NOLA in September?
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I cannot wait to get some of this extra fat off of me. Gotta wait til after march though. February will be my health month leading into my next stage 1 gap, nothing excessive or denying just try to eat more fruits and veggies
Maggie-2
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Maggie - don't forget that healing protein! Most important to the process
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I hope this is the right place to put my question. And I want to say, I live in New Orleans so if there's anything anyone needs let me know.
My surgery with Dr Sullivan is scheduled for Feb 5th. I am nervous. My current surgeon (I think he's my Oncologic surgeon??) is going to do my Mastectomy and then Dr Sullivan will do the reconstruction. I'm not feeling very confident with the billing/financial side of things at the office, did you think they knew what they're doing? Ultimately it doesn't matter but I'm nervous about how much this is going to cost at a out-of-network hospital with out-of-network surgeons. We've worked out a payment plan but still, they don't respond to my questions and the billing person was completely unprepared for our meeting to discuss the financial plan...
I am also having issues accepting the recovery. Can any of you provide your experiences? I've heard liposuction (2nd surgery) is The Worst and people who've had it say they wouldn't do it again but this is one benefit of having reconstruction!
And what about the numbness in your abdomen? How long did that last?
Yesterday I was contemplating switching from the reconstruction/tummy tuck (I'm not exactly sure which procedure I'll have, I think it's a flap) to implants and just working out and dieting extra hard to lose my stomach! Maybe it's just nerves.
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Marty-what do you mean by healing protein?
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Cherrie - from my understanding, a high protein diet is highly recommended for wound healing. I have been told this by several doctors and other medical personnel. When a friend had a problem with her abdominal incision, the wound clinic asked her to increase her protein. Many people concentrate so much on fruits/veggies that they actually do not eat enough protein from quality sources.
KKemp - while I can not comment on the billing office at the Center, I can say that from what I have heard they are pretty on top of things. I had DIEP 9 weeks ago in New Orleans with Dr. Massey and Dr Trahen. My surgery was in Covington at Fairway Medical Center because St. Charles doesn't take my insurance. I had an amazing experience. I had implants (2 sets) for 27 years. They must be replaced every 10 - 15 years and that left me with lots of scar tissue and distortion. I love my new breasts, even though we are not done yet. Very definitely worth it! Regarding numbness - that often happens with a variety of surgeries. I haven't had feeling in the back of my upper arm since my first mastectomy. You get used to it. That said, many on this thread report that they have regained sensation in various areas. We are all different. Calm those nerves! All will be well.
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Bless you, MartyJ. You're right on both counts. My Dr. wants me to have a huge amount of protein pre- and post-op. My formula was weight in kg /2. A kg is 2.2 lbs. so if you weigh 100 pounds, that's 220 kg. divided by 2 is 110 grams of protein. If you eat that much protein you won't be too hungry for much else! I'm trying to get there on shakes that have 42 grams. We'll see.
On the implant front you have personal experience but all I had to do was read the thread by the poor ladies with TE issues ...0 -
kkemp2211 - this is a great place to post questions and find support for your reconstruction journey. My experience with the billing/financial side was always professional and all aspects were covered before I even made any travel plans. I did not have any doubts that they knew what they were doing and any out of pocket costs were disclosed completely up front. Each case is handled on an individual basis and they work with your insurance company to keep your out of pocket costs to a minimum. In my case and many others, they excepted the amount my insurance company offered for out of network coverage and all I had to pay was the annual out of pocket maximum established by my insurance company.
Recovery from stage 1 depends on the type of flap surgery you have (DIEP, GAP, etc) but a typical time frame to feeling more like yourself is 4 to 6 weeks. The numbness in the abdomen can last months after the procedure but it really doesn't contribute to major discomfort. Recover from stage 2 (liposuction included) is much easier than stage 1. Although the liposuction is painful, it subsides very quickly and doesn't typically last into the second week after surgery.
Regarding implants verses flap surgery, it is a personal decision that only you can make. While recovery for implant reconstruction is much easier than flap surgery, it is not necessarily a permanent solution and may need to be redone every ten years or so. I had both types of reconstruction and after failed implants wanted a forever solution. The tummy tuck is a great benefit of flap reconstruction but isn't the only benefit. I am much happier with my DIEP breasts. They look and feel more natural. I have sensation back and that is something that was long gone with implant reconstruction. Even though it's minimal sensation, I am thrilled to be able to feel movement and temperature. I expect that as nerve endings continue to heal that the sensation will improve over time too. Also, having my pectoral muscles back on my chest wall instead of separated by implants has been really great for improved upper body strength. More importantly, everything feels normal on my chest again and I don't have that feeling of something foreign and disfigured going on. I never felt normal with implant reconstruction even though the implant breasts looked normal before they failed.
Your decision is a big one and being nervous about it is completely normal. You ultimately have to decide what is best for you because you are the only one that has to live with the decision you make. We are all here to support you no matter what decision you make on your personal journey. Welcome and best wishes to you.
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kkemp2211: With the billing/financial side of things, just make sure you know exactly what you are supposed to pay upfront....and make certain it's correct per your insurance benefits. The Center does a lot of the legwork, but like anywhere else, you can't just turn over 100% responsibility for making sure your benefits are correct to them. They are simply going by what your insurance company tells them. Last week my insurance company told Vickie that my benefits had changed effective January 1st. and that my out of pocket had increased 20%. I know for a fact that's not correct because our insurance at work doesn't renew until April. My insurance is the same today as it was in October. Had I not known that, it would have cost me almost $1,000.00. Vickie wasn't the problem, it was that she was getting incorrect information from my insurance company. My advice is know your own policy and benefits and make sure what Vickie tells you is the same as what you understand your own benefits to be.
I haven't had my second stage surgery yet...will do that February 20th, but my stage 1 recovery was every bit of the 4-6 weeks. I went back to work part time (desk job) at week 4 and full time at week 5. I'm now 11 weeks post op and my abdomen is still extremely numb. It's basically the entire bottom half of my abdomen. It's not painful and it really doesn't bother me at all, I hardly notice. I'm ok if it doesn't improve any more than it has.
Knowing everything I know now, I would make the same choice to have DIEP over and over again. My reconstructed breasts look great even at this early stage...that is what was most important to me. The tummy tuck is a nice bonus, but it certainly wasn't the deciding factor for me. I wanted soft, permanent, reconstructed breasts and diep certainly gave me that. You just have to decide what your priority is and make your decision from there.
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kkemp... very little I can add to what has already been said. In addition, people may tell you lipo is THE WORST, but it is not. It feels like you overdid it at the gym, and only lasts a few days. If you rest and stay still you will be fine and coast right through.
About insurance, no doctor that I could find with my insurance was IN network, but the Center did their magic and determined I have third party benefits, so when I showed up for surgery and they told me my bottom line, that is what I paid... no more. Some of teh stuff wasn't covered (I can see from EOB) but the doctors eat it (and continue to submit to Aetna even 18 months later). I would trust them, but as Audrella said, know your policy. I knew mine and it armed me with more information for a better conversation with Vicki.
About dieting... Since my surgery is two weeks from tomorrow, I have been advised by Laura to stop the Green coffee bean extract til surgery. BUMMER. But I will start up again on teh other side, and watch those pounds melt away. LOL
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Betsy, I was wondering whether they would have you stop. I will wait until after surgery if I do the Green Coffee Bean Extract. Do you know anyone who has tried this? I am always so leery about what I put in my body.
Thanks Marty. I have never been told about the protein healing connection. Why don't our doctors tell us these things? My normal diet tends to be high in protein, but not 110g.
Time to log onto fitnesspal. I had lunch out and hope I didn't go over. Yikes!!!0 -
KKemp, I had heard stage 2 was worse, too, but did not experience that. For me it was a much, much easier recovery with less pain, less everything. It depends on what you have done / what needs to be fixed.
I will chime in re: protein. Yes, our bodies need additional protein post operatively for healing, aka making new "parts". These parts are made from protein / amino acids which can only come from our diet. We cannot make new tissue from fat or carbohydrates, stored or consumed.
The conversion for lb to kg is 2.2 pounds per kilogram. Let's use a 100 lb person for this example: 100 lb = 45 kg. The estimated protein requirement for moderate stress is 1.4 to 1.6 gm per kg of ideal body weight (so needs are approx. 63-72 gms of protein/day); for severe stress 1.6 to 2.0 gm/kg ideal body weight (so 72-90 gm protein/day).
If you are not consuming enough calories overall, the protein you eat will be used for energy and not for healing so it is important to have a balanced diet with enough protein AND calories post op. Hope this helps! Peace to All!
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Cherrie, Sometimes doctors do not give nutrition advice because they do not get much nutrition training in medical school. There are physicians out there that take a personal interest and so have more knowledge but many just lack the background.
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Dr S's post op guidelines for diet says increasing protein will aid in healing. So they give some info, but don't really go into it unless you ask.
BTW, SCSH has Greek yogurt (high in protein) if you ask for it. Otherwise it's the regular yoplait.
Try cutting out wheat to drop some weight and belly bloat. It doesn't work for everyone, but for me the bloat goes away and I feel so much better.0 -
Jane - Great info on the protein. How do you calculate the "ideal body weght" or do you use your actual weight?
My cardiologist is one of those who goes against the grain (no pun intended) and says he believes we generally need more protein than usually recommended. But, then again, he is also board certified in holistic medicine. I love the integrative approach.
Cherrie - Since my Stage 2 is not until April 5, I will take on the role of green coffee bean guinea pig. I started this morning. I can get 8 weeks in before I plan to stop - 2 weeks before surgery. At least that is my plan. Will keep everyone posted.
Do go for the greek yogurt over the regular. The regular greek usually has at least 5 - 10 grams more protein than the non-fat greek. Amazing difference. 3 oz of smoked salmon will give you 22 grams. A quick snack if you don't eat dairy.
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Marty, Good question!
One place to find calculations for ideal body weight is calculator.net Once you see the estimates you can determine what number is best for you based on body type, energy level, and even your overall health including bloodwork. The information I am posting is general information for people in good health, close to their ideal body weight. Some folks have unique needs (including being overweight or obese) that warrant a visit to a registered dietitian. I will say that sometimes when I worked with obese clients I would use a weight that was the average of IBW and actual weight to start. I hope this answered your question without being too long winded!
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Ladies ~ so pleased to find this site. I am 7 weeks post DIEP / BPM, skin and nipple sparing. Had the honor of being treated by Drs. Sullivan and Stolier in NOLA. I have so many questions on the recovery processes. I have some asymtery - not that bad. However I have a lump in the right breast that is painful and a 2+inch area of painless hardness in the left breast. No discoloration is noticable in either. I think they are still softening up, but the painful lump has me a bit concerned. Planning stage 2 on March 15. Any recommendation on prep for it would be appreciated as I was NOT prepared for the recovery of stage 1.
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Jane - perfect explanation! Although I am slightly overweight (BMI=26), I have said many times that I need to lose 20 lbs. Because I hide it well, I get a lot of static from friends. By using the calculators, I am so happy to have some affirmation that the goal I am striving for is really within reason. I already know that I won't be emaciated at that weight as I was there only 15 years ago. I can't wait to get there!
Paula - I am so very sorry you didn't find us before your Stage 1. This has been the best support. While I am certainly not a medical professional, I will say that at 9 weeks out I do have a hard area in one breast. It was much larger at 3 weeks and is now considerably smaller. There is also a sort of ledge that is hard in the same breast. Dr. M indicated that it might be remants from the hematoma I had to have removed 2 days after Stage 1 or it might be a lack of blood supply. She said it would be taken care of at Stage 2. I think a lot of this healing is a matter of time and that is why they usually schedule a minimum of 3 months between stages.
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been trying to eat high protein since my second surgery to remove the flap per Dr M's instructions. Love greek yogurt and cottage cheese...lots of chicken and peanut butter and such...not losing weight but that's ok for now
Maggie-2
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Paula,
I had a really difficult stage 1 (body lift) recovery. I felt like the biggest wimp as I did not even start to bounce back until 6 weeks post op. I was in really good physical shape going in so was floored when I was exhausted, weepy, had minor post op issues, ugh, hard to think about. I was a mental mess because I could not do the two things that help me relieve stress: walking/hiking and soaking in my clawfoot tub.
Soccermom, Denouement, and Need2 were wonderful and checked in on me and assured me time would heal. I did not think I would go back for stage 2. I still pause to write about it as I do not want to scare anybody away from these fabulous doctors. The Center thought I had it rough because I do not tolerate meds well and I do not have a lot of stores. They also encouraged me to hang in there.
I am now nearly one year from stage 1 and nearly 3 months post stage 2 and am so very glad I had the surgeries. As Dana told me, it is tough but doable. If I can make it anyone can! Stage 2 was soooo much easier for me! Just eat right, exercise (especially walking), and if you have not already, figure out what calms you down. Peace, Tamara
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Did any of you ladies try to be sure to meet your deductible and out of pocket prior to surgery in NOLA? To time things just right for later in the year?
I did, without trying, because I had no idea I would even be having recon in 2012. My regular followups with my oncologist, prescriptions, and other docs helped. But, I was having some severe back pain, and had treated with a chiropractor.... I didn't even know I had met my out of pocket until Vickie called me.0 -
Jane - Thank you .I guess I am afraid that the larger mass in the left breast is a signicant necrosis. What do I do? I realize it is only 7 weeks post stage 1 - but I am afraid. Has anyone had significant necrosis to deal with?
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Paula, Dr. M told me that if she goes in and discovers that the hardened areas are necrosis she would remove it and use another flap to fill out the area. Not sure if this helps calm your fears, but . . .
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Paula, I also have hard spots that are sore due to necrosis and swollen tissue. Dr. D tried to correct it at Stage 2 and said it could take up to a year before we will know if they will soften. If not, he suggested a DIEP on that side if I don't want to live with it. NOT what I wanted to hear before Stage 2. Some days it feels softer, some days it is harder. I'm not going to worry about it for now.
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Oh great (eyes filling with tears again). I cannot go through more.. just can't. Stage 2 is the going to be my limit and I am anxious that I will back out of that.
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Paula_Kay.. I have... After stage I, I had a large area in left breast that was firm. Dr D said to be patient. At stage II he worked on it, and it went from being about 40% of the breast to about 20%... but in two weeks, I am having a stage IIb to remove the necrosis and replace it with a rotational flap. I had other areas that were firm and sore and stage II resolved that.
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Paula, I am afraid we are scaring you more than helping. From my understanding it gets easier and easier. You are only 7 weeks out. You will feel much different & better in a few weeks. I think that we all get to that "just can't do more stage" and then one day it doesn't seem so bad. This is all a big deal and we each process it differently. Please give yourself some time to heal and feel better. The end is definitely worth the challenges!
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Tamara,thanks for the info. I do tend to have a lot of protein and will keep doing so for this next surgery. The problem is the calories. I would love to lose a few before. I tried protein after stage 1 but I was so nauseated from meds that I came home losing 5 pounds and weak. I am now taking probiotics. Hoping this will help too.
Paula- I am 9 weeks out. I was very concerned 3 weeks ago about my hard areas too. They are somewhat smaller and softer in just the last couple of weeks. Hang in there. Dr. M said she would work on that on stage 2 and that it was common. My next surgery is Feb. 22. You will do great.0 -
Marty- my BMI is also 26 with about 20 to lose. My friends give me a hard time too. It is so much harder now that I am in menopause. I am a young 58 and 5' 2. Let me know how the green coffee bean extract works.
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Paula, I agree with Marty. At 7 weeks I could not think about stage 2. I did not really consider my next step until 4 - 6 months after stage 1. I did stage 2 eight months after stage 1 in part because I needed time to be mentally ready and to be physically strong again. I had a total hysterectomy + ooph just 3 months before my stage 1 so I was already a bit wiped out. By four months after stage 1 I was hiking big, tall mountains
and doing everything else this Idaho gal does. Once I started to feel more like myself, things improved at a good pace. My results are amazing - totally worth it. I have heard the same from every NOLA grad. Hang in there! You need more healing time! And, e-mail Laura &/or Jeanine about your hard area concern; they will tell you what you need to know and set your mind at ease - they would rather you ASK than worry. Peace, Tamara 0 -
Cherrie, You are a young looking 58! And you are welcome. Peace, Tamara (Jane)
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