I saw Dr. S. today. He's very pleased with my progress. They also took photos today for my official post-Phase I results. Even the photographer commented on how good everything looked. After going through this whole process, I guess I've finally gotten used to being viewed, poked, and prodded by assorted medical professionals!
Dr. S mentioned that mesh was used in my surgery. I was able to get more info about it during this visit. It's a natural mesh that my tissue will grow around, not a synthetic mesh. He used it to reinforce the abdominal area. He cautioned me again not to lift anything over 10 pounds, no sit-ups or crunches and to be careful not to stretch my abdomen too much. He also said I should avoid any heavy lifting for the next 6 months to a year.
He wants me to wear my abdominal binder or some type of support garment for now. I found some light-support underwear made by Hanes that seems to give enough support without squeezing too much. I can wear any type of bra now - even underwire if I want. Dr. S says my new breasts are part of me now and that I don't have to worry anymore about whether the flap will survive. I can sleep in any position now without worry. He also said to expect some "electric shock" type breast sensations as the nerves connections start improving.
I asked him what to expect during my Phase II revision surgery. He said he'd do a small amount of lipo at the outer edges of my abdominal incision to smooth out that area and then use it as fat grafts to "fluff up" any breast areas that need it. He'll also correct small dog-ears at the ends of the abdominal incision. The areolas and nipples will be created at that time. I'll wear foam shields over them until they heal.
I still need to have my ovaries removed, so Dr. S said that can be done during the same surgery. The doctor he recommended does a robotic-assisted laparoscopy. His office will give me a doctor referral since I need a surgeon that has privileges at that hospital. I want my uterus removed in addition to the ovaries. I've been discouraged from that by my previous GYN for reasons that aren't clear to me. In my mind, it will be one less thing to worry about. So, we'll see how the new consult goes. I've also requested the same anesthesiologist because he prevented me from all the nausea I've had in past surgeries.
We also discussed Phase II timing. I could have it done in December, but I've decided that I want to wait until later in January so I can enjoy my family and the holidays without trying to recover from another surgery. We had originally planned to do this in December since I'd already met my deductible for this year, but I've changed my mind. I just want to feel good and enjoy the holidays. I will have to meet next year's deductible for other things anyway, so I guess it really doesn't matter. I left his office feeling very relieved that I can finish this year out without any more surgeries. I'd say that a bilateral mastectomy and reconstruction is plenty for one year!
My biggest physical complaint right now is abdominal tightness. It's a bit of a strain to take a deep breath. I can, but it feels like my diaphragm is constricted to some degree. Dr S said this is normal and will improve greatly over time. I'll keep reminding myself of the progress I've already made and remember that "this too shall pass". I've started slowly walking again and am up to a mile now.
My next visit with Dr. S is scheduled for early January.
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HI Karen,
ReplyDeleteI'm glad to hear you're making such wonderful progress. After having been through both surgeries now, which would you say was the more difficult experience: mastectomy or reconstruction? I had a bilateral mastectomy on September 15. My Plastic Surgeon put in tissue expanders, and I will have DIEP reconstruction in June. I wasn't prepared for the surgery experience, never having had major surgery. Also, nausea was a big problem for me. I had my tissue expanders expanded only once, and I was surprised by how much larger he made me. Anyway, I'm a little anxious for the DIEP surgery not just due to the nausea factor, but also for how long I'll be there, and the doppler monitoring.
Thank you!
Jane
The mastectomy and expanders were, by far, the hardest surgery for me. I had alot more pain with that surgery than with the DIEP. I had severe nausea with the mastectomy, too, so I can really sympathize with you! In contrast, my DIEP surgeon used an anesthesiologist who used "multi-modal" anesthesia. He gave me anti-inflammatory meds, local numbing agents placed in the abdominal incision site (marcane - sp?)that lasted several days, anti-nausea drugs, plus the usual narcotic meds. I had ZERO nausea and that's a first for me! Make sure your DIEP surgeon knows what anti-nausea drugs work best for you. I gave a copy of my recovery room notes to my DIEP surgeon and anesthesiologist so they could see what worked and what didn't.
ReplyDeleteMy expanders had only 50ccs injected at a time. I didn't have any pain at all other than at the injection site. Don't be afraid to tell your PS to slow down if you're having pain.
I'm glad I had several months to recover before my DIEP. I walked alot and I think that helped me go into the surgery with more stamina.
The doppler monitoring was no big deal. My PS marked the monitoring site on my skin during surgery. The site was monitored once an hour for 24 hrs after surgery. The nurse places this small rod-like thing on the site and listens for the blood flow. The sound is amplified, so you'll hear it too. It's like hearing the baby's heartbeat when you're pregnant. No pain at all. They'll wake you every hour for monitoring, though. The doppler monitoring decreases each day.
The one thing I wasn't expecting was the "hot blanket". If you read back in my blog, you'll see my description. I've heard that some people are placed in a hot room instead. Either way, be prepared to be too warm for a day or two. The purpose is to keep your blood vessels dilated. I also got heparin shots to prevent clots. I needed 2 units of blood during surgery because my pressure was low. You'll have plenty of time before your surgery to donate some blood if you want.
I was admitted on a Wednesday morning and was released on Sunday by noon.
Let me know if I can answer any more questions.
Correction - I was released on Monday, not Sunday.
ReplyDeleteThank you! That is very helpful. I'm sure I will have more questions as the date gets closer. I won't be having the expanders pumped up any more because I have started radiation - thank goodness!
ReplyDeleteGood. That will give your skin/muscle time to slowly stretch out. Hope radiation treatments go well. Do you have to travel far? How many are you having? I'm sending good thoughts your way!
ReplyDeleteI have 6 weeks of radiation. I'm about halfway through now. I'm starting to notice itching and rash. It's only about a 40 minute drive with traffic, so it's close. My surgery will be an hour away, in Boston at Brigham and Women's.
ReplyDelete