Wednesday, February 26, 2014

Second Opinions Matter

As my mastectomy date rapidly approaches, I've been becoming increasingly worried about the reconstruction procedure I chose. Although reconstruction doesn't happen until later, I wanted to make sure I was making the right decision. So, this morning when I woke up, I started reading as much as I could from actual women who had the TRAM Flap procedure done before.

The more I read, the more I became convinced that this could be a mistake I would never be able to fix. And with each account of horror story after another, I knew that I would not ever feel comfortable with this surgery. I thought my only other option would be to go the implant route, which would mean that I would have to have a double mastectomy on Monday, so my breasts would match. But then I ran across a new option.

It's called the DIEP Flap. It's the same as the Tram, but leaves my abdominal muscle intact so that I can use it later. It's more surgery time, but shorter recovery time. The downside is that there is only one surgeon in the upstate that is certified to do this surgery, and it's not the one I've been seeing. So, this afternoon's adventure included a meeting with the new plastic surgeon, who's an hour away.

He was great at explaining everything to me. He said that the TRAM Flap surgery is outdated, and the DIEP is the way to go. If I had the TRAM Flap, as I had planned, the surgeon would have had to use both abdominal muscles to create a breast large enough to match the other. If they did that, I would never be able to do a situp again. I would have to roll to my side and use my obliques to sit up. And I would probably not be able to pick up Eliah anymore. And once the surgery has been done, there is no way to reverse or fix it.

The DIEP Flap gets the same results, to include a new breast and tummy tuck, and leaves the abdominal muscles intact. Because it's new and very detailed, there are many that cannot perform the surgery yet. It requires microsurgery to attach the blood vessel and vein to maintain bloodflow to the breast. The recovery time is also reduced from six weeks to about three weeks. And unlike the TRAM, if for some reason the DIEP doesn't work, I can start over with a new mastectomy and look at implants then.

The surgery will be done at another hospital, an hour away, and will require about 3-4 days in the hospital. The surgeon will be doing a Double Flap to create one breast. Typically they take out an elliptical area from the abdomen, and then use half to create the breast. Basically I don't have enough belly fat to use just one side of my abdomen, so he has to use both sides and attach both blood vessels. But the results should look very natural and much like the other breast.

He suggests that I wait six months after radiation to do the surgery, depending on what the radiation does to my skin. Minimum of three months though. I'll see him again after my last radiation to see how it all looks.

Overall, I'm SO glad I went to see him. And he understood my situation, as he has a special needs child as well. I feel relieved and excited about this procedure and know it's the right one. Whew!

Here's an illustration of what the surgery will do.....

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