March 2014 Surgery
Comments
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Aviva, thank you for the reassurance on the LE. The surgery was only two weeks ago, but I'd really like to feel my upper arm again. It's truly numb, as if I have had lidocaine, except sometimes it burns as if it is being held over a flame. Nerves are weird.
KLJ, the SNB procedure wasn't as bad as I had anticipated. The radioactive isotope involves four injections at 12, 3, 6, and 9 o'clock around the areola. The injections stung but were over quickly. Afterward, I could feel it spreading/radiating and it burned for 10 or 20 minutes. I would only describe it as somewhat painful not excruciating. Unfortunately, I had been told I wouldn't feel anything, so it bothered me more that I was unprepared and thought something was going wrong with me. They staff told me that people rarely reported pain with the procedure so I think I am in the minority. Also, my breast was traumatized having endured 3 core biopsies the week before, 2 of them stereostactic (very uncomfortable), so maybe that had something to do with my sensitivity. I didn't have the option for emla cream but I would use it if offered. I think everyone is different, but I hope my experience helps you.
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Thanks Kitty62!, I hope mine is like that. I have just heard such horror stories about that injection. And at least your husband stayed with you. Mine had to walk out when the surgeon did her exam. He just can't handle that kind of thing. Poor guy, I think he is going to be in for a rude awakening with this!
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blueberry - I had bi-lateral SNB during BMX, then five weeks later had a complete axillary dissection surgery where an additional 12 nodes were removed. I also experienced numbness and a burning/tingling feeling in the weeks following that surgery. I had numbness in the underarm, on the underside where my upper arm touches the side of my chest and on the back of my arm. It took about 6 months before I really started to feel the return of sensation on that skin, but now the only place I still have residual numbness is in the underarm itself and I only notice it when I shave.
Anyone who has had nodes removed needs to avoid needle sticks, IV sticks and blood pressure cuffs on that arm, if possible. I have a MedicAlert bracelet that states this and I wear the pink wristbands into surgery so that my 14 node arm is not accidentally used. I did have 2 nodes taken from the other side, and try to avoid using that arm, but it is not always possible. I personally think it is a good idea to have a consult with a certified lymphedema therapist so that you are informed about risk, preventive care, possibly fitted for a sleeve and glove/gauntlet for flying, and given appropriate exercises and instruction on manual lymphatic drainage massage.
I also had SNB done with the blue dye and radiotracer. I received the injections (bi-lat) at the noon, 3, 6, and 9 o'clock positions, was a bit of a sting, but only had a slight residual burning sensation for a few minutes, nothing particularly painful.
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The feeling from getting the blue dye injected is different than getting the radioisotopes. I've read that the dye feels like any injection, a little sting. Radioactive isotopes, however, have a different Ph than your body so you feel a pretty big sting. BUT it goes away very quickly...in seconds in fact. As Aviva said, make sure to have your doctor order some Emla cream to massage in an hour or so before the procedure. Apparently it makes the injections pretty easy. I had both sides done at the same time by two radiologists. They do one side of each nipple, massage it, and then do the other side of each nipple. It's over very quickly.
I asked for Emla cream to be ordered when I was at my pre-op appointment but my surgeon said it wasn't a particularly painful procedure and I wouldn't need it.
Wrong! When I saw him after the BMX, I told him he should never tell a woman that getting radioisotopes wasn't going to hurt unless he was sure it wouldn't...and by the way, it did hurt. (Apparently he was thinking I would have dye instead.) The sting scared me because I thought something was really wrong so I panicked for a second, making it hurt more. If I'd known it would feel like a Texas sized bee sting, at least I would have been prepared for it. It's NOT a good time for a surprise! My surgeon was quite contrite and agreed to recommend Emla cream for radioisotope injections and tell patients it would help quite a bit. Don't flip out..it's not the end of the world and considering what you are about to go through, it's a drop in the bucket. Plus you may be one of the women who barely feels it, especially if you have Emla cream. Even without it, it truly only stings for about 5 seconds. Have the radiologist massage the area. That helps a lot.
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One point about the emla: I had the nurse slather it on, and she covered it with some kind of plastic (like press n seal, but medical), then the ps came in later to mark me up- so he wiped a bunch of it off to do that! Probably cant control when ps comes in but either get more after, have it put on after or something. Not sure it made a huge difference in the numbing, but couldnt have helped.
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Hey there! Thanks for those that listening and replied to my vent earlier. I'm still hurt but moving forward with hopes to someday forgive my sister. We went to breakfast with my mom (my idea) this past Sunday. As soon as I saw her I just wanted to scream, so I hardly said anything at all. My feelings are still to raw. Some things you just can't fix so easily.
Pre-op appointment is scheduled with my PS tomorrow. Surgery is scheduled for 3/6. I've got my list of questions ready and available. I started shopping today for some button up PJ tops and loose bottoms. I still need to go buy some Hibiclenes (antibacteria soap). Anyone else told to use this soap 5 days before surgery? Met with the boss and have plans to take 4 weeks off. That seems like an awful long time. I gave in and asked that my mother-in-law
to fly in to help with the kids so my mom can help my sister. This all seems so surreal. It's wierd, I thought I was ready, but as it gets closer I seem to feel emptier and emptier inside. Anxiety? Perhaps. Can't sleep but only for a few hours at night and those few hours come with bad dreams. I hope to feel better after talking to the plastic surgeon tomorrow. How do you decide what size implants you want to get to? I'm a full C now and thinking I might go a little bigger, of course, the girls are starting to go south anyway...
Anyone know if the TE come in different sizes or do they just keep filling them until you are happy? I'm sure I'll get that answer tomrrow. Just curious. Deep breaths. Deep breaths. -
Emla cream should be applied an hour prior to any procedure that you are using it for, and then covered with plastic wrap. Once it has numbed the area you can wipe it off and the numbing effect does not go away.
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iwanna and all those awaiting TE's,
TE's come in different sizes just like implants. In fact, you need to know what implants you want so the right TE's can be put in. Go to our thread Breast Implant Sizing 101 and read the header first. Then send post or send a private message to the GURU of implants and TE's, Whippetmom with the info requested in the header. She can tell you what will fit you best and work with your body. She's never wrong!
For those who have not have TE's placed yet...it is CRITICAL that you decide on your implants first. The plastic surgeon has to create pockets that will fit exactly and make the exchange to implants go smoothly. Don't just say a cup size...that really means nothing and you will end up being disappointed. Changing your mind after the TE's are in means you are going to have to have painful additional surgery to modify the pockets. Take it from someone who has been there and done that...educate yourself now. Go to Breast Implant Sizing 101. At the bottom of the header are links to the different manufacturers and links to each style they make.
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Keep in mind that TE also have a height and width and must be placed anatomically appropriately. The height and width also dictate the total cc volume within the TE, and they can be overfilled beyond the max cc capacity, but not by too much. Your expectation of the outcome is very important to discuss with your PS, in advance of your surgery. I have found that most conversations about implant size happens as your TE are filled - the amount of added saline, which stretches the pectoral muscle and skin, determines the pocket size, which then determines the implant size. It is also important to have a conversation about anatomical versus round implants, saline versus silicone, and implant texture, as these may determine what type of TE is placed. Ask your PS to see before and after photos to help determine size expectations.
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SpecialK and Sandra,
This is great information regarding TE. I've added several addtional questions to ask the PS based on the information you provided. I'm headed over to Breast Implant Sizing 101! Thank you!
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Good news...I don't need a root canal. Good thing because I was told that I shouldn't have one. I knew there was something about not having dental work before surgery.
I am a bit worried that my surgery is in 9 days and I know nothing about what implants or TE's are being placed in my body. Or what type of attention will be given to nodes. I don't have pre-op that I know of. I had a phone pre-op with the anesthesiologist's nurse. I remember the BS saying something about nodes and pathology but I guess I was just taking in all of the other information and trying to decide on lumpectomy or Mastectomy.
When I first saw my PS I told him that I was hoping for DEIP flap. He didn't like the idea for me because my breasts are too large and my belly is apparently not big enough. I don't see how that can be true. He also didn't like that I only recently quit smoking. (embarrassed to admit that as I was a closet smoker...not literally cause that would really stink). I am stuffing myself into a DD but would much rather be a C. He thinks that I am a prime candidate for skin sparing with immediate implants. I didn't realize that the TE's stretched the muscle too. What will happen if I don't have TE's? I know that alloderm will be involved. Will there be time to discuss the implants the morning of the surgery? I'm not even sure what questions I would have if I had him on the phone right now. Guess I need to do some reading get my thoughts and questions organized and call the PS tomorrow.
Iwannaseeyoubrave- I am so sorry that your Mother and sister won't be there to help you and I'm sorry that they apparently just don't get it.
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Stfne if you are not sure of what you want for reconstruction you do not have to do immediate reconstruction. I had TE's placed at the time of BMX with a little fill to save the skin from the mastectomy. This gave me lots of time to research my reconstruction options. I wanted a DIEP and was just 4 weeks smoke free so was asked to wait and do delayed reconstruction. I got a surprise after surgery when they found some hidden DCIS in the original tumor bed against the chest wall so I had to do radiation. So surgery was in August I finished rads in mid November and will have my DIEP on March 10. You deserve a frank discussion with your PS about what size TE's, type and shape of implant before surgery. Please call and request a pre-op planning appointment to nail down your wishes with of course your PS suggestions but you get the final say. Consider delayed if you are not completely satisfied with the decisions. Good luck.
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Please add me to the surgery list, I just got my date today. March 10 mastectomy right, with TE placement.
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stfne - most people have not had a discussion about their TE(s) prior to surgery - you are not alone. Most have a vague conversation with their PS regarding what size they would like to be in the final analysis. If you are having a bi-lateral MX the only opportunity to look at your nodes is during the surgery. Once you have the breast tissue removed it is impossible to do a sentinel node biopsy because the structure through which the dye and/or tracer would move has been removed. I would imagine that your surgeon will do a SNB on your cancer side - many women wrestle with whether to do a bi-lat SNB during bi-lat MX in case there turns out to be any issues in the prophy breast - this conversation is referenced in posts previous on this thread. It is a difficult decision because it leaves both arms vulnerable to lymphedema, instead of just one. A skin sparing BMX with direct to implants will limit size a bit as your PS can only use as large an implant as will fit behind your pectoral muscle. Usually the PS will bring a variety of sizers (like disposable implant samples) to determine what size will fit, and will also bring TE into the OR in case placement of implants is not a workable solution and expansion would be the better choice.
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Thank you Jbdayton and SpecialK. I really appreciate your posts.
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Please -- anyone who wants to-- I need some No Snow Storm Vibes for NJ on Monday. They are predicting "significant" snow (some models showing 12+") starting Sunday and running through Tues. And yup, my surgery is Monday, smack dab in the middle of it. I live about 40 mins from hospital, but I asked my IL's if I could stay with them on Sunday since they are closer and not up in the mountains like I am.
Have you ever heard of anyone's surgery get cancelled b/c of snow? I have had several appts cancelled on all end b/c of the horrible winter we are having here. I don't think I can mentally handle that. *insert exploding head smilie*
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Hi All,
please add me to the march group - DMX march 18th with immediate reconstruction - really do not know what that means yep- I have my appointment with my PS on March 5th so will learn more then and would appreciate anything that you think I should ask. I have IDC in both breasts and both are triple positive but have been told by my BS that they are seperate cancers.
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faery - I have had car trouble on the way to two separate surgeries - I feel ya! The first time I thought I might have to put in a five mile run to get there, but we made it. The car stalled at each red light so the solution was to make a right turn, then a U-turn, and keep going without stopping. I was a bit stressed when I got to pre-op. DH took that car home and got the other one. This problem happened out of the blue on the way - I tried not to take it as a sign I shouldn't go, lol! Recently I needed a skin cancer MOHS surgery (a lumpectomy on my back) and had a flat tire on the way - different car. I ended up getting a ride in the back of a police car to the surgery center - it was pretty hilarious - especially to the valet parking guys! I also had chemo in the dark during a power failure after a tornado! You are doing the right thing being closer and I'm hoping that the weather cuts you a break!
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Woke up yesterday with a cold. I've been lucky to stay healthy all winter up until one week before my surgery. Seriously?! Must be stress related. I've been drinking a ton of water, hot tea , oj, lemons. Any extra tips to kick this to the curb ASAP? If they have to cancel surgery I won't be able to get on the calendar for over a month. I can't let that happen. Tips?
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SpecialK! OMG- that is just crazy! Talk about stress! I have had three snowstorms and a water pipe bursting so far and that is just the last 2 months! Now I have this 12+' storm coming and I have to say that I am so much more worried about that than any of the actual procedure!!
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brave- I feel your pain, I have become a germ-a-phobe this week too. I usually recommend garlic pills for prevention, but you can't take them as they are a blood thinner. The only thing that I can suggest, is apple cider vingegar and warm water tonics. ACV is supposed to be good for immune stuff, but I would check with your dr forst.
Good luck and virtual chicken soup coming to you~~~~
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iwanna - echinachea, Cold-Eze, something with zinc like Airborne
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Thanks ladies!
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I wanna -- trying not to get sick as well! Warm salty fluids? Tea, miso, broths?
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Yes, I think those of us with sugeries next week should hunker down and hibernate until day of surgery. There are way to many viruses going around. We don't want any of that! Snow storm is supposed to roll through Kansas City Saturday night through Sunday. Even more of a reason to hide under the covers with a hot cup of tea with a splash of
? Heck, I might just stay under the covers until next Thursday morning. Better yet, teleport me to the hospital and wake me on Friday. The anxiety is starting to creep in. -
I an a HUGE fan of the teleport idea!!
I called my BS's office and they say that they will be there on Monday even if it snows. I will be there too. Somehow!
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Yikes, it's March! How is everyone holding up? Iwanna, I'm really sorry you caught a cold and I hope it doesn't push your surgery date back or anything. I'm very paranoid about catching a cold.
I have mixed feelings right now. I'm excited that I'm getting this surgery over with in 9 days but getting nervous at the same time. I've had this lump since October and I'm really lumpy in that area. So I'm anxious about if there will be anything my nodes.
Take care and good luck to everyone having their surgery this week!
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I'm getting nervous too. My surgery is the same day as yours, Juliecc.
I'm wondering, what are you all taking to the hospital? I'm not totally sure what to expect when I come home. Should I buy a drain belt? Special bras? I purchased some zip up sweaters and hoodies. What else will I need? I'm going to call my nurse navigator next week, but I'm also wondering what you all are doing.
Stay healthy and good luck to those with surgeries in the coming week!
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Faerywings,
Will be thinking of you on Monday. Best of luck to you. Please let us know how it goes. From my experience day 3 was the worst. I did too much on day 2 (which was only out to dinner and a movie) and then by day 3 all the anesthesia had worn off. Allow yourself to heal even if you feel good. Take care.
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Julie,
Did you get any additional information about having a SNB on the prophylactic side, the pink lotus method I think you called it? I'm worried that they will find cancer on the right after my DMX and then I will have to have a full lymph node dissection. I was told this past week by my MO that without knowing where a tumor is they don't know where to inject and can't find the sentinel nodes. Is there anything they can do to be less invasive?
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