Anyone had radiation after DIEP?

[Callygee]

My PS doesn't want to do DIEP before radiation. I want this over with, it's been a long haul.
I'm trying to negotiate my emotions with my intellect - I understand most suggest DIEP flap reconstruction AFTER radiation, but I know some have had it before successfully, I'm sure some unsuccessfully. I'm desperately seeking others who have been here, before my scheduled unilateral mastectomy early May. HElp! and thank you.

[lhughes]

Glad to be of service, keep chin up!  And someday soon you can stick both breasts out again!

PS...had an update appt with my radiation onc.  She's wonderful.  No more problems detected at this time.  See my reg onc in June for his assessment and probably round 4 of testing in December again.  Am I starting to glow?

[Callygee]

Thanks Lisa, Making the connection - the words & intellect finally reaching out to my emotions - and the emotions slowing down enough to grab hold, come along.

Sometimes I think it's all really about denial. I still keep wondering when that "stand in" will show up to take my place in this line. Good thing my girls are older, we have no family here & my parents are well into their 80s (in NY). I  feel pretty lucky about still having them, even at a distance.  

So now, my concerns are confidence in this PS. I've heard good things about him. Do you know how many DIEPS your Doc did? Going further away would be tough (family-wise), but IF I'm going to be tortured, I'd like to make sure I get the best possible result. I'm being treated at the Ireland Cancer Center (University Hospitals/Case Med school.) They really are top notch, with the Cleveland Clinic here too. I'll call the Clinic today & see what their PS is about. I absolutely esteem & implicitly trust my breast surgeon. He has confidence in this PS.
Lisa, I guess you don't have more kids than I. Having these 2 girls, 21 months apart is one of my biggest gifts in life. They are amazing people and continue to become so more & more. We are very close, adore one another  & they motivate me. DH works very hard & is solid as a rock, here for the long run, if somewhat unresponsive to requests & unable to communicate much. (He's from Wyoming/Nebraska border). What's a nice little Jewish girl from NY doing with a western independent? Making a life.

So Lisa, your communications just straighten the tracks for me. Your voice is clear, your kindness, generosity & smarts evident in your clacks. Thank you.I hope you do know how much you help.

Why did the patient take all the treatments?
To get to the other side.

Thanks again, be well, Cally

[lhughes]

Yes, chemo will make you emotional.  Cancer will make you emotional.  Heck, having kids will make you emotional...and crazy!!!

Ok...here's sanity from the other end.... EVERYTHING IS TEMPORARY.  You will not have any more or less scars (emotional or otherwise) if you wait.  Go with what your doc is comfortable with.  I'm like you, I thought I was going to get my breast back before radiation, and I also cried like a baby when she told me "no".  Hormones I attributed to post-pregnancy and really wanting to get things OVER.  

Ask your doc that does the DIEP if he's had any failures, what are the procedures if it fails, what do they do to ensure all they can to help it not fail....same questions you would ask for any procedure.  What is the level of care at the two different hospitals?  UAB was awesome and much more proactive than I remember when my mom had her tram (which failed..different hospital).  Go with whoever provides the best care for "potentially bad situations".  You want someone who is going to be able to handle the good with the bad.

Oh, and you'll have a period of time after the radiation when you won't be able to have the surgery either.  Sorry.  Didn't know that one either.  But, turned out good, even though my initial appt with my surgeon ended up getting pushed to March (from Jan).  Radiation ended the previous August.

All things in their time.  You want to heal from the radiation before you go another round of surgery.  You will be so much stronger and better able to handle the surgery.  Radiation is not bad, but it will tire you out endlessly because it's an every-day activity.  Not difficult, but tiresome.  If your daughter thinks mono makes her tired, you are also going to join her in tired.  I've had mono, and yeah, radiation tired equates pretty good.

Sorry to hear about the mono though.  Mine lasted for over a year and then after that it seemed forever before I felt "good" again all the time.

My surgery was almost 7 hours.  Hubby stayed with me most of the stay in the hospital.   My mom handled the girls.  They stayed mostly at her house for the first 4 weeks until I was able to physically pick them up on my lap (yes, a little early).  I went down there every day to be with them, but mom had to do all the lifting and stuff.  I hear the DIEP is not as involved since it doesn't take muscle, so you may be good to go before I was.

Oh, and if they don't get the nipple on during surgery (I didn't).  You'll wait a period of time, then get the nipple (in office procedure), then wait a period of time and get the tattoo of the areola.  It seems to take FOREVER, but it doesn't.

As for getting there, I marked time on my calendar.  I did a count-down of my radiation.  Then when I got my appt with the surgeon, did a count-down until I got to see him...I'm anal about time, I guess.

Good luck to ya, it'll be beautiful in the end...or at least as good as a man-made breast can be!

[Callygee]

Thank you ladies!  Not often, but I was a mere puddle after realizing my PS wanted to wait - you know, another calendar year of out of pocket, another surgery, a scar to remind me, etc... Lisa, nice to hear you again, you've been so helpful before. I'm really worried that I'll have some sort of psychic scar while living with a "difugured"? chest, even for 6-7 months. How did you deal? (I'm very visual, but practical in the end) I guess I was hoping they could use less skin from my stomach if they did recon with skin sparing mastectomy. How long was your surgery? I know you also have kids (& more & younger than mine). Did you have family nearby> This has all been so incredibly diruptive to th efamily, esepcially since my older daughter (almost 15) has her 2nd case on mono. The kids are so sensitive to my treaments. But I guess all I have now is surgery, rads & surgery... befire hormone goobers. I've gotten so much helpful info from this board too:
http://community.breastcancer.org/
Strike, I've also been in touch with Dr. Allen's office in NY. (Microsurgery Breast Center?) I believe he perfected the procedure. Both NOLA (New Orleans) & NY are two of the best I glean, NY says wait, NOLA says it's okay tp recon before rads.
If I were in Co, I'd go  to NOLA. They also do S-GAp & I-GAp & wow, who wouldn't want the globs taken from one's bum, eh? I may end up going to NY if I have to wait anyway. I'm in Ohio, but from NY. It would be easier to work with th ePS here, about an hour+ away in Cleveland. My PS has done about 60 DIEPs. NY 100s. What do you ladies think about how much experience is needed? And thanks for your responses. I think the dwindling effects of chemo have also made it harder to deal with things. (any excuse will do - how 'bout cancer?) It's really good to have your support - helps get me through.

[Strike3]

I can't answer your question myself but in my travels around the internet I've found two other places where you could check for an answer if you don't get enough responses here.

1.  hopkinsbreastcenter.org - has a question site.  it's not always open for questions - but if you keep checking back you'll get through.  they do a lot of DIEP reconstructions.

2.  bcsupport.org is the other site -  - click on the Surgery/Reconstruction link and then the "Ask the doctor" link at the top of that page. The doctor who answers those questions is in New Orleans and specializes in DIEP's.  This should be the direct link:  http://members.boardhost.com/plastic/

Hope it helps. I'm headed to Hopkins next week to consult with them about DIEP's because no one in Colorado does them.  Good luck to you.

[lhughes]

My radiation onc recommended radiation before any type reconstruction to make sure they get it all and don't muck with the newly transplanted tissues.

It won't take long, and yes, it's a long haul.  You can do it, you are almost there.  You'll appreciate the results much better after radiation.  Radiation will burn/tan the skin, too.  Wouldn't want to harm the new stuff, would ya?

Hang in there.  It seems like a lifetime away, I've been there.  But, from this end, a year out from my reconstruction, it all seems like a bad dream now.  And the breast keeps looking better everyday.

You can do it.  Deep breath.  See the end of the rainbow???  You'll be there before you know it.  Best of luck on your upcoming surgery.

Lisa