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Donna Hiskey's Story 

  • Mastectomy

  • Breast Reconstruction with Latismuss Dorsi Flap and Expanders


My journey started on August 16th 2004. I made my annual appointment for my mammogram. Something I had been doing for 10 years.  Each report was always normal except for a few fibroid cysts. When the tech told me she needed a couple of more films I did not think anything was out of the ordinary.


A week later I received a letter saying that my mammogram can back with uncertain results and I was to notify my physician to follow up on the proceedings. Still I was not concerned, remembering a few years back having an ultra sound resulting in fibroid cysts. I called my OB-GYN; they also had received the results and told me to make an appointment at the Breast Center for an ultrasound.


I made my appointment for a week later. Now I am a little concerned. Talked to a few co-workers, was assured not to worry.  Some had had the same results and it was nothing.


My ultrasound found a small area at 1 o’clock to be round and solid. I had a consultation with the radiologist and was told to contact a Breast Surgeon for a follow up. I then called my OB-GYN and she referred me to Dr. Shelly Nukemera.  She and her partner Dr. Christy Borne operated the office, Breast Care.  I did some research and found both of them to be very well known in Arizona and their skills were impeccable. I met with her in a few days for a consultation and the result was to have a needle biopsy, which was schedule for September 20.


The biopsy took about 40 minutes.  There was a small amount of discomfort, was told to keep ice on the site for the first 24 hours.  At the time of the biopsy the physician showed me the area of the lump.  I would have never found or felt the lump on my own.


September 22, I received a call from Dr. Nukemera. She informed me that my biopsy came back positive for Breast Cancer.   The tumor size was 0.7 cm, grade 1, Estrogen and progesterone positive, stage 1 Intermediate grade Ductal carcinoma in situ cribriform type. I went numb. The first thing I asked her was “Am I going to die”.  She reassured me that it was in the very early stages and was very small. With treatment it was curable. With a sigh of relief she told me I had to make a decision whether to have a lumpectomy which I was a candidate for or the option to have a mastectomy. I was to make an appointment to go over my options, procedures and treatments. She urged me to bring my family so they would be aware of all the circumstances involved and to answer any questions that may come up.


My husband, daughter, son and I met with Dr. Nukemera on September 24.   She went over all of my options, the treatments I would be receiving, depending on the outcome of the surgery.  My hardest decision was the options of having a mastectomy or a lumpectomy. With the lumpectomy I would be receiving Radiation every day for 2 weeks, and a chance I may have Chemo if the lymph nodes were not clear. The chance of recurrence had a bigger percentage. With the mastectomy, I would not have to worry everyday if the cancer will return, even though there is a slight chance. If all nodes were clear and margins were clear, my treatment would only be medication for 5 years.  I opt for the mastectomy with immediate reconstruction with a tissue expander followed by an implant.  I wanted it gone. I again was reassured that I was going to get through this and the outcome was excellent. Having my family with me made it so much easier to accept. They were so supportive on my decision. They wanted me to do what was best for me.


The following month was like a blur.  Test, ultrasounds, blood work, consultations with my Plastic Surgeon, who assured me she would become my best friend, support talks for the Cancer society. The date was set for November 2, 2004. Both of the surgeons had to correspond to their schedules at the same time.  Also my body was having with drawls from stopping my HRT. Since I was positive for Estrogen and Progesterone I had to stop immediately.  Being positive makes the cancers grow faster and HRT produces both Estrogen and Progesterone.  On top of all the stress, I was not able to sleep, hot flashed, night sweats and irritability also returned. I was not a happy camper.


November 2, 2004, election day - I got to the center at 6:00am, I was having a Sentinel Node biopsy during surgery and had to do the preparations for the procedure. A blue dye is injected and goes to the lymph nodes closest to the breast area.  The nodes are removed and tested for Cancer. I went under the knife at 12:30 pm. I was amused that I had to take a pregnancy test.  The surgical center was fabulous. I was given the best treatment; they even had a television at my bedside to watch.


My surgery took about 3 hours. I remember being taken to my room, my family was there, told me everything went well. My surgeon came in and the first thing I asked was “were the lymph nodes clear?” She told me all nodes were clear from the Sentinel Node. Even though I was still pretty out of it I remember a sense of peace. I was pretty much in and out of it for the rest of the day and night. I kept watching the TV to see who had become our next president. I was able to get up and use the bathroom later in the evening and go for a short walk. Pain was minimal with medication.


At 7:00am the next morning my surgeon came in and I was told I would be released as soon as my Plastic surgeon came to see me and she also released me. I could not believe I was able to go home so soon. Mentally I was not ready, I was having a hard time accepting that I had lost my breast, I was not a complete woman and Breast Cancer was now a part of me. My Plastic Surgeon came in and I told her how I was feeling, she told the staff to call the insurance company and see if I could stay another day. The response was, if all vital signs were normal, I was to be release.  They were all so sympathetic, but beyond their control. I was released and home by 11:00am.


My recovery was a different story. I am a very strong and stubborn woman. I told myself this was not going to take me down. My recovery was to be from 6-8 weeks.  Two weeks after my surgery I was preparing Thanksgiving dinner, going to my Plastic Surgeon for fills in the expander and starting my Christmas shopping, I was back to my normal lifestyle except for working. My Mother had come down to help, but I felt I needed to entertain her as our guest. Needless to say I did not get the rest and healing during this time. I went back to work at the 6 week mark.  I am in the culinary field, which includes heavy lifting, reaching, pushing and pulling. All things I was limited to do. 


With the holidays, work and the fills every week, it finally took a toll on me. I had one area along the incision that would not close and was inflamed. My Plastic Surgeon had stopped the fillings 2 weeks before hoping the area would heal and close. I got up one morning and after my shower I noticed that I had drainage. I called my Plastic Surgeon and she told me to take it easy for the weekend and to see her on Monday.  I called off work and laid low, the drainage did not stop and my Monday I had a hole the size of a dime. My Plastic Surgeon took one look and said I had to have the expander removed. The hole was showing the expander and muscle.


On January 17th 2005 I went in for my second surgery to have the expander removed. The recovery process was long I had to put medication on the incision and the hole took forever to close. For over 2 months I had to use a syringe and insert peroxide/water solution to keep the area clean. Finally by April I was all healed. My Plastic Surgeon told me I had to wait 6 months for the tissue to repair before I could start over again. I began to fill like my old self again.


Fast forward to September 2005.  Scheduled for surgery my third, to reinsert the expander.  In and out in 4 hours. Took 4 weeks off work.  Two weeks after surgery, got an infection in the surgery site. Put on antibiotics and the plastic Surgeon put off fillings did not want to do any damage to the incision. Went on with life as usual. Feeling great healing well. 


January 2006 - Plastic Surgeon finally said she could start the fillings again. Went every week for 2 months.  During this time work was beginning to be very stressful. Working many hours with few days off.  By the end of March I was not feeling well. Tired, achy from the expander and running a fever. After a few weeks I was not better.  Plastic Surgeon sent me to a Disease Specialist.  He said he believed I was suffering trauma from over activity to the expander and it was causing the tissue to wear away resulting the expander rubbing on the incision and what skin I had. I guess you can say it was job related. Result was my fourth surgery to remove the expander again. I was so disappointed. I had only one more fill to complete the process.  My PS told me if she felt the implant would take she would put it in, but there was no guarantee.  I woke up without the implant.  I had no healthy tissue left, so the implant would not hold up.


Follow up appointment with PS was given options. Discontinue the reconstruction or do a different procedure with the Latissimus Dorsi Flap. Under one condition. I had to refrain from working during the process.  I am not a quitter. I had come this far and I wanted to complete the reconstruction no matter what I had to do.  I knew that in the summer of 2007 the resort I was working at was going to go through a major renovation.  I would be able to take the time off to recoup.


June 11, 2007 my surgery fifth and sixth, was set for the Latismuss Dorsi Flap and expander insertion. This was considered two surgeries. The Flap surgery involved the Latissimus back muscle, skin, and tissue tunneled through to the breast area and inserted. The expander is also inserted at the same time. Talk about feeling like being hit by a Mac Truck. I was in the hospital overnight. Drugged for about a week.  I vowed I was going to do everything possible to heal correctly.  I did nothing for 6 weeks.  The fills were started and everything went as scheduled I did have fluid buildup in my back. Had to have that taken out every week. No big deal.


On September 21, 2007 I underwent my seventh and eighth surgery for my expander/implant exchange and Breast Reduction.  It was done as outpatient and lasted about 3 hours. My recovery was uneventful. I have found a wonderful forum that was my life saver. So much support and advice was given. The best advice that was given was REST, REST, REST, and DO NOT LIFT YOUR ARMS.  I took that to heart as my recovery was going perfect, I did not want to screw up now. The only bumps I had was 2 spitting stitches.


I had only one complaint and that was the breast with the implant was too big. Little did my PS and I think that we would ever worry about size. She assured me what ever the problem it can be fixed. I waited until my six months and had a revision ninth and FINAL SURGERY. I had some excess boobage under the armpit removed as well as a lift. Also at this time I had my nipple reconstruction. What an amazing procedure.  Skin was taken from the flap area and formed to make a nipple.  I felt like a complete woman again. 


I had to wait a few months for the nipple to heal and finally was able to get my areola tattoo.  That was an option, but heck I have come this far. I was referred to Ellie a former tattoo artist, who is a Breast Cancer survivor.  She specializes in breast areola re-pigmentation and permanent make-up.  I had also asked her if she could do a pink ribbon tattoo for me. I was not ready to go to some biker tattoo shop. This was something I wanted to do for me as my completion to my Journey with Breast Cancer and Reconstruction.  She was happy to do it and it was her gift to me.


It has been a long and difficult journey for me.  I am writing this almost 4 years to the day I was diagnosed with Breast Cancer. I am Cancer Free. My Mammograms have all been normal. I do have a couple of non cancerous cysts in my left breast that is no concern. My breast surgeon has told me I have graduated and should recover fully. My oncologist is happy with my entire tests. I have been taking Arimidex for Breast Cancer prevention. It is to be taken for 5 years at this time I have 1 years left. I will take it as long as needed if I have to. I am concerned about the size of my breast with the implant. I will be making an appointment with my PS to see if it can be corrected.  She wanted to wait until the one year mark to make sure all changes had occurred.


I want to give a special Thank- you to Bailey for giving me the opportunity to share my story and include Breast reconstruction on this fabulous site she and all the wonderful women have produced.


Also to Big THANK YOU to all my Beautiful Breast Friends I have met on this board in the past year. You all are part of my life and I don’t know what I would have done without you.  You have all been here for me though most of my reconstruction your words of wisdom and support is what got me through this. I love you all. Thanks for hanging around.


One thing I need to add. I had to learn the hard way. Surgery is not a quick fix. You need to take the time to heal, and recovery does take time.  I took 6 months off from my job for my final surgeries.  It was difficult for me not to do things I take for granite. But I did and it paid off. I am so thankful I work for a company that takes things like this seriously and provides the benefits for you to take care of your health issues.


Remember ladies, PRINCESS DUTY is the most important recovery process.



                     Breast Reconstruction with Latismuss Dorsi Flap and Expanders

     Breast reconstruction with Latismuss Dorsi Flap and Expanders

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