DIEP 2014

Lilyn - I'm a patient of Dr Hofer as well - but Dr O'Neil did some of the consulting, and some of the after care. I like her a lot. And, I would guess that if Dr Hofer And Dr Zhong have taken her as part of the team - then she's probably excellent.

Lis -- I had both dog ears at the end of my ab incisions fixed (actually -- mine were more like mini muffins, but he fixed them).  I had some scar revisions to both breast scars as I had some stitches removed after stage 1 that resulted in some wide thicker scars, and I had fat grafting done to one side that had a flat spot at the top.

re: who decided -- I had a list and discussed each item with him -- he was fine with each of them -- in fact just before surgery, he asked me if there was anything else I wanted done (as he said -- all in a day's work for him, but I have to take time off from work.)  He's a sweetie.

We're going to try the fat grafting one more time -- a lot of it reabsorbed, which he said can happen, although its definitely better than it was before.  Then nip recon and tattoos and I'm done!!

I'm home from bi-lateral DIEP surgery last Friday 11/7 at Univ of KS Med Center! Thanks for sharing your prior experiences, which helped prepare me somewhat. I was still was very anxious, but I remembered so many of you saying you just have to show up!

My surgery was about 11 hrs and I was in hospital 5 days/4 nights. I can say each day I definitely felt better and no real complications. They noticed some redness above abdomen line (I think on Sunday), which they marked and watched but it receded. At first nurses checked checked every hour with doppler for the woosh-woosh on the flap blood supply then slowly increased length of time. Thankfully I never had any nausea after surgery. I looked at all the incisions as soon as I was able and I thought they looked good. (Drs, nurses and selected others all thought they looked great). On Saturday had me get up (most painful!!) and I sat up in a chair for about 4 hours. Sunday did same thing (getting up was easier that day) and when ready to get back into hospital bed they helped me "walk" in the room to the door and then back to the bed. Monday was a big day, they started me walking in the hospital corridor, took out the epidural and the catheter, and I had my first shower. On my first walk outside the room couldn't make it to the end of the hall but was able to go further each time, building up to 2 laps around corridor halls. Had some family and friends visit, but only a couple each day - which was about the right amount. Finally Monday night put an end to the constipation, must say I got very little sleep with lots of trips to the bathroom! I was exhausted after coming home yesterday, but ready to be in my own room. So glad I rented a power-lift recliner (suggestion from GeorgieGirl) which I am using alot. My body tires from being in the same position. My lower back aches alot after I get up to walk (hunched over of course) so I am using a walker for additional support. Quite a bit of bruising showed up yesterday and the last several days having some abdomen muscle spasms - which valium takes care of. My dr. provided light-compression bra for me to wear at least 23 hrs every day (can either shower with it on or not) and no compression at all on the abdomen incisions.

Hoping to hear also from Meg2 surgery. Thanks for all your prayers and support.

Meg2 and Seashore, hope your surgery went well!

Doing well just having lots of family health issues, has been one heck of a year, sister in law, aunt and brother all passing away within a few months of each other. Once again I embrace the joy of every moment, knowing this is a gift I don't want to squander.....

Thank you Ridley and Teacher! I do meet with PS in December, and I want to discuss Stage 2 for spring. I am done with medical procedures for 2014!

Glad you are home safe and sound Seashore! Waiting to hear from Meg.

Lisa

I avoided the dreaded swelly belly. In phase 2 I had some flank lipo for fat grafting. I got truncal lymphadema at the donor site. It has been 5 weeks and I still have it. It's very painful. For those of you suffering all along, you have my sympathies.

jmb - working out will make you feel more physically capable and stronger. It is something I do for myself because it doesn't involve a physician!

Yesterday I saw a dermatologist because my PCP was concerned about a spot on my face. Relief, all is well. I did get some scar improvement gel and will use it for a few months and if things don't improve he suggested laser treatments.

I had to have a JP drain after my gallbladder surgery in 1999. My late husband called it alien guts. A neighbor told me he was gyped because he hadn't gotten one after his surgery.

Happy Friday Ladies, I was sprung this morning from my DIEP 1 procedure; first line of order was a nap in my own comfy bed

Surgery was Monday, approximately 7 hours (I had a single MX last year, and chose to keep my other "healthy" breast intact). Was in my room and somewhat lucid around 4 pm. Was wrapped and wired and bed bound that first day…was surprised that I had so many attachments. Was fascinated by a machine the Doc and nurses call ViaOptics; rather than having the nursing staff check blood flow, etc using Doppler every hour this machine monitors the blood flow and other internal functions automatically. There was a small white paddle type device attached to the breast with stiches which was plugged into the device allowing staff to see what was going on inside the breast…how amazing our technology is! This did require that I be on oxygen to help increase oxygen levels overall. They still came in every hour to chart the results and told me that the machine is formatted to send information directly to the cell phone of my surgeon so he could see at any moment what was going on!

Once the heavy bandages were removed on Tuesday we were so pleased with results; very little bruising or redness on the abdomen scar and new breast; there was some swelling that continues but nothing that gives a false picture of what the final result could be. I was so apprehensive but now do believe that my surgeon is truly gifted. Scars are covered with a brown medical tape and so far I don't notice the "dog ears" that many of you have discussed on the thread so I am very curious to see results when the coverings fall off. Moved out of bed for the first time on Tuesday for just a short time to sit in a chair, walked the length of the room on Wednesday and sat in chair for meals and visit with friends. My strength got better every day and was allowed to go to the bathroom by myself once I was released from all gizmos and gadgets.

My first shower on Thursday was a little piece of heaven, I would have stayed in for an hour if it had been possible. Came home with only 4 drains, two at each hip. Was given a lovely "purse" to hang around my neck that was a great place to stash drains. I wore it while in bed so I could get up and down without having to "adjust" every time I wanted to move or get up. Hope to lose some or all in a few days at post op appt. While I am thrilled with the results and the overall experience was very good I would still say that was hard; having to lay in bed for so long, being attached to all wires can be emotionally draining. I was "connected" for 3 full days and only got relief on the 4^th morning. I had "hit" the wall on Wednesday and wondered if it was all worth it (temporary lapse for those of you who still have stage 1 coming up), I would definitely recommend this procedure (love the flat tummy) and add to the list of what you need to prepare for is the emotional results of that long hospital stay. Also for me I exercised for the 9 months leading up to the surgery, nothing crazy I wasn't training for a marathon but wanted to be in the best shape I could be to get through the physical work; walking/treadmill, yoga and strength training made all the difference in my ability to get out of bed on my own, have the physical stamina to get through the process and just have a better result in general. Thank you all for your thoughts and comments.

Seashore – so glad you are home and feeling well too, I can totally relate to the low back pain…hoping that subsides now that I can introduce a bit more activity.

Peace, healing and serenity to you all.

Hi everyone, I'm on my 5th week post-op Bilateral mastectomy with DIEP reconstruction. So far, so good. Able  to sleep more now I'm on Neurontin for the nerve pain in my chest. Only taking pain meds every 6 hours instead every 3 hrs. My back is still killing me though, can't wait to go back to the gym in the 6th week post-op. I do a lot of stretching and walks a lot, still can't tolerate sitting or laying down for a long time. Can't wait to be able to sleep flat in bed or on my side. Need to be in a reclined position all the time in bed to protect the abdominal incision and prevent more swelling in the chest area. TIPS TO REMEMBER FOR THOSE WHO ARE PLANNING TO HAVE THIS PROCEDURE, there is lot they did not discuss in pre -op: NO CAFFEINE,  there is a lot of med list that they told me not to take 2 weeks prior to procedure but caffeine is not one of them. Post-op they told me no caffeine for it can cause vasoconstriction meaning affects the perfusion or blood supply or oxygen on your new breast, so that 1st week I had wicked headache from caffeine withdrawal, also make sure you ask for Tylenol as PRN in case you need it, I ask for it in the middle of the night and I have to wait for 2 hours to get cause it is not ordered and have to wait for the doctor to order it. So no  coffee, no chocolate, no soda with caffeine for at least 2 weeks before and after surgery. VISITORS, I was glad to get a private room, I was in the ICU for 1 day, then afterwards I am on floor with me all by myself most of the time. The nurses check on your breast monitor every 1 hr and then every 4 hours if your stable, otherwise you don't see them until your next antibiotics is due, so if you ask for help you are most probably be waiting for at least 30 minutes. And me, if I have to go to the bathroom, I have to go, so I ended up getting by myself, unplugging everything which I know is not safe, and walk to the bathroom by myself, if I am an elderly lady I could have fallen easily. Also for the 1st two week your ACTIVITY is very much limited, you cannot move your arms up above your shoulder level, touching your face/ hair is okay but not your hands above your head. You are not suppose to twist your body, or use your hands to move yourself in bed. So repositioning yourself in bed is a challenge if you are on your own. You are in a recline position in bed and my back cannot tolerate that for long, I have to get up and keep moving. So if you can find someone to stay with you day in and night, please find that someone for at least 2 weeks post op. WHAT TO WEAR: I should have known this ahead of time, so ladies prepare some clothes that have openings/ buttons in the front where it is easy to put on, remember you cannot move your hands straight up in the air, so find loose soft clothes with opening in the front also to pins your drains, got six when I got home. Also prepare for some loose elastic pants, my yoga pants works great but remember even though they remove a lot of fat in your belly, your belly is still swollen from the surgery so my waist is not as small as I would have thought it would be. NAUSEA and DIZZINESS, make sure you ask for Zofran in the hospital and when you go home, I was in a lot of pain meds that causes nausea and dizziness, and they forgot to order it in discharge and I was just plain miserable when I got home til the visiting nurse called my PS to order some. I lost almost 10 lbs  for the 1st 2 weeks post-op because of this, also no appetite, everything taste bitter specially meat, but you need all the protein you can get to promote wound healing so make sure you have some protein shakes or greek yogurt, that's what I can tolerate at that time. Oh another big thing, go to RMV before the surgery and ask for a disabled placard, if you can have your doctor sign for it, it's a big perks for having cancer, you will be weak/ sick for a while, able to park in the handicap area is such a relief for I am seeing a doctor 2 or 3 times a week now.

drjr1968 - Thanks for the tips, glad you are feeling well.  When you were in ICU, was someone able to stay with you around the clock?  I don't want to have to call a nurse every time I need chapstick or a sip of water. What type of pain meds are you taking every 6 hours now?  I am hoping to be off pain meds by week 5.  Interesting point, also, about the caffeine.  I am a huge coffee drinker.  I really, really enjoy coffee in the way others enjoy wine.  That is going to be a sad thing for me to have to give up for a month, but I'll do it if it helps me!  What hospital did you use?  I am from Boston as well.

Random question:  What type of heavy duty pain meds do they send you home with?  I am nervous of anything relating to oxycontin.  I had a close relative who had a problem with it (is recovering and doing extremely well, thank you Jesus).  Anyone have success with something else?

kb33 - there was a woman on the diep 2013 thread who had a small implant with diep. I think she went by mammalou. Try to search on that name and if it's right perhaps you can PM her.

edukess1002- I had mine done @ BWH which happens to be where I also works, no special treatment I got, my co-workers keep telling me to ask if I need help but I just don't want to bother anyone. I basically need a back rub pretty much and some boosting. No friends really showed up except for close family members, and since everyone is saying I'm doing okay, they got all the cancer, etc. I guess everyone pretty much continue with their own lives. Anyway, I was in the ICU x 1 day, if it is BWH it is 1:1 nursing so your nurse is there pretty much all the time. But the minute they transferred you to the floor, I was at CWN, beautiful floor, not like where I work, looks like a hotel, it's a private room with your own fridge where you can stash some snacks, juice or fruits. The problem is your nurse has 3 other patients, when they are done with you, they are done, until like I said it is due for your next meds/ antibiotics. I was on pain pump/PCA where you can control and press the button when you need pain meds, no need for the nurse for that. I had the mistake of asking for Fentanyl instead of Dilaudid that is the usual meds they give because I had issues with being dizzy from Dilaudid in the past, 1st night, no sleep, I'm literally pressing the button q 30 minutes, so the following day I had them change it to Dilaudid and able to sleep q 3 hrs on that. The thing with PCA pump it is not continuous, it only gives you meds when you press it, so it would really wake you up when you need it. Of course the Dilaudid made me dizzy, nauseaus and itchy, so I was also on Zofran for nausea and Benadryl for itch, so the following day they switch me to Oxycodone coz they said it is more long acting. This is what, the 3rd day post-op and in the middle of the night I woke up with a headache and ask for plain Tylenol, of course I had no orders so I have to wait for it for 2 hrs, I called my husband @ 3A, he got there @4A, the nurse came in with it @ 5A, and I just pretend to swallow it. I don't want to get into trouble. And they said I am having caffeine withdrawal, that I should have stop drinking coffee for at least 2 weeks before surgery, like I said I didn't know, nobody told me about that. Like everyone else in US, I ran my body with Dunkin. I just drink the cheaper kind. Anyway, positioning, like I said, it is very difficult to move in bed since you are in a recline position, you are not going to tolerate flat in bed because of the abdominal incision and new swollen breast. And you are not suppose to use your hands to pull yourself up, just dig in with your heels and wiggle your butt, I tell  you it is not  easy. You can press the buttons on the bed to move it up and down, you can definitely reach for a cup of water and blow your nose, BTW be prepared for a very dry mouth, you will be on 6L of oxygen that causes dry mouth, so you will be needing that chapstick and water, and you will be coughing up thick bloody mucus from the surgery (being intubated) and that is just normal. The oxygen is not for your lungs but it is for the new breast to keep it well oxygenated, you will not go home with it. You will also have a monitor attached to your chest checking on how good is the perfusion/oxygenation of the new breast. And don't forget to take deep breaths and cough once in a while, they gave me this apparatus called incentive spirometer to help me take good deep breaths, it is easy to get pneumonia when you are in bed or just being in the hospital. I stayed there for 4 nights and I just had enough. I was still having a lot of pain, burning, pinching sensation in my chest and I vomited that day before I left. I was up to 20 mg of Oxycodone and I think that is just way too much. The floor was just too busy, I waited for almost an hour for someone to help me go to the bathroom, And when I have to go, I have to go, I ended unplugging myself and did it by myself to the bathroom, dribbling all over the place. If I am an elderly person, I could have easily fallen on the floor. But I said, if I can do it, might as well go home, everyone checks me off that I am good to go, including Physical Therapist, BS and PS, it is all up to me if I want to go home. So I did, knowing I am gonna be all by myself at home most of the time. I just have to talk to myself I am gonna be okay and I can do it. Anyway, I weaned myself off to Oxycodone 5 mg right away and seems to do the trick, pain is still there but tolerable. But I also mixed it with Tylenol 500mg or Motrin 600 mg (2nd week is okay for NSAIDS). I had this pain pump called On-Q pump attached to my belly area that numbs the area, but that only last x 4 days and when it is empty that is it, they are not going to change it, so be prepared for increase abdominal pain in 5 days when you are home. It does gets better like everyone says and knowing I did the right thing helps. I opted for Bil. Mastectomy vs simple Lumpectomy with Radiation. Because when my final biopsy came back, it is microinvasive carcinoma meaning I have to go to chemo and radiation or remove the other breast. Good thing it is gone now, right? Now I don't have to go back for another surgery. Just some niptuck, that nipple reconstruction and dog ear fixing thing.  One more thing, when they get you up to walk on the 3rd day, be prepared, you are not gonna be able to stand straight and if you have a weak back, it is gonna hurt like hell. Wicked back spasm that is why I needed someone to massage my back all the time. They told me not to use my core, right, but I think what helps my back is when I am up I tightened my abdominal muscle and that seems to help me move better. Good luck to you.

drjr1958, thank you for the description of what went on with your surgery. I only talked to the PS once to decide if I would do reconstruction. I chose to do the DIEP, however he won't do it until I am healed from my BMX. This week I got an email telling me to make an appointment the first of December. Even though I have been reading this thread since I first heard about DIEP and occasionally contributed, it looks like I won't get my DIEP in 2014. But I wish to thank you and other members of this thread for all the information that you have provided. You have affirmed that I am making the right decision.

edukes1002, just to add, make sure you are on Pepcid and bowel meds like Colace and Senakot, any narcotics- Dilaudid or Oxycodone can upset your stomach and can cause constipation, and don't forget to ask for Zofran for nausea on discharge med list. Your stomach is gonna feel bloated, swollen and tight as it is. Every little thing counts. Also they put me on Aspirin x 1 month to prevent blood clots, I am not sure if that is the same for everyone though. I happen to have blood clot problem during surgery and I have to be on Heparin drip for 4 days.