Another Tram Flap Question

BBK

I had a mastectomy (L) with immediate TRAM FLAP reconstruction, in January of 2003. I still have no feeling in my torso. And, obviously, am now missing muscle from my abdomen. My question is this -- will exercise help the feeling to come back (ie. the nerves to heal quicker), or doesn't that matter? And, then, what types of exercise can I do to help get what's left of my abdominal muscles toned? I feel kinda barrel-chested/torsoed right now, because I have little feeling in that area -- so feel like my belly is sticking out and I have no control over it. I know that these questions don't really make a lot of sense, but I'm figuring that maybe there are other TRAM FLAP survivors out there who will know what I'm talking about. Also, although I had a skin-sparing mastectomy, I still have no feeling in my reconstructed breast. I'm doubtful that I ever will, and I guess that's okay. But, as I'm approaching the first year anniversary of my surgery, I'm questioning why I'm not further along in the healing process. So, wondering if there's some exercises I can do to speed things along. I am overweight, and the Tamoxifen doesn't help in that area. But, I've always (up to now) been in fairly good shape, been toned and all that. I am walking at least a couple of miles every day, and trying to lose weight in spite of the tamoxifen...hard road...

Any suggestions would be helpful. We don't belong to a health club or gym, and that's not financially possible at this point, so suggestions of things I can do at home would be nice. Thanks heaps. ~Barb

cruf

Hi Barb! I had a tram flap 3 years ago and I'm still numb and will always be. When they do the surgery, the nerves are cut so you may get a little sensation back as time goes by but not full. There's no exercise that will speed this up. I do know if something is touching my breast or stomach but not true sensation. As far as exercise, walking is a great and inexpensive way to get your heart pumping and help with wt. loss. You'll never be able to do straight situps cause the Rectus Abdominus muscle is disconnected and used for the breast but you do have oblique muscles that are intact. You can try lateral crunches(situps by trying to situp at a diagonalby lifting your head and shoulders off the floor. You won't get far but you will be getting a muscle tightening. I do go to the gym and do walking and some machines for my arms and legs. There is a website, Staying Abreast.com, that is about breast cancer and has exercises etc. Try that for ideas. Hope this helped some. You will get used to the numbness. E-mail me here at any time. HUGS!! Cathy

jake10

I had a tram flap in Nov 02. Still no feeling on right side of torso. (R reconstruction). Breast has no feeling but is getting more bouncy and natural feeling as it ages. As far as exercise, the knee chin touch kind of sit up, does that make any sense? You know, you lay on your back, bend and lift one knee towards your chin as you raise your head and shoulders slightly. And we all know walking is very good for us.
I had problems with the abdominal wound healing and now the breast is dimpeling at the transplant area around the scar. Had problems with my plastic surgeon,got a new one. So I go back to the OR on the 10th for some modifications. Hope these take. Good Luck Beth

wingingit

Hello, Barb! I had a free tram flap Feb. 2003 as opposed to the tunneling method tram flap (one not necessarily better than the other but wanting to let you know from where my comments are coming). My abdominal muscles were pretty much left intact. However, I still have some difficulty doing a traditional abdominal crunch. (Truthfully, I could not do them that well before!) The kinds that jake10 and cruf suggest sound excellent and using one of the large exercise balls works well for supported abdominal exercises. Just do them slowly and deliberately with technique being more important than quantity. We are definitely on the right path with our walking. I like my stride just long enough to feel my abdominal muscles stretching. I felt short-torsoed after my surgery. Lifting light weights overhead and doing any stretching exercises with my arms above my head feel great. Although I have not done either one, I have heard yoga is good for stretching and de-stressing and Pilates is excellent for the core strength muscles. There are lots of videotapes for both on the market.

As soon as I had my last drain removed (Ugh, 5 weeks after surgery!), I started wearing a girdle, and pretty much wore it 24/7 for the next few months. Now, if I feel like my abdominal area is starting to protrude and/or I am getting that jelly-belly feeling due to numbness, I wear my panty girdle (the kind with a high waist) for a few days, including while I exercise. It makes me more conscientious about standing up straighter and holding in my abdominal muscles, which do seem to tighten and feel somewhat less numb, but that may be more of a psychological effect than a physiological one! I am trying to convince myself that my inability to lose weight is not totally due to the Tamoxifen. A lifetime of bad habits and the effects of menopause (chemical-induced) are surely responsible for SOME of it! I have lost 3 lbs. in 5 wks. on Weight Watchers. Not impressive, but not discouraging either! We shall persevere with the help from each other here . . .Kris

Kathy713

Barb,
I had my masectomy(L) and immediate Tram Flap reconstruction in Jan. 2001. I am on Tamoxifen too. I have always had trouble with my weight mostly due to my hypothyroidism. I joined a fitness spa after my surgery to start getting my strength back. I went to a nationally known gym, explained my situation and was set up with a "trainer". He had me doing all sorts of things. I then went to another spa and told them my tale and their trainer outlined a program for me. She had set up programs for other women with my situation. I sent my Plastic surgeon an e-mail asking him about the exercise program. He was thrilled that I had found a spa that understood my needs and had a program fitted to my situation. The physical therapist and my plastic surgeon approved of my exercise program. The other place did not understand the specific needs and limitations that my surgery left me with, nor did they do their homework. Having a pedical tram flap meant that my doing regular ab exercises could cause loss of symmetry - your muscled side would develop and you could become lop-sided. My trainer showed me other ways to maximise what muscles I had left and how to tone them and keep symmetry. She stressed repeated sets increasing the number of sets gradually with low weight resistance. She also had me work the muscles in my laft side, obliques I think, to help tighten that left side. I could tell a vast difference after only a week at the spa. As a spa is not in your budget, is their a community college that offers exercise classes? Most community colleges offer continuing education courses at a modest cost. Also, some areas have fitness classes offered by church groups, the YMCA or senior groups. Do you know anyone who is a fitness instructor who could do some research on exercises to help your specific needs?
I also use walking at home either on a treadmill or through the neighborhood with my husband. The tram flap gave me a "tummy tuck" and the hospital stay lost 10 lbs for me. The "cargo" netting my plastic surgeon used to reinforce my abdomen has helped me stay pretty flat. The masectomy and tram flap was a heck of a way to loose weight and get a flatter tummyI still have a sagging area on my left hip area. I suppose if it bothered me enough, I could have some liposuction done.
As for loss of feeling...it has been an interesting 2 1/2 yrs. I went from no feeling in my reconstructed breast and abdomen to pricks, tingles and knitting needle like stabs to un scratchable itches. I still have those unscratchable ithches and they can be a bit frustrating. The total amount of area that still has none or not much feeling is probably 1/2 what it was after the surgery.
Exercise,I feel, is the best way for me to keep from gaining additional weight. My thyroid and rheumatoid arthritus medications combined with the Tamoxifen make regular exercise a must. I never thought I would enjoy going to a gym, but I found myself liking how I started feeling after a work out. I have also gotten back to horse back riding to add to my exercise.
You need to remember, Barb, just how much surgery we had. A very lot of surgery! It took a long time to heal, recover your strength and get back to living again. I had a complication with my reconstructed breast - I developed what they call a "blister". A patch of skin on my reconstruction did not have enough blood supply and died off. This area didn't heal all the way for almost another year. Every January 24th, I celebrate my cancer-free anniversary. If I have to battle my weight for the rest of my life, at least I'm alive to gripe about it.
Kathy713