DIEP 2013
Comments
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Sea laurel, all of these plastic surgeons partner with breast surgeons. No corners will be cut with taking out your cancer and doing a full pathology. The cancer is the first priority. In fact in some places the cancer will be the only priority. You are right to be researching your options because some women aren't offered them. I am doing my surgery and bilateral mastectomy with immediate DIEP on May 8 in New Orleans with Dr. Stollier and Dr. Sullivan. They offered me a surgery date that was only 2 weeks from when I initiated. I pushed it out a little later because I could not be ready that soon. At that practice they reserve dates for women with active cancer. If you think this is the procedure you want you can get a better cosmetic result if you do it immediately. The only thing I worried about was if there was cancer in my nodes that was not found until the full pathology, so I got my nodes tested first.
I understand if immediate recon is not feasible for you but you should know its an option. If you have cancer and wait to do the recon you could be waiting a year until you finish all your treatments. I want to be healing all that time. I also chose DIEP because I don't want implants that will need to be replaced at some point. This decision is very personal so what you choose will be right for you. -
Pink heart, you have been heavan sent. You all have. I can't thank you enough for sharing
Dr. Baron is the onc surgeon and Dr. Kline reconstruction. When I had my consult here in Louisville yesterday, the micro surgeon said I couldn't have picked a better place.
I am so scared and was worried about the onc surgeon bc cancer is my biggest fear. Followed by appearance of all this after. This has moved so quickly but I can't afford to wait. TE and implants not an option and psychologically I won't do well without immediate reconstruction. Then I will do chemo and all my hair will go again. Feeling overwhelmed but will keep swimming. -
Movie - you have such great words of wisdom and strength for us all! Thanks for sharing your "secret" about blue days. I think we all do and they hit us hard sometimes because we have to be strong for so long for ourselves and everyone else. It's been a long year and half for me since diagnosis, chemo, BMX w/ TEs, radiation, and DIEP surgery. Plus we have to recover from all of these treatments we are receiving. I've definitely had my blue days just sitting here being tired after this surgery. I'm so tired of being tired and so ready to be my energetic self. I know if I do too much one day I will pay for it the next. Plus how to put this - people aren't surrounding you as much as the weeks go out. They check in but are back to their busy lives and we are still recovering and it can be lonely. I had so many people stop by the first few weeks after my surgery. It's all good but probably gives us too much time to think about all that has happened to us. I do feel very blessed with the awesome support of my family, friends and neighbors! I'm trying to enjoy my down time too because I know I won't have it forever! LOL Have a great Friday ladies!
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Hello ladies finally feeling much better. The night after surgery I had so much nausea and ended up getting really sick. So it's back to liquid diet for me. My pain is manageable, but for some reason my back and shoulders kill me!
I'm more comfortable sitting on a chair that in the hospital bed.
I went to take the binder off yesterday and put my marena bra on but it wouldn't fit. It's too small😞
How long did you guys go through the pain on your incisions or back? I'm ready to go home and maybe get some rest! -
Sea laurel. About the breast surgeon. In New Orleans I also had dr Stolier (like Marsha will). This is what he does. Only. He used to work in his own office for many plastic surgeons but last year he moved into the Center for restorative breast surgery. He understands that his job is all about the cancer. I went and had a consult with him prior to my surgery as I wanted to be assured he would strip me clean of all breast tissue and meet all the standards I needed and had locally. He exceeded my expectations. I am not trying to be long winded but you know that great plastic surgeons DO work with great oncology breast surgeons. You don't need to separate your surgeries and will get best results when it's one surgery. After each of my plastic surgery apps I would talk with my local doctor and I am confident with my decision to travel for both my MX and recon. I would have regretted a local MX and delayed recon.
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CRS,
Again, so glad to hear Dr Kline was able to get schedules worked out with Dr Baron to get you in quickly for your BMX and DIEP. Like many have said, getting cancer out quickly followed by immediate recon was easier to heal at same time to get through before starting other BC treatments.
How fortunate you are a medical professional and know many MDs so well, them knowing and telling you about the high level of expertise and reputation of these two SC surgeons definitely helps settle a lot of emotions of BC Dx. That's nice to hear that being so far away that your local surgeon is familiar with them. You will love and appreciate both. Enjoy the hugs from Dr B and Dr K!
And especially the healing virtual hugs and support from all of us on bc.org!
Post when you can, you've got a lot on your mind with planning and packing in 5 days. -
crs319 - I brought my comfy cotton button up the front PJs. Lots of ladies prefer not to bring their own stuff into the hospital - but I hate the hospital gowns and felt more comfortable. You'll be flashing the new girls often, so you definitely have to have button up! Keep swimming, girl. You can do it!
Ann thanks for reminding me of your story! Glad you have made your decision - go forth with confidence!
I'm kind of laughing at the "Dr McCarty" thing - it's actually Carty (I think a drugged Robin started that...) I'm laughing because I am a HUGE Grey's Anatomy fan, and the first time we met Carty my husband made a "McDreamy" comment.
SeaLaurel - what BS are you working with? They usually only work with one or 2 PS - which I think might be based on how their surgical days match up, or perhaps they match them up out of preference. In Boston, mine was the director of the surgical oncology dept, so when his asst said he only works with Carty, I thought that was a pretty amazing recommendation.
Marsha - good advice on testing the nodes! Many surgeons seem to wait until the MX. I had gone for a 2nd opinion at the Dubin Breast Center in NYC, and the really amazing BS there felt a little something under my arm that my MO in CT had not noticed (and she really is amazing, too). So they sent me on the spot to do an ultrasound and on biopsy found 1 node. For me, this helped me make the decision to do chemo first, before surgery. I didn't want to wait while my cancer jumped on the super-highway of my body to do as it wanted while I was healing from surgery. For others, it may determine whether or not the docs recommend rads.
Goodie we have been living parallel lives... I did the same exact pattern except for the rads. You are right, my bluest days were realizing everyone else had gone back to their own schedule I was left on my own. Even my mom stopped coming by every day - hahaha... (I'm sure she started to feel like she was bugging me, because that's just my mom.) It is a long time, but then I look at my survivor friends who are many years out, and I know that this will soon be a distant memory.
So question - some of you had the DIEP first and then did rads? I was told that it could ruin the results. That's why I did TEs.
Definitely enjoy the downtime, ladies! This week was back to business for me - already looking at the clock and panicking cuz I want to walk before showering and heading to work!
Happy Friday!
xo
Jeannie
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Hello lovely ladies! My sister sent me the following article re: a new drug that relieves optiate constipation, sorry for the long post!
FDA OKs Drug for Opioid-Induced Constipation
By Cole Petrochko, Staff Writer, MedPage TodayPublished: April 24, 2013WASHINGTON -- The FDA has expanded the indications for oral lubiprostone (Amitiza) to include opioid-induced constipation in chronic pain patients, according to the drug's manufacturers.
Lubiprostone is the first oral drug approved to treat the condition in adults with chronic, noncancer pain, wrote Sucampo Pharmaceuticals and Takeda Pharmaceuticals U.S.A., in a statement.
The new indication is the third for the drug, which is already approved for chronic idiopathic constipation in adults and IBS with constipation in adult women.
The supplemental new drug application for lubiprostone received priority FDA review.
Constipation is a common adverse event with opioid treatment as opioid binding to peripheral opioid receptors in the gastrointestinal (GI) tract can result in electrolyte absorption and decreased small intestinal fluid, as well as abnormal gastrointestinal motility.
The drug, taken twice daily at a dose of 24 mcg, works via activation of apical chloride (ClC-2) channels in the intestinal epithelium, bypassing the antisecretory action of opiates.
Approval for the new indication was based on results of three phase III, placebo-controlled trials of patients receiving opioids including morphine, oxycodone, and fentanyl for noncancer pain. Two of the three studies met their primary efficacy endpoint.
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Goodie - hang in there, it does get better, honest! I am three months post-op and have had pain issues, but now I am walking, going out with girlfriends and working. It does get better! As MartyJ kept having to tell me, give it time.
Congrats to all who have made it to the other side!
Question re: tummy and exercises. My original PS did not order me to wear a girdle until two months post-op when I was still complaining of pain. Now I am only walking, but getting sharp pains sometimes in my tummy. Is this normal? I stopped wearing a girdle, but maybe I should go back to it?
Loving my new figure. Even with all the scars I and my husband admire what the PS did. There is going to be an upside to all of this!
I did a bad thing at work... A lady came up and admired my figure and I told her that I would rather have my original boobs back that didn't hurt, and hey, she had some extra, could I have hers? Oy vey!
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Hi Jeannie, I am working w Dr. Dominici. Her patients are very fond of he and I liked her too, I am not sure if she works only with a particular PS or there is a variety
, my choice was mostly time dictated, I started to worry that it all (setting up a consult) is taking the way too long, pobably it was a mistake, though I liked PS who I consulted with just need to find out a little bit more about her.
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New SX date for Phase 2 - 6/7/13, 4 1/2 months post-op original DIEP. Breast lift, fat grafting, dog ear revisions. She said that some patients can go back to work after three days (I am not that hairy-chested), but asked that I take a week off from work.
Question: If you have a nipple lift, is there a chance that you will lose your nips? Anyone know?
Blessings to all, I'm not able to keep up with the boards working...but please know that I value each and every one of your journeys.
TOWANDA!!!!
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Hi everyone,
I lost internet this week. I have been a bad bad patient.
My nurse got me back on track. I stopped wearing my compression last week-I had lipo to thighs. I absolutely hate this thing. Hate it!!!!!!!!!
stopped wearing my nipple gaurds-IdK whats wrong with me. I am just so done. they are back in. hopefully nipples will be happy again.
I still have the mysterious headachs. seems it is a sinus thing. gettting better. can still have sharp pain when I bend over. very annoying. still too tired to go back to gym. Have to help with building chicken coop this weekend. We have baby chicks. my almost 21 yr old had been begging for years. was paying fortune for organic eggs. She got 15!! one died. and some will be roasters. didn't really want that many. the roasters will have to go. guess with this compression I will just be directing sort of.
Need to order mirena-think I spelled that wrong. Hated that stage 1 mirena also.
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Re: bras... heavy flaps do need support, but they don't need heavy support. Just a little something to take some of the weight off of the delicate connections. Immediately after surgery I was DDD and had a hard time finding a wirefree bra in my size. I ended up layering 2 surgical bras until I found something that would work better. "Leisure bras" or "sleep bras" are a good choice, they aren't as compressive as sports bras and they're easy to sleep in.
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So I just had my pre-op check-up at my family physician this afternoon, and have to go for bloodwork on Monday. Things are beginning to move into place, and I'm glad. Just want it over and done with.
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Heavenschild - if the compression girdle helps with the pain, put it back on. I did not have pain, but wore compression for 8 weeks after Stage 1. Also, re Stage 2 - i think the PS is being overly optimistic on getting back to work in 3 days. Two weeks ago today, I had a lift, dog ear revisions, ab incision lowering, lipo to flanks for fat grafting. I know I am old (tee hee), but no way I could have gone to a job at 3 days. I do work from home. My surgery was on Friday and I was working on Monday, but could work from bed or a chair. The lipo was challenging - ouch! Still bruised. Also, I had 4 drains. Be sure to ask if she will need to put drains in as that does effect the recovery time. Thanks for the article on the new drug for chronic narcotic induced constipation. While it won't really help all of us, since we just use the narcotics for a short time, people like my DH will benefit. As a service disabled veteran, he has been on narcotics for years so that he could have a life. Maybe this will replace his daily Miralax habit (endorsed by the gastroenterologist).
Fredntan - you can at least graduate to a stage 2 Marena (no zippers). I will be heading for that soon - waiting for sizing to stabilize a bit. The compression after lipo will help ensure a good outcome - just keep that in mind. It is only a few weeks for a lifetime of better thighs.
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Heavenschild... I have had 2 stage IIs and they were both fairly extensive (6-7 hour surgeries) covering many different parts of my body. I took two weeks off from work each time (or 1.5 weeks the second time). The first few days is very slow going... a very bruised feeling. I really wanted a second night in the hospital. But of course, not all stage IIs are created equal. Some women have a very in and out procedure, and for them, I guess 3 days and back to work is understandable. So you need to understand what is beong done and gauge from there.
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Rough day over this way
woke up at 5 am with a fever,chills and some stomach pain. Called the PS on call and he didn't seem to think that it was related to surgery. I just saw my PS two days ago and everything looked great so I doubt it has anything to do with surgery either. Seems I'm not the only on on here with sharp abdomen pains. I think the fever is just me getting sick but boy having the chills and a fever with fresh scars is awful !
Hope everyone is doing well
Ann so glad to see you were able to make peace with your decision ! -
Faith... Make sure it isn't cellulitis. Sounds like an infection at the very least. And those can come on very quickly....
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Faith-I was thinking the very same thing as Betsy.....those infections are sneaky and can jump on you before you realize it...take care!
Goodie-thanks for the vote of confidence....I appreciate being "appreciated"....:-) the thing is, we all learn so much from each other here......couldn't make it without my sisters here.....
Liefie....time is marching on, and soon you will be posting from the "other side".....one thing I tried to do, with varying levels of success, was to gloss over the actual operation/hospital recovery, and focus on the healing process, and what I imagined it would be like. (Probably a cowardly cop-out.....but I needed sanity more than I need brutal honesty
) I see you breezing through this...
Everyone: here's to a wonderful healing, preparing,and restful weekend....."TOWANDA!"
Namaste and God bless - Jackie
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sea_laurel---- you should check out PRMA in San Antonio TX. They are a great group of very experienced plastic/microsurgery Drs who do over 500 DIEPs per year. They can also recommend a breast surgeon as well if you need one. My BS is Dr Deberry who is wonderful and does a lot of work with this group.
Just look at their website for info, and then contact their office. The office is well organized and willing to answer any questions you may have. Also, they do not balance bill fortheir services.
There are several others on these boards who came to PRMA from out of state and they were not advised to stay in town for 8 weeks post op.
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Bdavis I remember you mentioning you had unfortunately gotten cellulitis are there any signs that stand out as tell tale for cellulitis ?
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It's another clear-sky in the 60's day here in New England! (Sorry to brag, we don't get too many of these up here!)
Faith - So sorry to hear you are not feeling well. I hope it turns out to be a passing virus, but sounds like you should follow up on the cellulitis...
Robin and others with the velcro binder - have you been wearing a cami under the binder? I think I mentioned it to Faith... So much more comfortable. I've been wearing one pretty much 24/7 and will be until June....
Marty - you made my day with "ab incision lowering"!!! I'd been planning to ask my PS about that when we discuss Stage 2, but was not sure if it was possible.
Mine is pretty close to my belly button.
I am off to another busy day.... I have 4 students in a competition today ("History Day") so it could be a long one!
All enjoy your day - whether you are still deciding/planning/prepping or are healing & resting or are starting to move on with daily activities!
Hugs,
Jeannie
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Jackie - great advice IMO to be in denial!!! Hahaha - I go the same route. I did not focus on the surgery, but on the "other side." That is what the Peggy Huddleston meditation does.
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Jackie & Jeannie -
Here's to denial!
I'm another one that is focusing on the healing rather than the operation, and am trying to gloss over the surgery details. To use your words Jackie - I'm doing it with varying levels of success.
I had the fortune to go to a Breast Reconstruction evening here in Toronto, where I heard the surgeons speak, and got to meet (and touch) a lot of reconstructed girls. But I also had the misfortune to keep my eyes open during the slide presentation where they showed pictures of surgery. I can't get these images out of my head, so I'm trying to concentrate on the other side, and the healing.
I'm not up for six weeks yet (June 13th) but I've started making soup, and I've received my 'Jacki', and I talked to my masseuse about herbs and teas for healing. And most importantly, I'm planning an estrogen fueled dinner party for myself, to say thank you to my old boobs and tummy, and make way for rebuilding!
Because I'm such a giant chicken, I'm doing this all with big knots in my stomach, so I also have my ativin in the top drawer. And Belleruth Napertak on my ipod. I like the sound of Peggy Hudleston, too, but Belleruth got me through my last surgery so I'm hanging on to her like a security blanket.
Faith - I'm so sorry that you're not feeling well. I hope today is better for you.
Janet
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Well, I'm finally scheduled on 6/24 for my DIEP. It's 2 weeks later than I hoped, but I'm just happy I got it in June. My sister gets married on July 6th. Do you think I will be able to move well enough to go to this wedding. I'm actually in the wedding, so I need to break it to her what is going on. If I don't do this surgery in June, I have to wait another year. I'm a teacher and have to do it in the summer.
I am very nervous about this and feeling like my summer is going to pretty much laying around recovering. I guess I'm lucky to have the time to do this. I do have a trip to Hawaii booked on aug. 3rd:) -
Mamma - I think it will be rather challenging to participate in the wedding. While each of us recovers differently, it is only 12 days between. My breast drains were out by that time, but I still had hip drains. I was home by 12 days, but exhausted. I had visitors and still have no clue what we talked about. Your biggest commitment might simply to attend. I am sure she will be delighted that you are there. Hawaii in August will definitly be doable and fun!
Faith - worried about you. I echo the concerns about cellulitis. Please keep us updated!
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Faith-- I hope you'll be able to find out what it is soon and feel better!
Mammalou-- right on with what MartyJ said. Within the first two weeks I was functional, but pretty out of it at times and only had my last hip drain removed then. It was only between weeks 3 and 4 that I started feeling more like me. You might be very tired just moving around at the wedding -- being part of a wedding party is tiring enough without having had major surgery right beforehand. I can imagine how it feels because its your sister. I had to pull out of my best friend's wedding (I've known since i was 11) because of my DIEP. It was a tough decision but I had to do what was best for me. Perhaps the goal would be to attend the wedding instead of being in the wedding party? Hawaii sounds marvelous, it'll be a great reward for you! -
Thanks for the advice. Now that I think about it, my first post op is July 10, which is after the wedding, so I will still have drains for sure. Yuck. I will just have to let her know the situation.
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Mamma - now the challenge will be what to wear to the wedding. Sorry to throw another wrench into the system, but . . . mid-section will be swolen and you will have to work to conceal the drains. One thing I did was use a small (6x9) open pouch on a crossbody strap to hold 2 drains. I guess what I am saying is do not buy a fitted dress. Relaxed is the key! Soft Palazzo pants, with a soft tank and longish jacket? Just thoughts.
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Happy Saturday, everyone! Wow, the board has been busy.
Mammalou, today is my post-op day 12. I know everyone recovers in very individual ways, so my current status may be WAY different from what yours will be at this point in your recovery. I'm pretty hairy-chested (LOL, heavenschild) about recovery and pushing myself, but still...I'm trying to imagine fully participating in a wedding party right now, and I know it just couldn't happen.
Right now, my days are filled with little tasks interspersed with lots of rest. Do some arm exercises, rest. Take a shower, rest. Pay some bills, rest. Some of it is related to the fact that I still can't walk completely upright and it makes my back sore, but some of it is from the long, long surgery, the blood loss, the anesthesia recovery, etc.
In my humble opinion, if you tried to do all the things a bridesmaid is expected to do, you will exhaust yourself. The energy you'll need for healing will be spent trying to ensure your sister's wedding is a beautiful success. On the other hand, if you explain all of this to your sis and the understanding is that you're pretty much parked in a chair most of the time, and your job is to walk down the aisle in a beautiful dress and be there for her, I would think that could work. No long rehearsals. No arranging the church. No hauling gifts to the van. Just your sisterly presence.
Faith, I hope you're feeling better! What lousy luck!
And now a question...how do you get the dried blood out of your belly button?!
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