I hope you are well!
Iím dealing with what I think is a rare circumstance and thought maybe you can help me figure it out. I apologize, but this is going to be long because itís complicated.
I finished up my DIEP reconstruction with you in late 2010 and all was well, until recently. I was diagnosed with an ascending aortic aneurysm last July and had open heart surgery to repair it in October 2017. Iím about 12 weeks out now and recovered easily. However, at about six weeks out, I experienced three days of stabbing pain in the medial side of my right DIEP flap, which subsided to duller pain by the fourth day.
My first thought was that I might have a broken sternal wire, but the PA at my surgeonís office didnít think it possible so I agreed to give it some time. Also around the six week mark, I began cardiac rehab and resumed painting my kitchen cabinets. I noticed that the pain was more frequent after sleeping on my right side for some portion of the night, so I avoided that for weeks. However, I am still feeling the sharper pains when I take a deep breath, turn my body in certain ways or make certain movements with my right arm. Most of the time, there is just a mild dull ache in the breast. Since Iíve been feeling pain for over six weeks now, Iíve had a lot of time to think about what could be causing it (and to worry about it). I decided I was either dealing with a broken wire, damage to the flap where attached near my sternum, scar tissue being stretched as I am building up my muscles again, or cancer.
I contacted your staff and Tori gave me an order for an ultrasound, which I had done today. The sternal wires were determined to be intact. No fluid was observed, nor anything else of concern. The radiologist mentioned that I could have my doctor write an order for an MRI next, if I was still concerned. There was more pain than usual after the exam and the tech said she had been using a lot of pressure so she wasnít surprised.
Finally armed with confirmation that there is no wire poking and scraping me in the side of the flap, I applied pressure to various spots where the pain is, and I found a spot in the flap where the discomfort is pretty intense.
During my heart surgery, my body temp was lowered quite a bit and blood circulation to my body was stopped for 20-30 minutes. Iím wordering if the cessation of circulation during that time could have caused an area of necrosis in the right flap, which is causing the pain I am experiencing.
Do you think this is possible? Would you recommend CT scan or MRIóif this doesnít resolve and I canít live with it?
Thank you for your time!