Latissimus Dorsi Breast Reconstruction
Comments
-
kfinnigan, Thank you! Probably won't know anything until tomorrow, but I'll keep you posted. I'm nervous, but ready to get this procedure checked off my list.
0 -
Raelan, your doc does sound like my PS#2. If I'd had previous good experience with him, it would have been easier to blow off the stupid appendix comment, but this will be my first procedure with him. All I have is other people's opinions that he's good. He is board certified and has done a lot of lat flaps. He told me he's done the most breast reconstructions of any doc in the state. I wish he did the muscle sparing version of the lat flap, but he said it didn't make any difference as far as muscle function. I can't remember why not. Does anyone know?
I came to the same conclusion as you about putting up with some asymmetry to avoid losing the other lat. It doesn't have to be perfect as long as I don't have a C on one side and an A on the other. I'll stick with just an implant on my right and do the lat flap on my left side where I had radiation. Now I just want to get the show on the road, but I'm not scheduled until November.
0 -
2Tabbies - I hear you regarding getting the show on the road. My procedure is scheduled for October 13th, and I have my pre-op today. I'm flying my mom up for 2 weeks to help out with the kids (I have 12 year old twins), spent all last weekend cooking and freezing meals for the few weeks I plan to be relatively incapacited, put in for STD at work, and now just need to start wrapping up some things in the office.
I think the reason most PS's won't attempt a muscle sparring LD on situations such as ours is because they simply can't get enough coverage with it and it therefore negates the purpose. The muscle sparring approach is generally used to supplement either an existing procedure or to address a lumpectomy defect. With radiation, you really need to bring in as much healthy tissue as possible.
0 -
Raelan, fortunately, I don't have kids to deal with, and I have a husband who cooks. I'm glad your mom can come to help and hope the preop appointment goes well. I have another month until mine. I need to file for STD too.
I know my PS said something about the muscle that's left in the muscle sparing procedure not functioning. I wish I'd written it down. I know there's a procedure called a TDAP where they just use a flap of skin and fat and don't touch the muscle at all. That's usually used for lumpectomy defects or to fill out the results of another procedure. But I have heard of one woman who got that procedure for recon after a mastectomy instead of an LD flap. She has a shoulder problem that would have been made worse by the loss of the lat muscle and wasn't a candidate for other procedures. The procedure is so rare that one PS accused her of lying when she asked for it. The muscle sparing LD flap I had asked about uses part of the muscle. Whippetmom recommended a doc who does it, but he's far enough away that getting fills would be a problem. So I'll take my chances with the regular LD flap.
0 -
2tabbies. I wanted to jump I here as I just reading your blog I just had bil LD flaps due to failed implants from too thin skin. I did prophylactic dmx Jan 2014 due to hyperplasia in both breasts dense breasts and multiple biopsies...very high risk. Thin skin from prior breast lift & augmentation I am also very active and notice no difference in back or arm strength as my LD surg was Aug 11th I still feel some tightness in back but not bad now. My chest feels warm and pink and I have normal sensation. Such an improvement over implants alone. I plan on doing some weights after 12 weeks or so but don't want to rush and cause any problems. I read u lose only 5% of strength but other muscles take over. My breasts look round and full and my under arms are soft. Before they were indented with loose skin and looked awful. I am very happy to have the bil LD as I didn't want to risk getting cancer in other breast. Alot of women have to come back as breast surgeons told me to have other side done later. I just wanted peace of mind. But good luck to you as u make a choice. I remember it being very hard for me to decide but I am happy. Wish you well.
0 -
Two Tabbies, my 2nd opinion young hotshot dr. recommended the TDAP to me. It is one of the newer procedures. However, I chose the LFlap due to my problems.
Hugs,
0 -
2tabbies, I asked my PS about the TDAP, and he said that due to radiation, I would need the thickness and blood supply the lat muscle would provide. He wants me to hold off on surgery for a while, which is fine with me. I hope to do the lat flap sometime next year.
0 -
sistagirl, I've already had a BMX. Left side for ILC and right side prophylactic. I also had very dense tissue that made mammograms virtually useless and had several biopsies. I was high risk due to prior ovarian cancer, current lymphoma, no kids, etc. Had I been BRCA positive, I'd have had a bilateral prophylactic MX several years ago. I wish I had been. I'd be in a lot better place now. I'll talk to my PS about doing the LD flap on both sides, but will probably go with an implant only on the right and LD on the left. I hate to lose any more muscle than necessary, and as far as I know, have nothing wrong on the right side that would put me at risk for an implant failing. I'm glad to hear you've done well with it. That's encouraging. May we all be so lucky!
Andrea and Ronna, I wish my PS did the TDAP. I'd give it a shot if he did. I'm really antsy to get going. It's going to be a long fall.
0 -
2Tabbies, I understand wanting to get the show on the road. Hopefully the weeks will pass quickly for you, and before you know it, you'll be sharing your experience. I wish I had done the lat flap 3 weeks ago instead of trying implants again. I want this to be done so I can move on with my life.
0 -
Andrea623, I'll drink to that. I'm so tired of all of this. I hope it's really over when the recon is over.
0 -
gosh 2tabbies..I wasn't aware you had been through so much. I have to praise you on your strength. I don't know if I could be so strong as this year has been stressful for me in spite of me being so lucky not to need chemo etc. It's funny because last Oct I quit job got a Germany shepherd puppy accidently cut 2 tendons on rt hand with surgery& cast and after abnl mammo and biopsies decided to do double mx. ..All in breast cancer awareness month. I was going crazy everytime I saw pink. But it's been a year already but I see you've been doing alot more for a long time...I am just fortunate to be able to read stories such as yours to make me realize how strong women can be and how lucky I am. Thank you...
0 -
Hi everyone....I have never posted under this topic but I have a question/concern regarding my mom. She is 6 weeks post-op from her LD flap surgery and is experiencing back pain that she describes as all over muscle aches. The pain and muscle aches are pretty much her whole back but I have heard her mention her lower back a few times. Back pain started after surgery so I'm sure it's most likely due to that but my mind tends to go to a dark place sometimes and I've been worried about it lately. Hate seeing her so uncomfortable....was just wondering if back pain is a normal part of this recovery and how long it can last? I know every one is different but it would be nice to hear from other people and their experience.
0 -
J92 - I'm in the planning stage of the LD surgery and I have already started physical therapy. It involves stretching, massage, weights, planks, and cardio. I cannot help but think it would be of benefit to your mom.
Ladies - I saw my MO today and he confirmed what we've discussed. He said the success of the LD flap depends upon the surgeon. He gave me a bunch in my area to avoid and strongly recommended I only have it done by someone very experienced with it. He said that when it is done well the women look good and recover well.
Thanks for the info. about the "loaf". Sheesh.
0 -
J92 - I am 23 weeks out from double lat surgery, & I experienced the overall muscle/back aches, lower back as well. It was definitely part of the recovery from the actual surgery, but I also think I was holding my body a certain way to compensate for the back discomfort. Whether it was trying to sit in a chair, riding in a car, walking, etc., I was either unable to sit normal, or overly cautious when standing/walking because I was afraid someone would bump into me or I would bump into something. I understand why your thoughts may wander, but I think a call to the PS may give you & your mom peace of mind. Even this far out from surgery, I get the occasional back ache or twinge, but definitely improved over time.
0 -
thank you Warrior Woman. My mom is already in the process of setting up PT appointment. Good luck to you with your upcoming surgery.
DPiggy, thank you so much. I guess a surgery like this just takes a long time for some people to heal. My mom has a prophylactic mastectomy on her right side and tissue expander placed on the right, and the LD surgery with the tissue expander places on the left, which was the cancer side. Her posture and the way she sleeps is most definitely different, she has also been laying on her back a lot because she finds it uncomfortable to lay any other way. So I'm sure those are all reasons too. Also she has had many complications on the cancer side due to all the radiation she had. She is finally finishing her antibiotics tomorrow because she developed a really bad infection. She has been on antibiotics since she was out of surgery and she just got released from the hospital last week after being in there for a week. She had a bad infection and the wound isn't healing properly on the left side, so she literally has an open wound and is now attached to a machine for the next 6 weeks to try to close this wound. I don't know what the name of this machine is calling but it basically helps all the good cells to go to the affected area to heal it quickly? So far it's working great though. Anyways basically what I'm trying to say is overall she has been feeling so crappy and this process has been hell for her. Once she starts feeling better she'll be starting physio so that will help I hope. It's just hard for your mind to not wander, at least for me it really is. This diagnosis has caused me a lot of anxiety. She actually called her oncologist last week just to see if what she is feeling is normal. She had her 3 month appointment scheduled for October 26th but the oncologist said that she is so post-op so of course she is going to be feeling this way, but if it makes her feel better and for peace of mind to come in on October 7th and she'll access her. So hopefully that appointment goes well. At what point did would you say that you noticed the muscle pains and back aches start to improve? My mom has surgery on August 18...it actually hasn't even been a full 6 weeks yet.
0 -
also I haven't been able to find much info online which is why I posted here. I either can't find any good info or it's saying something bad lol. So I thought I would post here
0 -
J92 - no doubt, this is a difficult surgery. I think I noticed the muscle pains/back aches easing up around 8 weeks post op. They didn't go away entirely, just not so uncomfortable. May have been due to getting back to some sort of normal activity, as well as the overall healing process. It takes time, & that is the hardest part. Please keep us posted as to how she is doing. Sending soft hugs her way.
0 -
Sistagirl, I don't know how strong I am. I had a virtual meltdown when I saw my radiation oncologist for a recheck the other day. Breast cancer has kind of been the last straw for me. The other two were actually pretty easy. The ovarian cancer was caught very early so I "only" had a couple abdominal surgeries. Not easy, but not awful, and they didn't leave me disfigured like the mastectomy. Sure, I have a scar on my abdomen, but nobody sees it. The lymphoma that I have has stayed relatively quiet. It's not curable, but has not caused me any real problems yet. It could kick into high gear, but might stay just as it is. Breast cancer has been a whole different story. Speaking of quitting jobs, I'd love to quit mine and just might one of these days. I hope your hand healed up. Cutting tendons is messy.
J92, I hope your mom starts feeling better soon.
0 -
good to know! Thank you very much Dpiggy, sending hugs your way as well. Thank you 2Tabbies
0 -
Ladies, Can anyone perhaps answer this for me. I was just reading the general "what to expect" on this surgery. It says you might need help with stitches in back. Can someone be more definite. Since I can't reach the stitches all I do is look and see if they are ok in mirror. Is something expected to be done with the stitches.
Still hating the loaf and hanging in. 18 days out from surgery. Went out first time with friends last night. Did not think I would be able to sit in restaurant comfortable but managed.
Hugs,
0 -
Ronqt, how big is the "loaf"? Is it visible when you wear clothes?
0 -
Hi Andrea,. thanks for asking about loaf. I am able to wear "special bras" from a mast. store, pretty comfortable, but it feels like it is being held in tight. I can wrap my hand around it and continue to massage, massage. My dr who I recently saw said to keep massaging, so that's what I am doing.
Just had to take a pain pill, I guess due to pain or anxiety. Getting upset with pain. I do not wear tight tops at all,but the sides of the bra are a little expanded. In fact, I just went to the mirror and the loaf is on the side of the breast to my back. The bra is able to hold it in. When bra is off it feels a little better. I do not think it would be visible in my clothing. Just wrapped hand around it again, lying flat the hand covers it, but hand is against the breast/chest not a huge roll, but you definitely can hold your hands around it and feel the muscle. Continues from the breast to chest with a little hanging from the breast area. I guess today is my pity party day. Have to get through it. So I read what to expect again, 4 weeks until pain should go away. Have to learn to be patient. One thing good, when I flex it, it feels better with the lat muscle there, when it was just implant, I could not stand the feeling. OK, talking in circles.
Hugs, Ronna
0 -
Ronna, I'm sorry you're still experiencing pain. You're almost at the 4 week mark, so hopefully it will start easing up. Are you able to sleep better at night without the drain? I'm so glad to hear that having the lat muscle feels better than the implant. How's your range of motion?
I again wish I had gone with the lat flap instead of trying an implant again. The rads side is very tight and feels like it'll split if I move wrong. I am not symmetrical at all, the rads side is noticeably smaller, even in clothing. I wish I could turn back the clock one month, so I could tell my PS to go ahead with the flap. I was too scared at the time to try it, but I am done with the problems I keep having with the damn implant. Sorry to complain, I'm frustrated today.
0 -
Ronna, I'm not positive what the instructions you read meant about needing help with the stitches on your back, but unless your surgeon told you that there was something you needed to do, I'm sure there's nothing for you to take care of. Maybe the instructions were referring to the drain from the back. I wouldn't worry about it. I hope your pain goes away soon.
Andrea, I can feel your frustration. Go ahead and vent. It's therapeutic. I dumped a load of frustration on my RO the other day. I kind of wish I hadn't now, but I was having a really bad week, and it just came out. A lot of things about this whole process from diagnosis to recon have been frustrating for me. I understand being afraid of the lat flap also. I still am, but I'm going ahead anyway. This doesn't help you any, but I'm benefiting from your experience. After reading your posts, I'm more willing to take a chance on the lat flap. Can you schedule another surgery and get it? Nobody wants another surgery, but if it would solve your problem for good, it would be worth it.
0 -
2Tabbies, I've already asked my PS about it. He says with the radiation damage, and how thin the skin is, the lat flap is my best chance of having a good outcome. He said I could schedule it next year, three years from now, or whenever I wanted it. I'm going to wait at least half a year though. I think my body needs a rest.
0 -
Andrea, you're probably right to rest and recover for a while. I'm not good at waiting. I get impatient. That's what's driving me nuts right now. I have to wait until November 11 for my surgery. I hope you can have a peaceful, frustration-free 6 months then get that lat flap moved with beautiful results.
0 -
2Tabbies, patience is not one of my virtues. When I mentioned the lat flap at my last appointment, I think my PS thought I wanted it now, cause he told me to wait. So I understand how you feel, but November will be here before you know it, and you'll be closer to finishing up this chapter in your life. Next year, you'll be encouraging me to go ahead with the flap!
0 -
Hi everyone, I am back after my Hawaii trip.... 4 months post op with LD on the left. I missed a lot of messages but what I can say about the discussion re. LD on both sides or one side; I have one LD and the other good side an implant. I have great symmetry, but they do feel different and move a bit differently. Oh well. I would not be inclined to have both LD unless medical necessity, it's a lot to recover from and more unknowns. My left was definitely a medical case. If one side can go implant without invading the LD, I would advise that -- based on my experience and recovery experience, still in progress.
Ok, so I know a few of you want to know, how much can I do and when.....Well.... I just got back from Kauai at 4 mos. post op; I swam in the pool and ocean -- not the strongest of strokes I am used to -- but I can do it. It will get better. I hiked the Napali coast and it fatigued by back quite a bit; I hung back and my husband stayed with me...but I made it. I just was a little slower because you can feel your core strain and then you worry how far to go, because you have to get back. It's a pretty tough hike. It was beautiful anyway and I was thrilled to be there. Second hike was in the mud to the waterfall on day 3; it was slippery and scary; I was afraid to fall. I did just fine, again; happy to be there. OK, drumroll....for those of you asking about kayaking....I kayaked 4 miles....2 miles up and then hike 2 miles and then Kayak back. My husband was the strength to be honest, and I was able to take a break when needed....but I did it. I paddled as much as I could. The next day I was surprisingly fine....the second day however, was very stiff and sore. Ooops. Nothing a little advil didn't help with and I stretched out. It was a little tough handling my luggage - and the 5 hour plane flights made my shoulder hurt (why are the seats angled like that????) home now, back to work tomorrow....Aloha.
0 -
Andrea, closing this chapter will be good. I'm not sure it will ever completely close give that I'm stage III and seem to be cancer prone, but at least I won't have to dress around my "problem area" every day.
Keryl, sounds like you're recovering very well and had a great trip! Thanks for all the info on how you tolerated the outdoor activities. I know I'll get frustrated with being weaker until I can rebuild my strength, but maybe I can prepare myself for it.
0 -
2 Tabbies, I'm not sure any of us really close the cancer chapter. But at least you can close the reconstruction chapter. You've been through so much over the years. I think after you've healed, a nice vacation is in order!
0
