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Topic: Seroma.....Help!

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Feb 11, 2009 03:30AM

Vinogal wrote:

I have developed a seroma in my left side........had bilat mx with TE placement on Dec 15th........have had a few fills.......I have been on antibiotics for a few weeks.....because of redness and fever......however that seems to have resolved.......so now I am just dealing with a seroma......I would love to hear from anyone who has dealt with this........what your PS did to treat......and how long it took to resolve........mine keeps draining from a small wound that has developed........but it's really starting to get me down.......I would like to put this all behind me.......so this complication has got me pretty down.......any thoughts would be appreciated.

Thanks

Jax

Dx 4/16/2008, IDC, 2cm, Stage II, Grade 3, 1/13 nodes, ER+/PR+, HER2+
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Feb 11, 2009 01:50PM emor wrote:

Dear Jax,

I am not sure where to start and I am afraid I my experience will not make you happy and optimistic about your situation. I had my bilat mx with TE in August 2008. I still have unresolved seroma issues on one side. I had drains for 5 weeks the first time, 8 weeks the second time and I am now on my 3rd week with the third drain. I had 4 surgery since my mx, was completely expanded but lost most of the fills during my surgeries. I tried complete bed rest for 2 weeks, compression for 7 weeks - nothing helps. I drain 50-60 cc a day. I even had a sclerotherapy (Tetracycline treatment) done during my last surgery. I had a lymphoscintography done yesterday - it is a very similar procedure to sentinnel lymph biopsy - to try and see if I have a lymphatic leak somewhere in the breast area. The test did not give a conclusive answer. My BC surgeon and my PS are trying to figure out together what to do. I do try to keep my chin up (as my PS keeps asking me to do) but it is not easy. I have learned to deal with the drain and live with it but it is uncomfortable and I do have to be on abx most of the time in fear of infection.

I am not sure what kind of an advice I can give you. The only thing I can think of is that you might want to raise the issue of reinserting a drain with your PS. I am sure my PS would let me drain through an open wound. The danger of an infection is too great.

I can only wish you that your situation will be resolved much much quicker than mine. I completely understand how you feel.

 Hugs to you -

Edith

Dx 7/18/2008, IDC, <1cm, Stage I, 0/5 nodes, ER+/PR+, HER2-
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Feb 11, 2009 04:13PM baywatcher wrote:

Hi Jax-

I had a seroma too but I didn't have recon. I had a "hole" in my scar that wouldn't heal because I had too much seroma fluid behind it, which sounds similar to your wound. I went to the doctor almost weekly and he would aspirate fluid (remove it) with a syringe. There was talk of reinserting a drain tube, also talk of opening the hole and packing it but it finally cleared up after about 10 aspirations, approximately 3 months. It was very depressing while it was going on. I feel so bad for Edith (the previous poster) and you. Hopefully you will both get this problem resolved soon. 

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Feb 11, 2009 08:20PM LibraGirl wrote:

Hi Jax

Glad to hear the infection seems to have resolved.  I've had both a hematoma and a seroma.  After my lumpectomy I developed a hematoma that drained from an opening in my incision for weeks.  My docs did not seem concerned, but did tell me to watch for infection.  Thank god none developed.

After my bilat + TE, my left side (cancer side) was really swollen with fluid right from the get go.   My ps wanted to see if it would resolve itself, but after a week it showed no signs of doing so and was very red and purple, so I went back in for day surgery and had the incision reopened and suctioned out (300 ccs!).  After that I had to have it aspirated once or twice a week and the volume each time slowly decreased. It took about 5 weeks for it to settle down. It was really disheartening, but it did eventually clear up.  I really feel for emor and baywatcher, as they've had a much tougher time than me, but I thought I would post to add to the range of experiences.

Has your ps recommended compression?  Some women on this board have found that + inactivity helped.

Emor, I really hope  your docs can get to the root of the problem and *solve it*.  

Dx March 14 2008, IDC 1.7 cm, Stage 1, Grade 2, 0/3 Nodes, ER+ PR+ Her2+
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Feb 11, 2009 09:06PM anianiau wrote:

My bilat mx was 12/08/08, with no reconstruction. Within about three or four days, I developed a firm swelling in the midline, above the incisions. After the drains were removed (too soon), I developed pockets of fluid  (about the equivalent of an A cup). There was one on each side, on the chest wall, but under each arm. There was more fluid on the side that had had the sentinel node biopsy.

My surgeon initally said it was 'fatty tissue' but finally he referred me for a chest wall ultrasound. This showed fluid under the arms--seromas-- and 'stringy clots' in the middle. When I asked the radiologist about having the surgeon drain it, he said that he would not necessarily recommend doing so, because the fluid in a seroma can be 'loculated'--contained in grape-like clusters that don't connect with one another. These clusters of fluid usually have walls that are too thin to see on ultrasound. His recommendation was to wait for the fluid to be resorbed. That would probably take at least six months and perhaps as long as a year.

As you can imagine, that definitely was not what I wanted to hear! Fortunately, I have no external drainage, and no infection. I find it does help to use a breast binder, especially at night. I still can't sleep on my left side. When I try, it feels as though I have a bean bag under my side.

Limiting your activity may also help, hard as that is to do. It's good that your infection seems to have resolved. It may help to keep notes about how you are progressing, and what you are noticing. I would also recommend asking your doctor about what his plan is for treating this, and what you can expect at each stage. He really does need to formulate a plan, and you should be in on it!

I wish you good luck. I can sure understand why you feel down. Please let us know how you are doing.

Dx 10/20/2008, DCIS, 1cm, Stage 0, Grade 3, 0/8 nodes, ER-/PR-, HER2+
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Feb 11, 2009 11:38PM Jellydonut wrote:

After bilateral without recon I too developed a seroma, but did not even know it until the BS told me!!  He drained the fluid and fortunately have been fine since, that's 2.5 years ago!

Best of luck to you,

Jelly

Dx 3/2002, IDC, Stage IV, 3/8 nodes, mets, ER+/PR+, HER2-
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Feb 12, 2009 10:03AM DATO wrote:

I developed a seroma in the abdominal incision site after my hysterectomy.  It was an 8 cm "tunnel" between my muscle and skin/fat.  I went in every week day for 3 months to have it packed with a thin gauze tape.  The nurses kept asking me if I was eating right.  I thought I was because I wasn't eating fast food or junk food.  Finally they asked me to tell them what I ate in a typical day.  I was eating cereal for breakfast, carrots or fruit for a morning snack, a veggie sandwich for lunch, another piece of fruit for an afternoon snack and dinner was usually some kind of meat or fish, with a veggie and a starch.  They told me I wasn't eating enough protein.  When I started eating eggs for breakfast and more protein at lunch the seroma started healing.  I don't know if it was cause and effect or just coincidence, but I plan to eat plenty of protein after my reconstruction next month.

Dx 5/12/2006, IDC, 1cm, Stage IIIA, Grade 3, 6/9 nodes, ER+/PR+, HER2-
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Feb 12, 2009 10:28AM Mykidsmom wrote:

Dato - That is a very interesting post. I wonder if the two are related. So many women have had seromas and I have never seen them post a connection to protein intake. I will try to remember to pass this along.

Jax and Edith - My heart goes out to you both. Take care and try the protein. It certainly can't hurt, right?!? - Jean

Prophylactic Bilateral Mastectomy w/ Tissue Expanders - 12/08 Exchange 04/09 Dx 8/25/2008, LCIS, Stage 0
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Feb 12, 2009 11:29AM suzyshyla wrote:

Before my bilateral, I had 2 lumpectomies and had a huge hematoma following both surgeries. I had to wear 'super-strength' pads under my arm where the incision was.  Pretty nasty, but it finally resolved itself. 

I also had a huge hemotoma/seroma that developed on my abdomen after my reconstruction surgery.  It had to be drained 3 times and finally the surgeon put a drain in.  It hurt like heck because it rubbed me contantly, but i endured it for 3 weeks.

I know it is not the same situation as yours, but sometimes it helps to know that others are listening and understand what your are going through. At the time it was so awful to go through, but now looking back, it's hard to remember how bad it was.  I pray that you will be looking back at this difficult time soon.

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Feb 12, 2009 12:03PM sherry64 wrote:

Protein intake is a vital component of wound healing. 

12/01/08 Bilateral mast with tissue expanders; LCIS in margins Dx 10/9/2008, DCIS, Stage 0, Grade 1, 0/4 nodes
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Feb 12, 2009 01:56PM anianiau wrote:

An excellent point, and as DATO said, one many people wouldn't have picked up on.

Sherry64, would you have any idea of how many grams of protein would put us in the ideal range for postop healing?

Dx 10/20/2008, DCIS, 1cm, Stage 0, Grade 3, 0/8 nodes, ER-/PR-, HER2+
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Feb 12, 2009 02:30PM sherry64 wrote:

anianiau-No, I'm sorry but I don't know specifics.  I've had wound healing problems in the past and was told by a wound care specialist and by my PS to eat plenty of protein.  After doing my own research it looks like protein really is essential in the healing process.  When I'm healing I try and incorporate protein anyway I can.  I also eat nutrient dense veggies and fruits and a big glass of OJ every night for Vitamin C.  I developed a seroma following a partial hysterectomy in May which caused my incision to open in three places.  I had it packed then switched to a wound vac. Feeling competely helpless, the only thing I had any control over was my diet.  So I really focused on eating healthy with tons of protein. I took the same approach when one of my mast incisions opened last month.  I don't know anything about seromas that don't drain to the outside. I guess they're not really wounds.  What is your surgeon telling you?  Are you able to go forward with fills?  Maybe the general/breast surgeon is more familiar with this issue than the PS.

Sherry 

12/01/08 Bilateral mast with tissue expanders; LCIS in margins Dx 10/9/2008, DCIS, Stage 0, Grade 1, 0/4 nodes
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Feb 12, 2009 02:48PM , edited Feb 12, 2009 02:50PM by Vinogal

Thanks for sharing your stories and tips ladies......I have been eating very well and that has included lots of protein.......Saw PS again today.......we drained some more and she agreed that redness has definately gone......we have cultured the fluid 3 times and have not been able to grow anything......so it seems it's just a waitng game......I will see her again on Friday......and will see about getting a fill......we did one last Friday.....to see what would happen if we tried to get rid of any empty space......seemed to make things a little better......so maybe another fill on Friday?......I just want to be done with this......I was doing compression and also remaining inactive.......but that is unrealistic indefinately.........anyone else have success with compression?

Cheers

Jax

edited for spelling......because I suck

Dx 4/16/2008, IDC, 2cm, Stage II, Grade 3, 1/13 nodes, ER+/PR+, HER2+
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Feb 12, 2009 08:02PM anianiau wrote:

Thanks for your answer, Sherry. No fills necessary, because no tissue expanders for me, and no recon. Breast surgeon hasn't made any suggestions re diet. I do see the plastic surgeon about potential scar revision (down the road) about a week from now.

Several years ago I saw a registered dietitian to review my diet (I am a diabetic controlled by diet for three years now) and if I remember correctly, for a 'normal' diet her recommendation was a minimum of about 60 g/per day--2 oz--of a complete protein. She didn't recommend going too much beyond 3 to 5 ounces of meat, even leaner cuts, though. Diabetics are prone to develop kidney failure, so too much protein on a routine basis can result in developing kidney problems. That's not to say that protein intake shouldn't be increased after major surgery. But because I'm on a controlled carb diet, that big glass of oj would be a no-no, though an orange would be okay. Mostly I stick with carbs that are low on the glycemic index. Nutrient dense veggies are a staple, as are whole grains.

Good luck with your healing! 

Dx 10/20/2008, DCIS, 1cm, Stage 0, Grade 3, 0/8 nodes, ER-/PR-, HER2+
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Feb 13, 2009 08:25PM pameliza wrote:

Hi Libragirl - I've been having a similar situation.  I had a TRAM revision due to fat necrosis about a month ago.  The PS didn't use drains so I've been leaking continually!  It started out with lots of swelling and then blood poured out of the nipple excision for a day.  It slowly tapered off after a couple weeks.  Now a small hole opened in a different incision area and continually leaks a yellow fluid and will bleed around the opening.  The doc just says to be patient!  I am so afraid of infection.  Any thoughts?? 

Oh yeah - I'm a Libra tooLaughing!     Pam

Dx 10/30/2007, IDC, 1cm, Stage IB, Grade 3, 0/4 nodes, ER+/PR+, HER2+
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Feb 13, 2009 08:32PM christinegrossutti wrote:

I am new yhere so  hang in there

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Feb 13, 2009 08:38PM christinegrossutti wrote:

Sorry, I don;t know all the lingo... I had ultifocal dcis with stage 1 grade 2 invasive... double mastecto my oct 2nd

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Mar 10, 2009 12:52PM Joannem65 wrote:

BC has been my worst nightmare x100. I have had complications to everything. I have undergone a total of 11surg. procedures including TEx3 due to leaks and infections complicated by the dreaded SEROMA... I  have had multiple aspirations, 3 drains (current one in x6wks) - still draining 60-100cc/day.  Cellulitis x 2 currently on IV Daptomycin daily.  Has anyone had exchange from TE to implant and had the "leaking" area cauterized??  I would love any feedback.  I'm planning on increasing my protein intake starting tomorrow morning.... I can do that myself.   Please help!!

DX:  6/08  Sage II  IDC and DCIS grade 3  Mastectomy ER/PR Neg  Her2 Pos.  Finished Chemo TX x 4 11/08   

Dx 6/23/2008, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2+
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Mar 10, 2009 12:56PM fairy49 wrote:

Joanne, I had cellulitis and was on IV daptomycin for 2 weeks so I can totally relate to that part it was horrid, I just had my exchange last Tuesday and so far so good, however I am totally paranoid to say the least, I keep checking the foobs! I am sure someone will post with more info for you I wish I could be of more help, I just wanted you to know I am praying for you that things get better, I just know they will, hang in there!!

DX 9-22-08 IDC 1.1cm Stage 1 Grade 2 SNB 0/5 ER+ PR+ HER- Bi-Lat Mas re-con,tissue expanders on 10/29 - Exchange to silicone implants on 3/6/09 Oncotype DX Score 9 - BRCA 1 & 2 Negative.....If God brings you to it, he WILL get you through it
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Mar 11, 2009 01:34AM emor wrote:

Dear Joanne, I am not sure I can help, but boy can I relate... I had my surgery on Aug 08, I am now on my third drain as well. This one is in for 7 weeks, previous one was in for 8 weeks and first one was in for 5 weeks (obviously was removed too early). I had 6 surgeries, tries compression for 7 weeks, manual lymphatic massage, tetracycline treatment, total rest for 2 weeks - nothing stop my leak. I drain about 60 cc/day. At this point I think I need a plumber not a PSWink. I have a cousin who is a PS, he talks to my PS and the common opinion now is that I have an open lymphatic channel that is draining into the foob area - probably going almost straight into the drain. My next surgery in the 19th - my PS will try to find the open channel and glue it with sealant. This better work this time! My BC surgeon told me to eat protein in every meal since I loose protein with the drainage (you can probably see "gunk" in your bulb - that's protein. I also take vitamins C and D, doesn't solve the problem but maybe keeps me in a relative good physical shape. I have been taking a lot of abx over the last 7 months.

I hear you Joanne, you are the only one I found on this great site that has similar situation to mine. I was lucky not to need to go thru Chemo, I can only imagine how difficult is for you while on Chemo. My PS (who sees me every week for 7 months now) keeps telling me to keep my chin up - not an easy task but I do my best. Overall I feel pretty good, I try to walk 3 miles every day and I am almost back normal activity (no heavy lifting and dragging). It is amazing what you can get used to doing with the darn drain...

Keep me updated Joanne! Best - Edith

Dx 7/18/2008, IDC, <1cm, Stage I, 0/5 nodes, ER+/PR+, HER2-
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Mar 11, 2009 01:41AM mizbabygirl4 wrote:

After my mastectomy, one of my drains stopped working and I developed a seroma under my arm and partially on my chest. Unfortunately, the docs did not realize I had a seroma until after the drains were removed, so I had to have, on two occasions, the seroma drained via a syringe. It came back afterward but once I began applying heat to it, it resolved on its own.

Good luck with yours!

Janet

Dx 8/4/2008, IDC, 3cm, Stage IIA, 0/9 nodes, ER+/PR+, HER2-
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Mar 11, 2009 08:45AM Joannem65 wrote:

 Janet, Fairy & Edith - How can I say thanks for at least letting me know I'm not alone in this battle.  I saw my Inf. Disease Dr. today, he's encouraged by the appearance of total resolution of the infection.  1 more week of abx - then we'll watch & see making sure no signs of infection before we go ahead w/ the exchange.  I guess I'll just hope it all works as planned.  Thanks for the support and I'll keep you all updated.

Joanne

Dx 6/23/2008, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2+
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Mar 11, 2009 05:15PM rferraris wrote:

Ladies, ladies, ladies.  I hate that you are going this mess after everything else we've gone through!  I had a bilateral tram 15 months ago and STILL have a seroma!  I had 2 strains of staph last year as well as strep growing in my belly.  My seroma started under my right arm and went down in to my groin on the left side.  It has been surgically removed 3 or 4 times (I've lost count).  I have also had TISSEAL which is a heart sealant to try to get it to close up.  Plus three injections of doxycilian.  In the last 15 months I have had a drain for 80% of the time.  When I don't have a drain I go in to be aspirated.  I've finally gotten to the point that I didn't have to go for three weeks and they only got 60 cc's.  Back before Christmas they were getting 250-300 cc's a week.  My PS has sent me to a major educational institution for a 2nd opinion.   They all can explain what happened but not why. 

Rachel

 We WILL get through this!!!  I know it is hard to stay positive but if I can do it, you can too!  I pray daily that God will use me.  I know He has a reason for my body to go through all of this and I pray that He will continue to keep my spirits lifted and that He be glorified through all of this.

Dx 7/13/2006, IDC, 5cm, Stage IIIB, 13/25 nodes, mets, ER+, HER2-
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Mar 12, 2009 01:18AM Mykidsmom wrote:

I am there with all of you - sending healing and loving vibes your way. You will prevail!!!!!!!!!!!! -Jean

Prophylactic Bilateral Mastectomy w/ Tissue Expanders - 12/08 Exchange 04/09 Dx 8/25/2008, LCIS, Stage 0
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Mar 12, 2009 11:25AM Joannem65 wrote:

hi again ladies  -- this is my daily check in with ladies who understand what I'm going through...

rferraris -- were any of your surgeries done after the seroma was already there?  I'm just afraid to go ahead w/ the exchange when I've still got 60-80ml draining per day.   My expander is filled up to 600cc and it's slightly bigger than my lt breast.  Technically I'm ready for the exchange but I don't want to procede if I'm going to be stuck w/ a new "implant" DRAIN and the continuing fluid.  I just wish there was a magic pill to dry it up... then I would do the next surgery -- I just want it to be the last.  (it will be the 12th OR procedure since my dx in June'08)  I appreciate your insight and support.

Joanne

Dx 6/23/2008, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2+
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Mar 12, 2009 11:51AM emor wrote:

Joanne, My PS specifically told me he will not exchange until my fluid issues will be completely resolved. I have an OR visit scheduled for next Thursday - my 7th one. Oh, if there really was a magic pill....

Hang in there...I know it's easier said than done.

 Edith

Dx 7/18/2008, IDC, <1cm, Stage I, 0/5 nodes, ER+/PR+, HER2-
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Mar 13, 2009 07:46AM Joannem65 wrote:

Edith,  Oh how I can relate to your situation.  Both my I.D. (Infectious Disease) and PS said to go ahead w/ exchange in few wks. providing no signs of infection return following the stopping of the IV Abx. next week.  They feel if we're going to open it up to "seal" the leak - do the exchange at same time eliminating another surgery.  I guess there is no easy answer - so for now I'll keep praying for it to "dry-up" and continue the high protein diet.  I'll keep you in my prayers too.  Good luck next week.

Joanne

Dx 6/23/2008, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2+
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Mar 13, 2009 09:07AM emor wrote:

Joanne, Thank you for your thoughts and prayers! I so hope for you this will work. Next week with my next visit to the OR my PS is going to try to find the leak and seal it with a sealant (basically glue). He thinks (along with another PS) that there is an open lymphatic channel that drains into the breast area. Since he has already tried sclerotherapy last visit to the OR and it did not help I am trying to be optimistic but have a hard time. I was fully expanded but with each surgery some of the saline is removed so I am now a few steps back. I eat lots of protein and I do take vitamins C and D which my GP told me to take and keep dragging the drain - you know how it goes. I'll keep my fingers crossed for you. Can you imagine life after drains...

Edith

Dx 7/18/2008, IDC, <1cm, Stage I, 0/5 nodes, ER+/PR+, HER2-
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Mar 14, 2009 03:08AM Daudine wrote:

I had seroma for 3 months after bilateral mastectomy with implants. My left breast opened 6 times with the implant exposed. PS did stiches everytime and gave me antibiotics every time it opened. It finally stoped by itself after 3 months. My PS told me that there was nothing to do. My body was trying to flush out the implant.......good luck!!! It is a rough time for you but II WILL HEAL!!!!

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Mar 29, 2009 01:15AM emor wrote:

Vinogal, how are you doing? Is your seroma being resolved?

Joanne, Are you done with the abx? I sent you a PM.

Hang in there gals, we shall overcome!

Edith

Dx 7/18/2008, IDC, <1cm, Stage I, 0/5 nodes, ER+/PR+, HER2-
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Mar 30, 2009 03:43PM Joannem65 wrote:

Hi ladies -- Sorry I haven't been around lately.   I am done with the IV Dapto (Abx) but still have the drain.  It's been 2 wks since we stopped the abx and so far no signs of recurrent infection.  I see my PS on Wed. to check everything out and discuss our OR plans for 4/20.  Exchange to implant and cauterization of the lymph leak - providing she can isolate it. 

I guess overall I'm doing okay and just keep praying this will go away and I can get on with my life.

Hope you're doing well & look forward to your updates!

Joannem65 : )

Dx 6/23/2008, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2+

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