Friday, July 14, 2017

Phase 2 Surgery: Pre-op Visit and Plans

Here we are in mid-July already!  Hard to believe how quickly this year is moving along.  A lot of days, I can almost forget that any of this breast cancer stuff has actually happened...then I'll roll over in bed and feel a pinch on the side of my breasts where the drains were or catch a glimpse of my incisions in the mirror.  The scars honestly don't bother me that much...battle scars aren't all bad.  However, I am most definitely ready for the nipple reconstruction portion.

Yesterday, I met with Dr. O's nurse, Crystal.  She went over all of the pre-op and post-op instructions for my upcoming Phase 2 surgery, sent in my prescriptions, gave me my lab orders, and scheduled my follow-up appointments.

Here's what I learned:
The scar revision portion is "as needed". Crystal explained that any areas where the abdominal incision scar might be wider than necessary, raised, or have hard spots is where Dr. O would target.  As I've shown y'all before, my abdominal incision has healed quite nicely so I'm not sure how much (if anything) he will do there.

The nipple reconstruction is pretty much exactly like the video I included in my previous post.  The new nipples will be large at first (in addition to swollen) because they anticipate them reducing in size by 50%!!  Wow!  I have read from a lot of women that over time their new nipples flattened out and were no longer 3D, so I asked my nurse about that. She said that this was very patient-specific and had to do with skin elasticity and health more than anything else.  A diabetic patient or a patient with lots of stretch marks on her breasts will have a harder time with the nipple reconstruction staying as intended.  Makes total sense since the new nipples are made out of the skin flaps that he placed during my Phase 1 procedures.  Since I do not have any issues with elasticity or healing, Crystal believes I should have great results.  

The fat grafting portion of the surgery is probably the biggest portion and the one that'll leave quite a bit of bruising and soreness.  Dr. O had told me that my thighs would be significantly sore.  He will liposuction my flanks and the abdominal area to remove those "dog ears" and smooth things out as needed.  What he takes from there and my thighs will then go toward building up some size and the overall shaping of my breasts.

Pre-op for this one is easy.  I only had to get two labs and an EKG (which I took care of yesterday after my office visit).  Dr. O wrote for an antibiotic for 1 week post-op (I picked it up yesterday too!)....I didn't have to take one for Phase 1 interestingly enough.  I am allowed to take Tramadol for pain if needed (but the pain meds make me nauseated, so I'll most likely skip this) or just Tylenol and Ibuprofen.  She also recommended having the Colace around again...constipation is pretty common after anesthesia and especially with the pain meds.  I also had the option of a script for an anti-nausea med....again, I think I took one pill last time, so I'm not worried about needing this.

I will wake-up in a bra similar to the one I had after the first surgery...not attractive but it does the job.  I will only wear it for 3 days this time!  At day 4, I can switch to the underwire-free bra of my choice lined with breast the ones used by breastfeeding moms.  Crystal instructed me to cut a hole in the center of the pads "like a bull's eye" and to stack 3-4 of them on my new nipples.  The goal is for there to be enough padding to keep my new nipples from being smashed by my bra. It was a little weird buying a box of these yesterday...haven't purchased any in 15 years!

I will also wake up in a compression garment. This one will go from just under my breast to my knees. My nurse recommended that I purchase a similar one (Flexees, Spanx, etc.) since I will wear it 24/7 for 4-6 weeks (Not to mention the fact that it'll be August in South Texas at that time!!).  She informed me that the one they provide is quite thick and VERY tight so most patients are more comfortable in a store-bought version.  I was able to find one like she described at Walmart yesterday for ~$20.
I liked the Flexees brand abdominal binder best after my last surgery too.  

I am not allowed to drive for 1 week and no lifting over 10lbs for 2 weeks.  Exercise is limited to walking. Unfortunately, it's back to showering with the water only on my back for about a month and no side or back sleeping for at least 3 weeks.  That will take some getting used to again!

Follow-up with the nurse at 2 weeks and with Dr. O at one month.  Crystal said that the stitches in the nipples will usually dissolve in 3-4 weeks.  Good news:  NO DRAINS with this surgery!!!  That's definitely a BONUS!

So, that's pretty much it. Obviously, all MDs do things a little differently, but this might give you a starting point for asking questions as you discuss your surgical plans.  

Y'all know I like to have a plan and the details so I can be prepared. Now that I've got that, I'm good to go. The only things left to do is a little housecleaning and grocery shopping next week. (I'm actually working Sunday and Monday before my Tuesday morning surgery so I won't have time to do anything the day before.)  Surgery is at 0730 (got to be there at 0530) and is outpatient so I should be home by late

Any of you already been thru this Phase 2 and have advice? Please comment below and share.

Counting down....T-minus 11 days...

12/22/16  Routine Screening Mammogram
01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results positive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing
01/30/17  Consultation with Surgical Oncologist, Dr. K
02/08/17  Consultation with Plastic Surgeon
02/21/17  Pre-op Visit with Dr. O's nurse
02/27/17 Pre-op Labs and Testing
03/05/17 Lymph Node Injection
03/06/17 SURGERY DAY!
03/10/17 Home!
03/16/17 10 day Post-op Visit with Plastic Surgery nurse
03/20/17  2 week Post-op Appointment with Surgical Oncologist, Dr. K
04/07/17  1 month Post-Op w/Plastic Surgeon, Dr. O
04/16/17 Returning to work!
05/19/17  Appointment with Dr. O to schedule Phase 2 Surgery!
07/13/17 Pre-op Visit with Dr. O's nurse; Pre-op Labs/EKG
07/25/17 Phase 2 Surgery!!

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