DIEP Flap Breast Reconstruction
Diagnosed: May 6, 2014
Triple Negative Invasive Ductal Carcinoma
Cancer…..It’s amazing what one word can do to your life. One six letter word, and your world begins to spin and your life takes a 180 degree turn. I describe it as if “I actually felt time moving. I was in slow motion and the world was moving around me.” Those of us who have received this diagnosis -- we understand the feeling.
That is what happened to me, and will happen to 1 out of 8 women in the U.S. I will never forget that moment -- “See this right here?…. you have breast cancer”! I don’t remember anything the doctor said after that, but I remember that moment with clarity. It’s rather odd, the things that race through your mind, and at an uncanny speed. It was May 6th, 2014, and I had gone to the clinic to have a mammogram. I found a lump under my arm the previous week, so I went to my family doctor, had a full-range blood test (which came back normal), but she wanted me to have a mammogram and ultrasound, as a precautionary measure.
A couple of days later, two mammograms and an ultrasound, of which the technician said she saw nothing suspicious, the nurse ushered me into an office where the films were starring me in the face. The doctor was sitting at the desk, and as if he were discussing the weather, or what he was going to do that weekend, with no “easing” into the announcement, just a perfunctory statement, “See this right here?... you have breast cancer. I will schedule you for a biopsy and we will go from there.” I am sure for the doctors and nurses, this is a common occurrence, but to the person that receives the diagnosis, it is anything but “common”.
Needless to say, my “auto-pilot” kicked in, I began to go through the motions, but all I heard was Charlie Brown’s teacher… “blah…blah…blah” -- sound with no words. Two days later, on a Thursday, a few hours at the other clinic, and 3 biopsies were performed.
At this point, I was torn between accepting that this is really happening to me, and scared that with each tick of the clock, the cancer is growing and I was absolutely helpless to stop it. Images came to my mind of the cancer growing and invading my body like the troops at Normandy, and try as I might, I couldn’t stop the advancement. I had to come to grips with the fact that I had no control over my own body and in some ways, my life. And the clock ticked on....
Four days later, Monday morning at 9:00am, I received the call from the doctor confirming the diagnosis; Infiltrative Ductal Carcinoma. I remember thinking “What if I get lost in the crowd?”, “What if time goes by and it gets worse and there’s nothing they can do?”, “I have to get this out of me, now!”. I do remember saying “take it out! Take both breasts now, I don’t care, just take them off now, we’ll decide what to do later!” At that moment, a woman really doesn’t care if she has breasts or not… that feeling will change later in the story. J
My next call was to my husband, giving him the confirmation. As is the case with most men, they aren’t sure what to say or do. Men are the “fixers” and he couldn’t “fix” this.
I decided that there were some things that I could control, and that was my medical care. I am a Region HR Manager for an amazing company based in Houston, Texas. My next call was to my VP, who said “Whatever you need, we will support you. M.D. Anderson is here in Houston, and you can come here for treatments, stay with me or any number of folks here. That is something you don’t have to worry about. You let us know what you need and we will be there.” For those of us who have walked the path with cancer, you know that words would never adequately express the gratitude to those who are your “Angels on Earth” those remarkable people who walk with you, support you and cheer you on to the finish line. This man is one of those people.
I then received a call from the Sr. VP who said “Well, I hear you got bad news. I want you to know we are here for you.” He then proceeded to tell me the history of his mother and sister who had fought breast cancer. And then, he threw me the lifeline that I have clung to for the remainder of my journey. He said “My cousin owns Breast Imaging of Oklahoma. She helped shepherd my sister through her journey with breast cancer. If you are ok with it, I will have her call you.”… And from there a complete peace came over me, and I knew that this was the path for me. Meeting Dr. Kelly Donough set my feet on a path that took me to Stephenson Cancer Center at the Oklahoma University Health Sciences Complex.
From the time I received the diagnosis, to starting chemotherapy, I wept…. wept, folks!.. over the thought of losing my hair! That was the first big hurdle that I had to get over. And I fought it like I was going for gold in the “ugly cry” event! You ladies know what “ugly cry” means! I cried every day! Just the mention of going bald and I would start the water works. I made the decision that I would be in control of “when” and “how” I would lose my hair; so I went to my hairdresser and yes, I cried and so did she!
Now to meet the team of doctors on the road to beating cancer!
I first met with my surgeon, who told me that due to the size of the tumors, I would have adjuvant chemotherapy, a mastectomy, and then radiation. At this point, I didn’t know all the facts about my cancer, and to be quite frank, I didn’t care to know. For me, if it didn’t change the treatment, I didn’t have to make a decision based on the “details”, or it wouldn’t change the outcome, I didn’t need to have any negative, worrisome thoughts in my head. I just needed to know and believe that I would beat it, and I would be a survivor.
My next visit was with my Oncologist. What an amazing woman. She walked into the room where my husband and I were waiting, and the first thing she said to me was “We know this cancer, it is treatable and it is curable. You remember that!”. All the tension and anxiety that I had been holding in rushed out of me and I wept (and this time it wasn’t because of my hair). I have clung to that statement more times than I can count. I did learn that I had a 7cm, 5cm and 3cm tumor on the outside of my left breast and a tumor in the lymph nodes, but still considered in the same quadrant. I also learned that my cancer was “triple negative” which meant that it does not contain the hormone receptors, and is HER2 -. This is a rarer type of breast cancer-- yeah me! I always wanted to be a little unique! J I learned that it was extremely aggressive and that 98% of my cancer cells were rapidly producing, so they were going to put me on a very aggressive chemotherapy and schedule (every other week).
Let’s just call a duck a duck, shall we! It sucks the big green weenie! For those who are starting the journey with chemotherapy, you will make it through. You are tougher than you know. You will dig down deep and find an inner strength and you will walk your path with grace, dignity, tears, anger, laughter and little grit to make it interesting! You will also shine with a beauty that only those of us who have endured cancer possess.
Let me just say here, the week that was my “chemo week”, I would have my infusion on Monday, Neulasta on Tuesday, and then the fun began! I called it “weepy Wednesday” and “Terrible Thursday”. How do you explain going through chemo therapy, especially when they are taking you to the edge of what your body can handle and aggressively attacking the cancer? I couldn’t give it justice. What I can do, is say I couldn’t get through it without all my friends rallying around me. The cards, flowers, prayers, words of encouragement, they kept me going. One of by besties knew that Wednesday was the downhill slide and she would call and check in on me, by Thursday, she was showing up with a large Sonic iced tea and a NY hotdog (chemo kills your taste buds and I could taste the sauerkraut) LOL She would read the personal ads with funny voices and make me laugh in spite of how I felt! The funny cards one friend would religiously send to me weekly, the e-mails that were God inspired and seemed to hit on the very thing I was struggling with at that moment.
I shall end with the same sentiment I started with… Chemo sucks! ‘nuff said.
Now, let’s get back to the hair issue, shall we?
I made it through the first of 8 rounds of chemo, and my hair was still hanging in there like a trooper! But the feeling of bugs crawling all over my head told me the inevitable was just around the corner. Queue the crying!.... round two… and it started to really come out, and it HURT! When the hair follicles die, the weight of your hair is painful. My husband, God bless his soul, said “Do you want me to shave it off for you?” Later, he confessed he really hoped I would say “No” because he didn’t think he could do it. So, out came the sheers….. I wept like a baby! Sobbing… then my husband starting sobbing and saying “You’re gonna’ hafta’ stop crying! You’re making me cry!”…. and the first step in losing my identity as a woman fell to the floor. I didn’t think I could look at myself, or feel my head when it was all said and done. But, by accident, I went to the bathroom and my husband yelled “Don’t look, yet!”…. too late, I saw my reflection in the glass pane of a picture. I just stood there staring at my image, not seeing me and yet it was me. And so, I took the next step, and the next step, and just kept going forward. That’s what we warriors do, isn’t it. Conquer, move forward and survive.
If you are reading my story and you are starting, or in the middle of your chemotherapy, I will give you the best advice I received, and I was smart enough to listen -- . “Stay off the internet! Do not read all the horror stories! Do not listen to others horror stories, they aren’t you! Keep your mind positive; fill it with music, books, movies that will lift up your spirits and encourage you.” I did that for each session. I put in my ear buds, listened to uplifting music, books, kept a positive outlook and made it through. You will too! This is a small time in your life, take chemo in small increments and milestones, so that you celebrate reaching a goal. I had 4 sessions of “The Red Devil”, and I broke it down to a half-way mark and then crossing the finish line when I completed the 4th round. Then I was on to Taxol…. rinse and repeat! LOL
Drink lots of water, become a Camel! Get lots of rest! Your body is trying to deal with the invasion of cancer and the effects of chemotherapy. Eat when you can and whatever you want. When you feel good, get a massage, pamper yourself. Do things that you did when you were “normal”. Cancer is as much an emotional battle as it is physical. It tears down that inner place that is deep inside each one of us that we go to in those quiet moments we examine ourselves, and dictates what we believe about ourselves. It is during this battle that we have to rebuild who we are, how we define ourselves, brick by brick. You can rebuild your self-image, the scars of your battle will never go away, but they can make you more beautiful than you were before cancer.
Now, the mastectomy.
Another hit to my identity as a woman. Remember, I was ready for both breasts to be removed when I received the diagnosis. Here is where I want to pause and say -- . “I wish I had known of PRMA and Dr. C before I had my mastectomy.” I would have had Dr. C perform my mastectomy. If you are pre-mastectomy, please do yourself a favor and meet with one of the Dr’s at PRMA prior to having the procedure. You have had a devastating diagnosis, you are walking an arduous path, and you owe it to yourself to have the BEST plastic surgeon! Let the best and most skilled surgeons, those who specialize in breast cancer reconstruction, evaluate and discuss options with you. You have earned the best in the world, going to PRMA IS grabbing the brass ring! Yes, I am bias… Dr C. rocks!
So, I had my first mastectomy on my left side, October 1st, 2014. 4 weeks after my last chemo treatment, followed by 6-1/2 weeks of radiation. Talk about a shock to the system! Going from a DD to nada… a virtual wasteland; I really thought that it would be harder to look at my missing breast than it was to see myself without hair. My hair was harder! Go figure!... Ok, enough with the hair, already! I was in recovery for an hour and then sent home. I went straight to the bathroom, took off the bandage and took a peek. Well, while it wasn’t pretty, I handled it quite well. 2 days later, I had a total breakdown and literally mourned the loss of my breast, my hair, my life as I had known it, my health, all of it. The despair that poured out of me, what can I say? But, I took another step, then another… and forward I marched.
I was told that I would have to wait at least 6 months after my last radiation treatment before I could have reconstructive surgery. Talk about an emotional rollercoaster. 51 years old, no hair and one breast! Not exactly going for Miss America! I was also not a candidate for the most common type of reconstructive surgery (expanders and implants) but I would have to have a “DIEP flap”. A what flap?! Who knew!
I began searching the internet for “post mastectomy DIEP flap surgery” to view pictures and understand exactly what having a “DIEP flap” would involve. Wow…. They’re going to do WHAT?!
As I searched other medical sites, I looked at pictures and thought, “Is that as good as it gets? Is that the best I can hope for?” and “Is this just another hit I have to take?”, and then I found PRMA in San Antonio. Holy Cleavage Batman!… “They know what they are doing”. I knew I had found the place for me. I didn’t care that I lived 7 hours away, I didn’t care that I would be in a hotel room for 2 weeks, I was going to PRMA!! As I scrolled through PRMA’s site, it is very obvious that they care about rebuilding a woman’s “inner-self” as much as they rebuild the “outer self”. The Doctor’s at PRMA are on a mission, a calling and they fulfill that role with patience, kindness, understanding, outstanding skills and most importantly, results!
I made the call! And it put me on the road to recovery and back on the path of feeling like a whole woman again. My first contact was Courtney. I will never forget her telling me that I didn’t have to wait 6 months for reconstructive surgery. Her warmth and caring came through the phone and I felt so comfortable with my decision to have my reconstruction done at PRMA and for the first time, in what seemed like a lifetime, I was excited and felt like I could find “me” again. Many friends and family couldn’t understand why I chose to go out of state. But when you have earned the best, you settle for nothing less than the best. From the virtual consultation, the first office visit, to the surgery, it is so well orchestrated. The staff of PRMA make is easy for out of state patients to receive world-class care. I have yet to meet anyone at that office that doesn’t make you feel as though you are their one and only patient. Everyone I have met welcomed me with a smile, a kind voice, patience and took the time to make sure I was completely comfortable with every step that I would take. You don’t walk into a doctor’s office, you walk into a family of people who will help you rebuild and take back your life from cancer.
Prior to my surgery date, I received a call from Denise, Dr. C’s nurse. She went over the entire procedure, pre/post- surgery requirements, answered any questions, made sure I had a place to stay while in San Antonio and took the time to make sure I felt at ease. Never did she make me feel rushed or that I had asked too many questions. She, like Courtney, was kind, patient and confirmed to me that I had made the right decision on choosing PRMA.
When I checked into the hospital, the care I received from PRMA’s medical team was outstanding. They explained everything that they were going to do, they took the time to listen and answer my questions. From the admission clerk, to the nurses, they ensured that I understood and was comfortable every step of the way. I remember Dr C. walking into the pre-op ward, he came over and took my hand and asked how I was doing, with his easy going way he put me at ease as he explained the entire procedure, timeline and what to expect waking up in recovery. He told me that I would feel like I had been hit by a MAC truck when I woke up, but that he would ensure that I had the “good stuff” to control the pain. Since I was choosing to have the right breast removed and reconstruction on both breasts, he asked if I wanted to keep my nipple. Well…. I didn’t’ have to think twice about that! Although I was pleased to have the question asked, I was always under the impression that they would take the right nipple with the mastectomy. When I said “Is it easier for you if I don’t keep it”, he promptly stated “It isn’t about me, it’s about you. Let’s keep it” and I was so elated that some part of my “woman-hood” was going to remain. You gals know what I am talking about. You lose sensation with a mastectomy, again, that’s part of your feminine identity… it is going away. Now, to hear that I can keep a little of it! Merry Christmas to me! The surgery lasted 7 hours with updates every 30-45 minutes. After surgery, everything was explained and everyone was assured that all had gone well.
The initial surgery for the DIEP flap was the hardest one I have ever experienced (physically), but having said that, it isn’t something that I thought I had died and gone to the depths of … well, you get the picture. The staff ensures that the pain is controlled, and honestly, gals… the hardest thing for me, the liquid diet for a day or so after surgery! I mean c’mon, I didn’t get my thighs by having a liquid diet! I even tried to bribe my co-worker to sneak me in a burger! When I woke up, I had on an abdominal binder and bra, 4 tubes sticking out of me (not fun) and some electrodes taped to my new breast. The electrodes monitor the blood flow to the newly grafted flaps. I waited anxiously every time the nurses came in and “checked the blood flow”… like an expectant mother waiting to hear the heartbeat of her baby, these were “my babies” and when you hear that “whoosh… whoosh.. whoosh” you just sigh and say “Thank you baby Jesus!”. The next morning after surgery, up and at ‘em! I had to sit in a chair and then walk around the floor. That was no problem; I would take my metal “boyfriend” (the IV pole) and go racing around the corridor. It actually felt good to me to get up and walk. It didn’t hurt, just very tight around my abdomen. If I can give you any assurance, it’s that the surgery is a big one, it’s very evasive, but it’s nothing you can’t handle! The doctors and nurses ensure that you are as comfortable as possible. The following weeks after surgery flew by and I was able to go back to work the third week after surgery. Sleeping on my back was not a problem, all in all…. I would do it again.
What can I say about Doc C??.... Well….. Besides being “eye candy” with a great accent (I had to say it)…. He’s one helluva a surgeon and an amazing advocate to ensure that you get the finest care and that you leave knowing that you have the best results you could hope for, and really, that’s what it’s all about. He listens to your fears, concerns and questions, spending as much time as needed to ensure that you are comfortable with everything. He understands the struggles and the emotional toll cancer takes on a woman. He is also honest about what you can expect and what he feels he can accomplish. He always strives to give you the best results, never cutting corners or rushing for the sake of ease or time, but he is committed to utilizing all his knowledge, skills and abilities to achieve excellence. From what I have seen and experienced, he delivers on his word.
I am scheduled for my 2nd surgery, to shape, contour, refine. So far, I am extremely pleased with my results and they will only get better with time. I love the slogan “Rebuilding lives the natural way”. As I say…. “The breast thing in life is a healthy cleavage!”
I hope you make the choice to have your surgery at PRMA. Celebrate life, embrace the new you, and accept nothing less than the best. You have earned it. You are a warrior, a survivor and a beautiful woman. Thank you Dr Chrysopoulo, Denise, Courtney and the entire PRMA staff. You made a profound difference in my life and to thousands of others. What a wonderful legacy.