I have made my decision.  I will be going with a free flap reconstruction, most likely the IGAP.  From butt to boob! I have to get an angiogram to check my blood vessels first to make sure everything is good.  But barring any unforeseen issues, I will be going for surgery on March 24th.  Not looking forward to the long anesthesia and recovery but this type of surgery is probably the best for me.

I eventually want to go back to working full duty which means wearing a uniform and a gun belt that weighs at least 25 pounds.  I thought about that before making my decision.  A TRAM flap would have meant removing muscle and tissue from my abdomen.  I couldn’t imagine how uncomfortable or painful wearing the heavy gun belt around my waist would be.

I saw the second plastic surgeon, Dr. U on Friday.  He explained the whole surgery to me and showed me a power point of a DIEP surgery.  He then explained the IGAP surgery and possible complications.  He explained that the wound recovery will probably be a little longer because of where the incisions are (I’ll be sitting on them!)  It’s crazy.  I realized doing a lot of regular things will be difficult, such as sitting on a toilet!!!!  Dr. U stated that surgery will be about 6 hours, though I thought Dr. L stated that it would be closer to 8 hours.  Dr. U stated 3-4 days in the hospital.  The length of the hospital stay depends on whether there are any complications.

Little nervous.  Tomorrow is the MR angiogram.  I don’t do well in MRI’s.  A little too tight for my liking.  I’ll deal with it though.  Xanax anyone?  Still not sure how it’s going to work out.  I was told before that my expander was incompatible with MRI’s.  The place doing the test knows this.  I guess I will find out tomorrow.

I go back to see Dr. L on Friday.  Using the MR Angiogram, he will mark up my body to show which arteries and such he will be removing to re-attach for my new breast.

I will keep you updated as I go.  Please keep me in your prayers!

I still haven’t had breast reconstruction yet, though I will soon.  I visited another plastic surgeon on Friday for a second opinion regarding reconstruction.  As for DIEP, he doesn’t recommend it.  He feels I don’t have enough fat in my stomach to make both breasts.  I need tissue/fat to fill out the left breast but I need a good deal of skin, tissue, and fat to make the whole right breast mound.  He would do IGAP, where tissue, fat, and skin are removed from my lower buttocks to make a new breast or SGAP, where the fat, tissue and skin is removed from my upper buttocks.  (I have more than enough chunk there)!  On the plus side, I would get a butt lift.

As noted in a past post, my plastic surgeon does a muscle sparing TRAM flap.  If I get this surgery, I will most likely never do a sit up, crunch, or leg lift again.  I spoke to a friend who had a TRAM flap about 5 years ago.  She said that if she had the choice, she would have gone with one of the “free flap” procedures.  This may hinder my Tae Kwon Do and my “Hip Hop Abs”.  I am concerned about the time I will be under anesthesia if I go with IGAP.  I will make my decision this week.

I started Weight Watchers last week.  I am trying to lose the chemo & steroid & menopause weight I gained over the last year and change.  I’ve been eating more fruit and veggies.  We’ll see how this goes.  I was going to wait until after surgery but surgery kept getting pushed back.

Gillian and I had a nice time together this past week.  We went up to Albany last Saturday (as opposed to this past Saturday) so Gillian could participate in a sparring exhibition.  It was nice watching her fight.  She really loves it!  Watch out for the head kicks.

Last week was “Kids Night On Broadway”.  Tickets were buy one get one free and I was able to get tickets to two shows.  (Thank you pre-sale!).  We saw “Pippin” on Tuesday night and “Lion King” on Wednesday night.  Both were wonderful but both Gillian and I loved “Pippin” the best.  “Pippin” was a more traditional Broadway show.  I got the idea to see “Pippin” while watching the Macy’s Thanksgiving Parade.  They had a short excerpt which really caught my eye.  I’m glad we saw it.  Gillian and I went out to eat after the show.  Yummy steak!  We stayed over in NYC.  She sat with me at work for two hours on Tuesday (I was supposed to be off) and for about 10 hours on Wednesday.  Gillian got to see how crazy it gets when I have a “Stat” meeting.  I had a Boro Traffic Stat meeting Thursday at noon.  While I was preparing for the meeting, she sat at another desk and worked on a project for school.  We went out for lunch at “Tea & Sympathy” and then it was back to work.  We left at around 7:35 to catch Lion King.  Charles met us after the show to pick up Gillian.  I was supposed to take her home, but I had to stick around to finish getting prepared for Traffic Stat.  Instead of working 1600×0100 on Thursday, I worked 0530×1620.  Needless to say by Friday, I was exhausted!

I was supposed to have three doctor’s appointments on Friday.  I made it to one.  I am re-scheduling the other two for this week.

I see the pulmonologist next Friday to make sure lungs are all clear and I’m good to go for surgery!  I will update when I have a date.

Xavier is home for two weeks for Spring Break.  It’s nice having him home.  Chris has been coming home almost every weekend.  (With all this snow, he’s been having a blast snowboarding!)

Continue to pray for my friends battling cancer.  The fight continues for many of them.

 I had to post this pic.  Gillian tried on one of my wigs to see what she would look like with straight hair and bangs.  I think she looks cute!

Glossary:

The TRAM flap (transverse rectus abdominus myocutaneous) is a tissue flap procedure that uses muscle, fat and skin from your abdomen to create a new breast mound after a mastectomy.  This procedure takes its name from the transverse rectus abdominus muscle in your abdomen.  There are two ways to do a TRAM flap —  as a free (detatched) tissue flap, and as a pedicle (attached and tunneled) tissue flap.

DIEP breast reconstruction is an advanced technique in autologous (own tissue) transfer. DIEP is a refined version of the TRAM flap, in that the DIEP utilizes only the blood vessels, fat and skin from the abdomen. Unlike the TRAM flap, DIEP preserves the rectus abdominus muscle(s) thus allowing for preservation of abdominal strength and integrity.

The SGAP flap (superior gluteal artery perforator) is a tissue flap procedure that uses fat and skin from your upper buttock to create a new breast mound.  You won’t need to have any gluteal muscle cut or moved for a SGAP reconstruction.  This procedure takes its name from the superior gluteal artery perforator in your upper buttock.  Your plastic surgeon will use microsurgery to reconnect the artery from your tissue flap to your chest area.

The IGAP flap (inferior gluteal artery perforator) is an autologous tissue flap procedure that uses fat and skin from your lower buttock to create a new breast mound.  None of your gluteal muscle will be cut or moved for an IGAP reconstruction.  This procedure is named for the inferior gluteal artery perforator in your lower buttock.

An IGAP breast reconstruction is very similar to the SGAP procedure, and differs in only one way: IGAP uses tissue taken from your lower buttock, SGAP uses tissue from your upper buttock. Both are free flap reconstructions that use microsurgery to reconnect an artery from your tissue flap to your chest area to create a breast mound. Most women have enough tissue on their buttocks to create a new breast. The removal of skin and fat from your buttock is similar to the procedure for a buttock lift, but includes an artery and vein that will supply blood to the transplanted tissue.