UCSD or San Diego Reconstruction Girls?

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  • LauraSD
    LauraSD Member Posts: 16
    edited July 2015

    Hi Ispy:

    I had surgery at Scripps Green in Torrey Pines. General surgeon was Dr. Kurtzhals, plastic surgeon was Dr. Pacella. I was happy to get off the narcotics over the weekend, but had a bad day today and had to take more. The expander is not very comfortable.

    I'll be praying for you tomorrow!

  • panthrah
    panthrah Member Posts: 433
    edited July 2015

    LauraSD Kurtzhals is my doc too :) I think shes hilarious.

    Ispy - Good luck tomorrow *gentle hugs* itll be over before you know it :)

  • Kimberli43
    Kimberli43 Member Posts: 14
    edited July 2015

    Ispy- good luck tomorrow. I'll be thinking of you. You might need help for a couple of weeks. You can't drive especially with the drains. Please keep us posted on how you are doing. You got this!

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Thanks girls! I'll post as soon as I can!


  • LauraSD
    LauraSD Member Posts: 16
    edited July 2015

    How are you doing Ispy? I hope you are recovering well and that you have a good support system. Send us an update. Sending good thoughts your way.


    -Laura

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    hi Laura -- hi everyone. I got home from the hospital yesterday but then I got a fever and had to go to the ER last night. The ER was too crowded and I wouldn't get seen for hours, so I was like "I'd rather sleep". I was able to get in to see my bs this morning. she said it all looked pretty good, except I might have a little infection around where the drain comes out. so she gave me an antibiotic and I'm now home in bed. I took the antibiotic this morning and I already feel better. My pec muscles are sooo sore though, and spasming. drugs are my friend.

    She got the path report back and they found LCIS in my left breast and atypical ductal hyperplasia in my right. That LCIS was not seen on the mammograms and the left breast wasn't even on our radar. I took it as evidence that I did the right thing, since one of my main concerns was getting cancer again and no one seeing it on the mammogram due to my dense breasts. Anyway, I looked at the incision and it looks pretty darn decent. The ps filled 120 cc's during surgery and I think I can tell how it is going to look (not too bad). I'll update my diagnosis in my signature line when I get a copy of the path report and can read it all. So that is my update!

  • LauraSD
    LauraSD Member Posts: 16
    edited July 2015

    Hi Ispy:

    How are you doing? I hope that your fever resolved and that your pain is under good control. I am starting to feel more comfortable now and actually had my first day without tylenol or any pain medications. I'm hoping this is the first of many more somewhat "normal" days to come.

    I hope you are recovering comfortably!

    Laura

  • SoCalGrl
    SoCalGrl Member Posts: 105
    edited July 2015

    Hi ladies! I just wanted to jump in this thread and introduce myself. Technically I'm in Temecula (north of San Diego), but I moved here after living in San Diego for a really long time. Temecula has a great breast care center called Breastlink, but they do not have a local oncologist so I've opted to see a breast oncologist in the UCSD system who sees patients out of Vista. It's about a 40 minute drive for me but worth it to see a doctor who specializes in breast only. I see her for the first time on Thursday.

    Ipsy - I know you from the surgery threads and I'm glad you're doing well. It still amazes me to hear when women get a prophylactic mastectomy only to find cancer in the other breast. I'm glad you made the choice!

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Hi SoCalGirl! What is the name of the doctor you are seeing? I'm at UCSD too....

  • SoCalGrl
    SoCalGrl Member Posts: 105
    edited July 2015

    Ispy - I'm seeing Dr. Rupa Subramanian for the first time this week.

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Wow she looks really nice and knowledgeable. Good choice! I did everything through Moores Cancer Center at UCSD in La Jolla.

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Panthrah -- how is the studying going for your test? Did you see they found LCIS in my left breast? So we're LCIS sisters now haha...

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    ok annnnddd I just got the full path report and it is crazy -- the left breast, which wasn't even on our radar, had LCIS, radial scar, microcalcifications, and a papilloma for good measure. Each increases my chance of breast cancer, to go with my other high risks. I saw my bs today (she took out one drain hurray!) and I asked her if she had known about the LCIS in the left breast before the PBMX... and she cut me off and started laughing and said "Yes!" I asked if that reconfirmed we did the right thing and she laughed again and said "Ohhh yeaaa." It's nice when I wrung myself out making this decision to realize it really was the right decision, and I may have just seriously dodged a bullet. It also helps when I'm dealing with pain and drains and a malformed chest to realize it wasn't just the right decision, it was the only decision. :)

  • panthrah
    panthrah Member Posts: 433
    edited July 2015

    I was in NYC and didnt go online there. needed to save battery so we had google maps to make back to the hotel :p Your left path seems like what I have. and yep..sisters..:p Im glad you are feeling well enough to be posting :) i had the calcifications too , those were removed on the first lx. I am thinking of doing the same as you ...just not sure when. next mammo is aug 3rd then doc again sept ( i swear she said nov) If they want to cut me open again.. i might flip. I have a very busy schedule ( comic con, aulani, half marathons, etc) I dont have time to keep getting cut open. so if i were to do the pbmx, Id either need to set it up now , for next year before things fill up and while im out of work. and as far as studying..well.. Ive read 3 pages .. on the plane back form nyc. hehe aug my cal is empty so ill have more time. starting tomorrow i have: skating pride, roller derby convention sun-mon, derby disney day, 3 day interpreter conference. and then poof its august .

    Im glad the drain is out ( assuming you have more?) and hope things are going well and you are binge watching something awesome :) is it as bad as you thought it would be?

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Pathrah your calendar sounds really fun. Even before my surgery I didn't have that much fun; I guess because I was doing school and work and had no time for fun, then had surgery as soon as school stopped. I can't wait to have fun again! I am bored to tears beyond belief. Like, it is painful. There are no movies I want to see on Amazon/Netflix (or I've already seen them), I'm caught up on all TV shows, and I'm too tired still to work on my novel. As to whether it is as bad as I thought it would be: yes. I knew it was a gruesome surgery, and it is. I've had other gruesome surgeries (open abdominal hysterectomy, open abdominal oopherectomy) and it definitely compares. There is the difficulty in recovering from anesthesia (exhaustion, lightheadedness) but the difference this time is you're forced to deal with the aftermath: you have to empty drains of bodily fluids. The way I've gotten through surgery in the past is I don't look at the incision, I just concentrate on resting and feeling better. The first morning I had to do my drains I almost passed out haha -- and I'm not squeamish with stuff like that! But my blood pressure was already low, and just the gruesomeness of emptying drains coming out of my body -- ugh. I had to hobble quickly to the recliner and lay back to stop from passing out. I am incredibly uncomfortable because the surgical bra is meant to be a compression bra, and it is shoving the tubes into my ribs, and the chafing all around is giving me a rash. hooray! And I am very independent and live alone, and I don't like asking people to do things for me, even though I have very willing friends. Speaking of bras: both my bs and ps have said the compression is necessary while the drains are in, so I have to wear the surgical bra. I hadn't seen that on here and I wonder if it is a small detail that keeps the drains flowing and prevents infection; note that for future reference.

    All of that said, the path report just confirmed that I did the right thing. This surgery was inevitable, but all of my choices would have been removed: timing, no lymph node removal, chemo, radiation. As soon as I recover I am done with this dog and pony show. I see the light at the end of the tunnel, I feel well enough to be bored, and so far everything is going as it should be (barring the first night fever and trip to ER which we handled). So yes, as bad as I thought, but I am getting through it!

    When I'm well we should meet for coffee. :)

  • panthrah
    panthrah Member Posts: 433
    edited July 2015

    Im a coffee addict :) try getting some Glide. its anti chaffing... runners use it. has no smell to it. its so common now that it can be found at sports authority vs only at a running store. painfully bored.. I get it. I broke my ankle and was couch bound for 2 1/2 months (work wouldnt let me come back) as far as netflixs... time to try new things or watch old favorites :) I recommend Supernatural.. cause .. well they are HOT :p I have split screen on my computer so I usually have netflix up while im doing other things.. quite the multi-tasker I am. and yes compression bra will help. just as in any other injury you use compression to keep the swelling down which in turn relives pressure and pain. once that drain is out it will feel better. I have the front zip under armour bra.. pricey but Im active enough to justify the cost. plus Im just an A cup so it doesnt take much to strap mine in. the cute soft ones wont have suffienct compression to them. once you are healed enough and get the ok.. the softer ones are more comfy to wear but really dont serve much of a purpose

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Once I'm healed and get the okay, I won't need a bra anymore ;) That at least is some good news....

  • LauraSD
    LauraSD Member Posts: 16
    edited July 2015

    Hi Girls:

    Glad to hear you are doing so well Ispy! You are one tough lady to be handling the double Mx so well so soon, and by yourself! Are you getting reconstruction and did you have expanders placed? I have an expander and am having a lot of problems with lack of support and pain. The localized pain started after my first fill. My skin is very sensitive under the expander and normal bras irritate it a lot and they don't seem to get under the expander and lift it. Instead, they push on the bottom edge of the expander which causes it to hit the deeper tissues in a spot that causes a lot of pain. The pain is bad enough that I have to address it by lifting the expander slightly with my hand to move it off the spot. I have tried numerous bras (sports, underwire, mastectomy) and numerous sizes (I'm normally a 36B and have used 38-44 to stop the rubbing on the skin but at the same time try increasing the support). The only thing I have found that works is if I wrap an Ace bandage under the breast and then over my shoulder to lift it slightly to take the pressure off that one spot. My PS didn't really have any helpful suggestions. He said it is probably because the expander is heavier now with more saline in it. Does that mean it is only going to get worse as he keeps on filling it???? I'm supposed to go back to work in a week. I am very active at work and do a lot of physical bending, lifting and movement. I don't know how all this is going to work. I have to say I have many moments where I regret that I chose reconstruction and I am really wondering if I want to have anything done with my other normal breast (the PS wants to do a lift because it is a saggy, almost 50 year old mommy boob and he said it may need an implant as well to match the new one). This road is a long, arduous one. I can't imagine having the expander be so uncomfortable for the approximately 6 months I have to wait before I get the implant. I feel like I live in the Victorian era where I have to put my corset on every morning!!!

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Hi Laura,

    Yes, I have two TEs, but I'm only two weeks out from surgery, so I'm not doing much moving; plus I am required to wear the surgical bra because I have two drains in still. I can understand what you mean about the pain from the TE, because I can feel the edges of them and my left one bothers my arm pit a bit. I will probably go without a bra altogether as soon as the drain is out, but I don't have a natural breast that needs supporting and the TEs aren't going to flop around. With my surgical bra, I use a type of bandage called an abdominal pad to relieve pressure from the bra on my ribs and the drains and my arm pit. So I have these pads tucked in everywhere along the seam of the bra. You might try that. They are cushiony but not so thick that you can't put a shirt over them and hide them. This is what I got:

    http://smile.amazon.com/gp/product/B00NSPKYQE?psc=...

    The other thing is I am able to recognize when part of the problem is my pectoral muscle being rigid and complaining. Remember that the TE is under the pec muscle (well, it should be unless he put it over?) and the muscle is angry and can spasm. So I take muscle relaxants but also I just put my hand gently on the part that is hurting and I concentrate on relaxing the muscle and that helps a lot.

  • SoCalGrl
    SoCalGrl Member Posts: 105
    edited July 2015

    Hi Laura, I'm a little over 4 weeks out from surgery and I have the same exact issues as you do - bras rubbing oddly causing a weird burning sensation and also pain underneath the tissue expander. Throughout the fill process I always thought my pec muscle would be the most sore, but for me it's underneath the TE near the chest wall. I feel like the TE is sitting on a nerve and I've also tried to "lift" it off and move it but it doesn't quite budge. I usually don't wear a bra, to be honest. The only time I put something on is if I'm wearing something that is see through or if my shirt could dip slightly too low if I bent over. When I do wear something it's a very loose sports bra that would offer me zero support if I still had boobs. I've decided that this week will be my last fill. I can't take the nerve pain any longer and I'm already slightly bigger than where I was before all of this (B cup.) Hopefully with no more fills, things will settle down.


    Edited to add that this is similar to what I have been wearing: Fruit of the Loom Sports Bra

  • LauraSD
    LauraSD Member Posts: 16
    edited July 2015

    Hi Ladies:

    Thanks for your advice. I used the abdo pads initially after surgery and tucked them around like you are doing, Ispy. I haven't used them for weeks. They would probably help with the skin sensitivity to the lower bra elastic. I can ignore the skin sensitivity more than I can ignore the pain from the deeper tissues. I don't feel like I am having pectoral muscle spasms. The expander is underneath the pec with an alloderm pocket. SoCalGirl, I can't believe you can go without a bra! My pain is definitely worse if I have no support and try to be upright. I actually sleep without a bra and the TE doesn't push on the spot in when I am laying down. I have tried bras that look like the one in your link but with front clasps. The TE seems to slip underneath them. Or they just don't lift enough. It's a conundrum, for sure.

    I got another fill today and the TE is about the same size as my natural breast now. Amazing that I look almost normal and symmetrical with clothes on after only 4 weeks. It is a surreal experience. Did I really have a mastectomy??? Guess the pain says so. My PS said I should only need one or two more fills. Since the Ace Bandage seems to work, I will keep doing that and hope that will work or that the TE will shift and not bug that one spot anymore. I got some disturbing news about my genetic testing yesterday. I am positive for the BARD1 mutation. I was negative for the BrCA1 & 2 gene mutations. I was hoping I got lucky and it wasn't genetic. Now it's time for more research to see what that means to me, my sisters and my children. My initial research leads me to think that maybe I need to have my left breast removed. Bummer, would have been nice to do both at once and get it all over with in one recovery. I am going to schedule an appointment with a genetic counselor and see what they say. This journey requires so many big decisions to be made and often in such a big rush. If they recommend prophylactic Mx of my other breast, the PS wants me to have it ASAP so he can reconstruct simultaneously. Ugh! Another big surgery? Then throw chemo into the mix and who knows how it will all play out? Who has time to work??

    Ispy, are you still on narcotic pain meds? SoCalGirl, how long till you stopped your pain meds? With the Ace bandage, I was finally able to get off the hard stuff and tylenol for the last 4 days or so.

  • I_Spy
    I_Spy Member Posts: 507
    edited July 2015

    Hi Laura -- guess what? I'm positive for the BARD1 gene too. They will tell you that they aren't done doing studies yet, and so you can't make a decision based solely on testing positive for that mutation. My genetic counselor says they think it is associated with a higher risk of bc after menopause, but they're not sure. The genetic testing websites just say higher risk of bc with unknown amount of increased risk (like BCRA is 85% but BARD1 is unknown). Anyway, yes, I figured my mutation into my decision for a PBMX, along with family history, dense breasts, DCIS, and new calcifications on 6 month follow up mammo after my LX.

    I am taking flexeril occasionally throughout the day, just trying to see if it helps the spasming. I definitely take oxy at night, since the surgical bra hurts my drains so much when I lie down and try to sleep. Hopefully I'll have the drains out tomorrow, and then I can isolate the rest of this pain.

    I know what you mean about the skin -- my skin is very sensitive.

  • SoCalGrl
    SoCalGrl Member Posts: 105
    edited July 2015

    Laura -

    I'm sorry to hear about having to make a big decision based on your test results and the possibility of another surgery so soon. :\

    I've been taking pain meds only the day after my TE fills because they have been so rough. I'm running out so I have to be careful how many I take. My PS was pretty adamant about not refilling them. I got 50 pills after surgery and have around 10 left.

  • Anonymous
    Anonymous Member Posts: 1,376
    edited January 2016

    Sorry to resurrect an old thread. I was searching for BARD1 on the site and I found this thread. I noticed ispy and Laura having the BARD1 mutation, I do too! (Also from San Diego). I don't know if it's coincidence or bias, but all the people I've found who had the BARD1 mutation have breast cancer. My genetic counselor acknowledged there isn't enough information on it but said that it could increase risk by 3x (up to ~36%). What are your specific variances? Mine is p.H36R, or c.107A>G.

    Hope you're all doing well.

  • I_Spy
    I_Spy Member Posts: 507
    edited May 2016

    Lovingisliving I believe we spoke over private message about this. I actually ruptured a disk in my spine on 1/22 (three days before you wrote this) and I have been dealing with that ever since. ugh. surgery 2/16 to remove the herniated disk and the surgeon messed it up. I feel like that saying: "They can put a man on the moon, but they can't..." instead, its: "I can get a BMX, Implant Exchange Surgery, and live through bc, but you can't fix a f$%#$ing herniation properly??" yea.

    So anyway, yes, I have BARD1. I wrote about it a bit in the postings above your question. I am very glad I had a BMX, because they found LCIS in the left breast that no one knew was there. So I could have had ILC before we knew anything about it. I am very happy with my decision to get the BMX, and frankly it is the least of my worries now. It is weird looking back at how afraid I was and everything I was trying to (and did) accomplish, and it is a a stupid herniation that is bringing me down. Well, I'm not giving up. I just may need another surgery.

    Hey other SD girls check in if you can! Like Laura, looking at your signature line it looks like you went ahead and had that MX of the other breast, I guess based on your gene mutation? Hope everyone else is doing well....

  • I_Spy
    I_Spy Member Posts: 507
    edited May 2016

    So for anyone finding this thread sometime in the future, I'd just like to say that Sarah Blair, MD, was my bs at UCSD Moores Cancer Center. and Amanda Gosman, MD, was my ps along with her PA Nora. They were AMAZING. Dr. Gosman got me an amazing result. They were all kind and compassionate through the whole thing. I believe that Dr. Gosman's infection precautions and her protocol for the whole reconstruction procedure greatly lessened my chances of infection (and at the slightest redness she yanked those TEs out and put the implants in, a tad early), and resulted in beautiful foobs. It all worked out great. So I can highly recommend them, as well as the whole facility.

  • MoniW
    MoniW Member Posts: 7
    edited May 2016

    Thanks for sharing such great info ladies! I may end up at Moores too, will find out this week what my insurance situation is going to be like. I originally was slated for UCSD but had such a bad experience with the first round of Dr.s associated with the group... the MedOnc I saw in Escondido was awful, then had a not so good 2nd appt with a 2nd MedOnc in Vista. This pushed me even more to seek an outside opinion at COH and that has gone really well. The SurgOnc I saw there was way more thoughtful/considerate of the details of my specific case. I wonder if the difference is also in MedOnc vs. SurgOnc? With my DCIS Dx, I seemed to have gotten a more favorable (but not pushy) support of my decision to have a BMX by the SurgOnc. The MedOnc says I'm 'overreacting.' Anyway, I'm in Temecula so as far as convenience I can drive in either direction... I just want to make sure I have the support of my Dr.s in the BEST choice for my situation.

  • nash
    nash Member Posts: 2,600
    edited May 2016

    Hi, ladies. I'm in SD as well. I wanted to ask if anyone has found a good PT group who specializes in post-reconstruction PT.

    I am a year out from uni lat flap, and although I am making progress, I am still miserably tight and uncomfortable 24/7. I wasted 8 months going to a PT place who claimed they handled my sort of case, but as it turned out, they were clueless. I'm with a chiro right now who is helping me with myofascia release and scar tissue, but I feel like I could also benefit from a good PT.

    I had my lumpectomy in 2007 and my mx/lat flap in 2015 done with Dr Wallace at UCSD. She was great for my lumpectomy, so I didn't think twice about going to her for the mx/lat flap. Well, she is not so great if you end up with issues post-op. I don't know if my tightness issues have anything to do with how she performed the surgery or not, but as far as suggesting resources for help, her office was useless other than sending me to Pain Clinic, who was equally useless. I had to find help on my own, and the whole office staff is quite defensive about the poor QOL issues I now have post-op, even though I have not raised much of a fuss.

    I had a bc friend who had lat flap done with Dr Wallace as well and who also had post-op issues. My friend also found Dr W to be unsupportive and in my friend's words, "a b-tch". So it isn't just me apparently, and I should have headed her story pre-lat flap. Anyhow, just a word of warning. Sounds like I might have been better off with the Blair/Gosman duo at UCSD.

  • I_Spy
    I_Spy Member Posts: 507
    edited June 2016

    Yes Dr. Blair and Dr. Gosman have been AMAZING. I got the feeling Dr. Wallace was a bit more hype than quality, and I guess I was right. I can tell you that Comprehensive Physical Therapy in Sorrento Valley has been amazing for me -- Elizabeth Leeds. She only works three days per week (and don't take my appointment slots haha). I too tried the pain clinic at UCSD and i felt like I barely dodged a bullet there -- it seemed the guy missed his calling as a psychiatrist, or that is what he wants to be rather than a pain management doctor. Also, I'd like to recommend "Happy U Namaste Yoga" in OB, specifically Tierney as a teacher, or Karson. That is where I made the MOST progress in range of motion. They have lazy day yoga on Sundays, and their noon classes during the week are usually restorative yoga. They use pillows and supports and Tierney is SO knowledeable and kind and knew exactly how to modify every single move so that I was able to increase ROM without injuring myself. Honestly she helped me the most through my recovery. I ruptured a disk in my spine while at work in January, and then a surgeon messed up the surgery and I have to have another surgery to add support in a few weeks. That is where my real pain is coming from, and why I went to the pain doctor and to PT. Prior to that, I was doing great just going to restorative yoga with Tierney. So I can't recommend that enough.

    Question on the lat flap -- was that a reconstruction choice, or was that your only option due to issues with radiation?

  • nash
    nash Member Posts: 2,600
    edited June 2016

    ispy, thank you sooo much for your reply. Yes, the lat flap was my main option b/c of prior rads. I suppose I could have had DIEP or SGAP done somewhere, but I am a competitive adult figure skater, and I was so afraid of compromising any body parts south of the boobs. Honestly, I went into my mx appt with Dr W not wanting reconstruction and she talked me into it, presenting it as an easy 8 week recovery b/c of her expertise. Sheesh.

    I actually was at CPT in SV for the wasted 8 months, but didn't have Elizabeth Leeds. I had April and Maureen and they were completely useless. I left when April suggested I see their psychologist when she couldn't help me. I was making progress with a PhD candidate intern they had working there--Elizabeth Delozier--but she left, and April and Maureen couldn't/wouldn't replicate what she was doing. I will see about Elizabeth Leeds (and won't take your appt slots, lol), b/c right now I am paying through the nose for my chiro and a scar release lady, neither of whom are covered by my insurance.

    And I will investigate the yoga place in OB--thank you so much again for the help!


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