Monday, August 9, 2010

DIEP Flap Surgery for Dummies

I am now 2 1/2 weeks out of surgery and still love my new foob. I had a little bit of post-surgical fogginess and depression from the anestesia that made me question if I made the right decision to go through a tough surgery and recovery for basically a cosmetic reason, and I am now totally comfortable with that decision. I know in the whole scope of cancer and death caused by cancer, a boob is nothing. It was difficult, though to look in the mirror day after day looking at a hole where one of my favorite body parts used to be. Since I had radiation that basically fried my skin and tissue under the skin an implant would be out of the question. Fried skin and tissue no longer stretch without trouble to accommodate a foob. Locally I had two options and one was to take skin and muscle from my back (LAT-flap) or take skin and tissue from my belly (DIEP flap). Trust me, the decision wasn't hard.

I had to wait a year after radiation was complete to allow my skin to heal before the surgery. When it was time to find a plastic surgeon, I already had one in mind: Dr. Anu Bajaj. First let me say that all my doctors could easily go straight to Hollywood to play doctors. For some reason I have a great looking bunch of medical professionals taking care of me. I know it doesn't matter, but I'm gush all the rest of the time about the awesomeness of my doctors. Dr. Bajaj spoke to my SHOUT Cancer Support Group a couple of years ago and was very passionate about helping survivors have a degree of normalacy and finding some happiness after the Big C. She brought pictures of her work and I remember wishing she did my original reconstruction. Not only is she a brilliant surgeon, but she has a wonderful bedside manner that totally puts patients at ease. My surgery was scheduled to take from four to six hours, and I think it was on the outside of six hours. The reason it takes so long is that microsurgery is involved attaching arteries and veins together to feed the transplanted material. According to my family, she looked exhausted when she spoke to them after my surgery.

The only negative thing happened before the surgery. When the nurse was placing the IV in my hand she had a very hard time finding the vein. Because of the lymphadema risk if any part of my left arm is injured I have to use my right arm for all bloodwork, IV's and blood pressure. Anyway...the thought of the nurse forcing my vein to pop up started to make me queasy and I became faint. When I felt a little better I begged to go to the bathroom because for some reason I was afraid I would lose control of my bladder. She walked me to the toilet and the next thing I remember is laying on the floor looking at shoes and wishing everybody would leave me alone and enjoy the coolness that was the tile floor. My next memory is in my bed getting an IV in a different spot on my arm. I think I scared a few people...I haven't passed out since college before I was diagnosed with hypoglycemia.

I remember little of the next 48 hours. I remember waking up in recovery and being very happy to look down and see a foob there. I remember eating ice chips, pushing my morphine button, and watching lots of TV. I was asked to get out of bed to eat the next day and that was about all I was capable of. I don't remember, but I also posted to FaceBook and sent pictures of my new foob to friends and family...something I'm not proud of.

I thought I would put my thought in writing what worked for me just in case I ever need to pass this information along.

DIEP Flap Surgery for Dummies:

Before Surgery:
  • Exercise and eat right. Your body is going to go through lots of trauma and it needs to be in good condition to survive what you are going to do to it.
  • Freeze meals. Unless your caretaker is a cook, you may end up eating a lot of pizza and takeout during your recovery.
  • Clean the house VERY WELL and do laundry. I would love to believe my husband could take over these duties, but no...if yours does, you are very lucky.
  • Put the clothes you will wear after surgery in an easy to access place. Many people recommend front button shirts, but I like v-necked t-shirts two sizes too big. I like to cut the neck out of the v-neck to make more room and easier to put the shirt on. Personally, it is more flattering. I like elastic waist yoga pants.
  • Prepare your nest for after surgery. When you get home you will not feel up to doing much. You need to have the things you want within reach. My nest includes Klenex, the remote control, my iPod, my phone charger, my laptop and a book. Do not try to read anything very intellectual during this time. I'm currently reading the Southern Vampire series.
  • Get your hospital bag ready. Mine was very basic: elastic hairbands, toothbrush/toothpaste, a phone charger, slippers and a lightweight robe. I wish I remembered my iPod. I wore the clothes to the hospital that I wore home: V-neck T-shirt with neck band cut out with elastic yoga pants. You will not need more than this.
When You Get Home:
  • Take it easy. You do not need to resume Mom job. If the house gets messy...who cares?
  • Take stool softeners. If you do not move bowels within a couple of days move to a laxative. Pain killers cause constipation, and the longer it takes the worse it gets. Truse me.
  • Wash your hands and take care not to get an infection. Don't create a nightmare out of something that should be happy.
  • Move onto anti-inflammatories as soon as you can. They will help promote healing and why stay on constipating pain killers longer than you need to? I take Alieve since I only need to take it every 12 hours.
  • Take picutres. It will be nice to see how things change as the swelling decreases and the brusing go away.
  • Take it easy. I know that it is hard. That is why I put it twice.


Anonymous said...

I am having my Diep reconstruction in the morning by Dr Bajaj. Does your foob as you call it really look like a breast or just a mound. I looked at her book in her office but it's hard to tell.

Amy said...

At first it looks like a a Barbie boob. It actually looks like a real breast after the nipple is placed. You can get your nipple(s) surgically so you have a little "headlight" bump(s) or have one tattooed on. Good luck with your surgery tomorrow! Did you already have your mastectomy or are you post-mast? I promise you, 2 1/2 years later, I am happy I had the DIEP, and Dr. Bajaj is an amazing surgeon.

Anonymous said...

I have heard from a few women that have been treated poorly by Doctor Bajaj and her attitude is rude and hurtful. The Medical board and others will getting complaints and some facts to back this up, even it this comment gets blocked from being on her, as I am sure it might-- Letters will be put together to get her behavior before the medical board. A doctor is more than just surgery . The whole person is to be respected and cared for. I Would suggest you dare not ask questions she doesn't like, she is hateful, arrogant, and at a vulnerable time for woman with cancer it is just so wrong. She should maybe stick to other plastic surgery where wealthy women get cosmetic stuff done and leave kindness and compassion to others that have some heart and Feeling about others that have cancer and it's devastation. she has a temper and is fake and she is hateful and rude. Money of course, a big issue go on her sites most of her pages are about paying her. If you don't have enough she makes you feel even worse about your body and she will drop you by treating you poorly so you will go elsewhere then make it your fault. I hope with people speaking out she can not continue to get away with this and then make up things to tell other doctors so nothing is her fault. If you feel or see her being rude, to you-- FIND another doctor it will not improve, some women it might not bother but quite a few I know of it is quite hurtful and shocking she gets by with it.

Amy said...

Dear Anonymous, First I decided to not delete so I can reply to you. If you found my little blog you must be searching for anything about Dr. Bajaj so you can write your opinion. I have never had a negative experience with her or anyone in her office. She has been kind and understanding through the whole reconstruction process. I have recommended her to friends who have faced breast cancer and they are all happy with her work. If you think the medical board gives a damn if you think she was rude you are hugely mistaken. Some of the best doctors I have had through my cancer experience have had terrible bedside manners but are brilliant. Dr. Banks happens to have a great bedside manner and is brilliant at the same time. Plus, if you want to come onto a stranger's blog and gripe you could at least use your name.