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Recovering from exchange surgery

sandra4611's picture
Posts: 121
Joined: Sep 2013

I had surgery #3 three days ago to continue reconstruction. Three months ago I had "BMX with direct to implants" which is a one and done operation. Unfortunately I developed an infection in the hospital that caused surgery #2 fourtenn days after the first one. The plastic surgeon had to remove necrotic (dead) parts of three muscles and lots of soft tissue under my arm and about 1/4 of the skin covering the implant, as well as the implant itself. There was no longer enough skin to cover it. Instead I got a tissue expander to try to grow some new skin in order to put in another implant. It took another three weeks on IV antibiotics to finally chase the infection away and start the saline fills into the TE.

Surgery #3 went fine. I was really nervous about another infection, but fingers crossed, so far so good. They took out the TE and replaced it with a smaller anatomical implant. They also took out the "good implant" that had never given me a minute of trouble in 3 months. I was sorry to lose it, but it was so much bigger, it had to be replaced with an implant to match the other side.

This surgery is much more painful than the last one. Most of the people I've talked to who had the exchange procedure breezed through it. My plastic surgeon had created pockets for the first implants in surgery#1 but now they were too big. That would cause these new implants to move around, which isn't good. So he had to reconstruct smaller pockets. Ouch! My ribs are killing me. I was not expecting this pain and was pretty upset at first since I'm allergic to narcotics of all kinds and can only take Tylenol. Today is better than yesterday so by next week I should be fine. I wish someone had told me that exchange surgery isn't always a walk in the park.

CypressCynthia's picture
Posts: 4017
Joined: Oct 2009

I am so sorry to hear about your pain.  Can you take NSAIDS such as advil, aleve, etc.?  They are not narcotics.  If so, you might ask about ketorolac tromethamine (toradol).  It is a prescription NSAID that works well on moderately severe pain.  It is often used directly after surgery for those who can't tolerate narcotics.  My younger sister uses it when she has surgery.  She just doesn't tolerate narcotics at all.

Everyone recovers from surgery differently, but tylenol would not be adequate pain coverage for most.  If you can't tolerate NSAID's either, then you can ask about adding a medication that might potentiate the tylenol such as an antidepressant or an anticonvulsant.

One thing I would not do is suffer in silence.  Pain can prolong recovery.  Talk with your healthcare team and try and find a workable solution.

Hugs and Prayers and hope you feel better soon!

hope67's picture
Posts: 181
Joined: Apr 2013

I am sorry that you are in pain. I hope you'll recover quickly. It seems to me that each surgery is a story by itself. For me my second mastectomy was way more painful than the first one. And I am not really looking forward to exchange surgery which will be I guess in about 3 months.

Good recovery, Carmen

sandra4611's picture
Posts: 121
Joined: Sep 2013

Wish I could take torodol. The first and last time I tried it, I ended up in cardiac ICU after a code blue. It's on my allergy list but I've often wished they would let me try it again. The first time I had coded on stadol 24 hrs prior in the ER, and dilaudid about 2 hrs prior, also in the ER. They  got me back both times, gave me narcon again, and admitted me to the cardiac floor. They said torodol should be fine since it's not a narcotic. No such luck. My husband was with me that time and he said I was talking to him one second and dead the next! I just remember opening my eyes later to a male nurse stradling my body, giving me CPR and shouting, "Don't close your eyes!" as we headed up to ICU.

I wonder if all the drugs in my system in such a short period of time caused the problem with torodol. I've asked several times to let me try it, but they won't. Chickens! So I've had only Tylenol for the past 10 years. Forotunately I have a high pain tolerance, so along with biofeedback, I can keep pain to a tolerable level. But boy, this surgery was painful. The PS had to do lots of pocket work and my lower ribs are so painful.

I will ask tomorrow about adding another medication that might boost the effect of Tylenol. I had never heard of that but it sounds like it could work. Thanks so much for your help.

sandra4611's picture
Posts: 121
Joined: Sep 2013

Carmen, everybody I know has said the exchange is so easy compared to the mastectomy, so you should do fine.  If it's a simple exchange with no pocket work, you should sail through it. But you are right, each surgery seems to have it's own path. I had no problem with the first two surgeries but this one kicked my butt.

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