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  • Julie Muller

The Big Operation

Updated: Dec 19, 2022

Christmas was a cosy family affair this year. We were all determined to allow my operation to go ahead as planned so we tried to shield ourselves away from other people as much as we could.

On Tuesday 28th December, Antony dropped me off at University Hospital Coventry and I prepared myself for my operation.

The next day, following several meetings with anaesthetists and plastic surgeons, I was taken down to theatre for my procedure. I felt confident that I was in good hands.

The type of procedure that I was receiving was called DIEP flap surgery and it is named after the abdominal blood vessels which are used to ‘plumb in’ the transferred body tissue.

Essentially, a large incision was made from hip to hip across my abdomen and tissue and essential blood vessels were removed, Meanwhile, the diseased breast was emptied of its contents, the tummy tissue was connected to the thoracic blood circulation and the breast skin was re-joined around it. Of course, all of these wounds needed to be allowed to drain and so small tubes were inserted into the affected tissue to allow the body tissues to drain. These tubes were attached to vacuum flasks that pulled out the body fluids. When the wounds have drained sufficiently, they will be removed. I left the operating theatre with three drains.

Of course, I don’t remember anything about the surgery itself. I remember coming around from the anaesthesia feeling a lot better than I had anticipated. I was aware of the lengthy scar stretching from hip to hip, but it didn’t bother me, and my breast felt absolutely fine.

The staff on the ward were extremely attentive . My flap – that is the transplant of tissue from my tummy, was examined every 30 minutes to check that everything was working properly. A doppler was used to listen to the blood vessels carrying blood into the ‘new breast tissue and to listen to the blood vessels carrying the blood away again. The sound of the latter blood vessels always seemed less strong than the afferent ones, but I wasn’t worried.

The next day, the breast observations reduced in number as the critical period was over when the ‘flap’ could be expected to fail.

Another 24 hours passed, and I was looking forward to going home. It was New Year’s Eve.

The checks had continued all day as usual, but the efferent pulse seemed to be getting feinter than ever and by the time the nurses changed their shifts at 8:00 pm, they decided to get another opinion on the state of the circulation in my breast. Roger, a lovely doctor who was on call came to the hospital and he tried to find that second all-important pulse but even the afferent one was less easy to detect. He stayed with me for a long time and sought help and advice from his more senior colleagues in his quest to find the pulse. I was anxious but again, I knew that I was in such good hands.

The following day, one of the other plastic surgeons came to examine me and, very sadly, he told me that my reconstruction had failed. The blood vessels leaving my breast were just too weak and friable to cope with the volume of blood entering them. The breast was engorged and so the ‘flap’ had failed. An emergency operation was needed to remove it – and so started New Year’s Day 2022.

However, as in all things, there is always a silver lining – when I had been told that the reconstruction had not worked my immediate reaction had been to have a double mastectomy. Nigel, my plastic surgeon, told me that he thought that I was too emotional to make that decision at that point and, besides which, they had saved my breast skin.

So, when the failed ‘flap’ was removed, it was replaced with a temporary inflatable implant that would be incrementally inflated starting in a few weeks’ time . Eventually , after about six months, this would be replaced by another permanent implant.

I left hospital with one remaining drain attached to my body but that was removed within 48 hours.

And now, I look forward to 2022 with excitement. I am truly grateful to the NHS for all of the amazing care and support throughout my stay in hospital. Everyone was so kind and considerate in spite of the drama that I presented.

Although the reconstruction didn't work, the cancerous cells have been taken away, my life has been saved, and I feel strong enough to get up and fight another day !

Daffodils on the windowsill - in support of cancer support by Marie Curie
Jellycat daffodils at the window

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