TRAM Reconstruction

HI Holly, My name is Kris and I had bilateral TRAM surgery 2 weeks and one day ago. Here's what happened to me. The surgery was 8 hours long and I had the sentinel node biopsy on both sides as well. I had to arrive at the hospital (Evanston, IL) at 8am for the dye injections into both breasts. It didn't really hurt. Within about 30 minutes, they did xrays which showed where the lymph nodes were. Then I was done until surgery, which was scheduled at 12:30. I was in my hospital bed with my family until about 12:15, and then they wheeled me into surgery. About 3 hours into the surgery, my breast surgeon was done and told my family that my lymph nodes were cancer-free (thank god) and then the plastic surgeon didn't finish until 8:30 that night (a long day in the OR). I woke up, feeling pretty out of it, but okay. The nurses will check your breasts (they call them "flaps" but I hated that) to make sure the blood is flowing through them every hour. This gets a little tedious, particularly if you've finally fallen asleep, but it's okay. Day two I was still in and out of it (sleeping a lot). Day 3 was okay, but by that evening I was getting nauseas and developing a migraine. I was on Norco (for pain) and some ointment was being applied to my left breast, where the cancer had been, because I had some huge bruise that needed help healing. My surgery was on Wednesday, and I spent Friday night and Saturday vomiting anything I drank or ate (which included water and pills). It was pretty awful. Hopefully you won't get nauseas. They quickly changed my medications to Darvoset and stopped using the ointment and by Sunday I was much better. Monday, I was finally allowed out of bed. I was terrified to sit up, but once they helped me to do it, I felt sooooo much better. Tuesday I was allowed to go home to my family of 3 crazy kids (boy, 4; girl, 3; and baby boy; 5 mos.) I spent the first week at home mainly in my bed, sometimes in the chair in my room. I went up the flight of stairs in our house very slowly but uneventfully. My daughter was scared when she saw me arrive home because I was walking soooo slowly, but I was able to stand about 95% upright, I wasn't stooped over too much. I had trouble sleeping the first week at home, but my doctor said I could take a benadryl, and that really helped me. The hardest part in arriving home was figuring out where/how I was going to sleep and get in and out of my bed. We don't have a recliner chair in our house, as I know some women have found helpful. We ended up taking some couch cushions and using them to force me to lay on a slight incline. My mom had to buy a step stool for me. for the first week at home, when I'd want to get out of bed, I had someone push me from my back into a seated position. Now that I'm two weeks out, I can roll a little on my side, and then use my elbow to prop myself up. The first week at home is rough. Now I'm just bored. I do feel a little bit better every day. I haven't had any issues with my incisions. I had four drains post surgery, two came from under my underarms and two more were in my lower abdomen. they were removed three days ago. It didn't hurt when they removed them and it was really nice to get rid of them. They were kinda gross... but not that big a deal in the scheme of things. You pin them to your pajamas on the inside. My older son saw it and thought it was a milk pump (that's how recently I was breastfeeding an infant!). Truly, my doctor told me that about 3 days after surgery, most patients are really angry at their surgeon and feel like they made the wrong decision. Howevery, by about day 5 or 6, everyone is feeling better and is pleased they choose the TRAM route. I definitely look better than I thought I would. Since I did both sides, and had some tummy fat, but not excessive amounts, I went down a couple sizes. I think I was a D before though, so I don't really mind. And my tummy is super flat. I'm still pretty tired, and frustrated by not being able to hold my baby for another couple of weeks, but I'll get through this. I do have a lot of help, which you will need also. Friends are bringing dinner over 4 times a week, I have a full-time nanny until I'm healed, and family members are rotating at our house in the evenings to get dinners served, kids in bed and bathed, etc. I've never had so much help in my life, but there are times when we need it, so please accept any help that is offered you. Let me know if you have any other questions. Good luck with your surgery!

seeknpeace said:

Hi there,

Ok, I can give some perspective further out. I had my bilateral mastectomy and tram feb 4, 04. So, I am a year out.

My surgery was 8 hours, my hospital stay 8 days. I have to say that it was like a mac truck hit me then did a victory lap to get me again. I did not realize it at the time, but, I was terribly anemic from blood loss, so that had a lot to do with my weakness. when I would try to empty the nasty drain bulbs, I could only do one at a time, then lay down because I was blacking out. Had four and it took a while. My drains sucked. I hated them. But, as was said, it is just part of it all. I feel that I am not hampered in any way physically. If I could do it again, I would hope to find someone who could do the diep. That surgery does not use your ab muscles, but, microsurgery, to provide the blood supply, so you get the tummy tuck and still have your ab muscles. The one thing that I regret is losing them. The doctor did put mesh in my loser abdomen, but, it is rounding out as if it stretches from the pressure of my innards. Not sure what that is, and I have complained to the doctor.

For me, the bottom line is yes, I would do it again. To wake up with no breasts would have traumatized me no end. I would not do well with that. Sometimes I forget that these are not my boobs. They are too big, I do not like that part, but, they are what they are. I did have nipple reconstruction using the surrounding skin on the breast but, he put them too low, so I am having them cut off next week then redone. Then the tattoo. I was unsure about nipples too,but, found that I felt more normal with them. But, when they first do them they are huge. Look like the fembots from Austin Powers..hehe.

I, for one, would not want or be comfortable with implants. So, my choice is ok with me. I have had two surgeries since, one was to modify the lower scar.

I would tell any woman who is thinking of this to tell your surgeons, both of them, to try to not cut so close to your underarm, or to the center of your chest. It makes it hard to wear a bathing suit. The scars want to show. Also, the bottom scar, I think that they could maybe make that sucka a little shorter.

Good luck honey and keep us informed. Welcome to the world of bc warriors!! Jan

I had tram flap reconsturction on 12/17/04..I'm 7 weeks out today!!! My tummy is flatter than it EVER was..My reconstructed breast is still not healed..I just started chemo last Tues...I also had reduction on the left. I would do it over again if presented with the same circumstances....I believe the end result will be great...that is if I have to have a reconstructed breast..Please feel free to ask specific questioins..After surgery is TOUGH..But in the long run, it will produce the optimal result!