Category Archives: Uncategorized

April 25, 2024 · 1:51 pm

#84 East Coast-West Coast

After leaving Manhattan we traveled to Plymouth Massachusetts, keeping us on the East Coast two weeks post-op before flying to the West Coast. I stayed in California with our son till April 6th, while my husband went to do a job in Iowa and Indiana. Once in California, my surgical incision started to open at the bottom tip. Dehiscence of the surgical incision was not painful, actually that whole area is numb. I was advised to put MediHoney on the wound. The plastic surgeon in New York agreed that MediHoney was an option, the other option would be to go back to New York for it to be re-sutured. MediHoney it is!

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( My son insisted on a 1st class ticket back to Maui)

Since arriving back home, on April 6th I was quite busy with a lot of (adulting) aka; taxes. I also reached out to my PCP here on the island. Dr. Haynes placed a referral for me to be seen by the wound care specialist, the same one that took care of me when I had the wound-vac last year. Terri with Venture Physical Therapy is seeing me once a week and taking pictures of the wound for me to forward to the New York surgeons.

I know that in the past I have been very transparent and have posted graphic pictures of surgical sites. I have opted this time not to post pictures of the dehisced surgical wound. What is important is that it is healing and it is not infected….grateful for that.

I am scheduled to go back to work May 6th, which I am looking forward too. What can I say, “I love my job”. Today (April 25th) is our 37th Wedding Anniversary , Jack flew home to surprise me.

Mahalo for reading

Pina

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March 5, 2024 · 5:40 am

#82 Getting Discharged

The colonoscopy last Monday (2/26) was clear with no findings. I opted to stay on clear liquids till my surgery to repair the Lumbar Hernia. Per the surgeon the repair was complicated but successful! We were given the option of a private room or shared, we opted for private suite ……that came at a price $$$$. Originally I was to be hospitalized for one to two nights. Well here we are on day seven and I am being discharged. Just yesterday March 4th I was cleared to start having solid foods. The restrictions to be on liquids was due to nausea. The medical team tried different nausea medications to help with the on going nausea, I couldn’t keep down water, it was bad.

When I was give the menu to order breakfast yesterday I got to see what they offered. Let’s just say I missed out on some delicious meals. Below is one of two menus to pick from, my husband Jack was well fed.

When we leave Mt. Sanai this afternoon, we will head out to a hotel at Times Square. I will have a post-op appointment with Dr. Reiner this coming Thursday. At that appointment the surgeon will lets us know exactly when we can leave this area.

Below is one of my favorite pictures, we are on the upper east side over looking Central Park towards the west side.

Signing off, many mahalos for the love and support and above all, prayers.

Pina

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February 27, 2024 · 10:35 am

# 81 PRE-OP APPT

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Yesterday’s colonoscopy went well, no abnormal findings!!! For those of you that have read previous blogs you know that I have a mutated gene for both colorectal cancer and breast cancer, so colonoscopies are preformed more frequently…YAY ME…NOT! Anyways “no findings” is a good thing (insert happy dance)

While I was having the colonoscopy, the surgeons office called the G.I.’s office and had them give me a message to call them after my colonoscopy was done. Dr. Peter Rubins office wanted to see me for the Pre-Op at 2:30pm yesterday. We took an uber back to the hotel, I took a nap prior to the 2:30 appt. Doing the cleanse for the procedure literally kept me up all night going to the bathroom, so I was a bit sleep deprived.

Dr. Peter Rubins office is across the street from the famous Met Museum. His examination of my hernia was very thorough, then we discussed the surgical options. Initially the plan was to do the repair laparoscopically, however due to past surgical history and for longevity of the repair he recommended an open repair. His explanation made sense but honestly I don’t remember the details to include them…so you are sparred from the detailed explanation. I was given to option to eat dinner last night, breakfast this morning, then liquids after 12 noon, then start a new colon cleanse for the surgery tomorrow. The other option was to stay on clear liquids until the surgery. I opted for the clear liquid option.

When our appointment was done, we opted to walk back vs. taking a cab back to our hotel. The reason for the above picture is because it was comical and challenging to be passing by all these great little hole in the wall places to eat and you cannot indulge! I have been on clear liquids since Sunday afternoon.The smell of freashly baked goods, pizza shops galore was torture. We made it to our room where I warmed up some broth, yummy.

Surgery is scheduled for tomorrow morning at 9am. Anticipated hospital stay is two nights and we will hang out in NY for 10 days post-op.

Mahalo for reading my blog

Much aloha Pina

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February 25, 2024 · 11:49 am

#80 New York

After completing the breast restoration process last year, I was so happy that all of that was behind me. All I wanted was to have successful breast reconstruction, which I was able to get going to Louisiana. I thought 2023 would be the final surgery, but apparently not. (details in previous blog)

Like I mentioned, this surgeon wanted me to have colonoscopy prior to the hernia repair vs. having one done later in the year since I am due for one. If you have been reading my blogs from the beginning I have mentioned that I have a mutated gene for both Colorectal and Breast Cancer. When Dr. Reiner asked me during my consultation when my last colonoscopy was, he was quick to say that he would not do the repair without a colonoscopy first. Also I would need to have colon prepped (cleansed) prior to the surgery, so might as well do them both.

Tomorrow at 9am eastern time I will have the colonoscopy done by Dr. Peter Rubin. On Tuesday we will meet with Dr. Reiner for a pre-op visit and instructions for the Hernia repair on Wednesday.

Sitting here in our hotel room at The Marriott Courtyard in the upper east-side of Manhattan, I have just finished one of the two bottles of Clenpiq, which is the colon cleanse kit I was prescribed (wish me luck) We are with in 1.5 miles of the locations where both procedures will be done.

Wish me luck, keep me in prayer that all will be seamless without complications.

Mahalo for reading

Pina

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February 4, 2024 · 1:22 pm

#79 Surgeon Found

Since my last blog in December, my family and I sought out surgeons on the west coast repair my herniated colon. Unfortunately we were unsuccessful, apparently my situation is very rare and to quote one surgeon from UC Irvine, “this is not with-in my scope”, “you need a complex hernia specialist”. The City of Hope Surgeon, consulted with his colleagues, and said he could approach it like a “Flank Hernia”, however he was honest in telling us that he had never done this type of repair…no thanks (I appreciated that he consulted with his colleagues about this case).

Surgeon found, New York here I come! Yes New York!……The surgery will happen at The Mount Sinai Hospital in New York, New York. Dr. Mark Reiner with the Laparoscopic Surgical Center Of New York will be doing the repair on Wednesday February 28th. This surgery is being coordinated with a Colonoscopy first on Monday the 27th.

During my virtual surgical consultation with Dr. Reiner, the fact that I have a mutated gene for both colorectal cancer and breast cancer came up and he asked when my last colonoscopy was. He was not pleased with my answer when I told him 2018 was my last colonoscopy. In 2018, the recommendation was repeat in 3 years. Well, with the pandemic and my 2023 breast reconstruction, we were planning on getting that done in 2024. Dr. Reiner was a bit stern ( in a good way) in saying that he could do the repair, but would not do it without a colonoscopy first. And, since the colon will have to be prepped for the Hernia repair, he arranged for a G.I. doctor to do the colonoscopy.

( I went whale watching yesterday, thought I would share)

When having surgery on the mainland, a lot goes into prepping for it. We have our flights, booked our accommodations. I have had to purchase cold weather clothes, because living in Hawaii what do I need a jacket for? Pre-op lab work was just completed ( can not be done more than 30 days prior to surgery) I have an appointment for my EKG on February 12, my PCP will also perform a pre-op physical requested by the New York surgeon. All results will be forwarded to New York.

This picture was posted on my last blog, the New York surgeon said that with out surgery the opening where the colon has looped out would only get bigger. Due to the trunk (opening) being measured up to 4.7 cm, incarceration is unlikely. This was a huge relief, I am just thankful that we found a surgeon that looked at my images and said “YES” I can repair this.

Please mark your calendars and send prayers and good vibes all the way to New York when I am having this hernia repaired.

Mahalo for reading

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December 16, 2023 · 4:11 pm

# 78 Beyond Frustrated

The title of this blog is an UNDERSTATEMENT of how I feel right now.

But, first let me go back a little bit before I explain. Recovering from the second phase of the SGAP Breast Reconstruction done on August 30th went smoothly. The surgeon modified the front DIEP flap scar, moving it down leaving the umbilicus at the waistline. The gluteal scar had/has an area that has decided to take its sweet time healing, today it has less than 5mm to go before it is completely closed. The left breast is a bit smaller then the right breast, and I am okay with that because I have two breast now! I was offered another revision, but I am happy with the current outcome. I was really worried for a bit when I had the complications and having the wound vac, I thought I was going to lose the flap. Beyond grateful for the surgical team in Louisiana !

Above is a diagram of the scars, I know it looks intense, but all scars a healing really nice. I did go out and buy myself new bathing suits, however I have not been cleared to go into the ocean due to the gluteal scar not completely closed. Just need to be patient……..and then this happened!

Last month I noticed that I had this “puffiness” on my left side near the waistline on my back. That area did not feel right, I would do my lymphatic massage, the puffiness would subside, but then reappear. On Monday the 27th as I was bearing down to use the restroom, I placed my hand on my back waistline and felt something literally plop out (and I’m not talking about a BM..lol) I asked the Ultrasound Technologist if it was possible to have a hernia back there, she said, rare, but possible. Since then I have had an Ultrasound and CT. I have a Hernia! The descending colon has herniated out.

The yellow line shows where the wall has been breached (so to speak) the large bowel should not be past that point.

What’s next? Getting this repaired before it gets “incarcerated”.

Tomorrow we fly to Burbank, I have a surgical consultation with a surgeon with City of Hope, on Monday the 18th. On December 28th I have surgical consultation with a surgeon from UC Irvine. This comes after the Specialty Care For Hernia Repair out of Newport Beach let me know that they could not do this repair. This facility does outpatient, and was not a good option for me. They recommended having it done at a University Hospital. I am not in pain, it is uncomfortable though, I am wearing an abdominal binder making it bearable throughout the day.

My kids quickly started sending me names of possible facilities/surgeons. I was really challenging coordinating this, making phone calls etc. However I have two consultations and hopefully one of the surgeons can do this ASAP!

So there you have it…this is why I am Beyond Frustrated ……simply at the thought of another surgery has me bummed.

Mahalo for reading……I almost forgot, the flowers were a gift from a wonderful patient during Breast Cancer Awareness Month!!! She totally made my workday, work week wonderful. I got lots of compliments from patients that got to see them, they were beautiful!

Mele Kalikimaka everyone,

Pina:)

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August 30, 2023 · 3:19 pm

#77 Pre-op/Post-op

Six Drain Tubes

Wow ! Where to begin! The non-cancer side (RT) was reduced/lifted and treated with fat transfer for contouring. The left received fat transfer through two small injections on the flap mound. The healed previous scar was not manipulated.

Scare revisions: The gluteal (buttocks) scar was revised, with fat transfer for contouring. The front diep flap scar was revised, the scar will now sit lower below the umbilicus, and will be tighter. For those of you that have been following my blog, you know that I have a long scar on my back from the latissimus dorsi, surgery in November 2018. My NOLA surgeon asked how that scar felt. I answered honestly,:the scar has been bothersome, sometimes it pulls stopping me in my tracks we talked about revising that scar as well, which he did. It turns out there was a void underneath the scar wear he had me point to at my pre-op appointment.

Seems like a lot, I am not in pain🌸 I did not expect all the scar revisions, however when we talked about it at my pre-op it made sense, especially for the Lat- D scar!

The Lat-D scar is long, starts just below the left shoulder all the way down to below the waist line. I grateful for this facility an all their expertise with breast reconstruction.

The current plan is to discharge me today, I will finish my recovery here in NOLA till next week, we will fly to Cali for a couple of weeks after that. I have always said “ all want is two boobs” I know they will never be twins, I am good with “sisters”

This time it is working 💞🌸Mahalo for reading my blog and continued prayers for Lahaina🏝️ Pina (Josefina)

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August 27, 2023 · 9:15 am

#76 Second Phase

This blog has been on my mind, I had intended to blog the week that the Lahaina fires happened also the fires in upcountry. Blogging took a back seat, as our beautiful island recovered and continues to recover from the tragedy that happened here. The picture above was taken April 2008, on one of our wedding anniversary trips to Maui. The Lahaina Banyan Tree turned 150 on April 24 of this year. The tree might recover and live…however so many people have lost their loved ones, families gone. I pray that the survivors of Lahaina will be able to recover from this tragedy.

The second phase: I am off to Louisiana for the second phase of my SGAP breast reconstruction. This surgery was supposed to happen the first week of June, however the complications pushed the surgery out. I am really happy with the way the left breast is healing. I still continue to wear a bandage under the fold of the breast that is still healing.

The plan for this surgery is to make the breast more symmetrical. Currently the right breast is quite a bit larger than the left. The left breast will not be manipulated, we plan on leaving it alone. I have always been told by the plastic surgeon that the breast would no longer be twins, that they will be sisters! Well currently they are not twins, nor sisters…they are more like distant cousins! The right side will be reduced and lifted to match the left.

I am going to stop here, I just wanted to touch base with all whom have subscribed to my blog and have been reading my blogs.

Mahalo for the well wishes and prayers for the people affected by the fires.

Pina (Josefina)

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May 22, 2023 · 2:17 pm

#75 DECOMPRESSED AND FREE

Since my last blog, I had mentioned how the Surgical Center in NOLA was trying to coordinate wound VAC care on Maui. The two facilities mentioned in previous blog would not take me on as a patient, however the Surgical Center did find a wound care specialist with Venture Physical Therapy here on Maui that took me on as a patient. I am forever grateful to the team in Louisiana for searching high and low for someone that allowed us to return to Maui for my recovery.

Originally I had six drains from the March 1st surgery. Four of the drains were removed 2 weeks post-op, leaving the two on my hips. Traveling with the drains was interesting, but now add on a medical device and it gets interesting. I was also required to wear a compression garment, with ABD bandages padding the drainage tubes and scars around my waist. Let’s just say that I had a private pat downs at the airports getting thru TSA.

Since I have been back on Maui, I have been seeing Terri with Venture P.T. three times a week for wound VAC dressing change, the Jackson-Pratt drains have been maintained by my husband. The WV can be disconnected for two hours daily to allow me to shower. In case you are wondering if it takes two hours to shower? Yes it does. having these tubes connected to your body and wearing a compression garment made it so it was a whole production to shower. The compression garment had to be undone for about half hour prior to a shower to avoid getting dizzy(we learned the hard way). The tubes then had to wrangled on a rope around my neck, they could not just dangle from my body. After showering, the drains, which I named “Bonnie and Clyde” were treated and padded and the compression garment was back on. Then the wound VAC, which I named ” Al Capone” was reconnected and turned on.

Above the tubes with blue are the drains, that are attached to right and left hips. The WV tube is the one that is just below the left breast. With each dressing change, the entry point placement is moved to allow my skin to recover from the adhesive tape. Quite an ordeal, my skin was not liking the tape!

I have been wearing a compression garment and have had the drainage tubes since the March 1st surgery. The wound VAC has been attached to me since March 28th! With that being said, I am now “decompressed and free”! I was given the ok to have the drainage tubes removed on Thursday May 11th! On Mothers Day, the wound VAC was discontinued and we switched to a topical dressing! Last week was a test for discontinuing use of the WC, the decision to keep it off was made on Thursday the 18th!!!!

The left breast flap that detached from my body warranting the surgical debridements and the use of a wound VAC, is not completely closed up. However, it is now to the point where a topical dressing will suffice, so I continue to see Terri with Venture P.T. My first visit with Terri was on April 15th. the open wound measured about 17cm wide and almost 3cm in height, I do not remember the depth. Today the wound is 6cm wide, and under 2cm in height, with the wound being flush to the skin. Wound VACS are cumbersome but amazing !

I am going to stop, I did not intend for this to be so long…Mahalo for reading my blog and for all the get well wishes and prayers.

Much ALOHA, Pina

The picture of me above was taken at The Hotel Wailea, which is where I was treated to breakfast for Mother’s Day by my son-in-law and daughter. We laughed because my shirt matched the orchids!

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April 5, 2023 · 5:17 am

Wound Vac

We arrived late Monday in Louisiana due to a flight delay in Houston, TX. We went straight to The St. Charles Surgical Center and where I was admitted. I was kept NPO for a scheduled surgery on March 28th, which coincidentally in 2016 is when I had my left mastectomy. The debridement went well, the left drain on my hip was exchanged for a larger tube and I now have a Wound-Vac over the left breast.

Here is where it gets tricky! A wound vac requires a dressing change, which my surgeon wants to be done 3x week. The center here was trying to coordinate home healthcare on Maui for dressing changes. Bayada which does home healthcare and does wound vac care refused to take me on as a new patient. (Not sure why) Next: WOUND CARE AND HYPERBARIC THERAPY with Maui Health. On Thursday the 30th , this clinic asked for labs to be drawn for them which was done, however afterwards they just could not get in contact with someone to coordinate and schedule appointments. On Friday 31st, I had another debridement under general anesthesia. I needed to be discharged from the hospital, because wound vac care, can be done thru home healthcare or clinical appointments. Hence, we opted to stay in NOLA, we are in an Airbnb. I have clinic appointments for dressing change, 3x/week. Jack continues to drain and track fluid output. We have this Airbnb till the 14th, If I still have a wound vac hopefully all can be sorted out with Maui Health for continued care.

Today is Wednesday April 5th, I have an appointment later today. Mondays appointment went really well, I am glad we opted to stay in NOLA, the surgeon is the one doing the dressing change on the wound vac, I am in great hands here…..really relieved.

The picture above is a paint by numbers app….very relaxing doing these. Aloha and mahalo for reading. ……Pina

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