Two Years and Counting

Trip to the Mediterranean 2012

It certainly has been quite awhile!  Yesterday, I received a private message from another compatriot that underwent a preventative mastectomy with reconstruction for LCIS and we both were wondering if we should follow up with our breast surgeons since it has been over two years.  I was told by Dr. Satoloff that I would just need to monitor myself to see if there was any change in shape to the implants which may suggest leakage.  She was told that she should have a yearly MRI to show if anything like that is occurring within her body.  We both decided that physical monitoring rather than the uncomfortable and expensive MRI would show the same thing if we were both vigilant.  

I wanted to update my post to talk about life after the PM and to tell you about our conversation.  We both shared information about our lifestyles in that they haven't changed much from life before the PM.  Personally, I like the way I look now more than before the surgery.  In terms of how I feel, I still consider it the "new normal" and very rarely is there any truly uncomfortable feeling with my body.  For me, the most uncomfortable feeling is when I do not have a bra on which has perplexed my husband.  "Why would you have discomfort when there is no tissue there?", he would comment.  My thought is that the skin has to hold up the implant without a lot of support so when there is no bra in place, it pulls and becomes slightly uncomfortable.

I still and will always welcome questions or conversations even though it has been more than two years.  Please feel free to call or email me at arlene.flick@yahoo.com if you are just beginning the process.  My mind is a little fuzzy since it has been awhile which is why this blog is still a good chronicle of events that will occur should you select this option.  I urge you to read from the very beginning and then call or email me.  It is a big decision and I would love to lessen the unknown if you would like to pick my brain.

Thank You!

It's been well over a year and a half since I had this surgery and I am amazed at how many emails and phone calls I still get.  I cannot thank you all enough for your kind words.  I decided to write this blog because LCIS is such a unique diagnosis and along with its uniqueness comes varying decisions about what to do next.  Ambiguity is the word most used to describe the thought process since there never seems to be a "set" prescription for treatment.  You are not alone in that thought process.  In fact, it's what makes the process so difficult.  I urge you again, to email me or call me if you have any questions about what direction I took and/or what I wrote about in this blog.  If I can reduce even a minute or so of stress in your lives, I will gladly do it.

Happy 2012!!!

Happy New Year!

Happy Birthday Boobies!

Happy birthday new boobs!  That's right.  It's been one year ago today that I was in the hospital recovering from my preventative mastectomy.  It's almost hard to believe!


I went back through my blog and reread about my entire experience and I was astounded at how quickly I was able to heal and get back on my feet.  Since I had never had an operation before, I didn't know what to expect in terms of the healing process so this was a completely new experience for me.  Looking back, I remember the discomfort from the tissue expanders the most and the grogginess from the valium.  Getting out of bed in the morning took more than just a deep breath and popping ibuprofen became an everyday occurance.  Overall, I have to admit that it was uncomfortable but very manageable.



I wanted to capture a few pros and cons about this surgery in the following bullet points to those that may be considering this as an option.  I enjoyed talking and emailing those who have contacted me the past year after receiving the news that they have been diagnosed with LCIS and were trying to decide which approach to take.  These may help summarize the  ordeal:

• Con: The tissue expanders are uncomfortable and feel like an iron band around your chest.  Make no bones about it.  Sleeping on your back becomes the only way to fall asleep.  However....
• Pro: They only have to be in there for three months (normally) so there is an end date to the uncomfortableness.  Also, bras were unnecessary and I finally saw cleavage on my body for the very first time.
• Con: I gained 6 pounds and I cannot get rid of it.  I tried to convince myself that it was the weight of the new implants but I know it is not.  I am definitely back on my exercise routine but, for some reason, I lose 2 and then a month later, gain them back.
• Pro:  I never have to do a pushup again....according to Dr. Bucky.
• Con:  I have some scarring around my nipples and on either side of my boobs.  They are pretty slight so I am hoping that, over the years, they will become less and less which seems to have happened in the last year alone.
• Pro: My breasts look like I had them augmented and not "replaced".  In fact, at my 25th college reunion this year, my friend (male) was looking at me and I blurted out across the table, "Oh Steve, I forgot to tell you I had a preventative mastectomy which is why they are bigger.  I didn't want you to think I had a boob job."  Too much to drink?  Perhaps...but I didn't want him to think I was vain enough to have a boob job.  However, the vanity part has sucked me into plastic surgery big time on the next two pros.
• Pro:  LOVED the eye lift surgery that I added at the last minute!!  I get so many compliments from people saying I look younger!  I promise you.  It's the eyes!!
• Pro:  Loved the removal of the "over 45 tummy roll that appeared out of nowhere" after the fat grafting was done.  This is where vanity and I become best friends.  I am now "all in" on Smart Lipo sometime in the near future if my thighs continue to not pay attention to exercise and reduce themselves.
• Pro:  No more mammograms.
• Pro:  Hopefully, I will never have to undergo chemotherapy or take any drugs because of breast cancer.
• Con:  I lost my natural breasts and I am aware that there is something different on my body.
• Pro:  I look and feel really good. 

I will finish with one final story.  All my life, I bought clothes that looked adorable on smaller breasted women since that was my body type.  When I tried on clothes recently, especially sweaters and dresses, I would sometimes get annoyed that I was looking too "fat" since my breasts were so large (for me) and it gave the appearnace of a larger frame.  Yesterday, I went out to celebrate the Boobie Birthday by purchasing some new clothes.  My husband knew of my dilemna and suggested a new approach.  "Honey" he said, "Think outside the box and try on clothes you never, ever would have considered wearing in the past.  You have nice breasts so show them off"  Good thinking!!!!!  It was like "What Not To Wear" and I had to rethink my look since it had changed.  I ended up buying a halter top dress and a strapless holiday gown; two dresses that I would never dreamed of wearing on my tiny, barely A frame.


So...thank you LCIS.  In a weird way, you saved my life and gave me a whole new "look".

Unexpected Trips

So, I took the bus to NYC to meet Margie wearing my thick white brace under my clothes.  Let's just say that it is not the most comfortable thing to wear if you are sitting.  Lying down?  Different story.  My stomach was still very sore and it looked like the stitches under my armpit and near my tummy were healing up nicely.  To anyone that may choose this additional surgery, I would have to say that it is very doable and compared to the previous ones, it is a walk in the park.  My only negative is the brace...under clothes.


I had a great time at the Open and I will admit, I did not feel like wearing that brace the entire time because I soon became Deenie in "Are You There God, It's Me Margaret?". ( If you are over 40, please tell me you remember that book.)  I wore it out one night and I couldn't have felt more ugly and uncomfortable although, truthfully, no one but me knew it since my dress hid it beautifully. I still felt like a dork which is not what one is supposed to feel like in Manhattan.


So here it the kicker.  I fly back Wednesday (wearing my brace) to my home in SC and on Thursday, I find out that I am being deployed as a volunteer for the Red Cross!  I have been training this entire year and BEGGING the powers that be to deploy me.  Holy cow!  I got deployed back to NY to help in a shelter in Binghamton, NY for two weeks.  Immediately, I read over the information and while filling out form number 147, I see where you have to check Yes or No if you have stitches.  Crap!  I check No and call Margie.

"Hey Margie.  Do you know how to sew?  Have you ever taken out stitches before?", I ask
"No but how hard can it be?", she replied
"Ok, I'll be over in ten and I"ll bring a tweezer.  Do you have tiny scissors?"

And the next thing you know, I am lying on the floor while Margie puts on her readers to clip and pull out the stitiches so that, technically, I do not have to answer Yes to that question.


I pack up my white brace and limited attire and get back on the plane to LaGuardia on Friday.  I knew going into this it was going to be exhausting but highly rewarding from all that I have heard from others who have deployed before.  However, this was my first deployment so I was excited and slightly nervous about the brace and the fact that I just had this operation a mere week and a half ago.  I knew if I declined, I probably wouldn't be asked again for awhile.  I also knew that there had to be nurses around and maybe a doctor or two.  I mean, it's the Red Cross, right?

Long Overdue Update

Seriously?  It is October already?  Wow..how did that happen?  Geez, you are probably thinking I have been such a slacker now that I am officially finished with the entire "boobie" ordeal but, actually, I have soooooo much to tell you!  So, let's roll back the months to August when I underwent the final, final operation.


We just escaped Hurricane Irene while driving down I-95 en route to my friend's house in Lehigh Valley, PA.  Her electricity was out all day Sunday (in fact for 4 days thereafter) and I was concerned that the electricity would also be out in Philadelphia meaning the operation would be put off until later in the week.  I called our hotel and, luckily, all was well with PECO in Center City.  We drove down on Sunday to settle in to my new "residence" at Le Meridien for the next few days while I recovered.


Monday morning, we showed up at Pennsylvania Hospital and it was getting to be easier and easier for me to go through the black markups by Dr. Bucky as well as meeting the anesthesiologist and his staff.  It's hard to believe that last December I was so freaked out by "going under' and now I was like, "bring it"!  Of course there was the familiar bantering between the medical group which, always puts me at ease.  I told Dr. Bucky to err on the side of "more".  More is definitely MORE when removing fat from my body.  While he was marking me up, he asked if I wanted the fat taken from my stomach.  Uh, hell yeah, Dr. B.  I am over 45 and that stupid roll came out of left field somewhere between 46 and 47 years of age so, yesiree, take that roll and reduce that thing!  Finally, he asked if I would mind if he took some fat out of my armpit area.  Seriously?  And you actually had to ask me?


I woke up about an hour or so later (I think) and I had absolutely no trouble breathing coming out of the anesthesia.  In fact, I just felt a little bit sore in my tummy and my armpits.  He inserted the fat into my left breast so there wouldn't be an obvious ridge and it just felt a little "hard" if you will.  Seriously, this was not bad at all.  In fact, I only took one valium and then an Advil on occasion while I healed in my hotel room the next two days.  I did, however, have a velcro white brace around my tummy to keep the swelling in place.  It felt a little like one of those black braces that you had to wear if you were lifting heavy items to avoid hurting your lower back.  Or better yet....they felt like Spanx.


The plan was for me to drive back with Bob to South Carolina two days later in our mini SUV with sport suspension.  Right there, you should immediately gasp while reading "sport suspension".  What the hell was I thinking?  Twelve hours driving in a vehicle that feels every bump in the road?  I must have been on something when I came up with that brilliant idea.  Luckily, the moons were all aligned and an angel called Margie called me up at the last minute and asked if I wanted to attend the US Open in NY at the last minute.  This would mean I could recoup at my brother's house in NJ for a few more days and then take the Megabus up to NY only to fly home a few days after.  Did I mention that she also had box seats for the Open?  Count me "in"!

Final (Truly Final) Operation Next Monday

Today, I received a phone call from Dr. Bucky's office to reschedule my fat grafting operation from Wednesday to Monday which excites me to no end.  My husband and I had decided to make the drive up north more of a vacation by combining a road trip to New England with having to be in Philadelphia on August 30th.  I am writing to you from Maine after being in Vermont and Cape Cod.  I should be able to drive home the day after the operation and, right now, I am absolutely ready to get back home to South Carolina.  I will keep you all posted on how this very last operation goes and what is involved in terms of pain and healing.

Final Round of Chemo for My Sister- Number 6

I thought we could have a little fun with the use of "boobie" balloons!

Caryl had a great support group of friends and I was honored to be given a TEAM CA t-shirt that I will wear proudly during the Susan B Komen 3-Day walk in Atlanta.  (CA is her nickname for Caryl Ann).

The dreaded and evil "IV" sporting brown boobies!

This was Round 6 which was her last and final round of TCH chemo.  She now has to have Herceptin administered until April 2012 with a final 5-year Tamoxifen follow up.  To reiterate, she was diagnosed with DCIS but after her mastectomy, IDC was found in her right breast which prompted the chemotherapy treatment.  Please take DCIS and LCIS seriously.

My Sister Finishing Round 4 of 6 Chemo Treatments

My sister is pushing through.  Chemo is miserable and I wouldn't wish it upon my worst enemy.  Hang in there Caryl!  Two more rounds to go and then one year of Herceptin and five years of Tamoxifin.

One More Operation (seriously?)

Wow.  It certainly has been a long time since I posted.  I guess you probbly have figured out that my life is pretty much back to normal.  I am doing spinning classes religiously three times a week and have really watched my food intake in a major attempt to lose those 6 stubborn pounds acquired from this ordeal.  I know, I know.  It's only six pounds but I have tried to justify them telling myself that my boobs are so big now that they are the reason for the additional weight gain.  Unfortunately, I am just too smart to fall for that......and my clothes are too snug to ignore it.  Therfore, I am trying desperately to lose that ONE pound in hopes that the momentum will accelerate and the other five will follow shortly.  That, my friends, is the plan.


Now, onto the subject at hand.  One more operation.  Yes.  But here is the story.  Last week, I had my final check in with the amazing Dr. Bucky and his staff.  I was photographed for my records and everything looks pretty good.  When you look at my boobs, however, there is a sunken area at the very top part called the "upper pole" where it dips down since there is no breast tissue there anymore.  It was suggested by the good doctor that I have a fat graft done to alleviate that problem.  My deduction for the year has been met so I thought, hmmm, why not do everything now so that I can look as good as can be going forward.


"What is fat grafting?", you may ask.  It is where they take fat from one (or more) sections of your body and reposition it in another area of your body.  There is a chance that the body will absorb the fat but, for the most part, it should stay in place.  The fat is liposuctioned from the thigh or tummy area and then transfered into place.  I know, I know.  You are thinking, "Way to go girl!  That is surely one way to get rid of those six stupid pounds!"  Believe me.  That did cross my mind.  I now understand why people do plastic surgery.


My feeling, at this point, is that I have just gone through a mastectomy six months ago with three months of annoying tissue expanders and, gosh darn it, I am going to look the best that I can look.  Therefore, I am opting for the fat grafting....with the additional bonus of thinner, outer thighs!  Target date is the end of August 2011.....so I will be in touch :)

Happy Easter

A gift from Terrie whose partner has battled and fought breast cancer.  Yup...those two "knobs" are battery operated and blink red! :)

I Hate This

It's midnight and I am crying.  I guess it finally hit me that my sister has to endure chemo for a year starting next Tuesday and it just sucks.  Do you know the thing that really gets me?  The whole reason that I chose the mastectomy is to not have to have chemo (hopefully) in my lifetime and, lo and behold, my sister gets diagnosed with breast cancer, has her mastectomy and NOW has to endure chemo!  So, to say the least...I am sad, mad and hurting that she has to go through this.  It was bad enough to watch my mom go through it years and years ago and, here we are again.  The only thing that is different is that my mom did not do preventative chemo but, instead, had to go through it years later when the cancer returned in the form of bone cancer.  At least my sister is going through all of this as a preventative measure.

If you have LCIS and are contemplating what to do, my opinion strongly says to go through with the mastectomy.  My sister had the "wait and see and be vigilent" stance and now look what she has to do.  You can't predict the future but if you can prevent this misery, then by golly, give up those boobs and get on with life.  I will get off my soapbox now.  I feel better. Thank you for listening....and please say a prayer for my sister that this gets easier.

This is the video that my sister made for me for the Atlanta 3-day Walk for a Cure.  Absolutely fantastic!!!!  If you would like to donate and help me reach my goal, please go to http://www.the3day.org/goto/Arlene

Recent pictures so you can see that I am 95% back to normal after three months. The top picture is my husband, Bob, and his grand-daughter, Makina.  (He was married super young at 18..thus the 13 year old grand-daughter!)  The second picture is from this past weekend when I tried paddleboarding on the SC marshes for the first time.  Great core exercise and I know I will be doing more of this!!

I Got Clearance

This past Tuesday, I went to see Dr. Bucky with my list of questions and for him to look at his new creations.  I swear that man is amazing!  When I looked at pictures of augmented breasts from an A cup to a B or C cup, my breasts looked just like them.  So why is this so "amazing"?  When the breast surgeon removes all of the breast tissue, the breast is left as basically just skin.  Therefore, when the plastic surgeon inserts the implant into the muscle pocket created by the expanders, he has to recreate a breast without any tissue surrounding the implant and use only the silicone (or saline) implant to mold and recreate a new "breast".  If only I could post pictures so you could see exactly what I am referring to when I say "he is amazing"!I was a bit disappointed when I was knocked back from an A++ down to an A+ but that is my own fault.  As you have probably surmised so far, I hate taking drugs.  Even Val and I have parted ways permanently.  I hate taking drugs so much that I failed to take the important drug that he gave me at the end of the surgery which is Methylprednisolone.  So now, two weeks post-surgery, I am taking them.  Damn..I loved that A++ too!
Today, I am sitting at my laptop at home in Bluffton, South Carolina sipping my coffee and writing this all down.  It has been one heck of a journey and I am glad that I am at the end of it.  I will post on occasion so that you can gauge my progress but I really feel like the only thing left is for the scars to heal.  So far, the scars from the first operation are slowly fading and I have moved onto the cocoa butter option rather than the Neosporin treatment.  Every day, I have to massage the implants because this is the crucial time that they need to be moved so that they do not become hard and continue to soften to feel more breast-like.  In terms of comfort, well...I am not going to lie.  They are still "burning" but Dr. Bucky told me that it is the muscle that is just not used to having to change its shape forever.  It really doesn't like those implants in there and it is making its voice heard.  I hear you but TFB muscle....!!!


If there is anyone reading this blog and is contemplating going through a bi-lateral mastectomy, please please do not ever hesitate to email me or call me.  My email is carpetgeek@sbcglobal.net and I can send you my phone number if need be.  I hope I helped some people.  I've already heard from a few women and I truly enjoyed talking and emailing them.  The whole purpose of writing was to be candid and honest about LCIS and the mastectomy process. I hope I was insightful.  Thank you for listening to me while I wrote down my thoughts along this three month journey.

First Appointment After Surgery

After spending four nights in the hotel room blissfully happy watching TV in my pj's, we packed up and left for my in-laws.  I am feeling okay considering that I just had surgery a few days ago but I look a bit goofy with a big "X" on my forehead with surgical tape.  It is holding up the stitches on my new eyelids.  Even though I am wearing dark sunglasses, the big ole "X" is staring straight at you.  I am at the point right now where I just could care less.  Let's get these eyes healed and those boobs healed and let's move on!

I am having a bit of a tough time washing due to not getting water in any of the stitches but I am doing my best.  I finally washed my hair and, although it still looks like a bird's nest, it is clean.  Monday morning, Bob drove me back down to Philadelphia from his parent's house for the nurse to remove the stitches in my eye lids.  Piece of cake!  Seriously, this surgery was a breeze.  The results are very subtle and I am perfectly happy with them.  Now onto my new boobs.  I was given an A++ on healing.  In fact, the nurse asked if I wanted her to remove the stitches and let me travel home with Bob.  My thoughts were that we lived so far away and I had it all arranged so I wanted to stay the week at my friend's house and then get the clearance from th good doctor himself next Tuesday.  I mean...it's not as if I live right around the corner.

As a reward for my perfect "grade" of A++, Bob took me over to Nordstrom's and I was fitted for new bras since I sent mine to the women of Haiti.  Seriously, there is a woman in NYC that gathers bras from smaller breasted women in good condition and sends them to the shelters in Haiti for women to use.  I figured I was going to be bigger than I was in the past so I sent her all my bras.  I found a nice saleswoman and she measured me and then proceeded to look for very soft, non-padded bras for me with a little bit of underwire.  I settled on a Natori that was as light as a feather.  Good news??  I am now officially a 34B.  Yup....I have moved into the big girl bra section finally at 47 years of age.

Done!

After waiting for two hours after being told to get to the hospital by 9:30, I was ushered upstairs to prepare for surgery.  I got the entire routine down.  The anaestheologist had a hard time finding my vein so I have a bit of bruise on the back of my hand.  Oh...remember that rash I had from taking those pills, well it appeared right before surgery.  I was afraid that the doctor was going to cancel but he told me that while I was in surgery, large welts showed up on my skin so he had to give me a shot of cortisone.  I still don't even know what they were from.  When I came back to the recovery room, I felt so miserable. It was nothing that I read from others on the breast forum, which was more of a relief not pain.  The stitches burned under my boobs and all my muscles were contracting on my chest which hurt really bad.  I also couldn't catch my breath but the anaestheologist said I was breathing at 100%.  The nurse gave me some morphine and that really settled me down.I ended up staying two hours in recover until I felt well enough to go back to the hotel. 



The nurse came over and said that my husband had a cab ready.  Really?  A cab?  What was he thinking?  He said it was too cold to go and get the car.  I was livid!  I felt like crap and now I have to get into a cab with no cushions, no shocks and a crazy driver!  I was besides myself and pissed at my husband.  I know I could have been nicer but I felt like crap and I had to endure a bumpy ride which killed me.  When I entered the hotel, I had to hide my face because of the eyelift surgery that I elected to add on.  What the heck, right? 


I was told by the nurse that I should relax and wear my tiara and watch TV.  Soo that is what I have been doing under some drugs to keep the pinching at bay.  I have to say that the boobs look pretty good.  I am guessing that they are a full B which is what I was hoping for.  They are rounder and not pointy.  I think I can get the cleavage back when I eventually get fitted for new bras.  I sent my other ones to a shelter in Haiti since they collect bras for the displaced women there.

T Minus two and counting!

I cannot believe it but in two days I will be at the end of the reconstruction process and I am beside myself with happiness!  Of course a little anxiety needs to be added since these tissue expanders have now become a part of my body and they are leaving me.  It sounds silly but, as uncomfortable as these TEs are, I know how to work my day around them.  They will now be replaced with a softer, more realistic breast; however, I am anxious because I don't know what it will feel like.  I read other's comments who have gone through this surgery on the Breast Reconstruction forum on Breastcancer.org and the overwhelming consensus seems to declare that this surgery is much easier on the body and the implants are so much more comfortable.  That being said, I am still a little anxious.
We leave tomorrow morning to drive the twelve hours up to Philadelphia with one overnight stop.  My husband is so going to heaven after all of this!  I have the surgery Wednesday morning and I made hotel reservations since I can't imagine feeling horrible and having to stay at someone's house.  We will stay in the hotel until Saturday and then stay at my in-law's home.  I see the nurse on Monday and then my husband will drop me off at my friend's home to hang out for another week.  I have to see the plastic surgeon on the 22nd for the final exam so it does not make sense to drive home and then have to turn around and come back.  Once Bob drops me off, he will drive home and then I will fly back after the exam.  If all goes well, I will be cleared and will not have to come back to Philadelphia for another six months.  There is a chance that a "touch-up" fat grafting may be needed in which fat from my thighs can be extracted and use as a filler, if needed.  Hmmmmm......

I have been off Ibuprofen and all other medications for almost two weeks now which has prohibited me from exercising so once again, those pounds reared their ugly heads.  I just keep telling myself that it is all part of the process and eventually, once I am finished with this, I will have my exercise routine back on schedule.  On an added note, I was given high-potency vitamins which caused me to break out in an itchy rash on my mid-section.  I called the manufacturer and this has happened before so I discontinued use.  Unfotunately, I have not been able to get rid of the red rash but Benedryl has come in quite handy.  Once I am able to comment after the surgery, I will post my experience for you to read.  Good luck to me!

Great news!

I heard great news yesterday.  My sister got her results back from the breast surgeon and there was no evidence of cancer in her lymphnodes.  Yeah!  She is getting better each day but her recovery will take about six weeks.  The good thing is that when she is "done", she truly is done.  Whereas, I still have my final surgery on March 9th and then, hopefully, I will be done as well.As of this past Wednesday, I have had to eliminiate all drugs which means not even an ibuprofen can pass by my lips.  As a substitute for the drugs, I have been given a full box of pre-surgery vitamins.  Since I have never been pregnant before but have watched my friends go through their pregnancies over the years, I will equate these to pre-natal vitamins.  For the next two weeks, I have to take three large pills between breakfast and lunch and three huge pills at dinner.  The problem I have been having is that I don't eat very much so when I could finally take the first three pill dosage, I felt very queasy and still, to this day, have not managed to take any of the dinner pills yet.  I know I had better step it into gear because, starting three days before surgery, I have to add on yet another pill (Bromelain with Quercetin).  After surgery, I then take Arnica Montana 30X NINE times a day to help with swelling and bruising.  On a final note, I have been able to ride the stationary Precor bike and am now up to 45 minutes.  Yeah!  I also walked my first long walk which was about 5.5 miles.  I can wear gym attire and I look extremely normal but I sure as heck, still know that those tissue expanders are in my body.  I keep reading on the community breast blog that when I get the exchange, the new boobs will feel more like real ones and are much more comfortable.  Between you and me........I CANNOT WAIT!

Started Out as DIEP

My sister's bi-lateral mastectomy was last Wednesday.  If you read previous posts, she was told to gain 25 pounds to prepare her stomach to harvest the fat and tissue to recreate new boobs.  However, there was always a chance that there would not be enough "material" to harvest and the DIEP technique would have to become Tram-flap which would then mean stomach muscle would be used in addition to the fat and tissue.  Well, unfortunately after 12 hours in surgery, it started out as DIEP and ended up as a Tram-flap.
Why is there concern?  Tram-flap recovery is much longer since the muscle has now been cut and removed.  Also, there is a tendency to loose strength in the abdomen.  My sister is very active so, hopefully, this will not be the case.  She has been in the ICU for the past five days and I just heard from her (via text) that is going home today.  It has been brutal!
See, Caryl, I told you to consume more cookies and pasta!