LONG overdue blog!

So the reason I was MIA for almost all of last month was that I needed to finalize a few things before I decided to blog about them.

I’m happy to report that 98% has been finalized and I have some updates.

First, I am officially 1 chemo treatment away from being done with chemotherapy FOREVER!! (Yup, I’m putting it out there into the universe, folks). My last treatment is January 18th.

The other big news is that I have decided to switch my course of treatment just a bit for after I’m done with chemotherapy.

I was originally going to wait a month after chemo and then have a double mastectomy and a TRAM FLAP reconstructive surgery done at the same time at the end of February.

After consulting with several surgeons, I am now going to proceed with my double mastectomy (1 mandatory mastectomy on my right breast and a prophylactic mastectomy on my left breast) and have expanders put in at the end of next month. I am fortunate enough to have “made a match” and will have 2 surgeons operating on me together who have never worked together before. I was a teensy bit nervous (and by teensy I mean having A LOT of anxiety) that they initially wouldn’t agree to work together but luckily, not only did they agree to work together; they both had nothing but good things to say about the other. I’m now just still waiting on a date for my surgery once the surgeons coordinate their calendars.

So...my breast surgeon remains Dr. Neimark (who I love more and more as I get to know her better) and my reconstructive surgeon will be Dr. Gary Rosenbaum from Mt. Sinai hospital. I have been so happy with the Memorial hospital system and I am so lucky that Dr. Rosenbaum has privileges at Memorial so I will be operated on at Memorial South in Hollywood.

The reason I chose Dr. Rosenbaum was that he is specially trained in what’s called the DIEP FLAP. You can check out his website: http://miamidiepflap.com/ but the gist of it is as follows:

“A breast is comprised of skin and fatty tissue. The DIEP Flap makes use of a woman’s abdominal skin and fat to reconstruct her breast. Unlike the TRAM Flap which also makes use of abdominal skin and fat, the DIEP Flap spares the abdominal muscles. This critical difference in the procedures is a major advance for the active woman of 2000 and beyond.

It allows activity to be resumed earlier following surgery, and with virtually no chance for an abdominal hernia or bulge that is reported to occur in up to 20% of TRAM patients. No mesh or foreign material is required to close or reinforce the abdominal wall as may be indicated in TRAM patients. This is frequently required in women undergoing bilateral breast reconstruction. The fringe benefit for patients who undergo a DIEP Flap is the tummy tuck closure of the abdominal wall. The DIEP Flap exceeds the TRAM taking it to the next level.

There is no need for the breast to have a muscle incorporated in it, as the normal breast gland does not have muscle in it either. The rectus abdominus muscle sacrificed in the TRAM Flap is not functional in the chest. In fact, the abdominal muscle eventually atrophies, or withers away, once transferred to the chest. Therefore, the woman has forfeited the rectus abdominus muscle. Any bulk needed to create a breast can be obtained from the skin and fat of the abdomen.

Many surgeons are not trained in this new technique nor do they wish to invest the additional time performing it. Dr. Robert Allen, MD who is the leading authority on this procedure in the United States, popularized the DIEP Flap procedure. Dr. Rosenbaum studied under Dr. Allen for over two years learning the methods and techniques required to perform the DIEP Flap safely, efficiently, and successfully. Dr. Rosenbaum has been performing the DIEP Flap in Miami Beach since 1997. He is formally trained in advanced microsurgical technique, and the only plastic surgeon in South Florida trained by Dr. Allen in the DIEP flap. His experience in DIEP Flaps is most likely the largest of any plastic surgeon in the state.

Dr. Rosenbaum has dedicated a considerable portion of his practice to breast reconstruction. Incorporated into most of his reconstructive procedures is the use of the skin sparring mastectomy. He is one of only a small group of highly skilled plastic surgeons in the United States who is trained in performing the DIEP Flap. Recent studies have shown that the DIEP Flap results in less postoperative pain, shorter hospital stay, and improved abdominal wall function when compared to TRAM flaps. For those women who are seeking breast reconstruction using their own tissue the DIEP Flap offers a woman the most advanced method for achieving a naturally appearing and feeling reconstructed breast.”

Because I am having radiation after my double mastectomy, I am going to have a double mastectomy and expanders put in temporarily for my 1st surgery, then I will have radiation for 6 weeks about a month or 2 after I’ve recovered from surgery, and then finally, hopefully by summer’s end, I will have the DIEP FLAP surgery with the added perk of a tummy tuck included. I will admit I’m still a little unsure of what this whole expanders business is all about but I plan on calling Dr. Rosenbaum’s office tomorrow to schedule a follow-up consultation to inquire about that.

If I choose to have nipples re-built, that will happen a few months after the reconstructive surgery and the last part is having my nipples tattooed to match normal nipples. I’m exhausted just typing all of this and quite frankly, the reality of it has not quite hit me. I NEVER thought I would bring in my 35th year spending most of it either having or recovering from medical procedures. The good news is that for those who know me, I have my fingers crossed that my mastectomy will be scheduled during Rotembuary (as I refer to February because I celebrate the whole month) because my oncologist told me that I am considered “cancer-free” on the day of my surgery!! (**There’s a whole bunch of “what ifs” that go with what can happen and/or what they can find during my surgery but emotionally, I’m not prepared to write about that today…hopefully for another day).

Whew! I’ve said a mouthful. More info/details to come soon.

HAPPY NEW YEAR!! Here’s to a happy and healthy new year for everyone...including me.