When you’re pregnant, your body goes through a LOT of changes. Some things, you’ve likely heard from your friends and family. You’ve prepared yourself as best you can and you’re ready for it.  Other things may not have made it into the conversation and you’re left wondering if it’s normal. That’s where we come in. Diastasis Recti is a fancy term for Abdominal Separation. Your baby needs a place to grow and your body accommodates. Diastasis Recti affects about 60% of expecting/post-partum women and typically fixes itself within 8 weeks after delivery. For women still struggling with symptoms six months after childbirth, you’re not alone, and physical therapy can help.

What are Common Symptoms of Diastasis Recti:

A tell-tell sign of diastasis recti can be a bulge in the center of the stomach, which can be easier to see when your abdominal muscles are in use. This bulge can be worsened by activities that activate the abdominal muscles such as:

• Sneezing
• Coughing
• Lifting objects

Another common symptom of diastasis recti is lower back pain, as this is because your abdominal muscles also support your lower back and as they become separated, they won’t perform as well as they should, causing your lower back muscles to be in pain.

Physical therapy for diastasis recti may include:

• Core stabilization and postural strengthening.
• An abdominal brace to provide support and reduce pain.
• An exercise program designed to stretch overly tightened muscles.
• Education and training on how to lift and carry your baby as your abdomen recovers.

If you are unsure whether you have diastasis recti, talk to your OB-GYN or physical therapist and ask them to evaluate your core muscles. If you do have an abdominal separation, a physical therapy program can give you all the tools necessary that you will need to bring your abdominal muscles back together.

For Breast Cancer Awareness Month this October, we’re getting personal and sharing stories from women we work with and love, who have gone through their own health journey with breast cancer or conditions related to breast cancer. Each story and experience is different. We hope these stories help push someone who may be on the fence regarding mammograms and care, to be proactive about their health, advocate for early detection, and support those who may be going through similar journeys.

Esperanza’s (Hope’s) Story: Breast Cancer Survivor (Getting a Positive Diagnosis)

At 48 years old, right before I was supposed to go in for my yearly mammogram, I started suffering from night sweats. I went to see my doctor about my fever, and he just prescribed me Tylenol, but I continued to have high fevers at night, and I would wake up the next morning with my sheets saturated with sweat. I decided to visit a gynecologist and told him about the other doctor who prescribed me Tylenol. He promptly told me that this issue would not be fixed with just Tylenol. I also told him that I noticed a lump in my right breast.

He ordered some blood tests and a biopsy of the mass in my breast. A couple of days later, the doctor called me saying, “I would not have liked to give you this news, but I must tell you that the tests came back positive for cancer. Don’t worry, I will arrange everything for you to be seen at M.D. Anderson in Houston, and I will pay close attention to everything they do for you in the cancer center.”

Starting Breast Cancer Treatment

I was scheduled to be seen just a week later at M.D. Anderson and had surgery to remove my right breast. The oncologist told me that the cancer I had was very aggressive and the team even had to remove parts of the tendons around my shoulder. I decided to go ahead with the chemotherapy treatments just three weeks after the surgery. My gynecologist then offered to give me a letter for a leave of disability, but I refused it and said I would ask for it when I really needed it.

When I would go to my chemotherapy treatments, I had severe nausea and vomited many times. I wasn’t eating very well, and the smell of food made me nauseous. Even the smell of Coke made me nauseous, which had been a huge vice of mine for some time. But after the treatment over the weekend, some of the nausea would wear off, I would come home and go to work during the week.

Dealing with Complications

I had 10 or 11 chemo sessions. After the entire treatment, one morning after I woke up and looked in the mirror, I noticed I was covered with bruises all over my body and blood that seeped out of my eyes and ears that had dried overnight. That same day, I was already scheduled to see another oncologist to run some tests. When I came to the office, my doctor was perplexed and quickly put me in a wheelchair to run several tests. I ended up staying at the cancer center for a full month.

They gave me blood transfusions because my blood platelets kept decreasing. I did not have the strength to even lift my arms! The doctors told me that I would need blood from either a sibling or from one of my children, so it was decided that it would be my son Ivan who would donate. After I was given transfusions, the specialists told me that it was successful and my platelets were rising, but after three days, my platelet levels went down again.

There were specialists from other hospitals who came to suggest other medications and treatments, but none of them were successful. Then they decided to perform a spinal tap, where they took fluid from my spinal cord. The needles they used were gigantic and they had to do the test several times. Even though they gave me anesthesia, I felt everything. The next morning, I woke up with blood coming from the sites they had punctured me with the spinal tap. They ran more tests and told me that they had to remove my spleen. After that, my health seemed to get better over time.

Looking Back

When I was a little girl, I was sick all the time. I had the same symptoms I had back then, with the fevers, the bruises & the blood clots; but when I became a woman and had my first menstrual cycle, everything went away, and I suppose, helped to regulate the things going on in my body. The town doctors could never figure out what was wrong with me when I was a little girl. I always thought I would have problems later in life when I no longer menstruated, which came to be true.

I had begun my perimenopause stage when I began suffering night sweats and was given the cancer diagnosis. As an adult, I became very disciplined about keeping a journal and writing down any symptoms and how I felt that day. I was also very on top of scheduling my doctor’s visits and exams.

I am very thankful I have been in remission for over 30 years now and no longer have to see my oncologist but has become a lifelong friend. I will always remember the friends I made during my chemo treatments in the cancer center who unfortunately did not make it. As a breast cancer survivor, I believe it is very important to look after your health because it is one of the most important things in life aside from your family.

Ending This Series

These stories are just a small glimpse into the diverse and complex world of breast cancer. They emphasize that awareness, early detection, support, and education are our strongest allies in the face of this challenging diagnosis. If you or a loved one have questions about breast cancer speak to your care provider. Additionally, there are many organizations like Susan G. Komen that do a great job pushing for awareness and research.

Physical therapy plays a crucial role in the holistic recovery process for breast cancer patients. Following breast cancer surgery, radiation therapy, or chemotherapy, individuals often experience physical challenges, including reduced range of motion, muscle weakness, and pain. Physical therapists help patients regain their mobility, reduce post-operative complications, manage lymphedema, a common side effect of breast cancer treatment, and address these issues by designing customized exercise programs that aim to improve strength, flexibility, and overall physical function. By tailoring their approach to the specific needs and limitations of each patient, physical therapists are instrumental in aiding breast cancer survivors on their journey toward improved health and a better quality of life.

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For Breast Cancer Awareness Month this October, we’re getting personal and sharing stories from women we work with and love, who have gone through their own health journey with breast cancer or conditions related to breast cancer. Each story and experience is different. We hope these stories help push someone who may be on the fence regarding mammograms and care, to be proactive about their health, advocate for early detection, and support those who may be going through similar journeys. 

Jenna’s Story: Breast Cancer Previvor  (Testing Positive for a BRCA2 Mutation)

I found out I had a BRCA2 mutation (a breast cancer gene) in 2012. My older sister was diagnosed with breast cancer at the age of 36, which is the same age our mom was when she was diagnosed with breast cancer for the first time. I was tested with a simple blood draw by the genetics team at my clinic and it was sent to Myriad Genetics for testing. My sister who had been diagnosed with breast cancer had already gone through genetic testing and when they found a break in her BRCA2 gene, her team wanted to know if her twin sister, me (her youngest sister), and her mom also had this same break. We did.

Even prior to my genetics testing, my care team wanted me to begin surveillance 10 years younger than my mom’s first cancer diagnosis, so at age 26. The plan was just yearly mammograms. I was 26 when I found out I had a BRCA2 mutation, but still young and stupid and put off my surveillance for a bit anyway. My OB was the person who really pushed me to take it seriously and go to my appointments and screenings.

When insurance tried to deny my mammogram at such a young age, she advocated for me and contacted them on my behalf to get it approved. I never had any issue with screening after that. My surveillance was a mammogram every year, a breast MRI every year, and a visit with an oncologist once a year, so I was being screened a minimum of every 6 months. Anything that was suspicious was taken very seriously. There were a couple of times when I found a bump or something abnormal and when I called to ask about it, they scheduled me to be seen right away for an additional mammogram or an ultrasound. Thankfully, those scares were always nothing and made me feel like I was a burden, but it was great that they never made me feel that way. One was simply a blemish on my breast, but they didn’t make me feel stupid at all for calling in about it! Better safe than sorry.

I remember trying to Google BRCA to find people like me and I couldn’t. It was maybe a month later that Angelina Jolie put out her Op-Ed about her medical decision after finding out she has a BRCA1 mutation. I began hearing about it a lot more after that, but I decided that whatever my journey, I was going to share it in hopes that it would help someone else. I now have a public figure account on Instagram where I share my journey and I have had lots of people reach out and tell me that my story has helped them. It’s the best feeling.

Choosing to Get a Mastectomy

Going back to when I found out, my now ex-husband and I took some time to think about it and talk it through, and we decided we wanted to have a family first because breastfeeding was important to both of us. I struggled to get pregnant both times, but in the fall of 2014, I welcomed my daughter Harper, and in the spring of 2019, I welcomed my son Oliver.

I felt good about my game plan because I had a solid care team who was monitoring me every 6 months. When I was pregnant, I had ultrasounds to keep up on my screening when I could not be in an MRI machine.

I then had a mastectomy in 2020 with a lot of complications. My plastic surgeon also helps run the wound clinic/hyperbaric department at the hospital I went to and while in surgery he actually sat me up and ran a dye through my veins to see how my blood flow looked. When he noticed that I was not getting proper blood flow to the nipples, he had me approved for hyperbaric dives through insurance starting the next morning.

Post Mastectomy Recovery

I remember being sleepy and still kind of out of it and wheeled into this department where they sized me for this weird helmet, checked my vitals, and then rolled me into a chamber room that looked like a submarine. I was the last one on that morning and there were 6 recliners in the chamber and 5 older people waiting on me. I was put into the 6th recliner, connected to leads, had pillows put under my arms and a blanket covering me up and the giant door was shut and locked.

I think I did 34 hyperbaric dives and it felt like a full-time job. It was Monday-Friday, each dive was 3 hours long and I also had to travel an hour each way to get there. I made friends with the people in the chamber with me, and almost every dive one of the older patients would pick a Western movie that was SO boring. On Wednesdays after my dives, I would see my plastic surgeon and he would evaluate my condition. Another complication was that I went directly to implant and the vertical incision under my right breast would constantly open no matter how careful I was.

Almost every week my plastic surgeon was having to cut away the edge of my skin to clean it up and re-stitch me. It got to the point where I developed a skin infection in that same breast that oral antibiotics would not clear, and I had to be admitted to the hospital for a couple of days of IV treatment (this was in February 2020). Those couple of days turned into a full week!

Shortly after my hospitalization my surgeon and I decided it was best to remove the implant on my right side and put an expander in and allow my body time to heal. Days after this surgery, the world shut down due to COVID, and I had a flat chest on the right side and a full breast on the left. I was supposed to go in for expander fills to stretch my skin once healed slowly, but those visits were flagged as unnecessary, and due to COVID restrictions, I had to wait a month before I could even begin going in for my fills. I had my expander removed and a new implant put in July 2020.

I also had fat grafting and revision surgery in August 2022 where they took some belly fat and inserted it into my breasts because you could see the ripple of the implants below my skin. This was an easy surgery.

How it Feels to be a Breast Cancer Previvor

Today my health is great! My breast cancer risk is behind me now, and everything has been taken care of. My scars are there but remind me of how strong I am, and I am proud of them. My one complaint is that I still don’t have much feeling in my breasts which I knew was a probability. I can feel pressure, but the nerves were all damaged during my surgery.

In addition to my mastectomy, I am now 5 days post-op (September 21, 2023) from my full hysterectomy and oophorectomy to reduce my risk of ovarian cancer to 0%. I am doing very well recovering from this surgery but did have one complication (shocker!). My surgeon/OB said that I had “a lot of” endometriosis that we were unaware of prior to my surgery.

I had been struggling mentally with the hysterectomy and almost pushed it off because I was nervous about kickstarting menopause and was sad that I was never going to have the option to have another baby if I chose to. But finding out about the endometriosis felt like a sign that I did the right thing. My surgeon said had I waited, things would have gotten “stuck” and it would have been harder for her to remove everything successfully, especially the ovaries which are what would cause the ovarian cancer.

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