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DIEP Flap Reconstruction 2016

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Comments

  • Katjadvm
    Katjadvm Member Posts: 117
    edited October 2016

    Hi everyone. I have been following the site for a bit. I had a mastectomy and tissue expanders two weeks ago in preparation for my DIEP pending histo path. Not sure about radiation yet. About a week after my surgery, which went awesome. Very minimal pain or swelling. TE's placed over the pectoral muscle because doing a DIEP. Six days after surgery I developed a small area of inflammation around one incision. They checked me and said to monitor. Well, it basically blew up over the last 4 days and now both breasts have central areas that are bright red with streaks. I have a mild fever and have been on three antibiotics for 7 days with no response. Went in today to see about removing the TE's due to concern for infection, but my PS said he thinks I am having an allergic reaction to alloderm used. I have been miserable for days, thinking I had an infection. Suck. So I start antihistamines and I am soooooo much better. Could not find any info about this type of reaction, so wanted to get it on here in case anyone else ends up in the same boat. Hopefully will save TE's and get back to normal (Ha!) before my diep. Take care.

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    Katjadvm, be careful. I am still fighting cellulitis. Problem is, it presents like nomal, after surgery symptoms, redness, swelling. Another symptom is all over itchies. Bad. I swelled so bad I had what looked like 3 heads, and my skin was hot to touch and a streaky red :( Just keep an eye. Hoto document, draw around redness to monitor if it worsens or improves.

  • Maya15
    Maya15 Member Posts: 112
    edited October 2016

    I am 2 weeks post op now and didn't have a great day. I woke up last night with a sharp pain on the side of my left boob under my armpit every time I breathed in. It's been a bit painful since the drain came out but this was a lot worse. I figured it must be fluid building up, and a combination of painkillers and gentle massage seem to have improved things.

    Then my abdominal and navel incisions have started oozing. The surgical glue is starting to come off and I'm scared this is the start of something bad.

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    Maya, are you documenting with pictures? It helps monitor any changes. Have you called your PS?

    Don't fret too much, having been there, I know how scary it is, but it does heal. Just try not to panic until your Dr see's you. Given that it's Friday, I'm sure you have or plan to call them?

  • Maya15
    Maya15 Member Posts: 112
    edited October 2016

    Thanks Simplicity. Yes, I'm doing the pictures so I can compare. I called the PS office and she is going to see me this afternoon. Thankfully Friday is one of her consultation days.

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    Ok. Please let us know how you're doing, what they say...?

  • Maya15
    Maya15 Member Posts: 112
    edited October 2016

    So my PS says there is delayed healing of the abdominal and navel wounds and the ab incision is irritated. When she first looked at it, she was fairly certain the ab wound was going to open. Once she'd cleaned up the glue etc she put the chances at 50/50. I have to put dressings on it and and restrict my activities to a minimum (wasn't doing much anyway but no more laps of the hallway, and I shouldn't try to stand up straight). She also gave me a binder to wear and some antibiotics.

    I'm the type of person who's very squeamish and has to look away when there's a surgery scene on TV, so the prospect of an open abdominal wound is very scary. My PS was very sensitive to that and made it clear I could call her anytime over the weekend. If it opens big-time or starts gushing then I have to go to the ER. I suppose I should be thankful I'm not in any pain. I am grateful for this thread which has helped prepare me for what to expect.


  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    :( I'm sorry to hear that Maya. Mine didn't really hurt that I remember but it did creep me out.

    Can you get a home nurse or do you have any physical support?

    I'm a single mom, and my moms not been in good health since strokes in 2014. So....

    You will be ok & you're not alone! Sounds like your PS is more on top of things than mine was.

    If you need anything, just pm me. Hang in there!

  • LiLi-RI
    LiLi-RI Member Posts: 160
    edited October 2016

    Maya: It sounds like you have a great, accessible PS. I did not. Take photos. It is so important to monitor your sleeping habits. I was in my recliner for many weeks because I am a side sleeper. The recliner kept me in the place day and night. I hope you have a strong support system to cook, etc. so you can stay still. I hope you have no more problems and a restful weekend. Sending hugs so you will not be afraid. 🌸🌸

  • lemint
    lemint Member Posts: 76
    edited October 2016

    Maya ,I hope you're feeling better soon. I have taken photos throughout this whole process. It's come in handy a few times. I'll be thinking about you

  • Houston2016
    Houston2016 Member Posts: 248
    edited October 2016

    Hi Stunned, I'm kinda surprised to see your post because I was going to ask the same question. I'm have similar DX like you, stage 2b, grade 2, but I did chemo first AC,Taxol , UMX 10/5, and now contemplating on whether I should do the left breast implant, or DIEP FLAP recon. Prior to surgery, I did want to do the DIEP because it all sounds good, I always prefer natural tissues than foreign objects. l also wanted to flatten my stomach a little bit even though I'm petite, small, (5'2, 120lbs). The reason I have some fat only seen naked when I had two daughters. My bra size is 36 C or D. When I wear clothes my stomach looks flat and I wear like size 6 or less.

    So I thought I wouldn't have enough fat to create a breast, no way. When I see the PS, he took a look and said, oh yeah, you have enough fat. So here I am almost two weeks post op with TE in place. I suffered 3 days of constant fever at the same time have to drained the tubes and stuff. I have my devoted husband most of the time. But I think the fever was more from sinus drainage than the chest which is healing nicely and I was able to exercise after four days but then the fever. To make it short, I began to have second thought on DIEP and don't want to put my body in the same trauma again. I also heard DIEP can cause hernia and weaken your stomach muscles. The implant, on the other hand, is shorter with quicker recovery, but most of what I heard (not from here) are the unfavorable results compared to DIEP. So can anyone shared if they had done implants after MX and what are their outcomes? I like to hear both good and bad so to help with my decision. Thank you all ladies☺

  • Maya15
    Maya15 Member Posts: 112
    edited October 2016

    Thank you all for your kind words, they mean a lot to me. I do have a good support system (husband and friends). This morning there were 2 places along the abdominal incision that are a bit open, each about an inch long, and an area about 5 inches in between that looks like it could open. It's so depressing. I've been doing this for 10 months and I'm so tired of it.

  • Dlia
    Dlia Member Posts: 135
    edited October 2016

    Hi all, bcbs did not approve the wound vac. I wentvto the ER on Wednesday night because the incision is so dark and excruciating pain on my right side over the incision. They gave me morphine and did a CT scan they still don't know where the pain is coming from. I saw the ps on Thursday and he took a piece of gauze and put it in the incision and slid it across the inside and OMG I was getting off the table. He said with the CT it is enough to show I need the wound vac because of how deep the incision is. He also said if it is not closed by 2 months when he does stage 2 he will close it.

    Not sure how i'll be able to be off work for stage 2... does anyone know how long recovery is for stage 2?

  • Dlia
    Dlia Member Posts: 135
    edited October 2016

    Simplicity are you home from the hospital?

    Hope everyone is healing well with no pain. I found it hard to sleep inthe recliner.

  • Maya15
    Maya15 Member Posts: 112
    edited October 2016

    Dlia, I'm thinking of you. I am having the same problem, though no pain so far. My incision is open along about 6 inches, but it just started, so it's not very deep. I need a Xanax just to deal with the dressing changes because it freaks me out. I can't believe they expect us to deal with this for several months. How are your breasts healing?

    Simplicity, how long did it take for your incisions to close? My PS says a month but it seems like it's taking peole a lot longer than that.

  • jbdayton
    jbdayton Member Posts: 163
    edited October 2016

    My lower incision on one of my flaps opened up the day after my staples were removed. It was about 5" long and 4" deep. I packed the incision twice daily for 8 weeks. It did not appear to be closing but the tissue changed over time to a bright red color and granulated texture. At this point, I was ordered a wound vac to finish the closing process. It took another 3 and a half weeks to close up the wound. I had a home health nurse come 3 times a week to change the foam on the vac.

    This was a long process but it healed nicely, except I lost about 50% of my flap. It took several fat graftings to replace the lost tissue.

    This is a long process that requires patience.

    None of this hurt. Carrying around the pump bag (like a purse with a shoulder strap) is an inconvenience but you get used to it. It didn't stop me from doing anything I wanted to do.

    Good luck and praying for great healing results for all.

  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited October 2016

    Dlia, stage 2 was pretty easy. The surgery was outpatient. I was up and running in a few days, but tired. You can work a desk job, but rest as much as possible.

    Houston, I started out with implants, but two infections with sepsis for the second made implants an impossibility I didn't want an LD flap, so I went with DIEP.

    Like you, I didn't have much tummy fat, but it was enough for 2 C cups. I am thrilled. The likelihood for wounds opening up are low when you are thin.

    It was a lot of surgery up front, but now I am done forever. With implants, you have to have them swapped out every 10 years or so.

    When I was deciding, I read through the entire 2014 DIEP thread. 100% of those gals were happy with their choice. You can't beat that!

    Taking a good quality vitamin and extra C and D coupled with probiotics and good nutrition will help with the healing.

  • Houston2016
    Houston2016 Member Posts: 248
    edited October 2016

    Big Sister thanks for your sharing. I also like to know from all ladies, if the DIEP is less post op pains than the MX, do any of you run fever like for two weeks? Also, do you have tubes drained again from the chest and from the abdomen? Do anyone developed hernia later afterward? Thanks.☺

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    Dlia, yea I came home that Monday. Sent home on 2 antibiotics. Evidently, the bactrim wasn't proper for the type of infection I had :/ I hate to hear the wound vac wasn't approved. That's bullshit! What the heck are you supposed to do? Ugh.

    Maya, I know how you feel. I just hit the 1.5 year mark. I'm tired. Um, I would guess at about 2 months...maybe a bit longer :( It does look good thou. I can send you a pic if you like of what it looks like now. Hang in there and hugs.

    My stage 2 recovery, I only missed 2 days of work initially. But I had a major abscess they had to close and more than the normal stage 2 stuff, bigger incisions due to the issues I was having. Then the cellulitis. So, everyone is different.

    Dlia, maybe a referral for a wound care specialist? Unfortunately, I am of the opinion our PS is not as skilled with complications as he is the surgery itself. Pleased with the results, but feel my complications could have been handled better.

  • Dlia
    Dlia Member Posts: 135
    edited October 2016

    Thanks all for your responses... I am really satisfied with the breast with just a few tweaks. I'm really concerned about stage 2 with him messing with the incision if it closed before then I don't want a repeat performance with the incision. Going up and down the stairs really hurts on the right side of my stomach or even just lifting my right foot.

    Those of you who had to pack the wound were you back at work with the wound open? I'm the only IT Tech here in Charlotte for my job so I would have to do the lifting of the desktops, printers and any other equipment so not sure how that will go.

    Does anyone feel like their stomach muscles are weak and will they get strengthened?

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    Morning ladies.

    I did Dlia, but only for a short while, and shorter days, and some from home. I luckily had donated days thou, and have few left :( I don't think it would be good for you to go back yet. I know you may have to thou, which sucks. But lifting? No. I didn't really have pain with my dehiscence. Yours sounds deeper than mine was, and definitely bigger.

    Dr appt today and hopefully my last for a while. All looks good except this pea like thing beside a drain hole. Didnt appear until after the aspiration. Also a new mole on my back that hurts and I keep scratching :(

    Hope all are doing/feeling well this morning and got a good nights rest.

  • Dlia
    Dlia Member Posts: 135
    edited October 2016

    Thanks Simplicity!! I finally got approvedfor the wound vac. It arrived today... now keep leaving messages for the nurse with no response.

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    Yay Dlia!!! I am so happy to hear that! I was so worried for you! Do you have their email? I've been having a time getting responses lately too. I'll pm you jic you need it. I seem to get better response via email, plus you can send them pics if needed.

    Hope everyone enjoys their day

    I had a pea like bump that hurt worse than you'd think. Went in Tuesday and he immediately drained it. Not much came out. And it felt good all day after that. Now it's swelling back up :( It's right next to a drain scar so I used a warm compress last night. Hoping to get my abdomen scar fixed Nov 22nd. Course, a simple scar revision he calls it, but bleh. Hoping all goes well. I think this will be my last procedure unless there is something he can do about my left breast. The flap is significantly smaller than the right, and where the flap is, it's just flat. idk Not sure how much I care.

  • lemint
    lemint Member Posts: 76
    edited October 2016

    Good morning ladies. I had my diep flap surgery on Tuesday Oct.11th I was in the ICU for 2.5 days (fever). I went home Saturday evening. They were also keeping an eye on a bruise on the interior side of the flap under the arm. Friday night it starting bleeding and they wanted me to stay until Sunday. I was fine with that then they let me leave Saturday and I was apprehensive. Monday morning it looked bigger so they wanted to see me .(Chicago traffic) they should of just kept me like they said. I guess he's keeping an eye on it. I was a little emotional and said to the nurse I was afraid that area would fail and become necrotic. She was super nice and sweet. My PS barges in and says there is no need to cry everything will be ok and the flap is not failing. Very defensive in my opinion. I told him I never said that I thought the "whole" flap was failing. I just don't know how to take him. He's super sweet one visit and abrupt and moody the next. He very good though and highly regarded. Oh well. Im doing good as far as I can tell. How much swelling is expected.? I feel so much swelling on the side under my arm and the top part of my chest.When will that start to go down? Any insights would be appreciated. Thanks, Laurie

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    Lemint, I don't think my swelling went down really, until stage 2 :( My last stint in the hospital with cellulitis, they really softened up after that. Ask the nurse about using a warm compress. It helps keep any fluid at the surface, and also seems to loosen scar tissue. Just be sure to test it on your arm before placing it on any area, and never skin to compress.

    Cry all you want lady. This is a rough road. I wish some of our Dr's could go through this poo they try to minimize!!! Let me cut some incisions into your balls, not once, not twice, maybe a few times, and see how you feel about it. Sorry, but it makes me angry. If you feel like crying, cry, and tell him to kiss your ass.

    Hugs. Rest as much as you can.

  • lemint
    lemint Member Posts: 76
    edited October 2016

    Haha Simplicity, that made me laugh out loud. You're so funny and right. Next time I see him and if he's moody In going to call him out on it. I shouldn't have to worry about my PS moods. I'm resting and have help from strep mom. Thanks again.

  • Maya15
    Maya15 Member Posts: 112
    edited October 2016

    Lemint, congrats on the surgery! I've been emotional off and on too with one breast oozing and the abdominal incision opening all along the middle. My PS is really great, she's seeing me twice a week to clean the wound, check for infection etc and her NP calls me as well to check up on me. She's very reassuring and thinks there is a chance the abdomen might close in a couple of weeks because the opening is very shallow. This process is so slow!

    Simplicity, would be great to see a pic of how yours looks now, it would encourage me to think I'm not going to look like the bride of Frankenstein forever. What does scar revision entail? My PS has mentioned it but I haven't asked any details. Please tell me they don't reopen the abdominal incision.

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    I didn't even consider putting a recent picture up, so good idea. Not a good photo. Bad lighting. Being lazy in my bed (does this fatigue ever go away?) I haven't had the stage 2 of the abdomen yet. I had so many various issues, he got those taken care of first. Abdomen is scheduled for Nov 22nd, He'll only be fixing the middle area. I think the difference is how many layers of skin they go in? The scar will technically still be under there, but the top skin will have a better appearance...not so bad considering I had 4 holes, in my opinion.

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    image

  • Simplicity
    Simplicity Member Posts: 723
    edited October 2016

    I think I should draw on it. Oooh I could do like a cave setting lo

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