April 2017 Surgery

Hydrocodone makes me sleepy too, and a little dizzy and not thinking clearly. But it does help with the pain. Doctor told me today I could take naproxen sodium, which normally works pretty well, so I'm going to work on replacing part of the hydrocodone with naproxen sodium. The hydrocodone is still making laxative necessary, and my stomach is so distended that I tried to put on a pair of pant suit today to go to doctor. Normally they are so loose I don't even unbuttonthem to go to the restroom, but i could barely get them pulled up and fastened. So ... I'm looking forward to cutting back if possible.

I got my bandages off today, and that has made me more comfortable too. But I also saw myself for the first time. And I'm put together with lots of metal staples. I'm cringing thinking about having them removed. It's hard to figure how that's not going to hurt? I don't want to think about it

I've been reading the posts but haven't got around to getting on the computer myself till this morning. Surgery was on Monday 24th - BMX w/ SNX. 8 injections in Nuclear medicine for the tracing of the sentinel nodes (stung!!). My anesthesiologist gave me a pre-emptive pectoral nerve block with bupivicaine (I have no pain - bruising & some discomfort but no pain) after a bolus of ketamine followed by propofol for induction. Anesthesia was maintained using a continuous propofol drip, no gas was needed. Because I have problems with reflux at night she told me they would intubate me, otherwise that wouldn't have been done. Went very smoothly (I'm told) & only had to take the one node. Only real bump in the road was the IV hydromorphone they gave me post-op for pain (of which there was none) which got the nausea and vomiting started - went on all Monday evening and through most of Tuesday. Wed was starting to feel reasonably human again, still weak as a kitten since I really hadn't had anything to eat since Sunday night and I had spent Monday in surgery and the next 36 hours throwing up! I think if they had not given me the hydro, everything would have gone much better, but they didn't ask

Have now had one full day of eating normally again, the bowels are approaching normal as well (lots of water and for me, some metamucil worked wonders) and stopped peeing blue Wed morning. I took Tramadol/acetaminophen (one every 4-6 hours - about half what I could have had) Tuesday afternoon (once I had stopped vomiting!) & Wed a.m. then just went to Tylenol and even that I have stopped. Like I said, I'm not really in any pain so why add more opioids on top of the hydro!

And Wed night I went to my own bed instead of the recliner. I have actually been sleeping on my back, lying pretty much flat and am sleeping much better than I was in the recliner. Because I'm not painful, I can carefully roll to my right side, swing my legs over the edge and gently use my elbow to get into a sitting position without putting much strain on the chest muscles.

Drains are going well - down to 10 - 15 ml in the morning after a 9 hour sleep. And during the day I will get maybe 5 ml after 6 hours. Going to see the surgeon Monday to have them removed.

Took the binders and the gauze bandages off yesterday. I swear they use crazy glue on the tape! I thought I was going to peel the skin off! Could have done it Wed afternoon, but I think I was procrastinating. And then had a shower (instructions from the surgeon said shower is OK after 48 hours!) Even though I "knew" what to expect, it was something of an emotional shock. The extensive bruising makes it look even more dramatic. But after giving myself a good long once over, I knew I had made the right choice for the BMX. It will take some adjusting, but every time I see myself it will be less of a surprise.

I have changed from the binders they gave me to a tight compression sports bra - front zip. The binders were digging holes under my arms and were really uncomfortable. Starting to itch under everything - the bruising & the healing are progressing as expected. I have had a few little phantom "zings" - light twinges that feel like they are coming from my nipple, which isn't there any more, and in an area which is completely numb from the severed nerves. Very odd sensation!

I have been extremely fortunate. I am in no pain, the surgery went very well, my recovery (nausea not withstanding) has been excellent so far, and I am really back to being able to do pretty much what I was doing before - walking the dogs, doing dishes, everything I need to do on a daily basis, just a little slower and with a few more breaks in between.

We will have the pathology report end of next week and then detwrmine what kind of follow-up treatments may be warranted - chemo? If so, what?

Hanging in there . So sorry to see you and a number of others are really having to struggle through so much pain on top of it all. I have a pretty good tolerance but I'm not having any to tolerate. Those of you that are or did experience a lot of pain and needing the heavy narcotics..... Did your anesthesiologist give you a nerve block first? I know I was ecstatic when mine told me the protocol. I really wanted a pre-emptive block and am so glad I got one. I know what it can do to prevent pain and was asking for it from the word go. It might be a good thread to start - compare post op pain levels with and without nerve block.

Glad to hear Hanging in... That tape is a bear! If it was pinching even a little I can imagine the strain on that sensitive skin. Its sensitive there at the best of times, let alone post-op! I thought I was tearing skin off when I was removing the bandages. Can't wait to see how it feels when the doc takes it off from the incisions!

hi BG. Not doing recon and had no axillary LN involvement. So all I have to come back from is the mastectomy itself. I do think, from what I've read at least, that the TEs and the reconstruction process can be a huge issue for the recovery time, pain and complications. That is probably one reason you're having a tougher go of it. I had a very "simple" procedure compared to many and the combination of that and great preanesthetic nerve blocks is likely why it's going so well. I got lucky!

Glad you're feeling better, hanging.

They removed my dressing for the first time at my post-op appt yesterday, and like you, I realized part of my discomfort was from the tape. I wush they'd been more careful taking it off, but I didn't lose any skin and once I got out of the office, bandage-less and tape-free (except for the drains), I discovered that my omfirt level had increased. Thankful for that.

I am glad you're feeling better.

ah, maybe that explains the difference. I had a longer incision than yours from my first partial mastectomy. I always meant to measure it because it curved around, but now it's all gone. Yes, I have miles of staples now, lol. Or it feels like.

I'm glad to hear they can be painlessly removed. They are doing a great job of holding things together! I can't imagine them in the neck, but it's really encouraging to hear you didn't even feel it there.

I was concerned about what I'd heard about dog ears, and told him I wanted all breast tissue under my arm removed that he could. He had told me he wouldn't remove any of it, but he certainly did! Like I said, the incision goes onto my back on both sides and I'm hollowed out under my arms. It might not have been the right thing to ask for. I did ask him to spare all the muscle. I just hope it will all work out someday, and I do still have fat pads and weird shapes of skin in the back. I guess I had a lot of breast tissue. No fair - I was an A/barely B young woman when I i might have wanted more. After childbirth and breastfeeding I ended up wth more like D and DD, when I was getting old enough for it to cause back pain, and then finally cancer. Ah well. No more, once I heal from this. I had thought when I was considering recon to get justa b-cup.

Hi ,

I am brand new to this site. And read your posts. I to will be having surgery in April or maybe early May, but this is my third (yes 3) surgery for reconstruction. I had a bilateral mastectomy in Oct 2016. I was suppose to get gummy bears but after research and speaking with doctors we decided (really the doctors, oncology surgeon, plastic surgeon and oncologist) I received salin implants. Something about a recall on the other option a few years ago. So I took the safe road. My surgery were not so bad. I live alone and wanted peace and quite ,so I did things for myself and on my own time which I think made me think, heal and get around better. My first surgery I had friends and family around and everything was driving me crazy!! Lol. But everyone is different, that's what just works for me. My son is back home and he is a great help around the house. ...oh surgery, I took the pain pills for 3 -5 days and only once or twice a day. I didn't feel any pain after that. But I think the first 2 days is the worst and you have to get up and start moving cause you don't want to get gas pain where you think its the end of the world. My next surgery is fat transfer again (well this is the bonus part, get the fat sucked out of unwanted places) to build on my skin cause I have a very thin layer of skin and skin grafting.

I wish you all well in your surgery. Try not to worry to much. Get your home, clothing, medical items, button down shirts and remote ready and everything will turn out fine. Just remember you have a community of help and others willing to listen and hold you up!

glad you're doing well, den1, and thank you for your kind words. I appreciate prayers! And I hope this is the last cancer for me too

deni1661- how is it your reconstruction surgery is May already? My PS told me they had to wait 90 days from the first surgery to do the second for insurance purposes. Same as you, I want a DIEP flap. Anyone else have experience with the length of time between the cancer surgery and reconstruction and how soon PS will do it?

tnd22 - My PS was ready to do recon at same time as mastectomy but wanted to wait for pathology in case I need radiation or chemo. I was given multiple choices on when to do the recon and after much thought, I decided the "immediate delay" option would work best. I couldn't handle the anxiety of waiting months for another surgery and just want to get it over with. The BS said 1-2 weeks would give my body enough time to heal from the mastectomy. Since I didn't have chemo, only HP, my MO felt I was in good shape physically to do both surgeries close together. It seems each doctor or medical group has their own criteria for treatment and surgery options. I have been blessed with doctors that give me plenty of choices in addition to the standard of care. My insurance approved all my procedures so it appears there are no restrictions on timing.

Today is my third day after surgery and I feel pretty good. I am off the narcotics and taking 600mg ibuprofen every 6 hours. I am up and moving around, but not too much because I don't want to overdo it. Fluid is starting to slow down...yesterday I had 130 ml! I don't see much swelling but there are a few good bruises starting to emerge. I won't have the drain removed since I have the recon surgery soon. Overall I feel this surgery was not that bad but I expect the next one will take much longer to heal.

keep on surviving- thanks for the positive post! I'm sorry you have to go through another surgery but you sound confident and prepared. I was worried about having multiple recon surgeries so I chose the DIEP. I can appreciate your desire for peace and quiet as that is exactly what we need! However, family and friends have other plans; I know they mean well but all the phone calls, texts and asking to stop over to visit is wearing me out lol.

I pray your next surgery is a great success, take care

tnd22 - my DIEP is scheduled for May 9. I received pathology today, clear margins and only a few cancer cells in the breast tissue. So, no radiation or chemo needed which means I should be good to go for surgery next week. I am healing nicely and glad I didn't have to wait too long in between surgeries. I'm sorry you have to wait; is there any way you can ask your insurance to make an exception? 90 days seems a long time to wear the expander, mine is very uncomfortable.

Hope88 - I'm not quite 2 weeks out, but I know if I had to, I could go back to work. I also teach - college though, so my students are gone now - so right now would be pretty low intensity - taking the back-hoe to my office, tidying up the loose ends from the past semester and getting course notes ready for the fall - which I can actually do from home anyway.

I went in for a 2 hr morning faculty meeting Friday, and although I feel great (no pain, the burning/sensitivity has started but nothing I can't ignore most of the time), I agree with you about the lack of stamina. Everyone else went out for lunch, and I just ran the 2 errands I had to do in town and went home for a nap instead! We have all just been through a huge physical and emotional challenge that isn't nearly finished yet! It takes a lot of time for the body to recover from that. I find that I'm good for about 2-3 hours and then I need to sit and close my eyes. I am in the fortunate position to be able to take a full 3-4 weeks sick time - and then slide directly into my holidays if I choose. And I may just do that. I am going to try to be nice to myself whenever possible this summer.

I am not having reconstruction, but I think given how long it may take to fully get back to anything close to 100% from just the BMX, I think postponing the recon sounds like it might be a good idea. Especially since you still have rads to handle. Give you a chance to get maybe a bit of an actual break in - a proper rest & recovery - before you have to head back to the crazy of the school year. Whether the actual reconstruction surgery would be significantly easier sooner than later, I don't know. Others might have an idea on that.

But if you can, remember you will also need (and deserve!) some time to just BE - not working, not recovering, not being treated, just some you time. You've earned it. Don't want to completely burn out.

deni, good luck this week with your surgery! Hoping for the best. So happy for you that you got clear margins and didn't have to wait too long. Keep us posted