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Exchange City

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Comments

  • robinblessed54
    robinblessed54 Member Posts: 485
    edited April 2015

    No pain pak for EX. Had one for BMX. Not needed for EX. Tylenol w/codene for a couple if days then OTC Tylenol was enough. Hope this helps. If pocket work needs to bedone, there might be more pain.

  • kingster
    kingster Member Posts: 289
    edited April 2015

    No pain pack for either surgery, but sure could have used one after bmx! That was so painful that I think I have post traumatic stress. Exchange surgery was a relief, but I did not have any pocket work. That was thoughtful of your surgeon😃




  • Chrisrenee77
    Chrisrenee77 Member Posts: 693
    edited April 2015


    Di- I'm so sorry for your recent experience,  as someone who works in a hospital, here are a few of your patient rights. Under the Patient Bill of Rights, 1. you have the right to make decisions as far as your treatment. When demanding that they not violate your affected arm, they should have complied with that.  2. you have the right to refuse any treatment you deem not necessary.  3. You have the right to file a grievance against the hospital and anyone that comes in contact with you that went against your wishes.  If you received a patient handbook, in the handbook should be a section on how to file a grievance. I would definitely tell your PS of your dissatisfaction of his and the anesthesiologist behavior in the OR. That you feel that your " voice" was not respected and listened to. Your rights as a patient were violated and I would stand firm with your complaint. You have to be your own advocate.   I have been very fortunate that I have not had any issues with anyone going against my wishes on IV's and BP's.  I have gone as far as wearing my compression sleeve (as I have lymphedema after having only 1 node removed) into the OR.  Both my PS and anesthesiologist have  both stated that it is my choice to do that.  My nurses have always put a pink band on me that states no BP or Iv's. 

    christy

  • fe_princess
    fe_princess Member Posts: 125
    edited April 2015

    Can you tell me what a painpak is?

  • robinblessed54
    robinblessed54 Member Posts: 485
    edited April 2015

    Mine looked like a little cannon ball in a fanny pak. Two wires were placed next to drain holes that went up into pocket with TEs. The pump automatically put an anethesia drug to help with pain. It worked. It lasted 1 week and was removed with drains.



  • fe_princess
    fe_princess Member Posts: 125
    edited April 2015

    Thanks, with the MX or Exchange surgery? I hear that exchange is a lot less painful?

  • anothernycgirl
    anothernycgirl Member Posts: 821
    edited April 2015

    I hadn't heard of pain pack before.

    I used pain meds after bmx, but just tylenol after exchange.

  • robinblessed54
    robinblessed54 Member Posts: 485
    edited April 2015

    Just BMX. EX is easy

  • kingster
    kingster Member Posts: 289
    edited April 2015

    Another name for that "pain pack" is called "on Q". We used it on our patients with chest tubes for open heart surgery (sometimes). It's effective.

  • vettegirl
    vettegirl Member Posts: 136
    edited April 2015

    Well my final revision surgery has been scheduled for next week-April 30, for well over a month now.  Just got told last week that my Blue Cross Blue Shield Anthem insurance has severed ties with the hospital that all my drs work out of, where I had 5 surgeries last year.  I have spoken with everyone all week-drs office, hospital, insurance compnay multi times-very, very stressful trying to fight what cant be fought.  So-I am going to have to pay out of network to have my surgery done now.  The insurance will cover the drs part, but not the facility.  I am being quoted over $5200...so I hope it is at least not more than that.  Do I want to pay it ?  Hell no-could think of many, many other things to spend that $$ on.  But I need this surgery and want to get it over with, not out waiting in the wind while someone may or may not figure it out.  So-next Thursday I will have a very expensive surgery-getting my nipple made on my left side, getting 100ccs added to my left side for symmentry as what I hope is my final revision.  Also getting my lat flap area on my back lippoed as I have a big hump on my back.  Been one of those weeks to say the least.  I hate insurance companies.  I filed out the request for continous care and was denied as it is not a "life threatening" surgery.

  • robinblessed54
    robinblessed54 Member Posts: 485
    edited April 2015

    Hi kingster, yes in fact that is what it said on it. So weird how it is so heavy at the start and slowly gets flat. It made my comfort level great after BMX!

    How are you doing 7 weeks out? Mine are looking great! But this morning my right foob hurt at the IMF?? Maybe slept on my side?? Yours ever do that

  • mjh1
    mjh1 Member Posts: 263
    edited April 2015

    vettegirl - Was your surgery pre-approved b4 the ties were severed?  Ask your doctor to submit a utillization review appeal first.  If that doesn't work, then submit a grievance.  If that doesn't work, then submit a complaint with your state insurance depatment.  Unfotunately, sometimes you need to get to that level b4 insurance companies reverse their decision.  I feel your frustration with BCBS.  I have finally just gotten claims settled now from all my surgeries last year.  It's truly sad that we must argue with them, but don't give up yet.

  • vettegirl
    vettegirl Member Posts: 136
    edited April 2015


    Thanks mjh1-The second part where you said submit a grievance-who do I submit that to?  I am not sure if it was pre-approved or not quite honestly.  I just know we scheduled it like a month or so ago and then they contacted me last week to say we had a problem.  Apparentally-the contract was changed as of April 1...so just recently.  It just really sucks because this is the biggest hospital network in my area-so if I cant go anywhere anymore-this insurance is useless.  they probably could care less if I dropped them or not since I am a cancer patient and cost them $$.  Just a very very frustrating thing to go through. 

  • mjh1
    mjh1 Member Posts: 263
    edited April 2015


    vettegirl - how to file grievances and appeals should be listed in your EOC (evidence of coverage) booklet that you got from your insurance company.  If you misplaced yours, look on their website.  But to make life a little easier, I would ask the doctor's office to do it on your behalf.  I also found this link that may help you formulat an appeal letter.   Good luck!!

    http://healthsymphony.com/appeal_letters.htm

     

  • LoriWNY
    LoriWNY Member Posts: 178
    edited April 2015

    Pain Pak?  I wish I had known about that!  I spent four nights in the hospital after my BMX because I had never taken pain meds before and they had me so doped up that I could barely move but was still in pain.  It wasn't until day 3 that a smart nurse finally said, "we've got to get you on different meds" and that made a huge difference and was finally able to go home after night 4.  Still, I was in a lot of pain for about two weeks post BMX.  The Pain Pak sounds like it would have been an awesome solution for me since I don't tolerate narcotics well (turns out Percocet and Toradol work for me but Dilaudid makes me a zombie)!  With my first exchange (simple swap), one Percocet and then extra strength Tylenol is all I needed.  With my second exchange, which included lots of pocket work, I took Percocet for about a week with an occasional Toradol thrown in at bedtime and then switched to extra strength Tylenol alternating it with Ibuoprofen.

  • LoriWNY
    LoriWNY Member Posts: 178
    edited April 2015

    Vette--I agree that you need to start the grievance process with BCBS!  It took me several months, but I finally got them to reimburse me for post-mastectomy breast massage sessions I had to help with pectoral muscle tightness and arm discomfort/cording due to my BMX and ALND.  I have a 12-visit annual massage benefit which I had exhausted with routine massages (at least BCBS recognizes the health and wellness benefit of massage).  I started treating with a different massage therapist who was trained in post-mastectomy treatment and received several 30-minute massages which targeted the reconstructed breasts and my arm.  I paid out-of pocket for the mastectomy massages but then wrote letters to BCBS with supporting documentation citing the Women’s Health and Cancer Rights Act of 1998.  This law mandates that group health plans include coverage for “physical complications of mastectomy, including lymphedemas in a manner determined in consultation with the attending physician and the patient” [see 29 U.S. Code §1185b(a)(3)].  BCBS has agreed to reimburse me for the out-of-pocket payments (less my per visit co-pays) for the mastectomy massages.

    It is a long process and a PITA but I hope you are successful in your appeal to BCBS.



     

  • LoriWNY
    LoriWNY Member Posts: 178
    edited April 2015

    mjh1--Excellent information regarding the appeals process.  Thanks for sharing!

  • kingster
    kingster Member Posts: 289
    edited April 2015

    Hi Robin:) Too bad I forgot to ask for the "on Q". I sure could have used it. It helps in order to not use narcotics so much, and have less side effects from that. I get various pains in different areas. Sometimes at the IMF, probably from the downward weight. My left side dropped nicely, and looks fuller at the bottom now:) My right side dropped a little, but needs to go down about another inch or so. I have been working with it. It is high and a bit tilted toward the arm pit. I've been using bio oil, coconut oil, vitamin E for massage. There is a crunchy tiny hard ball area at the top of my left incision (I think it's scar tissue), and have been trying to massage that out as well. Feeling good overall. I got my pcp opinion on them at my yearly physical. She thinks that I do not need fat grafting, so that made me happy:) I think since I am right hand dominant, that my muscles are holding it up higher. Go gravity go! Glad to hear you are well. Keep wearing bras with lots of lower area support for your IMF:) All docs that I know say that it's normal to have pains for a year or longer. I am 9 months out from my bmx now, and 7 weeks out from the exchange. Keep the faith and nighty night 😉

  • sugartoes
    sugartoes Member Posts: 14
    edited April 2015

    Hello everyone! Remember me??? I am the one who HATED my new implants? YOU WERE ALL RIGHT!!!! THANK YOU FROM THE BOTTOM OF MY HEART! I listened to you all. I have been waiting for these implants to "settle in". I went to see my plastic surgeon about a month ago and I told her I was not happy and didn't like my implants and in fact, I told her I hated them and they look like I have 2 sponge bob square pants in my chest. PS said I looked terribly depressed and PS was sad I was not happy. PS said she felt the best implant that would work for me was the Mentor MemoryShape teardrop (new since October 2014, FDA approved for USA). PS also said I was very swollen still and I was not to look at myself until my next visit, May 1st. Well, you were all right. The new implants are settling in. My new boobs are SOFT AND THEY JIGGLE AND MOVE!!! I am so happy with them. It has been a complete night and day experience!!! I take my finger and push on my implant and they are super soft and I can actually poke at the implant and my finger can push into the implant a good 2 inches. Before that, when I wrote how I hated my new implants, they were hard as rocks and I am not kidding you. The implants would not move and felt harder and more uncomfortable than the expanders. Now, it has all changed!!!! The picture below is what I took on my camera phone during my last PS visit to help me mentally know what I have in my chest currently. The implant (pictured above in first photo) is what I have currently in my chest, although mine is 555cc and in this picture, it is 450cc. In the bottom right (first photo), is the expander, similar to what I had in my chest after DMX, to prepare for the implant. The bottom left (first photo) is a round implant which in a way, looks the pictured implant above. The second picture is what my implant, that I currently have, looks like in this picture when it is upright or when I stand known as the teardrop. The third picture is more of an up close shot of a Mentor MemoryShape teardrop cohesive. THANK YOU ALL!!!!!!

    image

    image

    image

  • Leslienva
    Leslienva Member Posts: 343
    edited April 2015

    Unfortunately my implant exchange didn't happen. I knew there was a chance that an infection I had developed a few months ago on the radiated side might be a problem and it was. The PS ended up cleaning out the area and replacing the expander. I ended up with two drains and no implants. She's now afraid an implant might not work due to the thinness of my skin. I will get more details when I see her on Monday since I was just coming off the anesthesia when she talked to me. Needless to say, I'm really bummed about this. I was trying to avoid DIEP or tram. I saw three surgeons before deciding on implants and all felt they would work since my radiation was 14 years ago.

  • Iwannacookie
    Iwannacookie Member Posts: 117
    edited April 2015

    Hi Ladies!

    It's been a very long time since I've posted here. I've had my TEs in longer than anticipated because my doc wanted to wait until she had more experience with the new Mentor implants. But today's the day! My exchange surgery is in about 6 hours. For some very odd reason, I feel more anxious about this surgery than I did about my double mastectomy. I think that probably has more to do with how much work I have than the nature of the surgery. I hope I'm not being unrealistic, but I haven't planned to take any time off. I have appointments on Monday, and a very full week of work. Am I crazy?

  • sugartoes
    sugartoes Member Posts: 14
    edited April 2015

    Iwannacookie - You are not crazy! I felt the same way. I was more nervous about the exchange and what type of implants to put in. I went in for exchange surgery on a Wednesday and went back to work Monday as if nothing had changed with no restrictions. I even started slowly exercising again and was vacuuming a week later. I am a medical assistant with front and back office work.

  • mjh1
    mjh1 Member Posts: 263
    edited April 2015

    sugartoes - welcome to the squishy side.  Glad you love your new girls.

    leslie - sorry to hear about your complication.  Why does your PS now feel that an implant won't work when she originally told you it would?  Your skin could not have gotten any thinner since the consult you had.  Maybe, ask her if FG would help.

    Iwanna - good luck with your exchange.  I hope your new girls will be all you dreamed of.  Personally, I think that's a little too soon to be going back to work.  Although you may feel great, I wish you would take a couple of extra days and let your body heal more.

  • thinkingpositive
    thinkingpositive Member Posts: 564
    edited April 2015

    So I have my appointment scheduled with PS for next week to discuss exchange to implant and also possible lift/reduction of the other breast. If Anyone can share what I should be asking or what I need to know, it would be greatly appreciated. Also looking at some point to have ovaries removed, I have had a cyst on one for many years, its time to come out. Would you do it at the same time?? Or wait?? I procrastinate...took me a month to schedule the appointment to discuss exchange after my last fill.

  • momwriter
    momwriter Member Posts: 276
    edited April 2015

    Leslie- sorry exchange didn't happen. That's so frustrating- you'd think after 14 years it would be fine. I just had my exchange on the radiated side. My TE was in for 1.75 years. I had my exchange 2 weeks ago. My radiated skin was a bit thin, but he did put in a smaller implant than the TE (for symmetry reasons) which he thought helped. So far all seems to be healing well. I'm wishing you luck and sending healing thoughts. Perhaps go to second opinion before decide on DIEP? Sending healing vibes!

    Iwanna- good luck! Rest up over the weekend, take your tylenol, and you will probably be fine.

    Vettegirl- hope you can solve your insurance woes- so unfair and stressful


  • robinblessed54
    robinblessed54 Member Posts: 485
    edited April 2015

    I agree that is much too soon. Ex is easier, but besides your external incision, you are healing inside too. Your pectoral muscles need the chance to "adhere) to the implant. I was bound in a surgical bra and ace bandage for a week. I went back after two weeks but work for a school and were on spring break. But I think at least a week off. Pray all goes wel

  • momwriter
    momwriter Member Posts: 276
    edited April 2015

    Think Pos- I have this odd trust in my PS- I think he's an artist/scientist so I don't even know what kind of implants he put in me. But, the one thing he is not so good at is overseeing ROM recovery. I think he's so worried about me messing up his work he doesn't want me to do anything for a while. So if I did it again, I would ask about ROM exercises. I found some online which I did (shoulder shrugs, and rolls, etc).

    Also, I would ask them to take care with the ALND arm during surgery- mine was really achy afterwards- they need a reminder that it's compromised because of the ALND. (though they did give me a sleeve-cover so they wouldn't forget during surgery).

    I haven't had ovaries out so don't know anything about that. It might be a lot for your body all at once, but then you'd get to avoid two anesthesias.

    Good luck!

  • Leslienva
    Leslienva Member Posts: 343
    edited April 2015

    I will definitely get a second or third opinion before going with a tram or DIEP. I'm not sure why the skin being thin wasn't addressed earlier. I'm not even trying to get large implants. I would be happy with a B cup. I'll know more when I discuss it with her on Monday. I hope she can remove these darn drains..

  • Iwannacookie
    Iwannacookie Member Posts: 117
    edited April 2015

    Well--odd thing happened to me yesterday morning before my exchange surgery. Before I took a shower, I noticed that my right breast looked strange--like it had changed shape and/or volume. After my shower I put my robe back on with out looking at myself. But when I changed into my regular clothing--OMG! my right breast was disappearing! It was such a frightful sight. I had obviously sprung a leak and it reminded me of what it looked like before I had any fills in my TE. Needless to say, this did not help my anxiety.

    But I'm happy to report that a couple of mg Ativan took the edge right off, and surgery went fine. I was disappointed when my surgeon told me she ended up having to use smaller implants that we had planned for. I had actually been putting off my surgery just so she could use a larger implant, and I still ended up with little boobies. Alas--I was tiny-chested before anyway. I do have drains on both sides = a big bummer. She sent me home with Percocet for pain, but I only used Motrin last night, and plan to keep it that way.

    I don't foresee any problem getting back to work on Monday.But I keep asking myself--could this really be over? Smile

    Much love to you all!


  • Leslienva
    Leslienva Member Posts: 343
    edited April 2015

    Iwannacookie, I was told not to take Motrin because it can cause bleeding. Tylenol does nothing for me. I'd much rather take Motrin. Was that okay with your PS? Do you know how long the drains will be in

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