NOLA in September?
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Melanie.. Dr D and his nurses gave me the neosporin for the drain sites and encouraged me to use it, only there though... They said it would help with any drain site discomfort as well as it has a numbing agent. Putting ointment on any incision is a no no, and I know first hand how an incision can open if it is too moist. My right breast had blisters and they had me putting ointment on the blisters, but it must have gotten on the incision (as they were next to each other) and then low and behold my incision opened... So be very careful... A little dab will do ya.
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Thank you Spring for adding my date.
Quick question for other ladies who had stage 2b and so on. I need to use the minimal amount of time for travel. I could have swore Jeanine said I could fly in Thursday morning and have my pre-op stuff done Thursday afternoon and then surgery Friday. I spoke with Katie yesterday and she said I should come in on Wednesday. I was thinking since I only needed to meet with Dr. D and the hospital for pre-op stuff, that Thursday afternoon would work. Did anyone fly in the day of their pre-op for stage 2b,c,?0 -
I flew in early... had my pre-op on Monday for Wednesday surgery... The appt with Dr D was about 2 hours, and they neglected to tell me I was supposed to go over to the hospital, so I missed that. Oops. So just did all that paperwork the morning of. I would say you can definitely fit it in in the afternoon. My 2 cents.
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Thank you Betsy, that's what I was thinking. I know I have time to get details, but for applying for time off, I wasn't taking Wednesday off for travel.
Ok, I am on HRT....my new GYN won't call anymore in until he see's me for an appointment. I have my appt today, but I got the call Tuesday (automated message) confirming my appointment for a well woman visit and if it was anything other than that, I need to reschedule. I confirmed the appointment, but got to thinking....What is he going to examine? I have no uterus, no ovaries, no cervix and no breasts. So, I called yesterday to speak to the nurse about it, so I would have an idea what to expect. She had no clue...lol I completely stumped her. They don't have any other patients like me that don't have any of their female parts...really? Granted, it's just your typical OBGYN, but it leaves me feeling odd.
I am BRCA2+ and my surgery was supposed to be prophylactic, but the pathology confirmed beginning stages of DCIS. Should I be seeing a different type of doctor? I will go to this appointment cause I need the prescription, but I am just curious what others think.
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Wow -- you must be so relieved with your decision to have PBMX, Chelle. I had DCIS and I can't find an oncologist to follow me since I had BMX. I did establish contact with an oncologist and he examined my breasts, which made me feel better since my PS is on the other side of the country. He also let me know to come see him if I start having any unexplained pain.
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Chelle- They may still want to do a pap smear on the vaginal vault, to check for dysplasia. Mine also does "breast exam", but I assume she's feeling the chest wall in particular. And you probably want to establish a relationship with a gyn for HRT, vs. going to an oncologist. Oncs don't usually want to spend time on well-woman/QOL issues.
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Yes, I am SO grateful I had the surgery when I did and that I decided to have surgery and not just do extra surveillance. I had an MRI the November before my surgery and it didn't detect anything.
I thought about that, but I believe the occurance of that after a complete hysterectomy was really low, but I could be wrong. He is supposed to be very knowledgable about BRCA, so I guess I will see. I guess he will take blood and hopefully check my hormone levels. I just like to know what to expect when I go to the doctor and thought I was done with the "stirrup" visits....lol
Then knowing they didn't have any other patients like me threw me for a loop
I did tell the nurse what kind of reconstruction I had and she said OMG...they do that now? I offered her a sneak peak while I am there :0
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Chelle--I'm high risk too, BRCA1. Had total hysterectomy. I think doing vaginal paps after hysterect is standard for the doctors I go to, and they seem to follow the same screening guidelines as cervical screenings, i.e., if you haven't had an abnormal pap ever or in a long time you can just be screened occasionally. I may go back to a high-risk/BRCA specialist, just to keep current on screening improvements, but otherwise I'll keep going to a regular gyn and do whatever they're able to offer me. Which at this point is mostly QOL and paps. Oh, and the ever-critical estrogen prescription
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Chelle & Brenda - I had complete hysterectomy in 95 and have been on HRT since. My MX were in 1985 (estrogen neg). Over the past years, different gyn have had different ideas re PAP. Heck, they often thought I should still get a squishy mammo (talk about an implant pop risk). The gyn I go to now is a specialist in bio-identical hrt. We spoke at length about pap and she indicated that it really wasn't necessary. When I see her we chat about hormones and she gets to ooooo and ahhh about my new boobs = well woman check-up.
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Marty, I added your date.
Cherrie, I really really really suggest you do NOT do the plication! (esp. if you want to be ok 2 weeks after!). My 2 Cents! (wish I never did it, huge recovery for me, years, literally).
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Beverly, what problems did you encounter from the plication? Mine was 2 weeks ago. Not sure what to watch out for.
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Chelle... I DO suggest you find a MO (medical Oncologist). Since you ended up with DCIS, I would. Just get your pathology report and call someone who you have heard is good. They may only choose to see you 2 times a year, but its better than nothing. In addition, I am seeing a breast surgeon 2 times a year now for her to exam my nodes and surface area. She said after two years, I can come once a year. Its just my 2 cents... And MO also gives an exam, but might also get baseline blood work etc. Better safe than sorry.
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Spring- I am assuming that a plication and scar lowering are two different things. My doctor has never mentioned plication. How is that different from scar lowering and what sort of problems did you have? I am planning a Hooha lift. Does that have anything to do with plication? Sorry for all of these questions, but I am nervous about this surgery.
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OK, I need some encouragement here. I met with the local plastic surgeon who agreed to help me if I needed care after the surgery today. I tried to get in with another PS who had reputation for great bedside manner, but could not get past her front office staff for an appointment. I emailed this doctor and basically was like, I'm doing this surgery, I'm a patient at VCU (cancer center where I have done LOTS of business), and you lost all your DIEP surgeons -- can you do this for me. She said yes she would do it.
So she told me today that she made a stop at the center when she was in town for a plastic surgeon convention recently (this between our phone call and our meeting today). It was after 5 PM, and she said there were no doctors there. She asked about what happens if there is a complication, and they said they have transfer plans with 2 local hospitals Jefferson and one other hospital. She said that they said that almost never happens, but it was a much different environment than she was used to working in and this is major surgery.
But on the other hand while she does not like it she felt an obligation to help me since I did live in Richmond and was a patient at VCU, and felt better about me establishing care beforehand than when another patient asked her to take her on after she did surgery at Mayo clinic. She explained if I did surgery there the aftercare would be covered by the surgery cost, but that I would need to pay a copay.
I told her i understood, and I felt better I had someone to go to if there were complications like fluid that needs to be drained or infection, and didn't want to have to manage that by going to the ER. I think I impressed her slightly by knowing what the possible complications could be.
She did say that if VCU had a microsurgeon, which she is actively recruiting, that she would really be trying to twist my arm not to do this. She said that this center was trained on the latest techniques by Dr. Allen from LSU, who no longer works there. Now why do I not know about this Dr. Allen? Anyway, so I think she respected what they do there, but was not comfortable with the surgery center because it is not a hospital.
I left feeling all sorts of anxiety. It's not going to change my plans, but it doesn't make me all warm and fuzzy either.
Anyone know what that other hospital is that they transfer patients to? I want to see if one of them is an Anthem/ BCBS provider.
I told her that I did not expect her to research this hospital so thouroghly (on site visit!) and I appreciated her agreeing to help me. Her visit wasn't just for me, she is recruiting, but still.
OK, now tell me how I am going to be OK? What happens if you are in pain and need more pain medication, or the meds you have aren't working, or can't sleep. Are you basically on your own with the nurses, but no one is there to write orders for you? Is the doctor on call?
I'm still going but would like to feel better about it than I do right now.
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Marsha, the doctors stop by everyday. I was at Fairway Surgical Center and Dr. S lives closest to there so he stopped by to see me each day I was there. Dr. Massey was my primary doctor. Those nurses are great and your care will be top notch.
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Marsha = whew! I am a little confused, but let me say this to see if it helps. The flap techniques were developed by several doctors across the US, one of whom was Dr. Robert Allen. Dr. Allen was at LSU at the time. He left after Katrina and returned to SC (where he went to Med school). Dr. Sullivan and Dr. Dellacrocce at the Breast Center in NOLA were trained by Allen and have continued improving and perfecting his techniques, adding to the available procedures. Dr. Kline & Craige in Charleston also trained with Allen. Allen now operates in SC, NYC and LA.
The big plastic surgery conference was in NOLA last year. Two of the docs at the Breast Center live in NOLA and two on the North Shore. I am a patient of Dr. Massey and had a complication on a Sunday morning. Dr. Trahan was right there (I was in Fairway Hosp on the North Shore) and it only took her 45 min to get there - I was under anesthesia as she arrived.
St Charles Surg Hosp is a very special place dedicated to people like us (wish my ins would have paid for it, but Fairway was great). There will not be a problem getting a doctor if one is needed. Pain meds are all on record and the nurses are specially trained to deal with flap patients. Believe me, they will see a problem before almost any other nurse will recognize it because of how many they work with. I do not believe that there would be any reason to transfer you to anyother hospital as SCSH is a fully accredited private hospital. I hate that she made you feel as if it is a lesser institution. I actually prefer the concept as well people are going there for specific procedures, not sick people.
I certainly understand your concerns. We all have traveled for this surgery. My helper doctor was my gyn. She knew up front that if there was a problem it would fall to her to find the right person to assist. She was fully prepared and it didn't become an ego thing as it might have with another plastic surgeon. I am just saying that maybe expanding your options beyond the PS world might land you with a much more supportive helper.
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Marsha it is a law that when you are in the hospital some dr. Has to see you each day. Dr. Sullivan saw me 2 times and 1 day Laura came and saw me:) Sorry she made you feel that way ,the experience I had at Fairway hospital was top notch!! Everything was from start to finish!
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Chelle called me and made me feel MUCH better. Thanks, I'm feeling good again.
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Marsha... I agree with Marty.. There is no better place to have this surgery. Plus there are PAs (Laura) who seems to live right there and make rounds often. I do know of one woman who had a lung issue and was transferred to Jefferson Memorial Hospital... but there is also Tulane and Oschner right there. This would be if you had a problem other than the flap surgery. It almost never happens. But they have that option so you know you are well taken care of.
About Dr Allen... I have met with him, and am super glad I did not use him. He may have trained the other doctors, but he has not continued with innovation like they have. He proposed a couple of things, that looking back, I am so glad I didn't bite. A) He said I had enough abdominal fat for two breasts because he would ask his breast surgeon to retain breast fat, so he wouldn't have to harvest as much. WTF? and
Said I didn't and wouldn't need a stage II... and when I asked him about transitioning my love handles, he said, "you can go to the gym." What? He of all people should know one can't target a specific fatty area at the gym.These are just 2 examples why I did not go with him. So your doctor at home may think he is the be all and end all, but I have a different opinion... and traveled across the country to get the best.
And last, about having a helper doctor at home... Its nice to know someone is there, but to be honest, the NOLA docs can resolve a lot through photos, email and phone. And if it gets too harried, they will fly you back to them on their dime. This is fact. It happened to me. So fear not.
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Yes Betsy:) I had asked that question! If something happens to me at home and can't be fixed will they pay to fly me back and they answered yes without hesitation:)
I'm glad chelle made you feel better Marsha:)0 -
Marsha I am so glad I helped you and made you feel better. As I said, my heart went out to you when I saw your post. Your doc just painted the wrong picture for you. You are in the best hands before, during and after!!!
As the others have confirmed, you are not alone...promise!!!!
I'm always here :-)
Hugs to you!!!
Chelle0 -
I did not have a helper doctor set up. I didn't even discuss things with my breast surgeon directly; I just told the scheduler I'm going to NOLA! I did not need any local help after Stage 1 or 2b. After 2a I developed a seroma in my breast that needed aspiration a few times. One of the NOLA nurses got things set up with the radiologist at my Breast Center, where I got all my screenings and treatment. It was not a problem for them to aspirate. I pulled my own drains and snipped a suture or two after direction from someone in NOLA. I felt comfort in keeping close contact with NOLA and did not feel compelled to have a doctor here monitor.
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Thanks all who commented.
Bdavis--definitely I will start with Nola docs for everything. It is great to know they will fly me back if it goes wrong. Also good to know someone can see me if I need fluid drained. As always you have the 411.
MartyJ -- there actually was a plastic surgery conference between when I emailed her and when I met with her that was in new orleans last week. http://meeting.aaps1921.org. So I believe she visited there but they might not have offered her a tour.0 -
Marsha, I have sent my doctor (Massey) photos when there was a concern and she responded very quickly. It turned out to be nothing and she could see that from the photos. I felt I had excellent care and am moving on to a 2b in two weeks.
Both the Center and Fairway had a zero infection rate as opposed to some larger hospitals. That thrilled me. My care while in the hospital was top notch for sure. You can't go wrong with any of these docs. My doctor does all stage 2's in Nola, Charleston, and Chicago, but stage 1 in NOLA.
Good luck with your decision.0 -
Motherandchild- I had the beginnings of a sore throat right before I left. I also took zinc and was ok the day before and the day of surgery. I spiked a high temp the second day after surgery and when I went for my post op appt I was 101.7. I was just glad the fever happened after the surgery otherwise they would have sent me home. Hopefully you will be good to go.
With regard to the other question you asked me, yes it is possible, but it did take more effort.
I had my breast surgeon (who had only consulted and did nothing else) agree to be there in case I had an infection or problem with the drains. As it was my husband pulled my drains and I had no complications but it was reassuring to know there would be someone I could go to at home if I had any problems. I was too embarrassed to ask any of the three plastic surgeons I saw but did not use.
I am brca positive and I intend to see the breast surgeon twice a year for check ups. My gyn/onc takes care of the other thing. Even though I had a full hysterectomy due to ovca, I think once a year he does a pap. Probably not a bad idea because even in the face of a preventative hysterectomy there is a very very small chance of primary peritoneal carcinoma so follow up with gyn is still needed.
FYI happy to say that appt today with oncologist all is still good. Thank G-d! 3.5 years.0 -
I don't know what a Hooha lift is, what is that?? Someone educate me!
I had my abdominal scar lowered, it was way too high. That is totally different than plication. I am very glad I had the scar lowered.
Plication is internal to the ab muscles, like a corsette. It is a huge thing to do recovery-wise. I have another friend who has had constant issues with stomach cramps from plication. I recently had a very bad cold with lots of coughing, and I was also getting abdominal cramps. I typically don't have that issue otherwise.
To me, it is only worth it if your doc says you'd get a significant cosmetic result, and you're willing to have a long recovery. The recovery was over 2 years, lots of bloating, pain, reduced activity, abdoinal tightness. NOT worth it for me as I am typically very active, yoga, exercise. Others may have a different view, but this was my experience.
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Oh so sorry about the worry. I have always called for every little thing, sometimes the nurse, sometimes Laura (the pa), sometimes the doctor on call. I have emailed videos and photos and messages. And I have always felt well-cared for. Always. Laura totally walked the surgeon here through draining the seroma over the phone. She was wonderful. And I could never have gone anywhere else after seeing the results from NOLA. So it was a trade I knew I had to make. Had no problems at all stage 1 or 2. Had a small seroma this time. I love the surgical center! Way way better than your typical hospital.
So here is the follow up regimen I have as a BRCA 2+. Every year, I see a breast doctor, a hormone doctor, a dermatologist, and a cardiologist. The card. Is due to high risk for that in the family, the other three are for the BRCA. Breast doctor does exam. Hormone doctor gives script for vivelle and does pelvic every few years, derm does a full body exam yearly. Card does a bunch of other stuff. Just had my second post-mastectomy checkup last week and this is way way better than six month vaginal ultrasounds that show something suspicious sonnet another in six weeks along with an MRI or mammogram. Not having to do all that was wonderful!0 -
I agree with what everyone has said about the hospital and doctors in NOLA. I didn't have any appointments with any other PS. The Doctors and Hospital in NOLA were my first choice for having this surgery and traveling for me was so much out of my comfort zone. But I took the leap and I don't regret it.
As for doctors caring about you. Mine delivered a different antibiotic and anti nausea medicine to me at the Hope Lodge, this is where I stayed after my surgery. This is after being sick the night before, next morning I called the hospital and they contacted my doctor. I have also emailed Laura several times since getting back home and she has responded very quickly and always says if I have any more questions just let her know.0 -
Kbodie, what is the connection with the dermatologist. You look like you are dark haired, are you fair skinned as well? I ask, because my BRCA came back negative, but I have fair skin, redhair by birth, and green eyes. Father has multi melanomas (he and my brothers all take after his skin and hair). Does BRCA 2+ have factors with skin cancer as well?
I was confused by the word plication as well. But I believe I had it when I had a tummy tuck after having very large babies and insurance paid 100% due to medical necessity and them banding my muscles together....but that 1991 - is that the same thing, Spring?? Hurt like dickens healing, but was younger then!!! LOL
Still confused on houha lift though! or is that TMI?0 -
Goodie, also maybe a reason all non BC patients would assume one operation is all we need is because they are focusing on the cancer part - and WISHING us one operation. They haven't done the research, both about different options, Drs, and info about what our bodies (remember each of us are different, while one may want and embrace implants, I knew they weren't for me) needs. EVERY time anyone asks when my next surgery date is they also ask if this is the last one! Good grief!!! They still have the mindset you can capture a murderer in a one hour show, you can transplant a heart and have an affair in a one hour show, and they must imagine you can create a real feeling, perfect set of breasts from a breast cancer patient in a one shot deal! LOL!!!! So glad you found BCO so you could communicate with REAL people!!!
Hugs
Catie0
