Anyone have the double tram flap recon surgery?

[TriciaV]

Hello everyone,

I was just curious if there was anyone on the boards that has had the double tram flap reconstruction surgery that would be willing to talk with me a little about their experiance? I had the surgery on February 18, 2008 and I am having some issues with my abdominal area.... like a hardness, very full, very uncomfortable feeling in the area that falls just below my breasts to about my belly button. The area from my belly button and below is very flat and has no issues other than it has no feeling due to surgery. The best way that I can describe the feeling is when I was pregnant and I felt like my stomach was hard and could just unstrap it and sit it aside. I have talked with my plastic surgeon and he thought (after seeing the distended area himself) that I had a hernia, but MRI/CT scans showed everything in that regards was fine. It did however show that I had a very enlarged liver, but all my liver function tests are normal. My oncologist says the liver is in larged due to the Tamoxofin and since all the tests are fine no need in stopping the med. Anyway I just wanted to talk with someone about the surgery.

Thanks----> Tricia V.

Bumping this up for you Tricia. Hope you get some replys.

[madubois63]

Hello again Tricia! I didn't have a double, but just the left side. About a year after the surgery, due to my own stupidity, I herniated the left side of my abdomen (I don't know - lifting tree stumps or something dumb like that). I had the surgery to repair the hernia. The doc put a mesh in. After the surgery, my body kept generating fluid in the area that had to be drained. It was hard like you described. Don't know if that is your problem?? I had to go to the surgeon once a week for several weeks to be drained. I don't know if my body rejected the mesh or if I was stupid enough to do it again, but the area herniated again (about 2 years later). Yes, everyone. I've had more problems than I ever posted...Anyway, I was scheduled to have the hernia repaired again, but the reoccurance was discovered in my lung and liver. I was never able to have the repair work done, and have lived with the hernia for the last 4 years. My point - be very careful and DON'T LIFT ANYTHING too heavy to lift with one arm.

[TriciaV]

I have had problems with fluid and draining. ugghhh after my mastectomy they put those pesky little drains in and told me in about 10 days or so they would be ready to come out....Yeah right it was 6 weeks later. So when I had my Tram flap surgery they put a drain in each breast and two in my lower abdominal area, and the plastic surgeon told me in a couple weeks they will be ready, I told him that I didnt think so and I was a drainer, but he didn't believe me....it was 8 weeks later when I was sitting in the shower and I pulled them out myself..... I know a very stupid thing to do but I was so tired at that point of carrying those drains and tubes and bulbs around with me. My surgeon was really upset with me and told me that I might need to be drained in his office when I go Sept. 12. I am hoping that most of this is fluid but I have this crazy feeling that this is just how my stomach is going to be from now on. It feels like I healed with my stomach sticking out or something like that.

[madubois63]

As I am on my second week with this stupid drain coming out of my abdomen, I have thought about pulling it out myself (today as a matter of fact). I had a pick line in my arm last year that slowly fell out, but you are brave for pulling. Hopefully this is just fluid and it will settle in time. Keep me informed..

[swimangel72]

Hi Tricia - I'm sorry you've been having issues with your abdomen. My problems started (I believe) when my PS removed my drains too soon (about 12 days after surgery). I ended up with an abdominal staph infection in the fluid build-up - and my stomach incision re-opened, requiring packing twice-a-day for over 3 months. I hope you don't have to worry about THAT! I also have a large bulge in my lower right abdomen. In the beginning, the PS kept saying it was fluid, but I really didn't believe him. I had to see a lymphedema therapist for cording in my right arm - and she felt my abdomen and said it didn't feel like fluid to her (it's very hard - feels like a pregnancy.) After a couple of months of this - I went to my family doctor who ordered a cat scan - it didn't show a hernia, only the abdominal wall defect from my "muscle-sparing free tram." With that as proof, my PS had to admit it wasn't just "swelling" in my abdomen but an actual defect that he would have to repair during Stage 2. I've since lost trust in my PS - went to visit a surgeon who repaired a small hernia for me 7 years ago - and when he looked at the cat scan on his computer then felt my stomach he said I DO have a hernia - that my abdominal muscle on the right side is nearly gone. I said how is that possible when the surgeon only took 1cm of tissue? He said a staph infection (especially MRSA) can eat away at the internal tissues - also he said when they do a cat scan, you're laying down so the hernia isn't as obvious.

I'm so happy I went for a second opinion - and to a surgeon who's speciality is fixing abdominal wall defects and hernias (he's worked on many tram-flap patients - his before and after pictures were amazing!) I have to wait until next January when I can switch insurance companies since he's out-of-network - but I can't wait to get my stomach repaired.

I hope my story helps you and doesn't frighten you. I just wanted to let you know you're not alone. I'm assuming you had a pedicle Tram - where they tunneled your muscle up to create the new breasts? A teacher I work with had that surgery ten years ago and she still has a bulge just beneath her breast above her navel - she said it's actually the muscle that is bulging as it was bent and twisted. Do you think that's what your bulge is?

['lizbeth]

I'm glad everyone is posting their experience with the Tram surgery. I'm one of the lucky ones with no problems at all with my stomach - other than the unsightly scar from hip to hip and the numbess. And the corners look a little funny. I end up with the annoying drains in for weeks as well - some 3 to 4 weeks.

After seeing Madame Dubois post I will be careful about picking up heaving items. I didn't have any mesh as my PS advised against it.

I did have the problems with the partial loss so am a little bummed about the breast being smaller. On the bright side my breast surgeon did a skin sparing mastectomy so I don't have the huge scars - yet. When my PS does corrective surgery and then matches the other breast he will move the nipples up and use the anchor pattern. I am so not looking forward to more drains . . .

[TriciaV]

SwimAngel and Lizbeth,

Thanks for responding and sharing. I did have the pedicle tram flap and I never thought that the bulge could possibly be the muscles actually sticking out, twisted under there.....that for sure has me thinking. I just turned 33 in July and when I had my surgery in Feb 2008 my PS assured me that I wouldn't suffer much physical loss from the removal of those ab muscles, he said that my back would just start picking up where those muscles couldn't... But I have a hard time getting out of the bath.... it's like trying to do a sit up while being nine months pregnant...lol. I am very scarred and hate looking at myself.... it pisses me off that not only did cancer come and mess with my health and my future and my mind..... but also my physical body that now that I am NED I am still reminded of my battle every time I shower..uugghhh But I deal. I go see my PS on Sept 12 and we are going to schedule the next part of the sugery. He said he could work on some of the scars and I also have these little Knots just under the scar line that he said is where fat has deposited...but you know how feeling a knot in your breast can freak you out...so he is going to remove those as well. So we'll see.