May 2016 Surgeries

Papillon1 - I can totally relate about the stomach churning! I've kept super busy this week so I've kept my nerves on hold but it will be harder now that I'm not as busy. Valsti 52 - I'm concerned about the sleep too. I bought one of those backrest pillow things that has arms (my mom used to call them husband pillows) and I plan to basically sleep propped up. I'm hoping I can sleep since I'm normally a stomach and side sleeper - but hoping I will have some chemicals that will help with that. I don't sleep well normally and the fear of it being worse is one of my main concerns. We have a recliner but I'm not exaclt sure where I'd put it and its not very comfortable anyways so I'm hoping the pillow deal works. I bought mine at target - they had the choice of beige or beige, so I bought the beige, It was like 15$ ish.

Re: Sleeping position

I obviously spent the first two nights in the hospital and in that mess I needed to raise the top half of the bed to help me sit up. But as soon as I was home, I've been sleeping on my back in bed with no problems. I have strong abs and spent the month before surgery doing inclined sit-ups nearly every day to strengthen them so I could sit up from lying flat without using my arms or straining my chest muscles. It's worked and I have no problem getting into and out of bed or scrunching around using my hips to get higher or lower on the mattress. I tried bracing myself with a second baby pillow last night to sleep on my side but gave up - couldn't cushion the drain well enough for that not to hurt. So it's just flat on my back in bed, with a couple pillows behind me for comfort. If I lay perfectly flat, I start having coughing fits, which hurt like the dickens. So I try to keep my head elevated a few inches. Still haven't named my drains. Haven't had the energy.

About sleeping: what worked for me was being propped -up with pillows on three parts, so I could not roll on the sides (only one side had the drain but I was too afraid of disturbing something so I did not lay on the other side either), my pillow cocoon. My bed is high so it was easier for me to get up from there than from my lower sitting recliner. I would also ask my husband for help when he was around. I tried with a backrest wedge but it was too rigid for me. I did sleep in short intervals the first few nights I was soo not used to sleep on my back.

But, at 10 full days post surgery, it is almost painless to get off the bed now, so hang in there ladies, every day it gets a little easier.

Check'n in. Lumpectomy and SNB surgery done. Now it's waiting-for-results phase. Pain has been very manageable. I was given a Rx for hydromorphone and tylenol 3s (not to be taken at same time lol). Unfortunately the tensor bandage across my chest kept pulling down putting stress on the tegaderm tape which has caused a few nasty blisters. My husband went out last night to get me some non-stick bandages and polysporin ointment and so far this is controlling the blister pain. That tensor bandage was just a pain-in-the-*%$ so I took it off this morning (a day early) and started with the sports bra. Added some bra padding and it feels way better! Wasn't sure what I would find under the tensor. Had a 5-second scare that I couldn't find my nipple! Phew it was still there. The scares we women go through during this adventure. Found some more blisters on my backside from the tape which explains my constant need for scratching that area. Researching more on this tape and I think I may be one of those with a sensitivity to it. Anyone with experience with tegaderm bandage when this stuff will fall/melt off?

GreyKat hang in there. I know its a difficult time for you right now. I always to try to think of things I'm grateful for to defeat the not-so-grateful things happening. I'm grateful they invented non-stick dressings and polysporin for these nasty blisters I got from the tape that is there to ensure my wound will heal and get better.

Congrats to all my May 9 Week surgery sisters!

GreyKat, that's great that your ROM in your arms is better than you expected. At 4 weeks post-op I'd have to say that mine is nearly back to normal, except on the side where I still have the one drain. I'm positive that as soon as it comes out I'll have full ROM on both sides.

I'll tell you, getting even the one drain out has been like night and day. With both I was walking very stiff-armed and a bit like a little old lady robot. With just Flotsam gone it's made a huge difference - as soon as Jetsam is gone I'll be golden! In fact, they gave me a "new" Jetsam - shorter and a much thinner line, which has made the drain on that side much lighter. At this point I feel like I'm even going to start walking the neighborhood again on Monday morning (but without my big dogs, unfortunately - two 110 lb. German Shepherds - they're great walkers but can't take the chance of an "Ooooh, squirrel!" incident.)

Today is exactly 4 weeks post-op for me and I really feel like my day-to-day living is nearly back to normal.

Hydranne, so glad to hear from you and that you are doing well my fellow IBC sister

Greykat so glad things are better for you, and for all that posted their post op experiences thank you so much. Holding my breath for 5/24.

For all waiting on test results, in your pocket waiting with you.

Val

it appears I'm developing a hematoma... Dang!

tsoebbin - if it is thought that you have pure DCIS and are having a lumpectomy, it is not as necessary to do a SNB because you have breast tissue left behind. If a mastectomy is performed it is necessary to do a SNB because once the breast tissue is removed it is not possible to inject the dye/tracer because it has no tissue to travel through and identify the sentinel node. This would be the same reason that raven did not have one at the time of her first diagnosis.

greykat - have you been given Zofran for nausea? if so, it can cause a wicked headache. Do what you can do - the rest will work itself out, but I know it is hard to be patient.

jojo - I am allergic to Tegaderm and have to use another tape called Medipore.

moreshoes - there are some docs here that use the antibiotic cream in the nose for several days pre-operatively.

I have never slept in a recliner for any of my surgeries - just used a ton of pillows behind and to each side. I wear silky pajamas to ease getting in and out of bed.

wench - amazingly, I have also had a Nissen procedure done for reflux, but mine was in 1995 when they first pioneered it laproscopically. It was done at Portsmouth Naval Hospital - I ended up with pneumonia afterward from the instruments used to test the tautness of the wrap internally - no fun!

Tonight was night 5 after surgery w TE placement and some genius part of me felt that I could somehow sleep on my side, drains and all. I managed to cushion them and the TE with my hands/arm while sleeping and while it was really nice to change position, i really hurt by the time I woke up.So guess can't do that anymore.

Yes to whomever asked if I have zoflam or whatever for nausea. it works well enough that I can eat some. The other antinausea thing was a patch I peeled off today.

Still can't see straight to type. Back to bed for me. Luck to you all.

@Papillion1 I had double mastectomy with immediate reconstruction using tissue expanders and alloderm. It is the standard practice where I'm at. They can do immediate recon to silicon implant with alloderm, but using tissue expanders gives them more control over the final appearance because you can change the size as you go by injecting or removing different amounts of saline, which stretches the muscle and skin over it, and it allows them to do better positioning by giving them more chance to correct it if things don't match up right.

Expanders are like hard plastic half-rounds, with a metal port in them (the metal lets them find the port with a magnet over your skin and that's where they inject the saline filler). The expanders are sewn to your chest wall, underneath the pectoral muscle. The pec muscle is draped over the TE, alloderm is sewn to the bottom of the pec and also to the chest wall, making a sort of sling for the TE and then the future implant to sit in. The pain factor comes a great deal from having the pectoral muscle cut away at the inner corner where it attaches to the center of your chest, because they have to cut the muscle in order to lift it up enough to get the TE or implant underneath. And all those stitches can pull and tear if you overextend your range of movement before giving your tissues a chance to heal.

I feel two very different kinds of pain and I have separate meds for each. One is a hard tightness up on my chest below the collar bone, where the pectoral muscle runs across both sides of the chest - that is that muscle being stretched by the TE and also hurting from being cut and spasming from the pressure. That is absolutely common and they prescribe muscle relaxants for that and for each future fill, because the fill enlarges the TE a bit more, stretches the muscle a bit more, and causes spasms again until the muscle adjusts, etc etc until the size you want to be is reached.

The other kind of pain is deep, where the TE are stitched to the chest wall (under the muscle down by the ribs and stuff) and they pull and burn and ache and just all around freaking hurt. Also the stitches where the alloderm was sewn to the pec muscle on one side and the other side to the chest wall, making that little hammock for the future implant to sit in. There's also the pain left from all the nerves cut that used to connect to breast tissue which are now firing phantom breast pain. All that is normal too, and for that they prescribe percocet or some opiod painkiller because muscle relaxants would do nothing there. That's just straight up tissue injury and it takes time to heal. But there are lots of stitches that can tear out and even with enough stress the pectoral muscle can tear completely free (though it's rare) so that's why they want all the lifting and movement restrictions. If the pec muscles tear completely free of the chest you can tell because the implants (not the TE because they're sewn in place on your chest wall) - the implants in a case of detached muscles will actually migrate together to the center of the chest until they're touching in a sub-muscular uniboob. That requires more surgery to fix because just from a muscular standpoint you're supposed to have your pec muscles attached to something ligament or bone to pull against, like normal.

Hope that helps.

I wanted to have as few surgeries as possible since I have small kids. That said though, if I am

Not happy with the size the PS did say we could add size later using liposuction and fat transfer which I think could be good.

So I don't think the silicone implants are actually attached to the chest wall - which is probably why you are allowed to raise for arms and I have been told no no. It makes sense that if the implant is free until the muscle reattaches and everything settles that clenching the pec muscle could move the implant... And I don't want foobs under my chin!!!

The lack of arm movement is concerning me but no doubt I will adapt. Allowing my husband to do my hair is also concerning!!

Ausbear, sounds like things are going great for you. So happy to read that. I'm jealous about the drains coming out so quickly. I still have one after four weeks.Guh!

Papillon1, I have TEs, but mine are over the chest wall muscle which – I didn't realize – is fairly new and not all that common.

MoreShoes, that was an awesome blog article. I do not feel one BIT guilty about being sad about losing my breasts. I did take pictures and I've shed many a tear over this; that was the only way I said goodbye to mine.

Ella23, I have some minor itching, but nothing like you've described. Do you have bandages over your incisions? Could it be an allergic reaction to them? Definitely follow-up with either your BS or your PS; you shouldn't have to suffer so. I also only had 2 drains. I think the highest output I had in a 24 hour period was 45 ccs, but it's generally averaging to about 20 ccs per 24-hour period. Not sure about the weight gain – I've lost weight, despite eating like a cow since my surgery. Again, I would discuss with BS or PS. The exhaustion is completely normal. As my PS said to me "You just had major surgery, for God's sake. Give yourself a break!" At first just taking a shower would require a 2 hour nap, but that went away after about 3 weeks. Listen to your body and rest when needed. And speaking of showers, yes, I was allowed to shower after only 4-5 days and it was heavenly. Every PS seems to have a different protocol. Just enjoy the fact that yours allows it. As for the TEs, yes, they can look a bit creepy at first - lumpy and bruised. After a couple of weeks I asked my PS when I would start looking less like "Bride of Frankenstein" and more like "Bride of Dale" (my DH's name) and his answer was that "It's a process." And it has gotten better, so hang in there.

I love the blog MoreShoes, thank you. I've got 4 weeks before my surgery so I hope I've said goodbye to my breast by then. Nancy has a lot of other good points on her blog, I've saved her to my desktop for future reading

Raven, thank you for helping put myself at ease!! It means so much.

Thank you GreyKat. Your strength, tenacity and outlook are an inspiration. Thank you again, and wishing you a speedy and total recovery.