Latissimus Dorsi Breast Reconstruction
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Hi WindingRoad and welcome to our club. I can't give you any pointers as I'm still a good 6-9 months away from surgery. Like you, I've had radiation, but I tried implants. Three times! My PS said a lat flap is the only option I have left too. This is a terrific group of women, and the others who have already gone through the surgery will be giving you great support and advice. Hugs to you!
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Winding Road - Welcome to this small group of very supportive women. Seems we've all found our way here for different reasons, with the end result being that a lat flap is really our only alternative if we want to reconstruct what bc took from us.
I'm a little less than 2 weeks out from this surgery and have to admit I was scared to death right up to the point of finally deciding to move forward and get it scheduled. I worried about potential loss of strength, long-term pain issues, range of motion problems, the works. Although I'm still not out of the woods, I'm happy to report that in my case none of these things have materialized. My biggest issues right now are the drain still in my back (which I'll have for at least one more week), and the small "breadloaf" under my right armpit that my PS has assured me will reduce in size overtime to the point of being unnoticeable.
You will have some pretty serious lifting restrictions for the first 4-6 weeks after your surgery. I'm not allowed to exercise at all for 4 weeks, then can begin some light exercise the following 2 weeks. I'm also currently restricted to lifting no more than the weight of a gallon of milk for at least these first 4 weeks. I can see how this could be challenging with a toddler, but am wondering if there are any community resources available to you (such as the American Cancer Society) that might be able to assist in bringing in some help while you recover?
It was brutally hard for me to make this decision, but I'm glad I finally did and it's now behind me. I can finally see light at the end of the tunnel once I get my te's exchange for permanent implants (3-4 months from now) and I get my nipples (strongly leaning towards 3-D tats from Vinnie Meyers). I wish you the best of luck as you work through all of this.
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Raelan, "brutally hard" is a perfect description of this decision. Who wants to lose a muscle and add yet more scars to their body? But for me, it's better than the alternative of living flat and feeling mutilated. I've given that over a year and am not happy with it. I wish I was like the women who adjust to it and don't mind, but a bit to my own surprise, I'm not.
When you say you can't exercise for 4 weeks, are you just talking about upper body exercise? You don't mean that you can't even go for a brisk walk, do you? I hope not! If so, none of my clothes will fit by the time I can exercise again. Also, do the same lifting restrictions apply to your non-lat flap arm?
PS's office just called to remind me of my preop appointment Monday. As if I'd forget that one!
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winding road - hugs to you my little sister. What part of the country do you live in?
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2Tabbies - I specifically asked the nurse about walking as a form of exercise during my 4-6 week hiatus and she indicated she doesn't want me swinging my arms back and forth.....all to say she was discouraging it. However, I don't think it's a hard and fast rule. I mean, what's so wrong about going to the gym, walking on the treadmill, and holding onto the bar the whole time? No arm swinging with that, right? I think the point here is your back muscles need time to heal, and the more you rest and let them recover from the trauma, the faster the healing process can kick-in and you can get back to your normal life.
As far as lifting restrictions are concerned, I've definitely kept my end of the bargain on the lat side. The non-lat side.....well, let's just say I've pushed the limit a couple of times. Again, you just want to make sure you aren't doing anything to pull on the back incision on twist your back in such a way as to aggravate things.....especially as long as you have a drain still in.
Patience is a virtue with this particular surgery. I've had to stock my fridge with lots of fruits and vegetables to stave off any carb weight gain from lack of exercise and, well, comfort eating. So far I've been successful in not adding any additional pounds. Hope I can still make that statement a month from now!
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Raelan, I can even walk outside without swinging my arms if that's all they're worried about. Or as you said, go to the gym and walk on the treadmill while holding on to the handles. Being sedentary for 6 weeks isn't good for you either. You lose fitness, bone mass, and muscle mass. Plus, after surgery you need to move around to prevent pneumonia. It's not just the cosmetic problem with weight gain that's an issue although I could eat nothing but celery, and if I just sit around for a month, I'll gain weight. But also, I don't want my blood pressure to go up more or my lymphedema to get worse from added poundage. If it takes me a bit longer to heal, so be it. I will be walking.Carefully, but I'll be walking.
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Hello,
Lat flap was my only option after losing a DIEP flap, if I wanted a breast. I am very glad I went through with it. It is much easier than the Diep. Less painful. Yes you lose a piece of your muscle (that is how my PS performs the surgery he does not take the whole muscle) and I have not lost any strength that I had not previously lost with all my surgies to that side 4 weeks post lat I went to PT and she helped me with massage and stretching exercises. She has stretched me back to full range of motion during massage and I am working to get their on my own. I have a brief vacation now as I recover from tightening(to remove flap) which I didn't need and fat grafting to breast. But my new script is already their to restart PT as soon as incisions close.
Each PS is different but I was allowed to walk as much as I wanted, but not to do anything that would cause stress to incisions in back and breast. For my first week I was limited in arm movement and weight lifting, by second week I could lift arm until/if I felt pain then stop ( I never felt pain from lifting arm) I slowly incorporated the arm back into regular cleaning, etc and if it felt tired I stopped during first 4 weeks.
Then came PT and I started working it out slowly with bands and 1pound weights. I want to test it in the water swimming, but have not been able to yet. I also had some loss of strength and range to my right diep arm.
I will say my concerns for a lat flap and diep match are now at rest. Fat grafting has added volume and projection to my lat my PS added a bit more than diep side anticipating about 30% of fat is absorbed by body within a few weeks. But is is a very beautifully round and full breast. If it stays this full, then my Diep will get a little fat on top to match roundness when my port is removed. (5 more Herceptins to go)
Take care all
Vivian
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Hello ladies, I have finally made the decision to have the Lat Flap surgery. I have a surgery date on Nov. 18. I am getting nervous about what to expect. I am a few days away from 65, and hope that I am in good enough physical condition to handle this surgery.....any oldsters out there who have been through it?
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Vivian, thanks for the information on your post-op exercises. That all sounds reasonable. I just got back from my workout at the Y. I'm trying to gain as much strength as I can so I'll hopefully bounce back faster.
Thimbleberry, welcome to our little group. I'm 57 so not that much younger than you. It looks like you weathered the full gamut of cancer treatment and several reconstruction surgeries. If you can get through that, I bet you can get through this.
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2Tabbies - Want to make sure I haven't over emphasized the "no exercise" aspect of the instructions I was given during my initial pre-op appointment with the surgical nurse. They definitely wanted me up and moving around shortly after my surgery. I certainly met that request since I must have gotten up at least 5 times the first night I was in the hospital to go to the bathroom. She also instructed me to use my arm for normal types of activities like washing my hair, etc.....in other words, make sure the lat side is getting stretched and used. Reaching above shoulder level should be done in moderation the first couple of weeks, and when done it should be a somewhat slow motion. I was also sent home with some stretching exercises I do 3 times per day. Most involve shoulder rolls forward and back and finger walking my affected side up a wall. Fortunately, I maintained full range of motion, so am focusing more on just keeping things stretched as my incisions and lower back heal.
What she doesn't want me doing is going out and walking 3-4 miles at a quick pace. Prior to my surgery I was at the gym 3-4 times a week doing cardio (elliptical, runnning, stairmaster for a minimum of 3 miles), as well as lifting weights. She knew this, so wanted to make sure I ratched things down several notches. There's no problem getting out and about and walking around, but you just want to do it at a leisurely pace that doesn't get your heart rate up......especially the first couple of weeks.
I went out this morning and did some shopping for a couple of hours and that was about my max. My back started to feel pretty fatigued after being on my feet for a few hours, so I think you'll have a pretty good sense for your limitations once you have the surgery. I'm certainly gaining more strength with each passing day, but it will be a process getting back to my former self.
I do feel that getting in shape prior to the surgery is the best thing you can do for yourself. Kuddos to you for making this a priority!
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Raelan, thanks for the clarification. I won't be walking 3 or 4 miles right after surgery, but it just sounded odd that the nurse phrased it as no walking because you'd be swinging your arms. After my hysterectomy, I started out with just a walk to the mailbox. Then down the block, etc. It wasn't too many days before I could do our usual neighborhood walk just more slowly than normal. It's a couple miles but not strenuous. I'm hoping I can do the same this time. (Of course, if it's going to rain and the wind is going to blow like it is right now, I won't be doing anything outside. Our first gale of the fall is here.) Is there a specific reason for not getting your heart rate up, or did she just mean don't tire yourself out?
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I think the key here is everything in moderation for the first couple of weeks post-surgery. You will most likely have drains in for 2-3 weeks, and the more active you are, the longer you'll have those suckers in. That's enough motivation for me to keep my activity level low and slow. The drains are a pain!
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Tabbies - Are you still scheduled on the 11th? You're on the 11th, I'm the 13th and Timbleberry is the 18th. It's getting close. Preadmission testing is this week.
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HI, today is Sunday and here I am. The bandages that my PS wrapped on me almost three weeks ago are barely hanging on, I keep putting tape on to secure, but when I shower they loosen up. Apparently he was right on target with the 3 weeks b/c the tapes won't last much longer. I see him on tues, I have a tentative trip planned for Florida the 18th to the 21. I prefer to have surgery instead and hope with insurance I have they accept it and I can cancel the trip.
Anyway, Winding Road, glad you have joined us,
Ladies my friends, I keep stretching my arms up, finding I am moving still in slow motion. Up until June, I was in the gym two and three times a week, free weights and zumba. Worked with trainers for many years too much strenth training ruined my knees. With zumba, I also did a job on my knees, but not complaining. On leave until april.??
Why april, I don't know.
I know some of your surgeries are later this week and I will be posting to wish you good luck. Yes, I am feeling better, dealing with a husband who has handicaps has also affected me. He was my knight in shining armor who did everything for me until last Jan. he is still here and now reversed. He does when he can for me and I am thankful for that. Again, stronger each day, and hoping that this pocket gets fixed. 2Tabbies, I know you are anxious.
Andrea, Raelan, Warrior Woman, F Kinnegan and all others hello and hope you are doing well
As Warrior Woman said it best: What was I saying:. So many thoughts.....
Love to all, be back soon again I know some of your surgeries are later this week.
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Ronqt1, I think we must be surgery buddies as my op was 3 weeks tomorrow. Like you I was really fit, zumba, combat & aerobics every week, now im stiffening up after 10 mins of walking. I'm doing all my physio exercises & am starting to see a small improvement but there's a lot of tightness so I'm trying to massage the scar to stop it sticking.
My flap has shrunk a bit in the 3 weeks since the op, definitely will get fat filling but not for a few months.
To everyone waiting for their op, make the most of feeling fit & using your muscles. I even struggled to get out of the bath....
2tabbies, I was told gentle walking, no lifting or stretching for 2weeks then follow the physio leaflet. I had that horrible sunburn feeling on my upper arm where they dug about my armpit to tunnel the blood supply, the nerves are settling down now.
I think I expected to recover quicker than I am going to, I don't have any regrets, but wish I'd had more knowledge about the weeks after the procedure.
Good luck to those of you who are on their pre ops this week.
Xx
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Raelan, yes, I remember the lovely drains from my mastectomy. A pain indeed. I still have the camisoles with the special pockets for drains that I was given then. The don't have pockets for back drains, but maybe I can rig up something. My PS did mention they sometimes need to stay in for 3 weeks. I think I had them for 2 with the mastectomy. I won't do anything that seems to increase the amount of drainage.
Warrior, yes, I'm still scheduled for the 11th. I have my preop appointment tomorrow and will schedule whatever tests I need to have ASAP. You, Thimbleberry and I will be surgery and recovery buddies. It will be nice to have company!
Ronna, I hope you can get your surgery scheduled and that pocket fixed.
Artemis, I hope you are moving better soon. I was told this is a tough surgery. You never know exactly what your body is going to do until you get there, I guess.
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2Tabbies and Warrior Woman, let us know what directions you are given during your preoperative meetings. I hope that I have had all the appropriate tests within the allowable time frame.....my last failed reconstruction wasn't that long ago.......but, one never knows. It is nice for me that your surgeries are before mine, and you can give me a heads up on what to anticipate. In the meantime, I will go to water aerobics to keep what is left of this genteel body going!
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Best wish Ladies and looking forward to hearing from you during your recovery!
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I am a little over 3 weeks out and today I finally drove myself to the beach, walked a mile, picked up some sea glass (that was a little hard) and went home.... Felt the sunrise- it was amazing. I feel no pain when I'm there. It was only a 2 mile straight drive though- one handed. K turns are very difficult one handed. lol.
I'm still far away from washing dishes and laundry and picking up kids, but I'm so much better than last week!
Not pushing it but pushing it a bit, ya know?
I also still have one drain in and it's still filling up. It'll be 4 weeks post op Friday. They removed the first one last week. My back incision is half closed and the front flappy thing is still scabby and healing....
Drains UGH.
I want this gone.
It's getting sore with the stitches and hole... I put some medicinal Manuka Honey on it and it feels a lot better actually. Stuff kills everything including MRSA- heals wounds so well. It's been a godsend for wounds and surgery holes and all those things. I highly recommend it if anyone is having infection problems....
Hope y'all are resting up well and feeling good today
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Hi everyone,
I just had my pre-op appointment for my lat flap surgery with tissue expander that is coming up in approximately 2 weeks. I am nervous for all sorts of reasons: am I making the right choice? How will it affect my arm and ability to do things? Will I be back to work in time and not lose my job? How will my new breast look and is it worth it? What will my recovery be like? (etc.) I have read of many experiences that have quelled some of my fears, but I can't shake the feeling of fear that I may be worse off afterwards. I guess it's just that it's coming up so soon and becoming real.
Can anyone tell me what they did during the time after surgery but while the tissue expander is still being filled as regards their appearance (i.e., any sort of prosthetic)? I have 4 weeks off work and then I will have to return. Thanks, ladies.
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Welcome Sharsalo!
You've joined a very supportive and informative board. Seems we have several women who are getting close to their surgeries or are in post recovery, so you should be able to get some helpful tips.
I think one of the reasons lat flap surgery is so unnerving is because there are no guarantees that come with it. Most women do fine, and once recovered are back to their former selves. However, there are some who, for whatever reason, suffer ongoing issues. I think it's important to know going in what you can expect in terms of recovery. This is a big surgery and it does it take time for your body to heal.
Hopefully others will be able to provide some assistance in helping you with how to deal with your appearance post surgery while going through the expansion process. My te's were completely filled before I had my surgery, so this is not something I've had to deal with. However, during my initial expansion phase, I used coobie or genie bras and would add some additional padding if needed to balance me out. Loose shirts also helped disguise things quite a bit.
In terms of my own recovery, I'm starting back to work this week 5 hours a day, then full time next week. I'm 2 weeks post-op and still have one drain in. I suspect I'll have it for at least one more week since it continues to put out about 50cc's of fluid. I have a desk job and can work from home, so it makes it a bit easier for me to go back earlier than some. I'll eventually return to the office in a couple of weeks.
I'm also finding that the strength on my lat side is returning, and for the most part I can do all the things I was able to do before. However, this doesn't mean I should be doing those things. I'm having to "think about" not using my right arm to pull things or lift anything heavier than a gallon of milk, which is hard since I'm right handed. The one thing that is really annoying me is the "bread-loaf" on my side under my right arm pit. My PS assures me is will go down over time, but in the meantime I feel like a linebacker!
Best of luck to all of you who are in the waiting period for your upcoming surgeries.
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Thanks for the response, Raelan! I'm right-handed as well and it is my right side that will be worked on. I am an editor so I also work at a desk and don't have to lift much except an occasional book to check something. It helps me to know you were back to work so soon; one of my worries is not being back to work (I've only been at my current job one year) and I don't want to have that worry and stress when I should be focused on getting healthy and recovering well. I guess my concern is that even with research I don't quite know what to expect -- it is kind of like buy a pair of pants online and not knowing how they fit until you get them!
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Great pants analogy, Sharsalo..... Or, if the right leg will match the left leg! Raelan, thanks for sharing so much of your recovery.....it makes waiting for surgery less nerve racking.
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Hello ladies...I've been reading from several different places, but this seems to be the most active with my concerns...I'm 2 1/2 weeks post op bilateral mast with/LD recon with full size implants. (because I down-sized) Got all 6 drains out surprisingly last Tuesday...huge relief!! The only pain I've had has been in my mid to lower back..no where near incisions. But pretty painful at night from having to lie only on my back. Just really tight front and back. When I read the "linebacker" part, I sortof chuckled...that's what I've been telling everyone that I look like because I can't put my arms down by my sides. How long does it take for that to go down? My breasts are different sizes and lop-sided... I saw my PS last week; he just said everyone is different, and it takes time. Just wondering a general time frame... I don't go back to him for 5 more weeks. For those about to have surgery...what a difference 2 weeks make. I would not have thought that a week ago I would be drying my own hair...I woke up the morning 2 weeks out and wasn't tired when I first got up...and actually felt like myself. Not over doing it though....
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Welcome to the newcomers! 2.5 weeks out was a pivotal time postop for me, drains were gone, I was cleared to go on long walks and started to feel a lot better. Hang in there all in recovery.
I don't even remember now how long the "linebacker loaf" took to go down, it seemed like a few weeks. my lat flap was 6/25/14.
I still don't like the feeling I get when I get cold. My back (where the lat flap was taken from) tenses and it feels weird, very apparent...oh geez its hard to explain, does anyone else have this feeling?
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Yes, kfinnigan...I know the feeling...gives a new meaning to "skin crawling"... like goose bumps gone wild....the only way I can explain it....but it seems to cover most of my back.
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I've heard some PS cut the nerve that can make the flap twitch or jump. Has anyone had it done?
I have to admit to being a bit envious of everyone with upcoming surgeries. I wish I didn't have to wait till next year!
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kfinnigan - I have some weird sensations on my back as well, particularly the incision areas. There are times when I am leaning my back against something, like a chair, & it almost feels like it's vibrating. I'm thinking that will go away in time.
renee1008 - I think it was about 4-5 weeks before the "loaf" under both my arms went down. I'm 6 1/2 months out, & it's pretty much back to normal.
Having my exchange surgery on Wednesday. Starting to get very nervous, & can't keep still right now, so a little on edge. Trying to think positive thoughts & know this is all part of the process. Keep thinking about the restrictions I'll have to follow...again...but keep reminding myself they are temporary & nothing unfamiliar. Just keeping my fingers crossed that all goes well.
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A great big welcome to our new people, sharsalo and renee1008. I'm glad you found us.
Sharsalo, I have all the same questions and worries as you do except the job worries. I know I won't get fired. Wondering if I made the right decision still sometimes keeps me up at night. But the decision is made, and I'm going forward. I don't want to stay looking like I do now. I expect to be out of work at least 2 weeks but probably 3 or 4. To be honest, I'm not going to rush back. I took ask little time off as I could last year for my mastectomy, chemo, and radiation. (Trying to be a good employee for what it was worth.) I honestly feel like I've never had the chance to really rest. I've got 4 weeks of short term disability. If I need it, I'm going to take it.
I don't know what others have done regarding appearance, but I plan on just wearing layers, loose tops, scarves, etc. to kind of hide things. That's what I did last year when I was healing from the mastectomy and when I was getting radiation. For that matter, since I hate the mastectomy bras and prosthetics, I've been doing it a fair amount of the time anyway. Fortunately we're coming up on the cooler part of the year so layers and cowls and things won't be too hot. With you joining us, there are now 4 of us scheduled for this surgery in about 2 weeks - you, Warrior_Woman (the 13th), Thimbleberry (the 18th) and myself (the 11th).
Thimbleberry and others, here's the rundown on my preop meeting. We discussed the procedure in general. He took photos. Lovely! I read and signed several consent forms. I got instructions on things to do before the surgery - talk to the pre-screening department at the hospital, don't take meds that decrease blood clotting, etc. I also got some prescriptions for meds, nausea meds, etc. to get filled ahead of time. He said I'll have a PCA pump (yay!) for pain control and a urinary catheter (boo!) when I
wake up. He said they give you a lot of fluids post-op so that's
why the catheter stays in. It would be too much of a pain to have to
get up to the bathroom all night the first night. Not to mention I
wouldn't get any sleep. It should come out the next day. The PCA pump
will be discontinued as soon as I can take oral pain meds. He'll make sure I get a scopalamine patch to prevent nausea. I always get nauseated either when I first have to sit up after surgery or when they bring me something to eat. That first meal might sound really good, but as soon as I take a bite, it's all over. I'll have 3 drains - one in the back on the lat flap side and one for each breast. I might get
away with as little as 2 nights in the hospital. Might be as much as 4.As far as activity level, he said to let my body be my guide. If something hurts or pulls on an incision or makes me too tired, don't do it. The one thing he said to be very careful of is pulling anything with the affected arm such as opening a heavy or stiff drawer. He doesn't buy into the "don't raise your arm above shoulder level" theory. It's strictly what feels comfortable or not. I know one thing that will be a problem for me - driving. Well, not driving so much as parking. My car steers really hard. Regular driving is ok, but tight turns (did somebody mention a k turn?) or getting into parking places requires some muscle power. Maybe I'll have to get DH's car for a few weeks. It's much newer and steers much easier than mine. The book of instructions the doc sent home with me (Yes, a book! Well, 20 pages anyway.) says to walk several times daily but not to strain or over exert. Common sense stuff. Nothing really aerobic for 3 weeks. Nothing strenuous for 4-6 weeks. After all that, I went over to the hospital to get my preop bloodwork, urinalysis and EKG. I didn't have to do that right away, but his office is right across the street so I figured I might as well.
Mandala, congratulations on the drive to the beach! Bummer about still needing the drains. Thanks for the tip on the Manuka honey.
Raelan, I hope you stop feeling like a linebacker soon
Andrea, I wish I had remembered to ask about cutting the nerve when I saw the doc today. These different sensations people are getting sound, um, interesting.
DPiggy, good luck on Wednesday! I know what you mean about not being able to sit still. I can't concentrate very well at work. Just think though, after Wednesday, you'll be rid of the expanders!
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funny pre-op story:
I went to get my labs drawn at a Seventh Day Adventist hospital and the nurse said were going to do a pregnancy test. I said that would not be necessary but she was insisting. I continued to argue and she finally asked (in a somewhat condescending tone) " what wrong honey, you not getting your cycle anymore?"
I said " no, I haven't seen a penis in over 10 years"--she was speechless and could only answer "oh my".
There was as older, black nurse listening to the whole exchange. She turned toward me, looking over her reading glasses and mumbled "Hmmph! Wish I could say the same thing..." !!
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