› Forums › General Melanoma Community › Removing a vein and moving a muscle??
- This topic has 30 replies, 7 voices, and was last updated 12 years, 7 months ago by
jax2007gxp.
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- August 24, 2011 at 11:01 pm
Hello all,
Hello all,
I saw the surgeon today. Assuming the insurance company approves the PET (I was told that insurance companies are making this difficult lately) and it is clear, the surgery is scheduled for 9/9. He is planning to remove the superficial nodes from my right groin and will only take the deep ones if it makes sense to do so. I know the more missing nodes means greater risk of lymphedema. This really isn't what I'm wondering about though. He said that he would remove a vein from the area and then detach/reattach a muscle in order to protect the area where the nodes were removed. Has anyone experienced this movement of the muscle or removal of a vein? I had not read about it anywhere and I'm wondering what to expect afterward.
As always…thank you so much for any feedback you may have for me.
Jacki
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- August 24, 2011 at 11:45 pm
Hello Jackie,
When I had my nodes removed from my left groin in 2007, I did not know that this was a possibility, but my doctor flipped a leg muscle to cover up exposed blood vessels.
Apparently it is not that uncommon. But afterwards when I tried to walk, it was extra painful as motion that used to pull on the muscle was pushing and what used to push was pulling. My muscles had to relearn how to react.
The doctor that performed my lymph node disection was my onocological surgeon and was skilled in this procedure. The plastic surgeon that did my wide excision and SLN biopsy referred him to me, as he thought this area tricky.
It is good that you are waiting for the insurance to approve the procedure. My night mare was that my insurance company initially refused to pay for my stay in the hospital (due to the muscle flipping) and I had to fight for several months to get coverage.
Give yourself time to recover, and good luck!
Mike from Richmond
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- August 26, 2011 at 12:43 pm
Hey Mike! Thanks for sharing your story. Sounds like I will be following your footsteps, although I'll be happy to skip any fights with insurance companies! Just wondering how you are doing this far out with respect to physical activity? I am a hiker and the doctor says I will be able to get back on the mountain, but I'm wondering what it will take to get back to it. While it was painful at first, how long did that last? Was physical therapy required?
Many thanks,
Jacki
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- August 29, 2011 at 1:35 am
Hello Jacki,
I had my lymph node dissection in Sept. 07 and it was painful for the fist 4-6 weeks. I also got tired quickly. I did my first "level" hike in Jan. 08. I was back trying to keep up with our Boy Scouts on mountain hikes in that spring. (I said trying, as I could not keep up with them before and still can't!). Hiking is great low impact exercise to strengthen against lymphadema. I did not do physical therapy.
My biggest challanges when hiking are keeping out of the sun and bug bites.
Start by walking around the block until you can walk natual again. Your body will let you know when you reach your limits. Don't push too hard all at once.
Lastly, I had my 4 year exam/tests last week and still NED!!
Mike from Richmond
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- August 30, 2011 at 2:38 am
4 years NED…yippee!!! I'm looking forward to those celebrations! In fact, I have a great bottle of wine waiting for some kind of good news. 🙂
Thanks for sharing your post-op recovery. I'm not the fastest hiker either, so I will likely feel great just to get back on a trail.
All the best,
Jacki
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- August 30, 2011 at 2:38 am
4 years NED…yippee!!! I'm looking forward to those celebrations! In fact, I have a great bottle of wine waiting for some kind of good news. 🙂
Thanks for sharing your post-op recovery. I'm not the fastest hiker either, so I will likely feel great just to get back on a trail.
All the best,
Jacki
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- August 29, 2011 at 1:35 am
Hello Jacki,
I had my lymph node dissection in Sept. 07 and it was painful for the fist 4-6 weeks. I also got tired quickly. I did my first "level" hike in Jan. 08. I was back trying to keep up with our Boy Scouts on mountain hikes in that spring. (I said trying, as I could not keep up with them before and still can't!). Hiking is great low impact exercise to strengthen against lymphadema. I did not do physical therapy.
My biggest challanges when hiking are keeping out of the sun and bug bites.
Start by walking around the block until you can walk natual again. Your body will let you know when you reach your limits. Don't push too hard all at once.
Lastly, I had my 4 year exam/tests last week and still NED!!
Mike from Richmond
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- August 26, 2011 at 12:43 pm
Hey Mike! Thanks for sharing your story. Sounds like I will be following your footsteps, although I'll be happy to skip any fights with insurance companies! Just wondering how you are doing this far out with respect to physical activity? I am a hiker and the doctor says I will be able to get back on the mountain, but I'm wondering what it will take to get back to it. While it was painful at first, how long did that last? Was physical therapy required?
Many thanks,
Jacki
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- August 24, 2011 at 11:45 pm
Hello Jackie,
When I had my nodes removed from my left groin in 2007, I did not know that this was a possibility, but my doctor flipped a leg muscle to cover up exposed blood vessels.
Apparently it is not that uncommon. But afterwards when I tried to walk, it was extra painful as motion that used to pull on the muscle was pushing and what used to push was pulling. My muscles had to relearn how to react.
The doctor that performed my lymph node disection was my onocological surgeon and was skilled in this procedure. The plastic surgeon that did my wide excision and SLN biopsy referred him to me, as he thought this area tricky.
It is good that you are waiting for the insurance to approve the procedure. My night mare was that my insurance company initially refused to pay for my stay in the hospital (due to the muscle flipping) and I had to fight for several months to get coverage.
Give yourself time to recover, and good luck!
Mike from Richmond
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- August 25, 2011 at 12:32 am
Hi Jacki
I had my nodes removed,superficial & deep, and no veins or muscles were involved.
My greatest complication is that the surgeon cut into nerves which I am still numb in areas.
Of course, I am also dealing with lyphedema.
Did this surgeon explain why your surgery is so complicated involving muscle & veins.
For peace of mind, I would get a second opinion to be sure of your discision.
Deb
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- August 25, 2011 at 12:32 am
Hi Jacki
I had my nodes removed,superficial & deep, and no veins or muscles were involved.
My greatest complication is that the surgeon cut into nerves which I am still numb in areas.
Of course, I am also dealing with lyphedema.
Did this surgeon explain why your surgery is so complicated involving muscle & veins.
For peace of mind, I would get a second opinion to be sure of your discision.
Deb
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- August 25, 2011 at 5:14 am
I have heard of moving a vein and flipping muscle tissue to then provide protection for the vein. Have not heard of removiing the vein for this operation. i agree that they cannot always be sure how far they need to go with node removal until they are inside you.. I had extnsive superficial and deep iniac and inquinal nodes removed. My Oncological surgeon was able to follow the node chain so that he didn't have to move the vein or flip the muscle tissue. He had warned me that this could happen. Sure made me happier to wke up and learn he had not had to do the worst he had told me might happen. They had me on my feet that evening and by the second day the nurses were complaining that they couldn't find me because I was moving around too much!
Yes, I do have some loss of feeling in the groin area, but no pain and no lympedema. Good luck with your operation!!
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- August 25, 2011 at 5:14 am
I have heard of moving a vein and flipping muscle tissue to then provide protection for the vein. Have not heard of removiing the vein for this operation. i agree that they cannot always be sure how far they need to go with node removal until they are inside you.. I had extnsive superficial and deep iniac and inquinal nodes removed. My Oncological surgeon was able to follow the node chain so that he didn't have to move the vein or flip the muscle tissue. He had warned me that this could happen. Sure made me happier to wke up and learn he had not had to do the worst he had told me might happen. They had me on my feet that evening and by the second day the nurses were complaining that they couldn't find me because I was moving around too much!
Yes, I do have some loss of feeling in the groin area, but no pain and no lympedema. Good luck with your operation!!
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- August 25, 2011 at 12:30 pm
Earlier this year I had the Superficial nodes removed from my LT thigh/groin. The deep node(s) were negative on the BX so we decided to only remove the Superficial nodes. I did have a muscel moved to protect the exposed vascular structures. The surgeon was able to leave the vein intacted but had to cut a nerve to prevent issues when moving the muscle. I have some numbness in my thigh that has improved over the last few month.
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- August 25, 2011 at 12:30 pm
Earlier this year I had the Superficial nodes removed from my LT thigh/groin. The deep node(s) were negative on the BX so we decided to only remove the Superficial nodes. I did have a muscel moved to protect the exposed vascular structures. The surgeon was able to leave the vein intacted but had to cut a nerve to prevent issues when moving the muscle. I have some numbness in my thigh that has improved over the last few month.
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- August 25, 2011 at 1:29 pm
I had these things done in 09 and it was fine. The expert surgeon I had 'reconnected" that vein with no problem and while I have a deep crevice in my leg from the removal of the tissue, muscle, etc….I've been very lucky with little to no bad side effects.
Good luck.
debbie
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- August 25, 2011 at 1:29 pm
I had these things done in 09 and it was fine. The expert surgeon I had 'reconnected" that vein with no problem and while I have a deep crevice in my leg from the removal of the tissue, muscle, etc….I've been very lucky with little to no bad side effects.
Good luck.
debbie
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- August 25, 2011 at 11:36 pm
I had a little different scenrio. I had a latisimus flap. They removed a huge amount from my breast and to fill in the hole they took the muscle from my back and threaded it under my arm pit and filled the hole! It took quite a bit of therapy and now I have some issues with very thick inside keloid scaring. But, that was 5 years ago and the surgery was a success.
For a while if I wrote (I'm left handed and it was my left side) my breast would quiver. Even could feel it in my breast when I would open a sliding glass door! The skin area is still numb to the touch.
I know that PET scans have been refused after you are 1 year NED (with some insurances) but I haven't heard of problems if you just have had issues. It is always smart though to get pre-approval if that is part of your policy.
Good luck with the surgery,
Linda
Stage IV since 06, currently NED
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- August 25, 2011 at 11:36 pm
I had a little different scenrio. I had a latisimus flap. They removed a huge amount from my breast and to fill in the hole they took the muscle from my back and threaded it under my arm pit and filled the hole! It took quite a bit of therapy and now I have some issues with very thick inside keloid scaring. But, that was 5 years ago and the surgery was a success.
For a while if I wrote (I'm left handed and it was my left side) my breast would quiver. Even could feel it in my breast when I would open a sliding glass door! The skin area is still numb to the touch.
I know that PET scans have been refused after you are 1 year NED (with some insurances) but I haven't heard of problems if you just have had issues. It is always smart though to get pre-approval if that is part of your policy.
Good luck with the surgery,
Linda
Stage IV since 06, currently NED
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- August 26, 2011 at 12:39 pm
Thank you for all of the replies…I feel SO much better about this now. I did call another cancer center on Wednesday to see about a second opinion. I cannot believe I did not receive a return call yesterday, especially since I left information regarding the date of my surgery being only a couple of weeks away.
The doctor has already told me about the numbness, so this won't be a surprise for me. I do like the comment that the flipped muscle will not only prrotect the veins underneath but also help avoid a deep crevice where the nodes are removed. Of course, I am guessing my hip will be a little narrower on this side post-op. Hopefully I will be able to keep my pants on! lol
Thank you again….this board is made up of some wonderful people!
Jacki
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- August 26, 2011 at 3:46 pm
Hi Jacki,
The smartest thing to do is get that second opinion. If the cancer center does not get back to you do NOT wait, try to find another surgeon for a second opinion. Every hospital has a cancer center.
I looked up your past posts & I think that you were going to Chao & Dr. Jakowatz.
Perhaps,You should to do a search to see if you can find mpip post on Dr. Jakowatz.. Just a thought.
Barbara
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- August 30, 2011 at 2:56 am
Thanks, Barbara. It was the place I called to request the second opinion who never called me back. Very disappointing from a cancer center listed on this site.
I have seen a couple of comments on Dr. J but I am very comfortable with him. I like his style and approach, and I do recognize that his patient load is heavy. Knowing this going in makes a difference and sets my expectations accurately. Also, I have really enjoyed his staff. Everyone has been friendly and comforting, and more importantly, helpful! Each of us has our own experiences and interactions with those around us, so I don't discount what someone else may have felt, but for me, I am happy with my choice.
Jacki
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- August 30, 2011 at 2:56 am
Thanks, Barbara. It was the place I called to request the second opinion who never called me back. Very disappointing from a cancer center listed on this site.
I have seen a couple of comments on Dr. J but I am very comfortable with him. I like his style and approach, and I do recognize that his patient load is heavy. Knowing this going in makes a difference and sets my expectations accurately. Also, I have really enjoyed his staff. Everyone has been friendly and comforting, and more importantly, helpful! Each of us has our own experiences and interactions with those around us, so I don't discount what someone else may have felt, but for me, I am happy with my choice.
Jacki
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- August 26, 2011 at 3:46 pm
Hi Jacki,
The smartest thing to do is get that second opinion. If the cancer center does not get back to you do NOT wait, try to find another surgeon for a second opinion. Every hospital has a cancer center.
I looked up your past posts & I think that you were going to Chao & Dr. Jakowatz.
Perhaps,You should to do a search to see if you can find mpip post on Dr. Jakowatz.. Just a thought.
Barbara
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- August 26, 2011 at 12:39 pm
Thank you for all of the replies…I feel SO much better about this now. I did call another cancer center on Wednesday to see about a second opinion. I cannot believe I did not receive a return call yesterday, especially since I left information regarding the date of my surgery being only a couple of weeks away.
The doctor has already told me about the numbness, so this won't be a surprise for me. I do like the comment that the flipped muscle will not only prrotect the veins underneath but also help avoid a deep crevice where the nodes are removed. Of course, I am guessing my hip will be a little narrower on this side post-op. Hopefully I will be able to keep my pants on! lol
Thank you again….this board is made up of some wonderful people!
Jacki
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- September 1, 2011 at 6:34 pm
Hi Jacki,
Did you get your PET approved, If so, what were the results of your PET?
You made a commnets: "He is planning to remove the superficial nodes from my right groin and will only take the deep ones if it makes sense to do so"
Just curious:how does your surgeon know whether or not it makes sense to take out the deep nodes. What did he tell you the circumstanses would make sense totake out deep nodes.
Thanks for helping me uderstand.
B
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- September 2, 2011 at 5:39 am
I suspect that the surgeon is wanting the results of the PET to tell if he needs to o deeper inside. That is what made the circumstances where my surgeon went deep too.
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- September 2, 2011 at 5:39 am
I suspect that the surgeon is wanting the results of the PET to tell if he needs to o deeper inside. That is what made the circumstances where my surgeon went deep too.
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- September 6, 2011 at 2:20 am
Hi B,
Sorry for the delay in responding…I was taking advantage of my last pre-surgery weekend and 40th birthday!!! This week is when it all starts to feel real…PET/CT Scan tomorrow. Assuming no mets, surgery is scheduled for Friday.
Funny thing about the "approval"…apparently when the office called for pre-approval, they were advised no pre-approval is required for the PET/CT Scan nor the MRI. Something I really appreciate about UCI, when I called to verify it was approved, the person who answered (not in my doctor's office) was able to pull my record, give me the answer, and tell me the name of the person at my insurance company who gave them the answer. Wow!
And, I think Jerry is right…the doctor is waiting to see the scans to determine what he will take. He has told me he thinks he will need to take all of them, so I am not holding out for much hope that the deep ones will be spared.
If I learn anything more about the basis for the decision, I will be sure to update you.
Jacki
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- September 6, 2011 at 2:20 am
Hi B,
Sorry for the delay in responding…I was taking advantage of my last pre-surgery weekend and 40th birthday!!! This week is when it all starts to feel real…PET/CT Scan tomorrow. Assuming no mets, surgery is scheduled for Friday.
Funny thing about the "approval"…apparently when the office called for pre-approval, they were advised no pre-approval is required for the PET/CT Scan nor the MRI. Something I really appreciate about UCI, when I called to verify it was approved, the person who answered (not in my doctor's office) was able to pull my record, give me the answer, and tell me the name of the person at my insurance company who gave them the answer. Wow!
And, I think Jerry is right…the doctor is waiting to see the scans to determine what he will take. He has told me he thinks he will need to take all of them, so I am not holding out for much hope that the deep ones will be spared.
If I learn anything more about the basis for the decision, I will be sure to update you.
Jacki
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- September 1, 2011 at 6:34 pm
Hi Jacki,
Did you get your PET approved, If so, what were the results of your PET?
You made a commnets: "He is planning to remove the superficial nodes from my right groin and will only take the deep ones if it makes sense to do so"
Just curious:how does your surgeon know whether or not it makes sense to take out the deep nodes. What did he tell you the circumstanses would make sense totake out deep nodes.
Thanks for helping me uderstand.
B
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