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#60 Mutated Gene and Plan B of Reconstructive Surgery

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My Hyacinths in full blossom

 

This blog will cover two topics, first I will discuss the “Mutated Gene” topic.

On December 20, 2017,  I received a phone call from my Genetics Counselor from Queens Medical Center, Oahu Hawaii. Allison was calling me to  inform me that one of my genes that was previously tested had been reclassified. Genetic result: Positive – Clinically Significant Mutation Identified ! Yes folks, I have a “mutated gene“……add that to the bucket. This mutated gene is the CHEK2 gene, which is for both Breast Cancer and Colorectal Cancer, (as if I didn’t have enough to worry about) My job was to inform my siblings, as they have a 50% chance that they inherited this mutated gene as well. If they test positive and their kids (my nieces/nephews) can be tested, however their risk factor is 25%, that they inherited this gene. I was provided with test results and information to pass on to my siblings should they choose to test, also my children (if they opt too) can now be tested. These blood test are extremely costly, someone without a first degree relative testing positive would have a difficult time convincing an insurance company to run and pay for this blood test, which also involves an office appointment with a Genetics Counselor. The fact that my sister and I were diagnosed within weeks of each other warranted my insurance to pay for my test.

And now on to topic number two:

The removal of my bilateral expanders and placement of the implants surgery happened on February 1st. Going in,  I knew, because my plastic surgeon was extremely thorough in explaining ALL scenarios that statistically I had a 35% chance that my irradiated tissue would not take well to the implant surgery. During the implant surgery the excess tissue was removed, before cancer I was a natural DD cup, now I am down sizing to a full “C”. Well this surgery was a little too traumatic for my irradiated breast tissue. Initially it appeared to be healing just fine, every day was better (even with a broken toe).

I think right now would be a good time for me to insert my disclaimer. ” I will be inserting sensitive pictures with this blog at the bottom of this blog, if you do not wish to look just scroll slowly I will tell you when to stop”

The Right side is healing just fine without any issues. But remember the right side did not have cancer, I had a mastectomy as a preventive measure on this side. My follow up appointment on February 21st with my PS went very well. We did discuss nipple options at this appointment which I will save for another blog. The a couple of weeks later I had Jack take a picture for me, I still had visible discolored areas (like bruises) which was normal. However, come March the darkened areas began to get larger. I did not have “pain” associated with the darkened areas….the area is numb like due to the mastectomy. Kind of like “Neuropathy of the boobs”…if that is such a thing. I had a couple of areas, actually three, that the scab fell off then appeared to be opening….and oozing (lymph and blood, not puss).  What the Heck!!!! My next follow up at this point was March 19th, which was the next week. My husband tells me not to wait and call my Surgeons office. After a long day of surgeries my Plastic Surgeon Dr. Eko offered to meet me at his office at 4pm. I drove myself to this last minute appointment…..I knew the darkened skin was not good, nor my new little peep holes! We talked about “implant failure due to irradiated skin” and that 35% bracket that he believes I was falling into. He ended up doing a “Revision” in the office, in which he cleaned it up and sutured it…..again. With the help of my friend Lidocaine and my PS’s gentle touch, I didn’t feel a thing! I went back the following week,  March 23rd to have those stitches removed…however it was obvious at this appointment that the openings were not closing up! The stitches stayed in and doctor extended my prescription for antibiotics and extended me one more office visit before making the decision to remove the left implant…..That appointment was yesterday March 30th.

The verdict is in, I am scheduled for surgery April 4th, to have the Left Breast Implant removed. Implant failure due to irradiated skin does not mean the end of reconstructive surgery for me, just means that “Plan  B” will now be the options for me. I briefly discussed plan B on a previous blog, blog number 52&53. However, after the implant is removed we will wait six months before determining which Autologous of Flap Reconstruction option I will have.

I realize this turned out to be a very long blog…thank you for reading to this point, I truly appreciate it. For those wondering why I would post sensitive pictures of myself? To reach out to those just starting their BC journey, to educate, I have lots of people reading my blog that are not related to me, one person from Spain, someone from Europe and Australia……….reconstructive surgery can go smoothly with out hiccups, or it can take multiple surgeries…just want you to know it’s not all Hollywood and Glamour.

******************** STOP HERE IF YOU DON’T WISH TO SEE PHOTOS******************

 

 

 

 

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Right side healing accordingly the scar wraps around to the cleavage area

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Left side Feb 24th, healing nicely with slight briusing

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Left side March 3rd, at this point one obvious opening, more discolorisation

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Revision March 14th

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March 23rd, Radiated skin is not healing shut, darkening of skin more and more evident

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54: Surgery Date Set

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It seems like just yesterday my breast cancer journey started. As a matter a fact this month marks two years since my diagnosis. It was August 18th that I had my biopsies that resulted with those dreadful words….”you have cancer”! Many of you have kept up with my journey via this blog, and I thank you for your messages and support.

Now that Chemotherapy, Left Breast Mastectomy and Radiation Treatment are behind me, it is now time for reconstruction! The decision to have a Right Breast prophylactic Mastectomy was an easy one for me as I am aware that I am high risk for a reoccurrence.   This past month (July) I had a little scare, I had a Breast MRI, and was called back for a second look on the right breast! I immediately thought “oh crap….here I go again”! Fortunately it was nothing and I was given to go ahead to proceed with the surgery! (sigh)

The surgery will happen on August 22nd, as of today I do not have a time. I will have two surgeons working on me. While the Breast Surgeon is performing the skin sparring mastectomy on the right side, the Plastic Surgeon will be placing an expander on the left side. When the PS is finished with the left side and the right side mastectomy is complete he will the place an expander on the right side. When I wake up, I will have four drains, two of which will be removed one week after surgery. The other two drains will be removed when fluid has subsided. After the scars have healed somewhat, the Plastic Surgeon will then start to fill (inflate) the expanders weekly till desired fullness has been reached. After about three months of healing and praying that my body does not reject the expanders, the expanders will be switched out with the implants. The goal is a C cup:)

People have to understand that this is Breast Reconstruction after treatment for cancer…..it is not an Augmentation…….huge deference! I am thankful for the medical team that I have, but most of all for my husband and family without them this journey would have been impossible,  I know that I am in good hands!!!

I always mention a little something about the picture I include with my blog. My husband  and I took a quick little getaway trip to Maui the last week of June. This sunset picture was taken using a sunset setting on my camera, it cracks me how people (tourist, visitors) leave the beach as soon as the sun disappears from the horizon. This pictures was taken approximately 20 minutes after the sun had set! Dependent on the clouds, there is usually a show of colors AFTER the sun has set….you just have to be patient….dinner can wait !

Mahalo for reading my blog

I just got a call from the hospital, they verified name and insurance etc…. they will call me the day before the surgery with the time of the surgery!

 

 

 

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33: Back to Work

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Last week I started my Radiation treatment. As mentioned previously my treatment will consist of  Monday thru Friday for six weeks. If you notice in this picture, the ceiling is made to look like you are looking up at the sky. It is actually quite mesmerizing. Walking into this room the “True Beam” can look really intimidating. The therapist that work under Dr. Baker are truly compassionate and make my feel comfortable. My appointment time slot for this journey is 3:15, when I arrive they are literally ready for me, I am in and out. That mold of my upper body that was made at the simulation appointment is on the table and those two little tattoos enable the therapist to target the area that was configured by the Medical Oncologist.

I have been on medical leave since my surgery March 28th. Tomorrow I go back to work, again,  I am super grateful to Maui Diagnostic Imaging for being flexible with me. My work schedule will permit me to go daily for my radiation treatments. I continue to also get my Herceptin infusions in Oahu. On Tuesday I will get my monthly blood draw to check my blood count levels prior to the infusion. On Friday May 20th, I will have a follow-up Lung CT, followed by my Herceptin infusion, then I need to high tail it to the airport to make my flight to be back for my 3:15 RadTx appointment……yikes……wish me well!!!!

It is going on 10pm, I must somehow try to fall asleep so I can get up early. I have been sleeping in, need to get used to waking up early again. I need to do some physical therapy on my arm before going to work daily, my days will be very structured that’s for sure!!!

 

Mahalo for reading my blog

Aloha, Pina

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