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67: Time For Healing

 

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.

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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.

Josefina…

aka…Pina

 

 

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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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52 & 53: Reconstruction

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I’ve never been one for selfies but I wanted to share how much my hair has grown and how curly it is! My hair BC (before cancer) was curly but not as curly as this…. I will take what I get as some women that were given Taxotere are not getting hair growth back.

June 20th marked one year since my last Radiation Treatment, I had a total of 29 rounds to the Left chest wall at The Pacific Cancer Institute on the island of Maui, from May 11th to June 20th. The plan all along has been to do delayed reconstruction. My team at PCI thoroughly explained skin care to me which I followed to a tee. The week after I started Radiation treatment I was referred to a physical therapist for John Barnes’ myofascial release technique massage. I saw my therapist twice weekly thru the month of July 2016.  I was also prescribed Mometasone Cream for me to “gently” apply post treatment. Hence, my skin flap is pliable, and not hardened.

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These pictures are of  just two types of reconstruction surgery known as Autologous of “Flap” Reconstruction. This is not the type of surgery I will have but the surgeon did go over the details of these two types of surgery. Reason being, IF my body rejects the Implant Reconstruction, this is “Plan B”. I will pray that my body does not reject the implants as these surgeries are more invasive.

 

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53:  A Show and Tell Moment

In February of this year at my first meeting with my Plastic Surgeon he gave me homework. He wanted me to research as to how many cc’s I wanted my implants to be. I told him on how before cancer my breast were not symmetrical, my left breast was larger than my right breast. Although this was not noticeable with clothes on, I was limited to style of bras and swimsuits because of this. So, I told him I wanted them to asymmetrical (same size)…..he smiled and said he can do that. My husband chimed in and asked the surgeon if he can place a set on my back so he would have something to hold on to when we slow danced!!!!! We burst into laughter….got to love my husbands sense of humor!!! ( I hope this doesn’t offend anyone)

So, how does one determine reconstruction size? You google it, Pinterest it, or simply ask a friend! I was at the Cancer Center talking to my good friend and fellow Mammography Technologist Extraordinaire. I mentioned my dilemma to her, before I know it Catherina and I are in the bathroom for A Show and Tell Moment. She was quite impressed with how pliable my skin sparring mastectomy is, as Mammographers we are oh too familiar with what a post radiated breast can look like. She showed me her implants and her size, decision made, I will shoot for a “C” cup! I also have to keep in mind and make it clear to my readers that mine is a “reconstruction, post mastectomy” and not a “breast augmentation”, so end result can vary…..I will have no nipples, they can get tattooed on later!

Exactly what is a Modified Radical Mastectomy, Skin Sparing? Basically my nipple was removed (I opted for non-nipple sparring) along with all the breast tissue. For those of you that have been following my blog from the beginning, you will recall that the Breast MRI that was done when I was first diagnosed found an additional cancer on my left breast,  4mm away from the fascia of the chest wall, straight back from the nipple at clock face 12:00. What is left behind is a deflated breast, all my breast skin was sparred minus the glandular tissue…….I have a deflated boob.

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I was in Redlands last week signing a release of medical records for my primary doctor in Palm Springs, he wants surgical notes of my Hysterectomy/Oophorectomy from 2009. (I sure am missing a lot of parts now!!). I stopped in at the Women’s Health Imaging Center to say hello to Renee, we chatted a bit about my blog amongst other things. I showed Renee this picture and how I wanted to share what a “skin sparring” mastectomy was. I took this the above picture after doing my exercises, I was cooling down, stretching. But I wanted to show more, I wanted to share the actual skin flap.

So what does a good friend do….offer to take photos for your blog!!! Renee and I quickly go into one of the mammography room, off comes my blouse, bra and Betty (that’s my prosthesis name) another Show and Tell Moment! Mahalo Renee for taking these pictures for me on a whim!

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Needless to say, I am ready for reconstruction. Today June 21st I went to the Plastic Surgeons office, the appointment went well. My husband Jack was with me. There was a moment of laughter when the topic of the prophylactic mastectomy was discussed, the surgeon asked if I was going to spare (keep) the right nipple? I said no, I don’t want to be like a one-eyed pirate when the nipple is hard! I closed one eye and said “arrrrggg”, the surgeon laughed……it was a funny moment. So what’s next? The  Breast Surgeon’s office will be contacting me to schedule labs, chest x-ray and an EKG. The surgery will then be scheduled. The Breast Surgeon Dr. Laura Lee will do the Right Prophylactic Mastectomy and the Plastic Surgeon will be doing the reconstruction placing the expanders. Post operative I will have four drains, two on each side. Two of them come off one week post-op. The other two come off after the fluid drainage has subsided. Expanders will be expanded every week until desired fullness is obtained. Then, three months later, like in December sometime the expanders will be switched out for the implants.

Holy smokes this is a long blog! If you read it to the end, many thank yous.

Mahalo, Pina

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20: Chemo #4

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With Thanksgiving on Thursday my Chemo treatment was on Friday instead of Thursday. Which of coarse meant that I was able to enjoy dinner. My cousin was visiting me from San Diego, so she organized a Thanksgiving dinner on Sunday the 22nd. On Thanksgiving I prepared an Italian dinner, it was delisioso!!!(Spanish for delicious)

Jack, Jacquelyn and myself flew from Maui to Oahu early Friday morning, it’s a mere 25 minute flight! We have a routine, once we get to the Hospital we go directly to the cafeteria for breakfast, which is pretty delish and inexpensive! Then we go to Dr. Chong’s office for my 10:15 check in time. With in minutes I am taken back. You get examined by the doctor before your treatment. My labs, vitals were good he told me that my heart beat, beats like one of an athlete! (thank you Pilates and walking) We talked about what happens after the Chemo treatments are finished and he gave me slip for an Echocardiogram. One of the side effects of the Perjeta affects your heart. I had an Echocardiogram prior to starting the Chemo, now that I am half way through my treatment, time to repeat that test. My Chemo lounge chair is waiting for me with my pole for all my bags that will be flowing through my body. The nurse, using a sterile technique cleans my medi-port area, flushes it first then starts the drips…..one by one. I am soon off to what I call my “chemo siesta” (nap). When I wake up I am almost done with my treatment, it is approaching 4 pm. Before leaving the nurse attaches that self injector to my tummy, that in 27 hrs will inject Neulasta medication into me.

Today is Saturday, right now I feel a little nauseous and stating to feel tired. Tomorrow the full side effects will kick in…..I am ready. I have two me treatments. My next treatment is on Friday the 18th, which means I will be good for when my two eldest kids come to visit for Christmas! Can’t wait to see them!

Thank you for all the well wishes via text, FB etc..Hope everyone had a wonderful Thanksgiving!

Thankful for

Family, friends, all my past co-workers and current ones. The company I work for MDI, for accomodating my availability through out my journey. The Doctors and staff of Dr. Chongs office. And all the staff at the Palm Springs Comprehensive Cancer Center! And for social media that allows us to stay connected!!!

 

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10: Christmas tree?

August 24, 2015/Monday

As soon as I walked into the Cancer Center they ushered into the Breast Center. My MRI that was done on Friday showed a new finding besides the area biopsied and the lymph node. The new finding was directly behind the nipple about 11 cm back, just in front of the chest wall, but not attached to the chest wall. Additional Mammo imaging was done with second look ultrasound. When I asked if I would be having another biopsy the answer was no. It was too far back near the chest wall.

Cynthia the PET/CT Technologist started my I.V. Again I saw some familiar faces, it was nice to see people I worked with. Because of the privacy laws a lot of people had no idea why I was there having these test done. I did not hesitate to share with my CCC family, as I needed all the good vibes and support possible. I got lots of HUGS.

The radiopharmaceutical was injected, I then go lay down on this comfortable recliner chair in a small private room with spa music playing. I cannot use the bathroom, I have to hold still and not move around. I also had to drink to cups of water given to me…..which was challenging. The music was nice until the cd finished, which reminds me I forgot to tell them the music is definitely helpful. After the music stopped all I could think about is that I really needed to use the bathroom! I couldn’t hold off anymore, I called for Cynthia, she was so understanding. I only had a little more time to go, she let me go to the bathroom.

For the scan I was supine (face up), I did not know what to expect. The scan started, all I could think was please don’t let it light up! Being face up it was hard to focus on something. I would close my eyes and try to think of other things other than why I was having this test done. At one point I remember closing my eyes, I remember when I opened my eyes I saw a dream catcher! It made me smile. They had taped a dream catcher on the other side of the tube, so when I came out a little bit I saw it. The little things that make a difference. When the contrast was pushed thru the I.V., I had this warm sensation through out my body. I am so glad that my friend Catherina (tech extraordinaire) told me about this feeling. You feel like you are pissing your pants!!!!………..#igotthis

I was told that we could go to lunch then return for the results, also to get results from the Breast MRI, CD’s and reports for me to take back to Maui. The radiologist, Dr. Pearce took the time to explain the new MRI findings to me, my husband and one of my daughters. Dr. Pearce was very open when discussing my MRI, he printed some key images for me, gave me his opinion (which I truly appreciated). Dr. Pearce used to live on Oahu, he talked to me about doctors on the island. I left the Cancer Center armed with copies of all my scans and the reports. I am so grateful my CCC family!!!

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6: Breast MRI

Walking into the Cancer Center for my appointment, they did not waste anytime. I was immediately taken to one of the patient rooms were nurse Debbie placed the IV needle in my arm for the contrast access. Dr. Lee spoke to me, she managed to get the authorization needed for the PET/CT. My PET/CT was scheduled for Monday. My daughter Monique said that everything was happening #kardashstyle ! She was impressed how efficient this Cancer Center worked. It pays to have an amazing team on your side.

I’m glad I reached out to my supervisor at MDI on Maui. Without hesitation she was okay with me extending my stay on the mainland for the PET/CT.

The Breast MRI was intense. You are laying face down with both breast thru this opening. Your face is on one of those face things like when you get a massage. But this was far from a massage! Your arms are up above your head, kind of like in a flying superman position. Patricia, the MRI technologist was super helpful in getting in the right position, making sure I was comfortable. The exam started, the noise sequences were loud. I had earplugs in my ears but it was still loud. There was different variations of scans, it’s dark, loud, I kept telling myself “I can do this”! The noises went on forever, and I thought this isn’t so bad it should be almost over! And the contrast wasn’t so bad either! Then, Patricia’s voice came on over the speaker, she said she was done with the first half, next half would be with the contrast! Oh my, I was only half way done! I got thru it, the MRI was done!

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5: Telling family

On our way to Perris I received a phone call from Dr. Lee, they got the authorization for the Breast MRI, I will have that done tomorrow. She told me, due to the contrast used for the exams that the Breast MRI and PET/CT could not be done on the same day. Asked if I would extend my stay allowing for that exam to be done on Monday pending authorization.

Driving to the city of Perris where my mother and family lives was nauseating. I was by mere coincidence that my eldest brother had flown in on this day to visit our sister. My other sister lives behind my mother, my brother Oscar waiting in her patio, I believe he thought our mom was napping. He knew of my positive results…..we hugged.

While all of this was going on with me, my sister had made the decision not to have treatment. Again, I had not been involved as I was dealing with my own issues.

I believe my mother was wondering why we were all there. To this day my mom did not know that I was in California. She was shocked to see us all walk in,  my mother and sister were sitting at the table. I did not waste time, my mom was a little upset that I had been in Cali, and that I have not been calling her on a regularly. I explained why I came to Cali, I told them I had been diagnosed with  Stage III Breast Cancer. My sister with Stage IV, cried…….I did not cry. I asked my sister to fight this with me, I brought her one of the brochures that was given to me……she said no.

My kids came prepared with food to BBQ. My other sister came home from work, before I know it other nieces and nephews are showing up. I was an unplanned little family gathering.

My sister who also has BRCA has had chronic pain all her life, she is tired of living in pain. She told me that she just wants to fall asleep and not wake up. I have to respect her wishes but deep down I wish she would fight this with me!

I am choosing to fight this full force! Cancer messed with the wrong person!!!!

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