Rewritten Me

Natasha Cauchi was 29 when she was diagnosed with triple negative breast cancer. As part of her treatment she had a double mastectomy with implant reconstruction. Three years later Tash and her husband decided to try for a baby.

Chemotherapy can affect fertility and Tash was in early menopause. She had IVF, which was unsuccessful. Then she became pregnant naturally!

While the arrival of baby Oliver is joyous, Tash shares how she feels grief and sadness that she can’t breastfeed. Tash also talks about how she needed to advocate, especially when a nurse in hospital told her to ‘put him on the boob’ to breastfeed.

Tash also shares her story of:

• Treatment and fertility preservation
• Ovarian tissue freezing
• Trying for a baby after breast cancer
• What IVF was like
• Oliver’s dramatic arrival!
• The pressure to breastfeed in hospital
• Using donated breast milk

Thank you, Tash, for sharing your story with us. And welcome to this wonderful world, Oliver AJ, it’s so much more wonderful knowing that you’re in it!

Links for this podcast:

• Natasha's Instagram page
• Ovarian tissue freezing
• Mother's Milk Bank

Where you can find Luan:

•  Instagram
•  Website
•  LinkedIn

Subscribe to be notified when new Rewritten Me episodes are published.

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

What does Medicare cover for breast reconstruction? What do you need to consider if you choose to be treated privately?

The two different systems in Australia – public and private – can be confusing, and potential financial costs of reconstruction can cause anxiety. It can also be an awkward discussion to have with your team.

In this episode Luan talks to Specialist Breast Surgeon and President of BreastSurgANZ, Dr Melanie Walker, about how to navigate finances.

Luan and Dr Melanie talk about whether Medicare covers:

• All types of reconstruction
• Elective mastectomy
• Revision surgery
• Delayed reconstruction
• Liposuction and fat grafting
• Nipple reconstruction

Luan and Dr Melanie also talk in general about private cover, including:

• What to ask your specialist’s team
• What might not be covered
• What your quote may include
• Negotiating costs

Links for this podcast:

• AMA Guide for patients
• BreastSurgANZ
• Cancer Council resource

Where you can find Luan:

•  Instagram
•  Website
•  LinkedIn

Subscribe to be notified when new Rewritten Me episodes are published.

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

Note: this podcast talks about what is covered by Medicare. What you have access to and what resources and services are available to you, including waiting times, can differ depending on where you live. And things change. This information was correct at the time of recording (3rd July 2023). 

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

It isn't vain to want your breast/s reconstructed after a mastectomy. Some women choose not to reconstruct because they think it's cosmetic. And some women aren't given the option to reconstruct.

Reconstructive Plastic Surgeon, Dr Kirstin Miteff, talks about consulting both a breast surgeon and a reconstructive plastic surgeon when you research your reconstruction options.

Dr Kirstin also talks about how a referral to a plastic surgeon at the time of a breast cancer diagnosis may reduce the reconstruction timeline for some patients.

Luan and Dr Kirstin also talk about:

• What a reconstructive plastic surgeon does
• The role of plastic surgeons & breast surgeons
• And how they work alongside each other
• What to consider when choosing your reconstruction
• Telehealth consults for regional/rural patients
• What to ask a reconstructive plastic surgeon
• The training path of reconstructive plastic surgeons
• How some women haven't been offered recon

You might also want to:

• Listen to Dr Joe Dusseldorp talk about DIEP 'flap' strategies
• Listen to Dr Bish Soliman talk about other 'flap' options
• Subscribe to be notified when the episode about public & private health drops!

Links for this podcast:

• Aspire Plastic Surgery website
• Aspire Plastic Surgery on Instagram
• Australian Society of Plastic Surgeons

Where you can find Luan:

•  Instagram
•  Website
•  LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

When it comes to implant-based reconstruction, you might hear the terms UTM and OTM. But what do they mean and why might you choose one over the other?

Luan talks to one of Australia’s leading consultant breast surgeons, Associate Professor Sanjay Warrier, about under and over the muscle implants, including: 

• What’s involved for UTM & OTM
• What might dictate your decision
• The benefits of each
• Acellular dermal matrix
• UTM dual plane technique
• OTM two staged approach with expanders
• Exercise after UTM/OTM
• What happens if you have a port?
• What about radiotherapy?
• Potential complications of each
• How these can be addressed (eg rippling)
• Surveillance imaging after UTM/OTM

You might also want to:

• Listen to Dr Kylie Snook talk about mastectomy and expanders
• Subscribe to be notified when the episode about public & private health drops!

Links for this podcast:

• Dr Sanjay's website
• Dr Sanjay on Instagram
• BreastSurgANZ
• Sydney Breast Cancer Foundation

Where you can find Luan:

•  Instagram
•  Website
•  LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

In Rewritten Me’s first ever ‘extra’ episode, Luan talks to Dr Minas Chrysopoulo who devised the Breast Advocate® app.

Breast Advocate® is the world's first shared decision-making app for breast cancer surgery and breast reconstruction. It's the app that helped Dr Sandy Minck when she was researching her risk reduction surgery (episode 8).

Dr C, as he’s known, is an American-based board-certified surgeon and micro surgeon who co-created the Breast Advocate® with patient advocates and leading specialists.

Listen in to find out how the app’s easy-to-use wizard can be a useful decision-making tool, even for those who live outside of the States. And hear Dr C share how the process of partnering with patient advocates to create the app has helped him become a better clinician.

Links for this podcast:

• Breast Advocate® website
• Breast Advocate on Instagram
• Dr C on Instagram
• World Health Innovation Summit

Where you can find Luan:

•  Instagram
•  Website
•  LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

The results from a routine mammogram in 2022 led to a whirlwind of investigative tests for Dr Sandy Minck. Sandy was diagnosed with lobular carcinoma in situ (LCIS) and found out she carries the CHEK2 genetic variant. She also had dense breast tissue. This all contributed to an increased risk of breast cancer.

Sandy’s mother died of breast cancer. When Sandy researched what options she had to minimise her own risk, she was aware that her decision-making was very emotive. She sought evidence-based opinions but, even as a non-practicing GP with a high level of health literacy, Sandy found the process overwhelming.

Sandy wanted a ‘one and done’ bilateral risk-reducing mastectomy and direct to implant (DTI) reconstruction. 

So, how did she decide what was right for her? And is she ‘one and done’ or will she have more surgery?

Luan and Sandy talk about:

• How Sandy assessed her risk of breast cancer
• Why she decided to have a risk reduction mastectomy
• Why Sandy chose implants for reconstruction
• Whether she’ll have revision surgery
• Reconstruction decision-making tools that helped
• Breast density and other breast cancer risk factors
• Her advocacy work

Links for this podcast:

• Sandy Minck LinkedIn
• BCNA Breconda
• Breast Advocate app
• Pink Hope, Australian genetic risk charity
• EVIQ

Where you can find Luan:

• Instagram
• Website
• LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

In this podcast Luan and Sandy talk about Sandy’s personal experience. They don’t recommend any surgeon, practice and/or procedure or treatment. The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

It’s important to decide what reconstruction is right for you at the time. However, over time things can change, such as life priorities, work commitments and childcare responsibilities. So too can the results of your reconstruction.

Kylie Lynch had multiple surgeries to achieve a bilateral implant-based reconstruction following her diagnosis of invasive mucinous and ductal carcinoma with extensive lymphovascular invasion. Seven years later Kylie had an autologous ‘flap’ reconstruction because the long-term effects of radiotherapy had caused capsular contracture around one of her implants.

Luan talks to Kylie about why she chose DIEP, what she took into consideration when choosing a plastic surgeon and how she got over the ‘DIEP blues’.

Luan and Kylie also talk about:

·      Why Kylie chose implants initially

·      What tissue expanders felt like

·      Being ‘triggered’ by her DIEP

·      Her recovery from DIEP

·      Plans for revision surgery

·      The bonding power of support groups

·      Kylie’s advocacy work

Links for this podcast:

·      Kylie’s website

·      YPink, is at Mater, Sydney

·      Read about DIEP*

*You can also read about TRAM, which is the surgery Kylie refers to when she talks about muscle and mesh being used in other types of 'flap' procedures.

Where you can find Luan:

• Instagram
• Website
• LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

In this podcast Luan and Kylie talk about their personal experiences. They don’t recommend any surgeon, practice and/or procedure or treatment. The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

What does it mean to be a patient advocate and to ‘own your worth’?

When Terri Coutee received her second diagnosis for breast cancer she was mistakenly diagnosed with incurable metastatic disease. This prompted her to blog about her experience and advocate for others.

Luan and Terri talk about how Terri went on to set up not-for-profit DIEPC Foundation, and create a 24/7 library of educational resources to help those affected by breast cancer make an informed decision about reconstruction after a mastectomy.

Be sure to listen out for the poem Terri melodiously reads that so beautifully sums up the work of patient advocates #WorkIsLoveMadeVisible

Luan and Terri also talk about:

• The role of a patient advocate
• Keeping calm when things go wrong!
• Importance of open dialogue
• How we can all learn from each other
• Responsibilities of patient advocacy
• Improving patient outcomes
• Tips for navigating conferences as an advocate

Links for this pod:

• DIEPC Foundation website
• DIEPC Journey private Facebook group
• DIEPC Instagram

Where you can find Luan:

• Instagram
• Website
• LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

Hear about new techniques being used to try to preserve and restore feeling and sensation in the breast after reconstruction.

“That [extra] 20 minutes is this woman’s entire lifetime of [breast] sensation,” A/Prof Cindy Mak.

Loss of feeling after a mastectomy and reconstruction is a concern for many women.

Luan talks to A/Prof Cindy Mak & Dr Joe Dusseldorp about techniques they’re using to preserve and reconstruct nerves.

They also share the results of these surgeries: listen out for my "wow” jaw-drop when Dr Cindy tells us that they’ve observed that temperature sensation is developing after reconstruction.

And Dr Joe also tells us – hot off the press! – how he’s using the same nerve reconstruction techniques developed for the breast to help optimise the sensation in the tummy area after DIEP flap surgery.

We talk about:

• Breast sensory nerve preservation:
• For DIEP, TUG & implant
• Can it be used for delayed recon?
• ‘Spare part’ nerve grafting
• Breast sensory nerve reconstruction
• Abdominal nerve preservation:
• Sensory and motor (core muscle strength)
• Things to consider about these techniques
• How can patients find out more about them

Links for this pod:

• Dr Cindy Mak’s website
• Dr Cindy’s Instagram
• Dr Joe Dusseldorp’s website
• Dr Joe’s Instagram

Where you can find Luan:

• Instagram
• Website
• LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.

What other options are available if you want an ‘own tissue’ reconstruction, but you aren’t a candidate for DIEP flap?

Some women may not have enough tummy tissue for a DIEP. Others may have previously had abdominoplasty, or a DIEP reconstruction that didn’t work out.

Dr Bish Soliman is an internationally trained Specialist Plastic and Reconstructive Surgeon who specialises in complex microsurgical reconstruction, such as ‘own tissue’ or ‘flap’ reconstructions.

Luan talks to Dr Bish about the alternatives to DIEP, including the LAP flap, which is a relatively new procedure that may be a second-line option for women who’ve had abdominal surgery previously, such as a tummy-tuck or DIEP.

Luan and Dr Bish also talk about:

• What is a ‘flap’?
• Difference between a ‘free’ and pedicle ‘flap’
• LAP/TUG/PAP/GAP/Lat Dorsi flaps
• What’s involved in each
• Benefits & downsides of each

What to know more about DIEP? Check out episode one in the series.

Links for this pod:

• Dr Bish Soliman’s website
• DIEP information sheet

Where you can fin Luan:

• Instagram
• Website
• LinkedIn

If you’ve found any of the content upsetting, please reach out and get help. Breast Cancer Network Australia has a free confidential helpline – 1800 500 258. Beyond Blue has a range of free resources online, or you can call them 24/7 on 1300 224 636.

The information in this podcast does not constitute medical advice. For personalised medical advice you should seek a consult with a FRACS qualified surgeon.

Hosted on Acast. See acast.com/privacy for more information.