Guilt feelings about second thoughts re-immediate reconstruction

I’m wiped today:). I’m booked to have a L mastectomy with immediate DIEP reconstruction (mid-Nov) and my team do not know that I am having second thoughts about the reconstruction. I’m petrified of the aftermath; I know that not everyone is the same, but I do worry that I may experience sensations in my chest where they’ve re-attached blood vessels, etc. as per what other women have described. I am sensitive to any pains/twinges in the chest area and some women have reported these can feel scary (and have gone to A&E in the middle of the night thinking they were having a heart attack). I don’t want to be one of those women. 

 

I am under the impression that immediate reconstruction is favoured (by surgeons) over delayed…but if a woman is not 100% certain (or is petrified)…does it not make more sense to delay the reconstruction? 

 

I have also sought a second opinion (I feel I am cheating on my team)-I do have trust in them but had a couple of questions I wanted a second opinion on. Spoke to a consultant this evening (from the 2nd opinion hospital) and they said that the DIEP surgeries at their hospital take 5-6 hours whereas I’ve been told mine will take 8. They said “we would consider that a complex procedure”-something of that nature, i.e., only if there were complications would our DIEPS take that long. Please keep in mind the hospital I’ve sought my second opinion from is *the* cancer place (in the UK). I am not naming names but you can probably guess. 

 

And so I am left wondering why are my team telling me it will take 8 hours? 

 

I am absolutely petrified that I will find the feelings in the chest (post-op) intolerable.

 

Can anyone who has had a DIEP describe to me what these feel like? Are they near the heart? I worry that I will think I’m having a heart attack. It’s scary. I live alone. I don’t want to have those sensations for however long post-op. I’m really nervous. Sorry for going on about it.

 

I’m prepared for the mastectomy-not so sure I’m mentally ready for the DIEP (though I don’t think I want to be flat either)-have considered a prosthesis till I am more ready for reconstruction but perhaps some reassurance that I will be fine is all I need. 

xxxx 

  

Hi Marla13

 

Easiest points first.  Your op may not take 8 hours, it is probably the amount of time they have booked the operating theatre for.  My own similar op took 7 hours 40 minutes BUT that includes the time in recovery whilst I came round and was sufficiently compos mentis enough to ask the question, what time is it?  I actually went down to theatre half an hour prior whilst I was prepped in the anaesthesia room (with much hilarity in the process may I add!)

 

There are significant differences between an immediate and delayed reconstruction from a cosmetic point of view.  With an immediate version you are likely to end up with a very small amount of abdominal skin being transferred to/on show on your breast.  Your scars are likely to be circular around where an areolar would be, I.e. may be disguised with a future tattoo.  With a delayed reconstruction after a period of going flat, more of your abdominal skin is used to make your new breast and you will end up probably with a horizontal scar right across your breast.

 

Regarding phantom pain, I have not experienced anything.  There are no nerve connections to the transferred flap and my retained skin just feels like normal breast skin.  I have never felt or been aware of my blood vessel connector.

 

I hope this is of some help.  Most of us have probably had a panic at some point about our surgery/treatment but it does get better really.

 

Ezzie. ?

Hi Marla,
Having a burst of overwhelming anxiety does happen pre-op & unfortunately, it does send the mind off in all sorts of tangents.
I had a much simpler wle & snb as a day case & even so, had a very wobbly half hour one night when it crossed my mind I didn’t want to go through with it.
As ever, the prospect is far worse than the reality, but you’re doing all you can to be as well informed as possible.
When the day cane, I felt so relieved the day had arrived, I relaxed & my bp went down!
ann x

Dear Maria, I am having second thoughts myself. I have chosen for immediate implant during mastectomy surgery. Now I am thinking, is it worth it? How will it affect my health and possible future cancer treatments? It may not come out as good as the photos I have been shown, they almost seem too good to be true. Just going flat seems the healthiest option, but you and I also have to think about our mental health and wellbeing.

I am sure the BC team knows you are having second thoughts because I think almost everyone has.

Take care