Tuesday, July 26, 2011

Rolling in the DIEP

In these months leading up to my reconstruction, you know I'm going to be talking myself through this, while I educate myself and you about all the ins and outs of breast reconstruction using my own tissue, not implants.

For those of you new to the blog, you may not know that when I had a bilateral (or double) mastectomy, my breast surgeon did a skin-sparing, nipple sparing mastectomy.  Although only Flopsy, my left breast, had cancer, I chose to do both breasts since Flopsy and Mopsy have always gone everywhere together.  Joking aside, it made sense to me to do both breasts, hopefully lowering my risk of an occurrence in Mopsy, and an improved and symmetrical result if both breasts were "re-made" together.  I always wanted a breast reduction anyway, not exactly how I thought I'd get one!

A skin-sparing mastectomy leaves the breast and sometimes the nipple, and does not cut the breast down to the chest wall.  The breast surgeon removes the breast tissue inside which fills the breasts, including the cancerous tissue.  After my primary surgery, I was left with a deflated Flopsy and Mopsy, nipples still attached, waiting to be filled during reconstruction surgery that will be done by my Plastic Surgeon.

If there are those of you eligible to do your primary surgery (the one to get rid of the cancer) and your reconstruction surgery (to cosmetically fix your breasts) at the same time, I think it's a great way to go!  I sometimes think about that, how things would have been different for me, medically and mentally, if I had been able to wake up from a mastectomy with Flopsy and Mopsy The Sequel, in place.  It would have been grand.

All things considered, it was probably just as well that fate intervened and this did not happen for me.  I'm in a much better place now, physically and spiritually, having completed chemo 10 months ago, instead of having this major surgery a month out of chemo.  There is continued debate regarding radiating reconstructed breasts as well.  There are some convincing studies out of MD Anderson ( a big cancer research hospital) that suggest many women who have newly reconstructed breasts radiated have to go in for additional surgery to fix the effects of radiation.

The decision of what method reconstruction for any woman who has to make it because of cancer is a very personal one, and not easy to make after that blow.  These are some of my reasons why I want to do the DIEP.  The first one is simple and basic - I don't like implants.  I don't like how they look, how they feel, how they move, and the fact that you have to get them replaced every ten years or so.  Now there are plenty of Sisters who have chosen this path, and are very happy with their results and they look great.  It's just not for me.

I also have great concern that my body might not tolerate implants.  I had major problems with my two ports and PICC line.  The second port only lasted a few months before my body was trying to expel it.  Can you imagine the outcome if I had two implants placed in my body?  This may not be a logical argument, but I do know that the problems I had with my ports and PICC line were considered unusual and puzzling.  I just don't wanna go there with implants.

Another huge reason I think this is the procedure for me?  I have the perfect donor site!  After two C-sections, I'd be very happy to part with a poochy tummy that makes zipping up pants difficult.  I often have to buy a larger size than what my hips and butt and waist need, just to accommodate the pooch.  Even if I didn't need new boobs, I'd be thrilled to have that gone!  It makes logical sense, using my own tissue, getting a tummy tuck in the deal, and having a new rack that feels and looks very natural.

All that said, I am not looking forward to the whole ordeal one damn bit.

My Sister, Irish BC Warrior, sent me a great email after my last post about my reservations about the procedure, and I asked if I could share it with you.  Thank you Sister for graciously saying yes.  Here it is.

I wanted to respond to your blog about your reconstruction, but wanted a little more freedom then the response block on the blog.

I won't kid you, this surgery is a bitch.  Two to three months is just about a right estimation of how long it will take you to get back up to anywhere close to your regular "power level."  And yeah, you're going to be back in "drain city," but my drains came out in about a week.  

But I can't even begin to tell you how fabulous the "foobs" are when they build them out of your own body tissue.  It looks fabulous and the shape and texture is exactly like my right breast . . . if you take into account that the doc did a breast lift on the right side so it didn't sag while the new one he built for me is all perky.  It's warm to the touch and I hear implants aren't.  It moves like a real breast. 

The tummy tuck (as wondrous as that is) is the worst part of it.  You'll have to sleep at a 45 degree angle (because laying flat or on your side will be impossible) for weeks.  So plan for it.  I worked it out, but I really wish I had a recliner to sleep in for awhile.  My abdominal scar has faded almost entirely . . . but I'm more than a year out.

Keep moving as much as you can without over-tiring yourself.  It helps with circulation and prevents stiffness in your abdomen.  Stay on top of your pain meds (yes, that again) because it can get away from you if you're not vigilant.  Make sure you have lots of roomy sweat pants with elastic waist bands.  Zippers and buttons are not going to happen for weeks.  Drag back out your slip on shoes, because bending over to tie shoes also ain't gonna happen.

But Debbie, I'll tell you again . . . this is a freaking miracle.  It looks and feels so real, I just can't find the words to tell you.  I didn't have him build me a nipple because I've heard so much about there being problems with infections and stuff.  I had a 3D tattoo and I'm very pleased with it.

I have my life back because of this surgery.  I'm that sexy Irish lass again because of this surgery.  I look so good in my clothes that I'm not even the slightest bit self conscious.  I can even feel blessed when I look at myself in the mirror.  You're going to love it.  It's tough, but a couple of months after it's done, you are gonna be a happy Tink.

You can do this.  You deserve this.  I'm here with you every step of the way.  If you get scared or nervous, email me your phone number and I'll call and we'll talk.


Thank you so much Sister!!!!  What a great letter, and fabulous reminder of why I made the decision in the first place to do this procedure.  Yes, it's considerably more intensive than implant surgery, but I think it's the right decision for me, IF I CAN JUST MUSTER THE COURAGE TO GO THROUGH THAT SHIT AGAIN!  If you are new to the blog, you may not know I have crowned myself "Queen of the Glitch" - a title I earned da hard way in Cancer Camp. 

Anyway, back to my Sisters!  This network and safety net of Sisters that have come into my life because of this blog and my posts on the NOS Breast Cancer Message board has been an incredible blessing!  Not just for the tender comfort of knowing I am not alone in this, but the real life wisdom from Sisters who have gone through this stuff!  Their wisdom, born from experience, is far far better and reliable information than even the best and most well considered medical websites and literature.

I am indebted to all the Sisters ahead of me on the path, like Irish BC Warrior, who have come to me, from all over this country of ours, to encourage and light a path for me.

It is my deepest wish and hope that in some small way, my blog is paying it forward, lighting the way for Sisters behind me on the path who have just heard the words

"You have breast cancer."

Here's to my Sistahs!  Rock that shit, wherever you are on the path, grab your Sister's hand ahead of you, and reach back and grab a Sister behind you!

That's how we roll!!!!!!!!!!!!!!!!!!!!!!


Anonymous said...

Thank you soooo much for sharing!!
I just had my first radiation appointment and heard that procedure may also be in my future, ARHG!! I stomped my foot and had a hissy fit when we left! I still have one chemo left and just DO NOT WANT MORE SURGERY! I completly GET why this is vexing you! Bigs hugs to you sweet sister!!
Maybe you have "used up" all your glitches and will have a smooth sail thru this procedure and recovery. I wish that for you!

Sarah Lyman Kravits said...

Beautiful sister, I am so glad you found my blog. In part, and selfishly, because it led me to yours! I have only just started reading. I read May 2010 and almost had to take some leftover lorazepam (that's a compliment to your descriptive, creative writing).

I just had to say that I believe you will not be sorry you chose the flap surgery. I had a TRAM flap myself (in my case the surgery/reconstruction came first and then the five months of chemo and 28 radiation treatments -- same chemo drugs and schedule as you had). Similar to you I wanted to avoid implants although of course they have done wonderful things for those who need and/or want them. I just wasn't a fan of putting something foreign in my body and setting myself up for replacement surgeries down the road.

The recovery was pretty brutal, as I read it would be, and it was probably six weeks before I could really stand up straight. With a TRAM you are moving muscles around, though, which I think makes recovery even tougher than a DIEP. One of my rectus abdominus muscles is now folded up and providing blood flow to the new breast (I had a single right mastectomy). I had to wear a serious corset for a couple of weeks, and then a just-a-bit-less-serious corset for two more, and then I graduated to a Spanx for the last two. I hated those corsets but also relied on them desperately because they helped me stand up and hold myself together when my body just wasn't ready to do it.

Highly recommend getting a mastectomy camisole that has pockets for your drains. That made life so much easier for the first week or two. I had five drains (two for the abdominal incision, two on the right side, and one on the left for the mastopexy).

I ended up needing PT to get my range of motion back in my right arm, and it was incredibly helpful. I also pushed myself to be diligent about all the little exercises, five times a day or so, as often as I thought about them. I thought I would never stand up straight or put my arm all the way up again. And here I am a year later and I can do it all. Minus a nipple (can't afford to make that happen when I still owe my plastic surgeon thousands of dollars!!) and dealing with some scar tissue, but pretty much fully functioning.

Can't really do all those abdominal workouts I used to do, though!!! I can do curls, and obliques. But no real sit-ups. The tummy tuck is a nice perq though I have to admit. All my pants fit better than they have since high school!

So looking forward to getting to know you and your gorgeous family more. Keep putting one foot in front of the other, girlfriend.

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