PS Consult...Gotta Lose That Weight to Get the Foob!

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Wendiwithani
Wendiwithani Member Posts: 108
edited July 2017 in Breast Reconstruction

After a six week wait, I finally had a consult with a plastic surgeon and I LOVE him! I have decided to either go with the DIEP or TRAM flap. However, he was very frank when he said I have to lose 20 pounds to put me in the safe BMI range for this surgery. Anyone else here in the same boat or been there done that?


If I'm being honest with myself, I need to lose about 50 pounds to be at a good, healthy weight for me. I am very motivated to get the weight off. I've been walking on my treadmill regularly for the last six weeks but I beat my record tonight. Lol

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  • SanFranKitty
    SanFranKitty Member Posts: 145
    edited September 2016

    Sometimes it helps to have to have something to feel motivated. I would say the big thing besides exercise is a healthy food. Lots of lean meats, veggies and whole grains. Oatmeal is good. Brown rice can be good and you can do long grain or short. Eggs too, nuts. You can do it!

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  • Claire_in_Seattle
    Claire_in_Seattle Member Posts: 4,570
    edited September 2016

    Talk about a motivator!!! Good luck with everything. Can you exercise outdoors? Plan walks with friends and NOT hit the pastry shop later. I despise the gym although my sister swears by it and does her exercising very early in the day.

    I want to mention also doing strength training. This tones you, makes you stronger (and able to do more cardio). Muscle burns more calories so helps with the weight loss. Plus, you look better. You might want to check out a Livestrong program at a local Y.

    Looking forward to your new hot body!!!! - Claire

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  • nihahi
    nihahi Member Posts: 3,841
    edited September 2016

    Try using something like one of the free sites like My Fitness Pal.....it tracks your exercise along with what you eat, and guides you in not just eating less but eating healthier. No program is perfect, but it is important to accept the reality that you cannot balance out high fat/sugar/calorie foods with exercise....you need to find how to adjust both, to achieve a healthier you.

    Can you find a good friend or program to help keep you "accountable"? Sometimes that gets you moving, and keeps you going when the tough days happen.

    Find the activities that you enjoy the most, not just what seems hardest....you'll stick with what you like to do better. It's important to be guided in your exercise too, if you haven't been overly active. Start slowly and build up your time and exertion....nothing derails great intentions than doing too much too quickly, and getting injured.

    Some of the hormonal therapies make it really hard to drop weight, and keep active....get guidance if you can from someone familiar with the challenges of BC "meds", perhaps there is a program with dieticians, fitness instructors through your cancer centre?

    Good luck...you can do this!

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  • Sam2U
    Sam2U Member Posts: 233
    edited September 2016

    Yes, been there done that. One of the PS I saw told me I was not a good candidate for reconstruction due to my BMI. He said I was a good candidate for weight loss surgery. I never felt comfortable with the PS, so I went on to 4 more that said the same thing. I am still fighting the BMI.

    Hopefully your journey to a lower BMI will be successful and quick!

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited September 2016

    Thank you ladies for all the feedback and great suggestions! I am eating lots of fruits, veggies and lean meats...avoiding the white stuff, when possible. I am also exercising at least 30-45 minutes a day six days a week. Tamoxifen is not my friend when it comes to weight loss for sure. I will keep plugging along and will remind myself daily how important exercise and being a healthy weight is for the fight against cancer, not to mention necessary for me to have my reconstruction. :)


    I had Fitness Pal back in the day. I am going to check it out again.

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  • nihahi
    nihahi Member Posts: 3,841
    edited September 2016

    .....You are definitely on the right track!

    I especially like your comment about recognizing the value of a healthy diet and regular exercise to your long term health.

    I recognize the emotional and physical importance of a successful recon....truly I do!! Being able to look towards a healthy, quality life beyond that point is fantastic!

    Best wishes to you 😀

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  • hanley50
    hanley50 Member Posts: 146
    edited September 2016

    Hi Wendiwithani! - Hope you don't mind if I jump in here to ask a question. How close do you have to be to your BMI or do you actually have to be in your "healthy" BMI range to have DIEP?

    Thank you in advance -

    Maryann

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  • hanley50
    hanley50 Member Posts: 146
    edited September 2016

    I should have explained why the question so you don't think I'm just being nosey! I had BMX authorized and scheduled for 06/16/16, then lost my job and my wonderful PPO insurance as of 05/31/16. Jumped on my husbands insurance effective 06/01/16 only to be told they would only authorize a UMX (STUPID HMO!) I went ahead with the UMX anyway and had a tissue expander placed. Then found out I needed radiation (was not expecting that to happen )

    This is not gonna work out and the PS basically told me so since I refused to let him fill me up all the way due to pain and having to live that way for months and months.

    I had originally wanted to go DIEP, but the PS I was seeing doesn't perform them, but since I liked him (at the time) I stayed with him and went the TE/Implant route.

    I now have a consult scheduled 10/04/16 with a highly recommended PS that does lots and lots of DIEP. I could stand to lose 50 pounds at this point (I have gained weight during all of this and my energy level stinks!)

    That's my story!

    Maryann

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited September 2016

    Thanks, Nihahi!

    Maryann, you've been through so much! Gentle hugs to you this morning.

    My PS will not perform the surgery on anyone with more than a BMI of 30. He indicated that it increases the risks of complications during and after surgery. This is not something I had ever seen mentioned in all of the reading and research I did before my consult, so I was a little taken off guard. As I stated before, I too need to lose about 50 pounds. No more excuses here. I even walked for 40 minutes last night after date night so I could get my steps in. ;)


    Hope your consult goes well. Let us know. :)

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  • toomuch
    toomuch Member Posts: 901
    edited September 2016

    Wow! Your motivation has motivated ! I have gained about 20 pounds since my bilateral S-gap procedure 5 years ago. Weight always goes to my bottom. Nobody warned me that since my boobs are now essentially my back side, they would expand significantly with weight gain! I am currently uncomfortable because of their size. I'm going to follow this thread for exercise motivation and, hopefully, I can get the size ladies back under control!

    BTW, I think that you'll be pleasantly surprised and after DIEP surgery, you'll call your breast a boob and not a foob!

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  • hanley50
    hanley50 Member Posts: 146
    edited September 2016

    Wendi - Thank you so much for the info! I just calculated my BMI (currently 33.1) and played with the numbers. I would have to lose 19 pounds to get a BMI of 29.9, or if I lost 48 pounds I could get to 24.9 (the top of what they call a "normal weight.")

    No wonder I feel like crap! lol! This is motivation for sure. Now to figure out how to get some energy to move! I think I'll start by cleaning up my eating first and see if that helps, then incorporate some gentle exercise. My sleeping patterns are all whacked out too, so I'm sure that is not helping.

    Back in November 2015 I bought a Garmin Vivofit and had synced it with My Fitness Pal. I walked and walked and walked. It was so fun and I felt GREAT! Then the world fell apart in January. I wish I could get that feeling back.

    I cannot wait for my consult! Only 3 more weeks!

    Maryann

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited September 2016

    Checking in and happy to report I am down 9 pounds so far! My weightloss/get healthy journey officially began on 9/12/16. I am using Fitness Pal faithfully, watching what I eat and exercising a minimum of 45 minutes every day...no excuses.


    Maryann, how are you? When is your consult scheduled?

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited September 2016

    Hi, everyone--I thought I would chime in here, for what it's worth. My BMI was around 29 when I had my DIEP, which is considered overweight. I eat healthy (relatively), exercise a lot, and had no problem with the surgery. I was fit and strong before the surgery, and was riding my bicycle on post-op day thirteen. Not trying to brag...just stating it was being physically active that made the difference.

    According to the charts, I would need to weigh less than I weighed when I graduated from high school to be considered "normal weight," and I find this ridiculous. If my goal was to lose that much weight, and maintain it, my life would consist of nothing but obsessing on limiting my intake to 800 calories a day and living at the gym. Nope.

    My sister was told she needed to lose 50 pounds before her surgeon would perform her DIEP. I'm so proud of her--she did it, had her surgery, and is doing great. Like me, her genetics, age, and medical history fight hard against her efforts to maintain a "normal" weight.

    Wendi and Maryann, you can do it. You're on your way.

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  • SanFranKitty
    SanFranKitty Member Posts: 145
    edited September 2016

    Wow congrats! Sounds like your hard work is paying off :)

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited September 2016

    Sbelizabeth, I hear you on the "normal weight." I haven't been a "normal weight" since I was in high school. Lol! My comfortable, size 10, weight is 165 and that is my goal. I am 5' 7" tall. I have to lose weight to be healthy...period. It is no longer an option in my life to be obese. That is crystal clear to me. I was down a total of 10 pounds this morning. That is half way to my first (surgery) goal of 20 pounds. Woo hoo!!

    SanFranKitty, thanks! :)

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited September 2016

    Wendi, you go, girl! 165 and size 10 sounds PERFECT, and you're on your way. Proud of you.

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited October 2016

    Thanks, sbelizabeth! Down 11.6 pounds today. Chugging, chugging..... :)

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  • hanley50
    hanley50 Member Posts: 146
    edited October 2016

    Wendi - WOW!! You are doing great!! You will reach your first goal in no time for sure! I love My Fitness Pal. If I may ask, what kind of food are you eating (or not eating?) You are doing so good! WOW!!

    I had consult with my new PS this week on 10/04/2016. I was very impressed. He is very different from PS#1. He went over every possible option with me and my husband and explained why they would or would not be an option and the complications that could arise from each. My radiated foob is toast so no implant for me. He will take out the expander and cut off all radiated skin and do DIEP.

    I asked about how much weight I would have to lose and he said "none if you don't want to"??? I was like "what"?? I was thinking of you when I asked the question and was suprised by his response. I'm still going to get off the 19 pounds to get to that BMI of 29.9 and I have plenty of time to do it. Since I just finished radiation on 09/26/2016 I have to wait 6 months for surgery. I have a scheduled date of 04/03/2017!!!!

    How is everyone else doing? Sam2U and toomuch?

    Wendi - you are doing great! Have you made a decision between DIEP or TRAM yet?

    Maryann

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  • debiann
    debiann Member Posts: 1,200
    edited October 2016

    Is BMI the only consideration when determining if one needs to lose weight for surgery? BMI, in my opinion, doesn't really tell the whole story. I am a teacher and one year at school we had to give out letters of concern to students having a high BMI. While some of the students getting letters were "overweight", others were very fit, muscular athletes.

    My BMI is high, due to fat, not muscle, but at the time of my DIEP it was about 29, so my PS did not express a concern. My weight was only down due to the "chemo" diet. While effective, I never want to lose weight that way again. Since ending chemo and going on Arimidex I have gained almost 20 pounds, so my BMI is again over 30. I've also lost an inch in height due to bone loss form the Arimidex, which upped the BMI even more. Its a losing battle for me.

    I just had my final revision last week, which included lipo to the side boob fat and love handles. I also got my nipples (yeah!) Going to try hard to not grow back the fat they sucked out. Made an appointment with a dietician today. Wendi, your an inspiration!

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  • hanley50
    hanley50 Member Posts: 146
    edited October 2016

    Hi debiann - My experience is no, my BMI did not come into play at all. I don't know it it is just different from the PS that I saw from the one that Wendi saw or if it has to do with the fact that with radiation, I'm running out of options.

    I know what you mean about the BMI letters sent home to parents. We get them. Two girls now 13 and 15 and they mean nothing! One is always above BMI and the other is always below BMI (no happy medium.) They are both very healthy and athletic. We always look at them and then throw them in the trash! They don't take muscle mass into account.

    How did your nipples turn out? Hope you are healing well! Are you going for tatoo's also (I think I read that on another thread?)

    Maryann

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  • ChiSandy
    ChiSandy Member Posts: 12,133
    edited October 2016

    I think BMI is a concern only due to the length of the surgery, with some surgeons reasoning that obesity makes us less cardiovascularly fit to withstand so much time under general anesthesia.

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited October 2016

    Maryann, glad your consult went well, :) I am eating mostly whole foods...no refined sugar. And I am working out every day...no excuses. My PS said that a high BMI increases the risk of infection and can hinder proper healing. The bottom line is I need to lose weight...period.


    Debian, thank you for the encouragement. Hugs to you!

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  • debiann
    debiann Member Posts: 1,200
    edited October 2016

    I don't know what the final result will be for the nipples, I just got them last week and they had a cotton covering sewn over the top of them, so there was no peeking. Today was the "reveal" and so far they are kind of weird, lol. I got both areolas and nipples, some just do nipples, I think. So far the nipples look like mis-shapen mini marshmallows. They said they will shrink down and be more like button candy. I think one is going to be bigger than the other. Eventually they should look good, but they're kind of freaky right now. I will be doing tattoos, but need to decide if I want to get the medical tats (which insurance will pay for) or tats at a local tattoo artist.

    How in the world do you get "off" sugar?

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited October 2016

    Debiann, how are the nipples? :)

    Getting off sugar is hard, but I feel so much better when I don't eat it. I used the feeling better as fuel. I am down 14 pounds as of today. Only 6 more and I get to schedule my surgery!!

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited October 2016

    Wendi, we are SO PROUD of you! Way to go, girl!

    I'm just curious--are you drinking diet sodas during this weight loss rodeo?

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  • debiann
    debiann Member Posts: 1,200
    edited October 2016

    Wendi that is great! You're almost there!

    The new nipples are still kind of funny looking. They are gradually shrinking. The areola's look wonderful. Because they were made from scar tissue, the color and texture are a bit different from my boob skin. Looks kind of natural. PS said some don't bother with the tats. I'm undecided now.

    The first week the dressing was removed they wanted me to keep a large bandage tented over the top of the nips to keep them from being flattened. The problem was the bandages were making me really itchy so I cut holes in an old bra large enough for the nips to poke through, then I adhered the bandages to the bra instead of my skin. Nurse thought that was cleaver. I was soooo itchy, necessity IS the mother of invention.

    So this week I am allowed to wear a bra again, now they actually want them to be squished a bit to help them shrink. One is definitely going to be larger than the other. They can be "trimmed" in the office, but the problem is I like the bigger one better so I don't want to trim it. Have to wait to see what the final result is I guess.

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  • Wendiwithani
    Wendiwithani Member Posts: 108
    edited December 2016

    Officially down 23 pounds and my DIEP Flap surgery has been scheduled for 2/13/17! Last Herceptin is on 1/10/17. So ready to keep moving forward and upward. :)

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  • Meow13
    Meow13 Member Posts: 4,859
    edited December 2016

    Good luck, I am so happy with my left side DIEP. My bmi was 21.5 at the time of surgery. I received a totally flat tummy. The abdomen incision line also healed very well no opening up like some horror stories I have read on this site. I would do treadmill at 3.5 for 1 hour every day lost weight with reduced caloric intake.

    I was at a good weight at my time of dx and in excellent health. I hate cancer.

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  • pabbie
    pabbie Member Posts: 370
    edited February 2017

    Thank you for the information on the BMI. I did not know this. I'm a uni., and my PS suggested a breast lift/breast reduction on my "good breast." I'm the one that e-mailed her and asked, "Would losing weight help the "good breast" to get smaller?" She said that losing weight would not help the sagging breast.


    Take care.

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  • Artista928
    Artista928 Member Posts: 2,753
    edited February 2017

    pabbie- Losing weight in my experience caused my breasts to look even more saggy.

    My BMI is like 34 so ps told me when he saw me at consult that the only route for me is implants. Thankfully this sx isn't dependent on BMI. Infection risk was cited for me as being overweight increases the risk of it. I got infected 6 weeks after my bmx w/te's place I think cuz I had drains in for 5 weeks. Most people get them out in a week or two but with all the mass that got stirred, I wasn't getting under the 30 ml max per day to get them pulled. So I was put on abx for 10 days which did nothing. Next I was hospitalized for 5 days with IV abx with the thread of losing my te's. I was more worried about that, go figure. Then sent home for a week of administering abx through my picc line.

    Had my exchange sx this past Dec and a few days later, it was looking like possible infection. PS was in Australia on vacation so pictures were sent and he felt with my history to be safe and rx'd me not 1 but 2 abx! I have to think if a ps did do the fat grafting that I'd have been in more trouble. So I didn't get my free tumm

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