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Topic: Pain after Lat flap reconstruction

Forum: Pain —

Share important questions and provide support to others experiencing breast cancer and treatment-related pain.

Posted on: Oct 29, 2016 08:11PM

bleach1 wrote:

Hi everyone,

I'm new to this forum. I have been dealing with chronic pain at the site of the twist in the lat flap at the side of the breast, and pain where the edge of the lat flap would have Sat in my body. I have had this pain everyday, 24/7 365 days a year, for eight years. 17 doctors have no clue. I'm hoping someone may have an answer.

Sue

Bronna S. Leach
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Oct 29, 2016 11:04PM Moderators wrote:

Dear bleach, We are so sorry that you have been in pain for so long. We hope you hear from others here on the boards. We hope you will stay connected in the community. The MOds

To send a Private Message to the Mods: community.breastcancer.org/mem...
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Oct 30, 2016 01:53PM nash wrote:

Can you describe your pain? Burning? Sharp? Dull? Achey? Heavy? Tight? Has a pain clinic done a nerve block study on you to see if your pain is nerve based?

I had a unilateral lat flap done 17 months ago and have an unrelenting 24/7 iron bra/iron corset tightness. I have a lot of extra pulling and tightness in the area where the lat was harvested, mainly near the end of the back scar towards the side. Also extra tightness at the base of my scapula. And my foob always feels like having a rock duct taped to my chest, with the duct tape running down my side and across my back.

Most of my issue are muscular/skeletal, though, and I'm getting some relief from myofascial release, trigger point therapy and rib mobilizations. My intercostal muscles were really affected by this surgery as well.

But I don't have pain, per se. It's tightness, heaviness, pressure and restriction. I have some aching on the side of the breast, but it is in a spot where I have a previous lumpectomy and radiation (3 o'clock, near the chest wall), and I'd had the same aching for 8 years before I recurred and had the mx/lat flap. So I'm not sure if that's the same area as where you're experiencing pain in the "twist" of the lat flap. If it is, maybe my aching is now from the lat flap and it's coincidental about the previous radiation.


Stage IV Pleomorphic ILC, initially diagnosed at age 38 Dx 6/7/2007, ILC, Left, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (FISH) Surgery 7/19/2007 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 8/1/2007 CAF Radiation Therapy 12/27/2007 Whole-breast: Breast, Chest wall Hormonal Therapy 3/1/2008 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 4/24/2015, ILC, Left, 1cm, Stage IA, Grade 2, 0/10 nodes, ER+/PR+ Surgery 5/15/2015 Mastectomy; Reconstruction (left): Latissimus dorsi flap Dx 2/1/2018, ILC, Right, 6cm+, Stage IIIA, Grade 3, ER+/PR+ Chemotherapy 2/15/2018 Cytoxan (cyclophosphamide), Taxol (paclitaxel), Taxotere (docetaxel) Dx 6/20/2018, ILC, Both breasts, 6cm+, Stage IV, metastasized to brain, Grade 3, ER+/PR+ Radiation Therapy External: Brain Hormonal Therapy Faslodex (fulvestrant), Zoladex (goserelin) Targeted Therapy Ibrance (palbociclib)
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Nov 3, 2016 03:02PM bleach1 wrote:

Hi nash,I describe my pain as constantly being jabbed in the dude of the breast with a broom handle, a large sensitive bruise, an ache, a wolf biting me, just about anything that is excruciating. Thanks for the info. I am going to try to see a Dr. In San Francisco who specializes in post mastectomy syndrome and lat flap complications.


Bronna S. Leach
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Nov 4, 2016 12:03PM nash wrote:

bleach1, I sent you a PM to see about getting the name of the Dr in San Fransisco. I'd love to get up there to be seen.

Stage IV Pleomorphic ILC, initially diagnosed at age 38 Dx 6/7/2007, ILC, Left, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (FISH) Surgery 7/19/2007 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 8/1/2007 CAF Radiation Therapy 12/27/2007 Whole-breast: Breast, Chest wall Hormonal Therapy 3/1/2008 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 4/24/2015, ILC, Left, 1cm, Stage IA, Grade 2, 0/10 nodes, ER+/PR+ Surgery 5/15/2015 Mastectomy; Reconstruction (left): Latissimus dorsi flap Dx 2/1/2018, ILC, Right, 6cm+, Stage IIIA, Grade 3, ER+/PR+ Chemotherapy 2/15/2018 Cytoxan (cyclophosphamide), Taxol (paclitaxel), Taxotere (docetaxel) Dx 6/20/2018, ILC, Both breasts, 6cm+, Stage IV, metastasized to brain, Grade 3, ER+/PR+ Radiation Therapy External: Brain Hormonal Therapy Faslodex (fulvestrant), Zoladex (goserelin) Targeted Therapy Ibrance (palbociclib)
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Nov 4, 2016 12:59PM mustlovepoodles wrote:

Now see, this is exactly what I am afraid of. I sought out a second opinion after my first PS decided that implants were the thing for me. Um, no thanks. I had a lot of issues with healing post-LX AND post-BMX. I have no desire to put foreign bodies under my skin. So I told the second PS NO IMPLANTS. He immediately led with Lap Flap w/implants. Seriuosly. I told him that I know of people who have had chronic pain and weakness following Lat Flap. Do you know what he said? He said he had NEVER HEARD OF THAT. No kidding. He said that not even ONE of his patients had ever complained of lasting pain or weakness. Sorry, Dr. HotShot. I don't believe you.

I'm really sorry to hear about your pain. At this point, I think I'd be looking for a pain clinic, since no one seems to be able to help you otherwise.

Oncotype 23. Positive for PALB2 & Chek2 gene mutations. My breasts are trying to kill me! Dx 7/20/2015, DCIS/IDC, Right, 1cm, Stage IA, Grade 3, 0/2 nodes, ER+/PR-, HER2- Surgery 8/19/2015 Lumpectomy Surgery 9/2/2015 Lumpectomy: Right Chemotherapy 10/19/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 2/3/2016 Prophylactic mastectomy: Left, Right Surgery 10/18/2016 Hormonal Therapy Femara (letrozole) Surgery
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Nov 4, 2016 01:09PM nash wrote:

It's so frustrating when the surgeons say they've never heard of these complications and act like we're nuts. Then I talk to other women whose surgeons say, "Oh, this tightness after LD flap is to be expected." One gal I know just saw a surgeon who told her to expect issues for two years post-op.

It's taken the pain clinic at a major teaching hospital almost a year and a half to finally get on what I think is the right track with trigger point injections in my case.

Stage IV Pleomorphic ILC, initially diagnosed at age 38 Dx 6/7/2007, ILC, Left, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (FISH) Surgery 7/19/2007 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 8/1/2007 CAF Radiation Therapy 12/27/2007 Whole-breast: Breast, Chest wall Hormonal Therapy 3/1/2008 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 4/24/2015, ILC, Left, 1cm, Stage IA, Grade 2, 0/10 nodes, ER+/PR+ Surgery 5/15/2015 Mastectomy; Reconstruction (left): Latissimus dorsi flap Dx 2/1/2018, ILC, Right, 6cm+, Stage IIIA, Grade 3, ER+/PR+ Chemotherapy 2/15/2018 Cytoxan (cyclophosphamide), Taxol (paclitaxel), Taxotere (docetaxel) Dx 6/20/2018, ILC, Both breasts, 6cm+, Stage IV, metastasized to brain, Grade 3, ER+/PR+ Radiation Therapy External: Brain Hormonal Therapy Faslodex (fulvestrant), Zoladex (goserelin) Targeted Therapy Ibrance (palbociclib)
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Jul 17, 2017 06:43PM Jfsbrt1 wrote:

These surgeons are disgusting mine said I shouldn't still be on anything for pain. I am 8 weeks out from surgery and having weekly expansion and he has me on IBUPROFEN and LYRICA. He said he has been doing these procedures for 30 years and he knows " this type of pain doesn't linger" I was shocked. I was like no sir until you have lost a part of your anatomy then had something taken from another part of your anatomy and had it twisted and resewn into a new place then stretched out to the breaking point you don't get to pretend you know anything. My sister is a heroin addict and gets free methadone, for the "pain of addiction " I'm a cancer survivor I have 100,000 dollars worth of medical debt and no one gives a damn how much pain I'm in outst

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Jul 17, 2017 07:39PM JO-5 wrote:

Jfsbrt1,

My PS told me 6 weeks and the "loaf" under my arm would be gone....2 yrs and it is still there...a bit saggy but there all the same. I am very allergic and sensitive to pain meds and he told me I would be fine on Tylenol. Devil

One of my appointments was canceled because the dr was sick. His nurse was astounded because ..quote: "I've worked with him for 15 years and he is never sick. He has never taken off for being sick."

Well now.....that explains a lot doesn't it? The man has no idea what pain is!

Joanne

Org dx 04 lumpectomy rads arimidex stage 1 grade 3 no nodes er+pr+her- 2014 rads induced angiosarcoma, wide excision 2015 angio recurrence, rt mast. Lat flap, 1/3 flap went necrotic, skin graft leg to chest Seeing dr every 3 to 6 months.
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Jul 17, 2017 07:39PM JO-5 wrote:

Jfsbrt1,

My PS told me 6 weeks and the "loaf" under my arm would be gone....2 yrs and it is still there...a bit saggy but there all the same. I am very allergic and sensitive to pain meds and he told me I would be fine on Tylenol. Devil

One of my appointments was canceled because the dr was sick. His nurse was astounded because ..quote: "I've worked with him for 15 years and he is never sick. He has never taken off for being sick."

Well now.....that explains a lot doesn't it? The man has no idea what pain is!

Joanne

Org dx 04 lumpectomy rads arimidex stage 1 grade 3 no nodes er+pr+her- 2014 rads induced angiosarcoma, wide excision 2015 angio recurrence, rt mast. Lat flap, 1/3 flap went necrotic, skin graft leg to chest Seeing dr every 3 to 6 months.
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Jul 18, 2017 04:25PM Texas357 wrote:

I had a lat flap in 2010, and recall feeling tightness and pain, as well as that lump under my arm for what seemed like forever. but it DID eventually go away.

DX 9/08, ILC, Stage 3A, ER+/PR+, HER2-, 7/13 pos nodes. Mastectomy & six months chemo & 32 rads.Prophy mx 8/09 and they found DCIS and LCIS. Implant only on proph side; LD flap on rad side. 13 surgeries since diagnosis.
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May 15, 2019 10:08AM sb32 wrote:

I am new to this site. However, in 2012 I was diagnosed and by Jan I was undergoing 4 rounds of chemo, March I had bilateral breast surgery with reconstruction. Summer began the 28 rounds of radiation. Aug. 2013 was the lat flap. I have the burning, stabbing as if a 10 penny nail is going into the lat. Under my arm is bigger now. My oncologist was afraid my cancer metastasized to my bones. I have managed to tear the lat away hence the knife cutting sensation under my breast. I am 47 and a Physical Education teacher in middle school. No one understands unless they go through it.

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May 15, 2019 10:09AM sb32 wrote:

I totally relate to the pain 24/7 365

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May 21, 2019 03:28PM Gypsi wrote:

WTF is wrong with these doctors??? I am 2 weeks out from my double lat flap and having to fight like a badger for pain meds. My PS gave me 40 T3s when I left the hospital a week ago. Really?? They ripped my body apart then have a "suck it up" attitude??

What they don't seem to get is that their piece of my recovery is only a tiny part. I didn't come into this surgery all hale and hearty and top shape -- mentally or physically. I came into this after chemo, double BMX, 2 emergency surgeries for infection, 33 rounds of radiation... AND the mental work of dealing with little things like my own mortality and body image issues since my chest looked like smashed a$$holes. I'm depleted. I am one tough woman (my first PS said the strongest patient he's ever met) but damn, there's a limit.

Having cancer trumps all the "be careful with pain meds" b.s. Yeah no one one wants an addiction problem but if I don't have the strength to get through recovery without walking into the river with a pocketful of rocks, it won't really matter will it?

I'm 60 years old. I know myself better than any doctor. If I say I need meds, just give them to me. I'm walking around with my innards al rearranged and 6 drains flopping off me. Gimme a break if I want a little comfort.

Whew. End of rant. So glad to be here among people who I find to be the bravest and strongest ever. I don't post a lot but I spend a lot of hours reading here. It is an essential part of my healing and I appreciate you all! 💓

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