MRI

Hi there again @Lisa Janelle. I finished chemo oct last year and the wait list is so long as there are only 1 to 3 plastic surgeons available at the royal and they do more than just breast recon. And there are many times when one or two of them are away and this puts extra pressure on the system as they can only see so many patients. Breast recon is also considered an elective procedure some dickhead bloke politician must of made that decision for sure. There needs to be more funding to help reduce the waiting times and this is what I’ve been advocating for. No luck yet unfortunately. Depending on where you are the Gold Coast does it too I think from memory but it’s zoned and you would have to live within the zone. Margie. Xx

Hi Lisa Janelle. Hi. Im in the Qld Public system. i also had dcis, detected on mammo as 2 small areas of calcification back in January this year. This is a long post, but as you asked about QLD, DCIS, Mastectomy, recon, implants,  drains, Im not saying my experience is the same, but I may be able to answer some  of your questions
 I had 2 core biopsies and both showed high grade DCIS. They were talking about lumpectomy and rads  for me.
My brother in law who  is a gp in Sydney recomended I ask the surgeon  for MRI before the surgery. They dont usually do it as it is expensive (go figure) but for some reason they did an MRI on me, covered by medicare.
 I had already done all the preop and it was 2 days before lumpectomy when results came in. It showed 9cm mass in the biopsy proven area. I had no lump, no sign at all.The mass could not be seen on mammo or UltraSound.  Immediately they cancelled my lumpectomy at Nambour and referred me to RBWH for treatment. I went back to the start at the new hospital so time from diagnosis to surgery was almost 3 months. I also received the best and most compassionate of care in Public system at RBWH.
They said mastectomy was my only option. Like you I struggled to believe it. I got a copy of the MRI disc and had it read again by 3 radiology specialists. I wondered could it be a mistake, was I going to lose my breast for nothing. I had  read that MRI can give false results. What if I had the mastectomy and then found out I hadnt really needed it. Why was I getting a mastectomy when I didnt really even have cancer only DCIS. It seemed so radical.  I was still asking could it be a mistake  on the table just before the op at the end of March.
 I asked for immediate reconstruction. It isnt really immediate as it is still a fairly long process. I had to sort of apply for it, because it is a more complicated operation than a simple mastectomy .
You had to be a non smoker, have a healthy BMI, not have diabetes or some other health conditions. You also had to have a fairly low risk of needing rads, Because rads can damage the skin and make the recon process more complicated.   If you are eligible for the immediate recon and all goes to plan, you wont have the long waiting times because the process is started during the mastectomy itself. Some breast surgeons do both the mastectomy and the recon, but I asked for plastic surgeon, thinking they would have more advanced skills in the stitching. The breast surgeon and plastic surgeon were in the op together. Breast surgeon removed all breast tissue. In my case, nipple as well. They  do sentinel node biopsy to check if any cancer cells in lymph nodes, while you are asleep, during mastectomy. 
RBWH has a way of immediate testing during the op. As I understand, If they had found cancer cells in sentinel nodes they would have taken another layer of nodes to determine how far the cancer had got and so on. Lucky for me the sentinel nodes were clear, so  the plastic surgeon took over. I think that if they had found extensive spread and breast surgeon said rads would be needed then the Plastic surgeon would maybe not have proceeded.?????? 
They placed an expander which was then slowly inflated over the next few months.You wake up with the expander slightly inflated. They then do the biopsy of the breast tissue. My DCIS  was actually 7 cm so the MRI had overestimated, but the mastectomy was definitely necessary. All my cancer was gone, thank goodness,  so  I was a plastic surgery patient then, in the plastic ward.
 I had  2 drains in for 10 days it wasnt particularly painful, and there were no complications. They kept me in the hospital the whole ten days maybe because I live 2 hours away, maybe because the plastic surgeons have different way of doing things. Maybe because the aeroform co2 expander is a newish technology??? Im not sure but he wouldnt let me go home till the drains  came out. I felt good but very tired and was able to walk around outside and around the streets.Recovery was 6 weeks.
I had an aeroform co2 expander, which I inflated  at home, myself with a remote control. 
Then 3 months later this JUly,  i had a silicon implant. This was a simple op, no drains, home the next day. 6 weeks recovery again.  I have decided not to have my remaining breast lifted or changed, but I could have if I wanted to, covered by the public system.   I am on the list for a nipple but I'm rethinking it now and might just get the 3D tatoo, which is also covered by medicare. What started as a horrific and terrifying nightmare, I have now got used to. I look good  and feel comfy in my swimmers, which was super important to me, I can do everything I always did except for some small movement problems with my shoulder.  My implant is quite big and can be slightly uncomfortable at times. It also feels cold and a bit numb. I loved my old figure but Im still the same person and  feeling very happy and bright about the new Year. Im feeling very grateful to be healthy. I hope it all goes well for you. The scariest part really  is the unknown and the waiting. I hope you get the answers soon. Hugs Vallerina xx

My drain was quite painful at times and as I had a skin & nipple sparing mastectomy, and have large breasts, there was a lot of empty space to fill, so i had my drain in for over 4 weeks - then ended up with complications (sorosis & cellulitis) and another week in hospital and another different kind of drain inserted. 
I’m in the QLD public system and the treatment I have received has been wonderful. 
I was told no immediate recon due to radiation as it tends to destroy the tissue of the reconstructed breast. 
With regards to pain, your medical team can prescribe appropriate pain relief & sleeping pills if you need them as well. 
I am still wearing the soft form & mastectomy bra they gave me prior to surgery, it’s really not noticeable to others. You can add or remove the stuffing to suit. 
My radiation burns are still healing, once they do I will be looking to buy a proper prosthetic ($400-$420 @ Myer), which is rebatable on Medicare (up to $400 every two years) and also through most health funds extras cover. There are special bras to fit them in as well that are specially designed for the purpose & there’s some really nice ones. 
I am in the Logan area now, but as I was in North Bris when I had surgery, my treatment was all through RBWH. 
Feel free to send me a pm with any questions, also happy to catch up for coffee if you’d prefer. 
I have photos of different parts of my treatment I posted on my private Facebook page for my friends and have always been happy to answer family & friends questions. 
Happy to chat, answer questions & show you photos, etc if you want. 
Cat. 

My drains seem to have hit nerves and were very painful at times. I had mine in for about 4 days for the mastectomy and almost a week and a half for my reconstruction due to complications. They are not always a problem for people. At other times the drains weren’t so bad. 

Hi Lisa, yes you'll have a drain for mastectomy. I only had my drains in fir a couple of days. I was fortunate I guess as I know some ladies need them in for a longer period. They're not painful more just a hindrance. Xx

@onemargie have u finished all the treatment. Do they say why such a delay. ??

Hi @lisa janelle, I initially had a lumpectomy, then a mastectomy on the left. I had to wait 2 years for reconstruction because of radiotherapy damage. I chose LD reconstruction. Then I had reduction on the other side. The two years actually went by really quickly. I was a bit self conscious about wearing a breast form initially, but I got used to it. All of my treatment has been private, but my doctor also works in the public system.

 I guess if I was approaching my doctor now, I would ask:
What are my options?
How much will this cost?
Do you operate in the public system? If I go public, what would the waiting time be?
How long do drains usually stay in? 
What is the recovery time?
When can I start driving/ get back to work? 
I’ve always wanted to ask “What is your success rate?”, but have never been game to.

 I have also googled a surgeon’s name with the word ‘complaints/ problems’ and this has been quite useful in deciding not to have a surgeon for another procedure. Word of mouth is also really helpful in choosing a surgeon. 

My recovery time was quite long due to complications and you don’t know what your reaction will be until you have the surgery. I was quite surprised that it was so involved. It’s good to ask questions and feel comfortable with your surgeon. My surgeon and anaesthetists have never charged a gap so that has been great. They have all been wonderful. All the best. xx 

Hi there @Lisa Janelle I’m on the qld public waiting list  for recon been on it for 18 months already just to see the surgeon and there’s still over 100 it front of me. I had the BCNA approach me to do an interview with channel 10 bribane last month you can see it on the BCNA face book page. I’ll be waiting at least another 12 months to see the surgeon and then at least another 18 months to 2 years after that for my surgery. It’s consdered elective surgery which is bullshit. I’ve been pretty proactive wetness to my local member Susan lamb who has been very supportive and has spoken about it in parlaiament. But no light at the end of the tunnel yet to get the wait times down. You can sometimes have immediate reconstruction depends on your circumstances so check with your surgeon to see what your options are. In hindsight if I’d known it was going to be this long i would of considered having it done immediately so I wouldn’t have to have more surgery. Margie. 

After a straight mastectomy it can be overnight. I had a bilateral mastectomy and tissue expanders and sling in so was in 4 days, mainly due to illness from anaesthetic. I went home with drains.

This link explains the process a bit more. 
https://www.reclaimyourcurves.org.au/implant-breast-reconstruction.html

Call the public hospital you are referred to tomorrow and ask to be put in touch with a breast care nurse attached to the womens health or breast and endocrine unit. Failing that...

https://www.mcgrathfoundation.com.au/OurMission/OurNurses/FindANurse.aspx

We have a breast reconstruction group including photo stories as well you may wish to join. 

Drains are very variable. Mine stopped draining after three days and I went home on the 4 th day, but the process may take longer. You can however go home with the drains still in and have them removed later.