SIEA Flap!

Hello, I'm back!

This blog is coming to you courtesy of these darn drain bottles which are becoming very irritating and kept me up most of the night last night. By 6:30 this morning, there was nothing to do but get up and see if the computer could distract me from the discomfort for a while.

Going back in time to Tuesday, June 20, the day of my surgery............. I awoke at 4:30 AM to prepare for going to the hospital at 5:30 AM. I was forbidden to eat anything so had to satisfy myself with a shower, some last minute packing (what do you pack to go to the hospital for surgery? - nothing but a soft surgical bra to go home in) and some last minute cleaning - why not?

The time was quickly approaching and I was nervous. Dad drove me over to the hospital and vowed to stay there through the whole surgery (which he did - God Bless Him!) On the way, we had a very large scare. We missed the turn off and had to exit at the next one to come back on the freeway. As we made our way down the exit ramp, our light was green - very green. Dad was going very slowly and I remember wondering why. Just as we arrived at the intersection, a car came speeding through it from the cross street - right through a light that had been red for a very long time - no slow down, no look, no stop, no notice of the car in the lane next to him that was stopped at the red light. Dad slammed on the breaks and we stopped at the green light. A second faster and we would have been in the intersection and been hit - surely with some fatality due to the speed of the other driver. The light turned red and we sat there catching our breaths and our hearts. My mind was off the surgery for a minute. Thank goodness we were all right.

The light turned green again and we cautiously entered the intersection and made our way back to the freeway and to the hospital. At the hospital, I was quickly tagged and soon speaking with the anesthesiologist who ran an IV into my left arm and started my fluids. The nurse tending me told me that she had the same operation done by my Dr., Dr. W in August the year before and she was thrilled with the results. I was then walked into the OR. I climbed up on the bed as the various nurses and attendants introduced themselves - and, of course, I remember all of them right? ;) Dr. W was there looking at what I quickly recognized were pictures of the MRI on my left breast on the computer. She invited me to sit up and have a look, too. Then she showed me the lump in my left breast that she intended to remove before doing the mastopexy (lift) on my left breast which would take place if all went well with the procedure to rebuild my right breast and if I didn't lose too much blood. The lump was a fibroadenoma that Dr. K and I had found earlier - not expected to be cancerous but would be biopsied nevertheless.

I don't remember anything after that until the recovery people calling my name as I came out of a nightmare - can't remember what it was about - just remember it being a nightmare and asking what was wrong and why we weren't going to proceed with the surgery. They said it was done and that it was 5:00PM. The whole day had gone by!

And, then.....the agonizing pain! No, not along any of the incision points or surgical areas. A nurse was flexing my right arm and I had the worst pain in the crook of my elbow - agonizing! The tears were flowing uncontrolled from my eyes in big floods. You cannot imagine the pain. "Did you stick a needle in that arm?", I cried? My biggest fear. As a mastectomy patient, with nodes removed, no blood pressure can be taken, no finger sticks or needles in my right arm for the rest of my life or I risk a situation called lymphodema in which the arm fills with fluid and remains swollen, sore and semi useless and cannot be correted. Why was my right arm hurting so? They said no needles had gone in and that the muscle just needed to be worked to get it to stretch out again as they administered pain killers and Zofram for the nausea.

Through all of this, Dr. W came up and told me that they had been able to remove the lump and lift the other breast. She also delivered the most wonderful news of all.

As The Breast Reconstruction Guidebook puts it, "In a small percentage of women, the dominant blood supply to the lower abdomen is the Superficial Inferior Epigastric Artery (SIEA), rather than the DIEP. For these women the SIEA flap is performed. This procedure is similar and the cosmetic result is essentially the same a DIEP flap. But because the SIEA runs through the fatty tissue just beneath the skin, the blood vessels required for the flap can be accessed without dissecting the muscle."

I was one of those few women listed above and I had a SIEA flap! No muscle was touched - the kindest surgery of all for the donor site (abdomen). The surgery went quickly - about 7 hours and everything was accomplished. A minimum of blood was lost and no transfusion required.

This was all wonderful news! Despite the extreme pain in my arm, I had a big smile pasted on my face through the tears and couldn't wait to tell everyone my great news.

Dad came in soon after and I told him. I was proud of myself that, despite the anesthesia, I could remember things that had just happened and even come up with words like fibroadenoma. It meant that my brain function was doing well. And of course, the news was wonderful.

They were soon moving me up to the TCU (transitional care unit).