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tram flap disaster
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tram flap disaster

I had the tram flap reconstruction after having a mastectomy.  Three months after the surgery I started haveing a bulge where the plastic surgeon used a mesh to replace  the used ab muscles.
The plastic surgeon told me that the mesh had detached and needed to be removed and replace.  After it was replaced I noticed that a huge bulge was still apparant. I went to several surgeons and no one could tell me why I had a huge bulge and why I would have pain at times.

I would not recommend having a tram flap.  Especially if you have low back problems. ( which I did) You need your ab muscles to support your back.  I also have problem with having bowel movents.  I went to a gastro specialist and he told me it was because there is no  stomach muscle holding my intestines in. If i get slightly constipated I have ab pain where the mesh is.  So to treat the problem I must keep my bowels loose.
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I had a tram flap six and a half years ago.  As I had a double mastectomy I had a double transflap surgery.  It's been almost seven years and my cancer hasn't returned.  However, the transflap has been a nightmare.  It became infected right after surgery.  There was a lot of fluid drainage from the drainage tubes that they had placed after surgery in my abdominal area.  After a month of drainage a second surgery was done to clean out the surgical sight and hope for a better outcome.  Long story short, I drained fluid for another ten months before the tubes could be removed.  They tried to remove the tubes on a couple of occasions but without the tubes the fluid built up in my abdominal area causing me to go to the hospital where they drained a liter (about a quart) of fluid.  They then had to replace the tubes.  Although having the tubes replaced wasn't uncomforable, the large amount of fluid was very uncomfortable and it was a relief to have it drained.  So after eleven months it was finally healed although there was a small amount of fluid remaining.  I might add that on several occasions I was advised to have the mesh removed but didn't want to lose support of my intestines.

A couple of months after celebrating my five year cancer free date,  I became extremely ill and my husband took me to the emergency room.  I had been feeling badly for a couple of days but thought it was something like the flu.  I lost my appetite.  By the time we went to the emergency room I was feeling so sick that I could not stand to sit up and so I layed down on the floor.  My kidneys were losing function.  My blood sugar was off and I was very weak. The EKG of the heart was abnormal.  I was in the hospital for a week but they thought that I was having an auto-immune problem.  They were wrong.  It was an infected transflap mesh.  It was infected with a staph infection and I waited nervously while they tested to see in it was MRSA.  (half of all hospital staph infections are MRSA which is a difficult infection to treat and can kill you as it is resistant to antibiotics.).  

I had tubes put in again to drain the new fluid from the staph infection.  We eventually eliminated the staph but I now have psudomonas infection in the mesh.  This infection can also be dangerous and my Infectious Disease Specialist tells me that I need to get rid of the mesh and heal if she is to get rid of the infection.

I have spoken with two surgeons.  The first was hesitant to do the surgery since I have had a blood clot in my leg.  She fears another clot could develop during surgery which can then go to my lungs and kill me.  I would have to be on blood thinners during and after surgery.  Also synthetic mesh would not be used a second time since the mesh itself can harbor the bacteria that causes the infection.  My choices are now to use human donor material or porcine (pig) material., if I choose neither my intestines would not have much support and would probably bulge..  Oh yeah, I am overweight.  Overweight people have more water in their bodies.  My body is supposed to grow new cells on the human or porcine material but this might not work if there is too much fluid. Now I have been dieting for a year while on a combination of antibiotics to keep the psuedomonas infection at bay.

Will probably have the surgery in July 2010.  I worry about the blood clot and healing.  I worry about dying as a result of having had a transflap surgery.  I worry about my family.  I prepare family records, label photographs, pare down my possessions.   I leave notes for them to find later - just in case.  

Was the transflap worth it?  What was I thinking?  My spirit does not reside in my breasts.  It resides in my body.  If I am to stay with my family I need a body, not breasts.

Whew!:

Also, your abdominal muscles support your spine.  I now worry about future problems with my back.  And - after a transflap you can't pick up anything with any weight to it.

Sorry if I'm raining on anyone's parade but the plastic surgeons will not warn you of what can happen if things don't go well.  When I asked about the pitfalls of this surgery they mentioned infection lightly and acted as if it was no big deal.
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