Latissimus Dorsi Breast Reconstruction
Comments
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katehudson - I am keeping my fingers crossed that your blood pressure is fine today. Once the drains come out, you will have such a sense of relief. I can still remember when I got my last one out. It was invigorating!! (((HUGS)))
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Momluke, if the spasms persist, you might want to check with your PS and see if he/she cut the Thoracodorsal nerve during surgery. Some PS's routinely do cut it when doing the lat flap to avoid the spasms becoming an issue, others don't because sometimes the muscle can lose a little of the bulk without the nerve. My reconstructed breast jumped and spasmed terribly. The spasms didn't hurt, but that constant tightening seemed to pull my shoulders all out of whack, leaving me with constant, miserable shoulder pain. After putting up with it for two years, my breast was very smashed in, pulled up, and distorted. From articles I read on the BC forums, I found out that Botox shots in the breast could give temporary relief to the spasming. After 2 years of that misery, I was totally game to have someone stick a needle in my breast and armpit (around 8 pokes) for some relief. It pretty much stopped the spasms. Shoulders are improving. I plan to go in at the end of the year and have the nerve cut, and probably even have the implant removed. I just don't think my body appreciates the foreign object, cause it's never stopped hurting. Radiated breasts seem to have more issues with implants. I am looking at having some fat grafting to replace the implant bulk. (My implant is very small) I hope your spasms settle down on their own. But if they don't, don't let it go on for too long.
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Movingon1 - So sorry you have to go thru all of this. I had a lat flap after a UMX two years ago. Honestly, I've hated it. There's a bit of a bulge under my armpit where the muscle got burrowed through. I've heard some women describe it as feeling like you're constantly carrying a rolled-up newspaper under your arm. It's very uncomfortable. Not only do I have a breast that is numb, I now have a chunk of my back that is about 8 in. long and 6 in. wide that is numb. Yet, I constantly get this deep itch on my back, and scratching it gives no relief, but feels so creepy its hard to describe! That seems like an awfully drastic thing to do to repair a lumpectomy defect. I have been reading up a ton in the last 6 months on micro fat grafting. I think this will totally be the way breasts are re-built in the future. No more of this moving muscles or patches of skin, leaving big scars and big numb spots. There are getting to be more and more doctors who are trained in the micro fat grafting. They liposuction fat from your own body - abdomen, thighs, hips, and then inject that fat into the breast area. Right now, lumpectomy defects have a really great result. Creating full breasts from fat grafting is starting to get some amazing results too. I wish I had gone to the forums sooner and learned about this before I let myself get all cut up! Look up fat grafting at the Miami Breast Center, where it was developed by a Dr. Roger Khouri (I think that's how his name is spelled.) You can see video of the procedure, pics of patients, etc. It's very fascinating! Be smarter than I was. Learn all of the options before you make any big decisions.
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lalove55 - Fat grafting does sound like a better way to go in some cases. The only problem I see with it is, a lot of insurance companies are not yet convinved and therefore will not pay to have it done. As far as getting a lumpectomy defect fixed, half of my left breast was removed even though my tumor was very small. It left my nipple pointing down and off to the left. It is really discouraging to look at - so much so that I could not stand naked in front of a mirror or I would cry. I am very happy with my lat flap. I don't have the issues unfortunately you are having.
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katehudson2: not to turn you into a nurse, but we girls have to make taking care of ourselves Number !.
There are simple machines that can be used a home for a person to take their own blood pressure. You put the arm wrap on and press a button. Simple. Then write down the date, time and reading. Do it once a day upon awaking and then when you go to your Dr., you will be able to give him a good history of what is really going on with you.
Numbers: a reading of 140/80 is regarded as 'normal'. The first number represents your heart as it ejects the oxygenated blood out of your heart into your system. This number will flux up with pain and anxiety and down with rest and no pain. The bottom number indicates your heart as it fills with blood. This number won't flux as much based upon what's going on with you.
Summary: the top number is fine if it goes no lower than 100 but you let your nurse or Dr know if it goes above 160. The bottom number is fine if it goes no lower than 70 but should not exceed 90. If your blood pressure upon doing your morning reading is below the 'lows' or higher than the 'highs' then relax and retake it in 30 minutes. If your numbers aren't much different, then call your Dr or nurse.
This might be too much for you but I think information is power and I can imagine you wondering since you left the emergency room and until your home nurse arrives worrying if your blood pressure is down.
Most of us have also learned when we have pain after leaving the hospital, it's better to take the medication for pain and/or to relax the muscles at the first sign of discomfort as long as it is within the prescribed time and amount, than to wait and let the pain and muscle spasms worsen.
Again, Kate, if this is too much for you, then ignore me. The teaching RN in me just comes out at times.
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Lalove55....thanks so much for the info. I will definitely mention that to my PS on my next visit (when I have my last drain removed). I had mentioned it earlier this week and he said that muscle is still trying to act like its still in my back. He said it might last up to 6 months. But if cutting the nerve is an option now I'd rather do it while I'm on short term disability.
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momluke - I had my muscle cut at the first surgery in April and then again in Aug. After the last time, I lost the "fullness" under my armpit and I now have a much more soft, natural feel to the breast. No regrets. I would do it again if I had to. I am very pleased with my results.0
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Jo and Just a girl, thank you so much for your support. I am still having blood pressure issues, but I have a wonderful internist who is concerned, and monitoring it. He is even calling me on his day off tomorrow. I had one of the back drains taken off today-Yeah! I still have one back drain and one breast drain left. I still can't shower, because my surgeon does not want me to until the breast drain is off. I see her again on Monday, and I am praying that I can get both drains off.
Justagirl, thank you so much for all of the info. It was very nice of you to post it for me. It is helpful, and I appreciate it.
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Jo and Just a girl, thank you so much for your support. I am still having blood pressure issues, but I have a wonderful internist who is concerned, and monitoring it. He is even calling me on his day off tomorrow. I had one of the back drains taken off today-Yeah! I still have one back drain and one breast drain left. I still can't shower, because my surgeon does not want me to until the breast drain is off. I see her again on Monday, and I am praying that I can get both drains off.
Justagirl, thank you so much for all of the info. It was very nice of you to post it for me. It is helpful, and I appreciate it.
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Jo and Just a girl, thank you so much for your support. I am still having blood pressure issues, but I have a wonderful internist who is concerned, and monitoring it. He is even calling me on his day off tomorrow. I had one of the back drains taken off today-Yeah! I still have one back drain and one breast drain left. I still can't shower, because my surgeon does not want me to until the breast drain is off. I see her again on Monday, and I am praying that I can get both drains off.
Justagirl, thank you so much for all of the info. It was very nice of you to post it for me. It is helpful, and I appreciate it.
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Jo,
Thank u so much for the encouragement about helping the flap feel a little better. I love this forum because I try to explain to my DH how things feel and he says "okaaay?". He is totally supportive but can't empathize at all! Gotta love him!
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katehudson - I'll say you have a wonderful internest. You won't find too many that would call on their day off. I hope you get the blood pressure issues resolved quickly. My PS did not want me to shower either with the drains in. Can you imagine not showering for 5 1/2 weeks? I found a way to do it and I never said a word to him. I kept the drains sites cleaned and covered and had no problems with infection or anything else for that matter. I used the plastic wrap that is sticky on one side. I had my DH tape it over the drains and when in the shower I kept that side out of the water as much as possible. Yes, it did get wet some but I just made sure I dried that side off really good.
Momluke - My DH is the same way. Tries to be supportive but can't empathize. That is also why I love this board. Just wanted to mention if you do decide to have the nerve cut now, it is an easy out patient surgery. My PS made an incision on the lower part of my armpit and went in that way. It is now a very thin line and is not noticeable. You would only know it is there if I showed it to you. I went into surgery at 7:30 am and was home by 11:15. He used steri strips to close the incision. Went out to lunch with DH and really felt great. I think I took one pain pill. Went back to work the next day.
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Jo 1955 yes I am blessed to have such a caring internist, and I have good news my blood pressure was only 134/94 after the blood pressure meds wore off. Now if I can only get these 2 drains off on Monday I will be so blessed. OMG no shower for 5 and a half weeks is so discomforting I am glad you were able to cheat a little and take one. Have a nice weekend.
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katehudson - I also hope you get the drains out on Monday. Let me know what time your appt is so I can be in your pocket.
I have a follow up appt on Wed with my PS. I hope this is the last appt. Last time I said that, I left scheduled for a revision in the hospital - second time to cut nerves. This one should be a final check and photos. I love my PS - he is the best but it is time to say good bye and only after 5 1/2 months. Wish me luck ladies.
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Hi Jo1955, thank you again for your support. My appointment with my surgeon, on Monday is at 5:15 pacific time. Good luck with your appointment Wednesday. I will pray that it is your final appiontment. Best of luck for sure!
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katehudson - Okay! That is 7:15 for me. Dinner and dishes should be out of the way by them. LOL! Remember, we are all in this together.
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Hi ladies - I hope both of your appointments go ok. I haven't had my final appt with the PS yet. I think it will be after I get the nipple tattoo in November. My new nipple has flattened out a lot. It's still there but doesn't really show in clothes. Which is good, except the real side seems to be always sticking out. I can wear a lined bra, but part of me would rather have the new one stick out just a little more. Anyway....it's also been hard to think "that's it?" for this past year of BC. It's been a year since diagnosis and will be a year on Oct 11 since my UMX. Overall I'm happy with the results of the lat surgery. It still amazes me that they can do what they do with rearranging us around.
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jwilco - Congrats on one year cancerversary. I am also amazed at what the PS can do. He did a nipple lift - not too much and it made a huge difference. It was his idea - he is such a perfectionist and I am so glad.
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At risk of stating or asking the obvious but here it goes....I miss sleeping on my stomach! In fact, I normally sleep in what I affectionately call the lobster position, on my stomach with my hands above me on a different pillow. This position was birthed out of my surgery for carpal tunnel syndrome.
Sleeping on my back makes my legs and lower back hurt, even with a pillow under my knees. I had a reduction and lift of my healthy breast at the same time as my MX/reconstruction. Sleeping in a chair is just as uncomfortable.
Ok...venting over! Now back to being grateful for being on this side of my surgery! 0 -
I have a question regarding what the drainage amount had to be for your surgeon to remove the drains. My surgeon says a maximim of 20 for each day for 2 days in a row. On the internet it says 30 for 2 days in a row, and the hospital paper I received said 30 for 2 days in a row. I am going to my surgeon tomorrow and I think I will average 30 a day instead of the 20 she will require. I am just about to lose it from these aggravating drains. I am experiencing so much pain from them.
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I have a question regarding what the drainage amount had to be for your surgeon to remove the drains. My surgeon says a maximim of 20 for each day for 2 days in a row. On the internet it says 30 for 2 days in a row, and the hospital paper I received said 30 for 2 days in a row. I am going to my surgeon tomorrow and I think I will average 30 a day instead of the 20 she will require. I am just about to lose it from these aggravating drains. I am experiencing so much pain from them.
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My PS set the limits to determine if the drains can come out. The first 2 that came out had the goal of less than 30 in a 24 hour period. The last one (which I hope will come out tomorrow) has the goal of less than 25 in a 24 hour period. I agree....the drains are the pits. I had my surgery over 2 weeks ago and I still have one hanging on!
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Momluke I am sorry you still have a drain after more than 14 days. I sure hope you get the last one removed tomorrow. Tomorrow is my 13th day, and I can't tolerate it any more. I was up most of the night with pain. Tonight I have taken a percocet and I am drinking a glass of wine, and all that has not taken the edge off the pain. I see my surgeon tomorrow and I am going to beg her to take these darn things off.
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katehudson, with my first lat flap I had a drain in for 6 weeks. I had gone back to work after 2 weeks & ended up "crashing" from dehydration. With my second lat flap, my PS reacted & pulled it when I was down to draining under 80cc a day, I believe. I did not have any problems with fluid accumulating either time. Hope you get yours out soon!
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katehudson - My PS preferred 20 ccs a day but took them out when they were at 30 ccs per 24 hours. I had two and my last on came out at 5 1/2 weeks. I know they are a pain in the ass. With the last one, the stitch started pulling and the site was sore. I never got an infection and when the nurse pulled it out, it did get stuck a bit but she was able to get it out with no problems. I sure hope you get that pesky last one out real soon.
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katehudson - My PS preferred 20 ccs a day but took them out when they were at 30 ccs per 24 hours. I had two and my last on came out at 5 1/2 weeks. I know they are a pain in the ass. With the last one, the stitch started pulling and the site was sore. I never got an infection and when the nurse pulled it out, it did get stuck a bit but she was able to get it out with no problems. I sure hope you get that pesky last one out real soon.
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katehudson - My PS preferred 20 ccs a day but took them out when they were at 30 ccs per 24 hours. I had two and my last on came out at 5 1/2 weeks. I know they are a pain in the ass. With the last one, the stitch started pulling and the site was sore. I never got an infection and when the nurse pulled it out, it did get stuck a bit but she was able to get it out with no problems. I sure hope you get that pesky last one out real soon.
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Finally got my last drain removed today! I am so happy. The Dr had to remind me to take it easy! I think I'll take his advice!
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Momluke I am so glad you got your drain removed, Yeah! I know what a relief it must be. I hope I am as lucky as you. I see my surgeon at 5 pm pacific time and I am praying to get these God awful 2 drains off of my body. Jo1955 OMG drains for 5 1/2 weeks. You are much more patient then I am. I would have yanked them off myself by then.
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katehudson - Please wear something with big pockets so I don't get squished - LOL! I also hope you get the drains removed today. You have no idea how many times I wanted to clip the stitch and pull the damn thing out. I made a pest of myself at my PS office. It was such a relief to get that last one out. Please keep us posted. HUGS!!
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