DiepCJourney Podcast
Two-time breast cancer survivor, Terri Coutee, will share first hand knowledge of her personal Journey through successful breast reconstruction. She chose DIEP flap but will talk about all options for surgery for those affected by breast cancer and facing a mastectomy. She will talk to surgeons, patients, and other health care workers to help the listener navigate their own personal Journey to make their best informed decsion.
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Episode 52: A Patient Story: Transitioning from Implants to DIEP Flap
03/27/2024
Episode 52: A Patient Story: Transitioning from Implants to DIEP Flap
Whether you have had a breast cancer diagnosis, have a genetic mutation placing you at high risk of getting breast cancer, have had or are facing a mastectomy due to either of these situations you will want to listen to this episode of the . The time has come to share a personal story of a woman I interviewed twice about her decision to have a prophylactic mastectomy and implant reconstruction. This is the continuation of her Journey. She came to a decision to exchange the implants she never quite felt comfortable in and transition to DIEP flap breast reconstruction and use her own tissue this time around. Margaret Tueller Proffitt has a delightful Instagram account and describes herself as a lover of books, learning and travel. She is a Mom to four, wife to one, and friend to all. I am honored to have my friend Margaret on the podcast. On a recent trip to San Antonio to do advocacy work for DiepCFoundation, I visited where I had my own reconstruction. I received a text from Margaret mentioning her desire to transition from implants to DIEP flap. More importantly, she told me she was considering PRMA and wanted to know who I would recommend. Knowing Margaret as I do, I gently guided her to contact . In the weeks following that text, I watched and waited until her surgery date, answering more questions, and guiding her through a very familiar experience to me, traveling for DIEP flap. There are so many similarities to our story. We had the same breast surgeon perform our mastectomy in Tucson where both of us lived at the time and Margaret still does. The similarities grew when I found out who would be the co-surgeon with Dr. Whipple the day of Margaret’s DIEP flap. , the surgeon who performed my DIEP flap, would be working alongside Dr. Whipple that day. PRMA uses the two-surgeon model for all their patients that have autologous breast reconstruction. I am delighted to share Margaret’s story with the listeners. She discusses preparations, traveling to and from her surgery, her support, and caregivers, where she stayed, recovery, and what she is looking for to for phase two surgery. Learn more about resources mentioned and topics related to the podcast: First video with Margaret: . Second video with Margaret: . Connect with those mentioned in the Podcast:
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Episode 51: The Many Facets of Microsurgery
03/13/2024
Episode 51: The Many Facets of Microsurgery
Have ever been you curious about the networking, conversations, and education that happens among colleagues at medical conferences? Or are there topics you see online but are not aware of the stories behind the social media posts from these conferences? I invite a returning guest to give you a behind the scenes look at one such conference, the annual conference of . We chose a few highlights and topics from the conference to share our experience so you can learn more about these rich learning events. Here to share the highpoints and a few of our favorite topics is one of the presenters at the conference himself, . He is the current president of in San Antonio, Texas who works with a that perform primarily tissue-based breast reconstruction for those affected by breast cancer. He is a welcome returning guest to the . In addition to his microsurgical prowess, he is . Dr. Chrysopoulo founded and is the creator of Toliman’s flagship award winning app, , the first shared decision-making app for breast cancer surgery and breast reconstruction. He begins by highlighting the diversity of global skill represented at the conference sharing the moving moment when the “Best Case/Best Save” presentations were made. This is the most attended session at the meeting. It is a packed room. This year’s winner was an especially inspiring case of a young Ukrainian woman whose lower face was reconstructed due to a horrific shrapnel injury and repaired by Dr. Adam Maciejewski of Poland. We touch on the keynote address from CEO and Founder of the Proximie Surgical Learning Platform System, Nadine Hachach-Haram. Dr. C points out the mission of the Proximie system is to expand surgical education and improve patient access to surgical expertise. We revisit other topics like breast sensation, shared decision-making, and patient advocacy. Links to these topics can be found below. Dr. C congratulates the ASRM team for putting together another impressive conference from global leaders in microsurgery. We are happy to share our experience. Learn more about resources mentioned and topics related to the Podcast: Connect with those mentioned in the Podcast:
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Episode 51: Lymphedema Treatment and Surgery for Breast Cancer Patients
03/01/2024
Episode 51: Lymphedema Treatment and Surgery for Breast Cancer Patients
This episode of the t is well-timed to publish on March 1, 2024, the first day of lymphedema awareness month. We hope you will share this in your community for breast cancer patients affected by lymphedema to provide them with the resources needed to treat this condition and let them know there are specialists in surgical treatment options as well. My guest is one such specialist. is Chief of Plastic Surgery and faculty surgeon at and works as a microsurgeon with , , in San Antonio. It is important for listeners to understand the function and importance of the lymphatic system. Dr. Fries begins by explaining this and what can happen during breast surgery of any kind. He describes how the pumping mechanism that is the lymphatic system is compromised with patients who present with lymphedema. Anything that damages or interrupts the lymph circulation can cause lymphedema as in axillary dissection and breast cancer surgery. Radiation adversely affects the muscle of the lymphatic system and can also cause lymphedema. Dr. Fries tells us some of the symptoms at the beginning are heaviness and swelling from the accumulation of fluid. This is the time to start intervening with treatments to prevent progression. Lymphedema is incurable and progressive. He shares with us that compression, massage, and pumps are affective in managing the progression of lymphedema and the burden of fluid that can accumulate. He points out the importance of patients taking a holistic approach to the management of lymphedema including maintaining a healthy weight. there is a real correlation between obesity and severity of lymphedema. We continue our discussion with surgical options both in the office and in the surgical theater. Dr. Fries and I touch on issues with insurance coverage, and he proudly shares that one of his own patients was an advocate working for insurance coverage for the treatment of lymphedema. Links we discussed in the podcast: PRMA lymphedema measurement chart: YouTube video of the Podcast with Dr. Fries: Dr. Fries Social Media Accounts: Instagram: Facebook: LinkedIn: Twitter (X):
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Episode 50: A Young Nurse and Her DIEP Flap Story
02/14/2024
Episode 50: A Young Nurse and Her DIEP Flap Story
This episode of the shares a fascinating story of a young woman who graciously and professionally takes us through her Journey from being diagnosed with breast cancer, cold capping, the affect on her family and young daughters, and to the story of her DIEP flap breast reconstruction. She never felt a lump. She was enrolled in a high-risk program based on her family history. Because of this, she found the cancer early. My guest is Lacey Terpstra-Reid. She is a registered nurse residing in Guthrie Oklahoma. In November 2022 she was diagnosed with triple positive breast cancer at age 33. Lacey has over 10 years of bedside experience as a nurse from working in a cardiac ICU where she cared for countless ECMO patients to her current role as an outpatient surgery recovery RN. She is a young mom to 3- and 2-year-old girls. She has spent this past year navigating her cancer treatments while chasing toddlers. Lacey was familiar with the science behind the In her work as an ECMO nurse she understands the parralels and how the oxygenation and blood flow that the T-Stat monitor used to monitor her flaps. Links to other topics we discuss in the podcast: with
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Episode 49: Fat Necrosis: What to Know and Look for in Breast Reconstruction
01/31/2024
Episode 49: Fat Necrosis: What to Know and Look for in Breast Reconstruction
With any type of surgery there are risks and possible complications. We are tackling a topic on this episode of the that is frequently discussed in the community served at DiepCFoundation. I reached out to an expert in the field for our discussion on fat grafting in breast reconstruction. founded in Spokane Washington in 2010 after completing her surgical training at the prestigious University of Washington Plastic Surgery Residency. She works with a group of five other surgeons performing various aesthetic and plastic surgery procedures including like DIEP flap. Preoperative patient education and counseling is imperative to minimize fears about fat grafting. Dr. Williams discusses how a skilled surgeon minimizes the occurrence of fat necrosis for both implant-based and autologous breast reconstruction. She describes how fat is utilized to achieve symmetry but also signs and symptoms of fat necrosis and what can be done for patients who develop this after a fat grafting procedure. Recent study from France: Article from the Cleveland Clinic: Social Media Links for Dr. Emily A. Williamson: Facebook: Instagram:
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Episode 48: NAPBC Standards in Exercise Oncology
01/19/2024
Episode 48: NAPBC Standards in Exercise Oncology
There is hard science to support the benefits of exercise for those who are affected by cancer of any kind. We will discuss this on this episode of the . The good news is that now the introduced new standards in January of 2024 for exercise oncology. Supporting this initiative is . Nationally there are around sixty-five hospitals and locations Maple Tree Cancer Alliance is partnering with to help patients and the medical community implement these changes to improve the lives of those affected by cancer. I am speaking to the Founder and CEO of Maple Tree Cancer Alliance, , PhD, and their Chief Medical Officer, . They discuss the origins of Maple Tree and how it has grown internationally to provide free exercise training to thousands of cancer survivors. Their program is based on science and evidence with more than seventy peer reviewed manuscripts on the topic of exercise and cancer recovery. Leading organizations across the world are supporting these efforts. We discuss the following organizations in our conversation: You can reach out to Dr. Wonders an Dr. Harness on LinkedIn here:
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Episode 47: BIA/ALCL Symptoms, Diagnosis, and Treatment
01/03/2024
Episode 47: BIA/ALCL Symptoms, Diagnosis, and Treatment
Millions of women across the globe have undergone breast augmentation using a medical device called a breast implant. This is done for reasons such as cosmesis, sometimes called enhancement of the breast, but also for trauma to the chest wall or for oncological reasons meaning breast cancer. Any surgery is not without risks. Using a medical device like a breast implant is not different. This is the focus of our discussion on this episode of the . My guest is a leading expert in the field. We are going to discuss the medical definition, symptoms, diagnosis, and treatment BIA/ALCL. This stands for breast implant associated anaplastic large cell lymphoma. It is an uncommon form of ALCL. I am speaking to . After receiving his Medical Doctorate from Pennsylvania State College of Medicine, Dr. Clemens completed his Plastic Surgery residency at Georgetown University. In 2010, he came to the in Houston, Texas where he completed a fellowship in Microvascular Reconstructive Surgery. Dr. Clemens is an active researcher whose interests include BIA-ALCL, long term implant outcomes, robotic-assisted, microvascular, and reconstructive surgery of the breast. He is the author of the book, . I am honored to list this book on the tab under Books. Links to Dr. Clemens social media links can be found here: LinkedIn: Facebook: Instagram: Twitter:
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Episode 46: DIEP Flap and the London Breast Meeting
12/20/2023
Episode 46: DIEP Flap and the London Breast Meeting
I feel twice fortunate to be speaking to my guest on this episode of the on two topics, her specialty of performing DIEP Flap breast reconstruction and her role as conference scientific chair for the . It was a phenomenal experience for me to meet her in person at the London Breast Meeting where I learned a great deal from the game-changers in breast surgery, oncology, and breast reconstruction. This gives me the ability to bring more in-depth information to the listeners and breast cancer community we serve at . I am speaking with , a consultant in plastic and reconstructive plastic surgery at , part of the NHS Foundation Trust in London. Marlene’s specialists interests are breasts and microsurgical breast reconstruction. She trained in London at East Grinstead before embarking on her plastic surgery training. She completed her training in microsurgery at Guys and St. Thomas Hospital. Marlene is a published author on the topic of breast reconstruction, facial analysis, and lower limb reconstruction. Marlene shares with us the history of when DIEP flaps were introduced in microsurgery. She outlines the reason it is often called the “gold standard” in breast reconstruction, and what area of the body microsurgeons use to reconstruct the breast for those affected by breast cancer. Who is a candidate for DIEP flap and what concerns do patients have about recovery for this surgery? She shares with us the importance of using ERAS protocol to enhance recovery. We then switch topics and discuss the origins of the London Breast Meeting. Marlene and I glimpse into the celebration of the tenth anniversary of the conference and what the focus will be. It all began ten years ago with an invitation from colleague and friend Jian Farhadi while she was completing her microsurgical fellowship. Jian wanted to begin a conference on breast cancer treatment, breast surgery, breast reconstruction, and aesthetic breast surgery. It has evolved into one of the premier breast meetings to attend and be part throughout the world. With that, I invite you to listen to the podcast as Marlene shares the goals and theme of the London Breast Meeting 2024. You can find Marlene See and her colleague Jian Farhadi on Social Media accounts here: Marlene See: Instagram: LinkedIn: Jian Farhadi: Instagram: LinkedIn:
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Episode 45: A Wife and Husband's Journey Through Breast Cancer
12/07/2023
Episode 45: A Wife and Husband's Journey Through Breast Cancer
In this episode of the I speak to Nikki and Sean, a married couple who share the poignant story of going through Nikki’s discovery of a genetic mutation and facing the shocking news of breast cancer. It is who we meet through our own breast cancer Journey that has a profound impact on a person’s personal life. Nikki and Sean are two of those people in my life. We experience a range of emotions together throughout the podcast because we have known each other for some time. This story needs to be shared in as much as it was difficult at times for us all. Nikki and Sean give us an honest, raw, touching account of not only learning she had a genetic mutation putting her at high risk of getting breast cancer but also finding out after prophylactic DIEP flap breast reconstruction she found her own breast cancer. What is it like as a couple to hear the news, share it with two young sons, find the humor in life while facing breast cancer, and how they pulled each other through it all. They talk about surgery, chemotherapy, radiation, and recovery and survivorship. There are valuable resources we wish to share with you that we spoke about in the podcast. You can gain access to all of them in the following links.
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Episode 44: Fingertip Smears Breakthrough in Breast Cancer Detection
11/22/2023
Episode 44: Fingertip Smears Breakthrough in Breast Cancer Detection
Mammograms are known to be the most common form of breast imaging to screen for breast cancer. This form of breast imaging is known to some to be uncomfortable and for some women culturally unacceptable. So, this interview sparked great interest in the work my guest is doing. , Professor of Forensic and Bioanalytical Mass Spectrometry at is my guest. Her work and interest in forensic science lead her to a serendipitous discovery published in a paper she authored with others entitled, “. Professor Francese and I met at the this year where she opened the conference with her presentation on this topic. I was keen to follow up on an interview with her. This interview along with slides she shares on the study can be viewed on the . Research requires funding. As one who has had numerous mammograms, I am taking it upon myself to share information to reach out to Professor Francese for anyone interested in contacting her to bring financing to this project. It is a favor I am happy to do for her and to the breast cancer community I serve. Simona Francese Biomolecular Sciences Research Centre, Sheffield Hallam University Howard Street S1 1WB, Sheffield, UK Email: [email protected] Tel: 0044 114 2256165 You can find links to her social media accounts here: Instagram: LinkedIn:
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Episode 43: The Drain-Free DIEP Flap Concept
11/08/2023
Episode 43: The Drain-Free DIEP Flap Concept
DIEP flap breast reconstruction most often requires surgical drains for post operative care. Patients often mention to me they are awkward, can become infected at the suture site where they are attached to the skin, and are cumbersome to hide under clothing after surgery when going out in public. My guest on this episode of the has been in communication with me over the past year in anticipation of his recently published paper, . , is a Consultant Plastic and Reconstructive surgeon with the NHS and private practice at . He graduated with distinctions from University College London Medical School in 2003 and completed his general surgical and higher plastic surgery training in London. Mr. Nanidis was awarded specialist fellowships at the Royal Marden and Queen Victoria Hospitals, where he spent two years specializing in microsurgery with a focus on breast reconstruction. He has a special interest in surgical innovation and was awarded The Life Sciences Entrepreneur of the Year Award from Cambridge University in 2013. His research interests include meta-analytical outcomes research, volumetric analysis of flaps and patient enhanced recovery pathways. He has published and presented his work nationally and internationally. We reference a paper by , . This was the impetus for further work and the recently published paper by Mr. Nanidis. You can find his work on the following social media channels: LinkedIn: Twitter: Instagram: Facebook:
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Episode 42: Clips, Mesh, and Sutures in Breast Reconstruction
10/18/2023
Episode 42: Clips, Mesh, and Sutures in Breast Reconstruction
from in Charleston, South Carolina, discusses the use of clips, mesh, and sutures used in breast reconstruction surgery on this episode of the . Many patients ask about these tools and devices. The information Dr. Craigies provides helps the listener understand their use and function in procedures like . This podcast cast is a remake of the . We want to present platforms to watch and listen for patients as they reserach options for surgery after mastectomy. Our aim is to provide this information so the listener can takes notes, pause, rewind and replay the episode to prepare questions in order to have a shared decision-making conversation at their surgical consult for breast reconstruction for those affected by breast cancer and facing mastectomy. You can reach out to their office on the account of their COO (chief operating officer):
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Episode 41: Achieving Wellness through Breast Cancer
10/04/2023
Episode 41: Achieving Wellness through Breast Cancer
My guests on the are often made through connections in the breast cancer community. This is the case for Amy Robinson. She was introduced to me by another survivor who like me, benefits from the practice of meditation as part of her survivorship after surgery, treatment, and recovery. As a treat at the end of the podcast, I ask Amy to take us through a three-minute meditation. You won’t want to miss it! My guest, Amy Robinson, created Radiant Healing Together in 2022 transforming the breast cancer experience with vital research, caring support, and warm community. Her 12+ weekly live events, curated experts, and exclusive 170+ on-demand recordings of events, meditations, and classes help you achieve your greatest wellness & vitality, wherever you are on the breast cancer healing journey. This includes: Warm supportive community with 12+ events/week Metabolic Approach to Cancer, Radical Remission Healer, Healthy Recipes & Cooking, RHT Expert Summits Leading-Edge Experts in Medical + Emotional Healing and Spiritual Direction Classes with Nutrition, Lymphedema, Pelvic Health & Alignment, Art Therapy, Meditation and Yoga Professionals 70+ breast cancer meditations from 5-60 min 100+ ON DEMAND events, interviews & classes You can find Amy and more about her work and resources here:
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Episode 40: Breast Imaging in Breast Cancer
09/06/2023
Episode 40: Breast Imaging in Breast Cancer
This will focus on breast imaging. The questions we will discuss are when to see a radiologist, types of imaging, and more specifics about each type. We will look at what the future looks like in medical imaging in breast cancer. I’m speaking to Dr. Randy Miles. as the chief of breast imaging at with oversite over the breast divisions clinical, research, and educational programs. He also serves as the associate director for research in the radiology department. He earned his medical degree from . Dr. Miles has achieved multiple awards throughout his career and served on medical missions in Haiti and the Dominican Republic. He completed his master’s in public health degree from Harvard School of Public Health. He completed his diagnostic radiology residency training at the where he served as chief resident. He went on to complete his breast imaging fellowship training at the Medical Center, . Dr. Miles has been the recipient of numerous research grants and has published over fifty papers. He talks nationally on his work in artificial intelligence, health literacy, and breast cancer disparities. Join us as we share these topics that are of interest to those in the breast cancer community served at . Connect with Dr. Randy Miles on his social media accounts here: Twitter: LinkedIn:
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Episode 39: The London Breast Meeting 2023
08/23/2023
Episode 39: The London Breast Meeting 2023
The will be held from September 7-9, 2023, at the Royal College of Physicians. It is a special opportunity for me to interview and be interviewed by my guest today on this episode of the . My guests and I discuss opportunities we will be involved in at the London Breast Meeting from the perspective of industry leaders, a world class microsurgeon, and patient advocacy. My guests are , CEO of , a medical device company that makes advanced molecular sensing devices like the for microvascular breast reconstruction like DIEP flap. I also welcome Vice President of Operations for Spectros. joins us in conversation to discuss his role as at the London Breast Meeting. Dr. C is the current President of in San Antonio, Texas. We engage in conversation about the he created. It is the first shared decision-making app for breast cancer and breast surgery. Dr. C is the Founder of , a digital health company committed to improving patient experience, outcomes, and satisfaction via empowering shared decision-making mobile technology. I would like to share that this podcast interview was conducted in early July of 2023. We discussed a topic regarding insurance coverage for DIEP flap breast reconstruction that has been a great concern for many, especially those patients affected by breast cancer facing a mastectomy who are interested in tissue-based reconstruction. I am happy to announce at the publish date we can share the news that coverage for DIEP flap and other autologous tissue reconstruction will continue to be covered by insurance allowing full access to reconstructive options for women. We share the excitement of attending the London Brest Meeting and connecting with colleagues across the globe to learn from gamechangers in oncological breast care and breast surgery. Be sure to listen to our fun London favorites at the end of the interview! You can follow my guests and find out more on their LinkedIn accounts here:
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Episode 38: Sisters, BRCA 1, Three DIEP flap Stories
08/09/2023
Episode 38: Sisters, BRCA 1, Three DIEP flap Stories
My guests on this episode of the are three sisters, all of who have a BRCA 1 genetic mutation, and all of whom had DIEP flap breast reconstruction at the same surgical practice, , Plastic Reconstructive Microsurgical Associates, in San Antonio, Texas. This is also the surgical practice I had my DIEP flap performed by in December of 2014. Elaine, the youngest of the three sisters, lead the way being the first to have her prophylactic DIEP flap with . After finding she tested positive for the BRCA 1 genetic mutation, she completed her surgery in late May of 2017. While she was in recovery, her sister, Eleanor, the oldest of the three, had her prophylactic DIEP flap two weeks later with . I met Emily, the middle sister, while we both lived in Tucson, Arizona. Emily traveled to San Antonio in 2017 to help her sisters out during their recovery. After we sat down together in Arizona in 2018, it was in June of that year Emily decided to move forward with her DIEP flap with Dr. Ledoux. Her story is especially unique in that she planned a pregnancy after her DIEP flap. She shares the beautiful story of the birth of her young daughter after her DIEP flap. This is perhaps one of the most emotional, delightful podcasts I have recorded. We talked about so much we had in common, especially our ties to PRMA. All three sisters are advocates for those who carry a genetic mutation placing them at a high risk of getting breast cancer. They share their story and what others can do to mitigate their risk of getting breast cancer. Links on Facebook can be found here: Link for LinkedIn Account:
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Episode 37: Shining a Light on Survivorship in Breast Cancer
07/27/2023
Episode 37: Shining a Light on Survivorship in Breast Cancer
Breast cancer is a scary word that no one wants to hear from their physician. When you’re diagnosed with breast cancer your mind can often go to, “How long am I going to live?” But because treatments have improved over the years, survivorship in breast cancer is a word we are hearing more often now in breast cancer communities, online, and in the media. On this episode of the , we are shining a light on survivorship with our guest, , who has “seen both sides as a breast cancer survivor and breast cancer surgeon.” She completed her residency in general surgery at Ohio Health Doctors’ Hospital and went on to complete a fellowship in breast surgical oncology at OhioHealth Grant Medical Center in Columbus, Ohio. Dr. Halaharvi practices at the OhioHealth Physician Group. She shares her personal story, the procedures she performs for her patients including those with ptotic (droopy or sagging breasts) called the goldilocks mastectomy, her procedural practice in clinic for the newly diagnosed, and what she does in her personal life to achieve work-life balance. Links and social media accounts to find out more about Dr. Halaharvi
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Episode 36: Sexual Function Concerns in Women with Cancer
07/12/2023
Episode 36: Sexual Function Concerns in Women with Cancer
When our bodies are physically changed because of breast cancer, it has the real potential of affecting sexual health. There are multiple layers to look at when a person presents with sexual dysfunction. In other words, the natural process of the act of sex has been disrupted due to treatment, surgery, the emotional impact of cancer, and other considerations. My guest on this episode of the is an expert in this field. I want to welcome , professor of obstetrics and gynecology at the . Her Clinical Interests include Cancer Survivorship, Female Sexual Dysfunction, Female sexual function, Gynecologic Cancers, Integrated Women’s Health, and Medical Ethics. I am pleased about our common connections and would like to mention that I am conducting this podcast because of being asked to help in gathering information on the from patients in the community I serve. We are going to take an in-depth look at that program with Dr. Lindau today as part of the sexual concerns in women with cancer. Dr. Lindau is also the Founding chair of the on female sexual health and cancer. She also created, , a platform where every woman – and everyone who loves and cares for women – can learn truths about sex. On the podcast “,” Dr. Lindau tackles fully the problem of sexual health not being discussed among many physicians, no matter what discipline they specialize in. You can find Dr. Lindau on LinkedIn here:
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Episode 35: Achieving Symmetry and Understanding Fat Grafting in Breast Reconstruction
06/28/2023
Episode 35: Achieving Symmetry and Understanding Fat Grafting in Breast Reconstruction
Achieving symmetry and understanding fat grafting in breast reconstruction are topics patients frequently ask about. I reached out to an expert in the field. My guest on this episode of the is Dr. Tim Matatov of in Phoenix, Arizona. Dr. Matatov is a board-certified microsurgeon who performs procedures such as implant breast reconstruction, several autologous reconstruction procedures, autologous meaning using the patient’s own tissue to reconstruct the breast, nipple reconstruction, and a variety of other breast reconstruction procedures. He works with a team of two other surgeons, and . We discuss mastopexy, or breast lift, in the setting of breast reconstruction. Achieving symmetry in the contralateral breast for a unilateral DIEP flap is important to the patient. It serves a functional purpose as well when wearing wardrobe items like a bra. He points out the psychological benefits to the patient since this becomes a quality of life and self-image concern for women. Dr. Matatov outlines the various names and details of mastopexy procedures and why one might be chosen over the other for optimal patient outcomes. Dr. Matatov shares how important it is to have an open discussion with patients about managing reasonable expectations. Dr. Matatov continues the discussion with fat grafting. He points out that a lot of the techniques and percentages, and how it all works is for a majority of cases, theoretical. He states there is not any hard proof that one technique or device works better than the other. There are studies that are peer-reviewed but not randomized and controlled to a degree which backs up his statement on fat grafting methods. However, Dr. Matatov feels it is a very effective part of the breast reconstruction process. He points out again that managing patients’ expectations is very important in this step of breast reconstruction. It often takes more than one fat grafting procedure. Techniques, patient outcomes, value of patient support groups, are discussed further in the podcast. Social Media accounts to find out more about Dr. Matatov and his practice:
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Episode 34: Patient Advocacy: Living with Stage IV Metastatic Breast Cancer
06/14/2023
Episode 34: Patient Advocacy: Living with Stage IV Metastatic Breast Cancer
My guest today on the has a blog and website titled, No Half Measures, Living Out loud. 2017 was a pivotal year in the life of my guest, . Early that year, while dual nursing her twin boys she felt a lump in her left breast. The next few months involved multiple appointments with radiologists, oncologists, and surgeons. Abigail was diagnosed with metastatic breast cancer. Abigail Johnston is a wife, mother, writer, educator, earned her JD after completing law school and is a patient advocate. She begins the interview by sharing her experience at the held in early 2023. She sat on . With all the complexities on that topic, she felt the FDA worked hard to make sure her voice was heard. Attending conferences allows her to meet other patient advocates and for Abigail and me, this is always one of the highlights of traveling to these meetings. We met in person in December of 2022 at the San Antonio Breast Cancer Symposium. As she says, “Those in person hugs, nothing is better, honestly.” She talks about the idea of “finding a purpose after a serious trauma.” Abigail states that trauma changes you fundamentally as a human being. The question becomes, how do you carry that trauma? Advocacy is the way Abigail has found some purpose in “the derailment of her life.” It has become an overarching theme in her life. This was a podcast interview that felt comfortable, informative, and one I will go back and listen to myself often. You can reach out to Abigail and find more of her work in the following links: Blog: Bio: Contact Information: Place to find Abigail’s writing and work:
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Episode 33: Democratization in Microsurgery: The Proximie System
05/24/2023
Episode 33: Democratization in Microsurgery: The Proximie System
Democratization is a noun. The meaning of democratization as it pertains to microsurgery is the action of making training and education available through technology, in this case, microsurgery in breast reconstruction. The chosen field of microsurgery requires hours of training and practice. Observing colleagues perform this sophisticated and complex surgery increases their own skill set with the primary goal being improving patient outcomes in breast reconstruction. I invited back to the two internationally known microsurgeons. practices in Sydney, Australia and is a fellow of the . He has a keen interest in microsurgery and did his training overseas to achieve this status. He is also trained to do robotic assisted surgery. is the current president of in San Antonio, Texas, and founder of the , a free shared decision-making app for breast cancer surgery and breast reconstruction. He holds a board certification in plastic surgery. As he states, board certification matters in your relevant field. Dr. C underwent further training in microsurgery that included burns and hand which led him to microsurgical breast reconstruction. It is the core of his practice with his team member surgeons at PRMA. Dr. Joe invited Dr. C to join him live in the operating theater using the Proximie technology system to observe a robotic assisted DIEP flap breast reconstruction. When you hear the term “mate” from a London born microsurgeon, Dr. C, referring to Dr. Joe in Sydney, you know they have become colleagues in surgery as well as friends who have a passion for providing the best outcomes for breast cancer patients in breast reconstructive surgery. I invite you enjoy the conversation and explanation of how these two cross-continental surgeons seamlessly joined each other via the Proximie technology system in the operating theater discussing, learning, and sharing their combined skill in a robotic assisted DIEP flap breast reconstruction. Dr. Joe and Dr. C both say this is the way forward, democratization in surgery, allowing more surgeons to train in real time, avoiding the need to travel and take them away from their patients and time in clinic and the OR. Resources discussed in the Podcast. Dr. Joe’s Dr. C’s Connect with Dr. Joe Connect with Dr. Chrysopoulo
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Episode 32: Patient Advocate, Storyteller, and Lobular Breast Cancer Survivor
05/10/2023
Episode 32: Patient Advocate, Storyteller, and Lobular Breast Cancer Survivor
is a breast cancer survivor who deals with a lot of effects from treatment and being diagnosed with lobular breast cancer at a very young age. But she excitedly begins our conversation by saying her pain melted away at the when she was able to meet patient advocates in person for the first time. Social media connects many of us but the conference we both attended in early December of 2023 allowed us to sit down together to share intimate conversations, ask each other how we are doing, and share our advocacy work. I was fortunate to be one of those advocates to finally meet her in person at the meeting. Megan-Claire experienced strange symptoms for about two years that were left without a diagnosis. Her mother had ovarian cancer when she was pregnant with Megan-Claire. She states she felt this made her a miracle baby for her parents. Megan-Claire felt certain at some point in her lifetime she would get cancer because she has a strong history in her family. Because of this she was able to get a mammogram at age thirty-five and have it covered by insurance. Being hyper aware of her body due to family history of cancer, the signs she saw were concerning. She noticed tiny green bruising on her legs, weight gain, loss of hair on the left side of her head, and a “zit” on the outside of her left breast. She knew something was not right. Megan-Claire shares with us she would like the medical community to be more aware that black women and other women of color will present with different symptoms that her white counterparts. This leads us to a more in-depth conversation on health disparities, implicit biases in breast cancer care and what Megan-Claire accomplishes in her community and advocacy work to improve the communication between the patient and physician. Megan-Claire will be participating in a community event to connect patients and provide these resources June 15-21 of 2023. The event and other ways to join Megan-Claire on social media can be found here. started by the FDA through the . Megan-Claire’s Linked Account: Breast Cancer Program Director:
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Episode 31: Project Restored after Breast Reconstruction
04/26/2023
Episode 31: Project Restored after Breast Reconstruction
The art of microsurgery transcends the work behind surgical loupes and microscopes when a breast cancer patient has breast reconstruction after loss of breasts due to a disease. My guest on this episode of the are two microsurgeons who worked together to create and selected several of their patients to participate in this unique artistic endeavor. Our key guest today is one of those patients, . Chelsey shares the story of her diagnosis at the very young age of 33. She has an extensive family history of breast cancer and felt she had a wealth of knowledge. However, when she was diagnosed with triple negative breast cancer, she tells us she had never heard of it before. Chelsey raises awareness not only for this subtype of breast cancer but also for those with metastatic breast cancer. A year after her initial diagnosis and breast reconstruction, she was diagnosed with metastatic disease. Her connection to and the program brought Chelsey to know she would be in caring and trusted hands with the community that NYBRA had set up. She felt both seen and heard. Chelsey states it is the most important thing in your breast reconstruction decision process. Chelsey shares, along with Dr. Israeli and Dr. Bank, the poignant moments and process of Project Restored.
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Episode 30: Classical Art & Drawing Concepts in Breast Reconstruction
04/02/2023
Episode 30: Classical Art & Drawing Concepts in Breast Reconstruction
We are speaking about the art and practice of microsurgery as it relates to breast reconstruction surgery in this episode of the . Microsurgery is a specialty of plastic surgery requiring training beyond plastic surgery residency. Microsurgery involves moving tissue and blood vessels from one part of the body to another to repair or replace tissue that has been affected by disease or trauma. Carefully dissecting blood vessels from a donor site, microsurgeons then place the tissue from the donor site to the new site and tie blood vessels together at the new site under high powered microscopes. One form of breast reconstruction is the DIEP flap. The donor site is the tummy tissue. This abdominal tissue is disconnected, and the new recipient site is the breast area that has been affected by breast cancer. My guest is a microsurgeon who frequently and successfully performs this type of breast reconstruction surgery. is a Professor of Plastic Surgery and Director of the Breast Reconstruction Program at . He has a keen interest in classical drawing. The parallel between classical art, drawing and breast reconstruction is our topic of conversation today. You can view some of his drawings on his Instagram account at
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Episode 29: Breast Cancer Answers from a Medical Oncologist
03/15/2023
Episode 29: Breast Cancer Answers from a Medical Oncologist
In this episode of the I speak with a medical oncologist. has her own podcast called, with Dr. Teplinsky. She is Head of Breast Medical Oncology and Clinical Assistant Professor of Medicine at The Icahn School of Medicine in Mount Sinai, NY. She has a robust and education speaking about key topics in cancer care and survivorship. She addresses the consequences of a cancer diagnosis and the very real occurrence of patients playing the “blame game” thinking they may have caused their cancer. She addresses risk factors and how risk factors are not causal. Her favorite quote in her office and what she shares with her patients is, “Inhale the future and exhale the past. I ask her about research in alcohol consumption as it relates to breast cancer patients. Dr. Teplinsky discusses those risk factors and what we need to be aware of. She carefully explains the affects of cancer treatment and how it can vary from patient to patient. Coordination of care with your medical team to manage these side affects is important. Working with your oncologist, radiologist, surgeon, and physical therapy among others becomes important in treatment management. Dr. Teplinsky shares her sage advice on using social media for breast cancer information. She also shares her thoughts on the financial toxicity breast cancer patients can face. You can find her on LinkedIn at .
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Episode 28: A Breast Cancer Journey of Resilience
02/27/2023
Episode 28: A Breast Cancer Journey of Resilience
, Adjunct Professor at Trinity Washington University in Washington, DC is an author, educator, breast cancer survivor, and woman of faith. She personifies resilience. Neosho is my guest on this episode of the . We met as patient advocates at the in December of 2022 and found our lives had many parallels. We talk about these parallels through our Kansas heritage and our own personal Journey through DIEP flap breast reconstruction. Neosho has experienced homelessness and going through breast cancer treatment at the same time. She writes about her life’s experience in her book, . Her faith has sustained her and grounded her throughout her life. Weaving in her healthy sense of humor she tells us it has been her strength and foundation. She is a first-generation college graduate and proud alumni of Howard University where she earned her Ph.D. Neosho is a volunteer as a sharing the knowledge she gained through her own breast cancer treatment and surgery. She also volunteers in the DC and . Our conversation wraps up as we share our Kansas connections. I am honored to share the story of her uncle, , a former mayor of Chanute, Kansas. Connect with Neosho on LinkedIn:
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Episode 27: Is Access to DIEP Flap Breast Reconstruction in Danger?
02/08/2023
Episode 27: Is Access to DIEP Flap Breast Reconstruction in Danger?
Access to DIEP flap breast reconstruction is in danger. Why? Because of coding changes to insurance, it may become out of reach financially for some women. This is the most advanced form of breast reconstruction available, and I felt it was time to address this concern. I begin by sharing my own story and how I was positively affected by making the choice to have DIEP flap after a second breast cancer diagnosis. I am one of thousands of voices who need to be heard, to be honored as we work to reverse this decision so access to this type of surgery can continue to be available. It was important for me to hear from the voice of a microsurgeon who is passionate about doing DIEP flaps and advanced microsurgical procedures to understand from her perspective why the coding changes are concerning to her for her patients. I invited my guest, to address the topic in this episode of the . We want the listeners to have resources to other entities who have set up advocacy pages so that you can share your voice, your story, so decision makers can see how important this choice in surgical options is for those affected by breast cancer. The following list is websites set up to help bring awareness to this coding change and what you can do to help.
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Episode 26: Breast Cancer Through the Lens of a Nurse Navigator
01/25/2023
Episode 26: Breast Cancer Through the Lens of a Nurse Navigator
We are discussing a topic that will resonate with many of our listeners who have been affected by breast cancer. Whether you are the patient, caregiver, physician, or surgeon we are going to discuss navigating the complex Journey of being diagnosed with breast cancer through the lens of a nurse navigator. How does one seek this help at the cancer center you are being treated at? We will discuss working during a diagnosis and while in treatment and living a full and purposeful life as a survivor after breast cancer and breast reconstruction. We will also unpack the often challenging topic of palliative care and end of life for those who have metastatic disease. My guest on this episode of the is , Co-Founder of (Adademy of Oncology Nurse & Patient Navigators) and University Distinguished Service Professor of Breast Cancer and the . These are only a few of Lillie’s accomplishments. She has many and is a well-known, well-respected voice in breast cancer and breast reconstruction. I am delighted to share this conversation with you. It felt so comfortable for me to record it for our listeners.
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Episode 25: Flap Monitoring in Breast Reconstruction and the History of the Guinea Pig Club in Plastic Surgery
01/11/2023
Episode 25: Flap Monitoring in Breast Reconstruction and the History of the Guinea Pig Club in Plastic Surgery
Since having DIEP flap, a plastic reconstructive surgery technique performed to rebuild breasts after a mastectomy, I have been fascinated with the field of plastic surgery and topics related specifically to breast reconstruction. I interview , CEO, of Spectros for the first episode of season three of the . Rob shares the story of his visit to the Queen Victory hospital () in England. He was able to visit Queen Victoria while attending the in late 2022. While at the conference, Rob demonstrated the developed by Spectros. T-Stat is used to monitor flaps in breast reconstruction and in our conversation, we discuss the efficacy of the T-Stat system and why it improves the surgeon’s success rate of flap procedures like the DIEP flap. We begin our conversation with the history of the Queen Victory Hospital treating burn victims during WWII. A surgeon from New Zealand, Archibald McIndoe, came to the Queen Victory hospital via a chance meeting with his cousin, Sir Harold Gillies, often considered the father of plastic surgery. Seeing the severe burn injuries sustained by pilots in WWII, McIndoe saw what his cousin, Sir Harold Gillies did using tube pedicles to rebuild the faces of WWI soldiers and expanded on this technique by treating the soldiers at Queen Victoria. He took healthy, unburnt tissue from other sites on the soldiers to reconstruct burnt tissue. He nurtured this community, and these airmen were considered “guinea pigs” as part of his pioneering work in reconstructive burn surgery. These young airmen treated by Archibald McIndoe became known as the Guinea Pig club. He took them under his care not only during their physical healing but also treating the psychological impact of having disfigurement from these burns. There were over 600 of these airmen. Rob shared some of the photos hanging in the halls of QVH taken during his visit listing the members of The Guinea Pig Club, Archibald McIndoe, and the operating theater. We go on to discuss modern day techniques used in microsurgery and how Rob became the CEO of Spectros. Flap monitoring is an important question many patients ask about. The T-Stat monitoring system is at the bedside of the patient after DIEP flap breast reconstruction to ensure that the blood flowing into the breast and out of the breast is monitored. The physician performing the DIEP flap has 24-hour access to real time data provided by the monitoring system via a small sensor placed on the flap to monitor it while the patient is in hospital after surgery. We went on to discuss how T-Stat can be used regardless of the coloration of skin. I hope this educational podcast discussion will encourage patients to ask about the type of tissue monitoring system their surgeon uses to monitor flaps during their initial consult for breast reconstruction. Many thanks to Rob for educating us about the benefits of the T-Stat system by Spectros.
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Episode 24: Thought Leaders in Shared Decision-Making
12/18/2022
Episode 24: Thought Leaders in Shared Decision-Making
The final episode of Season 2 of the DiepCJourney podcast brings together thought leaders in shared decision-making. This fireside chat includes the members of the (WHIS) . This team was formulated and is led by who founded WHIS in 2015. Taking a Good Health and Wellbeing (SDG3) approach to person centered health, Gareth Presch recognized that there were five key cornerstones of which all needed to be supported, at a the same time, by the same people: Health, Economy, Education, Environment, and Ecosystems. He discusses his work by looking back at the accomplishments and milestones met in his 2022 global travels, speaking engagements, and participation in the in Katowice, Poland in June of 2022. connects people to knowledge. She received training as a genetic scientist at Harvard and she is using her expertise through the project she created to find access to care for those across the globe. Her work has transformed the lives of cancer patients. You can read more about her story with one patient, through personalized treatment. is the current president of PRMA in San Antonio, Texas. He is a reconstructive microsurgeon performing breast cancer surgery primarily using the patient’s own tissue to reconstruct breasts lost to mastectomy. is an entrepreneur. He is the Founder of and through Toliman developed the first shared decision-making breast cancer surgery app, . His innovations brought him to Katowice, Poland with his daughter to present the Breast Advocate app at the World Urban Forum along with Gareth. I am proud to work with and know these thought leaders as we continue to understand the needs of global digital health, personalized care, and building communities through our collective efforts. As Susanne stated, “Movement is the greatest facilitator”. Dr. Chrysopoulo stated that the only constant we have is change. It is through incremental changes as change agents we can work to improve health care through shared decision making and promoting and developing best practices in health care communitcation.
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