It’s been a while since I have updated the website and I wish it was because I had nothing to report. It’s actually because I just have not taken the time out to do so.
As of my last surgery in January to remove the infection which resulted in the loss of the implant, I am still not healed. The surgery site has been quite stubborn and still has two open areas that leak body fluid continuously. When they first appeared my plastic surgeon as well as the infectious disease specialist (who I was still seeing because I had the PICC line in for the IV antibiotics) were not alarmed. They assured me that this was fairly normal and that it was my body’s way of dealing with the fluid build up after the surgery. It does not hurt but it is annoying as heck because these holes leak fluid so I have to keep the wound covered at all times with gauze.
I wasn’t really too happy about the fact that there were holes in my body, but since I had faith in my medical team I assumed they were right and these holes would close on their own after time. They did not.
On a checkup with my plastic surgeon in late February we talked a bit about other cosmetic options now that I basically have no breast on the left side. We decided that I’d get a prosthestic breast for that side. Luckily my wonderful sister in law works in the medical equipment field and she has guided me through the process of fitting the prosthetic. What a blessing she has been!
Anyway, back to the appointment. My plastic surgeon explained there were other microscopic options available for cosmetic surgery, but that she would like to refer me to another specialist at the U of M Hospital. Honestly, while I really, really like my plastic surgeon – Jim and I think a small part of why she brought up a referral is that she wasn’t quite sure what to do with me any more. All the infections, now the open wounds…..I am not an “easy” patient. We welcomed the referral and decided that while I wasn’t at all even thinking of cosmetic surgery at this point, we should go and meet with the doctor so that we were educated with our options and could ponder them down the road. Knowledge never hurts, plus we love a road trip and the U of M Hospital is only about 15 minutes from IKEA! We love IKEA!
We met with the plastic surgeon and presented him with my “book” of medical history relating to the breast cancer and subsequent reconstruction process. He joked that he’s seen shorter novels! He is brilliant; immediately Jim and I took to him and felt comfortable in his presence. He reviewed my history and then looked at the wound. He explained that in his opinion, something needed to be done or else the holes in the wound will not heal. He said that my tissue behind the skin has been compromised with the radiation and possibly even the bone. If there is dead tissue inside it gives the infection somewhere to live and thrive and my body isn’t able to conquer it. The best treatment in his opinion would be to open the area up and debride the area, cleaning out all dead tissue. The best case scenario would be to bring healthy tissue from my body to the area, promoting healing. Since I had the fat grafting procedure in December where fat was harvested from my tummy and injected into the breast for symmetry, my tummy was not a candidate for the tissue. During the fat grafting procedure there is a good chance the blood vessels were compromised and thus when transplanted to the breast area they most likely wouldn’t thrive.
Another option is to take tissue from my thigh or buttock and use that tissue to form a breast without a need for an implant. This is a highly specialized surgery requiring 10 hours or more. My new specialist doesn’t perform this surgery but did say I could be referred to another doctor whom he works with if I opted for this treatment. He explained the risks to us and we decided that at this time, this is not a solution.
The other treatment is what is called a latissimus dorsi flap. This option was available to me at the very start of my breast cancer diagnosis but I opted for the tissue expanders and breast implant after my mastectomy. Who knows; maybe if I would have chosen this reconstruction procedure initially all of this would have been avoided. Maybe not. I am not one to dwell on what-ifs, so enough said on that subject.
Basically, the latissimus dorsi muscle is located in your back, just below your shoulder and behind your armpit. It’s the muscle that helps you do twisting movements, such as swinging a racquet or golf club. An oval flap of skin, fat, muscle, and blood vessels from your upper back are used to reconstruct the breast in a latissimus dorsi flap procedure. This flap is moved under your skin around to your chest to rebuild your breast. The blood vessels (artery and vein) of the flap are left attached to their original blood supply in your back. Because the flap contains a significant amount of muscle, a latissimus dorsi flap is considered a muscle-transfer type of flap.
I needed to have an MRI to verify that I was a candidate for this surgery (I am). I also needed a Cat Scan to make sure the vessels in my body at the site of this flap were not damaged during my lymph node removal (they were not). We visited IKEA that day too!
So (yes, I am pretty sure you know where this is going….)……next Thursday I’ll be having surgery. Again.
This surgery isn’t a walk in the park – it isn’t an outpatient procedure. It’s likely I will be in the hospital at least 2 to 3 days. I’ll have two drains in my body that will remain in for up to 3 weeks. We have been warned that the recovery process is slow; for the first 4 weeks I can not do anything. No lifting at all, no driving, nothing. The doctor said I can’t even dust the house, load the dishwasher or pull weeds. Apparently any stress on the area can cause the operation to be compromised and it would be unrepairable damage. I think that aside from the discomfort of the actual surgery (thank heaven for meds and an amazing nurse/hubby), this 4 weeks of down time is going to be nutso. I am a do-er, like many of you. I don’t sit and watch TV for hours, or widdle away the day snoozing ….. oh boy! The doctor did say I can walk (but not on a treadmill), and it will be important I move my arm to encourage the muscle to heal. That being said, I see many walks in my future; that is a good thing because the dryer keeps shrinking my clothes!
There will be many follow up appointments so he joked that we should get used to driving US23. (It takes us about 2 hours to get there.) More IKEA time!
We’ve already been to the U of M hospital; how impressive! The care I have received in the pre-operative process has been wonderful, and I am at ease with the decision we have made. I can’t go on having two leaking sores on my body. It’s getting old; 3 months is enough of that.
We want to put this behind us, and while we hoped beyond hopes that the surgery at the end of 2013 would be it, it wasn’t. We honestly hope and pray and believe this one will do the trick. Will I look “normal”? No. This is not a cosmetic solution and I will eventually be using the breast prosthetic. I am OK with that. Maybe years down the road I’ll change my mind and want to explore more cosmetic surgery; maybe – but probably not.
As always, thanks to all of you for your prayers and continued words of encouragement. Who would have thought that over 2 years later I’d still be messing around with the cosmetic end of this disease? Not me, but I know it could be so much worse and for that I am thankful.
I’ll update you after the surgery!












