Latissimus Dorsi Breast Reconstruction
Comments
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jo1955 - so sorry that last drain didn't come out yesterday. I was rooting for you. I got one pulled Monday and one remains and is still producing more than the required 30 cc/24 hrs. But my nurse practitioner (I haven't seen the PS since surgery 5+ weeks ago) says we are pulling the last drain Monday no matter what since this will be my six week anniversary. We'll drain any fluid that builds up after that with a needle, if needed. Which I figure shouldn't be so bad since much of my back is still numb. So, perhaps our last drains will come out within a couple of days of each other. I was wondering whether your PS said anything about taking the drain out at a certain date even if it was still draining and periodically removing any fluid that accumulates by aspirating?
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joan888 - My drain that came out Monday, 5 weeks post-surgery - was indeed harder to get out than the others as it had made itself at home. But it didn't hurt coming out as much as one that came out more than a week earlier which was pulled out of a very irritated entry hole.
I don't know why some of the drain tube entry areas are extremely irritated and unbearably painful and others (like the one remaining drain, thank goodness) can barely be felt at all.
I am still on antibiotics until the drains come out. The Keflex made me sick by week 2 - I wasn't eating much back then - but the Doxycyclene I have been on since then has been fine.
Jen78 and jo1955 - I also had a bout of depression at 3 or 4 weeks and I think I did attribute it to feeling ready to get up and move but feeling like I couldn't because of the miserable drains. But maybe something physiological is also going on at that point.
My drain fluids have jumped, sometimes doubled, after a steady decline and it felt like starting over again .... what a disappointment.
Can't wait to look back on these posts in a couple of weeks and "remember when"
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Abby - My PS did not say anything about taking the drain out at a certain time and then doing needle aspiration. BUT, I really think this one is come out on Monday. The overnight level came down once again. That is encouraging. I should be at about 35 ccs today. That leaves the weekend and half of Monday to go. When it does get pulled, how much is it going to hurt after almost 5 weeks. The first one was a piece of cake.
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Jo - I got a drain pulled last Monday, exactly 5 weeks after surgery. The nurse pracititioner did have to pull harder to get it out but it still didn't really hurt. Is your back still numb? I hope the numbers keep coming down for you. I am about 45 ccs in the last 24 hours ...
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Abby - My back is still numb in spots. Yesterday was at 45 ccs - today is 30 ccs. Things are finally looking up. My first drain was pulled at 2 1/2 weeks and it did not hurt at all - just really weird and was over before I knew it. In fact, the nurse told me to breathe. LOL! Hope your numbers keep coming down as well. After Monday, I will be drain free and then can move on to other things.
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Marnie, thank you for your response. I did everything you suggested and was allowed to start PT and massage (done by my pt) six weeks after surgery. Within 4 weeks my ROM was much improved and in a few more weeks I could stretch my arms as well as I could before the surgery. I continued with PT and did gentle strengthening exercises. If I am remembering correctly this constant daily pain along the incision line (scar) didn't start until a couple of months ago. I began to get twice weekly massages by my PT, who by now has become a good friends, as she didn't just want me with anyone. No improvement except relief from pain for a couple of hours after the massage.
I am going to see the PS and one of the main things I was going to ask her was about my wandering left boob, my fat flap under the LD arm side, wrinkles in one implant, etc, etc, but really my main concern now is to get rid of this constant pain and I totally agree with you that it is adhesion's. I was just wondering of the PS could use the arthroscope machine to go in a loosen up the adhesions.
Thanks for your guidance.
To Jo and the ohter drain ladies: they will come out and sometimes it's uncomfortable for a few seconds because the tissue has actually adherred to the tubing, but it's sooooo much better out. On my last drain I had to go in a couple of times weekly to have her needle aspirate the fluid from the base of my LD scar, but it didn't hurt , even when the fluid was in there. Much better than having the drain int.
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justagirl - I am looking forward to having my last drain come out on Monday. I have been a 30 ccs for a couple of day now. Finally seeing the light at the end of the tunnel.
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it does come jo.
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Overnight output on the last drain was down to 15 ccs for 12 hours. It has been at 20 ccs. This is looking so good for tomorrow. My PS appt is at 3:00. I will keep everyone posted.
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24 hours from now I will be drain free (it is 3:15 CDT). Yipee!!!!
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I haven't checked in for a few days and was hoping all those with drains would be free of them. Sorry to hear you still have your dangling friend. Sounds like you are on your way to giving it the old heave ho!
I hope tomorrow is goodbye drain day! You will feel fantastic! I promise!
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jwilco - I am so looking forward to getting rid of my dangling friend. I can't wait to go back to sleeping in my comfy bed again - haven't been there in almost 5 weeks.0
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I am happy for you jo1955. Wish I could be drain free tomorrow too. Can not believe its been almost 6 weeks and I still have one dangling friend. My PS wants to see me tomorrow and make sure everything looks okay, but I doubt that he will be pulling it. Uggh!
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joan888 - What is your output numbers? Mine seemed like it would not come down - especially ovenight. Found out as long as I was laying down it would stay high. I started sleeping in a more upright position and it gradually went down. Number today was down to 25. I sure as hell hope he pulls it tomorrow. Hopefully you will get rid of your last dangling friend soon.0
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Last drain came out today! Yipee!!!!! Go back in two weeks and move on to the next step. He wants to let things settle down and make sure I will not develop a seroma. That's not going to happen. Feel so good now.
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Me too!!!!!!!! re: the last drain out! Congratulations Jo! Doesn't it feel so good?
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AbbyM - Congrats to you too Abby. Yes, it feels absolutely wonderful!!!!!! Can't wait to sleep in my bed again. Haven't seen it in 5 long weeks.
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Congrats, Ladies! So glad to hear that more drains came out today. Such a relief, right?!
I saw my PS today for my weekly follow up (wound check and drain fluid from my back). She thinks I've still got too much fluid going in my back, so she referred me for physical therapy. I guess they'll handle it like Lymphedema. It's good timing, too. I threw out my back this weekend and have had horrible sciatica. The PT saw me today and I already feel a bit better.
Thinking about all of you - hoping that you're feeling good.
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I have a question for those of you that have already gotten your implants. I was a 36-G before my BMX. I don't want to be anywhere near that big again...but I do want to stay in the large C small D arena. My PS keeps warning me about gravity and how a heavier implant will sag more in time. I just wanted to see what your experiences have been in that regard. I haven't even been able to start fills yet, but I'm worried about the final outcome already.
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Jen ~
The implants do seem to weigh alot. I was a solid 34D prior to surgery and I am now a 32DDD. I don't have projection like a normal breast and the implants are very wide. I have a 450cc on one side and a 400cc on the other. I wouldn't want to be any bigger. Because they weigh so much and my tissues are fragile, I would think it would be crazy to go through all of this and not support them in a good underwire bra almost all of the time. I want to stress that even though my cup size is bigger now, I definitely don't look as large as I did pre-BC. I wear an x-small in most shirts.
I can see my implants moving down on my chest when I take my bra off. Gravity is not our friend, whether you have implants or not.
My PS keeps telling me I look like a C cup, but I definitely don't wear a C cup.
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Me three!!! Yeh!!! I am drain free today too! I set the office record (by 2 weeks) for keeping drains the longest. Even though the output was still running around 45cc's, my PS said it had to come out any way and hopefully will see that my body can just absorb the drainage. So I will have to keep an eye on any fluid buildup, but he does not seem worried about it. I cannot believe that I was able to put up with that last drain for 6 weeks! I will go back to see my PS in 3 weeks and then can move on to my next thing.... back surgery. Ugghhh!
Jo1955... I have been sleeping in my own bed since day one. Don't think I could have handled sleeping in a recliner, especially with my back. You are a real trooper to hold out this long. Abby... congrats to you also. Isn't this wonderful?
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Thanks, Westieluv! Getting some different perspectives helps!
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Thank you for your responses,it helps to make a decision. I sent an email to my surgeon to ask about the circle instead of the football scars. A friend of mine said she had the BMX done w/no scars because of the circular incision. She likened it to a bag that cinches at the top to close. She wasn't sure if I would be a candidate as I have the long scars from my BMX already. Anyway i'm hoping my surgeon is onboard w/this as it seems perfect for really skinny girls. Crossing my fingers.
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Joan888 - Congrats on being drain free. I could not sleep in my bed because I would automatically roll on my left side and that is where the drains were. Plus, I figured out that by sleeping in a more upright position the output went way down.
When I saw my PS yesterday he looked at my log and said to me "You didn't believe me when I said it would come out today - I should have bet you and I would have won some money." We both laughed and I called him a smarty. He is so nice and easy to get along with. Once I am finished with my bit of revision work and it is time to part ways, I am really going to miss him. Felt the same way when I finished seeing my BS. I guess I have gotten lucky in that both my surgeons are down to earth people and leave their egos somewhere else.
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Congratulations to all the with drain removals! That is so liberating! My flap surgery with a TE was 2 months ago, but the TE had to come out last week. I've lost 2 implants and now the TE on the left side. My right implant is doing well. I will have to wait 3-4 months to try another TE, but the new PS is gaurded about the outcome because my skin is thin where the infections leaked. I know the left side will never look like the right; I just want to pass in clothes. I didn't have radiation, but I wonder if the skin is thin because I had DCIS on the left side, and a tumor on the right. Who knows. I'm just tired of the roller coaster, implant in, implant out, wait, and do it again and again. Hopefully, May 28th will be my last day of twice daily Zyvox infusions. Has anyone lost a TE after their flap surgery and had a successful outcome?
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jlmg, sorry to hear about your TE. I had a thin spot on my rads side that just wouldn't heal & caused me to lose 2 implants after a lat flap. I now have an adjustable saline implant that served as a TE. It was overexpanded & I had the overfill removed last week. Now we are trying to shape it up with a tight underwire 24/7 so it will hopefully match the silicone implant on the other side. (I have lat flaps on both sides.) If that can be achieved, the saline implant will remain as my permanant implant. My PS moved my lat flap over a little when he put in the adjustable saline implant & the thin spot healed up & behaved itself during the expansion process. I'm not finished yet, but this route appears to be working.
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Well my PS says no to the circular incision vs football since I already have long scars from the bmx and delayed recon. Anyone have a clue as to why those things matter w/regard to the lat flap?
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wahooo to the girls who are now drain free :-)
I am reliving the relief I felt when all the drains were gone.....felt better than sex...lol
I am a 34C and have had my implants in for 3.5 yrs. They seem to still be in the same place...no drooping. I agree with Beth about always wearing a good supportive bra....just because we "can" go braless is not always the best thing to do with these girls.
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Undercoverebel ~. I think that the issue has to do with the vascular viability of the skin that was excised from the BMX. The PS is taking into consideration how much of that skin could be vascularly compromised and needs to be replaced with the flap skin to support an implant. We've had sisters here with skin necrosis and it isn't pretty or fun to go through.
I know that you were hoping for a more aesthetic result with the circular incisions, but unfortunately a lot of us can't go that route due to trauma or rads damage to the skin. Fragile skin does not give a good result with the implants. You will have ripples, puckers and you won't like that result either.
Have you seen pictures of the lat flap patients your PS has done?0 -
Joan888 -
Congratulations to you as well.
I'm in the same boat. My last drain came out at 6 weeks even though I was still draining 45 to 50 ccs and not going down. My Nurse Practitioner thought maybe it was the drain itself irritating the tissue and causing the continued flow so removing it may slow it down. In any case, we are watching for fluid build-up but nothing yet. I just hope it doesn't happen over the long weekend.
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