DIEP Flap Reconstruction 2016
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So, Jbdayton - A friend of mine thinks my arm was probably positioned in a manner that the nerves became pinched and that this may have then caused swelling that then limited nerve flow, which then caused the extreme numbness that I'm experiencing. The itch is bad because the numbness is at the superficial skin level whereas the itch is the lower tissue and we can't connect to that because of the damage at the superficial skin level. She's a former nurse - it all made sense when she explained it, not sure I've re-explained it well here. Long and short it sucks!! (Oh, and the first time I had nodes removed it was through an incision under my arm, but this time would've been through the cuts for the lumpectomies; however, there could've been digging because of the ARM procedure I had to limit the nodes taken).
Well, late - think I'm gonna turn in for the evening!!
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Mel2328, great suggestion to bring flip flops to the hospital. I was going to bring slippers, but had not thought about the shower.0
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thank you bigsister. Your post gave me even more courage. I meet with the PS Tuesday for follow up from the TE removal surgery. I still have a TE in the right, the left was the cancer/radiation side.
Back when he explained I could do a flap recon down the line he said he'd just swap the TE out on the right for an implant, and since I'm thin, I could have decent size breasts only doing the left with belly donation. Is this a bad idea to have two types of recon? I have so many questions for him now that the danger from the infection and fear from the emergency surgery is passed and can't wait to meet with him and discuss what his plan is.
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flipflop, what is your BMI? I am 5' 11" and 175 lbs, which put me at 24.4, which is the high side of normal (18.5–24.9). You can calculate your BMI here: http://www.bmi-calculator.net . My belly gave me 2 C breasts, which was more than I was expecting.
You could go with an implant on the right and a DIEP on the left, but I am not sure you would want to--whether you would end up lopsided. You get the same tummy incision whether they do one or two breasts, and it is possible to put a small implant under the DIEP to give it more volume. You can also get more volume from fat grafting. Is the PS that you are getting your information from a DIEP surgeon? Meaning he does a lot of DIEPS (1-2/week)? If not, I would not count on his wisdom.
You have time. They usually have you wait 3 months between surgeries. (If he is pushing to do something sooner, I would be concerned!)
Also, since you had an infection, you'll want to be bolstering your immune system. Be sure to be taking probiotics. My doctor recommended a long-acting one: Probiophage from Designs for Health. They are pretty pricey, so if you would rather go to your GMC store and get a good probiotic there, that should work. Just be sure to get a refrigerated kind.
She also had me take a bottle of glutagenics from Metagenics. You take 1 tsp/day in water until the bottle is empty. It helps make your gut flora friendly to good bacteria.
I have also gotten into fermenting my own sauerkraut. It is super cheap and provides huge amounts of probiotics and my cruciferous vegetable to boot! If anyone wants instructions on how to do it, just PM me.
If you aren't eating healthy, now is the time. Focus on good proteins and veggies, especially the green leafys. Limit the grains. Just because they are whole grain does not mean they are good for you!
Do be encouraged that the risk for infection from a DIEP is much less than for an implant. The implant brings a foreign body into the mix, and germs love those. The DIEP is all your own tissue with a good blood supply, so the risk for infection there is much lower.
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calculated me at 22.71. He is a general plastic surgeon but he said he's done "quite a few" flap procedures with great success. I'll ask exactly how many when I see him. He said when I saw him after the surgery "a long time down the road" and my radiation oncologist recommended an entire year from end of radiation which would put the recon after 12/24/16.
Thankfully I have so much time. The right looks beautiful. The left did too. Everyone who saw my temp recon was amazed he made me look so natural (minus nipples) so naturally he and I are bummed to have to rip up his good work. That's why he wanted to leave the right alone and do an implant swap. Since it's so nice looking. But I do worry about the lopsided aspect if Ido go that route.
Thanks for the probiotic tips! I do eat green and try and limit grains already so that should help. Until this crappy dx I never had any medical issues (expect fertility) not even a cavity. I was a healthy active 36 year old. But such is life...
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flip flop, it sounds like you are in good hands.
Fwiw to anyone else, this is allthey had to work with for my DIEP. Somehow it was enough for two C cups. Hurray!
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Back to work part time starting Monday! I'll be one day shy of 4 weeks post op. My surgeon has told me I need to do 1-2 weeks part time before going to full time. And I have other restrictions as well to minimize my activity. Somehow I thought I'd be back to work at full strength by next week, but my surgeon makes it sound like it will be 8-10 (or even 12) weeks before I'll be back to normal at work. It's frustrating that this recovery is so much slower than I was expecting.
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Ducky, How are you feeling? Everyone heals differently, so your surgeons instructions may be generalized and not so specific to how you will feel. My P.S. actually had very little in the way of rules for me to follow. He said that I knew my body best and would know what I could do and when. I was pretty active early on after surgery and felt like it helped me progress faster. Listen to your body and let it guide how fast you return to work.
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Thanks for the photo, BigSister. It makes me feel better hoping to get more than an A cup. I am 5'3" and 130 lb, so BMI of 23 or Body Fat of 26% depending on which chart I use. I guess I should keep eating for the next six weeks.
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I feel pretty good most of the time, but I'm not sure how much stamina I have. Other than some errands and follow up appointments, I haven't really been very active. I have some random aches and pains that seem to evolve every day, which is a little frustrating. The only constant is upper back pain which seems to be from being a little hunched over much of the time. But I manage to go full days here and there without even taking OTC pain meds.
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Lilyn, haven't seen you posting lately - how are you feeling? You're two weeks out. All well?
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Hi Barb. I'm doing well. All drains out now feels great. I'm just puttering around and walking well. no terrible pain just tightness around abdomen but will take time. I guess we will get twinges of pain here andthere for quite some time as our bodies heal. All in all feel very positive with outoutcome. Your surgery will be here before long and we will guide you every step of the way. Give me a call next week
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Hi Sportysister,
Thank you for posting pics. I think your results will be amazing! And I am happy that you are only taking Tylenol. That tells me that the pain is not so terrible as I am envisioning. I wish you a speedy recovery and that you regain your strength soon. You are a very brave lady and I admire that. My Diep with bilateral masectomy is set for March 28th and I am just freaking out already. Where did you have your procedure done?
Thank you again for the posts. Rest well.
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jstacey, LOL! I find myself saying a lot of weird things, like thank you for the belly button compliment! How are you feeling? I feel pretty good except for the pain I get in my back over my hips
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Hi Wings2Fly! Believe me, if the meds didn't make me so sick, I would have taken them, lol! It would have been easier! It's definitely doable, you just have to go REAL easy. I still think they're too big and wide but hopefully that can all be fixed in stage 2. I was a small B before BC and went nuts with the implants (full c) And now I just want to be close to how I was before all of this
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Sportysister- I'm having some pain at my abdominal incision site. I'm taking more pain meds now than I was a week ago I think! I also have itching around my ab incision, which I suppose is a good thing. I know I'm doing too much, but it's not like I'm cleaning the house. It is hard not to do little things here and there, which I am doing!
It's driving me crazy that I can't sleep on my side. I also have to have my husband push me up to get out of bed. I slide down my wedge in the middle of the night, so I wake the poor guy up at 3am to prop me up!
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jstacey-I know its hard to do nothing but thats what we have to do! I had 4 implants on my right (the original and 3 revisions) and 2 on my left (original and 1 revision). I always felt great after surgery and would be cooking dinner that night! My husband said not this time. I will be Queen for 6-8 weeks, whatever the dr says! I think if it's itchin', it's heelin'!!! I know what you mean about the sleeping! Last night was the first night I slept in the bed. I felt like an upside down turtle this morning! I literally could not move at all, dead weight! My husband is going to have major muscles after this
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anyone else have some bloody spots after wearing a bra? I would have some spots on my hospital gown but now that i am at home its different bc there is no nurse lol.
Makes me leary about putting on bra. Will call doc tomorrow to double check
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Tanya- I was told to wear my surgical bra and binder for six weeks. Are you wearing a surgical bra? Are the spots near where your drains are? Or your incisions
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Hi Tanya, I would put a tank top on (from target) like a man`s undershirt on first then put the bra on over it. It did not rub on anything then. Hope that helps.
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Hello DIEP surgery sisters in the Toronto, Ontario area:
While I am still a long way away from my DIEP surgery, I am looking for a DIEP-surgeon (anywhere in the GTA up to Barrie) and have some questions:
1. Surgeon's name and hospital he/she works from
2. Why did you chose this surgeon? Are there any surgeons you did not chose and why?
3. How long did you wait from the time of referral to the time you first saw this surgeon?
4. How long did it take from the time you saw this surgeon to the actual surgery?
5. Would you recommend this surgeon to your best friend and why/why not?
6. Are you pleased with the end result?
Thank you for letting me ask these questions, this is a great forum and I appreciate everyone's honesty and openness; this illness can be so isolating.
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Tanya, the spots are not because of the bra. Ifanything, the bra will slow the bleeding down because it adds pressure.
Wearing a T under the thing can help keep it clean or you can tuck a gauze pad under the bra at the incision/drain sites. That is what I did.
If you have an extra bra, let the thing get spotty and just wash it. Who cares if it stains, right?
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Hi Jacklin. I am almost 3 weeks out from delayed bilateral DIEP at Toronto General Hospital. My surgeon is Dr. Anne O'Neill. Dr. O'Neill is with Dr. Hofer and Dr. Zhang the DIEP plastic surgeons at TGH. My family doctor sent referral to Breast Reconstruction Program and I was given consult with her and I felt very confident with her and then booked. I have in the past attended the BRA day, Breast Reconstruction Day which is held every fall in Toronto. It is something u should attend as many different surgeons talk about what is available and different options. They also have a show and tell room where lovely women speak to you about where they had the surgery, which doctor and you can see first hand the results. I had seen the results of two DIEP surgeries one by Dr. hover at TGH and one by Dr. Laura Snell at Sunnybrook. They looked very nice. Dr. Snell and Dr. Joan Lipa work out of Sunnybrook. I think all these surgeons are excellent. Perhaps get referral to both hospitals and meet for consultation. I don't think Royal Victora in Barrie has DIEP surgery. take care
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Hi Jacklyn,
Like Lilyn, I also went to a DIEP seminar held at the TGH and after it, had a meeting with Dr. Hofer who is the head PS there. Since I've been a patient at Princess Margaret Hospital, it is easier for me to go to TGH than Sunnybrook. I hear good things about all three PS at TGH but am still waiting for my surgery so don't have personal experience of DIEP. I've been waiting for over a year and a half since the end of my radiation treatment, so I would suggest you put your name on the waiting list as soon as possible.
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wondering how soon after DIEP you ladies felt confident to drive short distances store etc
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Lilyn, I read somewhere here that you need to be able to look behind you and to turn the wheel easily. Perhaps try it in the driveway first?
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also be off narcotics
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After both my DIEP and BMX, I was ready to drive etween 2-3 weeks. I was still a luttle sore after my BMX, but it was safe.
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Soooo... Just had my post op. Was hoping to schedule an appointment for nipples. Doc wants to make my areola's smaller and remove dog ears first. Surgery scheduled for March 31. Then a third surgery for nipples a couple months after
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Myajames it always seems to be more surgeries than we hope for. But sounds like you will be done by summer!
Re: driving and recovery please be careful. These are delicate arterial connections. Don't risk blowing one out. I mistakenly did and lost a lot of blood; which forced another surgery and delayed healing.0
