Recovering after a TRAM flap

SusanAnne · May 2004

Hi guys. Just getting back on the computer after my reconstruction with a TRAM flap. Wow! What a big operation. I was prepared for the abdominal and breast incisions, but was surprised at how much pain there is in the midsection from moving that muscle. I'm 9 days post op now and beginning to see some improvements. Anyone have any tips for me or comments about your recovery that might be of help? Thanks.
Susan

BBK · May 2004

I had a skin-sparing mastectomy (left side only) on 1/10/03, followed by a TRAM flap reconstruction. I had to have some of the dead tissue removed at the breast site, so it took 3 months for that to close up. LOTS of dressing changes (which I did myself), which were annoying, but not painful. When I was wondering if the transplant would be a failure, my plastic surgeon remained hopeful that it would be fine. A year later...it is fine. And, I'm happy with it. As to pain...yep. There was LOTS of that. It took me about 3 weeks before I felt ok, and got the go ahead to drive again. But, it was really about 6 weeks or more before I was feeling pretty good. I spent a good deal of my days sitting on the couch, not doing much. It was a big deal to hobble into my study to get on the computer. But, it was nice to be able to do that. I was back to doing most household stuff after a couple of weeks. Give yourself time -- you're not that far out of surgery!

As to a year later, and after AC chemo...Well, my hair is back (and in need of a cut, finally). I've developed some of the more nasty side effects of chemo and tamoxifen -- and learning to live with them. My TRAM flap incision sites have healed well, and the scarring isn't unsightly. I still do not have any feeling in the mid-section, where the flap was moved. And, I have no feeling in my new breast. Depending on how I sit, I sometimes (rather frequently, actually) get a "stitch" of pain in my abdomen, which my plastic surgeon assures me is "normal" and is a pulling of the mesh he placed there to help prevent a hernia later on. I'd like that pain to go away...but, I suppose I can learn to live with it over time.

I still feel as though I'm healing, but much of that could be from the chemo and the resultant difficulties of all the medications over the past year.

So, my advice. Be patient. Take care of yourself. Give yourself time to heal. Get as much help as you can, and as you need. Be honest with people. If you're tired, don't accept guests. Rest and sleep as much as you can. Be grateful for whatever your friends and family do for you. Be thankful that you've come through this ordeal, and you're now on the other side of it, on your way to complete healing. Enjoy every day, and live it to the full. You'll get through this. Hang in there!

besci · May 2004

BBK said:
I had a skin-sparing mastectomy (left side only) on 1/10/03, followed by a TRAM flap reconstruction. I had to have some of the dead tissue removed at the breast site, so it took 3 months for that to close up. LOTS of dressing changes (which I did myself), which were annoying, but not painful. When I was wondering if the transplant would be a failure, my plastic surgeon remained hopeful that it would be fine. A year later...it is fine. And, I'm happy with it. As to pain...yep. There was LOTS of that. It took me about 3 weeks before I felt ok, and got the go ahead to drive again. But, it was really about 6 weeks or more before I was feeling pretty good. I spent a good deal of my days sitting on the couch, not doing much. It was a big deal to hobble into my study to get on the computer. But, it was nice to be able to do that. I was back to doing most household stuff after a couple of weeks. Give yourself time -- you're not that far out of surgery!

As to a year later, and after AC chemo...Well, my hair is back (and in need of a cut, finally). I've developed some of the more nasty side effects of chemo and tamoxifen -- and learning to live with them. My TRAM flap incision sites have healed well, and the scarring isn't unsightly. I still do not have any feeling in the mid-section, where the flap was moved. And, I have no feeling in my new breast. Depending on how I sit, I sometimes (rather frequently, actually) get a "stitch" of pain in my abdomen, which my plastic surgeon assures me is "normal" and is a pulling of the mesh he placed there to help prevent a hernia later on. I'd like that pain to go away...but, I suppose I can learn to live with it over time.

I still feel as though I'm healing, but much of that could be from the chemo and the resultant difficulties of all the medications over the past year.

So, my advice. Be patient. Take care of yourself. Give yourself time to heal. Get as much help as you can, and as you need. Be honest with people. If you're tired, don't accept guests. Rest and sleep as much as you can. Be grateful for whatever your friends and family do for you. Be thankful that you've come through this ordeal, and you're now on the other side of it, on your way to complete healing. Enjoy every day, and live it to the full. You'll get through this. Hang in there!

I had a dorsi-flap last summer, would love to share my experience with anyone out there who wants to know about it. 13 years after wearing a prosthesis, I now have a BOOB! I'll explain the before and after, too. Would love to help someone go through it, as support.

seeknpeace · May 2004

Hi Susan Anne..

I had a bilateral mastectomy with immediate reconstruction on Feb. 4. It took me a good two months to feel like I could move around more normally, but, I have been surprised at how easy it has been to get up and down without my abs. I still have some pain, especially after I eat, in my ribs. I had to have more surgery a couple Fridays ago to remove some of the fat necrosis in my right breast, which has given me a lot of trouble. The pain in it is much less now but, the right side is still hard. Softer than it was, but, not right.

The hardest thing for me is when I lay down to watch tv or whatever and get up. The pulling feeling that I get on my chest, and the unpleasant sensation that these are not my real breasts. The numbness bothers me too. I am still quite numb in the breasts, they feel like nothing, and my abdomenal area the middle part from under my breasts to my lower incision. All numb. I have to catch my breath sometimes to just not get a panic attack about it.

I went to see Fleetwood Mac on Thurs nite and on Sat. nite, and it seemed that all the mens eyes would go to my chest..hahaha. The ones that the doc created are larger than I wanted, prob a d cup at least, and I cannot wear a bra, so there you go.

Give yourself some time, don't push yourself to do anything that you are not ready to do. When your body is healed for the next step, you will know it and God bless you. I think by next year I will love my chest, just not quite there yet. And, I was lucky, no chemo or radiation.

Jan

martyzl · May 2004

Hello Susan!
My Tram will be 2 years old in July. In the beginning, I was miserable! Unable to do anything and wondering if I'd done the right thing.... I didn't think I'd ever be a TRAM proponent. It took me a year to really start to appreciate it and I had to have it revised due to size difference from my left breast last October. The scarring is minimal for me as well. The worst scarring is from my sub-clavian port.
The numbness is still there down the midline but I've recovered sensation around the outside of the reconstruction. My outer, upper arm is still without much sensation as well,due to lymph node removal.
Right now the midline numbness is a pain in the bum as I am 5 months pregnant (after chemo-induced menopause, yet!) and tend to run into things... it used to be my overly large TRAM, Babette, that I had to watch out for! *laughing*
Also amusing that I just had it resized in October and now (due to pregnancy) my remaining breast is overshadowing it at an alarming rate! I'll look like a bloated unicorn in another 4 months!

My pains subsided after about a year. Now I am having tearing sensations about the navel due to the expanding belly... very, very disconcerting...particularly when I cannot feel anything from sternum to belly scar and 3 inches across.
Haven't yet found anyone else who has been pregnant after a TRAM, so not sure what is "normal". I just create my own "normal". *grin*

Do take it easy Susan, as others have said... take your time and heal well. No fun to have to go in to fix things you could have avoided! (said the Marty who nearly ruined everything playing to hard at badminton a couple of months out of surgery...)
To get my mental perspective at the time it all happened, go to my personal web page in here. (martyzl)

Be well Susan, be patient, BE GOOD! *smiles* Have fun and soon you'll be feeling better than new!

Marty

SusanAnne · May 2004

martyzl said:
Hello Susan!
My Tram will be 2 years old in July. In the beginning, I was miserable! Unable to do anything and wondering if I'd done the right thing.... I didn't think I'd ever be a TRAM proponent. It took me a year to really start to appreciate it and I had to have it revised due to size difference from my left breast last October. The scarring is minimal for me as well. The worst scarring is from my sub-clavian port.
The numbness is still there down the midline but I've recovered sensation around the outside of the reconstruction. My outer, upper arm is still without much sensation as well,due to lymph node removal.
Right now the midline numbness is a pain in the bum as I am 5 months pregnant (after chemo-induced menopause, yet!) and tend to run into things... it used to be my overly large TRAM, Babette, that I had to watch out for! *laughing*
Also amusing that I just had it resized in October and now (due to pregnancy) my remaining breast is overshadowing it at an alarming rate! I'll look like a bloated unicorn in another 4 months!

My pains subsided after about a year. Now I am having tearing sensations about the navel due to the expanding belly... very, very disconcerting...particularly when I cannot feel anything from sternum to belly scar and 3 inches across.
Haven't yet found anyone else who has been pregnant after a TRAM, so not sure what is "normal". I just create my own "normal". *grin*

Do take it easy Susan, as others have said... take your time and heal well. No fun to have to go in to fix things you could have avoided! (said the Marty who nearly ruined everything playing to hard at badminton a couple of months out of surgery...)
To get my mental perspective at the time it all happened, go to my personal web page in here. (martyzl)

Be well Susan, be patient, BE GOOD! *smiles* Have fun and soon you'll be feeling better than new!

Marty

Wow Marty, pregnant after a TRAM flap! I asked my plastic surgeon today if any of his TRAM patients have gotten pregnant and he said no. He has had tummy tuck patients go thru it though with no problems. Is this your first, or do you have other children?

I am wondering at this point if I had known what I know now, if I would have gone through with it. I guess I need to go through the whole process to answer that question. Thanks for your comments and good luck with the baby!
Susan

workingtired · May 2004

Hi SusanAnne,
I am approaching my 1 year anniversary of my tram flap following mastectomy. One suggestion my nurse gave me was to rub vitamin e oil on the scar to soften it up. I purchased a few of the abdominal support wraps to rotate around and allow for washing as well as use one for swimming and one to put a dry one on after swimming. I wore mine well into September and then only in the daytime, slowing weaning my way off.
I have recovered some abdominal sensation since last summer but not all. At first I had a difficult time wearing wasted zippered pants like jeans.. it was too uncomfortable, but now have no problem. I still sleep with a pillow under my arm and can almost sleep on my stomach.. still a little discomfort but tolerable.

I certainly did not like all the drains.. felt like a walking science experiment. And was relieved when they were removed. I thought it was going to be painful, but didnt feel a thing, it was a very strange sensation when the pulled out the tube, I didnt realize how long it was, sort of snaked up inside.

Getting in and out of bed was a challenge at first, I used my good arm to help pull myself up and sat in a lounge chair during the day.. I had it set up in my bedroom, sort of mixed things up a little, lounge chair, bed, ect..

All the best to you on your recovery.

Angela

SusanAnne · May 2004

workingtired said:
Hi SusanAnne,
I am approaching my 1 year anniversary of my tram flap following mastectomy. One suggestion my nurse gave me was to rub vitamin e oil on the scar to soften it up. I purchased a few of the abdominal support wraps to rotate around and allow for washing as well as use one for swimming and one to put a dry one on after swimming. I wore mine well into September and then only in the daytime, slowing weaning my way off.
I have recovered some abdominal sensation since last summer but not all. At first I had a difficult time wearing wasted zippered pants like jeans.. it was too uncomfortable, but now have no problem. I still sleep with a pillow under my arm and can almost sleep on my stomach.. still a little discomfort but tolerable.

I certainly did not like all the drains.. felt like a walking science experiment. And was relieved when they were removed. I thought it was going to be painful, but didnt feel a thing, it was a very strange sensation when the pulled out the tube, I didnt realize how long it was, sort of snaked up inside.

Getting in and out of bed was a challenge at first, I used my good arm to help pull myself up and sat in a lounge chair during the day.. I had it set up in my bedroom, sort of mixed things up a little, lounge chair, bed, ect..

All the best to you on your recovery.

Angela

Hi Angela,

I agree with you about the drains and was so happy to have them removed this week. It's so much easier now to shower and dress.

How long did you take pain meds? I'm still taking a Darvocet every 4 hrs. I'm aiming to cut the pill in half in the next few days hopefully. Also when did you go back to driving? My surgery was 2 wks ago yesterday and I'm getting antsy about being stuck in the house and having to get rides for the kids to go everywhere. Thanks
Sue

workingtired · June 2004

SusanAnne said:
Hi Angela,

I agree with you about the drains and was so happy to have them removed this week. It's so much easier now to shower and dress.

How long did you take pain meds? I'm still taking a Darvocet every 4 hrs. I'm aiming to cut the pill in half in the next few days hopefully. Also when did you go back to driving? My surgery was 2 wks ago yesterday and I'm getting antsy about being stuck in the house and having to get rides for the kids to go everywhere. Thanks
Sue

Hi Sue,

I can understand your frustration, I have 2 kids too.

I think it was 3 weeks post surgery before I drove. But don't get too ambitious.. you tire after sitting for a while and grocery shopping is still out of the question for a few more weeks.. the bags are too heavy.. don't try it alone.

Get someone to carry it for you even at the store, be one of those bothersome customers and ask for someone to bag and push the cart to the car and unload.. and have someone unload at the other end. You'll find it too tiring.. I think it was no lifting more than a coffee cup for a while.

I had someone help with the laundry for a while too.. make someone carry the baskets. think coffee cup..

I took off from work with FMLA for 12 weeks ended up going back at 10 weeks and worked 2 days a week to 3 days working up to 5. That worked great for me.

Email me if you want to here or at home angelacarlucci@hotmail.com

Angela

Recovering after a TRAM flap

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