July 2017 Surgery

Hello, I've had right breast mastectomy and lymph nodes surgery on July 28th. I thought I'll be up and running by now . Please help ... Skin is still very tender on breast and under arm and armpit. Pain is manageable with one hydrocodone at night and ibuprofen during the day.

MCOlivia,

i am 3 weeks post op and still in pain. for the first two weeks, i took percocet every 6 hours.that is how bad my pain was. you are just around 1 week off...hang in there and hugs to you.

MCOlivia I too am in pain as well and I am 2 weeks post op. I met with my surgeon today and was told to take 3-4 advil every 4-6 hrs and I have tramadol for night. I was only taking 1-2 advil & that definitely was not enough. It hurts the most when I get up - the pressure is brutal.

Snowfall I am sorry about your path results & its good you will talk to your oncologist in more detail.

I discussed my path results again today with my surgeon & she agrees with my oncologist that I need radiation. She said to meet with the radiologist to get more info before I decide...which I plan on. It is just a tough decision! my tumor was 7.5 instead of 3.5 and was not completely gone from chemo although they did say they got it all out from doing the BMX so technically now i am in the clear. But they recommend radiation as another precaution for no reoccurrence. I know some of you have all heard this with your own cases as well. For me if i do rads then my PS would remove my expanders (I would prob remove both sides) then be flat during rads (which is fine). But then I would have to do the DIEP flap to reconstruct & I REALLY dont want to do that surgery. My PS said he cannot use radiated skin for the implants.

I am just really torn and upset because we really thought I would not have to do radiation & I was hoping I wouldn't have to make that decision. My dr said I have been so aggressive doing chemo & then BMX that she feels i should continue being aggressive and do rads.

I am just TIRED & ready for this to be done so I can move on with my life. I feel like I have been in a fog since my diagnosis in Dec not sure I can handle another 6 plus months and that other surgery. Has any of your PS told you that they cannot do implants after rads

Snowfall-sorry to hear the news. Neralynx was just approved ( and I'm trying to get it). There are a few other treatments. I listen to Cancercare podcasts and videos by Dr. Neil Love as well as read the Asco posts. Learning about new treatments keeps my mind busy and thinking rather than worrying. My chemo was post surgery so I don't know if it was effective.

If any of you end up with fat grafting and a revision I can report two weeks out I'm doing well. The hardest part is not wearing a sports bra because I can't compress the new fat graft. Still no vaccuming

lynae,

goodluck and keep us posted. i will see my PS in 1 week. i will ask him to put a smaller implant than TEs .i am currently 400 cc and i want to be in the low 300's or 300.i feel the 400 cc is too heavy. have a nice day to all!

Shelabela thanks for the info! Are you planning on having implants? Will you have to use skin from somewhere else? My PS said the radiated skin may not be useable but I plan to discuss again tomorrow.

I plan to start working from home next week. I am not looking forward to that as I know I am behind as well

wishing and praying that the pain and tightness will go away.... i will try to drive soon. but just near tge house..

On the topic of rads & reconstruction: I was really worried about my PS's plans to put in TEs during my BMX and expand before rads and complete the process after rads. I pasted below replies to my post about this. Maybe it'll help someone else too.

Poster SpecialK:

"The purpose of radiation is to help clear the breast area and axilla post-surgery and prevent local recurrence, and potentially distant recurrence, by killing any errant cells left behind before they have a chance to travel and set up shop elsewhere. That is why there is usually a timeline to start radiation post-surgically. Neoadjuvent chemo can cause some trouble with the radiation timeline if reconstruction is desired. The dilemma is this - hurry with expansion and risk damage by radiating the new recon, or wait and risk damaging the skin and muscle and then not being able to reconstruct with implant based recon due to that damage. Is rads being offered for the positive nodes, the tumor size or location too close to skin or chest wall, or all of those things, or is being offered as another treatment modality because you are TN? What was the size of your positive lymph node? This might dictate what type of rads is needed, specifically to the axilla and/or whole breast, and you can also ask about a shorter course of rads (Canadian Protocol), or a different radiation approach customized to your personal situation.

Radiation on reconstruction does come with risk. You may experience tightening of the skin around the implant, or the reconstructed side may sit higher on the chest. Ask both your PS and RO to delineate their experience with how many patients they have who have experienced this type of complication, and how it was handled. One of the ways some plastic surgeons mitigate this is to expand the side to be radiated slightly more to account for the potential shrinkage, so you have a better shot at evenness. Some overfill the expanders, then drain them for the duration of rads, then refill. The problem with waiting to try to expand after radiation is that the skin is less likely to stretch - thus the previous approaches. The failure rate is higher for implant based recon initiated after rads without stretching the skin beforehand - about 50%. So that figure is higher than the complication rate quoted by your PS (15-20%) when expanding prior to rads. If you decide to wait until after rads to attempt recon most PS will wait a minimum of 6 months before attempting, but I would add that post-rads implant recon success has increased with doing some fat grafting to the radiated skin prior to starting expansion and this has helped the skin to stretch and have better vascularity. I had several of these procedures over the course of a year, while having no expander or implant in place, and it made the difference in being able to proceed later with a successful recon on that side. Your recon timeline would be lengthened by fat grafting, and in general by doing post-rad recon, because of the need to let the skin/muscle heal - this is what your PS alluded to in terms of taking less time."

Another reply from Poster Sam0623:

"Regarding the impact (from rads) to your reconstruction, I also went to 2 Plastic Surgeons. One didn't seem too concerned about radiation damaging the reconstruction. He just said they would delay my implants for about 6 months to allow the skin to heal (So I would be left with tissue expanders for longer). The other PS said the same thing, but if there was damage he would have to use tissue from my back to repair it, however he also said if I delayed the reconstruction completely until after radiation he would have to use the back tissue, so he recommends placing the TEs immediately , allow patients to have the radiation and take the chance you may not have any issues and need the back tissue for repair."

The whole thread is in All Topics → Forum: Triple-Negative Breast Cancer → Topic: Questions. Too many questions & feeling pressured to commit. My original post was on June 23rd.

A life saver for my sleeping situation has been an L shaped pillow, wish I would have had it after BMX. I found it at Steinmart. So if you can imagine an L shape, I use the short part of the L under my regular pillow and the longer part of the L goes down my back and keeps me propped up a bit so I'm not flat on my back or all the way on my side. Can't quite be comfortable fully on my side yet. I used a long body pillow to do kinda the same thing after BMX but it wouldn't stay well and it was hot and kinda too big. Right after my TE surgery I used it on top of my wedge pillow, like an upside down V, and it helped to give my arm great support. The V part was under my head and the two sided were under each arm. I'm a sure this was confusing, however, the pillow was a life saver!!

Hi, I had my surgery on July 20th and have been waiting for the mammaprint results to see if I need chemo. Was just told today that they have to resend a sample because the first one wasn't useable. Has anyone else experience this? As you know the waiting is unbearable! My team feels I will not need chemo but are waiting for these results for final determination . I feel like I'm going out of my mind waiting for this test and now it could be 2 more weeks. Wondering why first one wasn't usable. My tumor was small at 1.2 can't believe there is any left from original pathology from surgery and first sample for mammaprint.

Thank you Shelabela. I hope I will hear something by next week.

I woke up this morning with more pain than I've had in a while and then I had a fill today and omg I'm in so much pain tonight. I'm only filled to 220cc after today and I won't have another fill for 2 weeks because I'm having port surgery next week. I took a Percocet for the first time in over a week. I hope I can sleep tonight!

Is anyone else having skin tenderness in the areas where the drains were?? Or any skin tenderness at all?? I am 2 week post op bmx with immediate implant placements

Ca-sunshine, so you have a bandage around the drain? My skin was a little itchy from the tagaderm that was over the drain.

Gigilala, so they have not put tissue expanders in when he did the first surgery? My PS put them in at the time of my BMX. I won't have another surgery for at least another 6 months

kae, I'm still I so much pain too. I had a fill on Tuesday and felt like I was back to a week after surgery. I extended my leave of absence from work until after my first chemo, so the plastic surgeon said he was going to do more fills with less saline since it caused me so much pain. The pain isn't just where the expanders are, it extends into my ribs, sides, armpits and sometimes is like hot knives or burning all over. He says I'm healing well though. I thougt I had a high tolerance for pain but this is awful. I keep asking my husband if this will be my new normal. I hope not!