Thursday, December 20, 2007

Chat with the plastic surgeon

It's 9:30 and I just got off the phone with Dr. S, the plastic surgeon. He told me yesterday that he'd call back today to see how I felt about things. I told him that I would like to try the DIEP flap procedure but had a couple questions.

Yesterday he mentioned that there is a chance that the tissue is not viable due to a number of reasons. I asked him at what point will he know that it's not viable, and what are the options. He said he won't know until the time of surgery or shortly thereafter. The tissue could 'die on the table' which will make it unusable. Also, my prior c-section could have caused significant damage or the tissue could die after the surgery which would require removal.

If the tissue dies on the table or they cannot match up the arteries or whatever, he will insert tissue expanders into my breast at the time of surgery, which gives me the opportunity to insert implants at a later date. If the tissue dies during the recovery period we'll have to schedule another surgery.

He also said that the DIEP flap wasn't a given. He had to get approval from Dr. K. I asked him what events would cause Dr. K to nix the procedure. He said they generally won't do it if there's a chance of chemo. I believe Dr. K mentioned that there really wasn't any chance that I would need chemo, but Dr. S needs to hear that himself. He also said that my mastectomy would be more difficult than most because I have especially large breasts, so the surgery will last longer than 'normal'. Dr. K might feel it's too risky to have both surgeries going on at once, or have the surgeries going on so long.

Dr. S is going to call Dr. K tomorrow. He is usually in the Monday cancer board meeting, but was unable to participate in last Monday's session where they discussed my case. It would have been so much easier if he had been, so he'd already be up to date. (Oh well!)

Dr. S mentioned that there have been several cases where he and Dr. K have disagreed with a patient and refused to do the requested surgery. They will not do something they don't believe in 100%. He said he feels like I am the ideal candidate for the DIEP flap and wouldn't have recommended it if I weren't, but Dr. K has to agree. Oh and he also said something curious. He said that he is in this business to help cancer patients. He said it really bothers him when people demand the flap procedure, just to get the free tummy tuck. He said that the cancer is the number one priority and the aesthetics come second. I gotta respect him for that, but I'm happy he wasn't at dinner with Jaime and I tonight when I was giddy talking about my new bikini body!

Anyway, if I don't do this, then I'm honestly not sure what I'm going to do about the implants. I'm wondering if I want to bother with them. That will be a much longer decision, I think.

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