DiepCJourney Podcast

My guests on this episode of the DiepCJourney podcast 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, PRMA, Plastic Reconstructive Microsurgical Associates, in San Antonio, Texas. This is also the surgical practice I had my DIEP flap performed by Dr. Minas Chrysopoulo in December of 2014.

Elaine, the youngest of the three sisters, lead the way being the first to have her prophylactic DIEP flap with Dr. Peter Ledoux. 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 Dr. Chet Nastala.

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:

Eleanor Ryder

Emily Koellner

Link for LinkedIn Account:

Elaine Murray

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 DiepCJourney podcast, we are shining a light on survivorship with our guest, Deepa R. Halaharvi, DO, 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

The Breast Cancer Podcast

Instagram Account

LinkedIn Account

Facebook Account

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 DiepCJourney podcast is an expert in this field. I want to welcome Dr. Stacy Tessler Lindau, professor of obstetrics and gynecology at the University of Chicago Medicine.

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 Bionic Breast Study 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 Scientific Network on female sexual health and cancer. She also created, Woman Lab, a platform where every woman – and everyone who loves and cares for women – can learn truths about sex.

On the podcast "The Curbsiders Internal Medicine," 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:

Dr. Stacy (Tessler) Lindau

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 DiepCJourney podcast is Dr. Tim Matatov of Southwest Breast and Aesthetics 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, Dr. Joseph Zakhary and Dr. Matthew J. Mino.

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:

Instagram Account

Facebook Account

My guest today on the DiepCJourney podcast has a blog and website titled, No Half Measures, Living Out loud.

2017 was a pivotal year in the life of my guest, Abigail Johnston. 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 National AACR conference held in early 2023. She sat on a panel with the FDA speaking about the importance of overall survival as an important end point in clinical trials. 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: No Half Measures: Living Out Loud

Bio: Abigail's Story

Contact Information: Email Abigail

Place to find Abigail's writing and work: Social Media and Elsewhere

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 DiepCJourney podcast two internationally known microsurgeons. Dr. Joe Dusseldorp practices in Sydney, Australia and is a fellow of the Royal Australasian College of surgeons. 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.

Dr. Minas Chrysopoulo is the current president of PRMA in San Antonio, Texas, and founder of the Breast Advocate®, 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.

Proximie Healthcare Platform

Dr. Joe's DiepCFoundation educational video on Robotic Assisted DIEP flap

Dr. C's DiepCFoundation educational video on Reducing Abdominal Complications: DIEP Flap

Connect with Dr. Joe

Dr. Joe on Instagram

Dr. Joe on Twitter

Dr. Joe on LinkedIn

Connect with Dr. Chrysopoulo

Dr. C. on Instagram

Dr. C. on Twitter

Dr. C. on LinkedIn

Megan-Claire Chase 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 San Antonio Breast Cancer Symposium 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.

National Black Family Cancer Awareness Week started by the FDA through the Oncology Center of Excellence.

Megan-Claire's Linked Account: https://www.linkedin.com/in/megan-claire-chase/

Breast Cancer Program Director: Share Cancer Support

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 DiepCJourney podcast are two microsurgeons who worked together to create Project Restored

Dr. Ron Israeli and Dr. Jonathan Bank selected several of their patients to participate in this unique artistic endeavor. Our key guest today is one of those patients, Chelsey Pickthorn.

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 Mollie Sugarman and the Patient Empowerment 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.

We are speaking about the art and practice of microsurgery as it relates to breast reconstruction surgery in this episode of the DiepCJourney podcast. 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.

Dr. Sumeet Teotia is a Professor of Plastic Surgery and Director of the Breast Reconstruction Program at UT Southwestern Medical Center. 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 drsumeetteotia

In this episode of the DiepCJourney podcast I speak with a medical oncologist. Dr. Eleanora Teplinsky has her own podcast called, INTERLUDE: Cancer Stories 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 Instagram account 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 Eleanora Teplinsky.