Although October, National Breast Cancer Awareness Month is over, we would still like to recap all of our breast cancer survivor stories. Thank you to all of our patients who have submitted your stories. They are truly inspiring, encouraging and heartfelt. If you've missed any of patient stories, you can catch them all compiled below.
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Laleen's Breast Cancer Story
"After losing my mom to pancreatic cancer, having two sisters diagnosed, treated and surviving breast cancer and a brother having survived prostate cancer, (and even more biological family members than that also with cancer), I couldn't be too surprised to find out that I too would enter a similar battle.
Yes, breast cancer requiring a double mastectomy and my choice to attempt reconstruction all at once.
Although nervous coming out of anesthesia, I felt so blessed to wake up in a special pink printed corset-like velcro garment that was holding all the bandages in place. It was from Dr. Miles's wife, Vicki. It was such a sweet surprise and kind gesture, I felt cared for in such a personal way.
Unfortunately, due to infection, which required some off office hours, and even an appointment on a holiday from both, Dr. Miles and his PA, Heather Parlett, I still had to have the expanders removed. After that I chose to wear the prosthesis' that several of my dearest friends purchased for me️...
Three years later my breast cancer has metastasized and I'm fighting the battle again, yet with much answered prayer and diligence I am beating it again!
Looking forward to future reconstruction with the wonderful Dr. Miles and his incredible staff!
Continuing to enjoy a very blessed and fulfilled life!
Sincerely,
Laleen"
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"At the age of 32 I was diagnosed with stage 3 B ductal carcinoma. It was a triple negative cancer and had spread to my lymph nodes. It was very aggressive and my tumor double in size in two weeks. The Dr. gave me a 60% chance to live 5 years. Yikes....it was extremely scary to say the least!!!
I wanted to celebrate this big 15 year milestone with breast reconstructive surgery. I researched and visited many Drs. One of the Drs. I visited refused to operate on me because of the side effects from my cancer treatment, but instead referred me to Dr. Miles. WHAT A BLESSING!! He is the best! I instantly knew I wanted him to be my Dr. I felt so much love and confidence every time I went to his office. Dr. Miles and his entire staff are amazing! They are so kind, caring and compassionate! I truly was sad to leave when my last appointment came, they were great friends to me! AND for the first time in 15 years I feel whole again!!!"
Thankfully I have an incredible family and wonderful friends who gave me the love and support I needed to make it through. And I CANNOT IMAGINE GOING THROUGH THAT WHATOUT THEM!!! I also had a great Dr. and very aggressive treatment and I am happy to report I have been in remission for the last 15 years!!!! WOOHOOO!!!
I wanted to celebrate this big 15 year milestone with breast reconstructive surgery. I researched and visited many Drs. One of the Drs. I visited refused to operate on me because of the side effects from my cancer treatment, but instead referred me to Dr. Miles. WHAT A BLESSING!! He is the best! I instantly knew I wanted him to be my Dr. I felt so much love and confidence every time I went to his office. Dr. Miles and his entire staff are amazing! They are so kind, caring and compassionate! I truly was sad to leave when my last appointment came, they were great friends to me! AND for the first time in 15 years I feel whole again!!!"
Heidi
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CG's Breast Cancer Story
"I was at work on Friday, August 15th, 2014 in my classroom when I received the phone call that changed my life. My doctors office called and told me my results were in… I had breast cancer. I was in shock and total disbelief and I thought… I am a runner who doesn’t smoke or drink? I eat healthy and take care of my body? How did this happen? All of that didn’t matter anymore because cancer doesn’t discriminate and at that point I knew I had to focus on the fact that I have two beautiful children, a fiance’ (now husband), and three soon to be step children. I knew I had to pick up the pieces and begin the fight of my life. I began immediately with more tests, scans, and doctors appointments. We developed an aggressive treatment plan of five months of chemotherapy followed by surgery to remove the tumor and breast reconstruction. The last step was radiation which would be followed by a year of lower dose chemo/targeted therapy and an oral medicine with an injection for 10 years to keep the cancer at bay.
I met with my cancer surgeon in September before I started chemo and she gave me more bad news, the cancer had already spread to my lymph nodes. I was Stage 3c so I would have to have my lymph nodes removed as well. I scheduled an appointment with a plastic surgeon to discuss my reconstruction options. I went to my first plastic surgery appointment and I left that office in complete tears. I was scared and all I could think about were the scars the doctor said I would have and how many I would have and how my breasts would never be the same. It was more than I could handle after hearing from my oncologist that I was going to lose my hair, eyelashes, and eyebrows, while on chemo. I returned to my cancer surgeon and told her all of my concerns and she said I needed to go see Dr. Miles. She explained to me the importance of having a caring and experienced plastic surgeon that I felt comfortable with. I made an appointment to see Dr. Miles and from my very first visit I felt completely at ease. He went over my options with me and talked me through each one. He set my mind at ease and I can’t say enough about what an incredible peace I felt leaving his office that day. Dr. Miles and his staff have been the happiest part of my journey. Tara always has a smile and has such compassion for all of the patients. She is thorough and organized and has a HUGE heart. There was never any confusion with paperwork or insurance and everything was always handled so I never once had to worry or figure it out. Vicki his nurse is extremely knowledgeable and very compassionate as well. She really put my mind at ease as well and is incredible at what she does. Dr. Miles did an amazing job with my surgery I honestly look better than I did before I had the tumor removed and reconstruction. It has only been 7 months and I am completely healed and the scarring I was so worried about has been a non issue. He did an excellent job and I am so thrilled to have him and his team with me on this journey. My journey is not over yet but I can say with confidence that God truly directed my path to Dr. Miles and his office and I will forever be grateful."
CG
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E.G.'s Breast Cancer Story
"Hello All You Believers!
My story begins with the passing of my mother at 94 years old on June 18. Tara, the office manager and Dr Miles waited for my call and accommodated me early on a Monday morning to set up the surgery. They knew what I'd been through, watching my Mom pass, but they also knew I had to have the bi-lateral mastectomy ASAP! They were kind and gentle and got me ready. This was a whole new world to me; two surgeries at once! I would leave the hospital with both breasts intact having moments before lost both of them! A miracle!
When I woke up in the hospital, it was close to 10 at night. I felt so relieved, I was close to tears! These two excellent surgeons worked side by side to help me. I was so grateful; the primary Cancer tumor was GONE from my body, I was safe and my parts were still all there! The miracle happened to me.
The expansion process is another miracle. Every week or so, I made the lovely drive to Redlands
My treatment is still in process and currently I am undergoing chemotherapy for preventive purposes. Radiation may be in my future and the team at Dr Miles' office will help me through that as well, I am confident. The important thing is that I haven't lost my self image through all of this with the help of Dr Miles and his staff. I still look and feel womanly and have the confidence to face whatever comes next because I never lost that confidence! And here's the icing on the cake: they've lent me a beautiful blonde wig! I call that complete care!
From speaking with other Breast Cancer survivors, it's clear that Breast Cancer care has advanced a lot over the last twenty or thirty years and obviously will continue to change with the help of events like this one. So let's keep walking and moving forward so that my comfortable experience will be become even better as new cures and methods can be discovered and be available to great doctors like Dr Duncan Miles!"
E.G. Palm Springs , CA
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JJ's Cancer Story
"My cancer journey:
I did everything right...I had children and breast fed them and worked out and ate right. So when I found a lump in my breast, I monitored it for a couple of months. It was different than all the rest, which had been fiber-systic lumps from caffeine and would go away after I cut down.
So I decided to get an appt. with my Dr. and do my annual check up/mammogram. Then back it up with a sonogram. I have been sharing with every woman I can, that even though I was pointing right at the lump, the mammogram never picked it up. The sonogram did, though and then I had a needle biopsy. That was the first nightmare in the journey of pain.
They diagnosed me with Stage 1 breast cancer, so I had a lumpectomy. When the surgeon went to cut it out, he found a more aggressive and reoccurring type of cancer that they described as stars in the galaxy. I knew immediately that I would have a double mastectomy.
My daughter wanted to help me out afterwards by asking her plastic surgeon to recommend someone for my reconstruction, who also took my insurance. Why, Dr. Miles, of course! He was also highly recommended by the American Society of Plastic Surgeons as well.
I went back to work and was so self-conscious, even though I had been a 34 A. I tried prosthetics and they were hot and uncomfortable and would move around. I just used them while I waited to go in for surgery for my reconstruction. Now that I have spacers and am getting ready for the last surgery, I feel so much better about how I look and will look when it is all over.
This last year has been a long road, but every time I went in to Dr. Miles' office everyone was so happy and sweet and understanding. It helped me feel a little better each time."
JJ
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-Amber
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"In December 2013 I was diagnosed with breast cancer, stage 30. I was only 3 years old, that news changed my life forever. I was sad, felt hopeless, scared, and thinking I was going to die! And so scared for was coming. By January 2014 I was doing my first surgery, removing the tumor, and thought it was all over because it was out of my body. But no! I was wrong. I prayed to my God to help me, that I needed Him more than ever. Then came chemo for 4 months and finally the time to remove my breasts. I did a double mastectomy and then other surgeries. I was more sad not having my breast anymore, but Dr. Duncan Miles changes all those feelings. He did my reconstruction of my breasts and did an amazing job. Incredible. I love them. They look very natural. I call him my Angel on Earth. Thank you Dr. Miles for everything. I have my life back. What a journey!"
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Amber's Story
"Hello. My name is Amber. I am currently 28 years old. I grew up watching my mom have stage 3 of breast cancer, and stage 3 of endometrial cancer. So when I found out that there was a way to prevent me from possibly having to go through the horrible things she went through, I decided it was time I take the BRCA 1/2 test. When the test came back positive it was no surprise that I had to take action. So I met with Dr. Miles, who had operated not only on my mom but myself previously before. I continued to have the double mastectomy and reconstructive surgery with hope I was at a 92% chance of getting it and I dropped it down to a 1% chance. Best decision ever!" -Amber
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"Hello
My Name is Pam Null I have become a breast health warrior.
In August of 2012 a mammogram detected micro calcification on my left breast but biopsy’s came back clear. That’s when I diligently learned the correct way to do my self-breast exam.
That’s when I detected a lump 2 inches below the biopsied area. The mass that was present was not detected by several mammograms it took over 6 month of declining health issues and my insistence to check this lump. This is where I learned to be my own advocate.
In April 2013 I was diagnosed with stage 2 ER+ PR+ Her2- ductal carcinoma and my life was going to change. I had Breast cancer. Now I was one of them.
I was scared to death and started doing as much research as I could. I am a born again Christian and my faith was being tested. Through much prayer, research and seeking God’s guidance through the Holy Spirit I had to make some hard decision.
I choose to have a single mastectomy to avoid the possible long term side effects of radiation over my heart, it turned out to be the right decision because I had positive lymph nodes. Now it was the decision for treatment. It was hair pulling at times to navigate through the insurance maze but I eventually had 3 different oncology institutions opinions.
With the advice form a nurse who is a friend and my research and much prayer, learning how important the immune system is in healing; that’s when I decided to choose a natural immune building treatment. The Gerson Therapy. I choose an alternative way to fight breast cancer.
It required change, everything in me, on me and around me needed to detoxify my body.
It was a major lifestyle change. I turned a nice (“70’s” tan) orange from the 40 lbs. of organic carrot, green apple and combination green juice the Gerson Therapy requires but I will take that anyway over the years of side effects. Test results on the tumor Onco DX 22% I fought to get the mamoprint and it was 10% chance of distant metastasis. It was scary to tell my Oncologist that I didn’t want 4 rounds of Chemotherapy.
Don’t depend on others for your responsibility for your health. Take charge.
The body is marvelous a healing machine don’t discount alternative medicine using your immune system to fight cancer.
My medical team was not under one roof. I decided after much research and testing that I did not want to go through traditional treatment.
I had the opportunity to learn and follow the Gerson Therapy nutritional program for cancer treatment in a local setting. I also added additional nutritional supplementations to the protocol and let my immune system fight for me:
Integrative Therapy, preventative medicine, naturopathic, an oncologists willing to follow my progress and order tests, chiropractic, psychiatric, lymphatic therapy, and a supportive husband and a prayer team of friends and church members.
A Single mastectomy, no radiation, no chemo. I juiced, detoxified, and supplemented. I fought with dedication to use alternative and preventative medicine and with God’s grace I stuck with it as my Doctors advised watching my numbers decrease and health restored over the last 2 year. I have tests to show I am cancer free and I plan on permanent remission to stay.
Reconstruction.
My choice of the kind of reconstruction were greatly increased because I didn’t have radiation an my immune system was strong form my lifestyle change.
I knew I wanted to have reconstruction because I felt maimed by losing my breast. My girls were always a part of my identity. So now one was missing.
Knowing all the options and what I could do were important. I choose the DIEP Deep Inferior Epigastric perforator flap surgery. With fear and trepidation I decided on the DIEP reconstruction surgery long term results using my own tissue natural substance non foreign didn’t require follow up treatment surgery’s 10 years down the line to replace. Using my own extra stomach fat, a flatter tummy and a mastopexy, breast lift to lift the other girl which was healthy but sagging. This was the way for me.
Finding a plastic surgeon that could do the micro vascular surgery and covered by insurance was the next challenge. I again interview several doctors and choose Dr. Duncan Miles in Redlands
I needed to post pone the surgery once because I was not emotionally ready for this big surgery and fight my fears. But in August of 2014 we proceeded. It was a hard recover but I was so overjoyed to see my breast restored.
Cancer has taught me to trust God and not man. You dig in to you inner soul to find courage. You need to reach out to find others to help you when needed.
Family responses –
My husband has been a steadfast provider and supported me in my choosing an alternative and a natural supplement treatment plan to heal and restore my health. He trusted my decision and would provide the physical items needed to succeed with the Gerson Therapy. He took off time form work to care for me after the reconstruction but when it came to the emotional support that where he was at lost; overwhelmed emotionally I needed to look for outside support. So that’s where I had to reach out to others for help. These were my church friends. Sometimes I just needed someone to cry with and a hug. My being open about what I was going through enabled me to receive the support I needed. Texting and Facebook were helpful to know people were there.
I looked for a support group but there wasn’t a natural cure one that fit me. The Caring Bridge Internet Cancer Journal site enabled me to keep interested friends apprised about my journey, and also enabled me to get out what I was feeling inside. This was very helpful. I had a lot of fear and just needed my good Christian friends, who would listen to me and then gently remind me about God’s truths and His promises to care for me. I kept attended different cancer support groups and learned what I could and shared what I have been doing with nutrition. “Bosom buddies” in Beaumont “Forget me not” in Redlands
God, I believe, really directed me to follow the natural nutrition cure route. This is where the blessings of God shown through. Friends came alongside me and strangers I would meet along the way gave me encouragement. There were bills and tests, second opinions and things not covered by insurance provided for. I call these my mini miracles.
I was in tune to Gods leading and saw his blessings. He was and is my greatest support, and I grew much closer to Him through this trial. I didn’t ask "Why God?" Because I accepted it was His plan for my life, though the hardest challenge I have been given yet.
Yes I have scars but we all will bear our scars. We have to choose to continually release the emotional and physical pain to God. With His help, good health habits and monitoring I plan on staying Cancer free."
Breast Health Warrior
Pam Null AFID
M. Sanchez's Survival Story
"In December 2013 I was diagnosed with breast cancer, stage 30. I was only 3 years old, that news changed my life forever. I was sad, felt hopeless, scared, and thinking I was going to die! And so scared for was coming. By January 2014 I was doing my first surgery, removing the tumor, and thought it was all over because it was out of my body. But no! I was wrong. I prayed to my God to help me, that I needed Him more than ever. Then came chemo for 4 months and finally the time to remove my breasts. I did a double mastectomy and then other surgeries. I was more sad not having my breast anymore, but Dr. Duncan Miles changes all those feelings. He did my reconstruction of my breasts and did an amazing job. Incredible. I love them. They look very natural. I call him my Angel on Earth. Thank you Dr. Miles for everything. I have my life back. What a journey!"
M. Sanchez
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My personal journey
"I was an active 44-year old female, a physical therapist, mom to two teenage boys in their final years of high school, and a wife. Our family was very active, often hiking 8 miles a few times a month with my husband and boys, and running 2 miles three to five times a week. That all changed in April 2013 when diagnosed with Triple Negative Breast Cancer. Initially I was told it could be handled with minimally invasive treatment with lumpectomy and radiation, but my journey quickly changed. A month later I found myself scheduled for a double mastectomy and facing chemotherapy. Chemotherapy was more challenging than I had anticipated. After mastectomy and chemotherapy I wasn’t sure I even wanted breast reconstruction. Dr. Miles and his staff offered and provided me delayed breast reconstruction. What I could not see then but have learned in the process is the incredible kind, caring, and loving ways Dr. Miles and his staff gave me back my confidence, peace with my appearance, and renewed sense of self. Their attention to me went far beyond and much deeper than just my reconstructed breasts. I feel, and I believe, they reconstructed me with a faith-based attention to every part of my cancer recovery."
-Celina
-Celina
"For whom it may concern:
This all started in 2011, when I had a routine mammogram. The radiologist said that we had to have the mammogram redone. Following this, I had to have a biopsy done and all I could think was, “Please do not let her use the dreaded ‘C word’”. Unfortunately, the doctor told me that it was breast cancer, and my journey to find a solution began.
Upheaval became normal and because of my personality, I decided to consult seven doctors. One of my dear friends referred me to Dr. Duncan Miles. Bingo! I knew from the moment I walked into the doors that this was the doctor and staff I wanted to care for me.
I had already decided on a double mastectomy. After my research and experience with Dr. Duncan Miles and his staff, I knew he was the best reconstructive breast surgeons. I also knew that if I were to remove and reconstruct both breasts, it would be given a more symmetrical cosmetic outcome. This also meant that I would not have any future mammograms or ultrasounds, which would cause me to worry about cancer coming back.
I felt secure with my decision because Dr. Duncan Miles is the Head of Plastic Surgery at the VA Hospital. My father was a veteran who passes away in 2012, before my last surgery. I felt I had been adopted by his compassionate and caring doctor. Dr. Miles and his great staff now are my dear friends and co-workers. I am also blessed to be able to share and communicate with patients about the phases of diagnoses, denial, and all of the difficult problems that are inherent for these conditions and treatments. I feel optimism, determinism, and ability to share, guide and be an advocate with patients lessens the burden. I feel I am able to give them hope with the knowledge that I have gained through walking my own journey with Dr. Miles. I am proud to say that I am a survivor because of his encouragement and wisdom.
Sincerely your,
Monique"
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"1978. That was the year that breast cancer changed our families lives. My mothers youngest sister Jodie, (who I shared a birthday with, she was exactly 10 years older than me!) at 30 years old, had just had a baby girl, and while nursing, found a lump in her breast. Through a biopsy she found that she had stage 3 breast cancer with a year to live. Surgically, they removed both of her breasts. She underwent horrible radiation - burns and all - and even worse chemo. This was all going on while she had a newborn baby at home! She had reconstruction, which in those days meant skin was taken from her back to create breasts. I remember. Her saying how painful it was - she couldn't sleep on her stomach or back. - just her side. BUT, things got better! She ate healthier, exercised and even ran in a marathon! My 30 year old aunt/sister/friend recently passed away at 59 years old. While still too young, she beat that 12 month estimate by almost 30 years! Unfortunately, her cancer had metastasized.
Shortly after Jodie was diagnosed in 1978, my Grandmother was also diagnosed with breast cancer. Then my grandmothers 2 sisters. And, come to find out, my grandmothers mother also had breast cancer.
My mother, at age 49, was also diagnosed with breast cancer. Because she was afraid of the burns from radiation and the side effects of chemo, she chose NOT to have treatment after the mastectomy. Very quickly, her cancer metastized to her brain. Surgeons were able to remove the tumor. She then decided that radiation and chemo were her only options to slow the monster down. Unfortunately, it was too late. The cancer had metastized to her liver. My mother died on May 25, 1988. She was 50 years old.
As an only child, I still miss my mother everyday! She would have been 78 this year.
Cancer has taken the lives of all of the women on my mothers side of the family - with two exceptions: my cousin (Jodie's newborn daughter) who is 37 and me, at 57. Not surprisingly, we both tested positive for the BRCA gene. She had a double mastectomy in January. I had mine in July. We both decided that breast cancer was not going to rear its ugly head in our lives!
She lives in Colorado
My cousin and I see each other often, and we have both agreed that our mothers would be proud of us for doing preventative surgeries. I can't speak for her, but I suspected that I had the gene, but wasn't really worried about it. Just because you have the gene doesn't mean you have cancer! The reasons why I had the surgeries were many. My aunt, at age 59, was the catalyst. I promised her that I would take care of her daughter after she passed, and my cousin (her daughter) felt strongly, well, she was insistent - that we both do this. Although I did not have breast cancer, I had seen too many women in my family die much too early of the disease.
As I said above, I miss my mom everyday. I often wonder if she had undergone treatment after the first mastectomy, would she be alive today? I don't know. But I understand now. Facing cancer is scary. It was hard to make the decisions that I did. But I had choices. All the women in my family did not.
After speaking with many plastic surgeons, who didn't give me options - it was either implant, implant or implant! I found Dr. Miles' office. Even setting the appointment was so easy and pleasant! They worked around my schedule and stayed late to see me - how often does that happen with a Drs office? Never!! Dr. Miles and Tara gave me options - I had never heard about the TRAM flap. They spent quite a bit of time with me so I understood the pros and cons of implants vs TRAM. Overall, it was a pleasant experience. Dr. Miles even suggested what size would best fit my frame. He told me about the pros and cons of the TRAM flap surgery.
I decided on the TRAM flap - using my own tissue vs an implant. The surgery was a success, and the follow up has been phenomenal! I have been in their office once a week since leaving the hospital, and both their professionalism and great attitudes have never changed. They are genuinely vested in the quality of my care - coming in early, staying late - everything has been way beyond my previous experiences and expectations.
Ladies, research your options! Know that you do have choices! There is no "one size fits all" when it comes to surgeries. Go see Dr. Miles and his staff- you won't be disappointed!!"
S.S.
"I was diagnosed with breast cancer in October of 2012. I began treatment with six sessions of chemo. The side effects got progressively worse with each session. Chemo was followed by surgery. The surgery revealed much more extensive tumor than was first expected. I had 15 lymph nodes removed in addition to the radical mastectomy. I had 33 sessions of radiation. It took many months to regain energy and achieve healing. 2 years after the completion of all my treatments I was given clearance to see Dr. Miles for my reconstruction. We decided on the DIEP procedure followed by surgery on my other breast to achieve symmetry. I am currently healing from the DIEP surgery. Dr. Miles and his staff are very thorough, professional and compassionate. I am thankful for them. They have been highly recommended by personal friends and professionals."
Suzie W.
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Suzie W.
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“Under Re-Construction”
One Woman’s Prophylactic Bilateral Mastectomy Journey
“Abnormal right breast. Suspicious microcalcifications in a cluster.” What? How can this be? This is my very first mammogram. I have zero family history of breast cancer, so this should be normal.
Because of this finding in October 2014, I needed to get magnification views which I got the following month. “You will need a biopsy.” The stereotactic biopsy was painful. I feel like I’ve just been shot in the boob! Thankfully, the radiologist managed to get some of the microcalcifications within the first four core samples in early January 2015.
“Atypical lobular hyperplasia with apocrine metaplasia. Even with no family history, this places your risk for developing breast cancer at over 40%.” Atypia is bad news; it has the potential to lead to cancer. I had a coin’s toss chance of getting breast cancer. What should I do? I had some options: enhanced observation, lumpectomy, or prophylactic mastectomy. When I was a medical student, the answer was obvious to me: You lop them off and get new ones. But this was real, and it was happening to me. The decision wasn’t going to be as simple as I once naively believed it should be.
With enhanced observation, I have to live with the fear of what if the next biopsy is cancer? With a lumpectomy, my breast surgeon Sharon Lum, MD of LLUMC advised me that even with the small metal marker left behind from the needle biopsy she would be scooping out breast tissue almost blindly until all those suspicious microcalcifications were removed. With each scoop, she would decrease the volume of my breast on only one side. What if I needed biopsies of abnormal findings in my scans every six months? That still leaves the rest of my breast tissue, which could potentially become cancerous. And I would be responsible for the cost all of my reconstruction once I couldn’t stand the shrinkage and asymmetry in my breasts anymore.
A prophylactic mastectomy seems extreme to many because it entails cutting out breast tissue that has not yet become cancerous. I’ll get you before you get me, cancer! With her announcement, Angelina Jolie immediately became an advocate for women who wanted to be proactive and cut their breast cancer risk dramatically. There were risks and benefits to all these options, so it was a decision that I couldn’t make lightly.
I need more data to make sure I’m making the right decision for me. At the end of January 2015, I opted to get a genetic test as I have colon cancer and melanoma in my family history, and many types of cancers have been shown to be linked. While I waited for the genetic test results, I began my search for the best plastic surgeon in the area to do my breast reconstruction in the event that I decided to undergo a prophylactic bilateral mastectomy (PBM).
In early February 2015, I met Dr. Miles and his nurse Vicki for the first time. While I was in the waiting room, I was impressed by how aesthetically pleasing my surroundings were—a good sign that much care was paid to how things are put together at this office. Because I was thinking I’d kill two birds with one stone, I went in with the not uncommon idea of having a butt lift the same time I had reconstruction done. Dr. Miles explained that a simpler procedure would carry less risk for complications and provided me with referrals to other plastic surgeons so I could compare my options.
In late February 2015, I received my genetic test results. “MRE11A is a variant of unknown significance, but it is linked to the BRCA1 mutation which is known to significantly increase risk for developing breast cancer.” Clearly, my body cannot fix itself as I have deranged cells in my breast already. I guess this means the best choice for me is a PBM with reconstruction. Like many women who choose this route, I so badly wanted peace of mind because this would decrease my personal risk for developing breast cancer to 5%, less than half the risk of the general population. As Dr. Lum told me an oncology psychologist once said, “How much does peace of mind cost?” I am willing to pay whatever price for my own peace of mind. The pain will be very real and last awhile, but it too shall pass.
I looked at many southern California plastic surgeons’ portfolios and ultimately decided that I wanted Dr. Miles to do my reconstruction. I’m going to keep it simple and have the two-step reconstruction with tissue expanders and implants. No point in having more cuts on my body than I need, right? If I’m still not happy with my butt, I could always do more squats.
Not only were Vicki and Dr. Miles very personable and willing to answer all my questions, it was apparent to me that they genuinely care for all their patients. Additionally, I have other physician friends who had only positive things to say about Dr. Miles. Because people within an industry know who the best are within their own industry, we physicians know who the best physicians are to see for a particular medical need. Recommendations about surgeons from other doctors are the best recommendations I could possibly get. Dr. Miles’ reputation was excellent. I liked his office staff who, along with Dr. Miles, made me feel I belong. That is a very important factor because the nature of breast reconstruction necessitates a long relationship with your surgeon and his office.
As a fourth-year medical student during my elective plastics rotation, I had the opportunity to be the first assistant to a locally well-known plastic surgeon who once was the residency director for the plastic surgery residency program at LLUMC. The patient was a breast cancer patient who had her right breast removed ten years prior, so she was flat and fabulous on that side. Ten years later, she was diagnosed with breast cancer in her remaining breast. This time, she decided to undergo reconstructive surgery using her abdominal rectus muscles, what is called a bilateral TRAM flap procedure. Being on the operating side, the whole reconstruction seemed pretty easy (standing in the OR for about six hours) and magical. Wow! I can’t believe that he created new breasts out of abdominal muscles. This is amazing. Despite seeing the patient in her hospital bed the next day, I could not imagine how her body felt. All I had to gauge how she felt was her beaming smile and looking so happy that she had breasts again.
Now I’m a physician, who understands the different types of breast cancer at the cellular, anatomical, and physiological level, as well as the potential ramifications of each treatment option. One would think that having that understanding would make this decision easy. The accompanying emotional rollercoaster, however, was a ride I wasn’t expecting. There were the good times. My boobs will look like they’re 20 when I’m 80! They’ll be perky forever! And there were the not-so-good times. What if my nipples die? What if I have complications and this takes longer than expected? What if I lose sensation for the rest of my life? What if I developed breast cancer if I don’t choose to get rid of almost all my breast tissue now? The what-ifs tormented me, as well as my husband who is also a physician.
For weeks I alternated between these emotions. At the advice of a friend, I joined a closed support group on Facebook, Prophylactic Mastectomy, which is a community of women who have gone or are going through the same journey; they provide a wealth of information and support which helped give me a realistic expectation for how my PBM with reconstruction could turn out. Some of the pictures of complicated cases were frightening but as a doctor, I know these were not the norm. The love and warmth of these women from all over the US, the UK, Canada, Australia, and New Zealand was matched by their strength and humor. I learned a new word: foob, slang for fake boob. LOL!
As the time drew near, I focused on strengthening my core through yoga with Lisa Vest at Vasa the Studio and preparing my home for the weeks I would spend recovering. By Easter weekend, I was feeling comfortable with my decision. Maybe I could do this. I understand the risks and the benefits. And for me, the benefits outweigh the risks. I know I have excellent surgeons. I expect I’ll have a good outcome.
I had my reconstruction pre-op appointment at the end of April 2015. Dr. Miles took multiple pictures to document how I looked before my PBM and asked me detailed questions to make sure he understood what my desired result would be. The one thing he told me that made me a little sad was that because this is reconstruction—and not augmentation—I may not ever look as good as I looked at that point; however, he promised that he would do his best. I really appreciated his candor and was able to develop realistic expectations for my reconstruction. Further, I had both his and Vicki’s mobile phone numbers in case of any questions or concerns. Equipped with contact info and prescriptions for post-op meds, I now felt ready mentally, emotionally, and physically. I can do this! In a couple weeks, I’ll be on the other side!
On a bright sunny morning in May 2015 at LLUMC, Dr. Lum performed the skin- and nipple-sparing bilateral mastectomy; Dr. Miles then inserted tissue expanders under my pectoralis muscles, attached acellular dermal matrix (Alloderm) to my chest muscles, and placed four drains. I stayed one night at the hospital. I suffered through a lot of nausea and pain, which was mostly controlled with the medications ordered for me. The nausea was so bad that my plans for getting up a few hours post-op were shot. Early the next morning, I was determined to go home so I fought through the nausea and walked around the unit, as well as demonstrated that I could void on my own. I grinned a very large drugged up grin. I did it! I’m on the brighter side!!
Within minutes of my accomplishment, Dr. Miles came in to see how I was doing. He made sure that the drains were in place and there were no signs of infection. He explained what he did and asked if I had any questions. He told me that he would see me in his office in a couple days. I felt happy and at peace, and I looked forward to getting well. But oh, the pain! I’ve been flayed and had hard plastic objects with sharp edges shoved under my pecs. Thank goodness for modern medicine. Nurse, is it time for my next dose of Dilaudid…?
Two days later, Dr. Lum called me with my surgical pathology results. “I’m so happy you made the choice you did. They found just about every type of atypia and hyperplastic process in the book in both breasts. If we did enhanced observation, we would have biopsied you almost every year.” I’m so glad I made the decision I did. I dodged some serious bullets by getting rid of my ticking time bombs.
I had my first two drains pulled seven days post-PBM; my last two were pulled two days later. I blame the drugs I was on because I stretched a yoga stretch and popped one of the sutures that anchored my left tissue expander. The tab of this partially-filled expander began to rub rather painfully on the inner aspect of my left breast skin. Dr. Miles educated me on the mechanics of the expanders, gave me an additional fill to help flatten out the expander, and called in a prescription for some lidocaine patches to help alleviate the pain. I can feel pain and that means…I have retained sensation! He smiled and said he has the “odd patient” every so often. Are you calling me ‘odd’? If so, I’ll take it—I still have feeling in my breast skin! Two days later, Dr. Lum looked at me with surprise when I thanked her for doing such an excellent job with my mastectomy because I still had sensation. “No, it wasn’t me! That’s all you, your body.”
I kept a close eye out for any redness or warmth that might indicate infection, my number one fear. I began to telecommute for work two weeks after my PBM. My next few fills were uneventful other than my chest gradually grew at 50cc increments. This is so weird and fascinating. My foobs are going through puberty in a matter of weeks! When I hit the 350cc mark, my chest felt so heavy. I’m bending over and straightening myself out like the Dippy Bird. This is kind of crazy. I’m nowhere near my original breast tissue weight, so why does my chest feel so heavy?
Two weeks later on a Monday, I was brought up to 450cc in both expanders. While doing post-mastectomy exercises, I did something that gave me sudden pain. Oh, no! I popped some sutures! These “popped sutures” poked mercilessly at my tender breast skin from the inside. I could see the little bumps under my skin. I was in so much pain that I was in tears from morning to night. I made sure that I used lidocaine patches during the day and heavily drugged myself with Percocet and Valium in order to get some sleep at night. I thought I could hold out until the following Monday, but I couldn’t. I can’t take this much longer. I’m going to take my Wustof knife and cut them out myself!
That Friday morning, I left a pain-filled voicemail message for Vicki. Even though their office was closed on Fridays, she returned my call and said she would let the surgeon know immediately. Within minutes, Dr. Miles called me to ascertain what the problem was and what could be done about it. He met with me at his office later that day, examined me, and determined that I didn’t “pop any sutures” but rather exposed some suture knots that anchored my pectoralis muscle to the Alloderm he had sewn in to create a supportive sling for the final implants.
Because the Alloderm did not have enough time to mesh with my muscle, Dr. Miles couldn’t cut the torturous knots out. Instead he asked if I would be amenable to having some of the fluid drained to ease the pressure of the knots on the inside of my skin. Yes, anything! I’d do anything not to feel this pain anymore! He drained 60cc from my left expander, and I felt instant relief. He recommended letting my tissues rest for a week and a half before we start to bring the left expander back up to meet the right. You know, I named them, these suture knots. Dr. Miles looked at me with one raised eyebrow and a slight smile. I call this one Excalibur—after the Sword in the Stone—and this one is Sir Lance-My-Poor-Skin-a-lot. He laughed. Well, what was I supposed to do? I could cry, or I could laugh. I did both—I laughed through my tears.
Over the next two weeks, my left expander was very slowly brought up to match the other without further incident. By July 1st, my expanders were both at 450cc where Excalibur and Sir Lance-My-Poor-Skin-a-lot first made their appearance. Although those points on my skin were much better than before, they were still tender. Unlike many women who lose some or all of their sensation and feel muted pain, my breast skin still retained sensation. Miraculously, my nipples were still responsive to temperature and touch…the trade-off to the constant pain I suffered throughout the expansion phase. This gave me a whole new meaning to the phrase ‘no pain, no gain’….
I looked at myself in the mirror. Oh my word, I’m standing and walking like a Neanderthal. I need help to get back into some semblance of physical shape in order to move around like a normal person when I physically return to my offices so random people looking at me can’t tell that there are these large foreign bodies inside me. During the expansion phase, one has limited range of motion and strength so there are many muscles that become weakened during this long process. My back muscles became weaker as time went on. I began oncological physical therapy at Outback Physiotherapy. My physical therapist Lisa Olson Hunt, RPT did wonders for me during this phase of reconstruction when time seemed to move like molasses. In a couple weeks, I was able to drive short distances by myself again. Freedom! I returned to work at both my offices with lifting restrictions, but I was functioning again.
As some of my bosom buddies from my support group went through their second step in reconstruction (removal of expanders and replacement with implants), I longed for my day to come. My friends and family told me that I looked great. Yes, and that because I’m wearing clothes that hide what my Sponge Bob Square Foobs really look like. LOL! But thanks for saying that I look good with my Frankenfoobs. It helps me appreciate what surgical magic Dr. Miles can perform because no one could tell, at least outwardly, just how many changes my body had undergone.
I also call them my Iron Maidens, legalized torture devices that are sewn directly onto my rib cage. As my skin and underlying tissues slowly heal to create a suitable pocket for my implants, I must endure these boulders (as so many of my pink sisters liked to call them) for anywhere from four to six weeks. When I invite my girlfriends to touch them, their initial reaction is the same: Shock. “Oh, they’re so hard! You poor thing.” “Oh, my! They’re like 2-liter soda bottles that have been shaken up. OMG, they’re so hard! Now I understand why you want them out.” I honestly don’t think that anyone who has never had expanders could fully understand how un-fun these are, but I really appreciate the sympathy. They’re hard as rocks and uncomfortable as all get out. One day when I have time, I need to invent a device that could achieve the same goals and yet be less unpleasant….
The immediate relief that my bosom buddies report right after the remove and replace surgery is universal. I waited impatiently for the weeks to pass. How much longer do I have to have these spare foobs in? Right, four more weeks to go. I want my soft squishies…and soon!
Two more weeks to go. Ow! These foobs are starting to yank on my ribs. Just fourteen more days. I’m almost there. My scar tissue was shrinking the pockets, and the expanders had no choice but to move toward the path of least resistance. Remember how I popped the suture tab on my left expander early on? Well my left expander began to move laterally as the left pocket developed a little more scar tissue and began to shrink. Yay. I now have a foob making its way into my left armpit. Hmm, not the look I’m going for.
I had my step-two pre-op appointment with Dr. Miles a few weeks before my remove and replace surgery. We discussed my expansion course, specifically how I had to stop fills prematurely because of my Medieval friends crashing my foob party. Based on the width of the pockets, Dr. Miles selected four sizes of implants for me to “try on” in the OR; that was a total of twelve—three of each size in case there was one of any particular size that was defective. He discussed the possibility of drains in the event he needed to correct my outwardly mobile left pocket and more Alloderm for the upper poles of my breast because I had visible horizontal grooves across each breast area, the telltale lower margin of my pectoralis muscles. Oh, no…not the drains again! But you know, I’ll take drains for up to a week any day rather than wear these Iron Maidens any longer than I need to.
Alternatively, he could use fat grafts or a combination of both. Dr. Miles said he wouldn’t know for sure until he went back in to see what the situation when he was inside. Vicki took several pictures from various angles to document my final stages of expansion. She was so sweet and supportive, and was nearly as excited as I was to cross that finish line: “We just want you to be happy.”
T minus 7 days. I’m pretty sick of these spare foobs. I call them spare foobs because they’re a lot like spare tires. They’re hard, and they don’t quite fit right, but they do the job ok. I take the time to get my house ready again as I will have limited strength and range of motion.
T minus 2 hours before check-in. I’m almost there! Dr. Miles will take off my spare foobs and give me my high-performance smooth, high profile Mentor silicone rounds. What’s this? Oh, it’s Vicki just texting me to say she’ll be thinking about me today! I feel really good about today.
For Thursday September 3rd, I made a sign to wear as a surprise under my gown when Dr. Miles comes to visit me in pre-op. The nurse there laughed and thought it was a fun idea; she helped me fasten it to my chest under my gown. When he arrived, Dr. Miles greeted me by name with a big smile. With graffiti marker in hand he asked me to stand, brought my gown down from my shoulders, and stared in confusion for a few seconds. When the words “Under Re-Construction” registered, he laughed and said that made his day. I told him I made it just for him. He loved it so much that he wanted to put it on the OR.
T minus a few minutes! Time to go to the OR. Look! The sign I made for Dr. Miles is taped to the door of my OR. The anesthesiologist and nurse who were wheeling me to the OR got a good laugh and said that is such a great idea. Just before I was given my anesthetic, Dr. Miles leaned over one last time and said, “It won’t be perfect, but I promise I’m going to do the best I can.” I trust you. I never was perfect to begin with.
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I’m so sleepy…. Oh, I have my squishies now—yay! But where’s Dr. Miles? Can I talk to him before I go home? Apparently, Dr. Miles had spoken to me twice already in the recovery room. I just couldn’t remember. Nevertheless, he came by again and told me that he put in the implants that fit in my pockets best (550cc) and did fat grafting on me. I was still very sleepy but he smiled and said, “I think you’ll be very happy.”
Saturday morning of Labor Day weekend, my iPhone rings. Wow, it’s Dr. Miles! He wanted to know how I was doing. I’m doing extremely well. I’m sore from the fat grafting, but I’m doing really well. I told him that I was waiting for the 48hrs to be up before I could take off the dressings and have a look at myself. He said that it was fine to do so now. He reminded me of my post-op instructions and told me to call him or Vicki if I need anything. He again told me that he thinks I’ll be very happy with the results.
Time for the reveal! Whoa, I look like a mixed martial artist who got boxed in the foobs and abs. But I am victorious. I made it through this journey…and most importantly, they’re squishy and feel like my own breasts!
Writing this, I am four days post-op and have several more weeks of healing to go. But I can see beyond the already fading bruises and Dermabond-covered incisions. As a physician, I see the skill and expertise with which Dr. Miles reconstructed my new breasts. I’m astounded and impressed by his meticulously detailed handiwork and sense of artistry. I am so thankful and blessed that Dr. Miles was the one who helped me with my post-mastectomy reconstruction.
As a woman, I feel whole, confident, and beautiful.
~ AA
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