Thursday, April 24, 2014

Stitch Glitch! - Diep Flap Reconstruction Week 4

Section of my tummy scar...healing nicely at 4 weeks!

I measured my abdominal scar. Guess how long it is?  If you said 23 - 1/4 inches, you are correct! Yes, my scar is nearly 2 feet long. Wow. That was a big incision.

I know I said week 3 was pretty boring, as far as recovery goes. Well, week 4 decided to add just a little bit of excitement. A piece of glue came off my incision on my abdomen and the incision was still a little sore there, and oozing a bit. I didn't think much of it, just put some gauze over it to protect my clothes and got on with the week. It got a little red, and kept oozing. There was a hole about as big as a pencil eraser. Throughout the week, it seemed to improve, and I was seeing my surgeon soon, so I just figured I would ask him about it. Monday morning (April 14) I went for a walk, and walked more normally than I have since surgery. It felt pretty good to be moving more easily. When I got home, the little opening had leaked more than before, and looked worse as well. I also had a reddened lump under my tummy incision nearby.

Some minor complications with an incision the size of my abdominal incision are not terribly uncommon. Tuesday morning (April 15) I went to see my surgeon and he took a look at it. All those stitches underneath my skin are in the process of dissolving (apparently they take about 6 weeks to disappear). Since I am at week 4, he said the stitches were breaking apart, and sometimes they can work their way near the surface. My body, in all likelihood, is reacting to a stitch and treating it as a foreign body, and thus, is not healing in that spot. He got gloves and a little packet of instruments and some gauze and told me he would remove the stitches that were causing the problem.

I couldn't really see what he was doing, as I was laying on the table at this point. I did raise my head once in awhile to check it out. I may not have been able to see everything, but I could sure feel it! He re-opened a little section of the incision, and probed around to find the stitches that were the culprits and remove them.

Me: "Ouch!"
Surgeon:  "Does that hurt?"
(Really??? You are cutting into a tender incision without any localized anesthetic!)
Me:  "Yes, a LOT."
Surgeon: "Sorry."

Don't get me wrong, my surgeon is incredibly gentle, but this did hurt. That Lamaze breathing from so many years ago still comes in handy!  I came home with iodized tape (for packing wounds) to put on the incision opening for 3-5 days, and then I will be putting Neosporin on it to keep it moist, covered with a piece of Aquacel (absorbent pad infused with silver to fight infection) while it heals. I also have an appointment in a couple of weeks to make sure it is healing well. The adventure continues!  Oh, and the doctor said, the reddened lump I was worried about was just skin irritation and some scar tissue forming underneath the incision. Scar tissue starts to peak, apparently, at 6 - 8 weeks. He said massaging the incision could help.

After 4 weeks, I am off baby aspirin and no longer have to sleep exclusively on my back. Since I am a side-sleeper, this makes me happy! I am wearing a compression garment during the day (I could probably write a whole post about my love/hate relationship with Spanx...but not today!) My doctor says I no longer have to wear the compression garment, but it does help with the swelling. He said I may want to wear one when being more active (going to the gym, hiking, etc.) over the next several months, as I will continue having the swelling for some time. He said in 6 months I will be mostly healed. But right now, I can increase my activity level and work on getting back to normal. Aside from my stitch glitch, things are progressing normally. Once the incision heals, I will probably meet with my surgeon in a couple of months to make a plan for phase 2, which will include any touch-ups to the new breast (NAC or nipple-areola complex), breast lift on my natural breast if I want it, any liposuction or fat grafting to improve symmetry, and any revisions to the abdominal incision. These touch ups are done on an outpatient basis with a 1-2 week recovery. Tattooing of the NAC complex takes place after phase 2 touch-ups have healed. I have heard that these revisions can take a good result to a great result. After all I have invested in this process, I think I am going for greatness!

Some people look at me like I am crazy to have gone through all of this, but let's put it in perspective. My cancer treatments and related procedures went from July 2012 - September 2013.  This reconstruction process with take up most of 2014. And then, I am done. No procedures down the road related to implants and their complications (capsular contracture, implant failure and replacement, etc.) If I am cured of cancer and live another 30-40 years or so, I say this is definitely worth it.  I am happy I am doing this. I am already pleased with the results.

For more on my Diep flap experience:
Diep Decisions! Diep Flap Reconstruction
Diep Flap Surgery & Recovery - Week 1
Diep Flap Reconstruction Recovery - Week 2
Diep Flap Reconstruction Week 3 - Recovery Can Be Boring

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