Immediate DIEP, (Aged 58)

I was diagnosed with DCIS (Ductal Carcinoma in Situ) on the 13th July 2007, and was admitted to hospital on 16th August for a wider local incision and Lymph node removal, this operation was carried out and I was sent home the next day.
Unfortunately my wound became infected and opening up to the chest wall. When I saw my surgeon, some 10 days post operation, he told me that the lymph nodes were clear but that I would need further surgery as they did not have the clear results for the wide local incision, and that they needed to take more tissue, my boob was already a mess.
I asked and if he didn’t get enough this time what next, to which he answered a mastectomy was then needed. So I said then I wanted a mastectomy now but with an immediate reconstruction, he advised that they would delay the procedures by a week or so as the team of plastic surgeons would need to be available at the same time.

My husband fully supported my decision because as he put it he did not want me to be subjected to ‘salami slicing’. I was seen by Richard Haywood the plastic surgeon the next week, this was the beginning of September, he agreed that he could perform an immediate DIEP following a skin saving mastectomy, but explained that I would need some skin grafts from the skin they would remove from my stomach as I had a large open wound on the present breast due to the infection. I had to attend the dressings clinic to check that the wound was not infected etc as the operation could not take place if there was any infection present.

The operation went ahead as planned on Friday 28th September, Richard was so reassuring , in addition to two visits to see me on the day before the operation he also came in on the morning of the operation taking my husbands telephone number tucked into his shirt pocket. I went to theatre at 8am and that was the last I remember intil about 4 in the afternoon when I found myseld back in my own room on Coltishall Ward.

I was wrapped up like a baby in a cocoon of a warm pink quilted blanket, but here begana three days of intense monitoring to start with every 15 minutes day & night (the ward sister had said that the first day that within the within 24 hours I would hate them all for constantly disturbing me to check the new boob was ok). I remember on one occasion when I was awake fully asking how they could tell that the Doppler was picking up the blood supply flow in the new boob and not my heart beat as it was in the same region, and the nurse showed me the readings from both.
The first day post op I was full of beans even though I had three drains a drip and a catheter from my bladder. Day two wasn’t too bad, but on day three having been walked to the bathroom for a strip wash I saw my new boob for the first time in the mirror, I burst into tears with shock. I don’t know what I had expected but I am sure it was a combination of everything that had happened that caused me to react in that way but I was weepy for the rest of the morning. Later I was visited by a lovely lady called Angela from the chaplaincy team, the tears started again, but she talked to me and told me her story. She had not had reconstruction but I think just talking to her calmed me down and helped me to see things clearly.

Of course looking back now I am sure a lot of it was due to lack of sleep because when I got used to looking at me boob it was not too bad and slowly got better but in the first instant it was very red & raw, and all the colours of the rainbow from all the bruising. Within a month it has settles down and I was proud of it. I had a new nipple and a new belly button in addition to a tummy tuck! I left hospital on day 9 staying an extra day as we live nearly an hour away from the hospital, I could not stand straight which I had been warned about and my stomach was a tight as a drum – I wondered if I would ever stand up again but the medical staff assured me I would.

I had to return to the hospital on the Monday morning. My stomach suddenly started to pour sebaceous fluid through the new belly button (at least that is how it appeared to me). A quick telephone call to the plastics clinic who told me to go in as soon as we could, but there was nothing to worry about.

Apparently I had a build up of fluid which can be quite common, and once it had been released my stomach was a lot less taught and I began to straighten up. There then followed weekly trips to the plastic dressings clinic to have my new boob and stomach checked. The staff were always very patient and happy to give advice on how I could help myself, for instance one staff nurse suggested using Bio Oil on the wounds once they were healed, massaging it in daily after a shower, this certainly helped to minimise my scars and I still use it today.

I had a further small operation in the August to make my new boob slightly smaller and the spare skin on my hips was taken away. I also had two sessions of tattooing which has given my nipple area more definition. I still use the bio oil daily and I appreciate that age means my skin does not heal, or fade as quickly as those on younger skin – which is something that older ladies should bear in mind.

Anyone contemplating breast reconstruction who like me know nothing about what I was about to undergo (apart from what members of the medical profession told me & what I read) must talk to someone who has been there. Before and after my surgery members of Keeping Abreast were both there to reassure me over the little things, which helped me immensely.