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Tram-Flap Complications
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Tram-Flap Complications

I've been wondering if I have been going crazy over my tram-flap surgery!  I'm developing a weird pooch on the side they removed my abdominal muscle, too.  It's tender to the touch and that whole side is now radiating pain.  I've gone back to my cancer doctors and they tell me that it's all normal.

It's been a year and a half since my surgery and I've been having problems walking, getting up, bending and the whole situation is causing me so much agony that I am getting terrible anxiety over it.  Now I can't keep food down and to make matters worse, the tumor is back for the 3rd time in 2 years.  So much for their "radical" procedure.  :-(

Too much tissue has been removed for further surgery, however, and now all the doctors can do is monitor me with CT scans.

I feel like my life has been absolutely violated and I'm really depressed over it.  I'm not "glad" to know that there are others out there like me, but it validates how I'm feeling and for that I'm grateful.


This discussion is related to TRAM Flap Complications.
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12 Comments
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Avatar_f_tn
I was dx w/ breast cancer in 1997 w/ bilateral masectomy/saline implant reconstruction. The plastic surgeon over the years became obsessed w/ like time ! how long it would take him to finish any repair I had to do over the last ten years, which were 4, one implant burst, etc., so I got ref. to new Dr. he introduced me to the tram. I had surgery 6-5-08. second day was sent down for ultasound because rgt breast so swollen and had huge lump, everything checked out w/ scan, sent hm went back for post-op I have 2 holes underneath rgt breast that continuosly drain, Dr. said will get better, my belly button will not get better it continuously drains, Dr. said clean both areas more. Dr. says lump in rgt breast from his surgery could be necrosis which means death of tissue he transferred from abdomen, that in few months may have to be removed. I looked up necrosis its very scary to think maybe the bacteria could harm me I pray Dr. knows best. I'm so soon out from the surgery I can't help you, except the fact to talk to someone about helps, Thank You, I do have a huge lump in middle of my incision of abdomen hope that its scar tissue to go away?? Did you have prblem w/ belly button or healing in one breast or other? Regards
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Avatar_f_tn
I feel for you!    This is my 1st online comment about my 2004 bilateral TRAM flap.  What a disappointment!  I have never recovered from it.  I to, feel violated.  It feels like my bottom ribs are broken and the mesh pulls and burns all the time.  About 9 months after the surgery, the upper abdomen began to protrude about 2-3 inches.  All this pain and horror was not worth it.  I to, have not had the nipple work done because I want this pain to stop first.  You are not crazy!  I am on pain meds. still 4 years after the surgery.  The pain management doctors, acupuncture specialists and physical therapists are sympathetic because I need their help.  The 2nd opinion plastic surgery consultation was odd.  I think he was guarded against saying something is wrong because the original plastic surgeon is in the next town.   I really don't care!  I need some relief from the pain and want to be off pain meds.  This affects my every movement and has been life altering.  I had more than 6 months of physical therapy including the massage therapy.  I fight to stay fit but movement hurts. And now I am taking Cymbalta for the depression and anxiety of long term pain and the personal struggle I have gone through to find answers.  I can't say anything about the saline reconstruction.  I did not want anything foreign introduced to my body so opted for the TRAM flap.  The mesh and associated staples were a surprise to me.  I think they never settled down because you body moves and stretches with breathing, eating and digestion.     Is there a medical professional out there who is willing to help us out???? Or at least point us in the right direction. Or is this a life sentence of pain management.  I am 56 years old and feel like there is a lot to live on for.  CCC
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326352_tn?1310997895
Sounds like an abdominal hernia which is not uncommon (or so I've heard).  Have you gone back to the plastic surgeon or another general surgeon for comments?  My tram is NOT at all like ya'll's.  I am thankful that my incision healed...I did not have staples and as far as I know, I don't have mesh holding me together.  

Personally, keep bothering doctors until someone looks at what is wrong and helps.  Yes, that's a pain, too...but you need someone to start listening.  I'm sorry I don't know how to make docs do that, but what you are experiencing is NOT normal, IMHO.

Good luck to all ya'll.
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Avatar_f_tn
I am considering tram flap reconstruction. However, I present  I am not experiencing any pain.. related to the mastectomy. I have the one straigtht scar. It  is not attactive. I sometimes do not wear the prosthesis because it is hot and  feels  too heavy. I have had to fight feeling depressed as well. Recent divorce after a thirty year marriage was probably a blessing in disguise. However, starting back on the dating scene with one breast at age fifty five is scary to say the least. I do not know if I could take two more years of pain and drains and pain meds.  I would like to hear some other peoples tram flap experience. I was planning to have mine done at Duke Hospital in Durham by Dr. Zenn.
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Avatar_n_tn
I am almost 7 weeks out from free flap surgery on rt breast at the same time I had my mastectomy.   I have hard areas on the breast and am hoping that they soften and are not necrotic areas that will need to be removed.  I am waiting as requested and will not jump to conclusions yet.   I had nipple sparing mastectomy with free flap transplant on the rt side only. The nipple is doing great so far.  The contour is not perfect yet in the mirror but is pretty close already in clothes. My stomach and belly button are healing beautifully ( there is a fine line around my belly button and from hip to hip).  They will fade I am sure over time.   No draining and no bulging.  That does not seem normal.  If your docs do not give you an answer, there are many more out there.  Get another opinion or two until you feel comfortable.  I am lucky being in Los Angeles near many great docs.  
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Avatar_f_tn
Thanks lhughes, butterflyfuller and Mel in LA for answering my August 1 comment.  Your thoughtfulness is appreciated.
I guess it is time for me to go get checked "again".   It is a pain to go back for more appointments.  The original plastic surgeon said this bulge is not a hernia.  He called it "Abdominal Weakness".  All I know is that I lived 53 years and never had a problem until the TRAM flap.  
For butterflyfuller, I recommend a serious support system for post op recovery.  I was on my feet walking laps (livingroom-diningroom-hallway-kitchen) 10 to 15 minutes 3 times a day within a week.  That needs to be your job!  That and eating healthy, happy movies/music and prayer.  Make sure the rest is done for you!  It was months before I could cut veggies, open the door normally and carry more than 5 lbs. Get the house cleaned  and get help with shopping for the first 3 months.  Be kind and accepting to yourself.
Make sure you have home nursing to empty those drains and confirm the meds you need until the drains are out.  I was lucky my nurse sister stayed with me day and night the first week.  Keep the compression on your abdomen. Obviously, I think it is important to have your body rebuilt.  Who wants to walk around with a front looking like a back?  But, I think you will never be the same, and that is OK!  Love conquers all.  I don't know that doctor. I live in another state.  Have someone stay with you in the hospital as an advocate.  You will be drugged and will not remember much of your stay or first few days home.  The good news is I believe they cut out all the cancer!
Best wishes,
CCC still looking for relief after 4 years.  
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326352_tn?1310997895
I'm not sure how much "help" any of this is, at least we can all commiserate with you!  Have you tried just a general surgeon and asked?  I understand about the appointments and seeing so many docs all the time.  I'm just now getting out from under a couple of docs and I'm so glad to have more time NOT going to see docs!!!!  

Strange enough, when I had my surgery done (thankfully my mother was keeping my kiddos at the time) I watched horror movies and zombie movies pretty much all the time.  I had a good laugh at a lot of them, some of them are SO funny!!!  Now those are my favorite kinds to see!!!  

Yes, the good news is the cancer has been cut out, however, if you cannot get back to some kind of normal life, then in my opinion, you are not done yet.  I'm pretty much back to close to what I was before the cancer...sans the old boob and with a relocated abdomen.  My hair came back in pretty much the same, my arm has issues, but then again.....that cannot be helped.  Oh well.  Some changes we do have to live with.

Gotta run!  Good luck to you I hope you can find some answers!
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Avatar_f_tn
I had a tramflap done in 1995. Starting the middle of 1997 I developed occasional fecal incontinence. Could the tram flap have weakened the pelvic floor muscles leading to fecal incontinence. I do not have urinary incontinence. I have been doing exercises to strengthen that area for several months and do not see any benefit yet.

Faustus
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Avatar_n_tn
I had a bilateral mastectomy and reconstruction.  I too, have a bulge below my ribs that causes some discomfort.  I was not too concerned about it (other than cosmetic) until I found out that my diaphragm is only working at 31%.  I will be doing some pulmonary rehab to raise that number but it appears that I have some serious weakening occurring.  My surgery was Jan 2003.  Has anyone else had problems with breathing as a result?  I have had numerous problems with pneumonia and asthma post-surgery and was wondering if it was all related.  Thanks!
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Avatar_f_tn
I had the Tram Flap procedure in August 09. I developed necrosis on my right breast which had to be cut out. It still has not closed completely. It takes a lot of time from my understanding. That is not my issue.
I went to a chiropractor last week and got manipulated for my hip and he moved my shoulder back and my hip the other way. Since then I have had nothing but pain the first four days in my stomach area. I do not know if the stitches were pulled or ripped out. I do not see any bulges it just feels weird. I didn't have that sensation before the manipulation.  Has anyone ever pulled their mesh in their stomach that's attached to the oblique muscles and if so, how long will it take to heal? Thanks
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962875_tn?1314213636
I would suggest you post your question to begin your own new thread.

When you add on a question to an old thread, there is less chance you will get  answers, because people tend to assume you are just replying to the original poster.
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Avatar_f_tn
A related discussion, back issues after tram flap was started.
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