Latissimus Dorsi Breast Reconstruction
Comments
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Some surgeons do; mine did. (I found my surgeon to be amazing every step of the way - surgery, ist revision, nipple recon, and tattoo) She also gave me a muscle relaxer for the first few weeks - it really did help. What I was really unprepared for was the drains. I had one of them for over seven weeks!!
Also be prepared for revisions.
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weety i did not have that issue, every other one but not that one! they can cut the nerve to prevent this
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Read all you can about this surgery and ask your PS questions. Ask about muscle strength, how much of the muscle the PS will move, cutting the nerve, PT for recovery, massage for recovery, scar reduction. Again, for some this surgery and recovery is not easy.
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You notice it in the strangest scenarios, lol. Like when I get in the passenger side of a car, and I need to use my left arm to "lift" up and move over. When I need to pull myself up with my left arm etc....General use of the left side does not feel any different but you just don't realize what all you use that lat doris muscle for until it's in a different place, lol. I'm getting more used to it as they days go by and not as afraid to "use" it.
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just to clarify...i did ask my surgeon about whether or not they always take the entire muscle etc and he (as did my second opinion PS) said that whether or not they use the entire muscle is irrelevant, the entire muscle function will be comprimised
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Hello! I had a surgery on January 22. I have a lot of pain in muy shoulder, arm and finger( left). Did anybody have such problems?
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olgah - many of us had this problem - the shoulder issues are one that is common with this surgery, the pain is probably radiating down your arm/finger -maybe some PT is needed
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Really? I was not sure, because I called my clinical nurse and she told me it was not related... I was worrying, also I had pain last year, the pinched nerve, it hurted to drive and sit at computer, I and took 20 PT it did not help. However now pain is different, I have problems to raise my left arm and sleep on the left side.I still have exchange operation on 18 of April, so I probably wait with PT. Thank you, first what I was thinking, that it was recurrence...
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Hello ladies! I had my surgery Tuesday, April 2. It went extremely well...love my PS. I was able to go home the following day. A little soreness but no pain. I have 3 drains which I'm keeping a log of output on. I can already tell a reduction in fluid. I have my follow up appt on Tuesday, April 9 to remove one or two...I'm hoping all 3. I did not have a TE placed. I am small breasted so I liked skipping out on that. If I want...on down the road when I have nipple recon, he said it would be no problem going a "cup" size bigger. I realized I was happy I had done this as soon as I was back home. For me, seeing a mound of flesh vs seeing my ribs made it all worthwhile. Wishing all the best. I know this road can be different for everyone.
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sunny2 - So happy your surgery went well and you are happy with the decision. Happy Healing!
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Sunny, you sound like me--I'm in the process of trying to decide to just go with the LAT reconstruction and no implant or the LAT with a small implant or implant only. If you don't mind sharing, how much of a breast were you able to get with just the LAT recon? My PS seems to think he might be able to get a small B cup without an added implant. Thanks!
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Hi weety: My PS was sensitive to my concerns about implant on radiated tissue and suggested we do just the flap which would allow me to get back into a bra. I have some swelling now but I'm guessing I would be considered a small B cup. Once I'm totally healed I will consider implants but for now I am quite pleased. I had gathered some info earlier that said delayed recon using flap and implant on radiated skin had no higher complication rate than those without rads. Implant only was never an option which is just as well for I would not even consider an implant only on radiated skin. Hope this helps...when is your surgery scheduled? Wishing you the best!
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Thanks, Sunny. Here's my final decision. I met with the plastic surgeon again yesterday for the pre-op to have one last discussion before I made my decision. . . I am going to do just implants only on the "good" side since it is just prophylactic and will do the LAT recon on the left side (but at a later time) on the breast cancer side since I also had radiaition. DIEP was not an option. Got a 2nd opinion on GAP, but was told LAT would still be the best option. I think this is a good compromise even though it will be done 2 different times in 2 different ways. On my right (good) side, I've been having some shoulder/back trouble and was really scared about making it worse. I'm right handed and didn't want to take the chance. PS thinks the end result will be very similar since I don't really want to go large (B cup probably) so I signed the consent forms and am now waiting nervously for Wednesday!
One other question--I just got my CBC results and my WBC are only at 3.6 (normal is above 4.0) I've had problems with keeping them up ever since chemo over 3 years ago. Usually they are slightly within range, but this time they are below. Will they cancel my surgery? Platelets are fine and hemoglobin is at 12 (a little on the low side but within normal range.)
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weety: the nurse in me is going to answer your questions. A WBC count of 3.6 is fine going into surgery as they should give you a dose of preventative antibiotics during the surgery and continue IV antibiotics as a preventative measure while in hospital, then send you home with tablets for 7 - 10 days.
They would not be happy if your platelets were low, as they need you to not bleed uncontrollably while during the surgery so they have clear vision of where they are working and try to avoid blood infusions and it sure would slow down healing time and removal of any drains. Hemoglobin is at the low end of normal, but again, no reason to not do the surgery.
During my 5th surgery, which was the shortest time wise and simplest (replacing the implant on the LD side and tightening up the muscle after it atrophied) my hemoglobin dropped more than it did with the original double mastectomy with the LD flap on the radiation side! But six weeks later I was back up. Ate lots of parsley, spinach and red meat.....and it wouldn't hurt you to do this too!
Your choice of not going large on implants I say is smart and better for your pec muscles, as they were never intended to support an implant and less stress on you LD flap side. I was a full B cup before the surgery but went small - 225cc implants, which is about an A cup. Well, my hubby and my two BFF's and my GP think I look wonderful and so do I. I always have perky breasts (so never have to wear a bra) and even have clevage if I so choose to wear something low cut.
Good luck........
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weety: I would not have been able to answer your question so thanks justagirl!! Weety: if you feel good about your surgeon I would encourage you not to be nervous. You will do just fine. I had surgery planned for Feb 7 and got sick with a cold, then rescheduled for Mar 7 and my father-in-law passed away same week....both times I had a meltdown. I didn't realize how mentally prepared I was or how badly I wanted this until it didn't come to pass. So when April 2 came around I was excited. Once everything settles down and I have nipple recon, I will probably go with a small implant on the good side so the girls will look similar.
I will be thinking of you Wed and look forward to hearing from you. I will also pray as I happen to love my Savior, Jesus Christ.0 -
Thank you!
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Weety - I was able to get the same size breast (C cup) with the Lat Recon ,however had revision for the addition of a small implant - not for size or fullness but to create a symmetrical cleavage. Without the inmplant the reconstructed breast had a small 'shallow/drivet like' indention. It was not a big concern, but the PS said she could make it look better, so I had the outpatient surgery.
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So good to hear the good recovery going on. I am now 3 weeks out from bmx/LD/TE recon and have all drains out and taking only Tylenol and IBU. Norco at night only to rest better. Arm movement is good and no problems so far with my back. Only the swelling and muscle under my arms is bothering me but time will tell. Should start expanding TEs soon, but no hurry by ps as wants it to heal well first.
Weety-good luck on your surgery tomorrow, hope all goes well, see you on the recovery side!0 -
Just wanted to go back and re-cap what some of the girls from pages back had talked about. I had my recon and ld flap surgery in November and just had TE Exchange on March 1st. Everything was going fine till I realized I was all bound up and my whole body was crooked. The flap surgery along with the TE's really caused me to contract my left side pretty hard. It got to where it was affecting my right leg and trying to walk for exercise. Well my brain finally kicked in and I went to see my Massage Therapist and she really worked me over hard. Your PS doesn't tell you these kinds of things, it's perfectly natural for your body to react this way but I just had not been paying attention. Fortunately my massage therapist shows no mercy, lol. She said the good thing is it is soft tissue and they can get those muscles stretched back out pretty quickly. It took me two appointments to feel so much better. Ladies, pay attention to your bodies!!!
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The breast care center at the hospital at which I had my surgery done set up appointments for me to see a physical therapist, a massage therapist, a nutritionist, and a Reiki practioner post surgery. These therapies really made a huge difference, I think.
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Fitz that is very cool!!
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Hi all! Had 2 of my 3 drains removed today. PS will see me in one week...he wants the drainage to stop completely before removing last one which goes to my back...looking for this to be the case by next week. He is extremely pleased with the flap as am I. I have gotten along amazingly well. Blessings to all.
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Great news Sunny!!!
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Good for you Sunny. I know the drains are a pain but you will have them out soon! Take care all.
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Glad to hear the updates. mama and sunny glad to hear that you seem to be recovering welll! Hope weety is recovering nicely also.
I am just sitting here waiting. Watched a video of the surgery and since it didn't look too bad to me I guess I am getting settled about all of it. Now I just want it to get here and over with.
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sherrybaby: You are so very brave to watch a video of the surgery....watching any surgery would do me in! I don't even watch the nurse draw blood from me! Ha! I have continued to have good days. Anxious for the OK to begin lifting my arm more. I do shoulder rolls and bend off to the side each way and it instantly helps with the tightness. weety: you have been on my mind too. Look forward to hearing from you!
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hi ladies
i was just wondering if anyone had any thoughts on why some women (namely me and others on this board) suffer so much with this damn surgery - what have your PS told you? i am sure some of you have brought up the horror stories you have read on this board. I am just not understanding why i am having such a difficult time of it when others breeze right through. Surgical skill aside (i had one of the top in my city) what is it????
what really shocks me is that i have connected with women 3, 5 and 7 years out (from this board) who seem to be doing well and yet they ALL have had some lingering effects - leg issues, low level pain inbetween shoulder blades etc. So even when it seems women are doing well there are issues. PS's certainly dont tell you this - i wonder if its because once surgery is done they are not followed anymore. Also i think women tend not to complain about pain issues as much as men (just my theory)
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I think they should go into a lot more detail. I realize that for some it is the last chance to have a breast...I think some PS's just think we will accept what ever comes along because it was our only option. When you stop to think about it though...they are moving a muscle from where it is naturally and placing it in a new foeign place. This throws your whole body out of balance. I think we should be more prepared to deal with it and not have to figure it out on our own...like I did with my massage therapist. I don't think the TE's help matters much either...they are not comfortable and don't allow you to move around as you would like. I have had issues but they have been managable, I don't feel like I will have many problems at all 6 months from now when I get myself back in shape.
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I didn't having the lat recon and instead decided on just TE and then implant on my right side. I've had previous back/ shoulder issues on that side so we felt it would be better to avoid lat. I am at hospital now but going home tonight. When I go back to reconstruct my original bc side I will be doing the lat since I had radiation. Thanks for thinking of me!
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To Rozem: I think you are right: the PS doesn't follow us for a long period of time. Once all surgeries are done, they are done with us. I did raise the issue with my onc last time I went in, and he said to see the PS, but not going to waste the co-pay to go complain - so he still doesn't know. More people should get connected to this website- wish there was a way to get that out!!
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