May 7, 2016 · 7:16 pm

32: Radiation Therapy

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We flew back to Maui one week ago today on April 30th. The picture above is a picture of Sugar Beach in North Kihei, it’s a really nice long walk!!! On Monday I had my simulation appointment with the Radiation Oncology department here at the Pacific Cancer Institute on Maui. I got to meet Dr. Baker (he was off island the last time I was there). Dr. Baker talked with us (my husband and I) and explained again the importance of radiation treatment after chemo for me. It is important to know that not everyone with breast cancer gets both chemo and radiation…..each case is different.

The simulation CT was interesting. My upper body was positioned on a deflated pillow that contained micro beads. These micro beads when heated up stiffened and hardened, forming a mold of my upper body including my head. I laid down on it with my right arm down and my left arm up with my elbow bent. The mold was created, this will be used for all my radiation therapy appointments. The purpose of the simulation CT is so that the Radiation Oncologist can determine the radiation field and create a treatment plan. That is the simplest explanation I can think of without getting too technical!!!

The Radiation Therapist (Radiologic Technologist with a specialty license in Radiation Therapy) was very kind. Part of the process for the simulation appointment is you get marked (tattoo)  where the laser beam is to be positioned for you treatments. I joked with Max when he was about to tattoo me that this was his “side hustle”! I also let him know that these were my first tattoos, we laughed because seriously they are two very small dots!!!

My treatment will be six weeks long, Monday thru Friday my first treatment is Wednesday May 11th!! I am off of work for one more week, I go back on the 16th of this month. Just like with chemo I will work thru the radiation therapy as well. Maui Diagnostic Imaging will work with my appointments for the next six weeks permitting me to work thru this next chapter of my treatment.

Time to sign off, much Mahalo for reading my blog. It is 9:11 am, I need to do my physical therapy and pick up two very special people that will be here with me for the next seven days!!!

Aloha Pina

 

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April 24, 2016 · 5:36 am

31: Appointments

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The past couple of weeks have been riddled with appointments. I can see why I was required to stay on this island after my surgery. I had an appointment with Honolulu Orthopedics to be measured for a compression sleeve. I will be required to wear the sleeve when I fly and when going on long walks to help avoid Lymphedema. My compression sleeve should arrive sometime this week. I have also continued to go to my physical therapy appointments (twice weekly) and I do my P.T. three times daily when our schedules permit. My range of motion has improved immensely, my therapist is really impressed with my progress. I have the advantage of  knowing first hand what happens when you do not do the recommended exercises.

Surgeon appointment:

Dr. Nakashizuka was really happy with my progress. The mastectomy site is healing just fine. I have avoided fluid build up (Seroma), probably due to my Physical Therapist. She does a Lymphatic Massage, and has taught me how to do it, which I do nightly. I went to this appointment with three questions in mind.

1: When can I drive?

2: When can I get in the ocean?

3: When would she recommend the Profolactic  Mastectomy (Right breast) and the    reconstruction?

Driving? I am cleared to drive because I am not taking any of the pain meds that were prescribed. Ocean?……..wasn’t expecting this answer! She would prefer I stay out of the ocean at least till July! When we talked about me paddling out with the canoe club she would prefer that I wait till at least September to do that! And as far as my next surgery, not till this time next year! Because I will still be going through Radiation Therapy, and continue to have my Herceptin infusions every three weeks till September, she would prefer that I wait six months after I am completely done with my treatments before going thru with the right mastectomy and the reconstruction of both breast. It is what it is, I can be patient. I just have to tell myself that “this time next year, I will be all done with this”.

Pulmonogist appointment:

My appointment with Dr. Roger Yim, went well. The lesion on the right lower lobe of the lung that showed up in my initial scan from August 2015, which measured 5mm. Then again, post chemo, only now measuring 7mm……..did not excite him! I told him I was excited the he was not excited!…..we laughed. He went over my complete medical history with me and told me his plan for me. He ordered another CT, which will be done when I have my May infusion. This will make it three months from the one done in February. So long as the lesion has not increased in size, then he will ask for another CT six months from May. Just need to pray that this lesion doesn’t grow!!! If it does grow……that’s another blog!

Our time here on Oahu is coming to an end. This past week my son made it out here to visit. We went to Pearl Harbor, however due to the wind we could not go visit the USS Arizona Memorial. The featured picture was taken at the Ala Moana Center, which is the mall of all malls!! It is the largest open concept mall in the world!!!   A true shoppers paradise. I features many ponds and sitting areas to regroup and rest. I was actually focusing on the Lily Pad flower not realizing that there was Koi fish in the water!! We also ventured to the North Shore again, this island has so many beautiful beaches, I would love to come back when I can actually get in the water!! Next week will be our final week here, Friday I will get another Herceptin infusion. Get to fly back to Maui on Saturday April 30th!!

Aloha, much mahalo for reading!!!

 

 

 

 

 

 

 

 

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April 10, 2016 · 9:37 am

30: “Lopsided”

Image-1Queens Medical Center gave me a post surgical camisole with poly-fil non-weighted breast forms. Although this was truly appreciated it just didn’t work for me. Prior to surgery I did purchase a couple of front closer bras that were soft and I thought would work well. However without having a weighted prostheses the absence of my left breast was obvious. I tried adjusting the size of the non weighted form to properly fill the left side of my bra. Yes, I was able to pull some of the poly-fil out and adjust the size of the form, it was actually quite comical! I put on one of the bras that I purchased prior to surgery and placed the adjusted breast form in the cup on the mastectomy side. Monique and I went to my physical therapy appointment, followed by a trip to TJMaxx. I found a couple of button front tops to try on, went to the dressing room, looked at myself and laughed!!!! I was Lopsided !!! Because the poly-fil breast form is non-weighted, the weight of my right breast was making the left side of my bra ride up! Hilarious!!!!!!

Monique was quick to call my surgeon to inquire about a proper prostheses. After many phone calls we found out that I could get fitted and measured for a prosthesis at Queens. I would have to pay out-of-pocket and bill my insurance on my own. The prostheses could cost as much as $400.00, not including the cost of the pocketed bras…..yikes!!! Well, it seems non practical to put out that kind of cash for a prostheses that I would only use for a short time till my reconstruction surgery was done.

Yesterday, Friday April 8th I had my Herceptin infusion after my appointment with my Medical Oncologist Dr. Chong. Again he was over the moon excited about my post surgery pathology results. He went on to tell me that has only had six patients in which the Chemo coctail which I received was used. All six patients had no sign of aggresive cancer cells in their pathology. With two patients having non aggresive cancer cells (insitu).  I am one of the two patients, which is why Radiation Treatment is important for me to have. The amazing part is, that I no longer have the aggresive cancer cells in my breast tissue or my lymph nodes!!!!!!!……can I get an AMEN!!!! The Herceptin infusion went well. My oncology nurses, Lynne and Bethany were excited to see me, as this was my first infusion post surgery. When they asked my how it went, I jokingly told them that I was GREAT, minus one breast, and that if I started walking around in a circle they new why!!!…we laughed. I was finished with my treatment by twelve, Monique suggested that we drive to Kailua to check out a lingerie store.

Monique found this Lingerie store that specialized in post surgical/mastectomy bras, however it was clear on the other side of the island. My daughter said we should check it out, if anything you can at least get a comfortable bra to wear. Amy, the owner of the store was so nice, her mother is a survivor and they opened up this lingerie store after her surgeries and her quest for nice lingerie to wear post surgery. Amy was quick to let me know that she could look up my insurance information to see what was covered, and that she would only charge me my portion plus Hawaii tax, she would file a claim for the balance!!!! Needless to say I was excited!!! With our insurance, I was responsible for 10% plus tax!!!! So, the prosthesis that was my size was $200, which meant that it was $20 for me plus tax…..SCORE!!!! I purchased three bras (my insurance permits 6/yr) and my prosthesis and paid just under a whopping $60.00! The bra was so comfortable, and what a differance a weighted prostheses makes, I asked Amy if I could walk out of the store with it on!!!

Monique and I went to a beach side restaurant called Buzz’s…….lunch was delisioso!!! After lunch we crossed the street and went for a walk on this gorgeous beach!! Picture below……taken at Kailua Beach.

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The water was so warm, definitely will have to come back over here once I am cleared to get into the ocean!!!!

Thank you for reading my blog, and much mahalo for all the prayers and well wishes.

Pina

 

 

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April 6, 2016 · 8:53 am

29: Post op

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To quote my breast surgeon Dr. Nakashizuka,

“ The chemotherapy worked, these are the results we want to have”. “The breast tissue showed no evidence of aggressive cancer cells.” “The Lymph nodes also did not show evidence of aggressive cancer cells!” “There was only signs of non invasive cancer cells.”

Doctor spoke these words in a joyful voice with such excitement. She talked about the size of the original cancer and the lymph node and that there was no longer any signs of the tumor and that the Chemotherapy treatment recommended worked. She mentioned that my medical Oncologist would again talk to me about the need for Radiation Treatment.

Doctor removed the dressing over the mastectomy site. While examining the surgery site, Dr. Nakashizuka was asking Monique about the amount of fluid discharge. Monique was rattling off numbers as fast as doctor was asking for them. Doctor then says, “the drains are ready to be removed”! I immediately ask, “is it going to hurt?” Doctor smiled and said I have been through much worse and tapped my shoulder. Ummmm, that didn’t answer my question! Well, no I didn’t feel pain when she pulled them out.

It was a good visit. I have a busy week of appointments. I am being referred to Physical Therapy, to help avoid Lymphedema. My first appointment is tomorrow at 730 am! No sleeping in for me!! After that I will get my monthly blood draw, and on Friday I get my Herceptin infusion after seeing my Medical Oncologist.

It’s going on 11pm here on Oahu, time to call it a night……good night.

Much Mahalo for reading

Pina (Josefina Wallace)

 

 

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April 4, 2016 · 8:07 am

28: Pathology Results

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Friday evening I received a phone call from the office of Dr. Nakashizuka. Her office assistant called to inform me that the pathology came back on my breast that was removed and the lymph nodes……..no residual cancer cells post chemo!!!!!

Tomorrow (4/4) I have my first post op appointment with Dr. Nakashizuka and she will go over the details of pathology with me and change the dressing over the surgical site. I have read many articles and books, in which they say that it is pretty traumatic for the patient the first time that she sees herself with out her breast. I don’t feel that I will break down, being a Mammographer and my time working at The Cancer Center in Palm Springs has prepared me for this. I have been extremely compliant as far as post op instructions go. I know far to well what happens to the surgical site if you over do it!!!! No seroma for me if I can help it!!!

I have two drains on the mastectomy site that have been draining well. My daughter has been emptying and measuring the fluid daily. The surgeons office gave us a log to track the fluid. I am sure she will be pleased with my daughters diligent entries.

The Little Things:

You don’t realize how important good range of motion of your shoulders is for getting dressed. Due to the ” Lymph node dissection” my left arm has limited mobility. I had planned ahead and purchased  tops with buttons up front. I had to do a little retail therapy today and purchase a couple more tops and easy pull on bottoms. I attempted to put my favorite pair of shorts on today, but pulling the zipper up and buttoning the button was too much! So, shopping one must go!!!

It is getting late here in Oahu (well late for me) so I’m going to sign off. Thank you for reading, will keep you updated on upcoming appointments. Thank you for all the well wishes and prayers.

Much Aloha, Pina

 

 

 

 

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April 2, 2016 · 12:36 am

27: Post Mastectomy

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Aloha Friday! Happy April fools day 🙂

Sunday evening I prepared the clothes I would wear to the hospital the next day. I  had been NPO (without food/water) since Sunday 7pm. I had a lite dinner as instructed, which we enjoyed at Monkey Pod here in Ko Olina. We chose Monkey Pod because we were familiar with the menu, now was not the time to try something new.

Getting up at 345 am on Monday March 28th was easy for me. I did sleep well,  however I was anxious to get it done. We pulled up to the valet attendant in front of the Outpatient Surgery attached to Queens Medical Center. Yes “Outpatient”! Lots of people were surprised to learn that this surgery would be done as outpatient! We arrived at about 520am, I was asked to be there by 530am. I signed in, and was attended right away by registration. Shortly after registering I was taken back to the pre-op holding. Everyone who has had any type of surgery knows the drill, you change, vitals are taken, you verify name, date of birth numerous times and confirm what it is you are having done. I had a clear view of the dry erase board that had the surgery schedule on it. All my Rad-tech family knows what board I’m talking about. I was the first surgery scheduled for Dr. Nakashizuka. Patient names were not on the board, the list was separated by surgeon then listed by type of surgery. Each surgeon was color coded, my surgeons schedule  was written in green.

I was her first case, Left Modified Radical Mastectomy Skin Sparing…….715am. Followed by two Lumpectomies and one subcutaneous mediport placement. Today was an observed holiday so the schedule was lite! All vitals were taken, I was ready! The anesthesiologist came to talk to me, he asked if I had a problem waking up from general anesthesia? I let him know that I usually wake up vomiting. With that being said he would give me something for that.

Just before they took me back I was listening to my “Fight Song” by Rachel Platten……it was on repeat!!!!! They Gurney I was on was put side by side the operating table, the room was cold. My gown was untied in the back and I scooted over. I laid with both my arms spread out. I remember Dr. Nakazhizuka coming over and placing warm roll under my left shoulder. Music was playing in the room, but I don’t remember the type.

Surgery was done by 945am.

I woke up fine, with out they usual projectile vomiting. Shortly after I was given a dry piece of toast and a small cup of juice. I didn’t take long after consuming it that the nausea set in. My daughter Monique told me I’m a “clean thrower upper”, cause I managed to get it all in that small emesis basin they give you. I’m a pro at vomiting, after chemotherapy!

The picture above was taken before the 12:00 hour. I was discharged before noon. Yup, up and walking!!!!! Monique went over to the Women’s Health Center at Queens and purchased this robe for me. Patients who get a Lumpectomy vs. Mastectomy are taken from the Mammography department after their Needle Localization to the Out Patient Surgery Center via wheelchair. They are given this spa like robe to cover them up versus a blanket over them. When one of the Lumpectomy patients was wheeled over she noticed the robe and asked about it. She surprised me with one! I love it!

The past days have been spent relaxing here in this house we are renting till April 30th. My son found it thru VRBO. We are staying in the Ko Olina area of Oahu right down the road from Aulani Resort by Disney, my daughter Monique is in heaven……she loves all things Disney!!!

Right now I feel fine, shoulder feels a little numb but other than that I’m fine. I will continue to blog periodically throughout this month…….tired of typing.

Aloha Friday

 

 

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March 24, 2016 · 11:22 pm

26: Happy Birthday to Me!

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Today I am 53 years young! Developing breast as a teenager I do not remember thinking I want to be large busted…..they just grew…..I had no choice! I have my  dads side of the family to thank for being well endowed, for the most part the Quezada women are large busted.

This summer will mark 17 years as a Mammographer, and when I started my career in Mammography, I never thought that one day I would be walking in the shoes of so many patients that have crossed my path. In three days I will be having my left breast removed. Patients this week when I would mention it, where in awe at how well I am handling the up coming surgery. I know I will be fine. I have a great doctor, and the love and support of my family and friends. I have had patients cry for me, I would console them and tell them not to cry for me that I would be fine. I have had patients say a quick prayer after their mammogram was done, and yesterday prayed with one of my co-workers. And I know that I have many people praying for me and wishing me well.

Today my  day will start early with breakfast at  Jax and Sean’s condo, followed by a massage and pedicure treatment at The Andaz Hotel. Will more then likely indulge with lunch at The Andaz as well! Throw in a little retail therapy and later in the evening my daughter Monique will arrive on island and we will have drinks and desert at one of my favorite restaurants”Monkey Pod”.

Dear Left Breast,

Thank for serving your purpose,  you nursed three healthy children. You’ve turned heads when I was younger and in my prime, well I’m not done living! In three days you will be removed from my body and that is ok. You do not define who I am as a women, and because you have decided to go rouge on me you must go!

So, nice try……………..you lose………………..I WIN !!!!!!!!!

H A P P Y          B I R T H D A Y          T O        M E !!!!!!!!!

 

 

 

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March 13, 2016 · 8:14 am

25:Surgery Date Set!

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I took the picture above last week end while enjoying some much needed beach chair therapy. The picture speaks for itself…..I love it.

Since my last appointment in Oahu, I have been busy working and getting settled into our condo that we are renting. Every day I feel better and better, my hair is starting to grow, Jacquelyn says a have “peach fuzz”! When working I get to talk to patients, a lot of patients remember me from doing their mammogram last year. I had one patient literally tear up when she saw me. I told her not to cry for me that I would be fine. She was so sweet, we hugged after the exam, and she said she would look forward to her next mammogram so she can see how I am doing! (that’s a first, “look forward to a mammogram”!)

March 9th:

I Had a consultation with the Radiation Oncologist here at The Pacific Cancer Institute on Maui. I will  be having radiation treatment. The Oncologist was very thorough in explaining the process and how it is done post-mastectomy. I will be having treatment Monday thru Friday for 6 weeks. Basically, Radiation treatment is the “clean up crew”. It will annihilate any residual cancer cells left behind. That’s what I want, NO CANCER CELLS LEFT BEHIND. I will be able to work thru this, just like I have been working thru my chemo treatments. Compared to chemo, this should be a breeze!

March 11th:

My appointment with my Medical Oncologist went well. Dr. Chong is really happy with my progress and how I am progressing. After he examined me, I was back in the chair for my Herceptin infusion. We flew out of Maui on the first flight which meant getting up at 4am. So of coarse I managed a little siesta during the infusion! Since it is only one bag it only takes about 1 hour, so it was a short nap!

After my appointment with Dr. Chong, I was off to see Dr. Nakashizuka. Again she examined me, the original tumor can no longer be palpated, however the lymph nodes still feel irregular. We talked about “the Plan”, she wanted to make sure that I was ok with the recommendation of delayed reconstruction vs. immediate. Here is what will happen:

  • Left Breast Modified Radical Mastectomy with skin sparring for delayed reconstruction, on Oahu, at Queens Medical Center. Will be required to stay on Oahu for 1 month post surgery…..the hunt is on for a place to stay post surgery!
  • Radiation Treatment to begin once healed from surgery. Treatment will be for 6 weeks Monday thru Friday, here on Maui at the Pacific Cancer Institute.
  • Herceptin infusions will continue every three weeks till September.
  • Appointment with the Pulmonary doctor on April 21st regarding the nodule on my right lower lobe. Lets pray that a lung resection is not necessary!
  • After my last Herceptin infusion, the prophylactic  mastectomy  on the contra lateral side will be done (Right Breast) with immediate reconstruction. Well it won’t be “immediate”…..its a process! That’s another blog.

Surgery date……………….March 28th …..On Good Friday March 25, I will be 53 years old, Birthdays after a cancer diagnosis will be special!

Aloha, everyone much Mahalo for taking the time to read my blog!

 

 

 

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February 14, 2016 · 8:07 am

24:Good News and Not so Good News

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Thursday February 11, 2016

One quick flight in the early morning and we are on Oahu. We arrived with plenty of time and I was early in checking into my 830am appt., by an hour. The CT of the lungs went fine. I was done with and without contrast. The Breast MRI was also done with and without contrast. For Breast MRI you are laying down, face down arms above your head with your face resting in donut (like a massage table). I was given button to hold in my hand to call for help if I needed it during  the exam. If this button is pressed after the contrast has been administered and the technologist has to stop the exam, then the exam would have to be rescheduled.

Minutes after the contrast was pushed through my I.V. my throat started to itch! I didn’t want to push the button and cancel this important test. My nose was stuffy, I was on the tail end of a head cold. My nose was just dripping, couldn’t do nothing about that. My eyes started to water and my throat was really itchy. I had to clear my throat a couple of times. I was trying really hard not to move. I was literally talking to myself, saying “I can do this, I can do this”! My throat didn’t close up, I was having to breathe through my mouth, because my nose was so stuffed up. I managed to complete the exam.

The technologist called over a radiologists, Dr. Kristen Nagata to examine me. A first responder nurse also came. I was told that normally they would take me over to the emergency department for observation, after a reaction to contrast. However, because I had an 11 am appointment with Dr. Nakashizuka (breast surgeon) they opted to keep me there and observe me. The nurse was honest in telling me that if they sent me to the ED, that I would not be discharged in time for my 11:00 appointment.

Dr.  Mari Nakashizuka; 11 am appointment:

Dr. Mari already had both the MRI and CT reports in her hand for this appointment. The “Good News” is that the original tumor in the left breast is gone!!!! Also, that area near the chest wall is also no longer there! The lymph nodes were a different story. Some lymph nodes appear slightly more prominent. Instead of doing a sentinel node biopsy during surgery she is now going to do lymph node dissection.

The CT, (sigh) as previously on the first blogs (blog #12) I mentioned a nodule on my lung, small little burger, only 5mm in size. Well today it measured 7mm, could be a difference in equipment, could be human error. This can not be ignored.

Surgery discussion:

The original plan was to do a bilateral Mastectomy with reconstruction. I have made the decision to have both my breast removed, this will still happen, just not as I had planned. Because of the Lymph nodes Radiation Treatment might be necessary. And because of the Lung nodule, it’s just another wrench in the bucket!! What Dr. Nakashizuka is recommending is a Left Mastectomy first, deal with the Lung nodule, get through the remainder of my Herceptin treatments, and have radiation treatment if necessary. Then do the Prophylactic Mastectomy on the right side with bilateral reconstruction. Dr. Mari feels I would opening myself up for the possibility of infection with my immune system being compromised with my continued treatment……………..I just want this over with!

Friday February 12, 2016

My appointment with my medical oncologist was at 1030 am. Dr. Chong went over the test results again with me. He made me feel better, by stressing that the main tumor in the left breast is gone! He wants to proceed with the breast surgery as soon as possible. He feels that I am strong enough for a bilateral mastectomy, however he is going to have me talk to a Radiation Oncologist. If radiation treatment is needed then putting off the reconstruction might be the best course.

So whats next?

Dr. Chong will contact the Thoracic doctor and have them look at my PET CT from 8-2015 and my CT from 2-2016 to determine if a Lung Dissection is needed. The office the Dr. Baker, Radiation Oncology will be calling me to set up an appointment. All of this should happen before my next appoint with Dr. Chong and Dr. Nakashizuka which is set for  Friday March 11th.

Not exactly the news I was hoping to blog about, but it is what it is. I need to stay on course and stay positive that all will be okay. This is just another bump in the road, or lung!

Mahalo for reading, and my apologies to family that I didn’t get a chance to talk to prior to posting this. (you know who you are) Thank you for the well wishes and prayers.

Much Aloha Pina

 

 

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January 17, 2016 · 9:56 pm

23: Chemo #6

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January 17, 2016

Chemo#6 was on January 8th. I not only had Jacquelyn and my husband with me, my daughter Monique was also there. The picture above was taken just before the treatment began. Monique got to talking to the other patients in the infusion room and before I knew it they were ordering pizza for everyone, party in the infusion room!!!! No pizza for me however, soon after my infusion starts I get sleepy and I take my chemo siesta!

Today is January 17th, I am nine days post chemo and still not feeling well. I did work half a day on Wednesday with full days on Thursday and Friday. The saving grace was that MDI scheduled me a lite schedule. In case your wondering, these patients were scheduled with my knowledge. Previously I felt better after days 3 and 4 post chemo. So, I did not want to call off and have them rescheduled. I know that all I had to do was tell my manager that I couldn’t work and she would have had the schedulers start rescheduling patients, no questions asked. Maui Diagnostic Imaging is a great company to work for.

Whats next?

On February 11 and 12 I will be back on Oahu. I will have my Breast MRI, CT and my second meeting with the surgeon, Dr. Mari Nakashizuka. Those appointments will be on the 11th. On Friday I will have my Herceptin infusion. My chemo therapy has consisted on of Taxotere, Carboplatin, Herceptin and Perjeta. I am done with TC and P however the Herceptin will continue every three weeks for a year! What I am not clear on is if it one year from now, or one year from when I started the treatment? Either way I will know more about the timeline for my surgery soon!

Since I moved to Maui, we have been renting a beautiful home here on Laumaewa Loop. The owner has had the house on the market since October of 2015. He felt really bad the day he told us they had to sell the house, especially because I had just started my treatment. I completely understand their decision to sell. Fortunately for us we were able to be in this home thru the holiday season. The house has not sold yet, I told the owner that after the New Year we would actively try and find a place to live. And we did, we found a condo to rent and will be moving in February. Jacquelyn and her boyfriend Sean found a condo in the same complex as well. Excited to have my own little place with no stairs! The stairs in this home have been challenging, especially on my bad days. The goal was to move before my surgery!

My husband just left to the airport to pick up two very special people. My two cousins Mary and Carmen dahling just landed (11:40am)!! Super excited to have them here with me this week!!!!

Going to sign off now, I hope everyone is well. Hug and love each other, life is short never take it for granted! Much Mahalo for the love and support!

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