DiepCJourney Podcast

Neosho Ponder, Ph.D., 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 DiepCJourney podcast. We met as patient advocates at the San Antonio Breast Cancer Symposium 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, GOD'S GOT JOKES: How I Used My Faith and God's Humor to Survive Breast Cancer. 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 Tigerlily Angel Advocate sharing the knowledge she gained through her own breast cancer treatment and surgery. She also volunteers in the Young Survival Coalition DC and For the Breast of Us.

Our conversation wraps up as we share our Kansas connections. I am honored to share the story of her uncle, Jesse Lee Jackson, a former mayor of Chanute, Kansas.

Connect with Neosho on LinkedIn:

Neosho Ponder, Ph.D

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, Dr. Dhivya R. Srinivasa to address the topic in this episode of the DiepCJourney podcast.

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.

Advocacy: Dhivya R. Srinivasa, MD, FACS

Advocacy: Jamie Zampell, MD

Advocacy: Dr. Elisabeth Potter, MD

PRMA: Dr. Minas Chrysopoulo, MD, FACS explanation of coding changes

Advocacy Page: PRMA Plastic Surgery

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 DiepCJourney podcast is Lillie Shockney, Co-Founder of AONN (Adademy of Oncology Nurse & Patient Navigators) and University Distinguished Service Professor of Breast Cancer and the Johns Hopkins School of Medicine. 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.

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 Rob Pupelis, CEO, of Spectros for the first episode of season three of the DiepCJourney podcast. Rob shares the story of his visit to the Queen Victory hospital (QVH) in England. He was able to visit Queen Victoria while attending the London Breast Meeting in late 2022. While at the conference, Rob demonstrated the T-Stat tissue oximetry system 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.

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 World Health Innovation Summit (WHIS) Shared Decision team. This team was formulated and is led by Gareth Presch 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 World Urban Forum in Katowice, Poland in June of 2022.

Susanne Baars connects people to knowledge. She received training as a genetic scientist at Harvard and she is using her expertise through the Social Genomics Moonshot 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, Harry, on his Journey through personalized treatment.

Dr. Minas Chrysopoulo 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. Dr. Chrysopoulo is an entrepreneur. He is the Founder of Toliman Health and through Toliman developed the first shared decision-making breast cancer surgery app, Breast Advocate. 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.

Food and what to eat after a breast cancer diagnosis is our topic on this episode of the DiepCJourney podcast.

About 80% of all breast cancers are ER positive. This means the breast cancer cells grow in response to the hormone estrogen. With so much information about what to eat, what not to eat, how much to eat, food can become a topic that triggers anxiety and confusion.

My guest today is Cathy Leman. She is a registered dietitian, nutrition therapist, and certified personal trainer. Most women diagnosed with hormone-positive breast cancer feel anxious and confused about food, especially after they finish treatment. She is also a survivor of hormone-positive breast cancer, and founder of the Peaceful Plate program. The Peaceful Plate program teaches how food supports survivorship health and well-being, and coaches women on ending food fear so they eat with peace, not panic. When you eat with peace, you enjoy your food.

Cathy also writes the dam. mad. About BREAST CANCER blog.

Having concerns is not exclusive to those who have had hormone positive breast cancer. It revolves around all types of breast cancer and Cathy has room for coaching in all types of breast cancer.

Cathy's mantra, "When you eat for your breast health you eat for your overall best health!"

Cathy can be found on Instagram at hormone.breastcancer.dietitian

How many people diagnosed with breast cancer think about clinical trials or being part of one? In this episode of the DiepCJourney podcast we are going to discuss the importance of patients asking about participation in clinical trials and studies to improve the lives of breast cancer patients.

My guest is Stephanie Graff, MD, FACP. She is the Director of Breast Oncology at the Lifespan Cancer Institute and Professor of Medicine at Brown University. Dr. Graff is passionate about connecting with her patients for personalized care and advancing breast cancer research, and breast cancer prevention.

Our interview includes the process and steps involved for patients who sign up for clinical trials and studies. There are benefits for patients and Dr. Graff examines the processes. Her hope is this becomes standard of care for physicians to tell patients about clinical trials available and encourage them to sign up if they qualify.

Dr. Graff is also involved with the American Cancer Society in Kansas City, The Susan Love Research Foundation, the American Society of Clinical Oncology, and other prominent organizations. She is a published author of several research papers. She was named "Woman Disrupter of the Year" at the 2022 American Society of Clinical Oncology Conference.

Dr. Graff obtained her medical degree at the University of Missouri-Kansas City School of Medicine. She is active on social media sharing tweets about her research and work. We are both Kansas City Chiefs fans and occasionally share our love of the #ChiefsNation on Twitter.

You can find out more about her work and interest in clinical trials and research on LinkedIn at:

Stephanie Graff, MD, FACP

High definition DIEP flap is combining the aesthetics of plastic surgery and the skill of microsurgery to optimize the donor site, the abdominal area, in breast reconstruction.

Dr. Andrew Gassman of PRMA in San Antonio, Texas, sat down with me to record a Facebook Live interview for the DiepCJourney podcast. This occurred the day after BRA day, Breast Reconstruction Awareness Day 2022. This podcast is being used across other platforms, including the PRMA YouTube channel, and will also be seen on the DiepCFoundation YouTube channel.

The techniques used in high-definition DIEP flaps include methods of suturing and fat grafting to contour the shape of the abdominal area. Dr. Gassman addresses what patients are candidates and the conversation he has during a consult to explain what he will be doing during a high definition DIEP and what the recovery will be like.

You have been diagnosed with breast cancer or find you are at high risk of getting breast cancer and are facing a mastectomy. Now what? If you choose to reconstruct your breast what does this process look like?

Patients are inundated with information at the beginning of a diagnosis or finding they have a genetic mutation. They see an oncologist, breast surgeon, plastic surgeon, radiologist, and other medical specialists. Where does a patient begin the research and planning for their breast reconstruction? Is timing important if you are currently undergoing treatment, either chemotherapy or radiation? Are lifestyle considerations important in the decision process?

My guest on this episode of the DiepCJourney podcast is Dr. Santosh Kale, MD, MBA. He is a board-certified Plastic and reconstructive microsurgeon who practices in Gahanna, Ohio at Midwest Breast and Aesthetic Surgery just outside of Columbus Ohio. Along with his team at Midwest Breast he specializes in breast reconstruction (implant and tissue-based), aesthetic breast surgery, body contouring, and lymphedema surgery.

The discussion we have today covers many of these topics in general terms for patients to begin to consider as they plan their own reconstructive Journey. Our goal is to provide this information to assist you at your consults in preparation for your breast reconstruction surgery.

DIEP flaps are a type of breast reconstruction using a patient's own tissue to reconstruct breasts after mastectomy for those affected by breast cancer. DIEP stands for deep inferior epigastric perforators. Epigastric refers to the abdominal area. The underlying tissue and perforators (blood vessels) are disconnected by the microsurgeon from the abdominal area and transplanted to the breast area to create soft, warm, tissue much like the breasts removed during mastectomy.

To do an efficient DIEP flap requires years of training, skill, planning, and a team. My guest, Dr. Nicholas Haddock is one of the Breast Reconstruction Team at UT – Southwestern Department of Plastic Surgery in Dallas, TX. He works with Dr. Sumeet Teotia performing state of the art autologous breast reconstruction in the Dallas/Fort Worth area in Texas.

In our discussion we reference the PRS Global Open paper he authored with Dr. Teotia titled, "Efficient DIEP Flap: Bilateral DIEP Flap in Less Than Four Hours"

Our goal for the conversation in this episode of the DiepCJourney Podcast is to inform and educate patients about the value of a team approach and to consider questions to ask at their own surgical consult for breast reconstruction.