daughter is a nursing student, so she had a lot of experience in wound care and drains those first few weeks. I slept in the lazyboy until my drains came out - about two weeks - then I made a nest in the bed with a bunch of pillows so I could sleep on my back. Strong ab muscles are good for getting out of bed without moving your arms.  I swept the wood floors with a Swiffer and my feet (we had 5 dogs and a lot of dog hair at the time!)

    Best of luck! Things are gonna go great!

  • carol57
    carol57 Member Posts: 3,567
    edited April 2013

    farmerlucydaisy's thought about strong legs and abs is a wonderful addition to the get-ready list! I was concerned about the potentially long diep recon part of my surgery and that motivated me into the gym 11 weeks ahead of time, sort of a desperation fitness need. Well, it worked. I worked with a personal trainer three times a week for core and other strength training, and from the very day after surgery, I kept saying 'bless the squat' and 'bless the crunch' because I was able to move myself in and out of bed with the help of muscles that could take the burden away from the lower abs and incisions from the diep, and as farmerlucy says, to get out of bed without arms.  I'm convinced that the cardio work I did every day at home helped me in what was a very speedy recovery.  Not to mention the bonus of re-introducing myself to the fitness I had said goodbye to in my 40's, so when I had green light to begin exercise again, I really wanted to, and it has been a key part of my strategy to be a healthier person ever since.  

    Now, just a reminder for doing exercise post-mastectomy / post lymph node removal (node removal probably doesn't impact many in this forum): do it safely, and be aware of exercise precautions to help minimize your risk of lymphedema, which is a small but real risk even if you have no nodes removed.  In the lymphedema forum, you can find out about this in a thread called 'new resource for exercising with LE' or some similar title.

  • auntiems3
    auntiems3 Member Posts: 67
    edited April 2013

    LADIES!Laughing  Thanks so much for all the helpful information!  Your ideas and tips are GREAT and I plan to use them well.

    I was in the medical field for a long time, but it never prepares you to be the patient. 

    I never would have thought to look for a surgical thread, but it makes sense now.  Audrey....wow same day?  My PS said I would be in at least one maybe 2 nights.  I will certainly ask about the meds at my pre appointment.

    farmerlucydaisy, I don't plan on having to do ANY housework for a while post-op.  (that's what teenagers are for).  But your plan to strengthen leg muscles is a really good one.  My bed is high and I will need a stool to "climb aboard". 

    I love this board and all the encouragement and support of the wonderful people I have found here!

    Thanks-Marie

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