Carta de Crédito Standby Irrevocable Confirmada. (DOCUMENTO 11-A)

Initially, your tummy will be tight, and your bed will be flexed at your hips to make you feel more comfortable. Drains will be used for the abdominal wound and also for the breast site. Your room will be kept warm and you’ll find it difficult to stand straight in the early days after surgery. You’ll begin to mobilise early on, and you may well experience abdominal tightness, which will ease with time.

You’re likely to have a small catheter in your bladder to help you pass urine without having to get up to use the toilet. The catheter also allows very careful monitoring of your body fluids and kidney function, both of which are important for good recovery. Your surgeon may advise you to wear leg stockings or to have injections to thin your blood. This is because your surgery takes a long time, and you’re likely to spend the early days in bed. During the early stages of your recovery, pain will be kept to a minimum using a number of tech - niques, including patient-controlled analgesia (PCA). It’s im portant that any pain is kept at bay to build up your confidence and to get you going as soon as possible after your surgery.

If you’re having both breasts reconstructed, then your surgeon may decide to use both rectus muscles, a so-called ‘bipedicled’ TRAM flap. When your flap is harvested, it’s left attached to both muscles and then divided in half. So each half is supplied with blood from its own pedicle or ‘umbilical’ cord, and is used to reconstruct one of the missing breasts.

A TRAM flap is a long operation, and there will be some blood loss. This will make you feel tired for some weeks after surgery while you restore your own levels. Blood transfusion is rarely required. If you’re undergoing any major surgery such as reconstruction of both of your breasts, it may be possible for you to donate some of your blood a few weeks in advance. This can then be stored and given back to you during your operation – an ‘auto-transfusion’.

I found it hard to move when I first woke up after the operation. There were drains, a drip and it felt sore rather than painful. I sat in

the chair after three days and had to use every single muscle in my body just to stay upright. When I first started walking, I felt as though I had lead weights on the end of my legs. I found it shocking

looking at the breast and tummy scar at first but now I don’t take any notice of it at all. The exercises were painful but it became easier. Doing a little bit at a time helps you to get a bit further. The most difficult things to do at first were walking because the

scar went from hip to hip and reaching for things. I couldn’t do an awful lot for the first month. I managed to walk around the

house and up and down the stairs. Now and again I tried something more difficult. After that, I started looking after the

house. I felt like a fraud and didn’t like accepting help because I was used to doing a busy cleaning job as well as doing everything

for my family. Once the pulling sensation went, it was much easier. It took a good six months to get back to my usual activities

but I did have chemotherapy in that time.

Sometimes, I just did not want the family to see me and I just didn’t feel like myself but I got over it in time. They were just feelings that you go through. I do go dancing again now and love

that. Having my family around me helped me get through it and they need me now just as much as before, even my new

grandchild does.

Because of the long anaesthetic, I wasn’t too with it for the rest of the day after the operation. All the things like oxygen, drainage bottles and a drip were manageable. It was four days before I got to the bathroom on my own. When you take your first steps, you feel the stitches pulling in your abdomen. It wasn’t

painful, just very uncomfortable.

I looked at my new breast as soon as I was conscious enough. I was impressed with it and it was a relief to see it. My husband

was also impressed when I showed him in hospital. I blow-dried my hair with the affected arm and I could get washed and walk across the ward to talk to people after five

days. I went home after a week.

I couldn’t do a lot when I first went home. My husband did the cooking and looked after me. One of the main things that strikes you is how tired you get. You very quickly find out that you can’t do what you thought you could. It is easy to become impatient. I found that I got used to it and settled into making the most of

being at home.

I drove again after two months. That wasn’t purely because of the physical side. I felt that because I had been out of it for so long, I

wasn’t sure that I was up to speed mentally.

I went back to work after ten months and had a staggered return. I have been back at work full-time for a year and I do get tired

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sometimes but I think that I would have done anyway. I have quite a demanding job. There are no practical things that I still find difficult. The reconstruction has given me a very natural appearance. I am confident in my dress and day-to-day life. If I had to, I would do the

same again.

I had to stay in bed for the first three days after the reconstruction and the worst thing was that they had to keep me really warm. I suffered from hot flushes because the chemotherapy had put me through an early menopause. I had no problems with my breast and

didn’t have a lot of feeling in it. My tummy was the worst part to get over. It was painful for the first three weeks but improved after that. My first walk in hospital was awful because it was very painful

but once I had done that, things got better.

It was hard initially at home. Walking up the stairs was difficult but the more I did it, the easier it became. My husband was at home to help me. I started to do more around the house after six weeks and the wound healed up really well. I did no heavy lifting

for some time. I found that swimming was very helpful. The breasts match pretty well and are excellent in a bra. The reconstructed breast is not quite as full as the other in one place and I am careful about some tops I wear. Everybody tells me that you can’t see it from the front. We did discuss having the other

breast reduced, depending on how the new breast turned out but this has not been necessary. As far as my tummy is concerned, I have a flat tummy now and that is great. I can wear

whatever clothes I like.

My husband has been very supportive and the mastectomy made no difference to him, although it did to me. Even now that I have had

the reconstruction, it still makes a bit of difference to me because although I have the shape, there is very little feeling in the breast. It is now eighteen months since the reconstruction and I can still not stretch up too far. It feels as though there is a weakness in my

tummy and my lower back feels as though it has not got the muscle support that it had before. These are not difficulties compared to the psychological benefits of the reconstruction.

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