Failed Tram Procedure

[baylee6897]

First off, I need to fill you in on everything that has gone on before I can ask my questions, just so you can understand where I am coming from. I recently underwent a left masectomy followed by a tram procedure.  It did not work.  Immediately after surgery, it started to bleed underneath the breast.  Mind you, I had a noticeable blood stain on my hospital gown.  The doctor when he came in to see me the next morning only looked at the top of my breast because, according to him, if anything was going to go wrong it would be on the top of the breast not the bottom.  When I asked him about the blood stains and the fact that I had blood dripping down my side, he got offended and said it was nothing.  He never even looked at it.  After I was released to go home (on a Friday) I was able to finally look at everything in a full length mirror.  I could tell that there was a small hole beginning to form underneath the breast in the curve.  i called the Doctor's office and asked about it.  Again, I was told it was nothing and he would take a look at it on Tuesday when I came in for my follow up.  When I came in, he looked at it and said, "Oh you do have a hole there.  I guess we'll just have to watch it and see where it goes."  See you Thursday.  It wasn't until a full two weeks after my surgery, with this hole getting bigger and bigger and him not doing anything or even trying to do anything to stop it, that he finally said that the procedure failed.  When I asked what caused this to fail he said it was because I was too healthy and my blood flow was so good, it just pooled in the bottom of the breast and that was what caused the hole to form.  Then to add insult to injury, he said it must have been your turn to get hit by the bad luck dart!  Talk about making me feel like crap.  Then he said we could try silver sulfadyne? to see if that would work.  Maybe if he had tried it sooner rather than waiting two weeks before doing anything, it might have worked, I don't know.  But this did not work.  Finally, after five weeks he said he had to schedule surgery to close it up.  I went in two days later in the morning and woke up a little while later with nothing there.  He had taken the whole thing off.  Mind you, I did not have a full masectomy to begin with, only the bottom part of my left breast where the cancer was, was removed, so he had the whole top part of my breast, nipple included, to work with.  Waking up to nothing there was quite a shock and when I asked why didn't he give me a heads up he was going to take the whole breast off, he replied I told you I was going to close it.  I'm sorry, but the words I need to close it up does not equate to lets take the whole breast off. Maybe I'm wrong.  Then to add insult to injury, he signed my back to work paperwork and made it the day after I had this surgery and refused to change it.  Need less to say, my first day back at work was a little rough.  Now, after saying all of this, here are my questions.  1)  Is too good of a blood flow a reason why this procedure fails?  Is it normal to not do anything until a big hole develops versus when it is just forming?  2) is it normal to have no and I mean no flexibility.  I cannot do any type of movement to the side, bend over etc...without a shooting pain.  3) Whenever I turn at the waist, I get a tearing sensation.  Is this also normal after this procedure. 4)  The area around my abdomen is hard and every now and then I feel a tightness that takes my breath away. 5) I can't sleep normally.  What I mean by this, is where normally you can toss and turn and shift positions while you sleep, I cannot.  I literally wake up and have to actually move my body into a different position.  Needless to say, I have not had a full nights sleep since this procedure. 6) The top part of my left arm is numb.  I had 9 lymph nodes removed when I had the lumpectomy done and after this surgery, underneath my armpit, a hard lump is there. He said it was scar tissue from the surgery.  I still haven't quite figured this one out.  7)  I used to run, now I literally can't.  It is very painful to run.  The pain that I feel in my abdomen and the fact that I have a hard time trying to breathe makes me not even try anymore. These a just a few that I have.  Mind you, I have asked my Doctor these and he told me that it was all in my head.  

[japdip]

Another thought ... you might get in touch with either The Amer. Cancer Society OR Susan G Komen Foundation and ask if they have any suggestions about Therapy .. they often have funds available in the form of Grants for P.T. following breast surgery. ACS also has video tapes or Discs with prescribed exercises for post-op breast procedures. They are free and will be mailed to you ... you can either keep them or return them in the pre-paid envelope that is included; it's part of their "Reach To Recovery" program.  

[japdip]

Well, I hate to say this and it certainly doesn't make me proud to have been associated with medicine all my life BUT I'd dump him .... often you don't need a referral to some Physicians ... I'd call around and see what's available. Do you have another Dr. .... family Dr. or GYN. ?? Anyone can refer you for a consult with a Physical Therapistand they can tell you if they can help with your flexibility issues.   Keep us posted when you find out something GOOD, OK ??  Take Care ....

[baylee6897]

Thanks!  Yes, I did ask about physical therapy and he told me no.  He said I didn't need it and he wasn't going to recommend me to anyone. I'm on the waiting list for the livestrong program, so I'm hoping they can help.

[japdip]

This is going to be a very short response ... Make an appointment with another Plastic Surgeon and have all your records ... this includes the OP procedures and any copies you can obtain from your present Dr's office. I can certainly sympathize with this predicament and perhaps it was your turn to be hit by the "bad luck dart" but that statement is totally inappropriate to my way of thinking. Sounds like an excuse to me as well as the "being too healthy" !! I will say that the numbness in your arm and the scar tissue in the axillary region are pretty much usual after breast surgery and these will most likely be life-long with maybe some improvement in the numbness. Were you not referred for some Physical Therapy following the surgery ?? That's always a good idea when it comes to the degree of flexibility and even now I wouldn't be too late to get an opinion about some prescribed exercises .... I would wait on that until you get some answers from another Plastic Surgeon.  Kindest regards ... don't give up just yet; time does heal any number of problems.