2018 DIEP Surgery
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I'm scheduled for flap reconstruction surgery on March 19th in New York City with Dr. Joshua Levine and Dr. Robert Allen! I can't believe it's a week away! I'm still deciding between PAP and SGAP. I'm leaning towards SGAP. Is there anyone here who's had PAP and/or SGAP? If so, what are your thoughts on one over the other, pros/cons, etc. I could have DIEP but don't carry as much weight in my stomach. Thanks!
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Hi Outdoorsy, welcome!I can’t answer your question but I wanted to welcome you and let you know we’ll be cheering you on!
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Sadie, praying for a truly successful sirgery and speedy recovery.
Twills, sorry to hear about the back pain and agree that Oxy ultimately makes you feel bad (fuzzy and naseous for me) and therefore using it longer is not the best. I haven’t taken one since midnight yesterday so hope that can be my last.
Cindyanne, no worries. Just wanted to make sure I wasn’t coming across flippant like this surgery and recovery wasn’t serious business.
Question for those who have gotten their bills already. My PS is out of my PPO network and therefore I will have to cover a bit of his bill. He forgave the remaining balance from my lumpectomy\reconstruction. But I have no doubt he will NOT do that again for the DIEP especially since this involved his partner.
Any ideas what I might be looking at in terms of out of pocket expenses. I think my portion is 10% and I’ve met my deductible for this year already for in and out of network. I know I should have asked the question already but frankly money was the last thing on my mind going into this.
Everyone, peace and blessings for a great week ahead.
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Cindy Anne- Call and talk to Heidi. It was a busy week when I was there too and the rate was over $500 a night at Windsor Court but with the centers discount it was far less.
Opt4life- if they balance bill it could be a lot. You may be able to negotiate it down though. Good luck with it!
Outdoorsy- here’s a link to a talk by Dr Dellacroce (he’s one of the NOLA docs that trained under Allen and pioneered SGAP back in 2005) that mentions PAP flaps. It’s at about the 12 minute mark. He makes some really good points on both it and TUG flap too. I’d personally stick to SGAP and DIEP.
https://m.youtube.com/watch?v=lGmoI21Tfbc
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Cindyanne, may 1 was the date they originally gave me! I told them no way...as this is jazz fest time in New Orleans !! You may want to ask for another date.
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When is your surgery Dawnann? I need to correct the list up top.
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May 15th @ nola
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What a difference a few days make! Back pain is so much better which makes everything much easier to do on my on.
Gotcha Dawnann, I missed your date change but I fixed it. I know it’s nice to have a plan:)
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TWills - Thanks for the warm welcome, and I'm glad that your back pain is subsiding! I can certainly relate to wanting to do stuff on your own.
Lula73 - Thanks again for the video link.
I found some other recent posts about SGAP on this forum and am starting to wonder if it's a good choice after all. I'm hoping buttock disfigurement isn't the norm.
I certainly like the idea of being able to hide SGAP scars when I wear a bathing suit or my underwear. I'm single, so I can foresee being glad that I could at least hide my scars until I'm ready to show them. PAP would put two scars right across the back of my thighs - and not in the buttock creases (my arteries are too far down for that to happen). But, I also want to have the surgery that will most likely produce the best results and is more likely to "survive" with good blood flow.
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Outdoorsy, you’ll find that people sometimes seek out sites like this one when they’ve had issues so try to take that into concideration when you read some of the topics. That’s not to say it isn’t a concern but sometimes the more negative results can sometimes get clumped together and make it seem like there is more of a problem. It can be hard to weed through all of the info here sometimes.
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Well, I made it though surgery fine today. I am in some pain, but nothing like I expected it to be. It’s an alternating pain between too many sit ups and being kicked by a horse in the chest.
So far, the flap has good blood flow and the goal is to start moving tomorrow morning.
The only downside so far is that the tv in my room is broken, so i’m patiently waiting for the staff to get it replaced.
I’ll try more updates later when i’m on fewer pain meds. I’m not sure this post even makes sense
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You sound great SadieSue, your description sounds very accurate. Hope your tv gets fixed soon, that would drive me nuts. Continued comfort!
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SadieSue09 - We're glad you still have adequate blood flow to your flaps! That's great! Hopefully, they'll get you a working TV soon.
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TWills, glad to hear you're doing better. The 2 week mark is the turning point, I guess.
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Sadie, congrats on being on the road to recovery. Just excellent!
Twills, good to hear about the back pain subsiding.
Lula, I'm sure the bill will be high. I'll not stress about it and find a plan once I know what is owed.
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Outdoorsy, if you don't mind me asking, are you having one or both reconstructed? I only ask because I think I may not have "enough" for DIEP but I am only having one side reconstructed. I have my first phone consult with a nurse from PRMA tomorrow.
Gosh, I hope y'all are all still here through the summer. You will be all healed. Just think of that!
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parachutes - I'm having both reconstructed. At first, I was told by Penn Med that I didn't have enough for DIEP or PAP, but then I had a consultation with Dr. Joshua Levine, and he assured me that I had enough in my thighs for sure. He said that if I wanted a DIEP only, he would prefer to preform an extended DIEP on me - to get the little bit that's wrapped around to my back/past my hips. He also mentioned possibly using 4 flaps (2 from stomach and 2 from thighs) to get enough volume, but I'm not crazy about that idea. If it helps you to get an idea as to whether you have enough tissue for DIEP -- I'm 5' 6", and have purposely gained 15 pounds since last November. I'm currently at 140 lbs and hold most of my weight in my butt and thighs. If you have other questions, feel free to ask me anything. I don't mind at all. I hope your consultation goes well.
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Sadie- so glad everythings going well! Don't be afraid to use the pain meds. No need to suffer.
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TWills- I’m so glad your back is feeling better. I went through that as well. I thought it was because of wearing this binder because when I took the binder off, my back actually felt better. I had a really hard time staying hunched over because I had to force myself to do it. When I couldn’t take it anymore and stared standing up straight, my back ache finally disappeared. Do you still work as a hairdresser?
SadieSue-Do happy you’re on the other side of this thing now. I hope you get your tv fixed soon, or can at least watch something on your phone or laptop. I hope you have everything you need when you get home And are comfortable!
Opt4Life-I had so many different quotes from different doctors and hospitals, in Network and out. It seemed like the doctors were more willing to work things out through payment plans than the hospitals. I hope you are able to make it work for you!
Question on wearing the binder......Does anyone know why we have to wear this binder? It seems to pull on my incision as it slides up. And then I have to use my muscles in my arms to constantly tug it down, pulling on my incision again and putting pressure on my chest when using my arms. The whole thing seems very counterproductive.
Good luck to all of you beauties at whatever stage you are in!
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One more question:
Does anyone still have a deep soreness in their chest? Like SadieSue09 said, “feels like I got kicked in the chest by a horse”. That is exactly it, and I’ve had it since my surgery.
Maybe the fact that I have to keep pulling my binder down is making it not go away? (It also feels so hard-like there is a steel plate in the middle of my chest between my breasts and it is completely numb). The only time I feel better is if I do ABSOLUTELY NOTHING. I have to literally sit in the same place all day or go from my chair to my bed and not use my arms at all. If I do that for a solid two days, my pain starts to subside. But the minute I do something, even lightly do something, the pain comes right back. My husband gave me a Xanax which actually really helped (and knocked my ass out!! Lol!! It's the weakest strength they make!) but they make me depressed the following day so I hate taking them. I thought by the third week I would not be in any pain but I guess that was wishful thinking! I've mentioned it to the PA and my PS but they said it's still too early and to give it time.
Just curious... Is anyone else having this problem or any pain by week three
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mitzi458, I did not have that issue, so I can't comment on it. I'm sorry you're in such pain.
Parachutes, since you're only doing one side and worried about having enough abdominal tissue for the DIEP, ask them about a "stacked DIEP." That's what I ultimately did after being told by the first PS I saw that I didn't have enough for a DIEP without downsizing my other breast. I sought other opinions and learned the stacked DIEP could work for me. It's only an option for unilaterals.
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Mitzi458, I am right here with you. My chest (not even talking about my breast pain) is so sore. This Thursday will be my 3rd week post op. I too don’t want to move...just sit in my chair. I dread going to bed at night because of the ritual I have to go thru and then I am still not comfortable. I too take Xanax at night...very low dosage. If you are feeling drugged the next day then consider taking it earlier in the evening before you go to bed.
Back to the chest soreness...if you watch a video of BMX with DIEP Flap reconstruction you will notice that there is nothing tender and gentle about that surgery. In fact, it is really rough how our bodies are handled during surgery. This is not an insult to the team working on us. I have been told by an acquaintance that is a surgical nurse that during any surgery it’s kind of like working under the hood of a car. I was told that years ago so it’s not specific to just our surgery. So I believe we have deep bruising in our chest muscles that will take time to heal.
I have this feeling in my chest, right about where my cleavage is, when I eat or drink anything cold or hot I can feel it going down my esophagus right at that location. Sometimes it’s painful especially with something cold...I describe it like a brain freeze when you eat ice cream too fast.
I have a lot of pain under my arms. The tissue is very hard. Any bra that I wear, even a camisole hits me right at that sorest place. I go back to my PS tomorrow to get the stitches out of my belly button and to learn some massage techniques and to get some cream to help all the sutured areas heal.
I am feeling depressed even though I am on anti depressants because I thought I would be more mobile and active. It’s not fatigue that is limiting my activity it’s pain. I am so tired of the pain. I alternate between Tylenol and 800 mg Ibuprofen. I finished Oxycodone a week ago and did not request a refill. It really didn’t do much for me.
Thanks for letting me vent and whine. Even with this painful recovery I am still satisfied with my decision to go with BMX with the DIEP reconstruction.
Blessings..
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In regards to the question about wearing the stomach binder...my PS explained that when our abdomen is pulled back together after harvesting the fat tissue and the veins, that there are many layers of stitches internally. Also, even with the drains, it’s so important to get any left over fluid out of that surgical area or it won’t heal and then we have real problems. So as uncomfortable as the binder may be it is vital that we wear it. I wear a sports bra and then a camisole and then the binder. It does make it a little more comfortable not to have the binder against my skin.
I do get tired of feeling so bound up. Sometimes when I get out of the shower I lay down on my bed with nothing on just to get s few minutes of relief
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on the binder-definitely wear a tank top or something underneath it. I also found that flipping it over so it was “upside down” from the way I was put in it after surgery helped tremendously. With that flip it came down partially over my hip scars (about 1/2 way down my hips). Very little ride up with those changes. Hope this helps!
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Recovery - Day 2
It was a prettly sleepless night last night because of the hourly flap doppler checks. But, i was able to get up and sit in a chair today for a few hours while my family visited. I also had my maintenance fluid IV and catheter removed.
Eventually, sitting in the chair exhausted me, so i am back in bed now and hoping to get some sleep tonight. I’ve asked for some sleep meds to help.
Pain has been constant, but manageable with a low dose of Percocet every 4-5 hours.
Tomorrow i will be up and walking around the floor a few times.
Overall, this has been easier than i imagined.
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SadieSue09, sounds like you are doing very well. I am sure you will get some sleep tonight. Blessings for a continued excellent recovery
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quick question for those that have already gone through the procedure...Did any of you have low blood oxygen readings? I am not talking about the flap oxygen readings, but the one they take with the finger clip.
My last reading was around 80% and I have been on and off oxygen today.
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Sadie-seems like I did after stage 1. I hate those oxygen canulas. Frankly I hate anything up my nose. I ended up with very dry nasal passages and had to get some saline mist for them. Pretty sure this is normal.
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Check out marsupialpouch.com So comfy! I had drains three times and I bought two.
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