125856453_web1_IMG_0317

Wilkes-Barre to pay more to get rid of recyclables

125861826_web1_TTL081119miscavage1

NEPA Virtual Career Expo set for today

For Maria Jiunta Heck, surviving breast cancer was only the beginning.
				Following diagnosis 10 years ago, Heck, then 47, underwent a double mastectomy as part of her treatment and recovery.
				She then underwent plastic surgery and implants. But her body rejected the implants, and Heck underwent 11 procedures over several years &mdash; finally deciding about four years ago to have the implants removed and get on with her life.
				But all was not well.
				For a woman who had undergone breast-reduction surgery in her 20s, having no breasts and no implants was a dramatic change, both physically and emotionally. Heck said she admires women who opt to live without breasts or implants, but that she was finding it very difficult.
				&ldquo;I looked like a 12-year-old boy,&rdquo; deadpanned Heck, whose trademark humor &mdash; and her struggles with implants &mdash; were previously shared with Times Leader readers through a column she wrote for many years.
				&ldquo;I was in a store, and I overheard two men saying something about me,&rdquo; Heck recalled in an interview this week.
				Looking at a photo of herself from a Christmas party was one of the final straws.
				Acting on advice from a friend, Heck turned to Geisinger plastic surgeon Dr. Lisa Jacob, who in late June of this year performed a breast reconstruction procedure using Heck&rsquo;s own abdominal tissue.
				The procedure, performed locally at Geisinger Wyoming Valley Medical Center, took about 10 hours for the initial surgery and an extra two hours to fix some blood flow issues, followed by five days in the intensive care unit and a sometimes painful recovery that is still ongoing.
				&ldquo;For me it was well worth it,&rdquo; Heck said. &ldquo;I now have breast tissue that was made from me.&rdquo;
				As Dr. Jacob explained, the operation is a microvascular perforator flap procedure called a deep inferior epigastric perforator flap, also known as a DIEP flap.
				&ldquo;It takes skin, abdominal fat, and blood vessels from the abdominal wall and is transplanted to the breast,&rdquo; Dr. Jacob explained.
				&ldquo;The blood vessels are then re-connected using a microscope to restore the blood flow. The tissue is then shaped into a breast. The abdomen is then closed, as in a tummy tuck/abdominoplasty incision. The surgery is very detailed and intricate, so it is lengthy,&rdquo; she said.
				For Heck, now 57, the procedure itself was important; so was being able to have it performed locally, something she wants people to know is available here.
				This type of surgery has been around since the 1990s, Jacob said. It is a common breast reconstruction procedure at larger hospitals and academic institutions where they have a microsurgical reconstruction program. Microsurgery is a sub-specialty of plastic surgery, where the surgeon is trained to operate on small blood vessels using a microscope, she noted. The program at Geisinger Wyoming Valley was founded six years ago, and is the only program in Luzerne and Lackawanna Counties, she said.
				Today, Oct. 21, is Breast Reconstruction Awareness Day, the theme of which is &ldquo;to close the loop on breast cancer in creating awareness of women&rsquo;s breast reconstruction options,&rdquo; Jacob said.
				Despite many advances, many women throughout the country are not informed of their reconstructive options prior to having their breasts removed, she explained.
				&ldquo;I agree with Maria, that breast reconstruction is an important part of the healing process after breast cancer,&rdquo; Jacob said.
				&ldquo;The breast is an intrinsic part of a woman&rsquo;s body and a symbol of femininity. When that is taken away due to cancer, it can dramatically affect how a women feels about and sees herself. Breast reconstruction can restore, not only the actual breast, but a woman&rsquo;s sense of wholeness as well,&rdquo; she added.
				The use of a patient&rsquo;s own tissue feels and looks natural, and will change with them throughout their lifetime, Jacob added.
				&ldquo;Dr. Jacob gave me my self-esteem back,&rdquo; Heck said.
				The importance of screening
				Like other breast cancer survivors, Heck is adamant about the importance of regular screenings, and of knowing your own body.
				In addition to the fact that her mother had been diagnosed with several different kinds of cancer, Heck was diligent about getting mammograms in the wake of her own breast-reduction surgery.
				&ldquo;I was always super-vigilant,&rdquo; she said.
				Heck had gone for a mammogram in the year her cancer was found. That turned up clean, but a few months later she discovered a lump in her arm pit during a self-examination.
				Tests revealed that she had ductal carcinoma in situ, or DCIS, a form of breast cancer inside a milk duct.
				<a href="https://www.breastcancer.org/symptoms/types/dcis" target="_blank" rel="noopener noreferrer">As explained by breastcancer.org</a>, ductal means that the cancer starts inside the milk ducts, while carcinoma refers to any cancer that begins in the skin or other tissues covering or lining the internal organs. In situ, meanwhile, means &ldquo;in its original place.&rdquo;
				In short, DCIS is a non-invasive form of breast cancer that typically isn&rsquo;t life-threatening, but does raise the risk of more invasive cancers developing later. While there are a variety of health and personal reasons that factor into the decision, the potential for recurrence is a key reason why some women opt for mastectomies after a DCIS diagnosis.
				Heck said one of the most important things her doctor at the time did was to reassure her that the condition was not fatal.
				&ldquo;He said, &lsquo;you&rsquo;re not going to die from this,&rsquo;&rdquo; she recalled. &ldquo;And I really needed to hear that.&rdquo;
				Helping others
				The years since her diagnosis and first surgery did include some dark moments, Heck acknowledged, but she also translated her tribulations into ways of helping herself, and others.
				One of those efforts was the creation of The Breast and Chest Buddy, patented &ldquo;seat belt enclosures,&rdquo; which she designed with comfort in mind after experiencing serious seat belt discomfort in riding and driving in cars following her mastectomy.
				It turned into a successful business, Green Gables Enterprises, <a href="https://www.timesleader.com/features/720938/breast-and-chest-buddy-helps-after-surgery" target="_blank" rel="noopener noreferrer">as the Times Leader reported in 2018</a>, finding favor not just with mastectomy survivors but also among women who had undergone breast-reduction surgery, as well as for women and men who had undergone open-heart surgery. Heck&rsquo;s products can be found in her <a href="https://www.amazon.com/stores/The+Breast+%26+Chest+Buddy/page/47E9E25B-0C8F-4385-A5D4-6A0CAD56A18A?ref_=ast_bln" target="_blank" rel="noopener noreferrer">Amazon.com store</a>.
				She also shared her experiences with the wider community through newspaper columns, and expressed a wish that this story would also help raise awareness, and hope. Heck noted that for many women, especially &ldquo;of a certain generation,&rdquo; even discussing issues surrounding breast cancer and reconstruction remain taboo.
				&ldquo;I&rsquo;d love it if I could demystify the terror&rdquo; that surrounds such discussions she said, and let others know that the procedure she recently had is available here in Northeastern Pennsylvania.

For Breast Reconstruction Awareness Day, a story of renewal