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One step implant procedure with Alloderm - Anyone?

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Comments

  • fortunate1
    fortunate1 Member Posts: 467
    edited January 2010

    Good morning everyone.

    I am so far out from my surgery that I'm becoming less than useful. Mantra, wonderful tribute to keeping active. Shoshi, I was lucky, my pain was minimal and very manageable without drugs. But I can tell you that I massaged a lot, even the sore spots.... seemed like my hand was always up there. It was my muscle relaxer and relieved the tightness and soreness temporarily. I also moved around a lot, plus the cure-all, naps. I hope you reach the point soon, when you just plain feel better. I agree with the others.... ditch the icepack. Thinking of you.

    I have a nipple story, just a little thing..... When I got up yesterday, I saw myself in the mirror, in a little T shirt. For a while I didn't see the reconstruction. Two breasts, two nipples, completely normal. Then I saw the different shape..... but for a minute it was as if nothing had ever happened, I forgot it. Surprising and very nice.

    Meg, I salute your chiropractor. Okiegal, hope your electric service survives the storms. Carole, I love that your PS is a perfectionist, it gives you choices. NewBride, I'm happy that your doctors are working as such a team for your good. Ally, Upcreek, Wendy, AnnL, hugs all around.

    I will think of you all tonight as I weep my way through La Boheme, dressed to the nines and ready for a good catharsis. 

  • okiegal
    okiegal Member Posts: 333
    edited January 2010

    Hi all, I've been out shoveling the driveway....trying to aggravate things for the BS appointment on Monday. I'd hate to show up and have nothing to complain about! We've made it throught the worst. It stopped snowing yesterday and the electricity stayed on, thank God! We would have been dressed like Eskimos and huddled around the gas fireplace otherwise. The little tented vegetable garden looks like an elongated igloo and is being insulated by several inches of snow. I'm confindent everything will still be alive. The experiment continues!

    Ally1423, wow, that's a lot of Percocet you were taking. I could only handle 5mg doses, but the Soma didn't bother me much at all. Go figure. Guess we're all different.

    Thinking of NewBride, AnnL, Shoshi and all of you that are in the healing phase and hoping you are doing a little better each day. 

  • GrandmaMickey
    GrandmaMickey Member Posts: 4
    edited January 2010

    Would someone explain the "one step implant procedure" to me?  I'm going to UCSF, one of the top 10 cancer centers and they don't mention it on their website.  I really don't want a TRAM due to muscle cutting and the idea of months of TE being filled doesn't thrill me either.  Thanks,

  • ally1423
    ally1423 Member Posts: 183
    edited January 2010

    hi grandma.....on this thread, page 39 stonebrook1 posts a link to an animated video of the procedure....check it out.....okie...had a laugh with you trying to aggravate things....i can't believe how much percocet i was on, and it didn't even get rid of all the pain.....glad that's over with....hope the veggies survive,

  • upcreek
    upcreek Member Posts: 157
    edited January 2010

    Hi everyone:  Tx for all your stories and updates.

    I'm having friends over for dinner.  It's the first time I've felt like having company for a long time.

    You are all invited.  Steak, homemade ravioli, and other veggies of course and boston cream pie for dessert!

  • I_am_OK
    I_am_OK Member Posts: 55
    edited January 2010

    GrandmaMickey

    You may want to read these websites

    http://www.breastrecon.com/id27.html

    http://www.realself.com/AlloDerm/answers

    upcreek,

    Thank you for the invitation. I would love to come. Menu sounds so yammy.

    Enjoy the weekend, everyone!

  • NewBride
    NewBride Member Posts: 126
    edited January 2010

    GrandmaMickey,  You should be able to find 1Step in the bay area.  Possibly nipple sparing as well.  If not, PM me and I have Dr.s not  too far away.  But you may want to wait til after rads to comlplete reconstruction.  TEs may be kinder to radiated skin.

    Yesterday was such a full day for me with OC and a drop in on PS office.  Then DH took me out for sushi.  At day 10 post-op, now that I'm completely off the pain meds, my body is telling me when enough is enough.  I do seem to be kind of tired at the end of the day and generally have some soreness in the pec muscle.

    Dropped in at PS and saw his asst,  She says it all looks OK.  A little yellow (or green) exudate is normal.  The little amount of blood I've seen on the bandages is a good thing as it is a sign of blood supply to the area. Yay,  Nipple!  Still about 40cc drainage.  Rats. I really would like to lose this drain when I see PS on Mon.

    Here's the latest:  We're still in that place where we're praying that BS got it all in MX.  OC is ordering a sample of the tumor to be sent for Oncotype DX.  So chemo may be in my future.  OC says now that I'm Stage I.  Path states Bloom-Richardson Grade 2.  No rads.  Nothing to shoot at, I guess, so looks like my recon is safe for now.  No PET because PET shows areas of inflammation and of course I am still quite inflamed from surgery in the general area of interest around the lymph nodes.  I_am_OK, how soon after your surgery did you have your PET?    I would really like to have it done and may ask for it just to see what else is/is not there.  I will wait til after tumor board meeting on Tues. to see if any new opinions arise.  For what it's worth, OC says I have IDC with colloid tendencies.  Apparently it's not pure colloid but perhaps mixed.  I don't know if that is good or bad.

    Okiegal, you are a wonderful example of creative diagnostics.  I hope my OC comes up with such a great way to pin down my DX.

    Thank you all for the continued prayers and support.  It really helps to make things easier for me.

    I hope all are having a good weekend.  I know upcreek is.  Dinner sounds delicious.

    I'll be back later.

  • I_am_OK
    I_am_OK Member Posts: 55
    edited February 2010

    NewBride, glad you are healing well. Don't hurry to get rid of you drain, it will happen sooner or later. And yes, you are very lucky that you decided on MX, and now there is a very good chance that your BS got it all. About you question, I had PET scan about one month after surgery.

    I wish you best of luck!!!!!!!

  • tracyanne
    tracyanne Member Posts: 58
    edited January 2010

    New Bride, my thoughts are with you...this must still feel like a shock to you.  I knew going into surgery that my extensive DCIS, because it was so large, had presented with a lump, and was comedo w/necrosis gave me about a 30% chance of turning out to have an invasive component upon final pathology...and I felt relief but also weirdly disconcerted when the pathology came back pure DCIS--like the pathologist must have missed something.   I still wonder about it.  You got the bad news that some of us here escaped, and there is no rhyme or reason to it--there's no making sense of any of it.  It just is, and I am so sorry.   You are facing this difficult time with great courage and grace. 

    Fortunate 1, I'm following your progress on the nipple reconstruction...I'm glad you shared your anecdote about catching sight of yourself in the mirror. Soon  I'll be making my PS appt to talk about that step, but I'm not quite ready yet...am still healing from radiation and dealing with flare-ups of the mystery skin rash on arms, chest, back and legs.  Just want to feel more like my old healthy, energetic, toned self again before taking another surgery step...I've really let myself get "soft" in the five months since surgery, so am hitting the diet and the gym again.  Am learning better and better how to not let the itching, irritation of the rash get me down...how to not let it be an excuse for not exercising and doing what needs doing.

    Ladies, my thoughts are with all of you.  I check in once every week or two...this is crunch time for us 7th grade English teachers here in the state of Texas with the approach of March and April achievement tests.  Am scoring benchmark essays this weekend...27 down, only 83 to go.  Only!

    Hugs to you, New Bride...

  • NewBride
    NewBride Member Posts: 126
    edited February 2010

    Hey.  It's day 11 post-op.  Drainage is still about 40cc so I'll probably be keeping this drain for a little while longer.  Sure would be nice to quit sleeping in the recliner.  Oh well.  I did drive for the first time today.  No problem.

    Ally and Carole,  I am developing a kind of pale area on my nipple.  Did either of you experience this?  I'm kind of worried now that circulation to the nipple isn't as good as it could be.

    Okiegal,  Good luck at the BS tomorrow.  I have PS appt. tomorrow so wish me luck there.

    I_am_OK,  Thanks for the quick response with info.  I hope you're right and there is a good chance that BS got it all.  I'm really glad that your PET came back with an "all clear".

    Tracyanne,  it's nice to hear from you again.  It's  also nice that you are fully involved in a life outside of cancer.  I guess it may take me just a little longer.  At least the post-op end of things is going well.  I haven taken any pain med since about day 7 or so.

    Fortunate1,  you are always useful. ALWAYS.  I like knowing that even if I end up with a nipple reconstruction instead of my own, there will be that day when I look in the mirror and it will all still be ok.

    DH is cooking king crab legs for dinner and it is just about ready so I'm going to go for now.  I'll check back later.  I hope all of you have had a good weekend.

  • ally1423
    ally1423 Member Posts: 183
    edited February 2010

    newbride...my nipples/areolas went through some color changes and shape changes, in fact they didn't resemble my nipples/areolas until recently. yes...i think i remember a spot that didn't have any color....i'm about 9wks post op and just in the last 2wks they look "good" the way they used to.

  • NewBride
    NewBride Member Posts: 126
    edited February 2010

    Thanks,  Ally. I'll try not to worry too much.  I see PS tomorrow.   I'll keep you posted.

  • fortunate1
    fortunate1 Member Posts: 467
    edited February 2010

    Good morning all. La Boheme was beautiful (and so was I, don't you love 'dress-up'?). We had a great time. Now I'm back in my grubbies for laundry and studio cleaning.

    Hi Grandma, welcome. I hope the one-step sites have helped you. If you haven't looked at them yet, here it is in brief. In implant reconstruction, the implant goes into a pocket created under the pectoral muscle. It is usually formed by stretching the muscle gradually with tissue expanders. Then the implant is put in - a second surgery. The one-step eliminates the stretching step by cutting/releasing the muscle at the bottom and using alloderm (processed donated human tissue) sewn in to form the lower part of the pocket, kind of like a hammock. The pocket is formed at the time of the mastectomy and the implant is put in then - hence the one-step. Hope this helps. It is not a widely used method yet. You may have to search for a surgeon if you want it.

    Okiegal and NewBride, doctor visits today? Or tomorrow? Good luck, write down your questions! 

  • okiegal
    okiegal Member Posts: 333
    edited February 2010

    Here's the update....nothing to worry about. The ultrasound showed nothing. No swelling or edema eventhough I've noticed swelling in the armpit for months. Wouldn't you know? Everything is looking good when it's time for my appointment. Kinda makes me feel like a crazy person. But "nothing" is a good thing when I consider that it's not LE and there are not pockets of fluid or anything to get infected, etc. My BS called in a more senior partner. He looked me over and explained that my sensations and the swelling are normal and to do whatever I wanted physically. He said that the muscle gets pushed up into the arm pit by the implant and that he had seen this sort of thing/ heard this complaint before and said it would improve over time. Nice guy. No one had any advice about the "pins and needles", but I'll see the pain doctor in a few weeks.

  • upcreek
    upcreek Member Posts: 157
    edited February 2010

    Fortunate1:  Glad you enjoyed your evening out.

    Okiegal:  Whew, that's good news. 

    NewBride, Shoshi:  Thinking of you both....

    Hi to everyone else.

    All is well with me.  Physio now down to once a week.  Only 20 degrees more to go in my left arm.  Going back to work next week. 

  • ally1423
    ally1423 Member Posts: 183
    edited February 2010

    GREAT okie.....nothing to worry about is excellent news.....you're not crazy....think about all that was done inside, that senior bs doc made sense to me....i guess it will just take time to do everything we did before, without it causing pain, swelling, etc..now you need some answers re: the pins and needles.....fortunate1..sounds like you had a wonderful time at the opera...dress up and everything..new bride...good luck at the ps tomorrow. tracyanne...sorry you are still suffering with that rash...i guess you've tried various prescribed creams from the dermatologist. in my experience as a nurse. only derm docs can deal with that stuff effectively....bye

  • Meg9
    Meg9 Member Posts: 306
    edited February 2010

    Hello Grandma, I chose the one-step because I didn't want any additional surgery and a fast recovery. The one-step reconstruction is done at the same time as mx. My nipples were removed at the time of my bmx, but many ladies have the one-step nipple sparing mx. Ask if that is a choice for you. I was originally going to have a lumpectomy in my right breast until an MRI of both breasts found DCIS in my left breast. I often wonder why I wasn't offered nipple sparing mx?...I think it was because my BS did do nipple sparring mx!  Unfortunately, I was not well informed at the time to explore my options. My PS has been doing the one-step for 3-4 years...you should be able to find a PS in your area to consult with.

    Fortunate1, I'm glad you had a good time...you sound happy!

    Tracey, Good to hear from you....sorry you are still having rash problems.

    Okiegal, I hope you have peace of mind after todays visit. Hopefully, the pain doctor has an answer to the pins and needles.  

    I made an appointment for Thursday with my PS to try to find out what the strange feeling (poking, pulling or being stuck) is in the cleavage side of my left breast. I hope I don't chicken out before then!  Carole asked if I could explain the feeling...I'm not sure, but the area...facing a mirror... that would be 9 to 12 o'clock feels stuck. When I move about using my left arm (reaching, pulling or pushing) all muscles seem to move ok except that area of my breasts. It's like something is holding it in place. I do not experience this on my right breast. It is not always painful, but annoying. My left arm is still weak and trembles when I lift something heavy. Maybe it's related?

    NewBride, You are in my thoughts.  Shoshi, I hope your feeling better.  

    Upcreek, you are doing well! Back to work! :o)

    Ally, I am OK and Ann, you all sound like your doing well! :o)

  • NewBride
    NewBride Member Posts: 126
    edited February 2010

    Hello to all.

    Okiegal,  I'm so glad you don't have LE.  I know you will work out the answer to your pins and needles.

    Meg,  Don't chicken out.  Knowing is better than wondering.  At least you might be able to do something about it if you know what it is.  I hate that you have an ongoing concern.

    Fortunate1,  La Boheme sounds wonderful.  I also enjoy a really good live performance.  I can't wait to be where you are now.

    Which brings me to the day 12 post-op report.  Drainage continues to taper off so I will probably get rid of it when I see PS again on Fri.  That's the good news.  Yes, there is some bad news too.  My concern for my nipple was not unfounded.  PS saw it today and said "eschar" around the bottom of the areola (incision).  It may heal from the edges in but if not then it will have to go.  We're going to keep an eye on it over the next couple of weeks or so.  I guess my life is now a big bunch of wait and see.  My 1Step may even be in jeopardy.  PS does say alloderm is fairly resistant to infection.  Lets hope so.

    Tumor board meets tomorrow so maybe I'll have something positive to report on the cancer front.  I will certainly let you know as soon as I find out anything.

    I hope the rest of you are doing well.  I'll be back later.

  • Tinkerbell99
    Tinkerbell99 Member Posts: 193
    edited February 2010

    hello laides finally found out whats wrong,,,,i have a breast infection & they did a cat scan...there is fluid but they dont know from what yet....i'll know more 2morow...so for now i am in the hospital for a few days w/ IV antibitics.  They may have to remove then & do a diff kind,,,,of reconstruction, !rst we c if i am getting better @ the hospital & if so they send em home w/ antibitcics & c if it continjues to work.

    hope ur all enjoying ur day & good luck grandma w/ ue decison,,,,,if i can keep the 1 stage i will

    say a prayer 4 me ladies

  • ally1423
    ally1423 Member Posts: 183
    edited February 2010

    meg...i'm glad you made that apt.....new bride...hang in there with the nipple....mine also turned black (eschar), and i think carole had some issues with her nipples too. hoping for good news from the tumor board. shoshi,,,,,wow,,,glad you're being treated in the hospital....i'm so sorry this happened...let's hope they caught the infection in time.....bye

  • Bigapple09
    Bigapple09 Member Posts: 247
    edited February 2010

    Shoshi:

    I am so sorry about the infection. Hugs and good thoughts going your way

  • Meg9
    Meg9 Member Posts: 306
    edited February 2010

    New Bride and Shoshi, It breaks my heart to hear that you are experiencing these complications. I pray that both of you heal soon.  Shoshi, now that you know the cause of your pain hopefully you will be feeling better. New Bride, has your PS given you anything to help the nipple along?  I remember in the beginning (8 months ago)...all the uncertainty with the ever changing breasts and the feelings that came with it ....I thought just take one day at a time...I had a lot to be thankful for...family and friends who supported me...the cancer was caught early and out of me!

    I hope you all have a good day. ((((HUGS to all of you))))

  • okiegal
    okiegal Member Posts: 333
    edited February 2010

    Shoshi and NewBride, I'll join the others with good thoughts and prayers.. Shoshi, I'm glad you are being treated, but SO sorry to hear about the infection. At least you know it isn't "all in your head" and that you will be feeling better soon. Hope you can hang on to your implant! NewBride, I remembered in the shower last night....it was JulieL who used the hyperbaric chamber. Here's hoping your keep your nipple!

    Meg9, you might want to read the thread about PMPS. I think someone mentioned something about muscle weakness and nerves. Or maybe it was an article someone linked to? Never the less, there are quite a few descriptions over there. But, the best thing to do is to see your PS.

    Gramma, do lots of research about your reconstruction options, the pros and the cons. Everyone is different, but there are a lot of little details that your BS or PS may not include in their explanation. This is a good place to ask questions!

    Edited: Here's a link (http://www.cancersupportivecare.com/pbtpshandout.php) from the PMPS page to a handout about this syndrome.

  • NewBride
    NewBride Member Posts: 126
    edited February 2010

    Ally,  you're such a comfort.  I hope my PS does'nt jump the gun and get rid of my nipple unless it really does have to go.  He seems to be comfortable waiting for now.  I hope Carole drops by to share some of her experience.

    Okiegal,  you always come thru in the clutch!  Thank you .  I will proceed to JulieL and see if she's still posting here somewhere.

    Meg, PS doesnt want me back on supplements (including those that might act as blood thinners) in case I have to go back for node dissection.  I disagree and have begun to take my vitamins, gingko biloba, ginseng and even aspirin in an attempt to stimulate circulation to the nipple area.  And it may actually be working.  Nipple actually looked a little happier this morning. I feel that if node dissection really is the thing to do, I can discontinue stuff at the time I schedule surgery.  You ladies feel free to tell me that I'm nuts if you want to.  Frankly, BS doesn't sound that eager to go in and take nodes at this point and I don't think I'll try to change her mind.

    Shoshi, as always, you are in my prayers.  At least you have the blessing of being such a strong woman.  I'm sure that will go a long way towards getting you back up and around quickly.

    Well I have a small quest to pursue. Thanks again Okiegal.

    I'll be back later. I hope all are having a good day.

  • fortunate1
    fortunate1 Member Posts: 467
    edited February 2010

    Just checking in. 

    NewBride, good luck with the nipple healing. I remember the seemingly endless waits for decisions and information. It was torture, and I hope your waits are short ... with really good news.

    Okiegal-the-completely-sane, Confusing and frustrating. Of course it is veryvery good that you don't have LE, that's for sure. But where's the answer to your pain? We all want solutions to our problems. Well, I guess that if it really is just a matter of waiting for the pins and needles to subside, could be the best answer of all.

    Shoshi, hang in there, I'm so glad that they found out what the problem is. Saying a prayer for you that the infection is quickly resolved with no damage to the reconstruction.

    Meg, glad you have the appointment. I hope you get answers.

    Hugs to all. 

  • carolehalston
    carolehalston Member Posts: 8,213
    edited February 2010

    It doesn't pay to get busy and not check in!  I miss a lot of news, not all of it good.  But some of it is good.  Okiegal, I'm very glad that you don't have LE.  Also glad that you didn't lose your electricity during the recent stormy weather that hit OK.

    Shoshi, my thoughts are with you as you focus on healing.  Try to calm down and let your body fight the infection with the help of your medical treatment.  I'm looking forward to the day when you can feel happy again.  I know you are, too.

    NewBride, don't give up on that nipple.  My left nipple was purple after the surgery and didn't even look like a nipple.  The left incision was purplish red.  The NP (who was the only medical person who saw me for several weeks when I would go in for apptments) was very worried.  She had me come in every few days and somebody took pictures for the PS to look at.  The right nipple looked slightly better but it had a thin spot about the size of a dime on the aureole where the BS had shaved me too thin.  A scab formed on this round spot and eventually came off.  I didn't have scabbing on the nipples other than the one spot.  Eventually both nipples started to look normal.

    I used two different ointments during my struggle to heal.  The first one was Nitro-Bid, which is nitroglycerin ointment used by angina patients.  It causes blood to rise to the spot.  It's applied with a q-tip and covered with a little paper that comes with the tube.  The bad SE is a headache.  I used this at least a week.  Next I used silvadene, an ointment for burn patients.  It's mostly to prevent infection.  Eventually I lost the battle with healing the left incision and went back to surgery to have it trimmed and re-sutured.  After that it healed fast and that incision is nicer than the other one, which wasn't trimmed.  In retrospect, I wish I'd gone back to surgery sooner.

    Meg, please keep the apptment with the PS.  It's better to know what's going on than not to know. 

    I did a weight work-out yesterday and did an exercise with the lateral bar that you pull down.  Before BC, I could easily pull the bar down with 5 or 6 bars of weight resistance.  I used only 2 or 3 yesterday, intentionally taking it easy.  This morning I could feel some soreness and stiffness in the chest.  Even a tingling sensation, Okiegal!  So I may not continue to do that exercise. 

    Lovely day here today.  Cloudy, then sunny and up into the 60's.  Dh and I went to the driving range, then played/walked 9 holes using our nifty Sun Mountain push carts.  Then pushing WW to the back of my mind, I offered to take him to lunch.  We feasted on oyster poboys and sweet potato fries. 

    For you moviegoers among us, AVATAR was outstanding.  I loved the planet Pandora  with all the exotic flora and fauna.  The story is simplistic, good versus evil, but I bought into the plot.  I want to see PRECIOUS.  Has anyone seen it? 

    Wishing everyone a pain-free and happy evening.

  • NewBride
    NewBride Member Posts: 126
    edited February 2010

    Carole,  Thanks for the input.  I have been given Silvadene.  I wish I had been given Nitro-Bid but it didn't look like a problem until this past weekend.  I guess we'll just have to see if it heals up.  I'm certainly not giving it up without a fight.   I worked too hard to keep it in the first place.  Do you remember about how long you used the Silvadene?

    I think Breast Board is meeting even as I type this.  I hope some good answers come about as a result.  My nurse navigator will contact me tomorrow to fill me in on the details.  I will keep you all posted.

    I looked for JulieL but her last post was on this thread back in Dec.  I sent her a PM just in case.  I have a call in to a local chiropractor who does hyperbaric treatments.  Again, I don't think it will hurt me and it might help.

  • fortunate1
    fortunate1 Member Posts: 467
    edited February 2010

    Where did everybody go?  Checking back in again with nothing but normal everyday life going on for me, and hoping to see that everyone else is OK too. 

    Thinking about you, Shoshi and NewBride. Back later. 

  • upcreek
    upcreek Member Posts: 157
    edited February 2010

    I was thinking the same thing.  Nothing but normal here too.  Maybe we are all on the mend?

  • NewBride
    NewBride Member Posts: 126
    edited February 2010

    Hi.  I'm here.  Not much to report just now.  Nurse Navigator went to Breast Board and said, " No huge new treatment ideas."  However it does look like the 11 MDs in attendance agree that "It is better to overtreat than undertreat." so it may be chemo for me.  I can't help wondering if it's overkill (no pun intended).  Gosh, I don't even know if I can have chemo until this MX heals.  Nurse Navigator and I will talk later today.  I'll fill you in then.

    Nipple seems to be holding it's own.  PS appt. tomorrow so we'll see if I'm right.  Appt. with hyperbaric people tomorrow too.  I'll report my findings on that too.

    Fortunate1 and upcreek,   I love that you are having a normal day.  I hope the rest of us are too.

    Shoshi,  I'm still praying for you.  I hope it's working and we'll hear from you soon that you're OK and on the mend.

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