snappy
Survivor
- Joined
- Apr 15, 2002
- Messages
- 10,382
Dawn, I can't add anything about the MRI, open or otherwise, since I did not have a MRI.
However, I WOULD like to comment on the plastic surgeon visit.
I would encourage you to definitely strike that doc from your list. It sounds like you have already come to that conclusion on your own. I will tell you that I find many doctors do advocate reconstruction unless there are contraindications. . . other health issues. My breast surgeon was very encouraging although he did want me to wait 18 mos after the mastectomy. Once I reached that point, he recommended it as did my female GYN. Age did not seem to be a factor. It is more that they have seen the results over time, how reconstruction has improved over time, and how a woman's outlook can be impacted. That said, it is not for everyone, and I had to think long and hard before I did it. There is a longer recovery from the tram flap than from the mastectomy itself. I do not have a single solitary regret though, it was a positive, healing thing for me in every possible way.
As with my breast surgeon, I did a lot of research for my plastic surgeon. I had three consults before I settled on one. The one I went with was suggested by the mother of DD12's class mate who is a hospital nurse. She actually polled the nurses she knew who had worked with the doctors I consulted with. One was a clear winner.
I liked that I had options with him, although implants were ruled out by all three since I did not have enough skin left to cover an implant of any size. I also preferred to avoid the implant as I think you are saying you do. He suggested either the free tram flap or the lat flap you posted about. He has done lots of each. I liked that he talked to me about which method would work well with MY body type. He specifically explained that he thought the flap would work well because I have a long trunk. Makes sense, that I would not "miss" the flap from my abdomen. It also made the recovery somewhat easier as I was able to straighten up faster since the abdominal incision was not stretched as much. He also presented the lap as a viable alternative.
I also preferred his manner. All of the life I have been repelled by any doctor who has a condescending attitude. Sure, I don't have a medical degree, but I am an intelligent, well-read, type A personality who can't really leave any stone unturned. This doc respected that, he did not have the fatherly "I will take care of everything" attitude, nor the what I call the doctor God attitude.
I really liked that he and his nurses were accomodating when I asked to see pictures of his work. What I found particularly enlightening was that he not only had many pictures of women with successful free tram flaps, lap flaps, etc., he also had some of a woman who had complications (a bad infection) and what the healing process entailed. It helped you understand what all the "complications" are that you sign off on before surgery. Nor did it leave you with the impression that a perfect result is guaranteed or promised.
Finally what sealed the deal is that he is the guy in his practice that does the microsurgery, which is what is required for a free tram flap. It is the single most important aspect of the surgery and from which stem the worst complications (total or partial loss of the flap through not getting a good blood supply to it).
I never heard word one about the difficulty of the surgery from any of the docs. They all use another board certified doc as an assistant during the surgery. My doc routinely assists other docs with the microsurgery aspect so I know he has done a lot of them. He trained quite extensively in another state before he began doing them here. My surgery entailed removing the flap and reattaching the blood supply, closing the abdominal incision, and doing a very extensive reduction on the non-affected breast, all done within less than 4 hours with the assistant.
I also liked the way he let me determine how I wanted to do the nipple construction. I opted for simple stuff, I needed no "adjustments" to the flap (this is routinely done during stage 2 of this type of reconstruction through lipo), as I was completely satisfied with the shape and look of it, so I was able to do it in the hospital with just a local. He was completely on board with this, even stopped the nurse from giving me an IV (it was standard procedure and she was resisting but he overruled her). I was awake throughout the 30 minutes it took to create the nipple. He made me feel so comfortable, let me choose the music, we talked about the upcoming parish fair.
I go into all this detail, as I have posted here before, to suggest that you seek another opinion. Ask about how many non-implant surgeries this new doc has done and currently does each year. Ask to see pictures of his work (believe me they will take pictures of you throughout this process). Ask if he will use an assistant during surgery, and of what experience level. You should also be told how long the surgery will take.
If the doc balks at any of this, try another. These are not questions that should alienate them. If they do, it is not the right doc, at least in my opinion.
I will add, please pm or email me if I can be of any help as you decide about this or as you go through it. I have been a supporter of others here in my town.
Regardless of whether you decide to do it, I think it is one you should continue to research. I really respect the doctors who specialize in reconstruction. Unlike their fees from cosmetic surgery, their income from reconstruction is reduced significantly due to insurance constraints. I believe many of them do it because they don't want women to be deprived of something that many see as having the ability to make you whole again.
Again, if you have ???, please ask. No question is too much or too little.
However, I WOULD like to comment on the plastic surgeon visit.
I would encourage you to definitely strike that doc from your list. It sounds like you have already come to that conclusion on your own. I will tell you that I find many doctors do advocate reconstruction unless there are contraindications. . . other health issues. My breast surgeon was very encouraging although he did want me to wait 18 mos after the mastectomy. Once I reached that point, he recommended it as did my female GYN. Age did not seem to be a factor. It is more that they have seen the results over time, how reconstruction has improved over time, and how a woman's outlook can be impacted. That said, it is not for everyone, and I had to think long and hard before I did it. There is a longer recovery from the tram flap than from the mastectomy itself. I do not have a single solitary regret though, it was a positive, healing thing for me in every possible way.
As with my breast surgeon, I did a lot of research for my plastic surgeon. I had three consults before I settled on one. The one I went with was suggested by the mother of DD12's class mate who is a hospital nurse. She actually polled the nurses she knew who had worked with the doctors I consulted with. One was a clear winner.
I liked that I had options with him, although implants were ruled out by all three since I did not have enough skin left to cover an implant of any size. I also preferred to avoid the implant as I think you are saying you do. He suggested either the free tram flap or the lat flap you posted about. He has done lots of each. I liked that he talked to me about which method would work well with MY body type. He specifically explained that he thought the flap would work well because I have a long trunk. Makes sense, that I would not "miss" the flap from my abdomen. It also made the recovery somewhat easier as I was able to straighten up faster since the abdominal incision was not stretched as much. He also presented the lap as a viable alternative.
I also preferred his manner. All of the life I have been repelled by any doctor who has a condescending attitude. Sure, I don't have a medical degree, but I am an intelligent, well-read, type A personality who can't really leave any stone unturned. This doc respected that, he did not have the fatherly "I will take care of everything" attitude, nor the what I call the doctor God attitude.
I really liked that he and his nurses were accomodating when I asked to see pictures of his work. What I found particularly enlightening was that he not only had many pictures of women with successful free tram flaps, lap flaps, etc., he also had some of a woman who had complications (a bad infection) and what the healing process entailed. It helped you understand what all the "complications" are that you sign off on before surgery. Nor did it leave you with the impression that a perfect result is guaranteed or promised.
Finally what sealed the deal is that he is the guy in his practice that does the microsurgery, which is what is required for a free tram flap. It is the single most important aspect of the surgery and from which stem the worst complications (total or partial loss of the flap through not getting a good blood supply to it).
I never heard word one about the difficulty of the surgery from any of the docs. They all use another board certified doc as an assistant during the surgery. My doc routinely assists other docs with the microsurgery aspect so I know he has done a lot of them. He trained quite extensively in another state before he began doing them here. My surgery entailed removing the flap and reattaching the blood supply, closing the abdominal incision, and doing a very extensive reduction on the non-affected breast, all done within less than 4 hours with the assistant.
I also liked the way he let me determine how I wanted to do the nipple construction. I opted for simple stuff, I needed no "adjustments" to the flap (this is routinely done during stage 2 of this type of reconstruction through lipo), as I was completely satisfied with the shape and look of it, so I was able to do it in the hospital with just a local. He was completely on board with this, even stopped the nurse from giving me an IV (it was standard procedure and she was resisting but he overruled her). I was awake throughout the 30 minutes it took to create the nipple. He made me feel so comfortable, let me choose the music, we talked about the upcoming parish fair.
I go into all this detail, as I have posted here before, to suggest that you seek another opinion. Ask about how many non-implant surgeries this new doc has done and currently does each year. Ask to see pictures of his work (believe me they will take pictures of you throughout this process). Ask if he will use an assistant during surgery, and of what experience level. You should also be told how long the surgery will take.
If the doc balks at any of this, try another. These are not questions that should alienate them. If they do, it is not the right doc, at least in my opinion.
I will add, please pm or email me if I can be of any help as you decide about this or as you go through it. I have been a supporter of others here in my town.
Regardless of whether you decide to do it, I think it is one you should continue to research. I really respect the doctors who specialize in reconstruction. Unlike their fees from cosmetic surgery, their income from reconstruction is reduced significantly due to insurance constraints. I believe many of them do it because they don't want women to be deprived of something that many see as having the ability to make you whole again.
Again, if you have ???, please ask. No question is too much or too little.
)!!
I layed there crying through the whole thing; I couldn't move, and all I could feel were the hot tears running down my face. When I opened my eyes I was in this "casket like" tube. Not nice visuals. Uggh. Awful. (This was not at the hospital I work at, but another one.)
but they made me very comfortable with pillows, blankets, optional music, a call button and hugs (because of course, I was crying). I didn't want the music, and actually didn't want anything, but they insisted I have ear plugs since the loud noises can affect your hearing (which the other people never explained to me). OK, I'm comfortable, I can deal with this. I was very glad that when and if I opened my eyes, all I saw was the pillow and not the top of the machine. I layed still and didn't attempt to get up since I knew I was in the tube. That exam lasted a really long time, about an hour. I cried during most of it. I also felt extremely "alone". It was before I fully appreciated the power of meditation, relaxation, and guardian angels and other "spiritual comfort" - though I was praying like crazy. 
Believe it or not, I derived strength from thinking about all the other women who'd done this before me. The Survivors. And my own patients. I can do this! 
and think about all the spiritual guidance I have around me.
in the room looking with the glass at me. DH had tears running down his face. But they allowed him in there so whilr they did the test he read poems to me 
so I heard his voice in the headphones and was able to drowned out the sound of the machine.
its the least I can do (outside of prayers).
But happy for you. 
Can't wait to see pictures.
