prophylactic mastectomy after RNY

So....I found out today that I can possibly qualify for a prophylactic mastectomy, given a lot of medical and family cir****tances. I am 2 months out from RNY ave lost about half of my weight that I wanted to lose post op. (Lost 215 total, 198 before surgery).

Reason I am even talking to the doctor is that my insurance is going to end in a month and I wanted to get stuff covered while I still had coverage. Long boring story.

What I wanted to know is if anyone has had a mastectomy after their RNY.. and if so what is your experience...how long after did you have it?  What kind of upper body mobility did you have afterwards and how did the mastectomy affect your exercise?

..doc is saying I can wait to do the reconstruction til after I lose my weight, (60 or so more pounds)  but there is probably enough skin on my tummy to do the reconstruction now, and it would be cheaper.

I am honestly more concerned about the pre-emptive strike on more cancer than I am about the TT or the looks of the reconstruction, per se.

Thoughts?

I have had that surgery.  My rny was in august 2009 and my mastectomy was in august 2011.  I have the brca1 gene mutation.  I had immediate reconstruction from my abdomen.  This allowed me to get most of the work of a tummy tuck and get it covered by my insurance.  My panni was all that bad as some that I have seen but I did have some sagging skin that is now gone.  Recovery wasn't as bad as I expected.  I was in the hospital for 5 days.  I left the hospital with 4 drains - one on each side of the breast area and 2 in the mons area.  The two in my chest each came out one at a time but the lower two both came out at the same time.  I can't remember how long they were in but it wasn't a very long time - probably 2 weeks for the last ones.  I was able to move around relatively easily.  I still had some fat clothes so hiding the drains was relatively easy.  My upper back bothered me for a few days - just achey - probably because I was walking around a little hunched over for the first few days.  But that passed quickly.  I had to lay off of exercise for a few weeks and then just go back with light cardio.  I think at 8 weeks I was cleared to do whatever I wanted but started slow.

I had no idea how much the threat of breast cancer preyed on my mind until I woke up in the hospital after sugery and felt such a sense of relief.  Feel free to come back with more questions if you want move of my experience.

 

JoAnn

Thanks Jo Anne.

I got insurance approval this morning, and even though it is not scheduled yet, I too feel a big sense of relief.  They can probably get me in in about two to three weeks, and I got my insurance extended for another month so that helps. 

The peace of mind that is already starting to exist in my brain lets me know that this is a useful decision for me. And I am lucky to have  a surgeon who doesn't mind doing the surgery so soon after my RNY.

Good luck to you with the surgery. It is good that they are getting it done for you so quickly. I have never regretted having this surgery. Do you have brca1 or 2? I ask this because there can also be a risk of ovarian cancer. I have brca1 which substantially increases risk of ovarian cancer. My mother also died as a result of ovarian cancer so I had my ovaries removed as well as a hysterectomy. I had that surgery prior to my gastric bypass.

I never did brca testing...my family history is so strong that my insurance company did not require it. I am also being scheduled for a hysterectomy later this fall. My opinion is that i am not losing all this weight just to get cancer caused by an estrogen dump. (Estrogen is stored in fat).

 

My bariatric surgeon was like, "wait a year"  when I went to see him the other day.   I have a non-h pylori peptic ulcer, which is being treated with meds. The catch is that I need to have these other two surgeries while I still have good insurance. ( I will be getting Medi-Cal in December, which means they wont be covered.)

 

So I am seeking a second opinion...My plastics guy was all okay with it, and so was my primary doc...but I am going to consult with a second bariatric surgeon just to see what they say.

Im a little hesitant, only because of the ulcer, but it's about life choices...gotta go one time or another, so I am just going to do the next things and get more information.

 

As of right now the hysterectomy is scheduled for October, and the Mastectomy for end of July.

My gyn would not take my ovaries cause I am still only 45, but I figure, one or two battles at a time. They are next on my list, as soon as I get these other two out of the way.

I am surprised they won't take the ovaries. I would be concerned about ovarian cancer. We don't us usually know we have it until it is too late. I didn't have my ovaries out until I was 50, but that is when I found out I was brca1 positive. Prior to that, I was on tamoxifen as a preventative which started when I was 45. That put me in medical menopause. Since I was unable to conceive prior to that, I really had no issue with it. To be honest, the ovarian cancer threat scared me more than the breast cancer threat, I guess because my mother had ovarian cancer. You are right, you have lots of things to consider, compounded by the insurance issue. I wish you luck in your journey.

JoAnn

Thanks....I plan on getting the ovaries out....pretty soon, but didn't want to argue too much with my doctor, as she was already being a bit "stretched" by the hysterectomy to begin with...plus the mastectomy on top of it...I figure once I heal from everything, I can go back and push on the ovaries...I was in menopause before they did my uterine ablation(s), and given the fact that those did not really "work", the simple hysterectomy was the simplest thing to get approved without the brca testing.

 

I am a bit worried about ovarian cancer, but I had more people in my family die from Gastro intestinal cancers....so I guess I am sort of going down a list of "more likely possibilities" in my head, and dealing with some "not that great" health insurance at the moment.

I really appreciate you sharing your experience....I found a website for people having mastectomies, but seems like few of them have had WLS.  So, thank you.

Good luck to you with the surgery. It is exceptional that they are finishing it for you so rapidly. I have never mourned having this surgery.

I went for my pre-op yesterday, and i think I am all set. I  had a surgical complication of a small ulcer at the staple line, but it seems to be healed now and I am eating better. I would rather take my chances on the ulcer getting complicated than having my insurance end and getting cancer. My doctors are behind me, and I got cleared for surgery. So I am excited. I am trying to figure out what size bra to go home with. I know they send me home with a mastectomy bra, and I will have two drains. And the doctor has a different bra that I will have when I get to his office the day after that.  They told me to buy a sports bra that opens in the front....IDK what size?  I am 38 around right now ---in the bras that I own....but the measurements I took yesterday showed a 36. I can't fit into a 36 in the store right now because my cups size is too big...they don't make a 36 in the cup size that I need. I am having a reconstruction with expanders and cadaver tissue put in on the day of surgery...I am guessing a 36 B to allow for swelling but was curious if others had some experience and does that guess sound right?  I am still losing weight and  the thrift store is an hour away on the bus so I don't want to make a million trips over there.....