Michelle - Dr. Marga's March 2013 Mermaid of the Month

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This September marks my 12 year anniversary of my meeting with this "devil" they call Breast Cancer. I had just given birth to my 2nd child in June of 2001 and my husband and I were as happy as can be. Two months later one of my breasts felt a bit "harder" than the other. I immediately called my OBGYN's office and they dismissed it as related to the pregnancy. After a week had passed, I started thinking about my hard breast again. I decided to call again and they had me come to their office to see a nurse. Again, I was dismissed as it was more than likely a clogged milk duct. I knew in my heart that there was something wrong. I also kept seeing ads everywhere getting ready for National Breast Cancer Month coming up in October. I called and demanded to be seen again at which time I was able to see the actual doctor. That day my life would change forever. When the doctor felt my breast the look on his face was complete sorrow. For me it was a moment of sheer panic, mentally and physically. My world seemed to stop dead in its tracks while everything else moved at sonic speed.

The doctor immediately tried to take a needle biopsy which didn't pull up any fluid. He called radiology and demanded I be seen for a mammogram ASAP. I received a call the following day asking if I could come meet my doctor over lunch with the results. My husband, mother and I met the doctor in his office and he presented the news...clusters of calcifications, see a surgeon today. My surgeon was incredibly compassionate and was able to squeeze me in for a biopsy the next morning. I couldn't believe how quickly things were happening, I know now in my mind with 100% certainty that I had Breast Cancer. Friday morning was the biopsy which was excruciating to say the least. To prepare for surgery, I had to have a mammogram and then they would put needles called "fishhooks" in my skin where they saw calcifications. Unfortunately for me, it took them several times to get the right spot. I almost vomited and passed out by the end of the needle poking. And to think this was just the beginning! The biopsy went well and I was able to go home and rest that weekend. My surgeon said to stay by the phone Monday as he would call me with results. This was going to be the longest weekend of my life.

Monday finally approached and I received the dreadful call. I heard him say that yes it is malignant however; if someone were to get breast cancer this is the best one to get! Preliminary pathology reports indicated Ductal Carcinoma in Situ (DCIS) stage 0. I would need a mastectomy for sure but he said because it was such an early stage no other treatment should be necessary. I started feeling relieved in a sense, the not knowing was over. On Tuesday I had an appointment with a local Plastic Surgeon. He told me my options were a LAT or TRAM flap with several months of painful healing or an easy implant with a very quick recovery. I just had a baby and a 2 year old at home so of course I chose the easy implant. The next day I received another call from my surgeon saying things are not so good and based on pathology my cancer was invasive and I will also have to undergo chemo and radiation as well. I lost it then.

Tuesday October 2nd, 2001 was my surgery, the day I had my cancer removed in my eyes. My tumor was whopping 9cm and I had 4 positive lymph nodes. I stayed positive though as I had two young children that needed a mother to raise them. About 2 weeks later I met with my new best friend, my oncologist. He stated the facts; I was at stage 3, ER/PR - and Her2 +3 which is a highly aggressive cancer, especially for a 32 year old. The 5 year survival rate was about 50%. "But," he said, "that number is NOT you and therefore you WILL be here in 5 years and longer."

My Oncologist submitted my name to a clinical trial with a new drug that biologically targeted bad cells called Herceptin. I hit the jackpot my oncologist told me and got the "arm" with the new drug. So the grueling chemo began and lasted for 6 months followed by 6 weeks of radiation. I did have all the horrible side effects with chemo, lost hair and horrible dry heaving that would last 4-5 days. When I was finally feeling "normal" it was time for another treatment. I couldn't care for my children nor could I go to work. My husband would work at one job then come home, changed clothes, kissed the kids and go to his retail job. We would get through this.

One year later, after I had healed from my radiation therapy I was able to have my "switch" surgery. It went very well, however because of the radiation my skin was almost "see-through". My Plastic Surgeon sounded positive though.

Fast forward 10 years, 2 MORE kids later I am happy and healthy. No cares in the world until one day I started having pain on the lower part my reconstructed breast, which was strange since I had no feeling for 10 years and the only thing on that side is paper thin skin. About a week later the skin started turning purple and then I noticed a pimple size wound. I finally called my Plastic Surgeon who wanted me to come in that same day. He said it looked like I may have an infection, sent me to have blood drawn and also an Ultrasound. The Ultrasound showed fluid on top of the implant so he sent me for a MRI the next day to see if there was a leak in the implant which there had not been. At this point my pain had gotten really bad so my Plastic Surgeon decided to take me into surgery that evening. The date was May 25th, 2011, the beginning of a new crazy train ride. He removed the implant and put in a Tissue Expander "half-full" temporarily to give my skin some time to heal. He determined in the surgery that I had a hematoma which is strange as I had no trauma to my breast. I ended up actually liking the Tissue Expander better than my implant as it sat better on my body even though it was still a hard rock. Two days later I ended up in bed with a fever of 102. My Plastic Surgeon admitted me to the hospital for 7 days and put me on a high dose antibiotic called Vancomycin. I had to start seeing an Infectious Disease Specialist to determine what kind of infection I had and how long I would need to have the antibiotic. My blood cultures turned up negative for staph, strep and MRSA. It turned out to be cellulitis of the skin. I went home with a PICC line in my upper arm with twice a day IV drip for 1 hours of the Vancomycin in hopes to save the Tissue Expander. A week later I got my stitches out and then days later my incision opened up again as I would not stop draining from the incision. My Plastic Surgeon scheduled me to have surgery to clean out the capsule and re-stitch the incision with a drain in place.

A week later everything started looking good. Doc removed the drain and also my PICC line. Three days later my incision opened again and more draining! My Plastic Surgeon stitched me up in his office this time and said that the skin might be too damaged from radiation to ever heal again, and then he referred me to a Micro Surgeon an hour and a half away who specializes in hands and also does flaps, one a month. I went to see him and he agreed that the Tissue Expander needed to come out to let my body heal and a flap will need to be done. Did I mention that he is a nationally and internationally known hand Micro Surgeon? I decided to have my local Plastic Surgeon who I trusted to take it out since he is 5 minutes from my house. I had the surgery to remove Tissue Expander on July 8th. That was nothing like I had imagined. I had a "pocket" of emptiness that I had to "pack" with saline and gauze twice daily. Let me tell you, the home care nurse that came to assist almost passed out from the shock of what I looked like. My mother ended up repacking my wound...my savior. Three days later 103.5 temp! I was put back in hospital for another 7 days with an infection again. I tested negative for staph, strep and MRSA. This turned out to be GRN...not sure but the Infectious Disease doctor tells me it is from going in and out of hospitals? I was put on Cefemine in the hospital. My Plastic Surgeon took me back into surgery to do a debridement of my skin. The next day he didn't like the way it looked, he didn't think I had "clear" margins, so back in to do another debridement. He ended up doing a few more until I had a large open wound the size of a small cantaloupe over my left side. So now I look like I had a radical mastectomy, concave and everything except with my muscles exposed.

I was released from the hospital July 18th with another PICC line to drip from home twice a day and now a wound vac! I went home and was basically home bound for the summer. Since I could not go anywhere I did a lot of reading on the internet about breast reconstruction. I happened to come across a website with a thread speaking about surgery with these awesome surgeons in New Orleans, LA. I read the thread for days, signed up and started posting and asking questions. I had so many women tell me that you need someone that specializes in flaps, doing way more than one a month. I knew that flying to another state for surgery with 4 children under the age of 11 at home was impossible so I researched the Chicago area. I ended up going to one of the teaching hospitals to a well known Plastic Surgeon. I had a great appointment however I wasn't sold on the idea of having "students" helping with the surgery because of the complications I have already had. I had no room for error. I broke down one day and decided to call this Plastic Surgeon that the girls on the website were speaking of. What did I have to lose by speaking with her?

I had an hour long conversion with this wonderful caring soul, my new guardian angel, Marga Massey! I had made my decision after minutes of speaking with her; I knew she was my new surgeon. I would do whatever it takes to make this happen. She wanted me to fly down to New Orleans that next month to meet in person and possibly put a skin graft on my open wound. I was really freaking out at this point because I would be staying in New Orleans for 10 days, away from my kids and husband which I have never done before. I ended up flying down to New Orleans in August 2011. As soon as I saw her in her office she hugged me like she knew me forever. She looked at my wound and knew immediately that I still had infection even though my local Infectious Disease doctor released me. She would not be able to do my surgery the next day as anticipated and ended up putting me on two antibiotic drips to be able to operate on me by the end of the week.

Thursday of that week Dr. Marga was able to do a skin graft to cover my wound. She put a wound vac over the graft however I ended up being allergic to the tape and had to remove the wound vac. Dr. Marga ended up putting a "daisy" over my graft to protect it for a couple days of initial healing. Three months later I was scheduled for a bilateral GAP in New Orleans. I needed fat from both butt cheeks to make one small breast. The staff, nurses and doctors were amazing at St. Charles Surgical Center. I felt so incredibly pampered. They understand that this is a mentally painful experience so I believe they would do anything for you as they know we deserve it for the hell we have been through. My mother was with me at this point and my husband would come down after my surgery and accompany me home. Surgery went great! I was up and at'em in no time. I ended up being allergic to the surgical compression they gave me to wear after surgery, I broke out in hives. Not sure what is going on with my skin with this and the wound vac. A few days later my mom flew home and my husband flew in to stay with me in a hotel for a couple days until Dr. Marga gave the okay to fly home. Later that day in the hotel I felt that something just didn't seem right with my flap. It seemed a bit cooler than it was when I was in the hospital. I ended up calling the office the next day. I was called back almost immediately saying Dr. Marga was sending a driver to pick me up as she wanted me back to take a look. As soon as I walked in the hospital I was ushered to the pre-op area where I was told to put a hospital gown and the doc would see me momentarily as she was in surgery. Everything happened so fast at this point. IV put in, nurses and the doctors looking at my flap and then checking my stomach to see if I had excess skin. I was terrified as was my husband that I was losing all over again. I couldn't go through anymore failures. Next thing I know, I woke up in recovery. I apparently had a rare complication, my blood vessel had somehow twisted after I had left the hospital, however Dr. Marga and Dr. S were able to save my flap. Yeah, but I would need to stay in the hospital for another week. My husband couldn't stay the entire time with me so he had to leave. I ended up staying by myself and making wonderful friends with the nurses. My mother ended up flying back to bring me home.

Part of my flap was saved but the part that had the twisted blood vessel would need a baby flap. Off to New Orleans again in March of 2012 for another stage 1, DIEP. This seemed a bit harder but not by much. I couldn't stand up straight that first day but managed to the next which my nurses were surprised. No flap failure this time around, I think I have had my share of failures. In August I was finally scheduled for my stage two. I flew down but immediately had to evacuate as hurricane Isaac was going to hit the day after I was scheduled for surgery. The entire staff along with the patients were evacuating for a week. I had to rent a car as all flights were full that day and they were canceling later flights. What a long 13 hour drive. I ended up being scheduled later that week in Charleston SC as Dr. Marga drove there to avoid the hurricane. The surgery again went well. She would keep tabs on me to see how well the flap takes the fat grafting. We decided to schedule another stage 2 in November to add more fat. I was lucky; Dr. Marga was now able to perform stage 2 surgeries in Chicago! YEAH! Again, surgery went very well. And again, Dr. Marga kept tabs on me to see how well my flap took to the additional fat. Slowly my new breast was becoming me. I had my final surgery in February, just a little bit of fat grafting. I love my new breast, maybe even more than my real one. It is never cold, never hard and shakes like it should. Dr. Marga was and still is an incredibly warm and caring person. She became my friend and even listened to me cry on several occasions. I know I made the best decision I could ever have contacting her. She truly did save my life.

Now, as I type this I think how fortunate I am. Here 12 years later and no evidence of cancer with a rocking boob that is me, not a foreign object. I am thankful to be alive today and am proud of my tolerance for what I have gone through. I will happily tell my story over and over again especially if it helps push someone to listen and be conscious of their body.

Michelle Bansch

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