Sunday, June 22, 2008 lindagonz asks

Q: TRAM flap in 2001 - miserable quality of life since

Breast cancer when I was 34- (1985) bilat. mastectomies, with saline tissue expanders over the course of the next year. Silicone implants- they ruptured - had a bilat. TRAM Flap done in 2001 ( was told it was the "gold standard" of breast reconstruction- free tummy tuck - no need for sit-ups the rest of my life...) I had many complications at the time of surgery ( difficulties DURING surgery (( not enough "fat" to make decent sized breasts - they had taken more skin from my belly to make way for the larger breasts they anticipated, only to find out I didn't have that much belly fat to work with- seems they did this step backwards)) they could not easily close my abd. incision after taking the excess skin, so had to sit me up on the table to close me. My incision burst open a week or so after surgery, and fat necrosis was a major issue. The incision could not be closed- had to heal from the inside out, and had to be debrided on a weekly basis over the course of months.

The surgeons were finally able to 'CLOSE' the wound, and the stitches are approx. 2" apart, and 3" long. Makes for a very Ugly scar, which is the least of my angst.

It's been over 7 yrs now, and the problems I have are, in MY OPINION, directly related to the TRAM flap surgery. They present as gastrointestinal.. I have gone through quite a few major tests (CAT scan, ultrasound, abd. xrays, endoscopy, colonoscopy) ALL within normal range. When I went back to the plastic surgeon regarding my abd. symptoms- 18mos. after the Tram, she dismissed me. Said to me "this is a problem for your primary doc". I am in constant abd. pain. - swelling, bloating, n/v, most times diarrhea, not often what most people would call constipation (although I feel better when I'm "constipated")- to me that means a soft stool every day. My life has not been a life anyone would want to consider... I miss MANY days of work- I come home in tears of pain - it's a struggle to keep my job, and I must... I pay the bills. I have NO social life... my house is literally falling apart around me- the simplest of tasks are painfully done, if done at all. No love life AT ALL (no sex in 7 yrs)- I live with my BF, and he has his own medical disability issues (ie: no help around- he's not capable either) It is truly the biggest struggle that I have faced- including the initial cancer surgeries. Suffice to say, I'm on anti-depressants, they don't seem to be helping me help myself, the docs give me pain pills, (they are a God-send to help me get through my work day. When I come home, it's curled in a ball for a couple hours - maybe I can eat dinner- maybe not. I work 4/10's a week, and from Thurs. to Mon. a.m., I'm on the couch. I'm thinking I'm circling the drain. ANY help you can impart will be much appreciated

Answers (3)

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Laurie Kingston

6/22/08 3:27pm

I am so sorry that you have had such a terrible time. You need to go to your doctor and tell her or him everything you have just written here. When I read something like "circling the drain" I get very worried. It sounds like you doctor has been somewhat sympathetic but you need to lay it all out. I am not sure what more can be done for the pain and I am not a doctor but it sounds to me like you have a lot more hard stuff on your plate than just complications from surgery. Please be good to yourself and do reach out for help.

Laurie

PJ Hamel

6/22/08 5:37pm

Linda, Laurie is right; your health issues are serious, and need to be taken seriously by the medical team at wherever you go for treatment. I'm wondering if all the digestive issues aren't due to some other cause, and it's coincidental to the tram flap- sounds a lot like Irritable Bowel Syndrome (IBS), actually. Has anyone ever suggested that to you? If not, you might ask them about it. What does your PCP say about all of this, by the way? If you're getting the brush-off - it's time for a new PCP.

You're in a terrible place right now, on so many levels. But if you could relieve your pain, I think everything would look better, for sure. My suggestion would be to hound your PCP, and if (s)he can't help, ask for a referral to a gastrointestinal specialist. I know these GI problems can be very tough to solve, but please don't give up; try to keep moving forward towards a solution. It's tough to have to always advocate for yourself, with no help, I know... But the choice is to stay in the situation you're in, which is not acceptable.

Does your cancer center, or anywhere near, have a survivorship initiative or survivorship clinic? You might ask about that. They're springing up all over the place, and they're specifically for people dealing with post-cancer issues.

Good luck - I really hope things improve for you soon, Linda- PJH

tramflap pain

11/27/10 5:15am

I had tram flap reconstruction on my left side in 2004, they took the muscle diagonally because my body was too short. I have chronic pain in the right lower quadrant where they took the muscle, have had every test for abdominal pain many many times all normal, had my gallbladder removed thought that would help and it didnt. Have chronic diarrhea/constipation and pain pain pain. Feels like a hot knife piercing me sometimes on top of constant ache. At least you can get pain meds, my doctors have labeled me and wont give me anything but levsin an ibs medicine. I live on tylenol pm only way i can get sleep, am taking up to four a night now. I know how you feel, circling the drain is where i am at too.

PJ Hamel

11/27/10 1:45pm

I'm sorry you're having to go through this. If you had chemo as well, they're finding now that chemo can produce gastric issues many years later, so this may be part of the problem as well. All these "gut" issues are difficult to treat; hav eyou tried any complementary or alternative tretments, since the standards don't seem to work? Acupuncture or chiropracty might be an option for you. PJH

Phyllis Johnson

11/27/10 5:05pm

I concur with PJ's suggestion to try some alternate forms of pain control. Be very careful with those Tylenol. Too many can cause kidney and liver damage. I have long-term nerve damage from chemo in my hands and feet, and the pain from that can make it hard to sleep. I haven't found any medication that helps the pain, but I have found medications that help me sleep. My main go-to for sleeping is Benadryl or any over-the-counter antihistamine that does cause drowsiness. Be sure to check with your doctor before you try even an over-the-counter medicine like Benadryl because there may be some reason why it would interfere with other problems you are having. I hope you can soon find relief. Long-term chronic pain can be very difficult to get under control, but there are techniques that can make it better.

Q: TRAM flap in 2001 - miserable quality of life since

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