DIEP Flap Reconstruction 2017
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I now have temperature of 100.4F/38C and have been sleeping all day. Do I have an infection somewhere? I'm not in pain anywhere (no Tylenol 3 since 09:00 this morning, just a bit nauseous. I hate the thought of going to emergency and really catching something there...
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Grateful – call your doctor and see what they have to say. I'm pretty sure they don't want you in the ER anymore than you want to go.
Tnd- if your insurance is excepted by Nola then you shouldn't have any problem going there and having it covered as in network. If they are out of network for your insurance, they usually will cover around 75% and you would be responsible for 25% unless you got an exclusion. One way to get an exception to the 75/25 out of network and get it covered at a higher rate of reimbursement is if no one in your area does this type of surgery. You may also be able to get an exception based on The surgeon in your area only doing i stage one in a two-step process when you're doing a skin and nipple sparing MX. And they may like the option of going to Nola and paying at 100% for one stage surgery instead of staying local and paying for two stage one surgeries.
On the logistics of having the surgery done out of your immediate area or out of state – Nola request that you be in New Orleans for a minimum of 10 days: arrival is day one, pre-op is day two, surgery is day three, you were in the hospital for days four and five, released on day six, postop appointment on day 10, and then you're released an allowed to travel home via plane train or automobile ( anyone old enough to remember that movie? 😀). You are given instructions on how to care for your incisions and stitch areas, what you can and can't do, and what you should expect and what to look for that would require contacting the center. Once you're home if any complications come up it's handled via phone, email, and photos sent over email when needed. Mild complications can usually be handled in this fashion. It is rare, but major complications can happen and when they do you would typically Fly back to Nola ASAP and usually, but not always, on Nolas dime. (I don't know the criteria for when you pay for a return trip due to a complication versus nola paying). The good news is Nola has the lowest flap failure rate – (which would be considered a major complication needing a return to Nola) in the nation at less than 1%. They also have one of the lowest infection rates at less than 2%. Complications at Nola, when they happen, are usually categorized as minor in the medical world.
I was out of network and the reason I went to Nola which is four states and 13 hours away is for their quality, their outcomes, and those statistics on failure rates and infection rates. It was a bonus that Nola works to restore your body as much as they can with their process versus just focusing on your breasts after stage one
I hope this helps and it's definitely worth checking to see if you would be in network for Nola.
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Thanks, Lula. I feel much better today. Nausea is gone, fever is gone, I'm still sleeping lots and being careful what I eat. A blister burst under the saran wrap tape they put over the abdominal incision - no air in there and hot, I suppose, so I took as much of the tape as I could and put a saline dressing on the blister. Now I'm worried that the incision will open up like it did the last time. Never ends...
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grateful – I'm glad you're feeling better. I have to ask when did the blister show up? That can be a sign of infection. You also may be allergic to the saran wrap stuff and it's causing the skin to blister. I basically had a ton of medical grade super glue overtop of my incision and the little baby stitches they used to close it. Once the superglue wore off, I did have a little spot open up where a knot in the stitch pulled through the skin
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Hi Lula,
The blister showed up this morning, day 3, so I don't think it's an allergy to the saran wrap. And it's only in two places. I'm thinking of pulling all of it off but don't want to risk getting an infection after the incision is open to the air. I put a regular dressing over it to keep it clean.
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I am a 2x cancer survivor. 19 years ago I had stage II and had a lumpectomy, chemo and radiation . I was re diagnosed Nov2016 and had a uni DEIP on Jan 30,2017. I am 6 months out from my uni deip. I thought the surgery went great. I never used pain meds , just Advil. My pc used an On Q ball ( lidocaine)and weaved it through my abdomen to numb the area and avoid pain meds. It stayed in for 10 days. It worked great! I was the first person they tried it on. I had one drain that caused a lot of discomfort but other than that it was uneventful. I am having my stage 2 revision on Tuesday . I'm a little anxious but looking forward to having it behind me. She is doing liposuction on the side of my new breast to even them out and on my hips and fixing "dog ears" and a scar repair that has caused uncomfortable scar tissue. I wish I had seen this forum 8 months ago! It could've alleviated a lot of anxiety
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I had bisteting as well my pc said it was fine. I emailed her a picture. I love modern technology! Good luck with your recover
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Dubcol-
Thank you so much for chiming in! That pain management method sounds amazing, hopefully another member sees this and can ask their own surgeon about it. Welcome, we're so glad you've joined us, and we wish you luck on the rest of your reconstruction!
The Mods
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I also have the Qball, really helps, and Valium as a relaxer. I am taking 5 mg of OxyContin but hope to be soon just taking Motrin during the day. The feeling is more of a tightness than pain.
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Grateful99 Thank you so much for the details on your stage 2.I am scheduled for stage 2 on August 9 and am getting a bit anxious about length of recovery
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StillBlessed, my recovery is a bit more complicated because the PS modified my large abdominal scar from stage 1 and did some lipo on the breasts to even them out. So, the surgery involved general anesthetic. Most people only have the nipples and dog ears done and this is done without general and so the recovery is much easier.
Today is day 5 after surgery and I'm feeling quite well, bladder and bowels back to normal, no fever, eating like normal, but still need to walk bent over to take care of the abdominal incision so that it doesn't open up like after stage 1.
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Hi everyone~
New here and just had UMX 2 weeks ago with immediate DIEP reconstruction. Today is day 15 and I'm feeling alright. I'm still hunch over slightly and back still aches when I walk.
My reconstructed breast is slightly swollen. PS didn't seem to worry after I had emailed him the pics. It is so freaking weird to email my boobs pics. Trying not to ponder too much on that. I'll see him next week, for now it's more discomfort. No pain.
My experience with DIEP is more of discomfort than pain. I was surprised how little pain I felt. A lot of tightness and back aches. I was in the hospital for 3 nights. They didn't hook me up with the morphine. Pump when I woke, so I requested it 😬
I'm still sleeping on the couch. Don't have a recliner. I'm surrounded by lots of pillows. My bed is way too high and I'm afraid that once I get in I can't get out!! Lol!! Besides, the couch is quite comfy and I can get in and out easily. I'm still sleeping at an angle, legs are straight with no problem. Abdomen incision seems to be healing ok. I had the tape over after surgery since I am allergic to dermabond glue. Tape and JP DRAINS were removed in 1 week.
Prior surgery, I have frozen shoulder on the same side. Now I find exercising that arm is excruciating. Anyone with suggestions? Neither my BS or PS suggested PT or any exercises. Really strange. I have to ask abt it.
Also, anyone doing essential oil therapy? If so, what are you using and who is guilding you through the process? Who usually prescribe PT if you need one and does insurance covers it?
Wishing everyone smooth surgery and recovery. 2 weeks ago I wondered how in the world would I get through it. Well I did and you can too.
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grateful99 was the lipo covered? I wont be going through stage two until next year after all my chemo node surgery and rads. I go to Dr. Hofer as well.
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I had trouble with my shoulder. My pc didn't recommend physical therapy. But my friend who is a physical therapist suggested that I have it and I got a referral from my PCbecause it was very painful . The more you straighten up the less your back will hurt. Try and walk around a few times a day to straighten up. I had a bed wedge on the couch it made it easier to get up and I put pillows under my knees for comgor
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Tpralph, yes, lipo was covered because I pointed out to them that they only put 340 grams in one breast and 390 grams in the other or some such (can't remember the exact amount, get the print out of the DIEP surgery for that info). Not sure if it would be covered under all conditions. And then the scar revision was covered because they had left two staples in my abdomen after DIEP which had to be removed. I had to wait 15 months for DIEP2 because of the extras - I am sure it would have been sooner if it was just the dog ears and the nipples. Also, they don't put you on the waiting list for DIEP2 until you sign the consent form, which is after the three month check up. So far, I'm happy with the results (the nipples are quite big still). I am not going to do tattoos because I'm worried about having ink injected into my skin and red ink especially can be toxic. Plus it fades so you have to have it re-done periodically.
Good luck with your rads and chemo - I'm surprised they did your DIEP before rads - I had to wait until almost a year after rads.
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FlaxenGirl, I had frozen shoulder for six months and then I went to Greece for a holiday and swam every day - it disappeared. I don't know where you live, but I'm guessing warm weather and gentle motion, being relaxed and not stressed helped. I got the frozen shoulder after exercising too soon and too vigurously, so be careful.
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grateful- good to know the frozen shoulder thaw out for you so quickly. I'm in Louisiana, USA. It is warm and humid here. I'm trying not to rush my arm but at the same time I don't want to be "cripple" with little motions down the road. I'll try gently exercise for now.
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I have a question regarding BELLY BUTTON. My PS stuffed a foam like earplug into the new belly button at my first post op visit. My least favorite things do is I have to insert the plug back in my belly after shower. Anyone have to do that? I tried drying the BB with cuetips after shower. Not sure If it is fully dried. Afraid to put the plug back in an cause an infection if it is not dried. Also, I couldnt get the whole plug back in like they did at the office. It is really a weird sensation. Anyone
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flaxengirl-this is after stage 2 or stage 1? I didn't haveto do anything with mine except towel dry my tummy
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I've never heard of such a thing. I showered on day 5 with no restrictions or plugs after stage 1. I am having stage 2 Tuesday , they are doing dog ears, repairing part of the incision and lipo on my hips and breast . I will have General anesthesia. A little anxious
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I have foam earplug in my belly button for stage 1. My surgery was 16 days ago. I guess PS are different everywhere. I don't like plugging anything in my belly.
Additionally, he didn't want me applying any lotions on the scars and neither did he gives me any instructions regarding arm exercise. How soon did you all start exercising your arms? Any links to online exercises?
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I didn't start exercising my arm till seven weeks postop. I asked my PC if it was OK and she gave me the guidelines as to what I could do. If your insurance covers it you can ask for a referral. She also told me after my drains were all healed that I could put vitamin E oil on my scars and encouraged me to rub it in so there wasn't as much scar tissue
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hello all- this is all new to me so please be patient with me. I am trying to decide between a latissimus dorsi flap or a diep flap to reconstruct my left side. Is there anyone out there that needed to make this choice? And if so, what did you choose and why?
I need reconstruction without an implant because my skin on the left side is damaged from radiation tx a year ago. I will have an implant put on my right side. Thanks for any and all advice!
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flaxen girl – I was told no scar cream or anything on the incisions until after stage 2 as there wasn't any need to spend the money on them until they did the revision on the scars. Did they do any other type of surgery where they went into your belly button for something? That really just doesn't make any sense. Did they give you the LE exercises to do with your arms and hands postop? Basically hold your hands out in front of you with your elbows bent at a 90° angle and spread your fingers and contract them back over and over – kind of like jazz hands. 15 reps done three times. Then ball your hands into fists and extend your arms pointing toward the floor in front of you, then curl your fists up and bend your arm at the elbow like you're doing a bicep curl. Do this with both arms at the same time. 15 reps, three times. Last, you basically do the flapping from the chicken dance – 15 reps, three times. Do this twice today. I would do them all in a circuit as I walked.
TJL3- it's interesting that you're looking at doing different types of recon on each breast. May I ask why that's been suggested? It's very rare. It sounds like you may be a difficult case (through no fault of your own). Have you considered DIEP for both breasts? You'd likely have an easier time with symmetry at the very least and both breasts would feel the same. Have you considered contacting the center for restorative breast surgery in New Orleans ( www.breastcenter.com ) for at least a consult? They're considered to be the best especially for tough cases where everyone else says it can't be done. They do it and the results are amazing. Women travel from across the US (I am one of them) and even across the Atlantic to have them do their recon (no lie). Feel free to PM me if you have additional questions or want to discuss personal experience.
I went DIEP vs lat dorsi as implants don't do well with radiated chest wall and my entire chest wall was radiated when I battled Hodgkins lymphoma at age 13. I only wanted to do this once and not risk implant failure by choosing the "easier surgery" and then have to have the DIEP flap later anyway. DIEP also gives you soft warm breasts that move and age with you just like the originals and implants don't give you that (and if you're on the younger side you'll likely have to have implants replaced at least once). This is why I chose DIEP and bypassed other recon options including lat dorsi. Hope this helps! Happy to answer any questions or dusvuss
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thanks for your response Lula! My right breast is cancer free (thus far) and that's why it can accept an implant. My PS doesn't think there is enough belly fat to create 2 breasts ( I think she's crazy!). She did assure me that she can get the 2 breasts pretty symmetrical even though they will be from different sources.
I'm having my surgery performed in Boston and the practice is highly recommended, if I could travel to New Orleans, I would:Can you tell me how long it took you to recover from your reconstruction? Are there any helpful hints you could share so that I'm fully prepared? I'm a bit anxious about such a long surgery.
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TJL3, I would, if I were you, read through the posts here about having implants before you go through with it, especially having different procedures in each breast. And get another ps's opinion. Just my two cents.
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tjl-I sent you a pm
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Apparently i have perfectly laid out veins for DIEP surgery! My husband and met with surgeon. CT scan of abdomen shows best scenario possible. Still nervous but much more calm after talking to the doctor.. so I nowthink I will actually make it to surgery on Thursday... fingers crossed.
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Here's the amazing thing. 8 weeks after DIEP I have a soft fleshy boob. It feels like a breast, no nipple yet, but wow! I'm so glad I chose this type of reconstruction.0
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Falconer- That is so encouraging to hear! I am 4 1/2 weeks out and mine still feels like a large hard numb lump. I was feeling discouraged and now you have given me hope.
Today I went to my dentist for a dental cleaning and they wouldn't do it. The dentist said you have to wait 6 months after surgery. They suggested I ask my doctors to get okay to do it sooner. I need to do it before phase 2 which will be at about 4 1/2 months or I would have to wait another 6 months. Has anyone heard this before?
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