TEs. A Beginner's Primer
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Sooty - you may want to try asking the questions in the subject BREAST IMPLANT SIZING 101 , they have a great moderator who is very knowledgeable.
She has some information that you provide her and she gives you implant makes, models and profiles that might work for you.
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yes check out that thread. While there is a maximum that the te can be filled I think a general rule of thumb alot of us were told is -- when you feel you like the size of them while you are dressed , then let your ps know that. He may or may not over fill after that- depending on how he does things. That will not affect the exchange size.
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I don't know if there are limits based on one's type and amount of skin, or if it merely has to do with the type or size of the expanders. When I first discussed reconstruction with my PS, I told her I wanted to be fairly small. Perhaps that dictated what kind of expanders she put in me. I do know that for whatever reason, I do not have the option of going as large as I now would like to go. But I agree with the others--that Breast Implant thread is very informative. Whippitmom should be able to give you the answers you seek.
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Anyone know of a good alternative to Valium for when I start fills? I didn't do so well with it after the BMX (spent one weekend crying the whole time), so I'm not sure I want to take it again. Also, i will be driving myself to and from the appts, so whatever I take needs to be something I can drive with.
Of course, this is assuming I can get to the fill stage! My infection has cleared up, and I got rid of the IV abx and picc line. Hoping to get rid of this last drain either tomorrow or next week (8 weeks is enough!). PS says we will have to wait a bit after that to make absolutely sure the infection is gone and no fluid buildup after the drain comes out before starting fills. He's being very careful because i came very close to losing the expander.
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I took Tylenol about half an hour before I went for my first fill. I had no problem (felt a little tight for about a day) and didn't take anything before the next fill. I was absolutely fine. If you need something, there are other muscle relaxants besides Valium your doctor can give you. I always drove myself to my appointments. Good luck!
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I used Tylenol too. My PS prescribed Norco (sp?) for at night, because the fills always gave me a lot of back pain.
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I've got some pain meds left from surgery, so I'm covered, but do they help when the muscle spasms? After my powerwash surgery (PS opened one side back up tp clean it out and replace TE after my infection), I had some wicked muscle spasms that lasted all day. I took norco, which didn't do anything for it other than make me sleepy. It felt like someone had a deathgrip on my right TE all day long! Maybe I can get some flexeril or something. I've taken that before for my back.
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The pain meds won't help the muscle spasms, but I would definitely try the Flexeril. I also only had fills of 50cc every 2 to 3 weeks, so I had a lot of time to adjust in between fills.
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For Newbies in pain.... my sympathies!!!! I cried every day for a month after BMX, (and almost ripped the TEs out myself in frustration!) but finally got my pain under control enough to start fills a month later.
Just a few suggestions:
1.) Always check with your PS if you are in pain. Once they check you out and see that there is no swelling, infection, or obvious reason for pain, you can feel somewhat reassured that it's not an emergency. But don't take our word for it in the beginning. We're all saying that pain is normal, but truthfully, get it checked out, then try to relax.
2) My Original Girls were huge, fibrocystic, and sagged to my waist. One thing I had plenty of was skin, and since I NEVER exercised, my pecs were very lax. That actually worked in my favor, and fills were not painful, except for occasionally on the same night.
3) I did have Norco for pain, and Valium for muscle spasms, and that combination worked well for me. Others have had success with other pain relievers, and muscle relaxants such as Flexeril. Remember that NSAIDS will do a number on your stomach!!!
4) After one fill, I had some serious pain on one side, which disappeared completely after the next fill. TEs are moveable, and added saline can push them off ribs and irritated nerves.
5) One thing that I did at night after a fill was stand under a VERY hot shower with the shower massage on, and let it run on my back. The muscles that are cut to create pockets (pectoral and anterior serratus) have origination points on the back. After my shower, I would have DH do some trigger point massage on the most painful places, then a nice overall back massage. That helped me sleep.
6) At the end, when I was filled to 620ccs, I found that wearing a tight sports bra actually made the TEs feel better. I thought that was pretty weird, since they were total boulders that didn't move, but hey, it worked.
7) For the longest time, I thought of my TEs as terrorists out to torture me. It helped a lot to re-frame that, and think of them as TEMPORARY items that were there to eventually give me the breasts I wanted. They were a part of me for as long as it took to get to Exchange. Changing my way of thinking helped me not be so desperate when I had pain or discomfort. After all, This too shall pass!!!
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I had small, frequent fills - 25ccs weekly - and never needed muscle relaxers or pain meds. Always remember that you control the fills, not your plastic surgeon, if you have too much discomfort you might want to have fewer - or smaller - fills. That said, if you need muscle relaxers here are several, of course Valium, but also Soma, Flexiril, and Skelaxin.
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Blessings--thank you for that post.
...and yeah--"terrorists" sounds about right!
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Straitlover try Lorazepam. it has a shorter half-life than Valium and it usually helps with my muscle spasms. When I take it I don't drive...
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I took extra strength tylenol after my first fill...it wasn't all that painful...until the next morning when I woke up and felt like i'd been shot but a few more extra strength tylenol and i was okay after that ... from reading all the posts I feel like one of the lucky ones that didn't need to have drainage tubes when I had my TE put in...I've also heard that radiation can make stretching of the skin harder to accomplish but again..i was lucky and didn't need to do radiation (just chemo)...I do however notice that when i lightly press on the top portion of my breast..i can fell the "balloony like" texture underneath...a little creepy..but no more creepy than being able to touch where your breast used to be and feel your ribs
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I agree-- see how it goes, might not need anything. I didnt. And I agree-- YOU control the fills. Low and slow is the way to go.
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I just had my TE's placed today. Omg, the stiffness across my chest is unbelievable ! No drains as I had my bmx in Feb 2013 but I did have 16 rounds of radiation.
Anyone know how long this crazy stiffness lasts?
Thanks
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shoppygirl - Everyone is different..but mine lasted a good 2 weeks..but if you can stand it, move your arms a little bit everyday to get movement..I'm 4 weeks in and feel much better..but i still have muscle pain..remember we all are different..
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Hello all. I am sorry so many are in pain! It usually will not get better but give yourself to heal.i know we want this over with asap, but it does take time for the muscles and skin to stretch.
Much love.
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Moon, did you mean it really WILL get better?
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Did you all get instructions after mastectomy and/or when TEs were placed, for stretching and exercising to increase range of motion? None of my docs mentioned any such thing to me. It's only because of my research here that I feel that this must have been overlooked in my case. It seems like my ROM is increasing naturally, but the tightness in my pects and under my breasts feels like if I try to stretch, I might actually break my skin.
So--were you given explicit instructions? And at what stage in your recovery did you begin these stretches/exercises?
Lastly--are any of you going to the gym? Can you do some arm/weight exercises? It seems like I could work on my biceps at least?
Any thoughts?
Thanks!!!
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hi everyone I have a couple questions maybe you can answer.
After chemotherapy is done in early December I will be getting a bilateral mastectomy. I have decided I do want some breasts. I have not met with my plastic surgeon yet.
Has anyone here been able to save skin and nipple that is HER+? My instinct would be they are going to want to take it all, and I too will need tissue expander's.
Can I get the tissue expander's place at the time I get my mastectomy? I want to avoid as many surgeries as I can. How long do the tissue expander's have to stay in?
I am a B cup right now and do not want to go any bigger.
Thanks everyone!
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hello
Thanks for your responses
I was not given any intructions for exercises but when I had my mastectomy last year, I did some them so I am assuming they will be the same.
The tightness is quite unbelievable !
Hugs to all
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I had read stuff on here before my surgery so was able to ask some questions about excercise, and te size before surgery.
I was not able to have nipple sparing, but would rather they were gone than worry about too much tissue left to potentially recur. Talk to your ps beforehand about size and shape. Barring something you havent mentioned or a quirk of your ps, you should have no problem getting the expanders in during the surgery. Check out the Breast Sizing 101 thread for some super information.
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My breast surgeon gave me a DVD with exercises, but I did not use it. In the hospital following my BMX, I was given a printed sheet of exercises by PT to improve arm and shoulder movements but was not permitted to do any exercises that involved lifting my arms over my head until my drains were removed. I did the exercises twice a day. After a month or so, my PS did not think my range was were it should be and sent me for eight sessions of PT. I felt that was a big help.
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i wasn't given any specific exercises to do after my TE was placed...discharge papers just said to do my exercises..but I knew the ones they told me to do after having my mastectomy...I didn't really do them tho..being a single mom with a 5 yr old running around, I didn't have alot of time to lay around and recover so, although I did take about 2 weeks, I still tried to do what I could as much as I could. Just regular everyday activities that required me to use my arms seemed to help give me my range of motion back. I would just say don't baby your arms so much that they get stiff...I'm not saying to lift anything heavy or do anything that is gonna cause extreme pain but pushing the envelope a little here and there will get you your range of motion back...the doc suggests putting your hand on the wall and walking your fingers up it the wall as much as you can a few times a day ...
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I was not given specific exercises to do other than walking my hand up the wall (which I did in the shower, aided by the warmth of the water to loosen my shoulders) and gentle stretching. I had a lot of surgery in a short period of time so never did too much of this until after chemo when I saw a LE certified PT, due to a diagnosis of LE during chemo. I recommend asking for a PT referral, preferably for someone that is LE certified, as they know how to guide any exercise. My Gyn NP (herself a BMX patient) also recommended going back after exchange to visit the PT to prevent any loss of ROM from that surgery - it was a good idea.
bippy - I was Her2+ and node positive and had skin/nipple sparing BMX. My surgeon had initially recommended a lumpectomy that would have left the nipple anyway as my lump was well away from the nipple, so there was not as much concern about this. You have to be a candidate for nip sparing - usually smaller breasted, with little ptosis (droop) and the size and location of the mass is a factor. I did have the nipple cored out and a separate pathology done on that tissue. I did have expanders placed at the time of BMX, but if you are wanting to stay on the smallish side you may be able to do skin/nipple sparing one-step direct to implant and skip the expanders altogether. If you do the expanders talk to your PS about the timeframe. How long they stay in depends on how fast your PS (and you) want to expand and how large you wish to be, how long you take to heal from the BMX before beginning to expand, and then how long your PS wants the fully expanded TE to stay in prior to exchange. There is no standard on this - some expand and exchange quickly, others want to wait longer after you are completely expanded.
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thanks Special K, that is great, helpful info! I would be happy with smaller to simplify things! I am worried about there being cells left in nipple tissue, or skin, so if they say no, that is okay. and this is also new to me that I don't know what questions to ask the PS. Well I should say I didn't know but now I do!!! I'm eligible to do just a mastectomy, but onco recommends and I agree, to a bilateral. Dense breasts, and mammo does not show my tumors, i found them myself. I'm hoping I never have to go through this again and don't want to take the chance....I know it's no guarantee but mentally I will feel better about it. I've been researching implant types, - a whole other issue! But I know plastic surgeons have their preferences so I'm just going to wait and talk to them.
Thanks for the information, it is very appreciated.
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Hi girls-- Well lots has happened since my last post ...infection set in and a trip to the ER was warranted left breast wall inflamed high fever...yea not pretty ..will make this condensed . I have been on iv antibiotics since last Thursday ..recovering slowly. Have had the site drained twice..iv out yesterday and oral antibiotics have replaced them. I knew going in that my left would cause havoc . I pray this is the end of problems . My right is fine no issues so I can tell the difference .I was in pain about an hour ago almost nauceous pain...downed 2 Tylenol ,ate some brekkie. just chilling . How much is too much to do I feel like an invalid .Thanks for listening.
Cheryl
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Hi ladies,This is my first post. I have been reading along since March and have gotten lots of good info from everyone on this site.
Iwannacookie: I had BMX July 21st. I was not given any exercise for ROM either. Someone on another board posted this link:
http://www.mskcc.org/videos/exercises-after-breast-surgery-reconstruction-using-tissue-expander
It is from Sloan Kettering Cancer Center.
I have been using this video and it helps a lot. My cancer side TE is having muscle spasms and the stretches and walking daily help some.
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Thanks Willowreed--that's perfect!
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I just asked this same question in the "Exchange City" thread, so forgive me if you've already read this. My concern is that my breasts bulge more on the outside than on the inside. When I swing my arms, I can feel them rubbing my boobs. I've had my last fill, and have to wait another 3 months before my exchange. I'm wondering if this is unusual or a problem, and if so, does it need to be dealt with now, or will it be corrected with the exchange. I'm just trying to gauge if this is "normal" or not because I don't particularly like my PS, and I would rather not have to email her if I can avoid it.
Thank you.
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