Tag Archives: survivor

#82 Getting Discharged

The colonoscopy last Monday (2/26) was clear with no findings. I opted to stay on clear liquids till my surgery to repair the Lumbar Hernia. Per the surgeon the repair was complicated but successful! We were given the option of a private room or shared, we opted for private suite ……that came at a price $$$$. Originally I was to be hospitalized for one to two nights. Well here we are on day seven and I am being discharged. Just yesterday March 4th I was cleared to start having solid foods. The restrictions to be on liquids was due to nausea. The medical team tried different nausea medications to help with the on going nausea, I couldn’t keep down water, it was bad.

When I was give the menu to order breakfast yesterday I got to see what they offered. Let’s just say I missed out on some delicious meals. Below is one of two menus to pick from, my husband Jack was well fed.

When we leave Mt. Sanai this afternoon, we will head out to a hotel at Times Square. I will have a post-op appointment with Dr. Reiner this coming Thursday. At that appointment the surgeon will lets us know exactly when we can leave this area.

Below is one of my favorite pictures, we are on the upper east side over looking Central Park towards the west side.

Signing off, many mahalos for the love and support and above all, prayers.

Pina

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#80 New York

After completing the breast restoration process last year, I was so happy that all of that was behind me. All I wanted was to have successful breast reconstruction, which I was able to get going to Louisiana. I thought 2023 would be the final surgery, but apparently not. (details in previous blog)

Like I mentioned, this surgeon wanted me to have colonoscopy prior to the hernia repair vs. having one done later in the year since I am due for one. If you have been reading my blogs from the beginning I have mentioned that I have a mutated gene for both Colorectal and Breast Cancer. When Dr. Reiner asked me during my consultation when my last colonoscopy was, he was quick to say that he would not do the repair without a colonoscopy first. Also I would need to have colon prepped (cleansed) prior to the surgery, so might as well do them both.

Tomorrow at 9am eastern time I will have the colonoscopy done by Dr. Peter Rubin. On Tuesday we will meet with Dr. Reiner for a pre-op visit and instructions for the Hernia repair on Wednesday.

Sitting here in our hotel room at The Marriott Courtyard in the upper east-side of Manhattan, I have just finished one of the two bottles of Clenpiq, which is the colon cleanse kit I was prescribed (wish me luck) We are with in 1.5 miles of the locations where both procedures will be done.

Wish me luck, keep me in prayer that all will be seamless without complications.

Mahalo for reading

Pina

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# 78 Beyond Frustrated

The title of this blog is an UNDERSTATEMENT of how I feel right now.

But, first let me go back a little bit before I explain. Recovering from the second phase of the SGAP Breast Reconstruction done on August 30th went smoothly. The surgeon modified the front DIEP flap scar, moving it down leaving the umbilicus at the waistline. The gluteal scar had/has an area that has decided to take its sweet time healing, today it has less than 5mm to go before it is completely closed. The left breast is a bit smaller then the right breast, and I am okay with that because I have two breast now! I was offered another revision, but I am happy with the current outcome. I was really worried for a bit when I had the complications and having the wound vac, I thought I was going to lose the flap. Beyond grateful for the surgical team in Louisiana !

Above is a diagram of the scars, I know it looks intense, but all scars a healing really nice. I did go out and buy myself new bathing suits, however I have not been cleared to go into the ocean due to the gluteal scar not completely closed. Just need to be patient……..and then this happened!

Last month I noticed that I had this “puffiness” on my left side near the waistline on my back. That area did not feel right, I would do my lymphatic massage, the puffiness would subside, but then reappear. On Monday the 27th as I was bearing down to use the restroom, I placed my hand on my back waistline and felt something literally plop out (and I’m not talking about a BM..lol) I asked the Ultrasound Technologist if it was possible to have a hernia back there, she said, rare, but possible. Since then I have had an Ultrasound and CT. I have a Hernia! The descending colon has herniated out.

The yellow line shows where the wall has been breached (so to speak) the large bowel should not be past that point.

What’s next? Getting this repaired before it gets “incarcerated”.

Tomorrow we fly to Burbank, I have a surgical consultation with a surgeon with City of Hope, on Monday the 18th. On December 28th I have surgical consultation with a surgeon from UC Irvine. This comes after the Specialty Care For Hernia Repair out of Newport Beach let me know that they could not do this repair. This facility does outpatient, and was not a good option for me. They recommended having it done at a University Hospital. I am not in pain, it is uncomfortable though, I am wearing an abdominal binder making it bearable throughout the day.

My kids quickly started sending me names of possible facilities/surgeons. I was really challenging coordinating this, making phone calls etc. However I have two consultations and hopefully one of the surgeons can do this ASAP!

So there you have it…this is why I am Beyond Frustrated ……simply at the thought of another surgery has me bummed.

Mahalo for reading……I almost forgot, the flowers were a gift from a wonderful patient during Breast Cancer Awareness Month!!! She totally made my workday, work week wonderful. I got lots of compliments from patients that got to see them, they were beautiful!

Mele Kalikimaka everyone,

Pina:)

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#76 Second Phase

This blog has been on my mind, I had intended to blog the week that the Lahaina fires happened also the fires in upcountry. Blogging took a back seat, as our beautiful island recovered and continues to recover from the tragedy that happened here. The picture above was taken April 2008, on one of our wedding anniversary trips to Maui. The Lahaina Banyan Tree turned 150 on April 24 of this year. The tree might recover and live…however so many people have lost their loved ones, families gone. I pray that the survivors of Lahaina will be able to recover from this tragedy.

The second phase: I am off to Louisiana for the second phase of my SGAP breast reconstruction. This surgery was supposed to happen the first week of June, however the complications pushed the surgery out. I am really happy with the way the left breast is healing. I still continue to wear a bandage under the fold of the breast that is still healing.

The plan for this surgery is to make the breast more symmetrical. Currently the right breast is quite a bit larger than the left. The left breast will not be manipulated, we plan on leaving it alone. I have always been told by the plastic surgeon that the breast would no longer be twins, that they will be sisters! Well currently they are not twins, nor sisters…they are more like distant cousins! The right side will be reduced and lifted to match the left.

I am going to stop here, I just wanted to touch base with all whom have subscribed to my blog and have been reading my blogs.

Mahalo for the well wishes and prayers for the people affected by the fires.

Pina (Josefina)

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Back on Maui

Jack and I arrived on Maui Wednesday the 15th, just al little over a week ago. We got somewhat settled, our daily routine in the morning with shower and dressing the left takes my husband about 1 1/2 hrs in the morning. I still have to two hip drains and those are emptied and logged 2x daily. Unfortunately the incision started to pull open. Our communication with the PA in Louisiana asked my husband to pack the opening after cleaning it with Dakin’s Solution. Well, we can not purchase Dakin’s Solution anywhere on this island, we ordered some on amazon. There was also a piece of tissue sticking out that they told my husband we can cut off with sterile scissors. This was a bit beyond what my husband was willing to do. Unable to get get at the Wound Care Clinic here on Maui, my PCP Dr. H. Haynes managed to get me to be seen Monday with Dr. Lugo here on Maui. I can not tell you how grateful I was that he worked me in on Monday.

Dr. Lugo assured me that the flap was doing well and that the healing process would just take time. He changed the dressing which included snipping off that hanging tissue and showing Jack how to clean and pack the open wound. Since we are unable to get Dakin’s Solution we are using sterile saline, which the surgeon in Louisiana said was ok.

On Tuesday we talked to the surgeon in Louisiana and discussed the wound care. On Thursday (yesterday) I gave them updated pictures of the open wound. We give them pictures on Monday and Thursday. This morning (Friday 3/24) the P.A. called to let us know of the meeting with the surgical team they had with the pictures I have been supplying them with. They asked we would be willing to return to Louisiana so that they can be more hands on wound care. Jack and I leave on Sunday arriving in Louisiana on Monday, will go straight to The Breast Center, where I will be seen at the clinic than admitted to their hospital.

Physically I feel really good, I am literally not doing anything. I pass my time reading, painting by numbers and doing puzzles on my iPad. The picture above is a completed puzzle, you have the option to save it as a picture when done.

I am no artist, but below is a drawing. Normally I would add pictures, however I am choosing not to, due to how graphic they are.

Tomorrow I am entering a new decade (as my dear cousin put it, we are both 1963 babies) I will be relaxing and prepping for our trip back to NOLA.

Mahalo for reading and all the well wishes…love to all

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HEADED TO NOLA

#69 HEADED TO NOLA

It has been a bit since I have blogged. Initially the purpose of this blog was to keep my mommacita informed, she was my biggest fan. Since the summer of 2019, when she passed, so much has happened. Got situated on Maui, back at work at Maui Diagnostic Imaging. Then we rolled into 2020, and we all know what happened that year. I stepped into Lead Mammography position as my co-worker left the island that summer.

In December of 2021, I contacted The Center For Restorative Breast Surgery, which is a hospital dedicated to breast reconstruction. My husband and I had our first zoom appointment with them. I then spent the first months of 2022 gather all and requesting all my surgical notes ( 9 breast surgeries) from the hospitals were they took place. It was a process doing all by phone and email, faxing etc. Once I had all my notes I then forwarded them to the Breast Center. Their team then reviewed all, along with pictures of myself that were sent thru a private portal. We were then offered an in person consultation which we did on October 17, 2022.

I was nervous and excited. Meeting them in person was the right thing to do vs. zoom and or conference calls. My husband and I sat with the surgeon and one of his assistants, he was extremely kind and thorough in explaining what could be done in my particular case. The in person consultation was exactly what I needed to put me at ease and hear his explanation of the recommended surgery vs. reading about it. When we left, I felt really good and hopeful. The decision was made to do the surgery in early 2023, since it would require 2 surgeries. Having it done in early 2023 would allow both surgeries to be done in one billable year, the Breast Center pointed this out. This center is so well organized, different teams reached out to me after my consultation. Scheduling, Financial team, Housing recommendations contacts, pre-op test etc.

Surgery is scheduled for March 1st! We have had our airbnb reserved since last year when the surgery was scheduled. When we were in Louisiana for the consultation we stayed in the French Quarter and did a little sight seeing then. This time around will be different, our stay in New Orleans will be post-op and recovering. I will be required to stay in NOLA for two weeks, before giving the okay to fly back to Maui.

The Procedure: Surgery will be about 8 hours long, it’s called SGAP breast reconstruction. For those of you that have been following my story, know that my right breast was a prophylactic mastectomy, currently with an implant. The implant will be removed and both my reconstructed breast will be with my own adipose. This being done for symmetry and realistic volume of both breast. At this point all I want is two breast. I am so over wearing a prosthetic breast and having the void of a left breast and being uncomfortable in certain clothes. I know that my breast will never be like pre-cancer breast, and I’m okay with that, I just want my new normal to feel a bit normal.

The picture above of my mom and I is one of my favorites, I miss my mom, that picture was taken on March 26, 2012. My birthday is the 25th, we always spent the day together for my birthday. My mom throughout my breast cancer surgeries always prayed for me, I know that she will be looking over me.

Mahalo for Reading my blog…much Aloha, Pina

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#64 DIEP FLAP RECONSTRUCTION

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Mischief and Repose, 1895 Oil on Canvas…The J. Paul Getty Museum, Los Angeles

How does one prepare for a surgery like this? The name is intimidating, Diep stands for Deep Inferior Epigastric Perforator artery, which runs through the abdomen. A lot of people think Diep and Tram Flap are the same…not so. The Tram Flap utilizes the muscle where the Diep uses adipose (fat) and the skin along with blood vessels. I am fortunate that my Plastic Surgeon, Dr. Frederick Eko performs this microsurgery.

With that being said my surgery date has been set, it will be on October 24th. I will be hospitalized for three to four days, two of those days will be in ICU. The surgery will be performed at Eisenhower Medical Center in Rancho Mirage.

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My husband and children are all making plans to care for me post surgery, I am blessed to have them available for me. My Diep Flap surgery will be on my left breast. My left breast is the one that had to have the implant removed due to “implant failure caused by irradiated skin”. When the left breast implant was removed on April 4th, all the dead skin was removed as well. Now that is has healed completely you can literally feel my ribs! I tell people that it is like the pictures of the “Radical Mastectomies” from the 1960’s. The right side will also be worked on…a revision is necessary, I have excess skin. That implant will be removed and replaced with a slightly larger one, and some skin will be removed.IMG_6779.jpg

The black lines indicate where my current scars are. The scars on the left side will be gone, the new scar will look similar to the picture above. For the right side revision the scare will remain the same. My OR room has been booked for 10 hours. I have a preoperative anesthesia assessment appointment on the 18th, body marking on the 23rd (that’s where the surgeon will draw on my body) and surgery on the 24th.

It has been one long journey….I just want two boobs..or shall I say “foobs” (fake boobs)

Above is one of my favorite pieces from the Getty Museum, the shear fabric, the detail….I could go on and on. I see this picture, and it’s like she is saying “uhh, I just want my reconstruction to end…two boobs…I just want two boobs”

MANY MAHALOS FOR READING MY BLOG

Prayers and well wishes are received with gratitude and love……Pina

 

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62: Blog Pictorial

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Aloha,

This blog will be a little different, as it will not be attached to social media. This will be a pictorial blog of my progress, since my last revision in late April.

 

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This is NOT infected, fibrous tissue was removed to help the healing process.second.jpg

This is how it looked after the debridement. My husband did really good in my wound care, he was instructed by my Plastic Surgeon how to care for it.

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This is a healing slow due to the 29 rounds of Radiation Therapy I had May-June of 2016. The latent effects of radiation treatment is the gift that keeps on giving. And because my treatment was on my left side, five years post radiation I will start seeing a Cardiologist, (add that to my long list of doctors)fourth.jpg

Got to LOVE my husband.fifth.jpg

Its coming along……remember that my left breast implant was removed on April 4th, and here we are in the month of June…this is not infected…it is actually healing really nice (finally)seventh.jpg

Skip to the month of July….from an original April surgery. My surgeon has given my the okay to get in our salt water pool ……YAY!eigth.jpg

Here we are three months after the left breast implant was removed. The trifurcation area of the scar is coming along. July 6th I met with my PS, he is pleased with the progress and my next surgery has been set…October 11th I will have my Diep flap surgery . Throughout this healing process, I have managed to avoid infection, by little home projects, caring and intertaining a four year old….Hulu and Netflix!!!

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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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#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.

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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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