Nipple Sparing Mastectomy with immediate reconstruction
Comments
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PB, They haven't given her a mentor booklet. I went to the PS's web site and it is memory gel, silicone implants. Which doctors in Palm Beach county did you use?
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sweetie and fairport- Appointment went really well today. The lump was just an inflamed stitch. I got all of my stitches removed today and she just wants me to put antibiotic ointment on it until it heals. My PS said things look good and she still wants to use me for her "poster child"! I thought this would be my last appointment with her but she said she wants to see me in 1 month, then 3 months, then 6 months and then a year! After that I'm done.
Delray- My PS said most implants last 15-20 years. If you have implants as a result of BC and reconstruction then insurance has to cover the costs of replacements even if it's 20 years down the road. I have Mentor implants and the implants, themselves, have a lifetime guarantee. It states that if you have a confirmed rupture you are eligible for up to two replacement breast implants of any size in a similar style at no charge. (That wouldn't count doctor/surgical costs but that's where your insurance steps in.)
There is also an additional 10 year warranty. The warranty pays up to $3500.00 for operating room, anesthesia and surgical charges not covered by insurance and only applies to implants after 5/01/09. There is no additional charge for these warranties.
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Kate, The information you provided is a tremendous relief. Thank you so much.
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Thanks Kate, I didn't even know all that. Did you have to send in any registration?
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My PS gave me the form when they gave me my I.D. cards for the implants. You can either register online or mail it in.
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Wow Kate thanks! I am getting Mentor Mod. plus. I had no idea about that!
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Thanks Kate, I attempted to register and it said it already had a registration in so either I did it and forgot or my PS office did. I needed the reminder of the warrenty and what it covers.
Welcome MIstyj
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Kate: Yay! So glad it went well !!!!
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Delray: I had my PS appointment today and they said at the front desk the billing code here is the same for this procedure. I don't know if they have the option to bill additional if they send in documentation of additional time required or what. I know I didn't have to pay anything additional though.
Kate: Glad your appointment went great!
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OK,How many NSM sisters had to take Tamox? or Arimidex?
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whitedove-I had IDC and a NSM, I am just starting Tamox.
Kate33-glad to hear your stitches are out. Poster child, that's a good thing!
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Kate, so glad it was an inflamed stitch and they are out! Hurray!! You pretty little poster girl, you.
.White dove, I had IDC first, and 5 years of tamoxifen with a lumpectomy. I had a second primary once I got off the tamoxifen one year later, went w a mtxmy, and am on arimidex. NO problems with tamoxifen at all, but have noticed stiff joints, and weaker legs on the arimidex. Oh well.
Interesting thread.....I wonder how many bilats get to take nothing. I do know many ladies w bi lats that are on arimidex, or tamoxifen tho. as those drugs are given to prevent it occurring anywhere else in case some stray cell escaped (doubtful) my onc likened it to shooting a fly with a bazooka, but it's a deadly fly, and they are the drugs that they have. Still, with only a 1% chance if you get a bi lat, those are wonderful odds. Some women, based on their diagnoses, have opted out of the drugs.
love to all
annie
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Whitedove: arimidex here. There are alot of threads on this so possible rephrase yours to give it a new spin of say "Any post bmx who are not taking hormonal therapy" something like that. Also you would want to determine if they had DCIS or IDC. My guess would be anyone with an invasive component is going on hormonal tx and the DCISs would have more of an option as what annie was saying. Whitedove, its like you think it ends with the bmx and then theres more tx/SE's.
annie like the deadly fly reference.
Something I recently learned while researching antiaging is and that doesn't belong on this thread but......many bodybuilder/strength training men who are taking test0sterone take arimidex. The arimidex prevents the supplemental testosterone from converting to estrogen so they dont have the estrogen effects of water retention, fat stores etc. How bout that.
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Colorado, Thanks for checking with your PS, Its the GS who wants the additional money. Its my understanding PB used the same GS and wasn't hit up. So I don't understand what's going on.
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PB, I read you are a Registered Dietitian/Nutritionist. Should my friend be doing anything special pre or post surgery in addition to the multi with calcium, Omega-3&6 Fish Oil 1000 mg, D-3 400 IU, C 500 mg? She plans on calling you this weekend.
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whitedove - i take arimidex
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anniealso-here's what my oncologist told me- my risk factor after bilateral is 14% this was based on the type of tumor ER positive and Oncotype DX test. If I take Tamoxifen it reduces that risk to 7-9%. He said the same thing you said about a stray cell elsewhere in your body. I couldn't quite understand why I had to take it if I had a bilateral thinking gosh I removed everything, but I guess that's not the case and Tamoxifen is like an insurance policy for a BC recurrence and elsewhere in the body.
by the way I asked him if keeping the nipple increased my risk and of reccurence and he said no.
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Tamoxifen is not usually prescribed for DCIS with a bilateral mx. It is usually prescribed for DCIS with a unilateral mx (to help prevent DCIS or even potentially IDC in the healthy breast). Women prescribed Tamoxifen who have the diagnosis of IDC are in a much different ballgame than those diagnosed with DCIS.
From what I was told from 2 oncologists, was that recurrence was actually very very low with a bilateral NSM mx (like 1-2%). Tamoxifen would cut that in half if you are ER+, but that is only 1% reduction, which in the eyes of many oncologists, is simply not worth the risks. If a 1% risk reduction sounds like enough to chance taking the drug, a doctor will prescribe it when asked for.
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Hurleygirly-you are correct, DCIS and IDC are completely different. With IDC the cancer has broken out of the duct and has/had the potential to invade your lymph nodes, blood or other areas. With DCIS it is still contained in the duct so if you remove the breasts you have removed the threat to a much greater degree than possible with IDC. I give you girls who had a bilateral/or uni for DCIS or LCIS a lot of credit because even with that some Dr's still take the "wait and see" approach which honestly would drive me nuts just having to always think about the risk all the time.
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Thanks everyone! So great to have the stitches out! Slept comfortably on my side for the first time since March.
Delray- One thing that is really good to do before or after any surgery is to up your intake of protein. It helps your body heal faster. This is hard for me to do as I'm not a big meat or fish eater. They do sell something by "Body Choice" that is a protein shot. (Shot as in small amount of liquid, not injection.) It is sold as a weight loss product (it's called "Concentrated Weight Loss Shot") but it's also great for healing. It has 25 grams of protein in a 3 oz. shot. It's not the greatest tasting thing but not the worst either. It's fat, cholesterol, lactose, preservative, egg, and gluten free and is also loaded with lots of vitamins. (100% of your Vitamin C.) They sell it at Costco- 12 for $20. Another thing to do is hydrate a LOT days before surgery and continue until she is off the pain pills. This will help flush the anesthesia out quicker and avoid some SE's of the pain meds.
sweetie- I actually had an oncologist tell me he wished his colleagues would stop recommending lumpectomy to patients with DCIS. He's seen too many nasty recurrences and he thinks the doctors either downplay the risks or just aren't educated about them. I have to say the hour and a half conversation with him is probably what swayed me the most to have a BMX. (That, and the fact my GP had DCIS and she chose BMX.) My final path report showed I made the right choice- multiple areas of DCIS that had never shown up on any mammogram, ultrasound or MRI. Thanks for the cudos.
Misty- Wanted to also say welcome!!!!
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Forgot to say, I decided I needed a little break from BCO so was going to try to stay off the threads for a few days. My DH went on a lunch date and as we are walking up to our favorite restaurant at this outdoor mall there is this GIANT advertising sign for breastcancer.org! We both started cracking up. I took it as a sign I am not ready to give up my addiction to this site yet! LOL!
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Hey all, thanks for the welcome
. I actually had a prophy BMX in June for LCIS and lots of other benign conditions along the spectrum. I did not have an NSM because some of the other weird things going on took part in the nipples. I had alot of worry from them so I decided not to spare them, only skin. I have been reading this thread because you all end up having so much good information. I feel like you all are so well informed and I suck up all the information you put out! Thanks again for the welcome! Kate, I keep telling myself I will take a break from BCO then find myself saying.....well I'll just log in for a minute . Misty 0 -
Kate33-I think you made a great decision for yourself-knowledge is power. I wanted to add even though I had IDC on my left they told me I could keep the right. Of course I opted to remove it and guess what, it was full of DCIS and LCIS, not to mention breasts that also 40% dense. Try finding something on a mammogram with all that! They pushed lumpectomy in the beginning and honestly I learned so much from BC.org I was able to make an informed decision that I felt was right for me. Not one Dr. told me out right what to do and I could have choosen eithe opitions. It wasn't until after surgery and the final pathology that they ALL agreed "I" made a great choice.
Kate your too funny, I guess your NOT ready to leave us! I like talking to to people going to the various processes because to me you are the one who has gone before me and I look to you for answers and for someone who has not yet even had surgery or just had surgery I can offer my support too. BTW, I don't have a facebook an I keep telling people it's because I spend too much time on here and If I did I'd never leave my computer!
Misty-so glad you joined and glad you are doing well. Your story is a great example of making the best choice for YOU! that is why being informed and talking to other women is so important. Of course we go to our Dr for the final word, but a lot of the time we do have options that we have some input on. A SSM is also a very good choice and will you an excellent final result.
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I just spent the last 30 minutes catching up here!
Kate: I am so glad your stitches are out and you can finally sleep on your side! I miss sleeping on my left side--makes me crazy that I can't. I am also glad that the lump wasn't anything serious. What a relief. Question: Do you know if the protein shots lso help increase white blood cell count? Just found out yesterday that mine is down to 29.2, the lowest reading I have ever had. Just condering.
So many new faces here! Welcome to the most friendly and helpful place on BCO!
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So funny! I just posted on the wrong thread! I wondered how I could have lost track of so many posts!
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Whitedove, No meds for me. Have you started your thread yet?
Welcome MistyJ, you will have lots of support here.
Kate, I love your story, I guess it was a sign! hehehe
Regarding registering implants: My doctor's office turned all the paperwork in for me, but it is always best to check to make sure they did so. The hospital gave me my cards with only the cc's listed, I had to ask my PS for the serial numbers. There is supposed to be stickers they take off of the implant box to put on your card, but I did not know that while I was in the hospital.
PB, I just learned something new about you, I did not know you were a nutritionist, that is awesome.
I hope eveyone has a wonderful weekend!
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MBJ- Everything I've read is that vitamins and minerals help more with boosting your immune system which in turn can help boost your white blood cell count. I am by no means an expert, though! I did find this article that I thought was interesting-
http://www.askdrsears.com/html/4/t042500.asp
It gives a few tips on what to eat and take, and what not to do, if you're trying to boost your immunity. I don't think the protein shots could hurt, though, and they do have 100% of your Vitamin C which you need when WBC is low, but I would take even more of that. You can't o.d. on C because the excess doesn't get stored. I would try to stay away from public places, too, because with your immunity so low you are liable to catch just about anything which will only push your WBC even lower. Did they say when they are going to test your counts again? Maybe PB has some suggestions on what's most effective?
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Kate, I know what you mean about an "addiction" to bco. Sometimes I try hard to not read for the weekend and just read a lunch.....or when I'm awake in the middle of the night. It is one step away again to a "normal" life though and a good step.
whitedove, I take Tamoxifen. I'm a uni and had both DCIS and IDC in the mx side....plus 2 kinds of pre-cancer cells as well. I figured it isn't worth the risk to not take the meds.
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I just kind of skimmed through the latest posts about nutrition. I am supposed to be packing for my son who is going on a church mission trip, tomorrow!
I met with an oncologist Monday, and was also told that because I had a bilateral, Tamoxifen would really not decrease my chance of recurrence by a tangible enough amount to warrant it. I did ask him about nutrition, and he said that he recommends Vitamin D and Calcium. He did a blood test to check my Vitamin D levels and it was low. He suggested 600 mg of Calcium and 400 daily units of Vitamin D two times a day. I figure, it cannot hurt and would also help with osteoperosis.
I had my first fill Tuesday. I have a great PS. Knowing how small I am, he just automatically said, we are doing 40 cc's so it will not be so painful. I was a little sore the next day, but it was not unbearable. I am getting along great with taking ibuprofen and a muscle relaxer at night.
Thanks again everyone for sharing not only your knowledge but your experiences as well. It is so nice having a relationship with ladies in the same situation.
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Hi all: thanks to all for such wonderful information. So much to respond to but first, thanks for your input. There is so much variation on the verdict
Misty-Welcome! Good to have you here. Naoko-Congrats on your fill.
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