TEs. A Beginner's Primer
Comments
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Your discussions have motivated me! I meet with my PS for a pre-op for exchange surgery next week. I'm gong to ask then about talking with the anesthesiologist about having a PVB. I must have had something like when I had my biopsy surgery. I know it was not general anesthesia but I was basically asleep. I woke right up when they turned it off and felt great. What is that stuff they knock you out with? Propofol? I think that's what made me sleepy and they can turn it on/off quickly. Nothing like my experience for BMX. I simply can't adequately describe the hell I felt when I came to after BMX.
Is the block something they inject through IV or differently? My DH had knee surgery and they gave him a block, I think, but all the injections he got were around his knee. I'm positive I only had an IV for my biopsy.
Glad things are going well grandma3X. I see your profession is marine biology/biochemist. My 15 year old DD has marine biology at the top of her list for college. Any advice you'd recommend? I'm overwhelmed just dabbling into college programs for info! Ever heard of a newish major called bioengineering? Got a little of topic here, didn't I?
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Jessie- my block was administered like an epidural - since it's a physical nerve block of a specific areait is not something that can be done with an IV.
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JesseJake - yes, it was propofol that they used to put me to sleep and it really did feel great coming out of anesthesia. I just felt very rested and it was like waking from a long nap. The PVB is to block pain and is injected along the side of your spine. They did a series of injections from top to bottom. It was slightly uncomfortable but they gave me something through my IV (I think it was versed) to put me at ease. I wouldn't call it painful, but it just felt weird.
I have heard of bioengineering, but do not know much about it. If your daughter is interested in marine biology, there are several good programs around the country. We have a new undergraduate marine bio program at the University of Delaware. The university is located in Newark, DE, but the students also spend a semester at the marine campus in Lewes, DE, where they can participate in research.0 -
Ok, yikes, here's where I become a big baby! I do believe that is what my DH had because I recall him having versed as well. I watched them inject the block into his knee. I don't mind looking but I don't like pain! Maybe it wouldn't be too bad if the sensation is more "weird" than pain, but I'd still be anxious!
I'll add DE to my list of colleges to look at. Thx!
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grandm3x, don't you like how we learn from each other? Mine was pure dumb luck. My anesthesiologist assigned to me was also a pain management doctor. I hope to ask for the same anesthesiologist. He's the first one that really took my aversion to anesthesia seriously. The only pain I had post op was from the TE.
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Molly - yes! I have learned so much from other women here!
JesseJake - I checked my notes and it was fentanyl they gave me (not versed) when I had the block. I think versed is for nausea.0 -
Thx, grandma3x, that sounds familiar, too
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Grandma3X, how long does it usually take the block to wear off?
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Lori - the PVB lasts for about 24 hours. I think it wears off slowly so that by the time it was out of my system I was already on a good pain med schedule. As long as I keep on a schedule my pain stays at about a 1 or maybe 2 at the most. On Fri. I didn't keep to my schedule and the pain did get worse (2 days after surgery) so I know the PVB had worn off by then.0
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Thank you for the information grandma3X. I think I might try it if it's offered. Seeing that I'm having a double modified radical mx I may just ask for it. It makes me nervous as the one I had 34 years ago didn't work but they've come along way in the medical field. I'll put my big girl panties on and go for it
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WenchLori, there is a study that says that opiods can possibly help spread cancer so the paravertrable block is safer. Here's the link http://www.uchospitals.edu/news/2012/20120321-opioid.html
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Thank you Molly, going to read it now 😀
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Thank you Molly, that was very informative. Let's see what else I can learn today.
My DH will start a conversation about what to expect after my procedure. When he says such and such will happen, I'll say not really as such and such could cause some problems. He'll ask where I learned that from and I tell him my BCS on BCO has gone thru it also. Then I get "Stop clouding the issue with facts" he's so funny
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Thanks Molly! I am scheduled for pre-surgery testing on June 7th. I called them this morning to confirm that I could discuss anesthesia options at that time. I will come prepared. Interesting the only pre-surgery test they are doing is bloodwork. I was under the impression that an EKG was also generally done. I like to know what to expect before I get there!
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It is very common to receive Versed in pre-op, it is a sedative often given just prior to being wheeled off to the OR. It is the med that often makes one unable to remember leaving pre-op. Fentanyl is an opiate pain med. It is likely that either of these would eliminate anyfeelings of pain or nervousness during the administration of a PVB
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Alex, I know what you mean about breathing. It was very difficult for me in ththe first post-op days to get a full breath. Even now, after one fill and four weeks (talk about taking it slow!), I sometimes feel my breath "catch". Since I practice yoga I've used a lot of breathing techniques from that, but the easiest is just a mindful belly breath, in and out of your nose, to a slow count, when you start to feel panicky. I hope that eases for you!
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I just realized I've been lurking without posting! First of all, thank you Moon for the the thread- it is so comforting to be able to hear other women's voices through this process! I had my bmx last February, followed by chemo. At the time, recon scared me and it was just too much to think about, with too many unknown variables in treatment. I thought for awhile that I would just "go flat" and kept that idea through treatment and all of the accompanying emotional stress. However, once I started to live my "after" life, I realized I wanted at least a little something something (I'd been a 34C, so it was a hard fall to concave!). I was terrified that I had blown my chances though, since I hadn't done an immediate recon. Fortunatly that was far from the case. However, I'm small-framed, with tight pectorals and thin skin, so the process has been super slow! Four weeks out and I have 40 ccs and one stupid JP drain (Ugh!). Having been flat and learned to be ok with that, I'm thrilled with even the small bumps I have (I told DH I look like a well-developed 13 yo boy, lol). Having done it this way, I'm honestly glad I waited. It's given me so much patience with the process, and I am not someone naturally blessed with patience! Tomorrow I will hopefully get this last JP drain out so I can start moving again. Being still has been the worst part of the whole thing, for me. I just wanted to say I feel grateful for the posters assuring us that slow is good. I know I'm just at the start of a very long process and I'm trying already to figure out how long it will take!
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Hi everyone, I would like to join this thread and am seeking advice from those of you with more TE EXPERIENCE than I. My BMX with immediate TE placement was May 4th, 2016.
- At week 1 PO, two of my 4 drains were removed
- At week 2 PO, expansion was begun but the remaining 2 drains were left in place. My first fill (40cc) was not painful at all. A slight increase in tightness was shortlived and soon disappeared.
- Today, week 3 PO checkup, my 2 drains still remain (output was near 30 cc daily but not below). We added another 50 cc to each TE and this evening, my final output for each drain exceed 50cc. I'm also in some pain (a deep ache)
Can anyone recommend good strategies for reducing post expansion pain?
I caved in tonight and took one of my remaining (few) strong pain meds.
I put on a supportive bra and it helps reduce my TE pain, but because two drains are still in place, the bra is causing me significant pain at the drain sites.
Does ice or heat help?
I'd appreciate any ideas you may have!
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LRG - I did not keep my drains long enough to start fills while they were still in, but for those who continue to produce fluid initiating fills can sometimes help reduce fluid production, and allow the drains to be removed sooner. There are different schools of thought on fills with drains, as the longer you have the drains the greater chance of introducing infection. For pain - do you have any muscle relaxers? Valium, Soma, Skelaxin, Flexiril? A muscle relaxer combined with Tylenol might be enough to help with pain control. Some doc's approve NSAID use, which is anti-inflammatory and can also help. I would not use heat or ice on the chest itself as the skin is thin and can be damaged, and the fragile blood supply to the skin impaired Some people get some relief using either on the upper back.
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SpecialK, Molly50, and WenchLori, here is a thread discussing
"A Simple, One-Time, Inexpensive and Non-Toxic Intervention to Improve Cancer Survival"
https://community.breastcancer.org/forum/73/topics/843381
It is a combination of several threads with similar information. If anything, the video is worth a watch.
https://www.youtube.com/watch?v=H8zVrYEW8vE&feature=youtu.be
Best wishes,
Madelyn / Mominator
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mominator - I'm way past that point, I was dx'ed in 2010. I am an exceedingly complicated surgical patient so have worked out the particular things that work for me. I am familiar with the threads, but thanks for bringing them here,they are full of excellent info for those new to this.
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LRGO2016-I only had 2 drains in, they came out 4 days PO. I did use ice on my chest(was ok'd by my PSas I had significant bruising and swelling on my non cancer side. I found if I did nothing and iced my output was greatly reduced. If I started doing too much my output would increase. If you are using ice make sure you have something between the Icepack and your skin. Good luck, I hope you can get those drains out soon.
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Has anyone else ever been told that they can't take both drains out the same day? For my first MX in January, they both came out at my first postop visit. I just had a PMX of the other side (same BS and PS) and the nurse told me that they never take both drains out the same day. That the risks outweigh the benefits. My appointment is on Friday and both drains are already less than 20 ccs per day and have been for the past 48 hours.
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grandma - posted on your other thread
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grandma-I had two drains in each side and all 4 were pulled at the same time. Docs are different. My fills seem to be a lot different than everyone else's but it's working. Hope you're feeling well
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Thanks SpecialK and BethL - I can understand doctors having different ideas, but this is the same doctor - just 2 different nurses in her practice!0
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thanks for the advice. I checked on ice idea with my PS. He said no to ice as my skin is still too fragile. So I'll forgo that idea. Pain today is nominal even without pain meds. But I'm still feeling tight, tight, tight! I'm hoping this tightness feeling will diminish after we reach full expansion and exchange. It is taking some getting used to for sure!
I did a bit much today. Drain outputs are up in the 50 cc range again. Tomorrow is a rest day for me!
Goodnight all...
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Ok, I also wondering whether the lumpy and highly irregular shape my right TE seems to be producing after only my second fill, will eventually round out as we reach max fill?
Right now my right breast is filling with surficial irregularities that suggest weak areas in my skin or muscle over the TE. Is this sort of thing normal?
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LRGO - My left TE is currently at 210 cc's - started at 60. For me, it looked really lumpy initially and then with each fill seemed to get lumpy again, but smoothed out between each of the fills as the muscle stretched. I'm waiting for my right side to catch up before resuming fills again, but even with only 210 cc's, I like what I see. Everything is smooth and round.0
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I have had little issues with my expanders until my last fill and am now considering stopping. They're plenty big enough so it would be fine. The center of my right side still looks like it needs more projection expansion, which is why I was gonna do another fill. I get fills every 4 weeks. Each one is 100ccs. This last one just about did me in. I'm ok until I try and get out of bed in the morning
I can barely move. Once I'm up and moving they're fine. Why after lying on my back (and propped up) do they hurt so much? Reminds me of those first days/weeks after bmx.
Surgery isn't until aug 2. Now I'm freaking that I had to go 2 more months like this .
I currently have 620ccs in. Skin looks good so that's not the problem. Must be the muscle. Pain is worse on right. Maybe cutting amount in half next time would expand with less pain. Not sure why he puts so much in at once but until now it's been ok.
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