need for physical therapy

unknown said:

Hi again hun,
A therapist came to my hospital room and showed me what to do when I got home. (Remember I did this twice.) Well, those exercises were HUGE as far as my overall recovery was concerned. When I had my first mast, I had a 1 yr old and I wanted to get back to being able to life him ASAP. The exercises free up your shoulder movement and improve circulation in arm and hand.
Here is some of what I did: Stand at arm's length from the wall and just walk your fingers up and down the wall. 'Walk' a little farther each day, according to what is comfortable.
Also, loop a jump rope over the top of a door and hold to each end with each hand. Pull your 'ouchie' arm up by pulling on the rope with your 'good' arm. Then slowly lower and repeat.
Try this: Lay on your back and hold a yard stick in both hands, keeping your hands just far apart enough to allow for the width of your body. Then lift and lower the stick over your head and back down (don't go all the way up at first), allowing your good arm to do most of the work at first.
And the other thing I did that helped a lot (which was not recommended by the therapist, but was a part of my life-style) was to hang laundry on the line! No kidding. I was soooo proud when I could hang sheets as well as 'hankies' LOL. Gotta love life, huh?
God bless, dear. You are going to be fine.

DAArps123 said:

I was wondering what made you choose the TRAM flap. My story is as follows:

Hello. I am 43 years old. This is the first time I've posted on this. I was diagnosed with Invasive Ductal Carcinoma of the right breast in October 2007. I have had 2 surgeries to remove the cancerous tissue. The first surgery removed the micro-calcifications found on the Mammograms. They thought they got clear margins, but the Oncologist wanted "wider" clear margins. I then had numerous magnified, digital mammograms, a breast MRI, a bone scan, a chest xray, and a MUGA scan of the heart. Nothing showed up on any of these scans. But, the Oncologist wanted a "wider" clear margin and wanted the lymph nodes taken out. I then had a central lumpectomy and they removed 2 Sentinel Nodes and 13 lymph nodes.

The scariest part was that the "wider" tissue that was taken had 5 more areas of cancer in it. These 5 areas did NOT show up in any of the scans! The first Sentinel Node also had cancer. The 2nd Sentinel Node was clean. The first lymph node after that also had cancer. So 2 out of 15 Nodes had cancer. It was rated Stage II. After all of these scans and xrays and MRI that showed the "all clear", the tissue actually had 5 more areas with cancer. Because of this, we are unsure whether the rest of the breast also has cancer "hiding" in it. I will therefore have a mastectomy in April 2008.

This comes after 6 rounds of chemotherapy. I have just completed number 5. I have been on TC (Taxotere and Cytoxin). The first round they included Adriamycin which tore my stomach up!!! It was intolerable and I told my oncologist I'd die before I did that again. He took me off the A in the TAC formula. It made a world of difference for me. The rest of the chemo treatments aren't fun, but they are tolerable.

My questions are now related to mastectomy and breast reconstruction. I DO NOT want implants. I can't even stand the stupid little port being under my skin. That thing has bothered me since the beginning! I don't want future surgeries to replace implants. I don't want something foreign in my body. Being from the Midwest, my options are limited. There are surgeons who will do the TRAM flap or the Lattissimus Dorsi Flap surgery to reconstruct. BUT..I don't want these either. They actually move MUSCLE, FAT and SKIN from the back or the stomach to the breast area to reconstruct the breast mound. I've had 2 c-sections and know what pain is, especially when it involves movement or cutting of muscle. Not only that, it leaves added scars and possible malformations (indentations)on the back and tummy. I don't want that!

The next option seems to be the DIEP (Deep Inferior Epigastric Perforator)surgery. Now...saying that is an option is not really true for people in the Midwest! My insurance company didn't even know what that surgery was when I called them to ask for my options. They also do not know of a surgeon under their plan who can perform this surgery. The DIEP surgery DOES NOT involve any MUSCLE moving, just the fat and skin. The fat and skin come from the lower tummy area and it is removed and reattached in the breast area. It also involves tieing off, cutting and reattaching blood vessels (artery and vein). Therefore, the surgeon has to be a micro-vascular, plastic surgeon who specializes in breast reconstruction. Hard to find in the Midwest apparently.

There is yet another option. The I-GAP (Inferior Gluteal Arterial Perforator) surgery. This is where they take the FAT and SKIN from the lower part of the butt and reattach it to the breast area. This sounded like the best option to me because I have plenty of fat and skin there. It also gives you a butt and thigh lift. The scar is not very evident because it's located in the crease between the thigh and butt. Well, this was virtually an impossible option. No experienced surgeons and not covered by insurance. There were surgeons in New York that can do the I-GAP. I didn't find anyone else qualified or experienced. This surgery would be for the rich and famous ONLY!

Speaking of costs. MD Anderson in Houston could do the DIEP surgery, but for over $100,000.00. Another place in San Antonio, could do the same surgery for $18,000.00. This is very confusing. Why so much in one place and not the other? I was considering the San Antonio location, but, my insurance won't authorize me to have it there and this place wants up front payment.

I'm just curious to know other people's experiences with reconstruction and where they went and was it covered by their insurance? If you have had the DIEP reconstruction, please let me know what to expect. I plan on traveling to get my DIEP surgery and I plan on taking out loans if I have to. Please help me with your advice. Thanks so much! DeeDee