After arriving in Louisiana Monday evening, I was as admitted The Surgical Breast Center, we were instructed to go straight to the hospital upon arriving in Louisiana. I was kept NPO, just in case I would have surgery Tuesday morning March 28th, which happened to be the same day in 2016 that I had my mastectomy! I did have surgery, the left gluteal incision was opening, they did a debridement and sutured it closed again. The left breast had a debridement done as well. The incision was closed up and a wound vac was placed on the reconstructed breast.
I am not in pain, the team here is coordinating home healthcare for the wound care and vac seal to be changed 3X a week. If all can be arranged, we will be headed back to Maui possibly Saturday. I also still have two drains on the hips.
I will stop here, once more, I do appreciate the comments, well wishes and continued prayers. the picture above is a puzzle I did, saved as a picture 💕
#thejourneycontinues #SGAPbreastconstruction #imua #breastcancer #survivor #mystoryisnot over
Jack and I arrived on Maui Wednesday the 15th, just al little over a week ago. We got somewhat settled, our daily routine in the morning with shower and dressing the left takes my husband about 1 1/2 hrs in the morning. I still have to two hip drains and those are emptied and logged 2x daily. Unfortunately the incision started to pull open. Our communication with the PA in Louisiana asked my husband to pack the opening after cleaning it with Dakin’s Solution. Well, we can not purchase Dakin’s Solution anywhere on this island, we ordered some on amazon. There was also a piece of tissue sticking out that they told my husband we can cut off with sterile scissors. This was a bit beyond what my husband was willing to do. Unable to get get at the Wound Care Clinic here on Maui, my PCP Dr. H. Haynes managed to get me to be seen Monday with Dr. Lugo here on Maui. I can not tell you how grateful I was that he worked me in on Monday.
Dr. Lugo assured me that the flap was doing well and that the healing process would just take time. He changed the dressing which included snipping off that hanging tissue and showing Jack how to clean and pack the open wound. Since we are unable to get Dakin’s Solution we are using sterile saline, which the surgeon in Louisiana said was ok.
On Tuesday we talked to the surgeon in Louisiana and discussed the wound care. On Thursday (yesterday) I gave them updated pictures of the open wound. We give them pictures on Monday and Thursday. This morning (Friday 3/24) the P.A. called to let us know of the meeting with the surgical team they had with the pictures I have been supplying them with. They asked we would be willing to return to Louisiana so that they can be more hands on wound care. Jack and I leave on Sunday arriving in Louisiana on Monday, will go straight to The Breast Center, where I will be seen at the clinic than admitted to their hospital.
Physically I feel really good, I am literally not doing anything. I pass my time reading, painting by numbers and doing puzzles on my iPad. The picture above is a completed puzzle, you have the option to save it as a picture when done.
I am no artist, but below is a drawing. Normally I would add pictures, however I am choosing not to, due to how graphic they are.
Tomorrow I am entering a new decade (as my dear cousin put it, we are both 1963 babies) I will be relaxing and prepping for our trip back to NOLA.
Mahalo for reading and all the well wishes…love to all
I have been wanting to blog for a couple of days now. I was discharged from The St. Charles Surgical Hospital on Saturday March 4th. My husband Jack stayed with me the whole time as each room is private and has a Murphy Bed for you significant other. Each day nutritional services takes down your order for breakfast/lunch and dinner for both patient and family member.
I remember when I was taken back to pre-op shortly after arriving at 6am, Jack was told that he can wait for me in my room (more like a suite), Suite 217. After changing into the gown the Physical Therapist came in and wrapped my left arm, which stayed wrapped for several hours after the surgery. It was challenging for the team to find a vein for I.V. access, one of the Anesthesiologist is the one who was able to get it after they placed my arm in a heated blanket. With that being said they did not have multiple nurses attempting to access my vein. They immediately let the Anesthesiologist know that they were unable to start my I.V. After the I.V. was successfully started I was taken to the O.R. I remember getting wheeled out of pre-op and that’s it!
The operation was over eight hours long, I do not know the exact length. I was brought to my suite between 7-7:30pm, making the surgery 12 hours, but I do not know how long I was in post-op. Either way , it was long. My incision is 360 degrees around my waist line. Bilateral SGAP and they harvestesd veins from abdominal area, hence the incision across the belly. I knew going in that, that was going to be a possibility if the veins from the back side were not long enough, they would harvest veins from abdomen. Drains were a total of six. Right side; Breast, Abdomen, Hip. Left side; Breast, Abdomen, Hip. I was up and walking the next day (March 2nd) and was going to be released on Friday the 3rd. However because I threw up my breakfast they opted to keep me till Saturday the 4th. Jack then took over my care, keeping track of pain medication times, draining the tubes, documenting the fluid for each individual drain, helping me shower, shampooing my hair and redressing the incisions, putting back on the compression girdle and compression bra.
My post-op was on the 8th, four drains were removed, I still have both hip drains. Everything is looking really good. Challenging for me is that for the next four weeks I have to sleep on my back, can not sleep on my side (I am a side sleeper) or tummy. Also the compression garment that I have to wear. My next post-op appointment is Monday the 12th, I should be released to travel back after that.
I am really trying to make these blogs short, one last thing. Thank you for all the prayers and get well wishes thru this blog and social media.
Tomorrow is the day! Over a year in planning, the day has come. I’m excited for the end result. I am emotionally ready, SPIRITUALLY READY, physically ready and with the love and support of my husband, family, friends and medical teams both here in Louisiana and on Maui I know this will be it! Since the beginning of this year every Friday I have had countless appointments leading up to this. Labs, urinalysis, physical therapy, dental cleaning, EKG, wellness therapy appointments have been non stop. Surgery number 9, but who’s counting! The day has finally arrived!
Todays appointments consisted of Physical Therapy, went over lymphedema of the left arm. My left arm will be wrapped from fingers to just above the elbow. My upper body strength and range of motion was documented, and we went over post-op therapy. I was then taken to radiology to have a Cat Scan and sat with nurse to discuss what would happen once I arrive at The St. Charles Surgical Hospital tomorrow morning at 6am. The pre-op nurse went over all the pre-op instructions, and gave us (my husband and myself) plenty of opportunities to ask questions. The Anesthesiologist also sat with us and went over everything. My final appointment was with the Surgeon and his clinic with one of the facilities P.A’.s. To say that this hospital is well organized, kind, empathetic and know how to place one at ease is an understatement. My body has been marked with the purple pen mapping out the plan. I have been given the Hibiclens (very familiar with that). The challenge for me will be NO products on my body, hair etc. after my shower this evening and tomorrow morning. It going on 9pm here in Louisiana, time to start prepping for tomorrow.
Mahalo for all the well wishes and prayers (KEEP THEM COMING)…Aloha Pina
It has been a bit since I have blogged. Initially the purpose of this blog was to keep my mommacita informed, she was my biggest fan. Since the summer of 2019, when she passed, so much has happened. Got situated on Maui, back at work at Maui Diagnostic Imaging. Then we rolled into 2020, and we all know what happened that year. I stepped into Lead Mammography position as my co-worker left the island that summer.
In December of 2021, I contacted The Center For Restorative Breast Surgery, which is a hospital dedicated to breast reconstruction. My husband and I had our first zoom appointment with them. I then spent the first months of 2022 gather all and requesting all my surgical notes ( 9 breast surgeries) from the hospitals were they took place. It was a process doing all by phone and email, faxing etc. Once I had all my notes I then forwarded them to the Breast Center. Their team then reviewed all, along with pictures of myself that were sent thru a private portal. We were then offered an in person consultation which we did on October 17, 2022.
I was nervous and excited. Meeting them in person was the right thing to do vs. zoom and or conference calls. My husband and I sat with the surgeon and one of his assistants, he was extremely kind and thorough in explaining what could be done in my particular case. The in person consultation was exactly what I needed to put me at ease and hear his explanation of the recommended surgery vs. reading about it. When we left, I felt really good and hopeful. The decision was made to do the surgery in early 2023, since it would require 2 surgeries. Having it done in early 2023 would allow both surgeries to be done in one billable year, the Breast Center pointed this out. This center is so well organized, different teams reached out to me after my consultation. Scheduling, Financial team, Housing recommendations contacts, pre-op test etc.
Surgery is scheduled for March 1st! We have had our airbnb reserved since last year when the surgery was scheduled. When we were in Louisiana for the consultation we stayed in the French Quarter and did a little sight seeing then. This time around will be different, our stay in New Orleans will be post-op and recovering. I will be required to stay in NOLA for two weeks, before giving the okay to fly back to Maui.
The Procedure: Surgery will be about 8 hours long, it’s called SGAP breast reconstruction. For those of you that have been following my story, know that my right breast was a prophylactic mastectomy, currently with an implant. The implant will be removed and both my reconstructed breast will be with my own adipose. This being done for symmetry and realistic volume of both breast. At this point all I want is two breast. I am so over wearing a prosthetic breast and having the void of a left breast and being uncomfortable in certain clothes. I know that my breast will never be like pre-cancer breast, and I’m okay with that, I just want my new normal to feel a bit normal.
The picture above of my mom and I is one of my favorites, I miss my mom, that picture was taken on March 26, 2012. My birthday is the 25th, we always spent the day together for my birthday. My mom throughout my breast cancer surgeries always prayed for me, I know that she will be looking over me.
To say that the past couple of months have been a “Whirlwind” is an understatement.
We sold our house in Yucaipa within one week of having it posted. My husband and I then moved temporarily to Palm Springs. The first week of June I flew to Maui and found a condo, we then found ourselves on the buying end instead of being the seller. Concurrently our family was dealing with our mothers ailing health. I am so glad that I got to spend time with her while she was a patient at The Rehabilitation Center in Riverside. My mom knew Jack and I had plans to move to Maui and was really happy for us. However I found myself not wanting to post on social media about our progress from selling our home, shopping for a condo and ultimately moving back to Maui. Our mother was discharged from the Rehabilitation Center on June 24th, where she had been from the beginning of April. She wanted to be in her own home.
Our mothers quality of life was not good, she was more than ready to be with our dad, brothers and sister and other family members whom have passed. I will miss my mother tremendously, I wake up some mornings and the first thing that I think about is ” I need to call my mom” and then I remember that she passed away. Our mother was laid to rest with our father and brother her ashes our in the Urn pictured above…she loved roses.
Today is Friday July 26th, Jack and I will leave for San Diego, stay with a cousin and then fly out tomorrow morning to Maui. Then comes the task of establishing with a new medical team. As a cancer survivor I must be seen by a Oncologist for 10 years….I am only three years out. I will also have to establish with a primary doctor, I can not go back to my previous primary as she has left her practice and is working at an Urgent Care Center. However working in the medical field and going back to MDI, I am well connected and will have not problem finding a doctor.
My car has shipped and is on Maui, husbands truck shipped this week and our small cube container with minimal items is on a ship on its way to Maui!
Aloha and many mahalos for the condolences via FB when I posted of my mothers passing…I did read all of them.
We are now in the month of May and I did not realize that I have not blogged this year! I received a message asking me about my progress and it made me think about the last time I blogged…so thank you for the gentle reminder.
Wow here it goes, in February I had a very candid talk with my plastic surgeon about moving forward with reconstruction. The decision was made to put off reconstruction to allow my body to heal. Dr. Eko was completely on board when I told him that I wanted to postpone reconstruction. I think having five surgeries under general anesthesia and several revisions under local anesthesia, merits taking some time for healing. So, we will wait for up to two years before I attempt left breast reconstruction again.
In the mean while I have been going to Eisenhower for Lymphatic Drainage Massage. The Occupational Therapist at Eisenhower Medical Center have been a god send. I asked for a referral for therapy, as I new that the heaviness that I was feeling on my upper arm was not just fat, and I could see my left side “puffier” then my right. However, the main concern as well was the adhesions that formed under my Diep Flap surgery scar. On both sides of my umbilicus (belly button) I have these tube like masses. The Therapist have been massaging them out in an attempt to break them up to no avail. Unfortunately they will have to be surgically removed. With that being said I am scheduled for a Scar Revision Surgery at Eisenhower Outpatient Surgical Center this Thursday May 9th. If the adhesions were not bothersome I would just leave them be, however, at times they cause me pain that stops me in my tracks.
The Therapist have shown me how to properly massage my chest wall, abdominal area, basically my front torso. And Jack (husband) learned how to do the back. The Latissimus dorsi flap is healing really nice. I have been fitted with a prosthetic (boob) and just this past week started wearing it. I kind of feel defeated, I feel like I am right back wear I started from but with a lot more scars on my body, the good thing is that I am alive and thriving! Scars are battle wounds that have a story to tell, I just didn’t think it would be part of my story.
Today is Saturday May 11th, my surgery went well, it was a minor surgery and I feel great. I am going to attach some pictures to this blog for those of you that have been following my journey, and wish to see how I am healing.
The Latissimus dorsi scar and drainage tube scars have healed nicely
The area in the black box is where the adhesions formed that were surgically removed May 9th.
This is the “donor site” where the skin from my left thigh was used to cover the Latissimus dorsi muscle when my Diep Flap surgery failed. My flap failed because it lost it’s blood supply due to a large hematoma. The picture below is a huge improvement compared to previous pictures. Losing the Diep Flap pretty much saved my life because that is also when the bacterial infections were discovered, preventing sepsis was the main goal. I am so grateful to the Infectious Disease team that worked along side with my Plastic Surgeon at Eisenhower Medical Center.
In the Month of March and April I had my Mammogram (of the Right side only) obviously even though I did have a prophylactic mastectomy of the right side, I also my annual Bone Density and Cat Scan at the Comprehensive Canter in Palm Springs…Happy to report that all my test went well, and my good friend, ex-coworker, cancer fighting sister was right along side me and she is doing spectacular!
Final picture…here I am again just before my scar revision surgery. I am recovering well, it was out patient surgery early in the morning, we were home be noon.
Thank you for reading my blog and feel free to share my story.
I have truly struggled these past months with what to type…how much do I share? And what pictures to share. I have been at a Loss for Words. Nothing could have prepared me for what was to come. What I am about to share will be a quick synopsis of what has happened since my Diep Flap surgery on October 24th. The surgery that I thought would be my final major surgery in regards to breast reconstruction of my left breast. I will not include sensitive pictures with this blog, the sensitive pictures will be included in a blog pictorial. Blog pictorial #65 WILL have graphic pictures so if you don’t want to see them just don’t scroll down past this blog.
Wednesday October 24th, we arrived at Eisenhower Medical Center before the sun came up, what was to be a 10 hour surgery was 13 hours! Wednesday, Thursday and most of Friday was spent in ICU. I was transferred to Med-surg late Friday the 26th and discharged on Sunday the 28th. My first post-op appointment went really well which was on Friday November 2nd. Everything was going well I even managed to get out and vote on election day!
Wednesday November 7th I noticed an odor coming from the flap, however due to the Xeroform being used over the blisters on the flap I thought it was that. Also my next post-op appointment with my PS was in two days. My appointment on Friday November 9th was at 1:00. My dressing was removed…Dr. Eko immediately talks about the need for a debridement! Then the words I was not expecting….this would be done under general anesthesia! By 6pm that evening I as having an unscheduled surgery. Dr. Eko suspected that a hematoma formed on top of the preforator, when he placed the dopler where it was, there was to sound. He was going to do the debridement, check the vascularity of the flap…basically he was going to try and save the flap. This surgery was about 7 hours long and I received 2 blood transfusions. A culture was taken and sent to the lab of the wound. If you chose to look at the photos, the picture taken on November 10th, it is obvious that the flap has lost blood flow! And yes, I had formed a very large hematoma on top of the preforator.
On Sunday November 11th I was having yet another surgery…this one to remove the failed Diep flap. However, what was next? I only had a plan A and B! This was not happening…my option..Lattissimus dorsi flap. This surgery took about 8 hours and yet again I required 2 more blood transfusions. After the Diep flap (skin from my abdomen) and the adipose tissue was removed and disposed of, a tissue expander was placed (for future skin expansion) and then the muscle was brought from my back, then covered with skin from my donor sight ( upper left thigh)… I was in ICU, when I awoke I learned that the culture that was taken and sent to the lab from Fridays surgery came back positive for not one, not two but three bacterial infections!!!! Worst one being a “Rare growth of Pseudomonas Aeruginosa” WTF!!! So now I have to be seen by an infectious disease doctor! In comes Dr. Dezfuli. The way I see it, IF the Diep had not failed this infection would not have been discovered, the infection would have gone to my blood stream causing sepsis. I had a would vac over the new flap, the wound vac was on me for 6 days. I was also started on an I.V. antibiotic called Cefepine.
The goal was to discharge me on November 17th, however due to case management being unable to coordinate home health care with infusion therapy in time prior to my discharge I was not discharged until Monday the 19th.
I was in the hospital from Friday November 9th till the 19th (11 days), 4 blood transfusions, and a wound vac attached to me for 6 days. When I was discharged I would continue to get I.V. antibiotics. Arrangements were made with home health care, so while everyone is getting Amazon packages delivered for the holidays we were receiving medical supplies from Optioncare. Cefepine 3x daily via my Pic-line.
On Thanksgiving when my husband did my dressing change he didn’t like the way the blackened area where the infection was looked. He took a picture and sent it too my surgeon (on Thanksgiving). Dr. Eko called my husband and asked if we can meet him in his office the next day ( I wasn’t planning on going Black Friday shopping anyways!) So there we go, to his office by 11 am. Keep in mind, he has no office staff it was just us. Thank god my daughter Monique who just so happens to be a nurse extraordinaire came with as she assisted Dr. Eko in what was to come. After several Lidocaine injections from the bottom up and around to the sternum, he opened up the flap to find that there was still too much evidence of the Pseudomonas infection, he cleaned up the mucus and deflated the expander removing the 350cc’s of saline to relieve pressure from the flap. He then talked to me about removing the expander all together. At this point it was more important to get a hold (control) of the infection then to keep the expander in. So out comes the expander…..shall I mention that my daughter Jax was holding my hand and got wooozy, had to leave the room and proceeded to pass out! Never a dull moment! Again he did a culture, having to hand deliver the swab to the Lab at Eisenhower himself due to the holiday. Dr. Eko also called the infectious disease doctor and they agreed that I was in need of a stronger antibiotic. Now besides the Cefepine 3x daily (every 8 hours) I am receiving Vancomycin 2x daily (every 12 hours)…making me a slave to my home not being able to go out and about ( not that I wanted to…initially) the plan is a total of 6 weeks of treatment with the I.V. antibiotics.
Christmas has come and gone, my daily routine is Cefepine 630am followed by Vanco, total drip time about 3 hours. If I have doctors appointments and the second dose of Cefe is administered a little behind schedule then the third dose is really late in the evening, ending sometimes a 1am!…..repeat.
This coming week will be my final week on the I.V. antibiotics, January 4th is the scheduled last day. On Thursday January 3rd, I see Dr. Eko, he will examine the would and is supposed to remove the dressing from my thigh, I am not looking forward to that.
I realize that everyones time is precious, if you have read this blog I thank you.
Picture below was taken on October 23rd, the day before Diep Flap Surgery. The plastic surgeon marked (mapped) his plan, there are also markings on my abdomen
This is 8 days post-op from Diep flap surgery done on the 24th of October. I have four JP drains, the red is actually a good sign…shows vascularity to the flap. However a hematoma formed just above the preforator causing loss of the flap.
Above you can see the shadow of where my abdomen surgery scar is. The garment I am wearing is a compression garment. I have two drains exiting just above the symphysis pubis and one on the left side, below the arm pit.
It is obvious that the Diep Flap has failed, and has to be removed. There is no implant here, this is all skin taken from my abdomen and adipose tissue. Once this is removed it will be necessary to proceed with the Latissimusdorsi reconstruction.
I am just a hot mess, an expander with 350cc’s was placed on the chest wall, then the Lat muscle was placed over the expander, then grafted skin from my left thigh was placed over the muscle….the picture below is just a fun picture I thru in the mix, my daughter and her fiance Stacy gave me a thurough bedside bath, complete with hair being shampooed!
The donor site: This area was uncovered December 3rd, however is was rebandaged due to the discomfort level…the bandage will be removed at my next follow up appointment, January 3rd….yikes!
This is the picture that my husband sent to my plastic surgeon on Thanksgiving Day. On Friday November 23rd, the medial aspect was opened up and the expander was removed…at this point it was more important to fight the infection, avoid sepsis and save the flap, then to have the expander with 350cc’s of saline!
This is actually healing, albiet, it looks awful.
The picture above was just taken December 28th
I have been on two anti biotics via I.V. Cefepine is administered 3x daily and Vancomycine is 2x daily…due to the Vanco being Nephrotoxic I get blood drawn twice a week to check the “peak and trough”.
Mischief and Repose, 1895 Oil on Canvas…The J. Paul Getty Museum, Los Angeles
How does one prepare for a surgery like this? The name is intimidating, Diep stands for Deep Inferior Epigastric Perforator artery, which runs through the abdomen. A lot of people think Diep and Tram Flap are the same…not so. The Tram Flap utilizes the muscle where the Diep uses adipose (fat) and the skin along with blood vessels. I am fortunate that my Plastic Surgeon, Dr. Frederick Eko performs this microsurgery.
With that being said my surgery date has been set, it will be on October 24th. I will be hospitalized for three to four days, two of those days will be in ICU. The surgery will be performed at Eisenhower Medical Center in Rancho Mirage.
My husband and children are all making plans to care for me post surgery, I am blessed to have them available for me. My Diep Flap surgery will be on my left breast. My left breast is the one that had to have the implant removed due to “implant failure caused by irradiated skin”. When the left breast implant was removed on April 4th, all the dead skin was removed as well. Now that is has healed completely you can literally feel my ribs! I tell people that it is like the pictures of the “Radical Mastectomies” from the 1960’s. The right side will also be worked on…a revision is necessary, I have excess skin. That implant will be removed and replaced with a slightly larger one, and some skin will be removed.
The black lines indicate where my current scars are. The scars on the left side will be gone, the new scar will look similar to the picture above. For the right side revision the scare will remain the same. My OR room has been booked for 10 hours. I have a preoperative anesthesia assessment appointment on the 18th, body marking on the 23rd (that’s where the surgeon will draw on my body) and surgery on the 24th.
It has been one long journey….I just want two boobs..or shall I say “foobs” (fake boobs)
Above is one of my favorite pieces from the Getty Museum, the shear fabric, the detail….I could go on and on. I see this picture, and it’s like she is saying “uhh, I just want my reconstruction to end…two boobs…I just want two boobs”
MANY MAHALOS FOR READING MY BLOG
Prayers and well wishes are received with gratitude and love……Pina
My Breast Cancer Journey 