Reconstruction: Prophylactic left side mastectomy & Bi-Lateral TRAm flap
5/25/2018--Delayed Procedure. 2 weeks prior to the major surgery, I had to have a small procedure where the surgeon puts 2 little clips on the blood vessels in my groin leading up to my abdomen. The purpose is to re-direct blood flow from moving up my leg to my abdomen. The blood is forced to come down my belly to my abdomen (or something like that). This turned out to be a horrible procedure. I had a really horrible experience with the anesthetic that they used. I had blurry vision & my brain was in a cloudy haze for about 7-10 days. I spoke to one of the anesthesiologists at Moffitt, Allan Escher, who was the greatest! After contacting Duke to release my anesthesia records, Dr. Escher went through 50 pages to determine what they used so that we could switch up the cocktail of anesthesia so that I didn't have those horrible symptoms again--which ended up working. I woke up from the major surgery totally aware & without symptoms.
6/12/2018-- Surgery Day. It took the nurses 3 tries to stick my IV, so I was already stressed out before the day even really got started. The anesthesiologist was cool, I asked him to wait to give me meds., so I could see the OR. He said the anesthetic messes with your short term memory & that I’d likely forget seeing the OR, but I didn’t. ;) It was such a tiny room, it was freezing cold & I remember they had Spotify up on the TV. Lol We all exchanged a few words & then I actually don’t really recall where I woke up, I just remember being in my recovery room. I was able to lay in bed the rest of the afternoon & overnight because I had a catheter placed to drain urine (best thing ever). But they did force me to get out of bed the following morning—Wednesday. Obviously that was very painful, but I had a walker & was told to shuffle around the recovery unit a few times to increase blood flow. Relying on my walker in a major way, I was able to make 4 laps that day. I also managed to take a shower that first day post-surgery, although my mom had to help me quite a bit. I stayed in a recliner for the day because getting into bed was horrible. I had to ask the nurse several times to “stop & wait,” & I was in tears before I was able to get my butt back in my bed. My hospital bed was raised, because I had to keep my body in a slouched position for 10 days (it ended up being more like 15+). I wasn’t very hungry that first day & I had asked the nurses to remove at least 1 of the 2 IV’s I had in my hand because they were so painful. They refused in case I needed IV medicine right away. I would end up taking the IV out myself a day or 2 later. The rest of the stay was pretty quiet. Several doctors/nurses in every few hours to give narcotics & check on the wounds. They tried to get me to go home Thursday, but I insisted on staying until Friday because I did not feel like I was ready to go home yet.
When I got home I had to sit & sleep sitting up on the couch for about another 10 or 12 days. This part was so horrible. My butt was so tired of sitting, but I couldn’t stand yet, nor lay down on my back or either side, so it was pretty much sitting for 12 days straight. I ended up with a 19 inch scar across my waist. At my post-op, I asked the doctor where exactly the 2 abdominal muscles were. He explained that they were under the breasts & the muscle remained connected to the fat & tissue that they took from my belly. The purpose of this is to maintain good blood flow to the fat & tissue that would now be my breasts. The reason I chose this procedure over implants or using tissue from elsewhere, is because there was little chance of rejection using my own tissue & by keeping the muscle connected to the fat, rather than just sucking fat from the belly & making breasts, was to maintain that healthy blood flow for long lasting-healthy results.
A few weeks later, the majority of the scars had healed nicely. They definitely aren’t healed—the nurse said they’ll only be 75% healed after 6 weeks, so they need quite a bit of time to actually heal up on the inside. But the outside looked pretty good. A thin purplish-pink line, just as one would expect. However, I had 2 different sections about 6 inches each, that did not get sufficient blood supply after surgery & developed fat necrosis. Essentially, the tissue & fat around those two areas had died & the tissue has to expel the fat/tissue & then re-heal. It’s pretty disgusting & it causing quite a bit of stress recently. After about 2-3 weeks post-surgery, I developed big, thick, black scabs on the areas, which have since started to come off with the help of a cuticle cutter & scrubbing in the shower per the plastic surgeon’s instructions. One of the areas is on my abdomen underneath my belly button & the other is on the side of the breast which was totally reconstructed. The plastic surgeon insists it's normal & that this is the natural healing process. They refer to it as healing with secondary intention. His directions are to scrub so roughly in the shower that it bleeds, eeeh. Blood=healing. Lucky for me, there is no sensation there, all the nerves have been cut. It's mentally difficult to stick a wash cloth INTO your abdomen to scrub it. It makes me want to vomit, lol.
Current struggle: I was left with 2 “dog ears” on my abdominal scar after the surgery. I’m not exactly sure what the point of leaving this extra tissue/skin is for, but it can later be used to create the areola part of the nipple reconstruction. Here’s my problem: instead of going under anesthesia AGAIN & having another surgery, I simply want to get 3D nipple tattoos. It’s non-invasive & there is no possibility of having sensation in the nipple ever again, so honestly WTF is the point? My plastic surgeon has been overwhelmingly aggressive about me getting the nipple reconstruction since, in his words, he’s an “artist” & he wants me to look like a beautiful woman again. When I told him I thought it was weird to have a random piece of tissue sticking out of my breast as a nipple, he responded by saying that right now I look “weird,” & when he looks at me he sees cancer. He pulled up some of his past patients & went on to gush about how beautiful their breasts look now & how having a nipple takes away from having a scar. I’m in the process of getting a second opinion, because this plastic surgeon is just not my style of doctor. Anyway--
Here’s the bigger problem. From what I was told by the plastics team, the ONLY way insurance will pay to have the dog ears fixed—is if I use the tissue in a nipple reconstruction surgery. Otherwise, it’s considered cosmetic & insurance won’t cover the procedure. Is that the craziest shit you’ve ever heard? So, I have 2 triangular bulges of tissue sticking out of my side as a result of a major reconstruction surgery & since I don’t want nipple reconstruction, now I will have to come out of pocket to fix it. I then learned that if I want to get the 3D tattoos instead of nipple reconstruction, that also may not be covered by insurance. I can’t even imagine how much money the insurance company would save from me NOT doing nipple reconstruction & just getting small tattoos. The anesthesia for nipple construction ALONE will be several thousand dollars. This feels like I’m in the damn Twilight Zone. Breast reconstruction is covered under Federal Law, that any woman with cancer by LAW has the opportunity to be made whole again & have her breasts reconstructed whichever way she chooses. Yet, the nipple reconstruction part is a one way road—no choice AT ALL unless I pay out of pocket. At least, that's what I'm understanding at this point. I will continue to work on this & update when I figure it all out.
***VIEWER DISCRETION ADVISED. Some of the pictures are gross.
6/12/2018-- Surgery Day. It took the nurses 3 tries to stick my IV, so I was already stressed out before the day even really got started. The anesthesiologist was cool, I asked him to wait to give me meds., so I could see the OR. He said the anesthetic messes with your short term memory & that I’d likely forget seeing the OR, but I didn’t. ;) It was such a tiny room, it was freezing cold & I remember they had Spotify up on the TV. Lol We all exchanged a few words & then I actually don’t really recall where I woke up, I just remember being in my recovery room. I was able to lay in bed the rest of the afternoon & overnight because I had a catheter placed to drain urine (best thing ever). But they did force me to get out of bed the following morning—Wednesday. Obviously that was very painful, but I had a walker & was told to shuffle around the recovery unit a few times to increase blood flow. Relying on my walker in a major way, I was able to make 4 laps that day. I also managed to take a shower that first day post-surgery, although my mom had to help me quite a bit. I stayed in a recliner for the day because getting into bed was horrible. I had to ask the nurse several times to “stop & wait,” & I was in tears before I was able to get my butt back in my bed. My hospital bed was raised, because I had to keep my body in a slouched position for 10 days (it ended up being more like 15+). I wasn’t very hungry that first day & I had asked the nurses to remove at least 1 of the 2 IV’s I had in my hand because they were so painful. They refused in case I needed IV medicine right away. I would end up taking the IV out myself a day or 2 later. The rest of the stay was pretty quiet. Several doctors/nurses in every few hours to give narcotics & check on the wounds. They tried to get me to go home Thursday, but I insisted on staying until Friday because I did not feel like I was ready to go home yet.
When I got home I had to sit & sleep sitting up on the couch for about another 10 or 12 days. This part was so horrible. My butt was so tired of sitting, but I couldn’t stand yet, nor lay down on my back or either side, so it was pretty much sitting for 12 days straight. I ended up with a 19 inch scar across my waist. At my post-op, I asked the doctor where exactly the 2 abdominal muscles were. He explained that they were under the breasts & the muscle remained connected to the fat & tissue that they took from my belly. The purpose of this is to maintain good blood flow to the fat & tissue that would now be my breasts. The reason I chose this procedure over implants or using tissue from elsewhere, is because there was little chance of rejection using my own tissue & by keeping the muscle connected to the fat, rather than just sucking fat from the belly & making breasts, was to maintain that healthy blood flow for long lasting-healthy results.
A few weeks later, the majority of the scars had healed nicely. They definitely aren’t healed—the nurse said they’ll only be 75% healed after 6 weeks, so they need quite a bit of time to actually heal up on the inside. But the outside looked pretty good. A thin purplish-pink line, just as one would expect. However, I had 2 different sections about 6 inches each, that did not get sufficient blood supply after surgery & developed fat necrosis. Essentially, the tissue & fat around those two areas had died & the tissue has to expel the fat/tissue & then re-heal. It’s pretty disgusting & it causing quite a bit of stress recently. After about 2-3 weeks post-surgery, I developed big, thick, black scabs on the areas, which have since started to come off with the help of a cuticle cutter & scrubbing in the shower per the plastic surgeon’s instructions. One of the areas is on my abdomen underneath my belly button & the other is on the side of the breast which was totally reconstructed. The plastic surgeon insists it's normal & that this is the natural healing process. They refer to it as healing with secondary intention. His directions are to scrub so roughly in the shower that it bleeds, eeeh. Blood=healing. Lucky for me, there is no sensation there, all the nerves have been cut. It's mentally difficult to stick a wash cloth INTO your abdomen to scrub it. It makes me want to vomit, lol.
Current struggle: I was left with 2 “dog ears” on my abdominal scar after the surgery. I’m not exactly sure what the point of leaving this extra tissue/skin is for, but it can later be used to create the areola part of the nipple reconstruction. Here’s my problem: instead of going under anesthesia AGAIN & having another surgery, I simply want to get 3D nipple tattoos. It’s non-invasive & there is no possibility of having sensation in the nipple ever again, so honestly WTF is the point? My plastic surgeon has been overwhelmingly aggressive about me getting the nipple reconstruction since, in his words, he’s an “artist” & he wants me to look like a beautiful woman again. When I told him I thought it was weird to have a random piece of tissue sticking out of my breast as a nipple, he responded by saying that right now I look “weird,” & when he looks at me he sees cancer. He pulled up some of his past patients & went on to gush about how beautiful their breasts look now & how having a nipple takes away from having a scar. I’m in the process of getting a second opinion, because this plastic surgeon is just not my style of doctor. Anyway--
Here’s the bigger problem. From what I was told by the plastics team, the ONLY way insurance will pay to have the dog ears fixed—is if I use the tissue in a nipple reconstruction surgery. Otherwise, it’s considered cosmetic & insurance won’t cover the procedure. Is that the craziest shit you’ve ever heard? So, I have 2 triangular bulges of tissue sticking out of my side as a result of a major reconstruction surgery & since I don’t want nipple reconstruction, now I will have to come out of pocket to fix it. I then learned that if I want to get the 3D tattoos instead of nipple reconstruction, that also may not be covered by insurance. I can’t even imagine how much money the insurance company would save from me NOT doing nipple reconstruction & just getting small tattoos. The anesthesia for nipple construction ALONE will be several thousand dollars. This feels like I’m in the damn Twilight Zone. Breast reconstruction is covered under Federal Law, that any woman with cancer by LAW has the opportunity to be made whole again & have her breasts reconstructed whichever way she chooses. Yet, the nipple reconstruction part is a one way road—no choice AT ALL unless I pay out of pocket. At least, that's what I'm understanding at this point. I will continue to work on this & update when I figure it all out.
***VIEWER DISCRETION ADVISED. Some of the pictures are gross.