DIEP 2015

today is my first day home after bilateral mastecomy/DIEP. Trying to get myself comfortable, I do miss the hospital bed. Definitely would be happier without my drains

Hello everyone! I am new to the thread! I will be having a right prophylactic mx and bilateral DIEP flap surgery on March 27th. I had a left mx last February. Chemo from March-July, Rads from August until end of Sept. Ready for this to be done! During the DIEP surgery, I will also have a lymph node transfer as I have developed lymphedema in my hand after removal of 37 nodes during last year's surgery. Has anyone else had a lymph node transfer along with DIEP or TRAM? I just got my surgery date today. I really need to spend a lot of time reading this thread and the 2014 one. Thanks in advance to everyone for sharing their valuable knowledge!

Pls add me to the list/group for DPIE. I am post op almost 9 weeks.DX: IDC <.07cm 1/25 positive nodes0.5cm in node

ER Neg PR NEG- HERS2 Positive

Surgeries:

ALND in 11/24/2014 by Dr Lisa Newman University of Michigan Medical Center removed 25 nodes, one out of 25 positive

Breast conserving mastectomy with immediate DIEP at University of Michigan Medical Center Ann Arbor, MI PS DR A Momoh, SO Dr Lisa Newman

Current Chemotherapy 2/17/2015: Receiving # 3 0f #6 doses of Perjeta, Perception Docetaxal and Cytoxan every 3 weeks x 6

My margins were "clear but close " .07cm. Concerned radiation is recommended but with the potential cardiac side effects of Perjeta and Herceptin I am reluctant to add more potential heart damage down the road with radiation- any advice.

Glad I did the immediate DIEP but recovery was very tough and I was very healthy and athletic pre cancer diagnosis. I started chemo three weeks after DIEP, also very tough

Happy to help out any newbies with DIEP....take your pain pills! This is a big surgery and you need to be moving.

Hi Shari, apart from the immediate diep I've been through something quite similar. I was diagnosed and treated in Ottawa, Ontario. I also had a lumpectomy followed by chemo (4xTC) and radiation (breast and half axilla) and then after that more cancer was found in the same breast, bilateral mastectomy followed by another round of chemo (dose dense 4xAC+ 4xT) and radiation to my clavicle. In my case the pathology of the reocurrence was different from the original (the new tumour lost PR+ and had lower ER+) so my MO argued that it could have been a residual or new tumour so he wanted to treat it like a new primary and go at it like I was triple negative as it was so weakly ER+. That way he got the funding to give me chemo again approved. Ask your MO if your pathology is different this time as it can impact treatment decisions. Also my RO decided she still wanted to radiate my clavicle the second time even if she couldnt do my chestwall because of the previous rads. This was after my MO said no point in me seeing her because i couldn't have rads twice. I wasn't lucky enough to be offered immediate recon but I've just had my delayed diep done almost 2 weeks ago now and I'm doing well. Inthink my recovery is maybe easier than some. Perhaps because I'd already had a mastectomy done before. I hear Dr Lipa is great btw.

slv58, I slept in my bed from the beginning. Used lots of pillows to prop me up a bit and get comfortable. I also spent most of my days on the chaise lounge part of my sectional couch, also using pillows for comfort. I moved a side table beside me with all my meds, water, reading material, etc. so I didn't have to move around a lot.

mefromcc, you are making me very jealous! It's so cold here in Ohio. My kids were on a 2 hour delay from school this morning because it was -10. Wind chill was -24 over the weekend. Tons of snow too.

nmh35, welcome home! I hope you are resting well and have enough help that you don't overdo.

I hear you on those drains! I have one in my hip. My PS thought it would come out on Sunday after 3 weeks but it plateaued at about 38 ml/day so now I have to keep it another week. I had two hips drains for 8.5 weeks with my SGAP and a seroma that had to aspirated 4 times, so I guess I shouldn't complain about this (but I am sick of it!!!!!).

the first 2 days in the hospital the drains didn't bother me too much, but now that I'm home they are bothering me more and more. But I was happy to wake up and find that I had 4 and not 6! My lower abdominal/hip drains definitely put out the most. Hoping that maybe I can get 1 of them out at my first post op appt on Thursday

Sounds like Iwas lucky to get rid of 3 out of 4 drains at my one week postop and the 4th a few days later.

trvler, I had immediate reconstruction. The results are lovely. I had a complication with my first recon requiring my recent stage 1 uni-DIEP. I'm worn out from surgery and still another stage 2 looms. Sometimes I wonder if it would have been better to be flat for a while then do delayed recon if it really felt important to me. I've seen nice results with delayed but I dont know if there are other issues to consider there. I probably would be singing the praises of immediate recon if I hadn't had the complication! I'm 45 now and was diagnosed at 42 and feel that all this surgery has aged me. I'm only 3.5 weeks out of stage 1 so maybe it's the blues talking.

LAstar, I'm 45 also. 😊 I don't know if the surgery aged me, but I feel like cancer did. Emotionally and the stress. It sucks. I think it will get better though as time goes on and we put this behind us.

Trvler, I was a candidate for immediate reconstruction so I didn't even ask about waiting until later. I guess my thoughts were to get it all over with at once. My results really are amazing.

I think most surgeons will lipo other areas during stage 2 to achieve a more natural shape. My PS offered to lipo the area above my hips in the back at stage 2 but I'm afraid I won't be able to keep my pants up if she does!

Yay for the 45 club, jmb! I still think I'm 38.

Trvlr, My reconstruction was delayed not by choice, just wasn't offered immediate within a reasonable time frame. The good thing was a quick and easy recovery from surgery and being able to start and focus on treatment without delay. Also now after DIEP im recovering quicker than most. I've been walking several miles a day since a few days after surgery, got rid of all drains within 10 days and I'm off painkillers at 2 weeks and getting back to myself already. Still healing but fingers crossed it's going well. The down side is esthetics. After rads and mastectomy my skin isn't able to stretch and I'm stuck with the much less attractive football scars.

Neta69,

My PS is Dr Chris Taylor, and my Surgical oncologist is Dr Allison Ross. I haven't been told anything about different stages--except they are hoping to do the Mx and reconstruction all in one shot--right now it is looking like it will be after radiation, instead of before in the fall. Just waiting to hear from the RO to see if PS agrees with doing it in that order. The advantage is that a lot of the tissue damaged by the radiation could be removed during the Mx, for better cosmetic results. I am still doing chemo, so still have a long way to go until my surgery. Just not really sure with the way Cdn healthcare is (with the added bonus of being in the military, so another system on top of that), what is considered covered and what is considered 'cosmetic'.

Neta69, I should have been more clear--my Mx and reconstruction both won't be until after radiation, at least at this point, and they will only remove the irradiated tissue that is needed to be removed for the Mx--which from what I understand will be a lot of the tissue that will be affected. It's a little unorthodox to do it in this order, but as I have already had a full lumpectomy, they feel there is no risk to delaying the Mx after radiation (the reason for the Mx is very small margins), especially since I am doing chemo as well. All the pathology so far says everything has been removed, they are just being thorough. I am going to be having an immediate DIEP reconstruction from my belly, and I have seen pictures of Dr. Taylor's work, he was very open with me when I saw him before I started chemo. Unfortunately, being military I have less options than civilians for healthcare--the military will only cover what they cover. In some case this is better (100% of my prescriptions are covered with no co-pay), but in others it means limited options. That said, I am very confident with Dr Taylor--he comes very highly recommended by my SO and MO and RO and I felt very good when I met with him that I was in good hands.

Aha Spookisgirl, now I get it! Just didn't clue in to the order your reconstruction and radiation was planned. I hear Dr Taylor is really good but for some reason I was told he did mostly implants and Dr Robinson mostly free flaps. Had I known he was a microsurgeon I would have asked to see him when Dr Robinson went on matleave. Do you like him?

I don't know about military but public health care covers all reconstruction and that included any changes, tweaks, fatgrafts lifts, nips and tucks of the reconstructed breast. Normally there are at least 2 stages with reconstruction. Stage 1, when the surgeon creates the "breast mound". If you have DIEP this stage is all about getting the transplanted tissue to take. Then some time after you heal is stage 2 when they tweak the breasts shape and tidy up scars. This usually involves fixing dog ears and issues with the abdominal scar too. Sometimes they make nipples in stage 2, sometimes that's another procedure. The final step is usually nipple tattoos. In Ontario where I used to live reconstruction was covered for your lifetime so you would always be covered for any procedure your PS agreed to do.