Exchange City
Comments
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Hi Ladies,
New to this thread. I came here with a question but now want to offer a warning to Myers as well. Last Tuesday night my incision on my radiated side split open after 6 weeks. I did not know if my implant was exposed or not. We butterfly bandaged and covered it and I immediately started on Keflex, it was the antib I had from exchange surgery.
Unfortunately it was also the day an ice storm had begun in Atlanta and I could not get to the hospital or my PS. We talked and texted and I sent him pics. We thought it looked superficial. Well it wasn't. The implant was exposed. By Friday it was getting good and infected and by Saturday they took a culture and then took me to emergency surgery to remove the implant and "pressure wash" the cavity with antibiotics. They could not put in a TE or new implant because it was Saturday plus the chance of reinfection was about 100%. So now I am told that they can probably not ever go back with a TE or implant ever again. Plus, no pretty PS stitching this time, just 4 BiG, non dissolving stitches that scream " I am a lost cause" at me every time I see them.
That's my warning! Don't wait until Monday!
Now for my question.... Has anyone here ever had an implant removed for infection on a radiated breast and then been able to start over with the TE expander process and get a new implant? I had areola sparring MX and my recon was really, really nice. I don't know what's left now until these ugly stitches come out. What's left of my breast is really hard. I'm guessing it is the previously stretched muscle and alloderm getting hard?
Any help would be appreciated. I'm pretty devastated right now. This is the first time since diagnosis I feel like BC got the upper hand and was finally able to steal something from me I wasn't willing to give.
Thanks, Lynne
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Oh, my PS also said it only takes 15 minutes from exposure to be compromised. Please be careful Meyers!
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Amy - I would not wait until Monday. I would have it checked out today. I will be thinking about you.
Cheryl - I too am aware of my implants all the time. My PS said it will improve with time. They will form to my body and won't be so obvious. I hope so!
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Myers,
I agree with everyone! Most surgeons have another surgeon or partner covering them in case of an Emergency, and this is an Emergency. I would call the RN and explain the potential consequences of waiting ( and ugh hello she should be well aware of what they are!) and demand a call directly to you live from you PS or to see a partner/ on call PS immediately, as in today! I am so sorry tou are dealing with this.
Take care ..
Mimi
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4sewwhat, I'm sorry I don't know the answer to your question, just offering a word of encouragement. There have been times in my life I have felt defeated too. I just can't stand the feeling. Knowing that life will not always feel the way it does in that moment helps me. During those times, my mantra to myself is "just keep putting one foot in front of the other". In other words, I kind of force myself to just keep doing those things that must be done and move forward. Hang in there and give us the opportunity to be there for you in the way each of us has found that support here too.
cjc, my implants felt heavy and unstable after the exchange too. Despite already feeling like you are wearing a too small bra, perhaps a well fitting bra may offer the needed support to counter balance the pressure. Maybe you are already wearing a bra. If not, perhaps wearing a bra 24/7, as suggested to me here (Thank you whippetmom!), might be helpful. I had a fitting at Nordstrom with a certified fitter. I am much more comfortable, my breasts feel more stable and I look better too.
Myers I hope your issue is resolved soon too! Hugs!
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I am so sorry 4sew that would be the worse news any of us looking for a light at the end can recieve. I would def. get a 2nd opionion to see if it would be possible to get something put in there.
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I will do a second opinion if I need too! Right now I just need this f#%¥*#€ infection to clear out. I called my PS and am going in tomorrow so he can take a look at it and see what's up. Hopefully he will have something encouraging to offer.
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I just called a Dr. at Northwestern and whom I spoke to referred to a Dr. and they felt comfortable that waiting till Monday would be fine. I am on on antibiotic, it is open which is good they said so any bacteria can drain. Phew.. I feel better thanks for all the help ladies!
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Amy, I'll keep my fingers and toes crossed for you that things improve or at least hold steady until Monday. I'll have to admit, however, that it seems strange that there's not a backup PS while yours is gone for a week. Perhaps it's more common to try to save an implant than a TE, but when my PS's PA was concerned via email pix that my TE might be exposed a tiny bit I had to race 2-1/2 hours to see the backup PS. They had a surgery suite booked just in case. I ended up not having it pulled because the TE was not exposed, but it seemed to cause quite a stir on their end and they made it seem quite emergent. Please keep a good close eye on things. I wish you all the best!!!!!
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Myers, don't wait. Go to the ER. You might be able to avoid a lot of heartache, pain, expense, not to mention losing the implant. Even if you don't have an infection now, with an open wound it's likely you will. My infection did HUGE damage in only one day. By the time an antibiotic was found that would stop it after two other antibiotics failed, it was day three. Parts of three muscles were already dead, not to mention all the soft tissue under my arm and on the side of the left implant. Take it from someone who is still dealing with repercussions from that infection five months later. Go to the ER. Please don't wait. Even if they send you home, you'll know that you did what you could.
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4sewwhat,
There are many people on this forum who've had successful implants after pretty miserable first and second tries. (Moon, you want to take this?) She was successful on the 3rd try. Don't give up hope.
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myers421 doesn't your PS have someone ho covers while he's out? They usually do.
Call the office to find out ASAP! Don't let it get infected,
Babs
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Ohhh Sandra you are scaring me! the nurse from my PS's office called me back and had me come so she could look at it. She took a pic and sent to the PS, the skin around the open wound is pink/red more so than a couple of days ago. My PS will be back in town late Fri. night and wants to see me Sat. a.m. I think I will see how it is tomorrow, I don't have a fever, did your infection give you a fever Sandra?
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Amy, I wish you didn't have to wait so long to see your PS. Doesn't he have another covering for him in case of emergency?
I am four weeks out from my revision, and I'm having a lot of nerve pain. It feels like someone's rubbing sandpaper into raw skin and at times it burns. Wearing a bra is torture sometimes. I'm back on neurontin.
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He either doesn't think it's an emergency or he doesn't have someone for me to call?!? not sure, what I am sure of is that I am frustrated!!
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Hi. I've been Mia for awhile. I've just felt crappy. My BMX was on Jan 7th. My exchange surgery is scheduled for March 24th.
Is that too soon? Most women I've heard had the TE'S much longer.
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TessaW - I think the "too soon" question is really subjective. In other words how are you tolerating the fills? How well have you healed? Do you think it's too soon? Do you feel rushed? Will you have achieved your size goal by the exchange date? The dates you provided are just one week short of three months, which seems to be about average if not just a little less. It took me four months to get where I wanted to be, but it was slow going at 50CCs per visit. I was also told they needed to wait at least two weeks, maybe a month after the last fill, but my exchange was scheduled ten days later.
So every PS and their protocols seem to be different. It's all in how you feel. You're in charge...0 -
Myers, I texted my doc a pic too and from that he thought it was probably superficial. The roads here were closed or i would have been in thenER in a heart beat. I also did NOT have a fever. I didnt really feel bad either, just started getting a little stiff. I started antibiotics within minutes of it opening. It split late tuesday, seemed fine weds and thursday, was turning pink and a little sore on friday with only a drop or two of drainage and saturday i woke up with a constant flow of clear, yellowish (apple juice looking) fluid that smelled kind of like bleach and some skin looked pink some mottled purplish.
These infections develope Biofilm covering on the implant that antibiotics don't kill, therefore implants come out for months and may or may not be a reconstruction option again later from what info I can find.
I started taking Keflex tuesday and Saturday I had an IV of 600 mg clindamyacin plus they washed out the cavity with antibiotics too. I have been taking 900 mg of the clindamyacin daily and not really getting better so going in tomorrow. I used a sharpie to mark the perimeter so I could tell if it was progressing. It is. Not a lot but still too much.
The culture came back staphylococcus Haemolyticus and said it should respond to the clindamyacin. Maybe I need a higher dose or an additional antibiotic or maybe I am just not being patient enough!
Sandra! Thank you for the kind words of encouragement! Hopefully I will know what is in my doctors head tomorrow and have some idea what the future holds. He was equally as devastated. I know first we have to kick this damn infection to the curb!
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Myers,
At 6 a.m. the morning after my surgery when the docs came for their rounds, the skin on the side of the left implant and onto my underarm was already turning red. The top of the implant that I could see was puffy and a weird pale lavender color. I couldn't see the sides but the look on their faces told me it wasn't good. I had started running a fever during the night. In spite of IV antibiotics, the infection was busy taking hold in the hours after the surgery.
They changed antibiotics but the infection got worse and the fever got higher. At 24 hrs post op I had a full blown gram positive bacterial infection. The damaged continued unchecked and the fever got to 103. They started me on the antibiotic of last resort, IV Vancomycin, and my fever was gone by the morning of day three. It took two weeks of IV antibiotics, another surgery, the loss of an implant, and two MORE weeks of IV antibiotics to get to the end of that dark tunnel. Since then it's been trying to make the best of a bad situation. I'm looking forward (?) to surgery #4 next month in an ongoing attempt to fix the damage the infection caused.
Infections are BAD and can come on very quickly. If you don't have one today, and I hope you don't, an open wound is a perfect breeding ground. Why wait three days and take a chance? At least if you go to the ER they can change your antibiotic to something that might keep an infection at bay until you see your doctor.
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Tessa - all PS are different, but mine said my exchange had to be 3 months after my BMX or two months after my last fill. That does seem a little soon, but each doc is different.
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first, I want to say so sorry for those of you having problems. I want to say that you have made me more aware that I should be careful and not push to do too much too soon.
I exchanged 2 weeks ago and I think I'm over a hurdle. The pain at the sutures is gone, the arm and back pain on the right side has stopped as of this morning after hurting off and on all night. So maybe I'm over the hump? I found out I can start driving and I don't need to massage the girls because they're textured.
I hope you, 4 and Myers that things improve quickly. My exchange was 4 weeks after the last fill. He originally said 6-8, but had a cancellation so I got in early.
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TessaW - As an afterthought, I realized that I had a conversation with my PS's office manager the other day that may shed some light on your question. I had BMX on 8/20/13 and went to her office six days later to have my drains removed and began my fills. Then it was every other week up to and including 12/16/13 which was my last fill date. A couple of weeks ago I got a bill for the 12/2/13 and the 12/16/13 fill visits. It seems there is a 90 day time limit following a major surgery which I was completely unaware of... Now mind you, I never paid anything at any of these appointments as I knew by looking online she had charged and been paid for my BMX by my insurance company. and that fee apparently included all of the follow up fills. (Or so I thought.) So maybe you're in that same 90 day vortex... I hope that makes sense.
90-day Post-operative Period (major procedures)
- One day pre-operative included
- Day of the procedure is generally not payable as a separate service
- Total global period is 92 days. Count 1 day before the day of the surgery, the day of surgery, and the 90 days immediately following the day of surgery
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Amy - I checked back in here hoping to read that you had been seen after all so I breathed a sigh of relief when I read that they called you in for another look and you don't have to wait until Monday. I deleted an earlier post because I didn't want to add extra worry. I had a situation when I was having some healing issues and my PS was out of town. His PA called me at 10pm after seeing photos I sent and after consulting with my PS's partner. They wanted me there first thing the next morning and had already booked an OR just in case the TE was exposed and needed to come out. I was a little startled by how emergent it seemed to them. I wonder if your PS's nurse sent him photos and that's why she called you back in after all? So happy things are moving along so this can get healed up ASAP!
Sending good thoughts your way. Hang in there and keep us posted!
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SchoolCounselor - good luck tomorrow! Hope all goes really well for you.
Hope all recent exchanges are going well. I am 2 months out and the only difference is a few divots at the top that will likely need fat grafting. I know my PS will insist that I do, but I am scared about fat grafting from reading posts here. Is there anyone for whom fat grafting went ok and not too painful or disabling?
Love, Nisa
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Hi Tina, His nurse did send pics to him I cannot wait until Saturday!! I appreciate you deleting the post I am trying to trust my PS however reading posts here scares the heck out of me.
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Nisa thanks!!! I guess I should delete that. I lost my left TE to infection last week so the surgery is delayed for two months now ... Sigh!
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I had to wait one month for the exchange after my final fill too. Post op restrictions were: no raising arms above my shoulders for 2 weeks, no driving for 2 weeks, no lifting anything over 7 lbs. for 2 weeks. I did not have drains so I could shower right away. No massaging was advised. I did not have to wear a bra after I left the hospital. LOVE that!
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Sandra. As a former 40dd. I look forward to not wearing a bra!!!
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School...it's MARVELOUS. So, so, so glad my PS doesn't require bras after you leave the hospital unless you want to or feel better in one or plan doing something where you'll bounce around. Even then, he says only a sports bra.
Every once in a while I put one on when I'm going walking, but it's so darn uncomfortable I can't wait to get home. I recommend that all women enjoy the experience of no bra. Feels great, especially after having to wear one for the last 53 years!
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