DIEP Flap Breast Reconstruction
My name is Tammy and I was diagnosed with Ductal Carcinoma In Situ (DCIS) in June 2009. I carefully and thoughtfully made the decision to have bilateral mastectomy with immediate DIEP flap reconstruction after spending a great amount of time researching all my possible options. I am very happy that I made this decision. I prayed a lot about it and once I met Dr. Chrysopoulo, a reconstructive microsurgeon from San Antonio, I had such a tremendous peace that it literally felt like a ton of bricks had been lifted from my shoulders. The heaviness was gone and I “knew” that this was the right decision for me. My experience has been a great one and I want to share it with other women who may be searching for information.
I believe it is important to share my story on how I made my decision to have bilateral mastectomy and immediate DIEP flap reconstruction. When I was looking for information on other women’s experiences, it was hard to find. If I can help even one woman feel peaceful about making her own decision, then it was worth it all. That’s part of this process… reaching out and helping others who are behind us in the journey.
MAKING THE DECISION
The most difficult part of all this was actually making the decision about what to do, where to do it, and with what doctors. Some of the decisions I was investigating were lumpectomy with radiation, lumpectomy without radiation, treating holistically, or mastectomy with one or both breasts. Once I knew “what” I needed to do, then I had to figure out where it would be done. As any woman going through this process knows, this is a very confusing and emotional time. It is difficult to know what is right or what is wrong. And what is right for me may not be right for the next woman trying to make the same decision and it is all made more confusing by all the emotions involved.
My nature is to research things completely so that I can make informed decisions. I am the mom to a severely brain injured little boy who is now 13 years old and I’ve spent lots of time over the years looking for information on how to help him to get better and have spent more than 20 years in the medical field as well.
I owned and operated my own medical transcription service for 13 years both in California and in Texas and had to shut down my business when my son got sick so I could care for him. I was also the Founder and Clinic Director of the Lufkin Hyperbaric Center that specialized in treating neurological indications using oxygen under pressure. I am known to my friends and medical professionals to be someone that will not leave any stone unturned and I am always looking for information. I am motivated and I love to learn and these traits have helped me greatly in looking for all the possible options for my own treatment.
My diagnosis came as a complete shock to me. I am sure it’s a shock to anyone who hears it for the first time, but somehow I never thought I would be hearing those words associated with me. I just remember how numb I felt when I heard the “C” word… CANCER. I had no signs or symptoms to indicate that there was any type of problem. I went in for my routine annual mammogram and they asked me to return for an ultrasound of my breast. Having me return was not an unusual request because I have had fibrocystic breast tissue and it had almost become routine for me to have to return. They would always do an ultrasound where they could see the cysts and then I would then be sent on my merry way.
This year was different. They called me back for the ultrasound but also wanted to do some spot compression views so they could look more closely at an area of my breast where they wanted to see more detail. The doctor told me that radiologists are trained to look for microcalcifications when they view mammograms. My mammogram showed some microcalcifications and this time I was told to follow up in 6 months to see if there were any changes in my breast during that time.
My gut feeling told me that I didn’t want to wait 6 months, so my physician sent me to a local surgeon and he decided to do a stereotactic breast biopsy right away. The results were back quickly and I was diagnosed with ductal carcinoma in situ (DCIS). Within a week the pathology came back as comedo-type. I was told it was one of the most aggressive forms of this kind of carcinoma. I also was told that this type of carcinoma tends to go to the other breast too. This absolutely grabbed my attention.
After getting over the shock of hearing the “C” word from my doctor from the biopsy, and shedding many tears in disbelief, I began my quest for knowledge and I went into research mode, reading and devouring everything I could lay my hands on. I literally spent the next 30 days reading and gathering all the information that I could find. I found it almost impossible to sleep (getting maybe 2-3 hours sleep each night) because I knew I needed to gather the information to make the “right” decision because I have a special needs child who relies on me.
I spoke to many other women both in person and in some of the online breast cancer forums. I found myself on the PRMA website many times during my search for information and I was impressed with the amount of information there.
I discovered that Dr. Chrysopoulo had written a great deal of information on breast cancer and reconstruction on the internet and I read all of it that I could find. He was able to explain things in a way that was easy to digest. I also listened to a one-hour radio interview that Dr C did on breast cancer and reconstruction. He really impressed me with his compassion and he seemed to understand what a difficult and emotional decision that this was for all women. He seemed to “get it”.
In addition, Dr. Moran, my primary care physician gave me a 30 day guest pass to his subscription service where doctors do their own research for medical conditions on their patients, and he told me to go in there and read and research all I wanted on any and all areas. I really spent a lot of time reading, printing, and studying information in that website. By the end of the month, my mind was made up on having a bilateral (double) mastectomy with immediate reconstruction. I made the decision to have a bilateral mastectomy because I wanted (and needed) peace of mind and I knew that I would worry every year that it could have spread to my other breast. I decided to take away that risk now. I absolutely did not like the way I felt emotionally with this new diagnosis and I knew that I never wanted to be in this “place” again and didn’t want to have to have this worry again. The stress, the tears, the fear, and the unknown were traumatic enough, but also coupled with emotional upset… I just wanted to get through this and move on with living my life again. One of my doctors told me that by doing the bilateral mastectomy, it would get me cancer free and keep me that way for a very long time. I needed that kind of peace of mind.
Everything that I read said that when a woman has a mastectomy and wakes up and still has breasts, it is emotionally and psychologically so much better than waking up without breasts. I felt that it would be important for me to have reconstruction immediately following the mastectomy. I didn’t want to wait to have it done later. I also knew that not many places offered immediate reconstruction following mastectomy and I realized as I spoke with other women that not many realized immediate reconstruction was an option. I felt blessed to have discovered this.
Dr. Moran my primary care physician, had also given me a PowerPoint presentation on nipple sparing mastectomy that he got while at a breast cancer conference in Boston. I began to research that as a possible option for my decision. The only places in Texas that did that type of surgery were MD Anderson in Houston and PRMA in San Antonio.
I had called MD Anderson in Houston (since they are a world renowned cancer facility) to see about getting a 2nd opinion and the lady who took my call made me cry. She was very cold and she seemed more concerned about getting me to commit financially in case insurance would not pay. I ended up crying because the way she talked to me, she made me feel like a cow in herd that she was trying to shove through the front door. I had to end the conversation because I got so emotional and I had a huge lump in my throat, which made it difficult for me to talk. I literally cried for two days after that call. She called me back the next week to see if I had made my decision. I told her that I would not be coming to MD Anderson. She wanted to know why. So I honestly told her the reason was because she made me cry and that I made the choice to go somewhere that I was treated like a person and not a number. Being diagnosed with breast cancer is tough enough without having some stranger add on those kind of emotional complications. In her job, she may talk to people like me (with a cancer diagnosis) all day long, but this was a first for me and it literally took all the courage I had to even pick up the phone and dial MD Anderson Cancer Hospital. I knew that going to MD Anderson was not an option for me. It may be the perfect place for someone else but I felt strongly that it was not the right place for me.
I then went online and requested information from PRMA through the website on a Saturday. By Monday morning they called me back to see what information I needed. The lady that called was so kind and nice. She really listened to what I was saying and took my medical information and then verified my insurance. After I gave her my medical information, the ball started rolling in the right direction. She spoke with Dr. Chrysopoulo directly about my case and an appointment was scheduled. Once I met him I had an incredible peace about the whole thing. I knew that I found the right doctor and the right place to have my surgery.
When I arrived for my initial appointment, Dr. Chrysopoulo made me feel at ease immediately. He was kind, compassionate, and knowledgeable. He spoke with complete sincerity and he also had a great sense of humor, which helped to make me smile and made me feel at ease. It was also wonderful getting to meet his nurse in person after talking to her on the phone several times.
I had initially wanted to do reconstruction with implants thinking that my recovery time would be quicker. Dr. Chrysopoulo spoke to me about the pros and cons of implants verses DIEP flap reconstruction. Once it was laid out in front of me, it made complete sense to have the DIEP flap procedure rather than reconstruction with implants. The DIEP procedure would use tissue from my stomach to reconstruct my breasts and Dr. Chrysopoulo would begin the reconstruction as soon as the general surgeon completed the mastectomy - while I was still asleep. I would not have to return for reconstruction surgery later. That sounded great to me.
Dr. Chrysopoulo was preparing me for what might be ahead after surgery by saying that when I woke up, I would feel rough but it would get better each day. I knew other women who had breast augmentation who said when they woke up; it felt like they had a Buick parked on their chest, so I knew that there would be pain following such major surgery. I prepared myself for whatever was ahead mentally. (As a note, my personal experience with pain following my surgery was so much less than what I mentally prepared for.)
Dr. Chrysopoulo also told me that my instructions following my surgery would be to sleep in a recliner for 2-3 weeks getting up often to walk”. I knew that walking was going to be a big part of recovery, but that rest was significant as well.
PREPARING FOR SURGERY
I was preparing for surgery and wanted to have all my ducks in a row, so to speak. I live over 300 miles from San Antonio and I was going to need stay in San Antonio for about ten days following my discharge from the hospital until I could see Dr. Chrysopoulo for my post surgical follow-up before returning home to East Texas. I organized my stay at the Marriott TownPlace Suites and a friend loaned me a recliner to sleep in while I was there recovering. It was important to my peace of mind to have everything organized and in place before my surgery. I also had to prepare and organize my son’s care since he has nurses that help take care of him.
I had my pre-operative appointment with Dr. Chrysopoulo’s nurse, two weeks before my surgery was scheduled. She took me through some paperwork and told me what to expect and answered all my questions. She had a bag full of “goodies” to show me like a surgical drain, the On-Q medicine ball, a container of the antibacterial soap that I needed to pickup, etc… She also gave me the prescription for a chest x-ray, EKG and some blood work to be done before surgery. I got a packet of information to take with me and I read it and studied it so that I would remember everything.
ARRIVING IN SAN ANTONIO
My surgery was scheduled for Thursday, August 13, 2009, and I arrived in San Antonio on the 11th. I had to have a test done at Methodist Hospital on the 12th, so this would give me time to be relaxed and take away the stress of traveling just before surgery.
The test I had to have done was the pre-surgical lymph node injection and scans. They injected radioactive dye into my breast in the tumor site to see what lymph nodes were feeding from this area. That way they could determine which lymph node (or nodes) would need to be removed and biopsied during surgery the next day. I had been warned that this injection was very painful from a friend who had just had it done. I was prepared for that. Once I got in there and they injected me, it did not hurt nearly as bad as I expected! It was uncomfortable but was not terribly painful. I had to return 1-½ hours later for the scans. Once I returned for the scans, they marked my skin so the surgeon would know a basic location of the nodes that showed up on the scans. That would help the surgeon determine what node or nodes were in question during the sentinel node biopsy.
I was told that my surgery could last about 8 hours in all. I knew that the general surgeon, Dr. Johnston (by the way, he was really great) was going to take about 2 hours to do the bilateral skin sparing mastectomy and sentinel node biopsy. As soon as he was done with his part, Dr. Chrysopoulo and Dr. Ledoux (the two microsurgeons) were going to come in and begin the reconstruction that could take 6 hours.
Once I met Dr. Chrysopoulo and also Dr. Johnston, I really had a peace about my surgery and I didn’t feel nervous about it at all.
I do believe that the Lord led me to them and I had been praying a lot. I also had a lot of others praying for me. My church gave me a prayer pager and every time someone prayed, they would call my number and my pager would vibrate. It was vibrating a lot!
I kept thinking that I would find myself feeling nervous, anxious, or having a stomach full of butterflies… but that never happened.
THE DAY OF SURGERY – THURSDAY, AUGUST 13TH
The morning of surgery arrived and I was admitted, checked in and then made my way to the surgery waiting area. I thought by this time I would start feeling nervous. It still didn’t happen. My name was called and I it was my turn to get dressed and prepped for surgery. I had to wear a special gown that they could pump warm air into and compression hose for leg swelling and circulation. The nurse asked a lot of questions and she carefully typed all the information into her computer.
It was finally time to go to the surgery holding area where all the other patients who are prepped for surgery wait to speak with their doctors. This is where my IV was started and I got to meet Dr. Barrella, the physician who does the anesthesiology. She was very nice and kind. One of the nurses told me that she takes very good care of Dr. Chrysopoulo’s patients making sure that they don’t get nauseated from the anesthesia. She put a Transderm Scopolamine patch (helps with nausea) behind my ear and told me that she was going to fix me a nice cocktail to help me sleep the day away. I never had any problems with nausea after surgery and never had any complications. She did an amazing job! I mentioned that I would like to pray before surgery and she went and found the chaplain who joined hands and prayed with all of us. That really meant a lot to me.
Dr. Johnston came and talked to me and it was great to see him again too. He was going to do the mastectomy and then Dr. Chrysopoulo would come in to begin the reconstruction. They obviously have a great respect for each other and work very well together. I could not have asked for a better team of professionals to help me though this. I was truly counting my blessings at this point.
Dr. Chrysopoulo arrived and asked me how I was feeling "all things considered". I smiled and said “Great!”. He smiled at my response and told me that he was not expecting to hear “Great”. But I truly felt optimistic. I knew I made the right decision, knew I was in good hands, and that everything was going to be okay. I was upbeat and knew that I would be sleeping the day away so it wouldn’t do any good to worry anyway. Dr. Chrysopoulo also asked me about my son and reminded me that his main concern about doing my surgery was that I might be tempted to (or forced to) provide care for my special needs child when I would need care myself after surgery. I assured him that I had everything covered with my son’s care and everyone was on board and understood that I would not be able to participate in his care for a while. I really appreciated his concern very much and I really understood the impact it could have if I didn’t follow his advice. I didn’t want to have any setbacks, so I was completely determined to make sure that I followed his advice completely.
After I had the chance to see all my doctors, it was time to head to the operating room. I looked back at my mom and my friend who were there and I waved and said, “It’s going to be okay…. I’ll see you later”. I was smiling and not one bit nervous. That is the last thing that I remember until I woke up after surgery.
WAKING UP AFTER SURGERY
When I woke up after surgery, I was in my hospital room. One of my friends told me that my first conscious breath after waking up from surgery would be the most difficult breath. I never experienced that pain. I woke up and tried to focus my eyes and found my mom there in the room. My first words were directed to my mother and I asked her, “Did you have anything to eat today?” I was worried that she might not eat during the long day of surgery and waiting. She burst out laughing when I said that obviously pain was not the first thing on my mind.
My pain level was really not that bad at all. I was able to sleep some but they were coming in every hour to use the Doppler on my reconstructed breasts to make sure the blood flow was still there and that the transplanted flap was surviving. The doctor put a stitch on each breast around the area where they needed to listen with the Doppler. It sounded very much like the ultrasound I had when I was pregnant when I got to listen to my son’s heartbeat.
They came in every hour on the first day, every two hours on the second day, every three hours on the third day, etc… I would hear them come into my room and hope that we would still be able to hear the “whoosh, whoosh, whoosh” on each breast. I think I would kind of hold my breath until I heard the wonderful “whoosh” noise. When I heard it, I got a sense of relief and said, “Yay…they’re alive!!!”. We always laughed at that.
I had four surgical drains (they become your friends that you have to take care of), the On-Q medicine ball helping my tummy, a Foley catheter, sensors on each breast to measure oxygen saturation, the compression stockings with the massaging air alternating to prevent clots, a surgical abdominal binder, a surgical compression bra, as well as my IV for fluids and medications. I had morphine that was available if I needed it just by pressing the button. One of my friends (who is a doctor) told me to use the morphine as I needed it because it would allow me to get up and move easier and get back on my feet sooner. I remembered that.
I slept without pain and I woke up every time they came in to check to make sure that my new reconstructed breasts were still viable and getting blood flow. The nurses were incredibly kind and helpful.
THE FIRST DAY AFTER SURGERY (FRIDAY)
The very next morning after my surgery, it was time to get up and they had me get into a chair. They got me a walker and helped ease me up out of the hospital bed. I was moving very slowly and very carefully. I stood up and took a few shuffling steps to the chair next to my bed and that really took all my energy. I really felt like a 90-year-old woman trying to move only a few steps.
After moving into the chair, I decided to use the morphine to help with the discomfort that I was feeling. Because I had been told that I needed to stay ahead of the pain rather than letting it get the best of me, I was paying close attention to that. I stayed in the chair for about 12 hours that day before I got back into the bed. It was tiring to be up all day like that but it felt good. I had visitors and family come to see me and it was a really good day. I never had any reaction to the anesthesia and my pain was completely under control.
THE SECOND DAY AFTER SURGERY (SATURDAY)
The second morning after surgery arrived and it was time to get up and try to walk. I was a little bit nervous about walking because I knew how much effort it took just to shuffle to get in and out of the chair sitting beside my bed the night before. Once I was ready to try to walk, the nurse helped get me ready. She had to get the walker and disconnect me from all the monitoring things and get me (and all my attachments) organized. She told me that it was very important not to stand directly upright, that I would need to walk hunched over like a “90 year old lady”… which is exactly what I felt like! Once I was up and started moving, I made it about one-third of the way down the hallway and then back to my room. I was completely exhausted from my very short stroll in the hallway. I got back in bed, pushed the button for some morphine to help with the discomfort and got connected back to everything and then I rested for a while.
Dr. Chrysopoulo came to check on me. Since my pain had been under control and it was now two days past my surgery, I had a question for him about his analogy of waking up and feeling like I had been hit by an 18-wheeler. I asked him if “the 18-wheeler was still coming – or did it miss me?” He grinned and told me that it had missed me. That was good news and it made me smile.
I got up and walked two more times that day, once making two laps and then the next time making three laps around the 5th floor hallway. It really felt good to be able to get up and move, was completely exhausting, but I felt like I had accomplished something when I got back into bed.
The nurses were coming in on schedule to check the Doppler of my breasts and it was always such a relief to hear the “whooshing” noise. I continued to be awake all day long and would sleep at night until they came into the room to check the Doppler or my blood pressure again. My pain or discomfort was completely under control during this time too.
THIRD AND FOURTH DAYS AFTER SURGERY (SUNDAY AND MONDAY)
The next two days I was working hard at walking the hallways. I tried to walk about four times each day and I would try to go a little farther each time. I was very aware of my limits and I was careful not to push myself beyond what I could do. I was moving better but I was still hunched over. The abdominal incision did not need to be stretched out yet, so it was important to remain hunched over. I did not want to do anything that could jeopardize the surgery that Dr. Chrysopoulo had worked so hard to accomplish.
I was moving around more and I was taking some oral medication by this time and I was not using the morphine any more. In fact, during the last two days of my hospital stay, I didn’t need to use the morphine for pain. I was feeling fine without it and it felt better to be walking. I was awake during the day and was able to enjoy my friends and company who were coming by to see me.
I knew that I was supposed to be discharged from the hospital on Monday, so I wanted to walk one last time before going to bed on Sunday night. I did my final walk in the hallway about 11:30 that night. I was feeling so good and so positive about the future.
The nurses all had just wonderful things to say about Dr. Chrysopoulo and they loved working with him and taking care of his patients. They said that they could tell “his work without even asking who the doctor was” because he does such a great job.
LEAVING THE HOSPITAL
Monday morning arrived and I knew that I was supposed to be discharged from the hospital. I didn’t have any problems or complications during my hospital stay and I felt like I was making good progress. I knew that once I was discharged, I would be staying at the hotel for ten days until my appointment with Dr. Chrysopoulo. My friend was ready to drive me home once I was allowed to leave San Antonio.
My last shower was the night before surgery and I was really ready to get a shower. A very nice lady came to help me get my shower and she really knew what she was doing and she was very organized and reassuring. I was very nervous about it because once my surgical binder came off and the surgical bra came off, I felt a little lightheaded. I had to stand in the shower and realized that sitting was probably not a good thing to do since I didn’t have my abdominal binder on for support. There were no visible stitches and no tape or gauze on my abdomen. This was the first time I got to see the incisions. It was amazing to look at and my mind was wondering, “How could I be closed up with no visible means of holding it together?” I think I was expecting to see a huge incision with a blanket stitch holding me closed so this was really amazing to me. Once I got dried off, she helped me get dressed and I felt human again! It is amazing how much better you feel after a shower!
Dr. Chrysopoulo came by to see me and discharged me from the hospital. I cannot say enough about the nurses at Methodist Hospital and the care that I received. I was sad to say goodbye to so many wonderful people at the hospital. They were great and obviously loved their jobs and it really showed. But I was ready to start the next phase of my recovery by leaving the hospital because that was one step closer to going home.
I intended to be a good and compliant patient and follow my instructions to the letter so that my recovery would be on track.
AT THE HOTEL
The personnel at the Marriott TownPlace Suites could not have done anything to make my stay there any more comfortable. They were all so very friendly and helpful. I got to know most of the employees from housekeeping, maintenance, and front desk to management. They saw me walking the hotel hallways in my Capri pajamas several times a day. The hotel is about a mile from Dr. Chrysopoulo’s office and maybe 2 miles from the hospital so it was close and convenient in case I needed to get to either place. I had family and friends staying with me to help me with everything. I needed help getting in and out of my recliner, and once someone pushed me forward was able to get over my feet, I could stand and walk. I also needed help getting a shower and getting dressed.
I arrived at the hotel with 4 surgical drains (one drain from the side of each breast, and one drain from each end of the abdominal incision), the medicine ball, the surgical bra and surgical abdominal binder.
They showed me how to empty the drains and I had to measure the fluid that was emptied out and I had to keep a diary of the amounts.
I had some pain medication that I could take and I did use it so that I would be able to walk and not get myself into a pain level that I could not tolerate. The instructions were to take 1-2 tablets every 4-6 hours. Initially I was taking them every 4-6 hours but then got to the point where I was taking them every 12 hours and my pain level was fine. Every time I walked, it helped my pain level actually. I enjoyed walking because it did make me feel better overall.
I went into the office to see Dr Chrysopoulo's nurse, and I was able to have both breast drains taken out after about one week. She also was able to take out the medicine ball. Getting rid of those things sure made me feel better.
TWO-WEEK POST SURGICAL FOLLOWUP AND GOING HOME
I had a followup appointment two weeks after my surgery. This appointment was to make sure that everything looked good before I made the journey back home. The drive back home would take us six hours on a normal day but because I was advised we would need to stop approximately every hour so that I could get out and walk, the trip was going to take a bit longer.
I was able to get the last two drains taken out at my visit before going home. Wow, did it feel good to not have to worry about the drains anymore! Everything was going well and was on track.
I really liked the way my breasts looked, even at this early stage. In my research I did a Google search for mastectomy photos or pictures. Most of the photos that I saw online were not from immediate reconstruction surgeries. The scars were horizontal from armpit to armpit in many of those photos. I realized that this was cancer surgery - but I really didn’t want to be left with significant scars and I didn’t want to feel disfigured by my decision. My cancer was caught early and I was fortunate to have options that many other women don’t necessarily have. I knew that the surgeons from PRMA did a great job and I was impressed with the photos on their website.
I wasn’t exactly sure how my breasts would look after surgery but I was certainly impressed with how it turned out. During my surgery my nipples were removed and all the breast tissue was also removed leaving the “shell” of each breast. Then it was filled with skin and fat from my stomach. The area where the nipple had been was replaced with skin from my tummy. Again, there are no visible stitches (which is so amazing to me). When I have the 2nd surgery, Dr. Chrysopoulo will do the nipple reconstruction where he will actually create new nipples and 3 months after that, I will have the tattoo to complete the process.
This surgery took tissue from my belly and actually gave me a tummy tuck. My stomach has never been more flat! I even got a new belly button and I love that too. I feel so good about how I look now and I am not done yet! And I know it will only get better.
I returned home to continue my recovery process after being in San Antonio for 15 days. I had my recliner waiting for me and had my treadmill set up so that I could walk several times a day. I was made sure that I was eating fresh fruits and vegetables and plenty of protein so that my body had all the nutrients and tools it needed to properly heal.
During my recovery at home, I began taking less and less pain medication. I was taking one-half of a pain pill every twelve hours and then I was able to change it to one-half a tablet every 24-30 hours and that was enough to keep my discomfort under control. My pain level was not really pain to me; I would say it was more like a discomfort. I eventually got myself completely off the pain medication and I actually still have 30 of the 40 tablets left in my prescription bottle.
I went back for my six-week followup after surgery and I had been working very hard to be a good patient. I followed all my instructions to the letter and I didn’t attempt to do anything that might jeopardize my healing. I didn’t want to have any setbacks!
During my appointment, I was thrilled to get a good report from Dr. Chrysopoulo. Now the plans were being made for the revision surgery, which is considered “Stage 2” surgery, which would be in six weeks. I am really looking forward to that surgery because that will put me one step closer to actually closing this chapter on breast cancer and beginning a new chapter into the future.
PRE-OP APPOINTMENT FOR SURGERY #2
My pre-op appointment was scheduled two weeks before the actual surgery which would be on November 17th, 2009. This surgery would include the nipple reconstruction, breast lift, and my abdominal scar revision. I met with the nurse and she went over the surgery and what I should expect. I signed the consent paperwork and I had the opportunity to ask and have any questions answered that I had. She showed me photographs from a textbook of what the nipple reconstruction would look like and gave me post-surgical instructions and how to care for the surgical area. I felt educated on what was ahead and well prepared too.
I learned that that this part of the surgery was dealing with reconstructing the nipple using tissue that was basically transplanted from my tummy during the first surgery. I had specific care instructions on how to care of my new nipples. I knew that I had to watch closely because there is a chance that the tissue could die, scab over and basically fall off. I knew that I was going to be watching this area like a hawk to make sure that nothing went wrong!!!
CHANGES IN ME… REFLECTING AS I PREPARED FOR THE NEXT SURGERY
I am so glad that I made the decision to have immediate reconstruction with the DIEP flap following my bilateral mastectomy. It really has made me feel so positive about the future. I was really very happy with how my first surgery turned out and happy how my pain level after surgery was completely managed. I really never felt pain – I would say it was more like discomfort to me.
I was now preparing myself for my 2nd surgery. I was actually really looking forward to getting it done because it was one step closer to being finished!! I worked very hard to follow my surgeon’s instructions, and I’ve been very strict with myself trying to make sure my recovery didn't have any complications or setbacks. I have been very focused on my recovery because I want to make sure that I am able to heal properly so I can put this behind me move on with my life.
This entire experience has certainly made me a stronger person. I am feeling more confident and certainly optimistic about the future. Since my diagnosis I have made some changes in my lifestyle that include eating healthy foods, walking daily and trying to eliminate negativity from my life.
I have spent the past 12 years completely dedicated to my special needs child and neglecting myself, and this has made me realize that I have to take care of myself or I won't be any good for my son. I have come to realize that I am not being selfish by taking care of myself. I know I made the right decision for me and I know I found the right doctors.
Although I was diagnosed with breast cancer, I can see that it has been blessing in disguise. I am coming through this a much stronger person, much more determined, not taking anything for granted and making sure that I let people around me know they are valuable and important. I was happy to get rid of the tissue that had cancer in it and in its place I have new (and fuller) breasts with the added benefit of a tummy tuck. My body is reshaped surgery, which has motivated me and I have had fun shopping for clothes that fit my new figure. This is one way of taking the lemons that life gave me and making some wonderful lemonade.
SURGERY #2 - "THE REVISION STAGE"
I arrived into San Antonio two days before surgery. It took us a day to travel there and then I had some followup appointments with Dr. Johnston (my general surgeon) and an appointment with Dr. Dice (my oncologist). My friend, Renate, was with me to help me following surgery and to drive me home. This time I was told that I would not have to stay in San Antonio for days… in fact I would be able to go home the very next day after surgery. Since I live so far away, I was going to be kept in the hospital overnight for “observation” after my surgery but I found out that patients who live nearby are able to leave after surgery and go home.
I arrived at the hospital on November 17th bright and early for surgery. I had many people who were still praying for me and again I had complete peace about my surgery. It was amazing to me that I was not feeling scared at all. I knew that the Lord led me to San Antonio and that I was in absolutely the best hands and actually felt excited to be getting through this stage of surgery… one step closer to being done!
I got prepped and rolled into the surgical waiting area. I saw some of the same nurses that I met from my first surgery and that made me feel even more comfortable. They started my IV and Dr. Chrysopoulo arrived and it was time for surgery. Dr. C has an amazing bedside manner and he even had me smiling and laughing before surgery. I am so thankful for a surgeon who has such amazing surgical talent and skill but who also can make you laugh.
This surgery included a revision of the abdominal scar to make it lay flat and got rid of the “dog ears” that were there from the drains from the previous surgery. He also did some contouring (liposuction) of the area to make sure that everything looked as good as possible. The nipple reconstruction was done here too. He basically cut, folded, and stitched the skin that had been transplanted there during the first surgery, and created new nipples.
This surgery was much easier to recover from than the first one and I was allowed to go home the next day to begin the healing process. I was on Tylenol very quickly after this surgery and had some soreness which kind of felt like I had worked out at the gym too hard. I did go home with the surgical bra and abdominal binder in place again, as well as some gauze strategically placed to protect the newly created nipples. There were no surgical drains after this surgery… Yay!!
I was up and walking quickly and I really bounced back quickly after this surgery. I was careful to follow all my instructions and my doctors orders. Again, I wanted to make sure that I was doing everything I could do so my body could heal properly.
My followup appointments went well and I was healing nicely. The final stage, referred to as Stage 3, is the micropigmentation (tattooing) of the nipples and areolas so they look natural. This final stage was done 3 months after my Stage 2 surgery.
By the time I arrived for my final stage, everything was healing nicely and looking really great! By having the micropigmentation done, it helps to complete the reconstruction and helps it all to look even more natural. I called and talked to a few women about their experience and it was pretty simple. You go in and help choose the skin tone color that best matches your complexion. They also have before pictures of you in the chart that you can use to try to compare and more closely match.
I went into the room and was reclined in a chair in the micropigmentation/tattoo room and the nurse went to work. The nipple area didn’t have much sensation yet following surgery but a numbing gel was applied to make sure it wouldn’t be a problem.
I was able to lay back while the wonderful nurse did her work in creating the nipple area with the tattoo color. We chatted about all kinds of things while she carefully finished and put the final touches on the new tattoo. It was not painful and chatting really helped pass the time.
Once I was done, I got a Certificate of Graduation from Breast Reconstruction, and I couldn’t believe that I was finally done!
A YEAR LATER - LOOKING BACK
Now that it has been almost 2 years since my first surgery, I wanted to give an update on how things were going.
I can honestly say that I am so thankful that I found PRMA and that I had the option to have immediate reconstruction.
I am incredibly happy with my surgical outcome and I absolutely love how my reconstructed breasts look and feel. I have made many changes to my life to help prevent cancer for the future including exercise and diet. I have lost weight and have toned up. I look so much better in my clothes and my confidence and self-esteem have really blossomed!
I can tell you that having had the DIEP flap breast reconstruction gave me back what cancer tried to steal and my femininity was restored. I feel pretty, sexy, happy and I have such a positive outlook for the future. Breast cancer is not on my mind all the time and it is not the first thing I think about when I wake up or the last thing I think about when I go to sleep like it was after I was diagnosed. I have been able to move on and not only live my life but truly enjoy my life! I have such an attitude of gratitude and I think its important to let the people around me know that they are important to me and that they are special.
This entire experience has certainly made me a stronger person, feeling more confident, and certainly optimistic about the future. Since my diagnosis I have made some big changes in my lifestyle that include eating healthy foods, walking and aquatherapy, and eliminating negativity from my life. Because I spent the past 12 years completely dedicated to my special needs child and neglecting myself... this made me realize I have to take care of myself or I won't be any good for my son. I have come to realize that I am not being selfish by taking care of myself.
I know I made the right decision and I know I found the right doctors at PRMA! Although I was diagnosed with breast cancer, I can see the blessing in disguise, because I am coming through this a much stronger person, much more determined, I don’t take anything for granted and make sure that I let people around me know they are valuable and important. I was happy to get rid of the tissue in my body that had cancer in it and in its place I have new (and fuller) breasts with the added benefit of a tummy tuck. My body has reshaped from the surgery and exercise which really motivated me and I have fun shopping for clothes that fit my new figure. This is taking the lemons that life gave me and making some wonderful lemonade!
I always welcome the opportunity to speak at any group about my breast cancer journey so that I can help get the word out there because women need to know that there are options when it comes to reconstruction and being educated about those options are every woman’s right. One of things I love to share when I speak to a group is now called my favorite quote. Because I had immediate reconstruction with the DIEP flap, I say “I went to sleep (for my mastectomy) with breasts and woke up with cleavage!” I never had to grieve the loss of my breasts this way. And because they were reconstructed using the fat from my tummy, I say “that’s one way to make belly fat defy gravity!” It always helps to make people smile.
My experience with PRMA was absolutely outstanding from the beginning to the very end. Everyone there was supportive and helpful. I never had any problems with my insurance coverage and they too the bull by the horns and truly took care of all that for me. I never had to worry about it and they always made me feel like a person and not a number. They truly want to help and they are really good at it and when you are worried and stressed about being diagnosed with breast cancer, it is nice to have someone help take some of the confusing burden off your shoulders.
always welcome the opportunity to reach out to other women who are in this journey behind me and I know that I was supposed to go to PRMA. I believe that the Lord led me there. I was in the most caring and capable hands and because of my amazing reconstruction, I have been able to make the transition from breast cancer consuming all my thoughts to now being able to focus on living life and taking every opportunity to take time and smell the flowers! Thank you Dr. C and PRMA for giving me my life back and for all that you do for all breast cancer patients! You ROCK!!!