Who Has Traveled Far for Recon?

Another NOLA girl here.  I traveled from the DC/MD area to NOLA for sGAP surgery.    For me it was the right decision.  I think the skill of the surgeons and the good nursing care were absolutely worth  traveling.It turned out to be very doable.  The majority of NOLA patients are from out of town and they are set up to do a good job of handling us.  

Following a bc diagnosis I had a very problematic DIEP reconstruction which was done in Maryland.  I had multiple revisions done with my original ps and then I jumped ship and went to another more experienced local microvascular ps who was affiliated with a different hospital for further revisions. I was worn down by the experience.  In addition to problems with the reconstruction  I had problems with my care - in one very stressful instance my pain spiraled completely out of control because the nurse took so long to respond to my call button.  I think the staff was just overworked.... 

I eventually went to NOLA for a ns prophylactic sGAP on the other side and further revisions to my DIEP.  I feel the skill of the surgeons and the nursing care I received at NOLA was way better than anything I experienced at home.  (At this point I probably I could write a Zagat Guide). The docs  did a nice job with my sGAP and greatly improved my DIEP side.   The nurses respond to the call button almost immediately (and were repeatedly checking on me even though the call button wasn't pressed.)  There, of course, can be problems with any surgery, but I think going to NOLA stacks the deck in your favor.

My DC oncologist originally discouraged me from going to NOLA.  "Why travel for surgery when there are good surgeons here..."  After she saw my results and heard about my experience she is now sending other patients there....

Feel free to PM me.  

I did a ton of research and decided not to go to Hopkins.  If I was going to stay local I might have gone with Bernard Chang at Mercy in Baltimore but I felt that NOLA (Dr. Dellacroce) would offer me more. 

In the end the two practices I considered were  Joshua Levine/Robert Allen's practice in New York City or Dr. Dellacroce/Sullivan's group in NOLA.  I had consults with both groups and I felt the NOLA group was the best choice for me.  

Many women just send photo's and records down to NOLA and then show up for surgery.  It generally is not necessary to have a consult before hand.  But because of all I had been through I wanted to meet with the doctors first before I made a final decision.

I got a NOLA surgery date fairly quickly -- I can't remember exactly how long I waited but probably only a couple of months.  But I think things can get very busy at the very end of the calendar year and if you are not in active treatment it may be more difficult to schedule at that time. 

I asked a number of physician friends to help me research this and the consensus was that NOLA was the place to go.  My husband supported my decision (but the decision was mine and he would have supported what ever I decided on).  He flew down with me for my surgery.  Again I can't remember the exact number of days at this point but it wasn't more than 2 weeks - possibly a week and a half. 

After a failed implant recon and much research, I travelled from Seattle, WA area to the Center for Narural Breast Reconstruction in Charleston,  SC. 

My husband was completely  supportive, close friends also. Other family members and some of my local doctors not so much., thought it was crazy and did not understand. I didn't have the energy to explain, just did what I knew was right for me and left them out of the process . A little hurtful. After the initial surgery I actually stayed for a month in a condo I rented. Honestly the logistics were not the easiest to figure, but I decided it was the only way I was going to do it. I live quite rural and closest medical facility is 4-5 hours over mountain pass so that was why I stayed so long. No regrets on that decision at all, had to shuffle caregivers , but the extended stay gave me piece of mind . I am a uni and yes very happy with my results. I waited 6 months, went for stage 2 and 6 months later went for minor revisions and a nipple. It is big surgery, big decision but I spent a year preparing both mentally and physically. So very happy that Dr Kline and staff came into life. No regrets

http://breastrecon.com/surgeons-who-perform-perforator-flap-reconstruction.html

My flap failed in surgery,the blood kept clotting and would not flow.So I woke up to hear that one side failed.It still seems unreal.The doctor worked for five hours,but it was not meant to be.I knew it was possible,just never seriously thought about what I would do if that happened.

I AM ALSO TRYING TO MAKE THIS DECISION..I HAD MY TE EXCHANGE TO IMPLANTS AND I HATE THEM..FEEL LIKE THEY ARE CHRUSHING ME EVEN WHEN I TAKE A DEEP BREATH..LEANING OVER TO TAKE CLOTHES OUT OF TTHE DRYER SENDS ME INTO SPASMS..HAVENT TAKEN MY BRA OFF EXCEPT TO SHOWER AND PUT ON A FRESH ONE SINCE SURGERY 3 MONTHS AGO.. GRAVITY IS A KILLER..SO I WANT MY OWN TISSUE RECONSTRUCTION.. I HAVE HAD 2 CONSULTS BOTH AGREE I NEED 4 FLAP RECONSTRUCTION.SINCE IVE NEVER BEEN PREGNANT... SO COULD I GATHER OPINOINS ON ANYONE WHO HAS HAD THIS?? I THINK I HAVE A GOOD DONOR SITE FOR A PAP FLAP ALONG WITH SMALL DIEP FLAP..I AM WILLING TO TRAVEL...  NOLA? DR ALLEN? GREENSPUN?   ANYONE HEARD OF OR KNOW ANYONE THAT HAS GONE TO DR SADEGHI IN NEWORLEANS OR DR HADDOCK IN DALLAS??  ANY AND ALL SUGGESTIONS WOULD HELP

Hi there Merrellgirl! I just read your thread and found it interesting as I'm also considering travelling for reconstructive surgery. Did you end up deciding where to go? I'm in Canada and wait times are long here. I'm also not feeling that confident with the surgeons I've seen. They just don't have the experience with flap surgery that some of the Drs in the US have and I'm told I'm not an easy case. I'm hoping for delayed bilateral Diep, maybe with small implants added in stage 2 if I can't get enough volume with my own fat. I dont want to use muscle and and I don't want scars in new places if it can be helped (already have a Csection scar on my tummy). I've looked at Nola and PRMA in San Antonio Texas. Both seem great but PRMA is a bit less expensive so I'm leaning towards PRMA.

I'd love to hear what you've decided to do.

So after almost a year and a lot of research I had my DIEP in NOLA. I also considered PRMA in San Antonio but NOLA won out in the end. I'm recovering now, back in Canada, 2 weeks out. My PS (Dr Dellacroce) will add small implants in stage 2 if I want to help with size and projection. Already I'm impressed with how he managed to find "material" for my bilateral reconstruction where other PS said there wasn't enough. I was apparently a difficult case with abdominal scars from previous surgeries and not enough tummy fat. I decided to travel and pay out of pocket for my surgery as I wasn't offered the type of reconstruction I wanted by my Canadian PS and because wait times are so long here. I also decided I wanted the best surgeon I could find after all I've been through and the ugly job the surgeon who performed my mastectomy did. Dr Dellacroce is one of the best in the world. I was looking at a 2 year wait here and I didn't want Lat Dorsi flaps, I wanted DIEP. The cost is horrendous but it's tax deductible and I don't regret my desicion to travel for one second. I wish every woman going through bc would be taken care of as I was at the Centre in NOLA. They really do live up to their reputation. I was lucky and didn't have any complications while in the US. If I'd ended up needing more surgery and a longer hospital stay the cost would have gone through the roof

Hi,

I am considering delayed reconstruction in New Orleans also, with Dr. Sullivan. Mainly because I had radiation and my options are limited since I am thin and even though I made an effort to gain weight I have not been very successful.

I am also worried about the complications from using the abdominal muscle and the resulting weakness in that area. I read that around 40% of women end up with a hernia and about 5% with permanent pain. In New Orleans they gave me an option that do not have those risks. I think that worrying about recurrence is enough; there's no need to add more health problems into the mix.

I would have to travel from Puerto Rico to New Orleans three times and of course pay for travel, hotel stay, etc. Now the plan has informed me that they will reimburse me 75% of the cost, but will not pay for it up front since the hospital is not a contracted provider. I do not have an estimate for the costs yet.  I had estimated that my out of pocket expenses, including copays, deductibles and travel would take around $30,000. Now it would probably require over $100,000.

I think that even though there are excellent choices for reconstruction that have fewer long term complications, the health plan limitations and related costs simply would not allow many women to take advantage of them.