Latissimus Dorsi Flap

I met with my plastic surgeon, Dr. Hijjawi, yesterday to discuss my upcoming surgery on April 28th. The surgery itself should take about 3 hours with a 1-2 night stay in the hospital (you can bet I will be opting for a 1 day stay! LOL). I will probably have 3 drains on that side that will stay in for approximately 2 weeks. Ughhhhh! Not looking forward to the drains quite honestly, but I made it through the last time and whatever I have to do to get myself a set of boobs I will do! Below is some information regarding the kind of surgery that I am having. I have lost so much breast tissue that he has no other option but to remove some skin from my back to create the right size boob, thus the reason for the dorsi flap procedure.

Latissimus Dorsi Flap

The latissimus dorsi (LD) flap is a standard method for breast reconstruction that was first utilized in the 1970’s. The LD flap is most commonly combined with a tissue expander or implant, to give the surgeon additional options and more control over the aesthetic appearance of the reconstructed breast. This flap provides a source of soft tissue that can help create a more natural looking breast shape as compared to an implant alone. Occasionally, for a thin patient with a small breast volume, the LD flap can be used alone as the primary reconstruction without the need for an implant.
Latissimus Dorsi Flap Reconstruction

Latissimus Dorsi Flap Reconstruction



Many surgeons will resort to the use of an LD flap as a backup option if a patient has wound healing problems or soft tissue failure in the setting of an implant. The LD flap can also be used as a salvage procedure for patients who have had previous radiation, and are not candidates for other autogeneous procedures. A large open wound on the chest wall is also an indication for an LD flap in patients that need chest wall reconstruction alone, without creation of a breast shape.

The thoracodorsal artery is the primary source of blood supply to the LD flap. At the time of breast reconstruction, the muscle flap, with or without attached skin, is elevated off of the back and brought around to the front of the chest wall. The main vessels remain attached to the body to ensure proper blood supply to the flap. The LD flap provides soft tissue to allow complete coverage of an underlying implant.

The length of surgery for LD flap breast reconstruction is typically two to three hours, and requires one to three post-operative days in the hospital. The initial recovery time is two to three weeks. Depending on the patient, the scar from the LD flap donor site on the back can be placed diagonally or horizontally. A horizontal scar can usually be concealed under a bra strap. Patients generally have no major long-term physical limitations from taking the latissimus muscle. Activities of daily living and most exercise can be resumed without significant loss of proficiency.

Secondary procedures after an LD flap reconstruction can be done in about three months. These may include expander implant exchange, adjustment procedures to improve breast symmetry, and nipple areola reconstruction. As with any type of reconstruction, if chemotherapy is needed, any additional surgery must await completion of treatment. Such additional procedures are typically done as outpatient surgery with a rapid recovery.

You are an ideal candidate for LD flap reconstruction if you:

* are thin with a small breast volume
* have excess tissue laterally and upward across the midback
* have had previous radiation and are having an implant reconstruction
* are not a candidate for other autogeneous procedures
* are having a partial breast reconstruction in order to correct a lumpectomy defect
* have thin skin that requires extra coverage for an implant
* desire a more natural appearance than that of an implant alone
* are having immediate or delayed reconstruction

You are not an ideal candidate for LD flap reconstruction if you:

* do not wish to have additional scarring to a part of the body other than the breasts
* have had previous chest-wall surgery such as a thoracotomy
* participate in extreme competitive sports such as mountain climbing, skiing, and swimming

Funny Photo

I have started reading this book upon the recommedation of Netherfieldmom and highly recommend it to anyone who is a cancer survivor and those who are not. It is written by a dedicated doctor and scientist who was faced with a brain tumor. This book combines memoir with a clear explanation of what makes cancer cells thrive and what inhibits them, and describes both conventional and alternative ways to slow and prevent cancer. "Cancer cells lie dormant in all of us-and we all must care for the "terrain" in which they exist." This is information you won't get from your doctor! Some of the information he presents I was aware of as I have done quite a bit of researching on my own (yippppee I am up to 8 supplements now! LOL Suzanne Sommers here I come) and some of the information was eye opening for me! Get the book, you won't be disappointed. Living a lifestyle that inhibits cancer from returning is my goal. Take charge of your health now before you are faced with cancer like I was!

Love to all and still walking in this damn cold weather,
Gail
ps 8 days until vacation but who's counting!!

Spring!

Spring is here! It is official when the pussywillows pop and the pair of mallard ducks that visit our little creek come back. Today we are expecting 2-4 inches of snow! HONESTLY!

So..... I am off for a walk before the snow flies.



I leave you today with a picture of my little naughty dog! Pure sweet naughtiness!

I was searching for Easter candy at Pick N Save on Thursday and the candy display just happened to be set up in front of an elderly lady who was setting up her table to give out samples. I was looking at a Lindt chocolate bunny and she said "how much are those, anyways?" I said " I am not sure. I don't see a price." We searched and found a sticker below the box of bunnies that said $3.99. " I have grandchildren " she said. " I will have to buy them some of those." Normally I would have gone on with my shopping but for some reason I felt compelled to talk to this women. She proceeded to tell me about her life as she set up her little table to give out samples of applesauce. She placed the tablecloth over the table and taped it in place and set up her little stand for the day. She lost her husband 35 years ago and spent her life volunteering for the Florentine Opera and Elmbrook Hospital while always having a full time job until she retired. Within the last 5 years she has had cancer twice and spent a good deal of time sitting at home feeling sorry for herself because she had cancer, until one day she decided to do something about it. She went out and got a job again. She works 2 days a week and then she has to "rest" she said. "My kids think I am crazy" she said, but "it was the best thing I could have done for myself." We continued on our conversation talking about the price of choocolate and how she remembered buying chocolate creme eggs at Quality Candy when they were only 39 cents a piece. Now they are $1.39 she told me. She smiled and laughed and said "well now that you know my whole life story, I hope you have a wonderful day!" I have been thinking of her all day. She touched my heart. It was if I was meant to meet her today and hear her story. As I have said before you never know what other paths people have traveled. You will find them in the most unlikely places.

don't you know I have cancer

I think back and remember my thoughts when I first diagnosed and weeks after that before I really had a plan. The world seemed to continue as normal, yet I didn't. Time all of sudden stood still.

I saw the guy running down the road on his daily jog..... "how can he be running... don't you know that I have cancer."

Some friends called us and asked us to dinner......"how can we do that... don't you know I have cancer."

The mom in the store was yelling at her little son who was crying....."why are you doing that.... don't you know that I have cancer."

My husband leaves for work......"work? Don't you know that I have cancer."

My kids are going out on Saturday night, can you pick me up at 11? "Yes, but don't you know that I have cancer?"

I see some friends laughing in the store......"how can you be laughing.... don't you know that I have cancer?"

I see the lady fixing her beautiful brown hair in the rearview mirror as she sits at the stoplight. "hair?.... don't you know that I have cancer?"

I sit in the house one night alone while my family carries on their daily activities....."don't you know that I have cancer."

"How can everyone and everything continue on as normal when I have cancer. My life has stopped right at this moment."

Little daily things that I always took for granted or never even really thought about had new meaning.....and they still do.

Time has moved forward. And so have I!

Thought for the Day

You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do.
- Eleanor Roosevelt-

Roasted Asparagus

Spring means asparagus and although the weather is anything but spring-like here in WI asparagus is plentiful in the stores right now. I love to roast asparagus and it is the only way I do it now. You can either roast it in whole spears or cut it up into smaller pieces.

Roasted Asparagus
1 bunch of asparagus.
large cookie sheet or jelly roll pan
Salt
Pam Spray
Butter and Balsamic vinegar
Place the asparagus in one layer on your cookie sheet or jelly roll pan. Lightly spray with Pam spray and salt the asparagus. Roast in the oven at 375 degrees for approximately 20 minutes or until desired tenderness is reached. Melt and cook a small amount of butter (approximately 1 tablespoons) on the stovetop until browned. Remove from burner and add balsamic vinegar (eyeball the amount-approximately 2 teaspoons) Pour over asparagus and serve.

Just last week I was sitting outside in this chair basking in the sun. Today, this!

Vitamins,supplements and food, oh my!

There is a wealth of information out there for us regarding health and well being. But information is conflicting in some cases. Drink wine, don't drink wine, eat this, don't eat this, get sunshine, don't get sunshine. It can be overwhelming! Just when you think that drinking red wine is good for your heart,they will tell you that it may increase your risk of breast cancer. Sheesh! My motto is everything in moderation. Am I now a vegetarian and a complete health food fanatic? Absolutely not! Have I changed my eating habits. Hmmmmm.... honestly yes and no. I will still indulge in junk food, especially chips (doritos, potato chips, cheez-its and tortilla chips)but maybe not as frequently as before (I do believe that additives in food is related to the increase in all cancers)and I may pick up organic fruits now where before I did not (I also believe pesticides contribute to cancer increase). I definitely read labels and look for soy in products (this is a no no for me)and always try to eat yogurt with granola and flax seed in it daily as well as drinking green tea daily. I do think before I eat, usually LOL One thing I have really changed in my path to being healthy is vitamins and supplements. I NEVER have taken any kind of vitamins before. I have bought them and they just sit in the cupboard. I am terrible at taking pills on a regular basis. I have blogged about my recent days of the week pill container and it does work for me! Right now I am taking tamoxifen, a multivitamin, vitamin C, vitamin B, COQ10 and calcium,mag and zinc. That is a lot for someone who has never taken any! I have just added to that list turmeric and vitamin D. I am waiting for these supplements to come in the mail as I just ordered them. I had read about turmeric being a natural anti-cancer fighter while going through treatment but when my friend Connie brought it up to me the other day and then my brother sent me an email regarding turmeric I decided it may be for me. Turmeric also helps with inflammation associated with arthritis and I do have some arthritis in my upper back. While eating lunch last week with a friend she mentioned she may start taking vitamin D herself, that she had just read somewhere that us northern folks don't get enough sunshine. Below is some information regarding both turmeric and vitamin D. While I would rather bask in the sunshine and feel the warmth of the sun on my face, living in the north we don't get a whole lot of sun in the winter. Pill popping is the way to go!

That all being said, I leave you today drinking a glass of red wine and munching on an organic apple! Enjoy the weekend (and get some sunshine!)

Love to all,
Gail

~~~~~~~
Turmeric (Curcuma longa) is the yellow spice most familiar in Indian curries and found in American prepared mustard. People whose diets are rich in turmeric have lower rates of breast cancer as well as prostate, lung and colon cancers, and recent research at the M.D. Anderson Cancer Center in Houston suggests that curcumin, an active component in turmeric, may help prevent the spread of breast cancer. In studies of mice, researchers found that curcumin helped stop the metastasis of breast cancer cells to the lung. Human studies following up on this finding are now in progress.

Breast cancer mortality rates in the U.S. vary according to the geographic region so that the highest rates are in the northeast and urban areas, and lowest rates in the south and rural areas. This is explained by the variation in sunlight and the subsequent vitamin D production. According to William B. Grant's analysis, breast cancer risk could be cut in half by sufficient vitamin D levels - or in other words, by sufficient sun exposure.

Kisses

This picture was worthy of my picture of the day for my 365 Day Photo Project and I also had to post it on my blog. This is the cutest picture ever and the story behind it makes it even better. My MIL is not an animal lover. She "likes" animals but could live without them. For those of you who know her you know that to be very true! LOL My husband and siblings never had any pets while they were growing up. Pets weren't allowed in the house. Sunday she came over for dinner,and I caught this photo of the dog kissing her, or was SHE kissing the dog! Omg! This was the funniest thing ever! First time ever she has kissed an animal!! (my family will appreciate this photo and get a good laugh).

Dog Story

I found this in my mailbox this morning and had to post. Hope this makes you smile!
Thanks Cathy!
~~~~~~~~

An older, tired-looking dog wandered into my yard.
I could tell from his collar and well-fed belly that he had a home and was well taken care of.

He calmly came over to me, I gave him a few pats on his head;
he then followed me into my house, slowly walked down the
hall, curled up in the corner and fell asleep.

An hour later, he went to the door, and I let him out.
The next day he was back, greeted me in my yard, walked inside and resumed his spot in the hall and again slept for about an hour.
This continued off and on for several weeks.
Curious I pinned a note to his collar: 'I would like to find out who the owner of this wonderful sweet dog is and ask if you are aware that almost every afternoon your dog comes to my house for a nap.'
The next day he arrived for his nap, with a different note pinned to his collar:
'He lives in a home with 6 children, 2 under the age of 3 - he's trying to catch up on his sleep.
Can I come with him tomorrow?'

Goals and motivation

I have a few goals this year and one of them is to get back into the exercise routine. I faithfully did Jazzericise for many years until I went back to work full time and then my exercise regimen was shot to hell. I hate the treadmill, absolutely hate it. I would rather be forced to eat liver and wild duck than get on the treadmill. I have been walking outdoors up until September when I went through surgery and then chemo and well, the exercise just hasn't been a priority. Now that I am feeling great I started walking again and have walked for the past week and half every day,rain or shine. My motivation? Summer (Shorts,tank tops and swim suits) and the proven fact that exercise just makes for a healthier person overall. (not to mention 2 vacations this summer that require lounging by the pool in a swim suit)I can procrastinate and I have found the best thing for me to do is exercise first thing in the morning. I put my walking gear on first thing in the morning before I do anything. Then I have no excuse not to go! It works for me. Only in Wisconsin can you fully appreciate March weather when you walk outdoors. In the past week and a half, I have worn a light sweatshirt, no sweatshirt, long sleeves, short sleeves, thermal running coat, winter coat, mittens, no mittens, scarf,no scarf and long pants with tights and without. Sun, no sun, wind,no wind, rain (or was that snowflakes today) or no rain, I prefer to walk outdoors despite the weather!

Dinner tonight was a new recipe that was absolutely delicious. Chicken Stroganoff with a huge salad. We loved it.
Check it out http://fullbellies.blogspot.com/2006/06/chicken-stroganoff.html

Cooking slump

I have been in a cooking slump lately. I am not sure why, but I needed some inspiration for some new recipes so I did some blog searching and found some great new food blogs that I have posted on the right under the link column. Check them out. They have great photos with all the recipes which make them even more appealing to try.

I made this recipe this week when we were pressed for time. The original recipe was a WW recipe that I tweaked a bit and added more veggies. The sauce in this recipe is great. Be sure to double it in proportion. I used broccoli, carrots and water chestnuts tonight.

Chicken Stir Fry
3/4 c. canned chicken broth,reduced sodium (I use Roundys organic chicken broth)
2 Tbs cornstarch
2 Tbs sugar
2 Tbs low sodium soy sauce
1 Tbs white wine vinegar
1/2 tsp ground ginger
1/2 tsp red pepper flakes
2 tsp peanut oil (I use canola with a splash of sesame oil. I don't keep peanut oil on hand)
2 medium scallions (optional)
2 medium garlic cloves,minced
1 pound boneless,skinless chicken breasts cut into 2 inch pieces (I use more chicken that what the recipe calls for)
Broccoli, carrots, mushrooms, bean sprouts, water chestnuts. (Add any or all)
rice
Whisk together broth,cornstarch,sugar,soy sauce,vinegar and ginger (I double this portion).Set aside. Heat oil in work or large skillet. Add scallions,garlic and pepper and cook for 2 minutes. Add chicken and cook until brown. Add vegetables and cook until semi soft. Add reserved sauce and simmer until sauce thickens and chicken is cooked through.
Serve chicken over rice.

Today I did some baking and made this recipe for Poppyseed Bread that I have had for years. This makes 2 loaves. Great to keep one and give one away.


Poppyseed Bread
1-18 oz package of yellow cake mix
1 small package of instant coconut cream pudding
4 beaten eggs
1 c. hot water
1 tsp grated orange rind
1/2 c. cooking oil
1/4 c. poppy seeds
Mix all ingredients together and beat for 4 minutes on medium speed
Bake at 350 degrees for 40-50 minutes.
Makes 2 loaves.

Elephant Ear Washer

After looking at the title of this blog post you must think I am losing it. An elephant ear washer you say. What the heck is that? After a trip to the walk-in clinic today I learned something new. No, it was not me who needed the services of the walk-in clinic. It was my son. For several days he has been complaining his ear is plugged and he can't hear out of it. We tried the over the counter ear wax removal drops but to no avail. They did not help and he is so annoyed he can not hear. I myself have had this problem once before and I know how annoying it is to have that plugged feeling in your ear. So off we trotted to the walk-in clinic today to hopefully clear up his ear problem. After determining he had a huge amount of wax build up his ears ("he has tiny ear canals" they said, "makes him prone to wax build up") the nurse came in to flush them out. The Elephant Ear Washer is this spray bottle gadget that flushes water into your ear canal to loosen wax. I had this done to one of my ears a few years ago. The feeling of the water being "sprayed" into your ear is quite strange, but is not painful. We left with two clean ears and a prescription for some antibiotic drops (ear infection on one side). "Come back in 2-3 weeks if you need another flush" they said (one of his ears still had a some wax in it they could not get out) I wondered if I could buy this gadget on the internet and of course you can (can't you buy everything on the internet). I may invest in this $30 ear washer and save myself a $200 visit to the walk in clinic if it happens again.

Inspiration

Getting Over It!

Does anyone ever "get over it?" I mean does any breast cancer survivor ever really get over it and move on? The question comes to my mind as an early cancer survivor just released from my hospital haven and now going on in the real world. I read so many times on the Susan Komen message boards about women who have had so many health issues related to BC(breast cancer) that prevent them from getting over it. Most people don't realize that with cancer comes a whole lot of other issues. Not only scars from surgery, hair loss and the obvious but other issues that sometimes remain with a person for the rest of their lives. Bone and joint pain, diabetes, insomnia, gastrointestinal problems, teeth and gum damage, hot flashes, depression, sexual dysfunction, and loss of self esteem. I read about these issues daily and after reading yet another sad story about another woman facing these realities, I am so thankful that I AM able to move on and get over it. I am really very lucky and thankful that I have no side effects (as of right now) that limit my daily activities of life. Aside from my physical scars and baldness I feel pretty much the way I did before I was diagnosed, except for some hot flashes (and I can live with that). I really truly believe that I have recovered physically and mentally in excellent shape due to the fact that I was very healthy before I headed into the BC world and my positive attitude. I had some bad, bad days, don't get me wrong, but I had more good days than bad and if I did have a bad day I kicked myself in the ass and got back on the bandwagon. I was not going to let cancer beat me, no way! I met with a friend the other day and she asked me "is it sometimes hard to believe that you actually had to go through all of that?" and the answer is "yes" It is hard to believe that six months of my life were on hold until I got through treatment, yet at the time the days seemed long and never ending. Do I think about cancer every day? I think because I am bald and I see myself in the mirror first thing in the morning I am reminded of my cancer, but I really tend to not dwell on it. I ran into a mom at a recent swim meet who had no idea what had gone on in my life over the past few months and she commented on how cute my hair was. I just smiled and said "thanks" I actually did not really feel like going into the whole story. Being a pretty private person, sometimes I would just rather not tell my story. I don't want breast cancer to define me as a person. I am the same person I was before cancer, with just a little more kindness in my heart.

We have another plate licker in the family!

Tamoxifen

I am free and clear with my oncologist for 3 months. I am now currently taking Tamoxifen for the next 5 years. What you ask is tamoxifen? My particular breast cancer is estrogen postive and progesterone negative, meaning the cancer is fueled by estrogen and taking tamoxifen will reduce the risk of cancer coming back. Unfortunately I am joining the ranks of the pill takers, those who have to put their pills in those little plastic containers that are labeled with the days of the week. I am also taking some vitamin supplements along with the tamoxifen and because I am terrible at taking pills, I need to have them all divided up for the week to remind me to take them on a regular basis. Now if only I remember to fill up the little pill container. LOL
~~~~~~~~~~~~~~~~~~~~~~~~~~
Tamoxifen information from chemocare.com

Drug type: Tamoxifen is a hormone therapy. This medication is classified as an "anti-estrogen." (For more detail, see "How this drug works" section below).

What this drug is used for:

* Tamoxifen may be given as adjuvant therapy (treatment after successful surgery) in women or men with lymph node negative or lymph node positive breast cancer. Cancers with positive estrogen and progesterone receptors are more likely to benefit from tamoxifen. Tamoxifen reduces the risk of getting breast cancer in the opposite breast.
* Tamoxifen may be prescribed in metastatic (cancer that has spread) breast cancer in both women and men.
* Tamoxifen may be prescribed in women with ductal carcinoma in situ (DCIS) who have completed surgery and radiation therapy. Tamoxifen may reduce the risk of invasive breast cancer. Risks and benefits of tamoxifen therapy should be discussed
in
this setting.
* Tamoxifen may be prescribed for women at high risk of breast cancer to reduce the incidence of developing breast cancer. Risks and benefits of tamoxifen therapy should be discussed in this setting.
* Tamoxifen may also be prescribed for treatment of ovarian cancer.
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

Long overdue blog post

Hello! I haven't been blogging lately. Between puppy parenting,working and getting back into daily life routines, I just have not had time. My life is nothing but boring every day affairs. Sleep, work, potty train, make dinner, do wash, clean up dog pee, watch American Idol. LOL

To update you on a few things......
Roxy the puppy is doing really well. She is sleeping through the night since day one. There was even a Sunday she let us sleep until 8 am. Pure Heaven! The potty training on the other hand is not the best. She is just not getting it! I scrubbed the kitchen floor the other day. That alone was hard enough. Try to clean the floor with a mop while a dog is attacking the pole of your mop and dancing around on the floor. It was cheap entertainment for the dog but took me twice as long to do the floor as it normally does. I left the kitchen to put the mop away and in that 30 second time frame the dog crapped on the floor and proceeded to dance in it and then run around the kitchen. Nice!!!!! I knew at that point we were not making any headway on the potty training and we might be in for a long haul.


This dog loves to retrieve! I found this great little pheasant that she loves to retrieve. She has boundless energy and will always bring something back that is thrown.


The dog and the cat do not like each other. I should rephrase that and say the cat does not like the dog. The dog actually is quite confused as to what exactly the cat is. She is intrigued by the cat and would like to become friends but the cat would rather hiss and run away at this point. It took Macie about a year to get used to Sunny. This too may be a long haul

Who could resist a face like this??


As for me....
I am starting Tamoxifen this week, my eyelashes are growing back (I can now use mascara again. Yippeee!) and my hair is nonexistent. But I am not complaining! Life is good!