Tag Archives: awareness

April 30, 2018 · 9:20 pm

#61 Another Revision!

Well, my surgery went well…the left breast implant was removed along with all the excess radiated skin……so much for a “skin sparring Mastectomy ! I feel I should have blogged earlier but I kept thinking, I will blog after this post op appointment. However to date I have had three follow-up appointments. My surgeon kept my drainage tube in for two weeks because at my first post op the daily fluid output was more than 25cc’s.

On April 16th, I had my annual Bone Density and a CT of the lungs for that little nodule that the doctors have been monitoring. Well GREAT news, my Oncologist, Dr. Ho from the  Palm Springs Comprehensive Cancer Center told me that the nodule is stable and has not grown, he will continue to monitor it annually. And my DEXA (Bone Density Test) is also good…I was so happy with that news!

On April 20th, my sidekick (drainage tube) was removed. However that week my incision where it all joins started to seep and open! REALLY could this possibly be happening again! My Plastic Surgeon wanted me back the following week to keep a close eye on it. Which that appointment was just last week on April 27th.

I would like to back up to April 25th. On the 25th, my husband and I celebrated 31 years of marriage! I love you Jack with all my heart, thank you for always being there for me, for accompanying to all my appointments when work permitted….my story is not over, I am looking forward to many years with you, looking forward to our week on Maui!

Ok, back to my appointment on the 27th. After Dr. Eko looked at the area he looked at me and said that he would need to do Another Revision. At this point, seriously my heart just sank! Of coarse I asked exactly what he planned on doing, Dr. Eko went on to describe the procedure. My husband and I waiting in the examination as they prepared the Procedure Room for me.

After administering plenty of Lidocaine he removed select staples in the trifurcation area. (I will be posting pictures, just do not scroll down if you do not wish to see them.) Slithers of irradiated skin was removed, then it was sutured. It was surreal, the area was well numbed up, but thru my body I could hear and feel (without pain) every stitch! My body was shaking uncontrollably, they covered my with a blanket….this was a pretty invasive procedure done in the office…my plastic surgeon and his wonderful M.A., Angelica made sure I was comfortable. My husband was in the room, a couple of times the blanket came off my feet and he tucked the blanket under my feet. It was nice having my husband in the room, Dr. Eko played smooth Jazz during the procedure, which was also very relaxing.

What’s next? I had a follow up appointment today April 30th, it went well. I am instructed not to lift my left arm above my head so the it doesn’t tug on trifurcation area. The doctor (and I) want this to heal!!! My husband and I will be going to Maui for one week, I will not be getting in the ocean, other than my feet….just plan on relaxing and visiting my Maui Ohana!

Microblading, on Wednesday May 2nd I will be getting my eye brows microbladed. Yes, the hair on my head has returned post chemo, however I have little to no eye brows! I will have to wear a hat while in Maui, which I’m okay with…just looking forward to not having to paint on my eye brows every morning to look normal! So grateful to the gals from the Cos Bar in Wailea that took the time to teach my how to apply my Tom Ford Eye Brow Kit.

 

****************************** SENSITIVE PICTURES BELOW************************

 

 

 

 

 

 

 

 

 

 

 

 

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On a daily basis my family stripped and documented the amount of fluid out put for two weeks until the drain was removed. Post op, my son Cisco took days from work and stayed home with me… he did really good, he only gaged once when some fibrous tissue was in the fluid!

 

 

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Damm, It looks like I had a “Radical Mastectomy”!

Here it is, I struggled with the decision to post this picture ….. but this is the reality of it. The Implant was removed with all the irradiated skin. Looking at the picture above my head is to the right with the tube going down. The stapled area that goes  up towards my axilla (armpit) is that darken circle that is seen on the first picture… that skin was removed, hence this result. The following picture was taken on April 27th, you will notice that the staples where it all trifurcates are gone. That is because on April 20th the plastic surgeon removed them, at this point they were  obviously just irritating the area. The area didn’t close which is why Another Revision was necessary. IMG_6071.jpg

I don’t have an after picture of the revision…my husband says it looks good, he has been doing the dressing changes, he has become quite the wound care specialist! I have instructions not to lift my arms above my head

My next follow up appointment, is on Monday April 14th. I will keep everyone posted with a shorter blog……I promise. If you have read to this point, many thank yous for taking the time out of your day to read my blog.

Pina

 

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January 17, 2018 · 12:36 pm

57: Phase 2 of Reconstructive Surgery

The much anticipated appointment went well. Last week on January 12th my husband Jack went with me to my appointment at the Plastic Surgeons office. Dr. Eko examined me and was pleased with the progress thus far. Of course my husband being the jokester that he is participated in the examination, however when he pressed on my boob he had his finger on his phone and activated a “squeaky toy” sound! Oh my honey…..got to love that man….we all got a chuckle out of it and proceeded with the exam.

On my previous blog I mentioned how the non cancer breast (the right one) has dropped and the cancer side is standing tall in place. The left side has been irradiated….though the  tissue on the outside looks fine, underneath the shin the tissue is damaged from the radiation treatments. The right side is natural tissue without radiation damage, hence the reason for it dropping, getting nice and cozy in the excess tissue from the skin sparing mastectomy. The excess tissue will be removed along with the tissue expanders and the implants will be placed. Dr. Eko will even the girls out when he puts the implants in.  I remember from previous appointments he would stress that they will be “sisters, not twins”. He will use the same scar, however the scar will be made longer in order for him to remove the excess tissue. I am unclear on whether or not I will have drainage bulbs again, as I for got to ask…….he didn’t mention them during the exam so maybe not! ( we will see)

After Dr. Eko was finished with the examination and questions were answered, Patricia took me into the “photo room”, where she took a series of pictures of me for the surgery. Through this journey called “breast cancer” you definitely lose all modesty. I can not tell you how many times since August 2015, I have been asked to disrobe from the waist up! I must say that with all the medical professionals that have examined me or have just been along side an MD while I was being examined I have never felt uncomfortable, every caregiver has been so compassionate through out this journey….I am very fortunate to have the medical team that I currently have and my team on the island of Hawaii.

Phase 2 of Reconstructive Surgery  will be February 1st !!

Mahalo for reading my blog!

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November 7, 2016 · 7:13 am

43: Mammogram Appointment

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Breast Cancer awareness month has come and gone. However for me, as a Mammography Technologist it is everyday of the year. And now as a Breast Cancer survivor, bringing awareness is just that much more important.

I had intended to blog about how to prepare for your Mammogram Appointment prior to the month of October, but it just did not happen. Preparing for the Voyage to Lana’i , paddle for life took precedence over everything.

So here it goes:

Be on time

You are given a check in time and an appointment time. There is a reason for this. We are only given a certain time slot per patient. At my work we are given 15 minute time slots per patient for a routine screening, 30 minutes for a diagnostic appointment and/or a patient with an augmentation.  And please, IF you have an augmentation (implants) please mention it when making the appointment if you are not asked that question by the scheduler. Some patients register, then proceed to talk on the phone or just be on their smart phones instead of doing the questionnaire given to them. So, the purpose of you check in time is to complete all necessary paperwork prior to you appointment time.

No lotion, powder or deodorant. 

You are probably wondering about the picture above., I will explain that in a bit.

Deodorant, deodorant  mimics micro calcifications. Some micro calcs get worked up, meaning additional images and after the additional images IF they are deemed “indeterminate” by the radiologists they are either followed up in six months or he/she gives a recommendation to biopsy them! Lotion or powder can come out in the image, especially if it has some type of shimmer to it. Also with lotions and or body oil, it makes the breast slippery making it easy to move when in compression, causing motion. An image with motion will be rejected and repeated. I had a patient that had coconut oil all over her body, her breast were small, there was no friction between her skin and my paddle. I was using my small half paddle for her but her breast kept popping out from the compression paddle. She agreed to go into our bathroom to wash her breast off with soap/water and we proceeded. And of course by now we were well into her 15 minute time slot for her mammogram.

When I bring a patient in the room I will ask I they have product on. If they did come in with deodorant on we offer baby wipes to wipe it off. I document it in my paperwork when a patient comes in with deodorant on. I have had a patient get called back for possible “residual deodorant vs micro calcs” therefore, I do not recommend coming into your appointment with deodorant on.

Sand

Here on Maui I have come across sand artifact on a mammogram. I did one view on a patient, then when I did the oblique view (side view) I noticed that on my image there was artifact where there was no breast tissue. My image receptor had all these sparkly things on it. I remembered that when she came in she had on a beach cover-up with a swim suit top on. I asked her if by any chance she was swimming in the ocean this morning? The answer; “Yes, but I rinsed off at the park before coming here”.   Well there was enough sand in her suit that clung on. Solution, my schedule fortunately was pretty open that day, this was the patients baseline mammogram (first one) she lived literally in the neighborhood of our clinic so she went home and took a proper shower then came back and I worked her in!

The Picture

I begin to position my patients first view, and I can feel that there is some kind of product on my patients breast. I continue to compress the breast, my positioning light is on, and with the compression this white stuff seeps from my patients breast tissue!!! I lift my paddle off of my patients breast and ask her, again if she has product on?

Me: I thought you said you did not have lotion on?

Patient: I don’t

Me: oh, what’s this…..as I point to my paddle

Patient: It’s sunscreen

Me: (with a puzzled look on my face) were you not asked NOT to wear  any lotion, powder or deodorant?

Patient: YES, they didn’t say I couldn’t put SUNSCREEN on! ( in a very harsh tone)

SERIOUSLY!!!!! OMG I COULD NOT BELIEVE HER RESPONSE TO ME AND HER TONE.

Me: I walked over to the baby wipes, asked her to please wipe, said that I would take one image, if I saw artifact on my view I would delete it and cancel the appointment. I then grabbed my cell phone and told her that I was going to snap a photo of my paddle to show the scheduler how these products interfere with the imaging. I tilted the unit at an angle for the image.

Wiping this sunscreen off of the unit made a mess. I managed to get it all cleaned up and we were able to complete the exam……of coarse this exceeded her 15 minute time slot!

Prior Mammograms

If it is your first mammogram at a facility and you have had priors elsewhere, please arrange for you priors to be sent to the imaging facility. I we receive them ahead of time the images are imported and prior reports are scanned, we have everything for our radiologists to make a comparison when he looks at the current study. IF, you don’t make those arrangements, we get you to sign a release for priors, we look up the location of your priors, and it helps if you know where your last mammogram was at. Last week, I spent 22 minutes with a patient on the computer looking for a facility on the mainland. She knew the state and city and part of the name of the facility (her prior was a 2015 study, how can you not remember)  We managed to find it. Release signed, we got started at 825 am, by then my 815, 830 and 845 patients were registered…….THEN….she had implants and was not double booked!!! My morning snowballed after that. You can not rush through a mammogram to get caught up, it was not until a patient called to reschedule an appointment that I was able to get caught up from my morning fiasco.

Clothes

Make every attempt to wear two piece clothing and not a dress. We only require you to change from the waist up, when a dress is worn to the appointment the patient is standing in her underwear with a long paper gown on (my clinic uses paper disposable gowns). I have had patients not have under clothes on,  which made it pretty awkward. In this case I got creative and taped a gown creating a skirt like cover-up, then a half gown on top. I do not understand why someone would not wear under clothes to a medical appointment!

Time to sign off, Mahalo for taking the time to read my blog, was not my intention to make it this long.

Pina

 

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September 2, 2016 · 7:41 am

38: The Hair is Growing!!

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I do not recall ever having short hair! The texture is soft and it is curly in the back and wavy up on top. I had to break down and by a hair product, using Tea Tree Shaping Cream by Paul Mitchell. When some patients  see me and remember me from last year, they say “oh , you cute your hair….that looks really cute” My response : “actually this is new hair growth after Chemotherapy”!  Their jaw drops, patients have teared up, hugged me and have just been so kind with well wishes and prayers.

I do the Bone Densities for MDI, twice a month. One of the x-ray technologists does them on Saturdays. My last Dexa day (as I call it) told me she refused a Saturday appointment because she wanted me to do her exam so she can see how I was doing. Apparently I did her mammogram when I was in the middle of Chemo, she was so sweet.

It is hard to believe that a whole year has passed already. The journey has not been an easy one (especially the chemo part of it) but I did it!!!!!!

TOMORROW IS MY LAST HERCEPTIN INFUSION!!!!!!!!!!!!!!!!  After tomorrow I will officially be finished with my treatment! Except for the Anastrozole that I have to take for the next five years (possibly ten) And of course the ongoing test to make sure the cancer does not decide to pop up somewhere else!!!…..one day at a time!!!

Matrixectomy

Well,  besides having a Primary Physician, Oncologist, Radiation Oncologist, Pulmonologist, Breast Surgeon, Plastic Surgeon…..I can now add a Podiatrist to the list! Since Chemo treatment number four and five I have had problems with ingrown toenails. (There has been no coorilation between ingrowns and chemo.) I have experienced and continue to have slight neoropathy of the toes and fingers (not so much on fingers) So the infections seem to creep up on me! I don’t feel them till it’s infected. The past three months have been riddled with frequent trips to the Podiatrist. Literally it seems like I have been to see him every two to three weeks. He has in the past mentioned a procedure to eliminate the growth of the nail going down, causing the ingrown. The procudure is call a Matrixectomy. I had this produre done yesterday, initially went in for the ingrowns, agian. After he (Dr. Lee) numbed both great toes, he offered the procedure. It required more numbing, which was super painful…I mean SUPER painful.  After the side of the nail is removed, acid is placed to kill future growth of the nail. So, once agian I am on ocean restriction…no ocean for two weeks!!! Today was challenging to work, the toes hurt but I managed to work the whole day!!! fyi: the pain was when the injection of lidocaine is administed, after that I didn’t feel a thing… and Dr. Lee continuously kept asking if I felt anything. He wanted to make sure i was completely numbed up.

Hopefully tomorrow mornings flight to Oahu is uneventful. The Hawaiin islands are on huricane watch, so far Maui has been unscathed from this threat (knock on wood), I dont like turbulance on the flights!

It’s getting late and I have to get up early to fly out….good night and much Mahalo for reading…

Pina

oh, one more thing…. I wore mascara the other day for the first time!!! the little things!

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October 16, 2015 · 9:00 am

18: Chemo #2,

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The week after taking my hair, on my terms I was able to work. I got lots of hugs from patients that recognized me from last year, some would just ask. I am more than happy to share my story, especially is if patients will realize how important Breast Self Exam are. I can’t tell how many women will tell me that they don’t know how to do them…..kills me! I had one patient tell me that she wasn’t sure why I obviously did not have hair, but she said that the way I wore the scarf on my head looked really beautiful, she told me I was beautiful……….made me a little emotional.

You don’t realize how much your fur (hair) keeps you warm at night! I wear a beanie to bed. The rest of my hair is falling, I have lots of little hairs on the bar soap when I shower. Oh, it was really weird showering the first time after buzzing it. I also see that some of my eyelashes are coming off! They somehow always end up in my eye, so irritating. This  past weekend Jax and I went to the beach for some much needed beach chair therapy…..felt good to get in the ocean!

Today, October 15th , Jax and I flew to Oahu. I had my appointment with the Genetic Counselor. Received the wonderful news that I am negative for the mutated gene! My girls will not need to be tested. However, with having a primary risk factor, meaning me (mother) they have a 20% increase risk factor for getting Breast Cancer.

My Chemo treatment today went well. The Oncology Nurse offered me an injection of lidocaine on the port site before placing the catheter. I declined, yea, not sure that was the right choice……it hurt! But it was fast, just felt like a shot, and so it started. One of the bags is a Benadryl, which helps with the side effects of the Taxotere drug. I am getting TCH + Pertuzumab. That is Taxotere, Carboplatin, Herceptin, plus Perjeta (Pertuzumab) I got sleepy due to the Benedryl, I took a book for continuing education, when I kept reading the same question over and over I new it was time for my “chemo-siesta”!

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The above picture is a device that was placed on my tummy. It’s a little machine that tomorrow will inject a medication called Neulasta. Neulasta helps reduce risk of infection by boosting my white blood cell count to strengthen my immune system. One thing for sure is I can not be around sick people!!!!

It is 10:46 pm here on Maui, but I just wanted to share today with you as I know a lot of you want to stay informed. I also want to say that I truly appreciate all the text, private messages, voice mails  etc. I do read/listen to each and every message. I had one friend send me a religious inspirational message that I saved and read it frequently. I am working tomorrow, I Have a light schedule done intentionally for me……MDI is really accommodating my work schedule needs, words can’t explain how much I appreciate them.

Warmest Aloha Pina (josefina)

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October 4, 2015 · 7:21 am

16: Breast Cancer Awareness

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On Saturday September 26th, the effects of my first Chemo treatment hit me like a ton of bricks. Words can not describe on how sick I was feeling. The vomiting and diarrhea was like NOTHING  I have EVER experienced. Your body is so weak, your bones ache, you have no desire to eat, drink, or talk. You know you have to eat, but it takes energy to eat, and you just do not have an ounce of energy to spare. I have a new appreciation to all the patients that have passed my path in my Mammography career, they are true survivors, I too will soon be a survivor!

On Monday morning (Sept. 28), my primary doctor took the dressing off of my Portacath. She reached out to my Medical Oncologist to discuss medications to ease the effects. The medications made a huge difference, but I still felt awful. I don’t know what I was thinking when I thought I could go into work on Tuesday!…….I only lasted three hours!!! On Wednesday, my day was going to be split between our Triangle Square clinic (11 miles away) and our Kihei clinic  (.2 miles away) from my home. Was fortunate that MDI was okay with me only working the afternoon in Kihei. I worked on result letters, waited for the Hologic service engineer as our power supply on the unit was going to be replaced. The part was scheduled to arrive on Thursday, so he bypassed the issue so I can do the QC and patients till Thursday. Because of this issue patients were taken off the schedule, I only had two patients to do, even then, when I was done, I was so exhausted. Lee, the front desk receptionist was super helpful. She was going out of her way to help me in any way possible……………….truly blessed to have amazing staff at MDI!

With the new month being October, it brings us the annual “Breast Cancer Awareness” month. The picture above is made from only some of the t-shirts I have accumulated from doing Breast Cancer walks. If there is a walk near you, please consider participating.

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September 20, 2015 · 12:05 am

14: Tsunami Watch

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Great! My first overnight stay on Oahu, and there is a Tsunami watch! In spite of the Tsunami watch everything went well, however I did not start my chemo yet…..getting a little anxious. One of the four drugs that will be used still needs to get authorized! I have to patient. My husband got to meet the Medical Oncologist, Dr. Chong. Dr. Chong went over the treatment plan with my husband, and at one point looked at me and told me that this treatment was going to kick my ass! I believe that was his way of telling me to be prepared! I am fully aware of what is yet to come, #igotthis! Doctor looked at  my veins and said that these latina veins were not going to cut it, I will need a portacath. There is a certain “calmness” about Dr. Chong, I really like him.

I also got to meet the breast surgeon Dr. Nakashizuka. She comes highly recommended and I really liked our first visit, she was very thorough, I will discuss my surgery option in a future blog.

We went to Waikiki Beach, as our hotel was in Waikiki. We only did this because the Tsunami watch was lifted. We walked around The Royal Hawaiian Hotel, which is a PINK hotel! Loved it! The doctor’s office called me and asked if I had time for lab work? Well of course we had time, this was not a pleasure trip! Jacquelyn and I quickly got in the ocean and took some photos, then we went back to Queens Medical Center.

My portacath will be placed early on September 24th, with my first Chemo treatment on that same day……It is going to be a long day at Queens. I’m sure one of many.

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