Nipple Sparing Mastectomy with immediate reconstruction
Comments
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Kelly - it took forever (seemed like forever) for my black scab to fall off. PS also said to just let it come of on it's own. Except at one appointment the one side still had a black scab - and he just scraped it lightly and it came off - so give it time.
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Hi all,
I have just finished my last fill (450 cc's) and have exchange scheduled in 6 weeks - wow, I am still in disbelief that this whole transformation started only 9 weeks ago. So much has happened and I have gone thru so many boob-sizes that I am a little nervous now. Gosh, I hope I am happy when this is all said and done. I feel like I second-guess myself alot on the fills and when to say when ;-). I feel good about where I am now and am going to put faith in all will be fine...the bright side is I don't have to drive 2 hours each way to appts for fills anymore! My weekday schedule just opened up a bit ;-)
I'm sooo glad to hear about the ladies who are healing well - hang in there, it sounds like you are doing great!
I like your advice, Angelisa!
Susan, I totally loved the scarf-thing, that and cute flowy cardigans...I do feel a little exposed at the gym when I take a class and I am in a tank - no hiding behind the scarf then ;-) It's kinda funny going for a fill every week and having your chest grow before people eyes!!! Good thing the aerobics classes are all women!
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Congrats on your last fill, Megan! 2 hours each way!? Yikes!
I know what you mean about not being able to "hide it" at the gym! Though I just discovered "Coobie" bras that are SUPER comfortable/lightweight and have a little removable pad so I don't show my headlights (oYo) when I get cold at the gym!
I'm hoping it will still be okay to wear them after the exchange! 0 -
I drive from RI to Boston, it should be an 1 hr 15 mins, but there is ALWAYS traffic. I leave right after I drop my girls at school in the am, drive up, go to the appt, and turn around and pick them up after school, it's become like a job! ;-) Especially the weeks I've gone twice, ugh...but worth it for great Dr's, right? I'm always beat that night...
I am totally going to have to check those Coobie bras out. I've been wearing a basic hanes sports bra and a tank with the shelf built it, darker colors seem to camoflauge the ole hi-beams! ;-) I know after surgery I'm gonna have to spring for good bras with better support esp. for at the gym...
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Yikes! Sounds like lots of trips in my future for TE fills. My drive to San Francisco is 3 hours each way. I'm trying to figure out how to use mass transit instead of making the horrible drive to SF (very stressful once in the bay area, the drivers are super aggressive). Best I've figured is Amtrak, then BART, then a MUNI bus to the PS office, plus a bit of walking in between. That figures to at least 5 hours each way.
Might have to line up some fabulous restaurants and museum exhibits and offer to treat a different friend each time in exchange for making the drive with me. My husband is willing, but I don't think he'll be able to take that much time off work.
OK, I've broken my rule - no stressing about any of the "later" stuff until the first surgery is done. One bite at a time......
Diagnosis: 12/8/10, Left ILC with LCIS, 5mm, Grade 1, ER+/PR+, HER2 -
Diagnosis: 12/20/10, Left DCIS, <1cm, Intermediate grade, ER+/PR+
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exciting nipple update (where but here would one ever say that??): one black scab completely fell off in the shower, didn't feel a thing just looked down and....beautiful pink!
kelly
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I also had a long drive (2 hours each way) to my PS's office for fills. She finally took pity on us and taught my DH how to do them. It really wasn't that difficult. There is a port about the size of a quarter that you find with the magnet they provide. As long as the needle goes somewhere in that port it will work. My DH was worried about hurting me but I was still pretty numb throughout all the fills. The nice part is I could do smaller fills more frequently so the stretching was very gradual which was a lot more comfortable. So not sure if you have someone in your life willing to do this, and a PS willing to teach them, but it worked out great for us!
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kelly: Yea!
Kate33: That would make me nervous, but we could handle it. Something to add to my list of questions. Thanks!
Tina
Diagnosis: 12/8/10, Left ILC with LCIS, 5mm, Grade 1, ER+/PR+, HER2 -
Diagnosis: 12/20/10, Left DCIS, <1cm, Intermediate grade, ER+/PR+
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Another question for you all. I'm about 2 1/2 weeks out and I'm just still so exhausted (even without the drugs in action), I'm asleep as soon as I recline. When I'm not exhausted I just want to be left alone which = tons and tons of guilt because I have four little ones clamouring to be with me. Feel like a rotten, rotten mom but I just feel the need to be alone, physically and emotionally. Normal? Crazy?
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Kelly- 100% completely normal and understandable. You have gone through a trauma and it's natural for your body to want to sleep to help with the healing. You're not only dealing with a physical wound but an emotional one as well. Either one is overwhelming but throw them together and most of us just want to shut down. I found myself zoning out with movie after movie when I was awake so I didn't have to think about stuff and wasn't aware of the physical discomfort as much. I also had the mom guilt so tried to arrange for friends and family to do activities with my son whenever possible. Knowing he was off having a good time eased the guilt a lot.
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thank you kate, i really needed that. wish we all lived nearby and could meet for coffee and chat in person!
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Yes Kelly, like Kate says , all completely normal! This is a major physical and emotional event! Kids are resilient and you need to make sure you are taking care of YOU so that you recover properly/fully! Don't be afraid to ask for help. I had a hard time asking for help but found that people were more than willing and actually it made them feel better that they could do something useful to help out.
Kate ~ that's amazing that your PS let your DH do the fills at home! Though I had to chuckle thinking about some husband taking advantage of the fact that we are numb and sneaking in a few cc's while we are sleeping! Lol!
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Thanks so much for your help ladies. I am almost there. Has anyone had previous rads to the breast? My first BC had the breast radiated and the PS seems to think that i could get a quite inferior result due to this. Has anyone heard of any good stories?
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Thanks for everyone's helpful info! I am now 12 days post-op.. hard to believe! I have a couple more questions for you guys. The first is about what position you slept in for the first while post-op. I am still sleeping on my back, and even with pillows propping me up, it's not particularly comfortable. I am so excited at the thought of sleeping on my left side (I had a right NSM), but it still hurts to twist, so I don't dare get in that position. How long before you ladies slept in normal positions?
The other question I have is about changing the gauze over the nipple and incisions. My DH puts the bacitracin on every morning and night and then I put gauze over it after letting it air-dry for several minutes. Still though, when I take off the gauze the next time, so much goop comes off with the gauze everytime, on the nipple area in particular. I feel like the nipple will never have the chance to scab over if the gauze is continually taking lots of stuff with it. It sounds like many of you had success with it scabbing black and then falling off by itself. Did some of you never scab over on the nipple? Or when did it happen? And what was your trick with the gauze over the bacitracin?
Thanks so much everyone!
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SusansGarden- LOL! Hmmm, hadn't thought of that possibility!
sunny321- PS's seem to be split on the best course of action with the nipples after MX. Some, like yours, have you put ointment and gauze on them. And others, like mine, say the best thing to do is keep them as dry as possible. I never used any kind of ointment. I soaped them very gently in the shower, patted them dry and then wrapped loose gauze around the entire chest followed by an ace bandage. I'd be curious to see what everyone else's experience was.
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Hi Ladies,
Kate - wow, doing the fills at home, what a convenience! especially being able to do them at your own pace, interesting!
as far as nipple-care after surgery, my PS really wanted nothing on them either. Post-surgery I did use an adaptic gauze when one of them bled a bit (which had like a moisturizing ointment built-in). After the 1st week or so I went the dry-route, just loose gauze held on with tape to protect them from clothing, etc. No bra or big bandages at all after the 1st week. I was verrrry gentle in the shower, just let the water kind of run over me with a tad bit of soap. It seems once the nipples were allowed to breathe and be dry, the scabs fell off. But it did take several weeks for the final scabbing to fall off.
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Interesting about the differing nipple after care advice... my PS wanted me to keep mine moist ~ his words "you can never moisterize too much!". Both of my nipples got dark, scabby areas. I used coconut oil. Eventually the scabs came off. Though my BC nipple kept getting "dry" and a little flaky easily. So I added a little "bag balm" over the coconut oil and it did the trick. I'm 2 1/2 months out now and just moisterize normally with body lotion.
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Funny how you think you've got things all thought through and suddenly another question comes up! I've been reading so much on various threads about wearing special surgical bras during the reconstructive process. How does that work if your incisions are below the breast? Makes sense for non-NSM or those having lateral or peri-areolar incisions, but it doesn't sound like a bra will work for me for a long time with incisions below the breast. I'm sure my PS has a plan in mind, but just curious.
Diagnosis: 12/8/10, Left ILC with LCIS, 5mm, Grade 1, ER+/PR+, HER2 -
Diagnosis: 12/20/10, Left DCIS, <1cm, Intermediate grade, ER+/PR+
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I woke up in the hospital with no bra/bandaging on my chest. I just recovered with soft flannel pj's and wore soft cami's under clothes. My PS said I didn't need to wear anything at all during my TE phase?
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TinaT- I also had my incisions below the fold of the breast. After my MX there were steri strips on the incisions and I was wrapped with gauze and then an ace bandage. After my exchange surgery there were steri strips and then a surgical bra over that which was just basically a good supportive sports bra. It didn't hurt having bandages or the sports bra pressing on it since the area was still pretty numb and the bra itself didn't move or rub since it was so supportive.
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Kate33 - Thanks...I hope you're doing well!!!
Diagnosis: 12/8/10, Left ILC with LCIS, 5mm, Grade 1, ER+/PR+, HER2 -
Diagnosis: 12/20/10, Left DCIS, <1cm, Intermediate grade, ER+/PR+
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TinaT: I woke up in the hospital a couple minutes before they wheeled me away from the OR and the nurse was putting a surgical vest (the RN called it a compression bra) on me. My incisions are at the bottom of the breast and around the nipple. I don't know how low down your incision will be, but for me the surgical vest is the only thing that is comfortable. At 8 days post-op, my PS told me I could wear a sports bra if I wanted if the elastic didn't dig in to the incision line. I was excited and bought a sports bra that was a size up (so it would be looser) and went longer down than any of the sports bras I already had, but alas, after wearing it a couple hours I was hurting. Unfortunately for me, the surgical vest is the only thing comfortable, which is unfortunate because it goes so high up on my neck, that my choice of clothing is down to just a few shirts. I'm really tall though, at 5'11, so no sports bra was long enough to really start beneath the inicisions. If you are on the short side, maybe you'll have better luck.
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My PS from the day of surgery said no bra of any kind unless I wanted it for comfort. As to the nipples, for two days only I was to use bacitracin with gauze over top and then that was it, was told to just let them be. Tomorrow I'll be 3 weeks post-op and both nipples are now scab-free, look as they did before surgery. Pretty amazing since they were pretty scary looking not long ago. All seems well now and they gave me a two week "rest" to let everything settle before I do a fill. Will only be doing a few fills: got 400 cc TEs put in, 325 ccs added at time of surgery. Hope you are all well.
Kelly
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It seems that what you wear post surgery is a preference of your PS. Right after my mx I had the drains in of course and some steri-strips over the incisions. No bra. After the drains came out I just wore a cotton cami as I was filled. I didn't go back to a bra until after my exchange surgery. Sometimes now I think it is a pain and just don't wear one and use the cami, depending on what I am wearing.
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sunny: I read on a woman's blog about her mastectomy journey that she bought a dozen soft, white washcloths to use as mini towels, just for her breasts. She used one each shower and threw it in the laundry. I did this, too. Not sure if it really helped physically, but mentally it was a relief to know I was using a clean "towel" each time!
I also washed my breasts with Hibiclens after surgery--available at Walgreen's, CVS, etc. I used it a few days prior to surgery per my PS recommendations and continued to use it until completely healed.
As far as swelling post op, I had some in my mx breast in the upper half. My drain came out on the 10th day post op and I had to travel across the country 13 days after surgery. I was gone a week at a conference. I also had to walk a total of a mile a day during the conference which I am sure was contributing to swelling. My rt breast swelled alot on the third travel day and the swollen areas were sort of jiggly. I was really worried about seroma, but I experienced that the swelling would subside at night and when I drank plenty of fluids. Eventually the swelling went down and I never had any problems.
Some swelling is normal and our bodies do absorb it if it's not too much. If you are worried call your doctor...that is what he/she is there for! Don't worry about their reaction to your worry, it's your body! You've been through so much and you want to have the best and healthiest outcome possible.
take care, all!
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My doc recommended a sports bra immediately, but because of where my incisions were they were just to uncomfortable. I tried stuffing maxi pads around the elastic edges (per docs recommendation) and we would find maxi pads all over the house because they would fall out....LOL
Then I purchased a ace bandage and started using that instead or with the sports bra and it feels much better to me. Doc says it is okay as long as I make sure there is good support she is all for it. Also, my doc wants no ointment on my incisions........its crazy how so many docs have so many opinions.
Oh.....here is is day 17 after my surg and I still have two drains in. Doc is calling everyday to get a fluid total, she told me in the last office visit I had that I was "JUST TOO DAMN JUICY".
we all almost burst a lung laughing
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Does anyone have a recommendation for an excellent general surgeon and an excellent plastic surgeon located near or in Nashville, TN who is very experienced with NSM?
I would greatly appreciate any suggestions of physicians any of you have used.
Thanks!
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Did you try the link at the top of the thread where some have posted who may be in your area?
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Yes, I have looked at the link for surgeons in the Nashville, TN area but am unable to locate anyone in this area. I am quite certain there must be someone located here but so far I am unable to find them. I am hoping someone who reads this will have had experience with a surgeon or know someone who has! If anyone has recommendations, please feel free to PM me if you are not comfortable posting their names.
I really need to locate someone fairly quickly - within the next week - so time is of the essence. Isn't it always? I have learned quite quickly this is an experience which causes each of us to evaluate time far more differently than we once did...
Sandy105
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Sandy- Didn't I read that you are having a prophylactic MX? If you are then I would definitely recommend trying to find a surgeon who does NSM even if it means postponing your surgery. I would almost guarantee that you will be much happier with your results as I think almost every woman on here would agree. I would call every breast center, cancer center, hospital, etc until you find someone experienced in this procedure. I did notice that the women that started this thread, TNLady, had hers done in Chattanoga. Not sure how far that is from you but I have to drive over 2 hours to find a BS that did NS and it was definitely worth it.
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