Latissimus Dorsi Breast Reconstruction
Comments
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justagirl.....thankyou so much for sharing your knowledge....i feel so fortunate to have your support and all the other lovely ladies on this site.......my pain is constant to under arm and back to scar, lower back pain when hoovering shopping etc, i take pain relief daily. I have mentioned this every time i see my onc...he just suggests massage, which i have had which helps for a while.
I work full time night duty, i wonder if the nights make it all worse, as it does seem to tighten up more after a run of them.
Sending you hugs and thankyou, kaza xxxxxxx
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Kaza, the pain under your arm does sound like the nerve is pinched or compressed and it isn't right to have constant pain from there to back scar. I still get the ache/pain to my lower part of my back scar when hoovering or doing heavy lifting or even hanging clothes on the line. Hey, you take the biggest muscle of your body out of one side of your back - something has to give! Under the lat muscle, lower down on the back are two tiny muscles, but I have to say when my back hurts, the only thing that helps is a valium or pain pill. The valium works better so I think it's my other muscles saying 'ouch I don't want to work'.
When I worked nights in the ICU I slept worse, ate worse and generally felt worse as I was out of synch with my normal body rythms. Being tired makes everything hurt!
Maybe you could chat with your PS about these pains.....after all, that's who did the surgery. And yeah, it would be great every time you hurt you could get a massage, but this is the real world and at least in my life, it doesn't happen!
I think sometimes to gain we get pain, but sometimes some doctors just don't do as good of job as they should be doing! Sorry doc's!
I also find turning my electric underlay on low at night helps my back loosen up while I sleep, even if I have to use lighter covers on the top over me.
I keep reminding myself that 25 years ago none of these surgical procedures were available and I would of been left with two gaping holes in my chest.....so I deal with the challenge of the pain and try to work around and avoid it from happening....like getting hubby to hang out the laundry!
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To justagirl and kaza, I feel your 'pain' lol literally and figuratively..was going to have implant removed from Lat side and reduce/lift the good one, instead have been thru a medical rollercoaster to get there..some my own doing, or 'un-', and now I have shingles, cancelling sugery for this summer. Was SO looking forward to it but circumstances not most optimal in many ways ..so..hope to go to MA for it next summer, stay and get loved up by family and friends up there and be the happier for it..Im 18 yrs out and there have been many issues over the yrs and I too never connected them all because none of the practitioners were able/willing to say...'uh YAAaaahh, its your back muscle in your front!' ( and your slight scoliosis. degen neck, tension. posture etc) all working together to make you feel so yucky! I DO need to be more disciplined as Im an ADHD kinda girl but this summer has shown me- get of the butt girl, put DOWN the knitting, shut off the TV, step away from the computer and take care of your BODY! (/mind/spirit/) Trying to look at it as a blessing in disguise (I like the Northern PS better) and not a big loss..enough of those already.. Debbie
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justagirl...i am going to my onc maybe a nerve maybe pinched under my arm, as you say constant pain there must be somethng causing it, i know moving this big muscle to a totally different place of the body is not going to be plain sailing, i could cope with a little discomfort but this is unbearable at times. Other back muscles lower back, as you said have to compensate for the removal of the LD, i understand now why i get lower back pain as you do when lifting hoovering etc, thankyou for sharing your medical knowledge.
Working nights is a strain on the body, like you said eating, sleeping body clock all over the place, i know nights are not good maybe i need to look into maybe working days, i do enjoy the night duty, but health must come first. The warmthof your underlay sounds like a good idea, i have a hot water bottle, ha ha even in warm weather . I remeber my grandmother she had a mastectomy now that must be 60 years ago, there was nothing then, everything was taken away, we are fortunate now to have the option as you said to reconstruction, and each other here.Hugs......kaza x Hi Debbie so sorry to hear you are unable to have your surgery at the moment, shingles poor you so painfull, yes spoiling by family and friends sounds just what you need at the moment, sometimes we have to hold our hands up and just accept spoiling kindness and treating ourselves well. congrats to 18 years out, as you say has not all been easy, knitting, computer, tv all sound very familiar to me, you have to do what you enjoy and trust your gut feeling to what makes you feel good. hugs x
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thnx kaza hugs back
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Debbie - you are so right about taking good care of ourselves, body and spirit. I know I would feel better if I went to yoga more often, occasionally got a massage, got to bed early or sat around for a few days and chilled. I am more a go go go person so all this has knocked me. I'm the doer in our family. I wish you the best.
Kaza: suggestion - when you go see your Dr, write out your questions first, so you don't get caught up and forget anything. And yes, I have always had a mild scoliosis, but it wants to worsen with having this surgery. And there is not way with that back muscle gone that I could lift or move heavy patients like I used to! I would be interested in what the Dr says to you. You can always PM me too.
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Hi cgesq, you're right, probably not too many people get to try two different types of reconstruction, so I will share my experiences. I originally chose a tram flap after my first mastectomy, because I wanted to wake up from surgery with a breast and I wanted to use my own tissue, I did not want implants. I really did not have much pain at all in my breast area, most pain was from the abdominal part of the surgery, my incision was from hip to hip and the abdominal weakness took some getting used to. It was hard to get up and down and move around (like to get comfortable in bed), kind of like having your muscles cut from a hysterectomy. I somehow did lose my hysterectomy scar in the process though, so that's a good thing. I had to wear a binder to give some support. It did kind of freak me out how my upper abdomen felt after having the muscle pulled up under my skin along with the flap to make the new breast, you could see where it turned. I still do not have full sensation in that area, even a year and a half out. I have dog ears on my sides which have kind of bugged me, but my PS is revising them next Tuesday when he does the skin grafts for my nipples. I have always been happy with my reconstructed breast, it is nice and soft and feels and looks very natural. It even has some natural droop now. So all in all, very happy with this breast and the surgery is for the most part just a memory.
I was pretty much in shock when I found out that I needed a second mastectomy just 10 months later. It really threw me for a loop. I could have had a lumpectomy I suppose, but just really didn't want to fool around with the possibility of having to repeat the whole mammogram, biopsy, surgery in the future. Any way I chose the lat flap so I would have a better match for my tram side. I thought I went through all the trouble to have the tram to have a natural looking breast, so I decided to have the lat flap with a small implant, because the tram is a one shot deal. My PS (who is just the best) told me I could go to a surgeon in Columbus and see about one of the other flap surgeries if I did not want an implant, because our hospital is not equipped for that type of surgery, but I didn't even want to think of being away from home for the surgery and I did not want to change surgeons. I was still pretty much in shock about having a second major surgery and was under a lot of stress which I think contributed to me getting shingles the week before surgery. It was on the opposite side of my back from where I was having surgery, so my BS treated me with an anti-viral and after consulting with my PS, decided to go ahead with the surgery. My surgery was long - 7 1/2 hours and I was in a lot of pain afterwards. For some reason, my catheter was removed after surgery and I had to get up to use the bathroom right from the start, not fun, because my underarm area was so sore. On the second day, my back got real sweaty and I broke out in little blisters over my entire back which just added to the fun. I also had horrible itching, so I had pain, blisters, itching and was taking, morphine, percocet, benadryl and steroids and feeling very sorry for myself. Probably the worst I have ever felt. I think I was run down from having shingles and the blisters were just not fun. I was in the hospital for four days and went home with four drains. I did have a tissue expander put in, but my PS was able to completely fill it during surgery and I never had to have a fill. A couple of the drains did stay in for awhile which kind of bugged me, and the surgery did trigger a bout of depression and anxiety, so I was not a happy camper for awhile. All that being said, I am glad I had the lat flap surgery, I am happy with my symmetry. I honestly think most of my problems were caused by having shingles and the allergic reaction afterwards, so I don't think my experience is typical at all, and I think I would have been in pretty good shape if not for those complications. So, I'm 7 months out from my lat surgery and at this point do not feel any weakness in my back or any loss of ability to do anything I am used to doing, so no complaints there. I did have numbness under my arm, but that is pretty much gone.
I had my exchange surgery in March and as I've said I'm getting scar revisons and nipples created next week, so I'm pretty excited about that, I've been waiting quite a while.
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cat - wow tram and lat - sounds like you are doing well tho so thats great
msdebbie - sorry about the shingles, i hope it clears up soon and you can have your surgery and get the relief you need
my pain/discomfort seems to be different then what justagirl and kaza are experiencing - mine is the upper shoulders/between my shoulder blades travelling up my neck. Like those muscles are tired all the time.
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rozem......Nerve pain from this surgery, can be referred so can be anywhere, back area i believe, sending you hugs , kaza x
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Just an update, will be able to do my exchange September 25th! Yea can't wait to get these TEs out!. (still a long 12 weeks away!) I forgot to ask where the incisions will be for exchange. Anyone have exchange with LD flap and let me know where your incisions are? I would expect the mam fold but not sure as my muscle covers all the TE and supports it underneath. Pre-op appt is a ways off just curious to know what others have experienced. Did you need drains? I don't think PS uses any but had so much seroma on the left after bmx. We finished the fills and so no appts till my pre-op appt but keep coming up with questions I didn't ask him last appt. Start PT next week to stretch these muscles some. Still having a lot of iron bra constantly. Hope everyone is doing well enjoying the summer and staying cool..
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Mama, Glad to hear you have an exchange date. I did not need drains for the exchange. It was done as an outpatient procedure...the whole thing from check in thru discharge was only about 4 hours, including time to recover from the anestesia. My PS went in through my existing scars. I have a lollypop type scar on my foob, and he removed the TE and inserted the implant through the top 1/2 the round part of the lollypop (sorry, I don't have a better way of explaining it!!) The recovery was also MUCH easier than the original surgery. I was up and about the next day, and driving by the 2nd day. I can also echo what everybody else says...the implants are much more comfortable than the TEs.
Hope this helps!!
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Thanks for the info! I had so much trouble with healing these incisions can't believe we will cut them open again! Hoping it will be as easy for me to recover and heal up again. He may be able to make them look a little better as they separated some from infection the first time making more scarring. Thanks again!
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mama, I will have my exchange on Monday, July 8th along with a lift of my right side. My PS said he will go in through the scar on the bottom of my eyeball shaped skin flap. Guess it depends on the surgeon. The nurses in his office also said I would feel much better with the implant compared to the TE. Good luck with your surgery in September!!
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Sherry-So happy for you, getting the exchange/lift done soon! Good luck to you and thanks for the info, will maybe call my PS nurse and ask if she can find out, just want to know what to expect. I really hate not asking as many questions when I am in the office. Even writing them down, I forget or come up with more when I leave. Still lots of time to find out answers! Give us an update as to how it's going after your exchange! Sending you many (((HUGS!)))
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I'm apologizing in advance because I am not sure where to post this.
I was diagnosed again with breast again on 6/19/13 with DCIS. I had SNB on June 21,2013 and it was negative...much to my relief. I am now seeing the plastic surgeon on July 9th for consultation and will be scheduled to have a bilateral mastectomy with immediate reconstruction.
Initially I had just had breast MRI one week prior to all this and an ultrasound, mammogram as well as ultrasound needle core biopsy was ordered. Needless to say I was petrified. When the results came back on the 19th I was a mess. I had already scheduled an appointment with my breast surgeon about having a mastectomy and the results that she gave me in the office only confirmed my decision to go ahead with this surgery.
I have been so tired of waiting for the other shoe to drop...and it did. I want to experience the freedom from worrying all the time about breast cancer. Of course I realize that it is not 100 percent, but the anxiety from all the scans, mammograms, tumor, follow up doctor appointments leaves me feeling anxious all the time. Mentally I'm tired, but feel like I'm in a good place now because I am going to do this. I have the full support from my wonderful husband and of course my breast surgeon.
I just needed to vent and also if you ladies have any opinions or suggestions I do welcome them. Thank you in advance.0 -
shorfi: you have landed in the right place! All of us have had lat flap surgeries. Some double, some single, some a double mastectomy with only one reconstruction being a lat flap.....which was what I had. Radiation just chews up the pec muscle and superficial tissue that is not breast tissue so it doesn't have the integrity to hold an implant. Sounds good that you like your PS and have a supportive husband.
A hint or two: discuss size of implants with PS. The silicone implants size wise will weigh more than your natural breast. Many women are finding significant back and shoulder pain after implants are put in that were as large as their natural breasts. The pec muscles are stretched and without the back lat muscles, you are putting a strain on your other back muscles. I was 57 and a triathlete when I got NC and had the DM a year later. I'm 5' 3" and now 114 pounds. My natural breasts were 400cc but those implants looked way too big so I opted for 225's. They fit in easily and I didn't have to go through fills and another surgery. They are perky and I have cleavage and never have to wear a bra even for cleavage! I like wearing cami's as I do notice in winter my chest feels a bit cold.
When you see your PS go in with a list of questions you have so you remember to ask them. Also I would highly recommend with your surgeon's ok, PT after 6 weeks to start stretching your unused muscles and to get you standing straight up again. Then at 12 weeks with a PT start exercises for strength to all of your back, abdomen and upper chest and arms. Be sure each time your PT gives you at least two stretches or exercises to do at home. I still do mine. My husband sometimes catches me with my shoulder slumped forward and says 'Deb, shoulders back' so I try to get them back and down. I think the implants, even small, make me want to hunch over.
Feel free to come here with any questions or thoughts. We all can relate. Some of our experiences are different, but that gives you choice to make your own decision. My PS was very conservative, which I appreciate and I never had any complications, even though the DM with reconstruction was 7 1/2 hours long.
A last thing. Once your suture lines have healed, rub a rich creamy lotion on the scars, and around your implants twice a day. Have hubby help with the back scar. Scars don't have the blood circulation of other tissue so needs help to keep it from gettting that tight constrictive feeling.
Good luck!
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Just wanted to pop in and say my exchange went well. I now have a breast shaped lump where there was nothing before. I don't think I am going to do nipple reconstruction (just don't care enough about it to have it done). The implant definately feels better than the TE did and the shape looks really good.
The lift on the other hand, wow. My PS fully explained what it would look like and how it would feel, so I was prepared, but still. I know it will settle down but for now it looks VERY strange and is quite painful.
Hope everyone is doing as well as they can and has a great weekend. Since I am still on weight restriction I plan to lay on the couch and do a bunch of nothing!
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Sherry-glad all went well,how long do you have lifting restrictions?
Can't wait to get rid of these TEs! Went to PT this week and wiped me out, really sore and tight! Will keep stretching hoping to build back my strength and energy level. Therapist says I have great ROM just need to strengthen which was encouraging, so will keep me busy till exchange. Rest, and enjoy the time off to recover, glad its easier this time around!0 -
mama - The weight restriction is four weeks, but for the lift. The nurse said the exchange 'was not a big deal'. In my case I have to agree with her. The incision is small compared to the other scars and it is healing well. The pressure from the TE is gone and that is great!! It is just really nice to look down and see something that resembles a breast down there. One good thing is I get out of helping my daughter move later this month!
I hope your energy level picks up and that the PT helps with the tightness. I haven't had any energy since the radiation
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Hi Ladies....I thought I would join you as I just had lat recon on Friday. They exchanged the non cancer side from expander to implant...not a big deal...but the cancer, radiated side is a bit different...thankfully they were able to go right to implant...but 3 days later and my back is the sorest part.
I'm shocked at how many of my women friends ask how "big" I went. I was a small b before all this and from the looks of things ....I still am, which is a bit disappointing, but I'm pretty sure they do what the can with the type of skin you have and mine was pretty tight.
Maybe I'm overly sensitive but it's offensive to be asked how "big" I went. I'm just glad to have something there again.
I'm wondering about the recovery time. Plan to be home from work for two weeks....how long before you feel back to yourself again?
Any tips on recovery?0 -
@ Chapter4, I went back after 4 weeks. I could have rushed back sooner, but it is a big surgery and even though I felt pretty good, I was glad to take the extra time. It let me go to physical therapy and keep the scar tissue at bay without trying to figure out how to fit it all in. I'm having my final (hopefully) exchange this Friday after 4 years of insanity. I was able to golf about 3 months after surgery...it wasn't pretty...but damn it felt good! At 8 months there isn't anything that I want to do that I can't except open a bag of potato chips and frankly, I don't need them anyway
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Love to hear your stories! It is amazing how this journey has brought us all here. Mine was done all at once, bmx with lat flap recon with expanders. Others delayed recon. Initially I did not have any back pain from incisions or muscular, probably due to the mastectomy being the major pain with drains etc. The back pain came later with muscle movement and pulling and burning in my back. Really got tired, (still tired ) of laying on my back. Still can't lay on my side due to the expanders. I went back to work at 8 weeks and now feel pretty good for 10 hr then the last 2 hrs of my nursing shift I get petty tired with increased cramping and burning in my back and foobs. Do not go back to work any sooner than you have to!
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Thanks ladies! I have to return to work at 2 weeks, but it's a desk job for the most part...I can't imagine a job like nursing during all this. Did it take awhile for the implants to shape properly? Non cancer side looks okay but cancer side.....not so much.
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chapter4 - glad your surgery sounds like it went ok. Take your time with recovery, but know that eventually you will feel better each day. I had mine in Oct 2011 and I feel blessed each day I put on my bra. So happy there are options. Oh, and I work out like before (minus the lat pull down machine) and for the most part am doing just fine. Go slow when you go back to work. It's surprising how tired you can get after surgery. I wish you well.
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Hello everyone! I have my preop appt with my PS tomorrow and my bilateral lat flap surgery scheduled for Aug 2nd. I was wondering if there are any specific questions I should ask him. I have done research on this particular surgery so I'm feeling ok going into it. My double mastectomy was March 2012 with immediate TE placement. I had to remove the TE at the end of January due to severe tissue damage from the radiation. I am nervous about going through another surgery but I can't deal with the emotional depression of not being a woman anymore. My other question is what advice do you have for recovery, natural remedies, PT, working with a trainer at the gym, yoga classes, etc. Plus I am goin on a much needed vacation the end of September, 6 weeks post surgery. Any suggestions for that? Before all this crazy cancer stuff happened I was a 38DD/40D and have opted for C size implants. I'm kind of emotionally confused (if you couldn't already tell:) ). Thanks a bunch!
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Mmadrigal05. Ouch second surgery! Recovery is pretty complex and different for every one. I will swear by a good mouth moisturizer by bioten post op for dry mouth. Your arm mobility will be compromised for a long time. I did get one of the grabbers from the local dollar store to help reach things. Don't push recovery and use yoga breathing to get through periods of discomfort. Breasts look good, back incisions healing great. I am 10weeks out and still wearing spanks with ace wraps. I do not have full mobility yet, I'm working on it. My PS wants no heavy lifting yet and no crazy activity like running, kayaking, I did get permission to ride my bike this weekend on asphalt only, I usually ride in the sand. Hope this helped a little bit. Good luck with surgery and keep u's posted!
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I'm joining the club. I had to have an implant removed on my radiated side due to infection last week. Scheduled for lat dorsi flap on 8/7. The good news...my lymphedema is much better. Either the chronic infection since exchange or the implant was contributing to it.
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Ok, I have tried to be patient but what to do with the underarm boob? My right, noncancer side has shrunk down and doesnt bother me. The left side,cancer side is still a sagging pillow that gets tight and crampy then swollen more after a 12Hr shift. PS says "it is just part of you and will atrophy over time." Well it is now 4 Months since bmx with lat flap recon and it isnt better. Shouldnt it be? Has anyone had this and how long does it take? Will it be better after exchange to implants or the same? I am ok with all the rest but carrying a sausage in my underarm gets very tiring and sore.
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mama - i dont have that (i have every other issue but not that one) the exchange wont make a difference because its the muscle that is the problem, not the expander. You might feel more comfortable in the front overall, but in my experience the exchange did nothing for any back/side discomfort. I am 9 mos from surgery and that pulling/ache under my armpit is still there - no atrophy. odd that its only one side that is the issue
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Rozm thanks for the reply, I cant figure why its only the left that is bothering me. Thank goodness it isnt both. I thought maybe due to lymph node removed it could be extra fluid or small lymphadema. PT has helped my strenth and decreased my fatique. I over did this week helping to pack and move my bro in laws stuff. So tight and swollwn this week, cant wait to get home and in my bed tomorrow!
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