Dr. Marga is a board certified Plastic Surgeon with additional training as a Certified Lymphedema Therapist. She is the Founder of the National Institute of Lymphology and serves as a Medical Advisor to the Norton School. Dr. Marga promotes the the highest standard of lymphedema care for surgical patients nationwide.
Cheri Varvil - Dr. Marga's May 2009 Mermaid of the Month
I live in Lawrence, Kansas. I have had insulin dependent diabetes for 24 years and have used an insulin pump for the last five years.
I learned that I had DCIS after two mammograms and a stereotactic biopsy at three sites in my left breast. Based on the reading I started doing, it seemed that I would likely only have to have the DCIS sites removed, since the cancer cells were not invasive; so, I was shocked and extremely dismayed when the first doctor I consulted announced that I needed to have a mastectomy because the DCIS was extensive and the cancer cells were stage two and three. I talked with another doctor, who was more willing to talk about other options, but ultimately agreed that the safest choice would be a mastectomy. I had done a lot more reading by then, and learned about the DIEP Flap procedure for reconstruction in Dr. Susan Love's Breast Book (a wonderful book for women dealing with breast cancer), who talked about it as an option and talked about Dr. Massey's practice partner, Dr. Allen, as the doctor who developed the procedure. Dr. Love made the point that it is a very complicated procedure and it is important to find a surgeon who does it a lot. I visited their website for Microsurgical Breast Reconstruction, and the more I read about the diep flap, the more it seemed like the option I wanted. I have felt for years that I would never want an implant; and the tram flap procedure, while at least using your own tissue, has the risk of loss of muscle in the abdomen – an area of my body that has always lacked tone anyway. As I read about it on other websites, however, I also learned that my diabetes might rule me out as a candidate for the procedure.
The plastic surgeon I was referred to in Kansas for consultation simply said that he didn't do that procedure, that I would have to go to Houston for it, and talked to me about implants or the tram flap procedure. He seemed to think that would be a possibility for me. He also told me that it would be easier for him to do both breasts, even though the DCIS was only in one. Further research indicated that doctors in Kansas didn't seem to know much about perforator flap procedures, and I couldn't find anyone who did them. After a lot of thought, I came to the conclusion that I didn't want either of the other procedures; and that I would simply have a mastectomy and no reconstruction if I could not have the diep flap procedure even though there are no doctors in my area who perform that procedure.
My adult daughter encouraged me to at least ask for what I wanted, so I completed a request for information on the Microsurgical Breast Reconstruction Website. I was fairly obsessive in my reading and research at this point, so I did this on the Saturday before Labor Day, knowing I would have to wait for a response. I stated that I have diabetes, but that I am generally healthy and asked whether I might be a candidate for the diep flap procedure.
It is hard to describe the feeling of amazement, hope and relief that I felt when I received an e-mail from Dr. Massey containing the words "I do think we can help..." and asking my permission to have her nurse call me after the holiday. She responded on a Saturday on a holiday weekend! (She has since told me about doing a surgery on a holiday).
Dr. Massey's staff is just as amazing. Once I talked to her nurse Jill Payne, I felt I was in very good hands. Jill coordinated a very complicated set of events to schedule me for surgery and get all the preliminary procedures done, some of which had to be done in Charleston, where I went for my stage one surgery. She also advised me about having information sent from my endocrinologist who sees me for my diabetes, and about finding a "helper" doctor in Kansas to see me after surgery for any needed care.
I didn't get to meet Dr. Massey in person until the evening before the surgery; but when I did, she made both my husband and me feel very comfortable and hopeful. I think we spent more than two hours discussing all our questions and possible outcomes. She supported removing just the breast with the DCIS, and she was very supportive of my keeping my insulin pump active during surgery - and even contacted the hospital endocrinologist for any needed support. My endocrinologist in Kansas was surprised and pleased that Dr. Massey and the hospital didn't make me remove the pump during surgery, as they had warned me might happen because of their previous experience.
My surgery went well, and my experience at Roper Hospital was very positive. The nurses seemed so committed to providing great care and support; it seemed like a mission for them. Dr. Massey saw me before stage two and for stage three at her beautiful new office in Chicago, as it is a little closer to Kansas. She has been wonderful each time. She really listens to what is important to me as a patient and adjusts her procedure to take it into account. She has treated us like friends while maintaining a professionalism that instilled in us a great confidence in her ability to help.
And my outcome has been great! I have had no complications from either of the surgeries, and people who see me tell me how good I look. I saw my primary care doctor recently (the only person besides my husband and Dr. Massey who has seen the bare skin finished result), and she told me that my breasts look really good.
I am very thankful that Dr. Massey responded to my inquiry that day almost a year ago. It has been a privilege to have her as my physician. I truly admire the work she is doing.