DIEP Flap Surgery: Day one, Phase one

hospital nurse checking inCheck-in

It was still dark outside the morning we left for phase one of my DIEP flap breast reconstruction surgery. We were told to be at the hospital at 6 a.m. Monday morning following Thanksgiving weekend had to be a good day for surgery. My surgeon had time to be with his family, enjoy a feast and be all rested up. It was a new week and a brand new month, December 1. We arrived at the hospital and signed all the paperwork for check in. The wait wasn’t too long but the room we waited in was the typical sterile, hospital environment, fluorescent lighting with CNN on the TV. They had coffee available but nothing for me, thank you very much. I had been on complete fasting since midnight.

They took us up to another smaller and quieter waiting area where all patients were checked in and waiting to be called back for their own specific surgeries. I was wondering if any of them were going to be “on the table” most of the day like I knew I was going to be. Most people, family and otherwise, are sitting rather quietly either out of respect for others or simply because they know it’s “go time” and there is not much more that can be done or said at this point because today is surgery day.

Prep and a Big Bair Paw

I was taken to a prep area but this time alone. My husband had to stay in the waiting area while they asked me some questions and prepped me. After they took my blood pressure, temperature and weight I began the standard disrobing, putting all my clothes into a bag to be given to my husband when I would meet him in the surgical waiting area. I was put into a blue gown called a Bair Paw. I was glad to know this would regulate my body temperature during surgery because I tend to run cold more often than not. I also tend to start shivering before surgery either because of nerves, the IV drugs or the temperature of the room. No nerves that morning. I was calm as a cucumber and so ready. In fact, I wasn’t cold either. The Bair Paw was doing its job!

I was given a blood test to test my clotting factor. It was a simple stick and the nurse assistant took a small, white, circular pad and timed the absorption of my blood. It took around eight minutes to complete the test. She stopped the timing of it when the tiny drops of blood finally stopped producing onto the little pad. I asked her questions about it as she was doing it so I could understand the process of the blood clotting test. But, I had never had surgery that lasted a full work day plus either so I was glad to know they were checking my blood clotting factors!

Meeting the Team

I was then wheeled to the pre-op room and was reunited with my husband. This is where all the action took place to get me ready for the big day and my DIEP flap surgery. It was crazy busy that morning. My husband and I glanced at each other and gave a quick smile as if to say, “This may take a while.” Not the case at all. In minutes, the nurse came in, introduced herself and started asking questions and writing them down on her clip board. Then a woman walked in with a very brightly colored shirt and a warm smile. She introduced herself as my anesthesiologist and told me “You’re all mine for the day.” I told her about my tendency to get sick after surgery. Again, a warm smile and reassurance that she was going to give me just the right mix of cocktail so that would not happen. She placed a scopolamine patch behind my ear to curtail any nausea after surgery and I reminded myself not to touch it. I made the mistake of doing that after surgery one time and then rubbed my eye. I got a weird sensation in my eyes from the medication on the patch so fair warning from one who did it! Don’t touch your eyes if you happen to rub your scopolamine patch! I also reminded her that I have mild TMJ as I knew that I would be intubated that day. She asked me to open my mouth as wide as I could and assured me it was not a problem. As she was leaving I asked her name. She looked at me and said, “Oh, I’m Stacy.” The fact that she didn’t even use “Dr.” lead me to believe I was going to wake up just fine.

The surgical nurse came into the room and went through the procedure for communicating with my husband during the day. I was so relieved when she told him to either go back to our vacation rental and rest or go Christmas shopping. Remember, it was December 1. That was music to my ears. My husband is not fond of hospitals under any circumstances so I was very relieved to know he could leave that day and still remain well informed.

Dr. Cool

Then Dr. C walked in as if he was strolling through a market on a leisurely Saturday morning. He had a broad smile and if he had fulfilled his self-proclaimed “coffee addict” dose for the morning it didn’t seem to be affecting him in the least. He was as calm as a cucumber. We had a good laugh over the fact that he had been in our hometown over the Thanksgiving holiday with his wife and two daughters to watch his oldest one in a tennis tournament. We joked about the fact that we must have just missed each other at the airport.

He carried on some light chat and shared a couple of laughs with my hubby. Then he politely asked if he could “take a look” and got to work with his keen eye and the surgical marking pen. He explained that he would have to make a little larger flap than he normally does. I was having a delayed DIEP flap and my skin was seven months post surgery from a bilateral mastectomy. My physical therapist worked the skin and scars good over a two month period and showed me how to keep it pliable as well but… it is what it is and he was being his usual honest and forthright self explaining everything he would be doing to achieve the best patient outcomes to the last detail. Since I had radiation on my left side twelve years previously I was going to give him a bit of a challenge for the day in removing it and placing the flaps under the nipple area. He carefully marked the areas that he would be working on and then quietly said, “I’m happy with that.” Confidence!

Never an Easy Stickneedle

As he was talking to me the nurse was trying diligently to get one of the two IV’s into the vein in my left hand that I would have in for the entire five days in the hospital. Through no fault of hers the vein she was using collapsed. This was not an uncommon occurrence for me as my skin and veins took a beating during the eighteen weeks I was on chemo twelve years prior to this surgery. I was used to it happening but I was trying to smile through the pain as I chatted with Dr. C. She eventually had to re-stick me right at the bend in my wrist, not a good place to have an IV for almost a week but again, it is what it is.

The nurse that would be with Dr. C all day told hubby to keep his phone close by and they would call him frequently with updates and that she did. Hubby would know when my surgeon had found the perforators. He would know when the flap had been successfully transferred and he would know when I was extubated (breathing tube removed) and in recovery.

gifted handsGifted Hands

Dr. C looked at me and asked if I was ready. He stood close by my side as my husband watched this exchange between my surgeon and me. I took Dr. C’s hand and said to him, “One of the first things I noticed about you were your hands. When I first saw them as you were examining me for my consult I thought to myself, that is one damn good surgeon.”

At that, Dr. C put his free hand out in front of him and looked at it as if to say, “What the hell is she talking about?” We looked each other square in the eyes and I quietly said, “I wish you and these gifted hands Godspeed today.” He softened his look, smiled at me kindly and said, “Thank you Terri.” With that, they wheeled me off to the surgical room. Stacy, my anesthesiologist was waiting to start “Miller time” and put me to sleep. We mentioned the fact we should be doing a dance. I told her I had the perfect song on my phone. When she asked what it was I told her, “End of the Line” by the Traveling Wilburys. I thought it seemed appropriate since I already had two lines in me. She said, “Hey, I’ve got that on my phone.” She played it for a few minutes and then put me to sleep.

“That’s a Wrap!”

My surgeon came out and spoke to my husband with a summation of the day’s work. He had to remove a lot of scar tissue from radiation twelve years ago. He also had to make a larger flap because of the nature of my mastectomy and being a delayed DIEP surgery. My husband always gets straight to the point. My surgeon had already more than impressed my husband at our initial consult in October. He looked at Dr. C and asked, “Are YOU happy with the results?” Dr. C’s answer, “I am.” My husband mentioned to him that he looked pretty fresh considering the length of the surgery and that only his eyes looked a bit red. Dr. C replied, “It’s the loupes. Wearing those a good part of the day will do it.”

Now it’s time to wake up and begin the recovery. Next blog…….




References made to my surgical group, surgeon and healthcare team are made because they are aligned with my values and met my criterion after I did research of their practices and success rates. Any other healthcare provider that displays the same skill, compassion education and outreach to patients will be given consideration and recognition on this website.  The information contained on this website is not a substitute for or should be construed as medical advice. Please consult a licensed physician for medical advice.

2 Replies to “DIEP Flap Surgery: Day one, Phase one”

  1. Alene Nitzky

    Reading these accounts are informative for patients considering the procedure and for anyone who hasn’t undergone this surgery but wants to know more, and there’s nothing better than the patient’s own perspective. Thanks for making the effort to share this, Terri!

    • Terri Post author

      Absolutely, Alene! You’re very welcome. It is a sense of comfort for all of us when we can see what someone else has been through.

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