my breast reconstruction, by Judy

It can take a looong time, but it will certainly be worth it in the end.

I’m in the midst of breast reconstruction. I had a mastectomy of my left breast in Aug. 2008, followed by radiation in Sept. and Oct. of 2008. I was told to wait a year after radiation to start any breast reconstruction process.

So I did. I waited a year, then saw a plastic surgeon I like to call Dr. Boobala (nope, not his real name) and have been seeing him for almost a year now. I had my initial consultation in early Sept. 2009 and had my first surgery on Oct. 12, 2009. That surgery was a latissimus dorsi flap breast reconstruction. That involved taking muscle from my back and moving it to my chest, forming a small breast mound. There wasn’t enough to make a full-sized breast, so I then had another surgery on March 15. That surgery was to reduce Righty and put a tissue expander into Lefty. Dr. Boobala did it that way because he didn’t think he’d be able to make Lefty as big as Righty (the remaining breast) . . . and that was fine with me. I don’t care that much about the size of the breasts; I mainly didn’t want to deal with prostheses anymore and wanted a breast back. Losing a breast was harder for me than I initially thought it would be.

After healing from the implant/reduction surgery, Dr. Boobala started the “fill” process. Every week since March 31, I’ve gone into the office, and they’ve “filled” my expander with saline. This stretches out my skin so that, when there’s enough skin, I’ll wait for six weeks, then have another surgery to put a permanent implant in.

Dr. Boobala recently told me that he might not be able to get Lefty to quite the same size as Righty, so if I want, I can have Righty reduced even more at the same time that they put the implant into Lefty.

After all of that, I’ll have to have another small surgery to form a nipple and aereola.

It’s quite a process, as you can see, but I already feel better about myself, not having to use a prosthesis and having two breasts, even if one of them keeps getting “inflated” 😉 each week. I think we’re almost done with the fills — maybe two or three more of those, but I’m not sure about that. At any rate, once those are done, I’ll take six weeks off to let the skin settle at its new size. Then I’ll have the surgery to put an implant in Righty and I’ll go ahead and get Lefty reduced again if needed and if insurance covers it.

So. There’s the story of my Righty and Lefty. I’ll admit, I’m getting tired of going to Dr. Boobala’s office each week, but that’s really a minor complaint. As I tell them when they say “back for more torture next week!”,

I’ve been through much worse.

And no, there will be no pictures of the new boobs. Well, Dr. Boobala will have those, but I certainly won’t be sharing any. *ahem*

Heh.

Clergygirl Itches, Fights Temporary Insanity

Thanks all who were praying today. I’m doing well. Digger indentation is gone and overall I can see a positive difference. The only hang-up I’ve had is itching. Once again I had an allergic reaction to the anesthesia and as I came out of my groggy slumber it became uncontrollable. The nurse and doctor tried to do as much as they could and were very patient and good to me. I don’t know if you’ve ever experienced itching to that extent….all over your body…but let me tell you….the word insanity comes to mind. I become a very different person….a crazed person. I told Jeremy….when it is at it’s worst….I feel like yelling like a crazy lady and grabbing my nurse and begging her to help me. It really is not fun. It has now happened to me three times. After my mastectomies, then reconstruction, and now today. This time it came on quicker and was probably the worst I’ve experienced. I wanted to rip the bandages off and itch everywhere like crazy. I would have invited anyone in the area to itch with me…..lol. What a funny picture that would be.  Everyone picking a spot and itching. But it would be downright gross. But Jeremy will scratch for me. What a good hubby he is! So the Benadryl only helped slightly so they got some hydrocortisone cream and we caked it all over. Finally, some relief. They decided then that I should stay the night. Much of the itching is gone thankfully. I’m on some sort of prescription and we rotate the prescription meds with the Benadryl every few hours and it keeps the itching under control, so now I can rest some.

On a good note. Before I went in to surgery Dr. D used his marker to plan out his strategy. On the sides where it pooches a bit under my armpit he suggested lipo’ing the area and asked if it was ok. Is it ok?  Is it ok?  He could do lipo on me anytime, anywhere! I would never not say yes to lipo anywhere but my breasts….lol! So he lipo’d my back fat and the sides of my hips a bit and after a tough cancer journey he gives me perks like this. He is genuinely a very kind man and a great surgeon. I am so grateful to have a surgeon who I really trust and who is helping me feel better about my disfigured body.

And if I sound super chatty and happy in this post, I am….lol.  Thanks to a little magic pill called norco I am feel’in real good….lol!  I’m just hoping I don’t come back and read this and realize how loopy I was.  Because then I get embarrassed by my misspelled words and sentences that don’t make sense….lol!  I have a good excuse:)

“May I show my nurse your breasts?”

My answer was “yes, bring her in…”

 

This was my most recent visit with my breast surgeon, Dr. P. It was a quick check-up as I am not due for another MRI until March.

 

She did a physical exam and was spending more time on my left side (the side my cancer was on). I was getting a little worried and then

 

“I do not feel anything – everything is feels great”.

 

Whew…

 

“Can you believe that it has been 33 months since your diagnosis?” “Your hair is so long and you do not look 47.”

 

I love my doctor!!!

 

Then she asked if one of her new nurses could some in to see my reconstruction. The nurse is in the operating room with Dr. P, but she is my breast surgeon so her nurse had not seen many reconstructions.

 

The nurse came in almost embarrassed –

 

but I was not embarrassed.

 

I think I am more proud of my “new” breasts than I was of my old breasts.

 

Do I miss my old breasts?

 

Sure I do…

 

but if you choose to have reconstruction, I cannot tell you what having a good reconstruction can do for your self-esteem.

 

The reason that I am writing about this is because finding the right plastic surgeon was not that easy for me. Dr. K was recommended by my breast surgeon as “the best”. When I was first diagnosed my surgery was scheduled for 13 days later. Not much time to do any research on anything, let along plastic surgeons. When I first met with Dr. K – he was great, he showed me photos of reconstruction, and we talked about saline vs. silicone. We spoke about the question of radiation and how that would change my reconstruction of I needed radiation. The only thing Dr. K did not speak about was the cost of reconstruction. When I finished the appointment and the secretary asked how I would like to pay the $2000.00 deposit – I lost it. “How much was this all going to cost? She did not know. Dr. K had just recently stopped being a preferred provider of any insurance. The reimbursement rates for breast reconstruction are pretty meager. In the world of plastic surgery – many, if not most procedures are elective. I also think if you are a good surgeon you have the prerogative to not have to accept insurance. I left the office that day in tears.

 

When I finally got it together I called back and asked for a break-down of the costs:

I was informed I was getting the Dr. P rate of…

Stage 1 – Expanders in $5700.00

Stage 2 – Expander’s out/silicone implants in $5700.00

Stage 3 – Nipple reconstruction $1000.00

Stage 4 – Tattoos $750.00

 

My insurance at the time was going to pay about $1500.00 of the Stage 1 procedure and could not tell me how much they would pay for the Stage 2.

 

My treatment plans changed over the next few days and the surgeries were cancelled in favor of neo-adjuvant chemotherapy. This also bought me some time to look for other plastic surgeons. I met with 2 other surgeons; another was not a preferred provider either. She had not performed that many reconstructions and had no photos of past patients to show. The last surgeon that I saw had the most horrible beside manner that I ever experienced. He was not positive at all. He was reluctant to show me any photos of past patients and when he did I understood why. The reconstructions were terrible, lopsided; I could not even tell if he had done the nipple reconstruction in some cases. I left that day telling him he was “Dr. Doom” and that there was no way he was cutting into my body.

On another visit with my oncologist I discussed the problems with the various surgeons. He told me if it was his wife he would only use Dr. K. We talked about the cost and the fact that hopefully I will have these breasts for quite a long while, but the cost was still on my mind.

 

After much thought, I decided that I would use Dr. K. We would figure out how to pay for it. He did offer payment plans and there was some time in between procedures. My insurances did end up paying more than I was previously quoted. The surgeries occurred in 2 different calendar years and because of some job changes the providers were different also. I only paid a few thousand dollars out of pocket when all was said and done.   

 

If you decide reconstruction is right for you, find the best doctor that you can afford, ask about the various types of reconstruction and what is right for your body; ask to see photos of their past patients.

 

If you have questions along the way… we at MotherswithCancer are here to help …