DIEP Flap Reconstruction 2016
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Can anyone tell me what to expect with a Sentinel node biopsy? Is this done as part of surgery? Will I be under anesthesia when the dye is injected? My paperwork said I need to arrive early on the day of surgery to have the dye put in and now I'm worried about feeling pain from an injection.
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Hi Katie,
The SNB will be performed as part of your surgery, under anesthesia. The injection happens prior to surgery, typically while you're awake and being prepped. Everyone seems to have a different experience with the injection, but for me it was unpleasant. I was told to expect a "bee sting" but it felt more like a burning sensation. It happens quickly, over just a few seconds, and hopefully it won't be too terrible for you.
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Simplicity, thinking of you and hoping for a,speedy recovery.
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good luck Simplicity! Warm hugs xx
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And in the blink of an eye (or so it seems), it's been 11-1/2 weeks since my UMX and DIEP! Time flies when you're recovering then getting your kids off to school again (sending the youngest off to college so I'm officially an "empty nester").
Things are going well. Was a little disappointed when I saw my PS at 8 weeks and was told we'd need to wait another 2 months to see how things progress before we can think about stage 2. Waiting is the hardest part in this process.
The belly is looking fantastic I must say. I am so thrilled to put on clothes and not have that pooch sticking out. Before the surgery I wouldn't have been caught dead in some of the clothes that I enjoy wearing now. There are several areas of the abdominal scar that feel very hard, but PS explained they used staples there that can take up to 4 months to dissolve.
Like a lot of you I don't like looking at Frankenboob. But, as my husband reminded me, it's not pretty right now, but it's totally amazing what they've done so far. It's hard for me to picture that PS will be able to make the flap small enough to create a nipple and get it tattooed to look almost normal, but he's done some amazing things already so I'll keep the faith.
Monday I go for my annual mammogram. It'll be strange only having one side done. Hoping the techs aren't too freaked out by Frankenboob.
My thoughts and prayers go out to those of you having your complications, those stressing as you prepare for your surgery day, and those still trying to make decisions as to what direction to take in this process. We're here for each other!
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Farmerma, could your surgeon not do the nipple sparing to avoid the extra surgeries? I am scheduled for bmx in December and they are doing all at once. Just curious why more people don't do that.
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Jiffrig - I had a lumpectomy in Dec. 2014 and radiation following. The damage done to the breast tissue by radiation made nipple sparing not an option for me. In hind sight I probably should have done the MX in 2014. Live and learn
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Evening ladies. Just wanted to let everyone know, I went to see Dlia this morning, and she looks great! There were complications during her surgery apparently, and she was in longer than expected, but she looks great and her spirits are good! Hopefully things continue to go well for her, and she will be released within the next few days.
Hopefully she will be able to update more soon. Keep her in your thoughts and prayers. This is a tough surgery. I did ask her permission to update everyone here.
It was so nice meeting her and I think we both could have talked for hours.
I am so exhausted. Things have been so crazy busy here. Thankfully, I really have nothing to do to prepare for next Wed.
Healing thoughts to all, and good wishes to all going in soon.
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Hi DIEP Sisters,
I recently heard that the FDA is attempting to regulate the use of autologous tissue for breast reconstructions!
https://www.cellmedicine.com/fda-poised-to-outlaw-...
I am concerned about this and wonder if you know anything about it.
Tigs
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Tiggerousity, interesting article. I started to read it and stopped after a few paragraphs because it didn't seem completely credible, so I moved to do outside research on the FDA and regulation of autologous breast tissue in breast cancer patients - and can't find anything that supports the statements made in the article that will classify, "a woman's own fat tissue as a drug when used in breast reconstruction procedures". This, in particular, made no sense whatsoever to me:
That's right ladies. Your fat tissue is an FDA-regulated drug if your doctor wishes to use it to help reconstruct your breasts following a mastectomy unless she goes through the FDA drug approval process, which can take a decade or two and cost upwards of 2 billion dollars. Needles to say, this is a financial burden that no doctor, clinic or hospital can bear. Once finalized, this new guidance will effectively shut the door on using a woman's own fat tissue to help reconstruct her breasts.
The "guidance document"** discusses regulating human tissue specifically relating to stem cell transfers (and the link you provided is from an organization called the Stem Cell Institute). Included is a link to the FDA guidelines ("for comment purposes only"), and includes exceptions to the rules they are proposing that read to me as if they specifically relate to breast reconstruction ("HCT/P" refers to "Human Cells, Tissues/Tissue-Based Products"):
"In regard to HCT/Ps from adipose tissue, we generally consider the exception in 21 CFR 1271.15(b) to apply only if the HCT/P from adipose tissue is for autologous use, is removed and implanted within a single operation or in a limited number of predetermined operations in order to achieve the intended effect, and does not undergo processing steps beyond rinsing, cleansing, or sizing. Limited handling such as rinsing and cleansing to remove debris would allow the HCT/P from adipose tissue to retain the structural function, while other processing steps such as cell isolation, cell expansion, or enzymatic digestion generally would not. Thus, if such other processing steps are performed that prevent the HCT/P from adipose tissue from remaining "such HCT/P," the establishment manufacturing the HCT/P from adipose tissue would generally not be considered to meet the exception under 21 CFR 1271.15(b)."
I don't think we're in any danger of losing the ability to have DIEP or TRAM procedures, nor later fat grafting or other reconstructive processes, nor is our breast tissue or transferrable fat about to be regulated as a "drug" by the FDA.
** At the beginning of the document is this disclaimer, which specifically notes this is not "law" but rather the "current thinking of the FDA":
"FDA's guidance documents, including this guidance, do not establish legally enforceable responsibilities. Instead, guidances describe the FDA's current thinking on a topic and should be viewed only as recommendations, unless specific regulatory or statutory requirements are cited. The use of the word should in FDA's guidances means that something is suggested or recommended, but not required."
That's just my unscientific two-cents' worth of thoughts. I hope someone else will chime in here!
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Hi Nancy,
Thank you for your reply and interest!
I admit I posted with out a thorough reading! It triggered a button on me! Here is a related article on regulating human stem cells,
https://www.bioinformant.com/fda-public-hearing-pa...
The whole issue seems to boil down to whether the FDA has a right to relate our cells as a drug IF they are taken out of our bodies and some how processed before reinserting. Processing seems to be specifically defined as altering the structural matrix they are in, reproducing, modifying etc. There is an exception for immediate reconstruction with ones' tissue in a single surgery.
The major issue seems to be pointed at whether we have a right to our own stem cell lineages. This could set a precedent for other tissues in the future.
I will read more today and report back.
Tigs
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Here is the FDA proposal located by another member on a DIEP flap FB page,
http://www.fda.gov/downloads/BiologicsBloodVaccine...
I am reading it now.....
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Good morning ladies. I have a question. I'm having diep surgery on Oct 11th and I'm wondering if they reposition your belly button? I've seen different information and I keep forgetting to bring it up.
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Lemint, yes they do, they will pull down your upper abdomen skin to meet lower area and reposition belly button. In short time you will never even realize it was moved, very unnoticeable
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Thanks for the information Jiffrig!!
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I was packing the now super-tiny wound on my nipple incision yesterday, and decided to use the magnifying mirror and flashlight to see just how deep the wound really is. As I looked in the mirror I noticed my nipple flap is covered in fine, longish, dark hairs!! Has anyone else noticed anything like this? (I can't tell if I find it more funny or upsetting at this point...)
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I have NancyHB, since the day after surgery. Lol IDC. I do but don't at the same time. Make sense? Im just glad to be here with all my limbs, hair, and mind somewhat about me ha!
Since I have a thick dark head of hair, their fine hairs but a tad dark. Eh. Least of my worries in my small world
Dlia is still in as of last night
Hoping she gets to go home today.0 -
Can't believe I'll be in surgery less than 48 hours from now. So ready to get this behind me and start the road to recovery! Thanks to all of you who've been willing to answer my many questions along the way.
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Best wishes Katiebird!!!!
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Best wishes KatieBird. I will be too for my stage II.
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Simplicity-I'm thinking of only positive outcomes for both of us😃 Hugs!
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Lucy I'm home...
First I want to start out by saying thanks to simplicity for meeting my husband while I was still in surgery. Giving him some things to look for and helpful information. It was good to see you when you came to see me on Saturday, it was like old friends reunited.
I too did the nesting trying to make sure everything was in place and easy for my husband during my recovery.
Surgery morning they had a hard time getting an iv finally getting it in my hand. When I came out and into recovery I realized they had an iv in my right foot. Not that I would call it pain but when I moved I knew I had been cut friday I was done with the pain pump but I think I couldve stopped earlier. When I was able to get out of bed Friday to go to the bathroom I had to take the oxygen off cause the cord was too short to make it. But coming out just that small distance I couldn't breathe. When I said it to my doctor he told me one of my lungs collapsed nothing permanent and the more I move the faster it returns to normal. I've read on here how some of you after the surgery was over questioned whether you made the right decision, I joined you but every day gets better and better. I don't know if I can say if I knew everything like I do now I would do it again.
Still very swollen, these are the biggest gallon jugs I've ever seen but grwat job and stage 2 will make it even better.
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Thinking of those ladies starting your diep journey. It is worth he recovery and wishing all a great outcome. Remember, as others have said, you just need to show up and the rest will fall into place.
I am 5 months out and I would love to hear about phase 2, fat grafting experiences to better prepare of what to expect.
Thanks!!
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Dlia, nice to hear from you and glad you're home.
Katiebird and simplicity, good luck!
I have started the countdown for my surgery on 29th, just 10 days to go. Right now I'm struggling with the caffeine ban, headaches and very tired all the time (does anyone know what the reason is for the caffeine ban?). I followed the advice from several of you and rented a recliner for a month after the surgery.
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I had my surgery in April and my dr did not restrict my caffeine intake before or after surgery.
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Maya15 - caffeine brings your capillaries to the surface. I have been told that by many Dr's over the years as well as my esthetician. So they suggest cutting back to help with inflammation and extra bleeding/ bruising.
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Maya - my surgeon explained that caffeine (coffee, tea and chocolate were his specific no-no's) constricts the blood vessels (a vasoconstrictor), which would inhibit blood flow to the flap. He banned caffeine (including decaf products as there is still a trace amount of caffeine in them) for at least the first two weeks, and then "minimal" caffeine for the next four (he said I could have half a cup of coffee a couple of times a week - I just chose not to have any at all). I was very happy to do anything and everything I could for this surgery to succeed, so it was a small sacrifice to make.
Dlia - so glad to hear you're home! Thanks for checking in with us, we've been thinking about you. Wow - I didn't realize a lung could collapse during surgery, that's pretty scary. I know what you mean about the swelling, they do seem huge don't they? Since I only had one done I was comparing it to my non-surgical side and I swear I was two sizes larger. It's been 8 weeks now and my swelling has decreased considerably.
Simplicity and Katiebird - keeping you in my thoughts today as you prepare for surgery tomorrow. Good luck and blessings for a complication-free experience.
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Katiebird and Simplicity, thinking of you today- Yea!! Nothing but great outcomes.
Dlia, great to hear from you and so happy your home now. I had lung complications also- I'm not really sure what it was but I was first told it was a collapsed lung (I couldn't take a deep breath and was on oxygen) then they called in a cardiologist who thought I had heart problems but an immediate echo ruled that out? Apparently they gave me too much fluids during surgery (?) . Anyway, even after having to spend a week in the hospital (I knew I was in good hands) I would still do it again and it all becomes a distant memory, xxx
Cedee, I found stage 2 very easy. I also had my tummy bulge fixed (hernia) so my surgery was a bit longer. I was walking 2 miles 6 days later. I found the binder supportive at first but grew to hate it quickly- but that was the worst thing. I bought a two strap kind which made doing it up much easier. I had very little bruising and only took Tylenol for a few days. Best of all I have a great looking nipple! I also got a reduction and lift on my other breast and am still getting use to my smaller perky girls!
Big hugs to all- have to get going to work
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For those who have had a lift/reduction on a natural breast as part of Stage II, do you still have sensation in the nipple, or does that disappear after surgery? I'm kinda loathe to mess with that if I don't have to. Thanks.
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Simplicity & Katiebird well wishes on your surgery.
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