TRAM Reconstruction

All my doctors are in one


All my doctors are in one place at the Palo Alto Medical Foundation so the breast surgeon told me to make an appointment with one of the plastic surgeons right next door. There were 4 plastic surgeons I just took the next available one. I admit I have been rather happy with him. He did the DIEP flap on me.

Perhaps you can ask you breast surgeon if she/he is aware of anyone.

I know how difficult it is
I know how difficult it is to make a decision to get a new dr. no matter what kind you are looking for. I am having a Tram reconstruction in 2 weeks at the University Of Penn. Hospital in Philadelphia. I met a great group of dr.'s there and one of the oncologists gave me the name of a reconstruction dr. and after meeting her and talking I felt confident that this was right for me. She has done over 1500 of these surgery's. The first thing I asked was how many of these types of surgery's did you do. I also asked about the success of them. I researched on the internet before I met with the dr. so I was able to ask many questions. The only way you will feel comfortable is if you ask questions and get straight forward answers. You can look up as I did Tram reconstruction and this will help you to find doctors also. I also went to hospital sites and checked out their doctors in this area.
I hope some of this info helps you out. Good luck in your search, just do your homework.

Joyce
TRAM has been around for a while, the DIEP flap is the one that is relatively new. The big difference (I know this because I just had the tram flap surgery on 12/11 and did a lot of research before) is the tram uses an abdominal muscle for blood supply and the DIEP uses the abdominal aoreta. There aren't a lot of plastic surgeons who do this because it is relatively new and very complex. I know for me to have this done I would have had to drive 2 hours each way and now that I've had the tram flap I am very happy and glad that I stayed close to home. I'm told that the healing time for both is about the same. Mine was almost 7 weeks ago and I feel great. Of course don't take only word. Research and find what feels best for you otherwise you won't feel good in the end and that is what matters most. I hoped I helped some.

joycee9308 said:

Thanks for all the suggestions
I am so glad I found this discussion board! All your suggestions helped a lot; I did my research and ended up going with the plastic surgeon that my surgeon recommended. I decided on the free flap, but not the DIEP flap because it is highly specialized and there is only one expert in this area who has had success with the actual surgery, but some complaints in terms of the final look. Once I spoke with the plastic surgeon and found she had done a lot of TRAMs with "georgous" results, I felt much more comfortable. My only concern is I have back problems from doing aerobics and the TRAM will take some of the abdominal muscle which will likely give me more back problems. I guess I have to give up something. I'd rather have nice looking results.

Now I'm struggling with my post op recovery. I have my pre-op doctor appt on Monday where she will give me the post-op information, but I'm not sure what questions to ask. I keep hearing it really does a number on the body. But of course, everyone is different (how I hate that cliche) but I want to know how I will feel. Help!

P.S. I have a sister circle of my close friends who are supporting me; what things besides the normal stuff (cooking for me and my family, shopping, etc.) should I ask for help with?

Joyce, a while ago, I

Joyce, a while ago, I responded to someone else who wanted to know about what to expect both in the hospital and during recovery, and what they should buy ahead of time. I've copied most of that response for you. It's a bit long, but I'm hoping that it helps to answer your questions.

As far as the hospital is concerned, I'd take a toiletries bag with toothbrush, toothpaste, deodorant, tissues, etc. They'll probably give you everything that you need, but I'd rather use my own. You will need loose-fitting tops that open in the front. You'll have to take loose fitting PJ's or sweats, since you won't be able to wear normal pants for a while. I took a bathrobe and did use that some. I love to read, but I couldn't really concentrate well enough in the hospital, so magazines were good, as was my iPod. Although some hospitals won't allow cellphones, mine not only allows them, they encourage that you use one. It's easy to carry and you won't have to try to reach for a phone. You won't want to reach for anything for a while. I didn't need any cash, but it's probably good to have a little. For a couple days, you'll probably be very happy to be in the hospital gown, so try not to overpack, since there is limited space in the room.

Onto recovery. With this surgery, you'll probably have six drains initially, although some may come out before you go home. Drains are a pain, but they are critical to your recovery, so don't try to rush them. While you are dressed, they'll be pinned to some of your clothing, but showering is a different story. I used a 'lanyard' around my neck when I showered, and pinned the drains to it. It didn't get wet and weighted down like washcloths or towels do. You'll have a hard time stretching and getting in and out of bed. I found a recliner to be very helpful. With time, I recovered the range of motion and could return to normal activity, without any type of physical therapy.

Unlike the reconstruction with expanders, you won't be able to bind your breasts, because you need to keep the blood flow unconstrained. I used camis and tank tops with a loose shelf bra for eight weeks before I was allowed to wear a bra again. You'll likely have an abdominal binder for a period of time. It really does make you feel better!

Things I would have at hand: at least four extra pillows (you'll sleep on your back and you'll want them to support your arms, legs and extra support for head), Tylenol or Advil for when you come off the painkillers, baby aspirin (my doctor wanted me to take it for a few weeks after surgery), thermometer (if you don't have one, in case you're worried that you might have an infection), antibiotic cream and bandages (they could come in handy), and a cellphone nearby. My husband did email updates to friends and relatives, so he didn't have to take as many calls, and he could let people know when I was ready for calls or company. He also ran interference with phone calls and sometimes told the person that I was resting or had crashed after doing too much (which I did often).

Joyce