It's been nearly 11 months since I had my bilateral mastectomy and TRAM flap reconstruction. I'm happy to say, I'm doing pretty well.
My Video Update
It's Now Been 11 Months...
It's been nearly 11 months since I had my prophylactic bilateral mastectomy and TRAM flap reconstruction, and I'm happy to say that I'm doing pretty well. Gosh, that actually sounded uncharacteristically optimistic. But really, health-wise, I’m okay (I'll say "kenahora," which is my grandma’s way of saying “knock on wood,” but I’ll refrain from spitting three times, which is supposed to help chase away the evil eye).
I want to share with you how my recovery has been progressing. I'll go through a list of different issues and let you know what I've been experiencing. In some cases I've found ways to mitigate the issues, and if I have I'll let you know.
At the end of this article I've included a number of comparison photos. There are some "before" photos (pre-surgery), as well as post-surgery photos from a couple of different points. One set of post-op photos was taken just 2 weeks after the procedure, and the other set was taken very recently, close to the 11-month mark.
A final note before we continue about medical terms. The acronym TRAM stands for "transverse rectus abdominis," and it refers to the abdominal muscle that's located between the waist and the pubic bone. In a TRAM flap reconstruction, the surgeon takes some of the skin, fat, and muscle in this area and uses it to reconstruct the breast.
Now that we've covered all of that, let's begin talking about how my recovery has been going.
In months 5 through 7 after my TRAM reconstruction, I noticed a strange development: a phantom effect. People who have amputated limbs sometimes experience phantom limb syndrome, and I feel like something similar has happened to me. I wonder if other women who have had mastectomies have felt this, as well?
My new breasts feel numb, and I no longer have nipples—but sometimes it feels like I still have nipples. In certain conditions (cold, arousal, etc.), it feels like they are responding. Even if I run my hand across the scarred mound, it feels as though the nipple is reacting.
Moreover, even though my breasts were gutted during the surgery, I still sometimes feel the “let down” sensation that occurs when women breastfeed. Even years after I stopped nursing my children, I still sometimes experienced this sensation—and the reconstruction surgery didn't seem to change that.
Itchiness and Stabbing Pains
For a few months, I went through a period of intense, periodic itchiness. Even though my stomach and breasts are numb to the touch, paradoxically, everything felt itchy. Unfortunately, scratching my numb skin didn’t relieve the itchiness. It was extremely frustrating not to be able to relieve a deep, itchy feeling that wouldn't go away.
Those deep itches have mostly disappeared by now, but they return periodically with a vengeance. They are also now sometimes accompanied by sudden, sharp stinging sensations that the plastic surgeon said could mean the nerve endings are trying to heal or reconnect.
My scars are still red/pink, but they are not as dark red and knobby as they were several months ago. The scars have mostly flattened out after massaging a cream into my scars every day after my shower for a couple of months. (I use Neutrogena hand cream, which is more like a serious ointment than a cream.)
As the skin around my scars has relaxed, I've noticed something odd with the appearance of my abdominal scar. One end of this scar, in particular, seems to have bunched out from where the stitches were. If you’ve ever done any sewing, the end looks sort of like a corner seam that doesn’t quite lay flat. It’s not noticeable when I'm wearing clothes, but it does look like a chunk of skin that flows out from the side.
Sitting Up Straight and Stretching My Arms Up
After the surgery, I couldn't sit up straight without pain for several months—but more recently I've been able to do so without trouble. Even so, I still feel a tightness in the muscles that run from my stomach up to my new breasts.
If I try stretching my arms up too high, it feels like a spring that has been stretched a tad too far. Pain strikes sharply in the muscles, and I must quickly hunch over to avoid experiencing more than a few moments of lingering pain.
Lifting is still an issue for me. Once in a while, I’ll try picking up something that might be just a bit too heavy, and the newly-placed muscles will snap. It feels like someone has reached inside my stomach, grabbed hold of the repositioned muscles, and wrenched them—causing me to bend over in pain.
I've learned that when I am preparing to lift something, I need to make sure I am facing the object. If I try to twist my body around to the side to pick something up, it hurts a lot.
Standing Still or Moving Too Much
Somewhat surprisingly, standing still for longer than a few minutes is difficult and tiring. If I’m moving, I feel okay, but standing in one spot for too long can be exhausting. I can feel it in my abdomen and up through my torso.
Conversely, if I’m moving around too much—whether I'm exercising (e.g., hiking up hills) or whether I'm just trying to get a lot done in my regular, everyday life—my stomach muscles will begin hurting and tugging, causing me to hunch forward due to the discomfort.
Going From Sitting to Standing
I've noticed an interesting issue that arises when I go from sitting to standing. I like to sit with my feet up when I watch some television in the evening. I have to be careful, however, not to sit on my side; otherwise, when I get up, I'll feel the stomach muscles pulling painfully. Or if I'm sitting at my computer in the kitchen, when I get up from my chair I have to take a long time in order to avoid pain. I look like those museum cave men who take a while to rise to an upright position.
I've learned that when I go from sitting to standing, or otherwise changing my position, I need to do it slowly. I need to allow my muscles time to adjust in order to avoid pain.
Another strange thing I've noticed happens when I lean over at the waist. Although my belly fat has mostly been removed, I've noticed that when I lean over the muscles start bunching up inside. It feels as though I'm wearing a fanny pack in front and I'm trying to bend over the trapped pack. I feel the muscles repositioning and trying to find a comfortable spot. It's a very strange feeling.
Sleeping is still an odd experience with regard to my stomach scars. I have to be careful about how I turn over from side to side. It takes more care than it did prior to my surgery, which means I tend to wake up more than I used to at night. If I turn the wrong way, I feel my scars tugging. Sometimes it feels as though they will rip open—especially where the scars end, at my hips.
I find that it's best to try to roll over as a single unit instead of rolling, for instance, legs-first with the upper body following. When I turn in stages, the stomach muscles stretch too much, which causes pain.
Coughing and Sneezing
Coughing and sneezing are still painful for me. The swine flu swept through our home last fall, and I learned that coughing is not at all easy. Every cough feels as though someone is punching you in the chest and stomach.
Getting sick with a cough is definitely something to avoid. If you are talking to someone who you realize is sick, don’t feel obligated to remain a polite distance from them. Back up and avoid contact! If you do end up getting sick, you will be in great pain.
And it doesn’t end when your cough subsides. Even when you're not actively coughing, your sore muscles will continue to ache. Holding your chest will seem like the only thing that can help, but it doesn't actually relieve the discomfort.
On the positive side, one benefit of having a numb stomach is that I can bring down a fever without experiencing the usual pain. Let me explain. When we had high fevers as kids, my mom would bring down our fevers by patting our hot skin with a washcloth dampened with water and rubbing alcohol. After wetting the skin, she would blow air on the dampened area to cool down our bodies. We hated this procedure because it would be painful when we had a fever of 102 degrees Fahrenheit or higher, but she would continue until our fever broke. She was always successful at her task.
Now that I have a numb stomach, I can use my mom's procedure without feeling the accompanying pain. I place my hands (chilled by cold water) on my numb belly, and my fever will soon drop.
Gaining Even a Little Weight Feels Uncomfortable
Another thing I’ve noticed since my stomach was stitched up from side to side is that when I gain even a pound or two, I can tell right away. The skin around the long scar becomes stretched tight—as if I've just eaten a massive Thanksgiving meal. And if I let my weight climb a little more, my stomach begins bulging out on either side of the scar. It’s not pretty, and it motivates me to get on my treadmill.
Breast Tightness and Shape
Several months ago, I mentioned how the tightness of the skin creating the new breasts feels like I am never able to remove a bra. Mostly, it still feels that way, but it seems to have relaxed a bit. It's possible that this is related to the reduced swelling, or it's possible that I’m just more used to it.
In terms of the shape of my new breasts, I was surprised when I saw photos of myself at my son’s recent Bar Mitzvah. Actually, the surprising thing wasn’t so much the breasts themselves; rather, it was the area just above them. There’s a strange indentation that wasn’t there before the surgery. I think the difference is that before the surgery, more of my chest was filled out by the natural breast tissue.
Menopause and Hot Flashes
I started going through menopause about a year and a half ago, when my ovaries were removed. I'm still experiencing hot flashes, and I've learned that sleeveless tops are required menopause-wear. My Southern husband tells me, a Southern woman would call a hot flash, “my own personal summer.” Perhaps that’s why First Lady Michelle Obama tends to wear sleeveless dresses and tops—I wonder if she’s going through early menopause? Perhaps these clothes help her cool down quickly after a hot flash sweeps through her body.
Anyway, when I wear my sleeveless tops now, I’ve become a little self-conscious because you can see the indentation in my skin above my breasts.
I think I'm having fewer hot flashes than I was a year and a half ago. Either that, or I'm just more used to them.
They still strike the hardest at night. My husband thinks I’m nuts when it’s winter out, and I keep the windows open and the ceiling fan turned up to its highest setting. All night long, I’m either burning up or frosty cold. It’s amazing that women who are going through this can this get any sleep at all. Oh, and does anyone else experience this: Sometimes, when a doozy of hot flash is about to strike, I’ll suddenly feel sick to my stomach. The sick feeling washes over my body, and it's followed by a wave of heat.
Did I Make the Right Choice?
Once in a while, I still question my choice to have this procedure, but that quickly changes when I think about my children. By now my kids are used to my strange, new body—and my daughter calls my scars a smiley face because of the way they look to her. I wonder if my son will grow up thinking a woman’s natural body is strange after seeing my thrashed skin. I still worry if my children carry this horrible genetic mutation, and I don’t look forward to waiting another decade before my daughter can be tested.
Sorry, some of these photos are gross! But I decided to include them because I think it's helpful for people to know what to expect.
For the sake of comparison, I've included some "before" photos (pre-surgery), as well as post-surgery photos from the 2-week mark and the 11-month mark.
Profile: 2 Weeks Post-Op
Profile: 11 Months Post-Op
Belly: 2 Weeks Post-Op
Belly: 11 Months Post-Op
Belly Button: 2 Weeks Post-Op
Belly Button: 1 Month Post-Op
Belly Button: 2 Months Post-Op
Right Hip: 11 Months Post-Op
Left Hip: 11 Months Post-Op
Left Breast: 2 Weeks Post-Op
Left Breast Scar: 11 Months Post-Op
Right Breast: 2 Weeks Post-Op
Right Breast: 11 Months Post-Op
Thanks to everyone for contacting me with comments, questions, and stories about your own TRAM flap and mastectomy experiences. Please continue to let me know how I can help you through this process and if there's any information you'd like more information about.
A Bit of TRAM Flap Humor
My family knows I'm terrible at telling jokes, but here's a little TRAM flap humor I heard from a friend. When I wince in pain and place my arm across my breasts, my kids ask me what's wrong. "It's okay," I tell them. "I just have a stomachache!"
Will you have TRAM Flap reconstruction?
What path will you choose?
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Bobbi Benzing on February 20, 2018:
Hi all, I had a bilateral Mastectomy/reconstruction with silicon implants, and overall I am really happy with the results. They nipples were reconstructed from the leftover breast skin, and tattooing. I finished with the last procedure 12/2017.....Yes there is still some visible scarring, but overall it was the best choice for me at the time! Good luck in your recovery, stay strong, and stay positive!
mmclachlan2016 on June 21, 2017:
I had a double mastectomy/reconstruction in November 2016. We took out the expanders and put implants in because my skin was too tight. I'm looking at the Trans Derm Flap surgery next year, but I'm a little scared after all these comments. I don't have boobs now and want to have some shape/form to look real again. Can that happen with this surgery? Overall would any/all of you recommend this procedure or do something different?
Mona on January 02, 2017:
I had tram flap for 6 months, I feel very tight in my abdomen and feel like swallow a wooden board in it that make me very uncomfortable, i want to know for how long this feeling will release？ thanks! Wish you happy new year:-D
Amy on December 24, 2016:
Thanks for the post. It has helped reaffirm that my choice not to reconstruct is the right one for me.
Judith G on November 19, 2016:
I just finished reading your story and realize that although my procedure and recovery is going to be hard I have made the right decision. I have my surgery date for January 23, 2017. I'm scared, worried and afraid for the entire process. I have an awesome family and husband but it's still a life altering experience for us all. My sister who is 44 is HER-2 positive and undergoing treatment currently. She helped me make this decision with our cancer ridden family, I somehow knew I was going to be positive. I am trying to stay body positive for the upcoming procedure and only hope (pray) things go well.
Joelle Burnette (author) from Northern California on July 29, 2016:
Sorry to hear about your TRAM troubles. If you search on Facebook, there are several groups that focus on TRAMs. Most are private and require approval before you can do anything within the groups. Privacy is key and allows for a more open conversation and sharing of photos, stories, and other resources. As well, you may want to check out the FORCE website: http://www.facingourrisk.org/. FORCE offers access to info, local support groups, and solutions.
I hope you find solutions and enjoy good health.
Barb on July 29, 2016:
Hi..6 years ago I had a tram with terrible results. Are you aware of a forum for discussion and support?
Tara on June 12, 2014:
I also had this surgery in 2013. Humor & attitude has helped me through it ....all by the grace of God.
One of my jokes is that now my boobs growl when I get hungry :)
NanciM on April 09, 2013:
Thanks. Esserman is supposed to be the best. Dr. Chen did a great job removing the plumbing down below. I have a different plastic surgeon, Sbitany.
Joelle Burnette (author) from Northern California on April 09, 2013:
Sure...breast doc: Laura Esserman, plastic surgeon: Robert Foster, oncological gynocologist (ovaries): Lee May Chen.
If you need more info, contact me through my website, JoelleBurnette dot com.
NanciM on April 09, 2013:
Is there some other forum we could use to communicate? I have the same procedure scheduled at the same place in about two months. Want to know which doctor, unless you don't mind saying who here.
Joelle Burnette (author) from Northern California on April 09, 2013:
Ovaries/tubes: Oct. 2008
Bilateral mastectomy/TRAM Flap reconstruction: May 2009
All at UCSF, Mt. Zion
NanciM on April 09, 2013:
When and where was the surgery done, if I may ask?
Susan Bailey from South Yorkshire, UK on February 02, 2013:
It is over 2 years since I had my bilateral Tram flap. I was diagnosed with invasive ductal carcinoma which had begun to send out satellite lesions in my right breast. I was so worried it would spread to the left side that my surgeon agreed to remove both.
I still suffer with itching which feels as though it's inside my abdomen and is therefore unscratchable. My breasts failed spectacularly, the patches where my nipples had been went first deep pink then purple and finally black and hard (eschars). The fat from my tummy turned necrotic in places and had to be cut away, shortly after this procedure the fat began to liquefy and run in rivers down my legs. It was disgusting and made me feel ill, especially when infection set in and the smell was unbearable. I was attached to a vacuum machine for 6 weeks following the infection. Eventually the holes healed but inwards so I looked rather as though I had two bagels. I now have silicone implants which I never wanted and these are very small, flat and misshapen. The scarring is really bad and the breasts still go in a little where the nipples were. My surgeon tried on two occasions to make me nipples but they just disappeared both times. I've lost count of the surgeries I've had to tidy things up but my teenage son still has nicer (and bigger) breasts than me! I have had 3D tattoos which from the front look great but from the side can't be seen. My abdomen swells all the time and feels like it could burst - very uncomfortable indeed but I do have a flat tummy. I get weird sharp nerve pains all over as well. I often wish I had just had the bi-lat mastectomy and immediate reconstruction with implants since I've ended up with them anyway. I'm sure cosmetically they would have looked better than what I currently have. More corrective surgery? I'm not sure; certainly not in the immediate future.
Gail Mucci on September 19, 2012:
I am at my ten month anniversary of a tran flap mastecomy. My stomach is very hard and looks and feels like I am six months pregnant. If I wear a tight girdle it feels somewhat normal. My doctor doesn't know what is causing it. Another thing I am having phantom feelings in my reconstructed breast. It is very weird. Hopefully this would go away.
jdolan on September 19, 2012:
What a great share! Thank you so much. I will be having a bilateral with tram flap done in 2 weeks. I am scared, scared, scared. But as awful as the the recovery sounds, I believe for me it is the best option for me. I also like to swim (was a college level competitor) and hope that that is something I can back to eventually. I also enjoy many of the activities you mentioned, so I feel hopeful. I do not mean to be weird, but although I have not met you, I feel somewhat connected. Your thoughts and situation are more like mine than anyone else's I have met going through this. I thought I was the only one worried about debt and pulling my weight financially. It is a strange sort of guilt. I have a 5 and 7 year old, and I need to be focused on getting healthy for them - so work is on the back burner. My husband is a teacher, and to start, we never lived a life of luxury - so it has been hard - to say the least "living" on one income. Although those pictures were gross, I am glad you shared. It is good to know what to expect. I think in the afters you look great. Thank you so much for sharing!
colleen on June 27, 2012:
Hi, I just went through a pediculed tram flap procedure 2 months ago. I enjoyed your video. It was a procedure from hell and one that I would never go through again. My breast is doing fine, but my abdomen is buldging and rolling and have been to the surgeon twice and was told that Iwould have to live with this, or undergo another major surgery that he pretty much said would not do a whole lot of good anyway. I wish I had waited for delayed breast reconstruction and had the diep flap procedure done that does spare the stomoch muscles. The pain of this procedure was terrible, to be fair it has only been two months, I too have lots of pics, before and after pics. I would post if anyone interested. Thanks
Nicole Forman from South East England on April 12, 2012:
I'm currently considering this - I think your brutally honest account is very interesting to hear...thank you for posting about your experiences and putting on photos too...I'm still undecided! xx
Sue on February 27, 2012:
I am almost 6 weeks out from a tram flap on my right side after a DCIS early diagnosis. Not wanting radiation treatment after a lumpectomy or implants to deal with in later years, I chose to have a Tram Flap.After 5 nights in the hospital, (with a family member staying each night)my husband and older sister became my caretaker team.My recovery has been pretty good, though I began to wonder about my tight tummy and funny sensations.I am comforted to read all of your accounts, realizing I am on a recovery track that will take time.I identified with the "tight rope"feeling of being cinched around my waste. Also the stiff tummy feeling like a pregnancy. I sometimes said it was like Braxton hicks.(An interesting sensation at age 60.)
Thankful for all I have learned from all of you. My Husband of nearly 39 years calls me Mrs.Courageous.Choosing a tram flap qualifies each of us to wear that badge patiently.
Grace Amponsah on February 24, 2012:
I'm scheduled for tram recontruction for breast very soon,but reading your experience has made me scared.So removal of your belly buttom is part of the the procedure? How long did you actually stay home before returning to work? Im glad everything is perfectly healed but that wasn't an easy trip. May God bless you.
Ahnoosh from Southern California on November 27, 2011:
You're so courageous for posting this! I am six-months out of right mastectomy with tram-flap procedure and just completed my reconstruction. I am doing well, knock on wood. My first round of breast cancer was 18 years ago...and then this year a recurrence. I have recently been experiencing the 'stabbing pains' that you mentioned...i think it's nerve regeneration, but I have them for days at a time, and then nothing. Weird.
Anyways, keep fighting the fight! And thank you for posting. God bless you with good health and happiness! And good luck with the writing job! Woot!
leslipvb on September 13, 2011:
I had bilateral tram flap reconstruction in July. I have since had a second surgery to correct some issues caused by a lack of adhesion from the mesh to my skin. I now have a giant bulge, I look like I'm 7 months pregnant and have numbness and tingling in my legs. As I am currently on my second phase of chemo it seems there's nothing I can do. The bulge is so low that it interferes with my sitting and my back is killing me. Has anyone else dealt with these issues? I have an appointment with my plastic surgeon tomorrow because the incision is now opened, about 4 inches long. I feel I should bring up the issues with the bulging, but I feel like my surgeon is blowing me off due to chemo. Any suggestions?
Ikeji Chinweuba from Nigeria on March 30, 2011:
I interesting but a heart feeling story and experience you actually had.Am really feeling for you but i guess everything is normal now and am happy you actually survived this.
Suzy P on March 21, 2011:
Cari~ I'm right there w/ you! Had my surgery 2 months ago too. Been wondering about these weird sensations..and how long it'll take until I reach my 'new normal'. Time will tell!
Joelle~ Thanks for sharing your experience! It's a really brave thing to do and will be helpful to so many women having TRAM surgery. I am also BRCA positive w/ a strong family history of breast & ovarian CA. While I did a lot of research prior to my prophylactic Bilat Mastectomy/TRAM surgery (Jan '11), for some reason I never researched 'TRAM Recovery'. It's really nice to see this information out here :)
I also had prophylactic oophorectomy a year ago. As you know, It's been quite a journey. And while I was scared to pursue these interventions and voluntarily alter my body forever...I knew it was for the best. I found that knowledge is power & I've met so many people along the way that gave me strength and support that I will never forget. I used to be a very private person, but realized that by sharing my experiences with my family & friends, I gained the confidence to make tough decisions and take action for my long-term health. I will be 40 in a few months, and I'm looking forward to starting a new chapter in my life, free of frequent Dr's appts, labwork, mammograms, MRI's, etc :)
Cari on March 21, 2011:
I have been having all of these symptoms and scared to death that something horrible was wrong, but now I feel amazingly serene! Knowing that my hard tummy and my unscratchable itches are normal makes me relax more! My surgery was 2 months ago, so now I know not to freak out that I am still healing!
Lily Rose from A Coast on November 10, 2010:
Wow, it's like deja vu! Except I had the bilateral mastectomy with tram flap reconstruction (in February 2009) after being diagnosed with breast cancer and unfortunately had to go through all the chemo and radiation as well. I am BRCA2 positive which is why I chose to do the second breast also and I had a bilateral oopherectomy to remove both ovaries and tubes (good thing I was done with them!) as well.
I too have felt a lot of phantom sensations like you described, but what I felt was the feeling I remember feeling when I was pregnant and the baby moved inside my belly - it felt like a little foot or hand rubbing/pushing me from the inside, very weird! I still get the itches that I can't scratch which drives me crazy!!
It's good to hear someone else talk about having gone through some of the same things...
Joelle Burnette (author) from Northern California on November 09, 2010:
Sheri, thanks for your story. I'm sorry you had to go through this horrible process. I can't believe the surgeon's comments about not knowing what to do once he entered the OR.
I hope you'll read some of my other stories so you'll understand why I did this when I tell you, I didn't have cancer. It sounds ridiculous every time I consider what I did to my body, but it's because of my BRCA genetic status and having too many relatives who have died from breast cancer. It's because of my own sister who has survived breast cancer twice. It's because of my more than 90 percent chance of getting breast cancer that I took these aggressive steps to make sure I'm around when my children grow up. I hope this doesn't change your opinion of my story.
Thanks again for reading. Let me know how everything turns out.
Sheri on November 08, 2010:
This is a great story and wished I found something like this before surgery. I couldn't much post op info at all when I was researching. I had this surgery in Jan 08. I feel very lucky after reading some of the blogs on line. Right now I am still dealing with some rough scars on the underscar of the breast and a bit square looking compared to other breast. Other breast had a large narcosis on the top. Pre op I was 36 A/B? and thought I was going to be a full C but ended up with DD. I've had 1 post operation to lift the breasts and take out some of the narcosis out which then left an indentation (like a line). I thought at this time he was also going to clean up the rough scaring but he didn't because he said I didn't tell him to when checking in, in the hospital right before the surgery. We had discussed this at various visits before but he said surgeons don't go over notes before surgery, they don't have time. I questioned what those notes were for. No answer that I recall. On the stomach scar new button is great and the side to side scar is OK with little "dog ears" on each side. My stomach really swells, becomes bloated after eating. I can feel my upper intestines fill and it all gets hard. When I asked my PS (plastic surgeon) what was going on he said "I don't know". I expected some kind of feedback since he said he does about 15 of these surgeries a year. I have since seen a different PS to do nipple reconstruct. He spent about an hour talking to me about because of me my children will need to check themselves daily and have med. checks often not just yearly. I heard what he was saying but also felt attacked, like I asked for this to invade my body. He also said you can't go operating trying to fix little things because there is only a little blood supply for all the tissue that was moved and you risk more narcosis or a fix that makes the problems worse. I did like his way of doing the nipple reconstruction by making 3 cuts in the breast, flap them over to make the nipple (in office) and then have the areola (sp?) around tattooed on. The other surgeon would do a skin graft taking the dog ears from the tummy scar to create the nipple which would require healing from the present blood supply. I will have another consultation after the 1st. of the year to be sure nothing else can or could be fixed.before having the nipple surgery. I too experience the sharp little pains but have to say that a good physical therapist has really helped. I didn't realize how much range of motion I was lacking and I also had the rotator cuff problem prior to surgery. You didn't mention if you had any lymph removed. The sleeve for compression really helps and then she also recommended one of those spanks underwear from midriff to knees for compression. I got the Penney's brand. Did you have to do Chemo and drugs, what stage were you? I was stage 1 with a low-medium oncho score. I weighed out the pros and cons of the side effects and chose not to do any chemo and took fomara (sp?) for only a short time as it made all my joints ache really bad. I felt like I 90 yrs old. I ,too, sometimes question my decision for this type of surgery but all the residual effects were not totally explained to me. Good luck with your job and finances. Many people are suffering in these times and it is sad. Take care