Too fat for reconstruction?
I recently had a visit with the specialist GP assigned to me at the hospital where I've been having treatment. I had a mastectomy last June. We started discussing whether or not I'd be interested in a reconstruction of my right breast. She then asked me what my height and weight was then proceeded to calculate my BMI.
I have put on a few kilos since surgery, chemo and now radiation. My fitness level has gone from really good to puffing walking up the stairs.
She said to me that at my current BMI of 30 (shocked at that) that it was most likely the plastic surgeons would consider me ineligible for reconstruction. Something about difficulty healing etc. Although my mastectomy has healed marvellously, in fact the nurses often comment on it. I would have to get back down to BMI of 25, about 58kgs. Yes I am only short but it's been a while since I weighed that. Most of my life I've been trim and a bit of my weight has come from muscle. I'm struggling to get back a basic level of fitness let alone knock off over 10kg.
Has anyone else been told this? By all accounts this would rule out reconstruction for a lot of women! I wish the surgeon had mentioned this before they cut me up so I would have been more careful about putting on weight. Considering the fact I was already over this magic BMI number anyway at the time of surgery. No mention was made of it. And this same doctor told me I would struggle with my weight for at least 12 months because I have to go on Femara after having my ovaries out. So basically sudden menopause plus the drugs will keep me fat or make me fatter. Marvellous.
The more I go along this journey the more I realise how little I am being told until something goes wrong or I ask the question.
Comments
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This bc ride has more twists and turns than any rollercoaster.You often don't know what you are facing until it's on top of you. I can understand if you are a smoker or very obese- these factors make you more of a risk for any operation. Was it Diep reconstruction you were looking to have? Because they actually like you to have some extra stomach fat for that op.You don't seem that over weight to me.I wonder if she made a mistake on the bmi calculation?I haven't heard of this issue being a problem for recon.It's unfair because all these bc treatments and drugs cause weight gain so it's not entirely your fault. Could you get a second opinion? If you are too tired to excercise then just concentrate on your diet for the moment. I chipped my front tooth last week and also have a tooth ache but can't see my dentist till 31/1.As a consequence,I've lost 1.5 kilos cos I can't bite or chew too well.So now I'm trying to stay with a low gi diet and have cut out all rubbish food.However,please don't chip your tooth!!! I know I'm carrying an extra 8 kilos but my surgeon has never said anything when I've mentioned reconstruction.(something I'll think about later).I hope you can get it sorted it out cos it does seem a little harsh to me.
Tonya xx
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This bc ride has more twists and turns than any rollercoaster.You often don't know what you are facing until it's on top of you. I can understand if you are a smoker or very obese- these factors make you more of a risk for any operation. Was it Diep reconstruction you were looking to have? Because they actually like you to have some extra stomach fat for that op.You don't seem that over weight to me.I wonder if she made a mistake on the bmi calculation?I haven't heard of this issue being a problem for recon.It's unfair because all these bc treatments and drugs cause weight gain so it's not entirely your fault. Could you get a second opinion? If you are too tired to excercise then just concentrate on your diet for the moment. I chipped my front tooth last week and also have a tooth ache but can't see my dentist till 31/1.As a consequence,I've lost 1.5 kilos cos I can't bite or chew too well.So now I'm trying to stay with a low gi diet and have cut out all rubbish food.However,please don't chip your tooth!!! I know I'm carrying an extra 8 kilos but my surgeon has never said anything when I've mentioned reconstruction.(something I'll think about later).I hope you can get it sorted it out cos it does seem a little harsh to me.
Tonya xx
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No the BMI looks right when I checked. Amazingly I am categorised as 'obese' although I fit into size 12-14 at the moment. Before my diagnosis I was 10-12. I suppose if I was 47kg I might be 'normal'. If you were to see me you wouldn't call me obese that's for sure! I do not smoke and have always been fit, active and healthy.
We did discuss all options but I might not be suitable for the Diep because of a hysterectomy scar so she tells me. So it would likely be an implant. She is going to refer me to the plastic surgeons so I will wait til I find out more. In the mean time all I can do is try to lose some weight anyway.
Helen
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I'm size 12-14 too.Maybe I'm bigger than I see myself. If you've had radiation I believe it maybe hard to have an implant.I guess your plastic surgeon will let you know your options.
Tonya xx
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BMI's are to be interpreted with "a grain of salt". There is no doubt that extra body fat will put us into the "obese" catgory, as will a body shape that is based on wide shoulders and wide pelvis. Coincidentally many people with an "athletic" build will be calssified as at least overweight when they have the stronger body shape aNd a good deal of muscle without a high body fat index.
Better to try to eliminate extra unneeded kilojules from one's diet and to try to maintain health rather than try to be skinny just so we fit into a recognised flawed system such as the BMI.
Being on femara isn't great for us who can gain weight very easily but it is possible to drop some weight if one eats mindfully. Such a hard thing to do when we are surrounded by many food choices!!
A shout out also to all those affected by the floods and tornadoes today in Queensland. Floods, bushfires....... what a country!
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Thanks from a wet and miserable Brisbane!
Yes I know BMI's aren't always the best indication of size or obesity. I guess that's why I was so surprised to hear the doctor bring it up and be so forthright about it being a problem for me. I've always carried quite a bit of muscle and I am hoping once I actually meet the plastic surgeon they might have some good news for me. Though I am having radiation and as was mentioned earlier, that may be an issue.
Basically lots to deal with but most of it later.
And yes it's hard to eat mindfully especially when those you live with like their sweet things ...
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i have never heard anything like this!!! :-(
Hope you get answers soon
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i have never heard anything like this!!! :-(
Hope you get answers soon
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Hi Linda
Thank you for your message. I'm glad you were able to get the surgery done. Have you had your treatment done privately? They didn't even mention me having immediate reconstruction, but it may have been because of the nature of my cancer. Who knows. I have been going public, so maybe that has some impact on it. I just wish these issues would have been told to me in the beginning, instead of giving me what may in the end be false hope. I know it's overwhelming for us at first, but some important things need to be told. I was quite fit before my diagnosis, playing regular golf myself and caddying for my pro husband. I hope that I get an understanding plastic surgeon when I'm finally referred. I also hope that having radiation will not stop me from having reconstruction. Otherwise I'll ask them to cut the other one off to balance me! I don't like the prospect of prosthesis's the rest of my life. Just too uncomfortable and hot in our climate.
All the best for your ongoing recovery.
Cheers Helen
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Hi Helen,
Yes, I did have my treatment done privately but I think the immediate reconstruction was offered because of my situation. I did not have radiotherapy which is why I was able to have the reoonstruction done immediately. I had breast cancer 10 years ago and had a lumpectomy, chemo and radiotherapy back then. My mastectomy is the result of a new cancer developing in the same breast - they cannot do radiotherapy twice to the same breast so mastectomy was my only option. As I was not having radiotherapy it made me a candidate for the immediate reconstruction. The skin of my breast was in good enough condition as the radiotherapy was done so long ago. My plastic surgeon told me that quite often the radiotherapy really destroys the skin and that the type of reconstruction I have had is not always possible. Other types of reconstruction are possible though - I think the work they are able to do is quite amazing so I would hope they are able to offer you some type of reconstruction.
Every Breast Cancer situation is so different. As I read other blogs I realise that it is very hard to offer advise as what is relevant to me may be completely irrelevant to you. I hope you don't have to wait too long for a consultation with a Plastic Surgeon. Discussing what your options are will hopefully give you some peace of mind.
Best wishes for this leg of your journey and take care, Linda
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