Hi, This is all very new to us. Last week Rich was diagnosed with this and he has had CT scans that shows it has spread to the lymph nodes in his neck. So far we have not really even had to much of a discussion on the tx. All that we were told is that he needs surgery and to have a flap taken from his forearm. Rich is disabled from other medical problems. He has liver damage, peripheral neuropathy, osteoporosis with 3 spinal fractures, and osteoarthritis. Tomorrow he is going to the cardiologist to see if his heart can stand the operation. I'm guessing the cancer doctors are waiting to see if he is strong enough before even discussing it with us. Our main concern right now although we have dozens is that Rich is in a wheel chair and uses his arms to transfer himself. Will he still be able to do this if they take a flap from his arm?

I would surely ask if they can use the other arm. As I understand this, the flap is a section of tissue with skin, muscle, fat, and, most importantly, nerves and blood vessels attatched. This would be stitched into his mouth after removal of whatever they plan to remove....and the circulation would be hooked up to vessels in the neck, to provide circulation to the transplanted tissue. I don't know if they have to use the tissue from the same side as the surgery. I don't really see why they would have to, though there might be a structural reason that it would be desirable. There are several on this forum who have had this procedure and can tell you more. I wish you luck. You will find answers, advice, and support here.

Julie. welcome. To answer your most pressing question about his arm...yes, he will be able to use his arm normally afterwards.

I had a free flap elevation from my left forearm, roughly 7 in. by 2 in. which was then covered with a skin graft from my thigh. Today, the scar is sensitive to exposure to sunlight, and I have to be careful about scratching the skin on something (picking blackberries is out).

He will have a while post surgery that he will be limited, but within a few weeks he should have full abilitiy back again.

As for all of the rest...you're overwhelmed. I know, and I understand. We've been there too; overwhelmed, terrified, looking for something, anything that will help you get through this.

The good news is you found it. Keep coming back here with your questions, or when you need to vent. There is a huge amount of firzt hand experience here, and we'd all be happy to help.

Hang in there...this is something you can do
Wayne

Welcome Julie and Rich

So sorry to hear you have another mountain to climb. You have found a great place for helping you get through this.

I am just starting treatment but I may need a free flap. Free flaps can come from different parts of the body, depending on which type of flap is required. There are 33 doner areas on the body for free flaps. My MO said he would take mine from the chest area. Explain your situation to the Doctors and they may be able to use another doner area and exclude the arms altogether.

Wishing and Praying for You. Good Luck, Petey

Julie,
Welcome, you have found a place that you will be able to find many answers as well as an amazing amount of support. The road you have already been down seems rough and I am sorry to hear that you are now dealing with this. Ask as many questions as possible..KNOWLEDGE IS POWER!


Shar

What a burden you two have to carry.I am glad you have found this site and i know its members can give you the love ,knowledge and support i am sure you are needing.

Liz in the UK

Hi Julie,
I'm new to this also,my mom was just disgnosed about a month ago. One thing I can tell you is that when we met with the plastic surgeon she told my mom that if she couldn't use her arm for the free flap, she would use her thigh. I hope all goes well. I'll keep you both in my prayers, my mom has to go in for a cath tomorrow instead of having her tongue operated on. Hoping all goes well. Donna

Hi Julie,
They don't necessarily have to take it from the arm, but when they do, they usually take it from the non-writing side. In addition to worrying about the flap, you mentioned lymph node involement. Are they planning a neck dissection? If so, this could impair his ability to transfer more than the flap. One is not supposed to carry anything heavier than 1 lb for at least 3 weeks after that surgery and we usually wind up in physical therapy to rebuild strength in shoulder. I would ask about that also?

Do they make wheelchairs that have a lift seat, like the chairs with a lift seat? If so, that might solve problem until he gets strength back.

Take care,
Eileen

I have no idea on the treatment except for that surgery that was just briefly mentioned. He went to the cardiologist today. As it stands right how he can't have the surgery. The doctor was great and very hopeful and feels that he could have angioplasty then be OK for surgery. Rich is very discouraged and is not sure he wants to go though it with all his other medical problems. I'm also very worried. If he is unable to transfer himself I can not care for him at home, But if he decides on hospice instead, that point will come with that plan too and it won't be temporary. He has had to go in inpatient rehab before for intensive physical therapy the last time he had a spinal fracture Thanks for the well wishes and prayers. We greatly appreciate them

Your husband's situation is very complicated and it's understandable that he would be discouraged. I can't tell you what to do other than to get all the facts about what is involved with each procedure. Does he understand what an angioplasty is? It might not be as bad as he is imagining. Would they do radiation and chemo as an alternative to surgery? Not everyone has surgery but they would need to consider the side effects of these treatments on his other medical problems. I'm sorry to hear that you are dealing with all this. It's just not fair.
Regards JoAnne