Usually there are two different approaches to reconstruction if radiation is involved. If you have surgery and expanders placed immediately you can fill aggressively, sometimes slightly overfill to account for some rads shrinkage, then do radiation with the expanders either still filled to max or deflated and refilled after rads, then exchange takes place after some healing time. Usually a longer wait for exchange to allow for a better look at how the skin will behave. Herceptin is continuing during this time period as surgery is not necessarily contraindicated unless blood counts continue t be affected by Herceptin, as can happen with some patients.. The other approach is to have MX or BMX surgery, do the rads, wait a longer period of time - usually a six month minimum before beginning the recon process with expanders. Some PS will fat graft after rads and before starting TE to help the skin regain some stretch and integrity - this is a fairly new approach but is definitely helping some women do recon without the need for a lat flap surgery in addition. Some PS will try expanders after a period of healing and recovery, slow steady fills, then wait a longer period of time between last fill and exchange, all while still receiving Herceptin.

Jumpship

Go to this topic:

Topic: Bras 101: The Great Post-Exchange Debate

It should answer all your bra qurstions.

As for night time, I still sleep in a sports bra or surgicalvest. My PS recommended it to avoid the "side slide."

Coach Vicky

ladies, i forgot to ask my PS when i had an initial consult with him.do we always need to use bra after reconstruction???? i am not wearing a bra anymore due to reflux/gastric emptying issues so i just wear camisoles with built in bra as these are less constricting than a regular bra...sorry if this has been discussed before.

Suburbs- It depends on your Plastic Surgeon. In my case, I had expanders placed with my MX (which was after chemo.) I already knew Then they very quickly filled them- this was over about four weeks. I had to do a lot of PT during this time to get where I could get into position for radiation during all the surgery recovery and rapid fills. Then they deflated one side to do radiation. After radiation they refilled that side again, I think it was over two fills. Then I have to wait six months from the end of radiation to do the exchange (at least). My right side (radiation side) is larger than my left, since radiation tightens and shrinks everything. And she actually just put a bit more in each side when I saw her at the 3 month post-radiation appointment. I won't have the exchange for a couple more months.

Jumpship- Good question, you might want to ask it on the TE or Exchange thread. I've been searching for the same. The best option I've found is sleeping in a light-support sports bra. I still have my expanders in and it really hurts when they shift to the sides at night.

Hi Ladies, I have a question regarding side effects and wonder if any of you have had these...I'm not sure if it would be the Tamoxifen I'm on or the Herceptin...One is that for a long time I've had a stuffy nose that really mostly acts up at night. Stuffy and presence of excess mucous (more crusty than loose and running). The mucous is partly bloody too. I'm not sure if it's the dry air or related to treatment.

The second one is more recent and relates to a tender scalp at the root of my hair. So, if I run my fingers through my hair, I feel the sensitivity. There isn't a lot of pain at all, but I do notice it and can't figure it out as it just started up within the last two weeks. Anybody else recognize this? I'm done all treatments except for the two therapies mentioned above.

Thanks for any insights you have,

Hi PoseyGirl I'm on herceptin and yes I get stuffy a nose at night too with some blood in it. I get headaches, sinus pressure, runnung nose and tiredness also but I thought it could be from the pollen.

I have had a bloody nose on and off since starting TCHP. The past week the eye tick in one eye spread to the other. It's very very annoying and frightening as my mind goes to the worst case scenario. : (

On the tender scalp subject, yes, I have experienced the same thing. My hair was cut off weeks ago. I have spots where I am completely bald, spots where tiny bits of hair has grown back, and spots that are sensitive

Started reiki/massage therapy this week in an effort to try anything to feel better and get healthy for surgery. I had tried it during my healthy life but it was different as I really used to concentrate my minds eye on healing (like pushing your edges in a yoga pose) and it was exhausting. I would hear sounds in my ears during a therapy session like the sound you hear when you put a shell next to your ear. I always felt as if I received a benefit from reiki if my mind was completely involved. Right now I am so depleted, I simply relaxed on the tabled and tried to rest. It seemed different being in a compromised state as I could not participate. Will have to see how it goes. This is probably not the right place to discuss. I was wondering if anyone else has gone this route.

PoseyGirl- I get cold-like symptoms from Herceptin. I also have the scalp thing from time to time- will last a couple days then improve. I just finished my last herceptin so I'm curious if it will go away.

Thanks SpecialK. The therapist is certified in oncological massage among other modalities. There was no pressure applied as the session was all reiki and no massage. It was more like healing hands energy work. I'm laughing at myself as that takes a great leap of faith. I will make sure to discuss the bruising issue next time.

Good to know that I am not alone with the crazy, random and every changing eye twitches.

PoseyGirl,

I started on Aromasin and I'm still on Aromasin. Aromasin made me moody and gives me hot flashes. To cope with the moodiness, MO prescribed Celexa. I have never been a fan of SSRIs, but hormonal changes have always negatively impacted my moods. I struggled with depression during PMS and pregnancy. I figured that there was no reason to suffer from depression for ten years, so I opted for the Celexa. It's worked well. As for the hot flashes, they occur mostly after 5:00 pm. Let's just say that I sleep with the ceiling fan on.

I do not have the severe joint pain others have endured. I can still walk, run, scooter, and swim without joint pain. But, I'm not going to win any races anytime soon. Best wishes! Hope you find an AI that has few SEs for you.

posey - my MO favors Femara so that is what I started with, and the pharmacist recommended that if I try one generic brand and have too many side effects to switch brands until I find one that causes me the least side effects. Often it is the fillers and additives that cause issues - my advice would be that whichever AI you try Arimidex (anastrazole), Femara (letrozole, or Aromasin (exemestane) - try to find the generic with the fewest additional ingredients. I am taking Roxane generic letrozole and it has fewer additives than the name brand Femara from Novartis, however, Roxane just merged with another pharmaceutical company so whether or not they continue to make it is a question. It is getting a bit difficult to obtain - my local pharmacy can't get it but the mail order one can.

OK, just figured out to add the DX...I had filled everything in, but didn't see how to add it. Thanks for the heads up!

Thanks for all the input on AI's and other, ladies. I meet with my onc. tomorrow and will ask. I am thinking I'd like to stick with brand name product for now (try it); my oncologist said it's more expensive, but generally speaking it will mean fewer side effects (other than the research you've done, SpecialK).

am on 3rd TCHP and the reflux is bad that it is hard to eat. i am going to the infusion center today to get some blood work and hydration.next week, i will meet with my MO and she mentioned reducing the dose of taxotere who she thinks is causing my reflux.i am also going to have an endoscopy...is reducing a dose of a certain chemo drug the norm when it has a lot of side effects.my tumor cannot be felt anymore..honestly i dont know if i still can endure the excruciating pain of the reflux plus i cannot eat my caloric requirements because of it.hopefully, it the taxotere gets reduced, it will still be effective and side effects will be minimal particularly the reflux

Hi SpecialK, I'm Canadian and so we are covered by OHIP as well as another government program for medications that are mandatory for breast cancer treatment. There is some cost to me, but I don't believe the brand names (from what I recall from my last meeting) are stunningly expensive. But I could be wrong. I will find out today for sure! My husband and I don't have private insurance. Thanks so much.

special K,yes i have all the anti reflux meds, omeprazole,pepcid, reglan for gastric emptying ( as i also have delayed gastric emptying which complicates matters).i have sucralfate to coat my esophagus and stomach plus i have GI cocktal ( mixture of viscous lidocaine and mylanta for when the pain is unbearable).so i actually have everything. even my GI doctor said, he wiil not add anything to my regimen.my gastro specialist will scope me next week. honestly at this point i dont think i can tolerate a full dose of taxotere anymore..i will probably asked my Mo what she thinks of reducing the dose9 she did mention it).my breast lump is gone and i want to achieve pCR but i think it has come to a point that full doe of taxotere is taking a toll on me..