Tag Archives: #reconstructivesurgery #expander #Ekoplastics

#77 Pre-op/Post-op

Six Drain Tubes

Wow ! Where to begin! The non-cancer side (RT) was reduced/lifted and treated with fat transfer for contouring. The left received fat transfer through two small injections on the flap mound. The healed previous scar was not manipulated.

Scare revisions: The gluteal (buttocks) scar was revised, with fat transfer for contouring. The front diep flap scar was revised, the scar will now sit lower below the umbilicus, and will be tighter. For those of you that have been following my blog, you know that I have a long scar on my back from the latissimus dorsi, surgery in November 2018. My NOLA surgeon asked how that scar felt. I answered honestly,:the scar has been bothersome, sometimes it pulls stopping me in my tracks we talked about revising that scar as well, which he did. It turns out there was a void underneath the scar wear he had me point to at my pre-op appointment.

Seems like a lot, I am not in pain🌸 I did not expect all the scar revisions, however when we talked about it at my pre-op it made sense, especially for the Lat- D scar!

The Lat-D scar is long, starts just below the left shoulder all the way down to below the waist line. I grateful for this facility an all their expertise with breast reconstruction.

The current plan is to discharge me today, I will finish my recovery here in NOLA till next week, we will fly to Cali for a couple of weeks after that. I have always said “ all want is two boobs” I know they will never be twins, I am good with “sisters”

This time it is working 💞🌸Mahalo for reading my blog and continued prayers for Lahaina🏝️ Pina (Josefina)

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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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#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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#58 Silicone Gel Implants !

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The final phase of reconstruction has arrived, tomorrow morning I will have my surgery.  My expanders, which I nicknamed “cinder blocks” will be removed and replaced with Silicone Gel Implants! Some people think, awesome ….you get implants! I’m sure I have said this before in a previous blog…..reconstructive surgery and a breast augmentation are two total different surgeries. An augmentation is an “enhancement” of you breast. Where as all my natural breast tissue and nipples have been removed and the implants will be placed to form a breast. Later, I will have nipples tattooed.

In the picture above, I am at my primary doctors office, this picture was taken today. The reason I was at the doctors today is because I ended up with a sore on/in my nose. I was placed on an anti-viral med and had to come see the doctor today. If the sore did not scab then my primary doctor was going to recommend that my surgery be delayed! Good results…it scabbed….the surgery is on!

The operating room is reserved for four hours tomorrow. I arrive in the morning, with pre-op time and post-op time, it could be a seven hour day. It is an out-patient surgery so I will be coming home tomorrow.

The pictures below were taken this past week end. I am so glad that my husband and I were able to get together with my cousins and spouses. Words can not express how much these two dahlings ( I know that is spelled wrong, that is the pronunciation we use) mean. My cousins have been so supportive through out this journey, besides my husband and kids.

 

Notice the label on the wine bottle says “Group Therapy”….that was the best group session ever!!!!

Maholo for taking the time to read my blog, I need to go take a shower with “Hibicleanse”  to prep for tomorrow.

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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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56: Hello 2018 !

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This past year has flown by so fast, looking back at 2017, I am amazed on where this Breast Cancer Journey has taken me. I took the picture above while on a walk with my nephew and his family in Oak Glen, near Yucaipa. Using my 84x zoom, from where we were we could not see all the nuts he was storing!!!!

My reconstructive surgery was on August 22, 2017. The expanders that were placed were inflated once a week for four weeks following the surgery post op appointment. Four inflation appointments starting on September 6th, ending September 25th. Definitely having this very large needle being pierced into your breast is not for the weak. My husband was with me for every appointment and watched as the Plastic Surgeon took the syringe, and injected the saline into the expander. Was in painful? Hell ya! I felt it more on the left side as the skin on the left was radiated ( 29 times!). The right side ironically,  where the PS injected was where my medi-port used to be, so the skin is deadened from the port being accessed for Chemo and subsequent monthly flushes, blood draw etc…….IMG_0876

The three month mark since the last expander inflation is fast approaching. The plan was to wait three months after the last inflation before doing the next surgery to exchange the expander for the implants. It would have been nice to have it done this year as we have met our deductible.

From Bricks to Cinder Blocks

Initially I called the expanders bricks….when all was settled they changed to cinder blocks….they are rock hard! Funny,  when I hug someone I find myself apologizing for my cinder blocks! They are really high up on the chest wall. The right side has dropped down some, but the left side is standing tall and proud!

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The mastectomies  where skin sparring, so when these expanders come out the excess tissue will be removed, the arrow is pointing the extra tissue on the left side. The straight lines are where the scares are, and remember I opted for non nipple sparring….the goal is NO reoccurrence ! I so plan on tattooing either 3D nipples or flowers covering the scars….who knows how adventurous I will get!

My appointment with my Plastic Surgeon is January 12th, at this appointment he will examine me and take pictures of me (without a top on) from the waist up ommitting my face, and he will have me remove my necklace, actually his nurse is the one that takes the pictures.  This series of pictures taken are for his use, so that he can plan his surgery on me, pictures were taken prior to this surgery as well.  I expect that the surgery will happen late January of early February….I’m anxious…I want to get this done.

Today is New Years Eve, my honey is sick so it will be a low key evening for us. I wish everyone A Happy New Year filled with Joy and Happiness, live life to the fullest, don’t take life for granted…….I would say that I am doing pretty dang good, but I would not wish this journey on anyone!   #F*%#cancer (pardon my french)

Mahalo for reading my blog…Pina

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55: Reconstructive Surgery

 

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Ok, This shit just got real! Warning graphic picture included in this blog

My surgery was one week ago today. It is kind of hard to describe what goes through your head as you are going to the hospital, walking in, registering, signing the anesthesia consent and being told the risk……reconstructive surgery is a choice, not a medical necessity. I decided I wanted this. As a licensed Mammogram Technologist, when doing a mammogram on a patient with implants, sometimes I wondered why they did it. Especially when they appeared to have adequate breast tissue in front of the implant. And what didn’t make sense, is when they had risk factors for breast cancer and got implants placed! I always thought I would never get implants, just wear good bras to bring the girls up some! LOL! My road to implant placement is different, it’s reconstructive surgery after breast cancer.

I will be forthright in sharing my experience as this has always been the purpose of my blog…..to share truthfully, to educate, to share my BC journey, so my apologies if anyone is offended by words typed or pictures posted.

I was wheeled out of pre-op into the operating room about 1250, with the surgery ending about 1830hrs, making surgery time just under six hours long. I was admitted to the hospital third floor at DRMC. I don’t remember much of the first three days after surgery, I think the pain pills had something to do with that! I do remember vomiting when I got to my room and feeling like my chest was going to burst open! Once we got home after my one night stay at DRMC, I do remember my eldest daughter (nurse Nikki)  making me eat regularly and giving me a slew of pills on a regular basis, draining and stripping my drains, documenting the fluid from each drain three times daily, showering me and dressing me.

My arms ached and the did not extend out much, initially after surgery.  I was so thankful that by the time I had my first bowel movement (4 days later) I was able to clean myself! I would have been mortified asking my husband or daughter to wipe my #@** ! My daughter was not too concerned that I had not pooped till then as I was passing gas regularly…..I realize this is one of the TMI moments! OK, enough of that subject.

My husband (quite the comedian)  says I have Tyrannosaurus Rex arms! He is having fun (at my expense) about my limited reach! (maybe I should have had him wipe my #@** ! However,  he has been quite helpful with draining my drains, showering and combing my hair etc. You don’t realize all the things that you can not do for yourself after a surgery. The plastic surgeon was clear when talking to my family that I could not do anything! So it has been a little hard on me know that I am more mobile. Simple things like tidying up the kitchen, or wiping a spot on the tile floor….I just have to look away, my family has been great doing everything.

How does it look?

The expanders are placed really high on the chest wall, literally just below the clavicle! I knew this so I was not freaked out when I saw them for the first time…..I am swollen, with time this will go done. I have the four drains coming out of my body, which I know some people get freaked out about. I have an appointment tomorrow Wednesday the 30th with the PS, two of the drains will come out. (ouch) Right now the scars are held together with a type of Dermabond (skin glue). For me too look at my chest wall right now I am a bit taken back on the appearance of them. But I know that this is not the end result, this journey will not be finished till the end of this year. So please keep that in mind when looking at the picture that I will include with this blog. I thank you for reading this blog to this point, as I realize it is a long blog.

I am literally a little nervous about the following picture, but if these pictures just helps one person out there debating weather of not to go through reconstructive surgery then  it was worth posting. And if you are on the fence of decision making please follow my blog to see the end result towards the end of this year, if that is too long to wait then research reconstructive surgery pictures……your Plastic Surgeon should be able to provide you with pictures as well.

I seem to have breezed through Chemo, Mastectomy and Rad TX, but honestly this shit just got real! I remember my husband telling me not to do reconstruction for him! My response: Oh, IF I have to go through this shit (meaning treatment) I’m going to get new ones out of it!………..So bring on the final phase………Reconstructive Surgery.

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The first pictures was taken on our 20th wedding anniversary trip to Maui…here we are in our 30th year of marriage, who would have thought we would be going thru this (notice I said “we”) because your diagnosis affects the whole family! I am blessed to have a very supportive one ……….#bumpintheroad

Thank you for reading……Pina

 

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