The Grand Unveiling - Feb 25, 2010

Saw my PS today for the "reveal". I'm thrilled beyond words! The new aureola and nipple are healing well with only minimal scabbing. The nurse removed all the stitches possible. Some are still stuck under the dermabond. He said the dermabond will come off gradually as I begin to shower. I'm excited that I can shower now! I have to wear the foam "donut" over things for 4 weeks for protection. The nipple is still really swollen - he says it will shrink 50% over the next few weeks.
Abdominal revisions look great and are healing well.
Abdomen is still swollen, but now I can't tell if it's Lupron effects or swelling from the hysterectomy. I'm sure it's some of both. I'll just have to be patient and give it a few weeks to see how things shake out.
Happy day!

Surgery and Post-Op - February 10, 2010

Stage 2 surgery was Feb 3 and included nipple creation, some fat grafting, and dog-ear revisions. Also included was a hysterectomy (ovaries, tubes & uterus), and bladder suspension. Surgery lasted 9 hours. Not long after I arrived in my room from recovery, my nurse and my husband helped me stand by the bed. I was surprised that they wanted me to walk so soon after surgery, but I was trying to be compliant. I remember feeling faint and sitting back on the bed. The next thing I was aware of was the nurse and my husband holding me by the arms in a sitting position on the bed. It seems I passed out cold after I sat back down on the bed. I was unresponsive for about 30 seconds. My husband said the nurse jumped on the bed and started calling my name and lightly tapping my cheek. That little episode resulted in getting 2 units of blood and having my vitals taken every 20 minutes all night. My blood pressure was around 80/49.

After reviewing things, my doctors wanted to keep me an additional night. I was happy with that because I really didn't feel that well. No much pain to speak of, just not very steady. I got up to walk at least a couple of times the next day. I was discharged on Friday, Feb 5.

I didn't have much pain at home and was able to discontinue pain meds after 2 doses (except for Tylenol). I was prescribed Bactrim and iron supplements. By late Saturday, I didn't feel well, but attributed it to the antibiotic or the iron. Felt worse on Sunday - kinda achy and feverish. Felt nauseous by Sunday night. By Monday norming I was vomiting, too. After consultations with nurses from each of my 3 doctor's offices, I was told to stop the Bactrim and iron. I tried to control the nausea with Compazine, but couldn't keep anything down. I finally got it under control with Phenergan by Monday night. So, in retrospect, what I assumed was medication reaction was actually some sort of virus with fever, body aches, and vomiting. Nice.

As of today, the virus seems to be waning and I'm back on the Bactrim.

I have flat, round foam protectors with a hole in the middle taped over the new nipples, plus steri-strips over the laproscopic incisions (1 by navel, 1 over pubic bone, 1 on each end of original abdominal incision.

I can't shower yet because I can only tolerate paper tape and my PS doesn't want the nipple area to get wet and doesn't want the bandages disturbed yet. I can sit in a few inches of water in the tub and wash my hair in the sink. No drains, hurray! I have alot of bruising in the lipo areas, although it looks much worse than it feels. He promised me that the lipo wouldn't be very painful and he was right!

My PS post-op appt is Monday, Feb 15 for the grand unveiling.

Pre-op PS office visit - Jan 18, 2010

Had my pre-op PS visit today. As far as the abdominal swelling goes, my CT scan showed nothing anatomically wrong - no abdominal wall or muscle weakness, no hernia, no lymphadema, no fluid collections. That's wonderful news! That means that the Lupron must be causing this swelling. The Lupron effects should wear off by early February and I can't wait for that! Dr. S says that if, for some reason, the swelling doesn't go away, then he can fix the problem surgically at another time. I sure hope that won't be necessary.

My Stage 2 surgery is Feb 3. Nipples will be created, left side will be reduced a little to match the right side. Fat grafting will be done to fill in some hollow areas and dog ears will be fixed. I'm also having my ovaries and uterus removed laproscopically as well as a bladder lift. The gynocologist will go first, followed by the urologist, then the PS will do his part. They estimate a 4 hour surgery with 1 night in the hospital.

I'm getting nervous about surgery, but I keep reminding myself that this is nothing like the Stage 1 surgery. I'm just ready to get this behind me and move on.

Wednesday, December 30, 2009

My PS's office called today to schedule an abdominal CT to see if the swelling is due to muscle laxity. It's scheduled for Jan 4. I thought he was going to wait to order the CT until after my Stage 2 surgery in February, but I guess he changed his mind. That's ok with me because I'd rather know sooner than later just exactly what's behind this problem.

Dr. S said I'd start to have some "electrical shock" type sensations within a few months after surgery. He says it's a sign that some of the nerves are starting to regenerate. I've had several of them in the last week. They are very brief, but definitely there. A good sign.

December 22, 2009 office visit

I saw my PS today for a final consult before my Stage 2 surgery on February 3, 2010. Three separate procedures will be done during that surgery, in this order - ovary and uterus removal, bladder lift, stage 2 breast revisions. My PS's goal is to make my breasts symmetrical since the left is slightly larger. I would need a small implant on the right to match the left side, so I definitely said no to that. The whole idea was to avoid implants. So, the left side will be reduced slightly to match the right. The right side will have some fat grafts to plump things up abit and create a more natural slope. That will involve some lipo. I've heard that is quite painful, but he says it won't be nearly as invasive or painful as regular cosmetic lipo. There will be lots of bruising, though, and I'll have to wear a compression garment for a week or so. Breast drains are a slight possibility, but if I need them, they'll be removed at the first post-op visit in 6 days. Both breasts will be moved towards the center more. They're a bit to the east and west right now! He thinks he will most likely be able to do nipple creation assuming everything else has gone well up to that point. He'll also remove the dog ears at the end of the abdominal incision.

My abdominal swelling remains the same. Very annoying. I was afraid he'd want to open the abdominal incision to see what's going on, but he said let's wait until the Lupron has a chance to wear off (February 10 will be 3 months). If Lupron isn't the cause of the swelling, then he'll order a CT scan. If necessary, he can use abdominal mesh to pull my abdomen back in. I was worried that I'd be left with a "tight girdle" feeling if he has to do that, but he says I won't. He says it will be unnoticeable. So, I'm still hoping that Lupron is the culprit because I certainly don't relish the thought of any more abdominal surgery.

He said I'd stay one night in the hospital as far as he was concerned. Any additional days would be at the order of the gyn and/or urologist. Let's hope not.

Monday, December 7, 2009

My biggest complaint right now is still abdominal swelling. After consulting with the PS and oncologist, the two possible causes are the Lupron or some abdominal fascia laxity. The frustrating thing is that there's no way to know for sure just now. The Lupron won't wear off until mid-February. I've read that a CT scan can detect abdominal laxity, but I don't see the PS again until just before Xmas. He assures me that if that's the cause, then it's very easily corrected during Stage 2 surgery. I'd rather him find out from testing than to do any more exploratory work than he absolutely has to.

I had a consult today with a urologist. He plans to do a bladder lift during the same surgery. I can thank those two big babies I had for that problem! They were worth it, though! So, assuming the PS and gyno's procedures go well, the urologist will do his procedure last. I guess it's kind of like going in for an overhaul - ha!

Sunday, November 29, 2009

I had two doctor appts last week to see if I could find out why my lower abdomen looks like I'm 3 months pregnant. From what I can tell, it's probably due to my last Lupron shot on November 10. Within 4-5 days, my lower abdomen was noticeably distended. Before that, my stomach was flat as a board. I saw my PS last week to see if it could be the result of my surgery. He says no. My abdominal muscles are very strong and he does not believe this new symptom has anything to do with the DIEP. Wearing my abdominal binder doesn't seem to help at all.

Had a consult with a gyn to discuss ovary removal. She did an exam plus ultrasound but everything is normal and she didn't see any reason for the abdominal swelling. She will coordinate with Dr. S so she can do ovary removal during my Stage 2 revision surgery. I'm shooting for a late January surgery date.

I found several references to abdominal swelling as a side effect of Lupron. I'll check with my oncologist this week to see if she has experience with this side effect. It was a 3-month shot, so this swelling may last that long. It's not painful, just very annoying and tight feeling. I hope to gt some answers this week.