Archives for September 2011

The Good Fat versus the Bad

avocadoFor several years, we’ve been told to reduce or cut fat from our diets. While it seems like good advice, this message is too simplistic. A better message is to make sure we get enough good fat in our diet and cut out the bad fat. Not all fats are equal, and once you know the difference, you’ll be well on your way to better health.

What is fat and why do we need it?

Essential fatty acids (EFAs) are just that: an essential part of our diet like protein, carbohydrate, vitamins, and minerals. EFAs cannot be produced by the body and must come from food. The truth is that you need a certain amount of fat to be healthy. In addition to providing energy and insulation, fat has several functions in the body:

  • Your body needs dietary fat to transport and use the fat-soluble vitamins A, D, E, and K. These vitamins keep your eyes, skin, blood, kidneys, and bones healthy.
  • Dietary fat, particularly omega-3 fatty acids, reduces symptoms of inflammatory conditions such as arthritis.
  • Fat helps the body synthesize hormones, and it promotes healthy cell function.
  • Children need fat to develop normally, both physically and mentally.
  • Fat slows digestion and helps your body absorb nutrients.
  • Your brain needs fat to function, and nerves are covered with a substance made from fat.
  • Omega-3 fatty acids reduce depression, dementia, and memory problems.

Unfortunately, many people have been led to believe that any food with fat should be avoided, which has spawned an incredible number of “fat-free” foods. Fat gives food flavor, so to replace this flavor, manufacturers add sugar—not a good tradeoff.

Which are the good fats?

Good fats come in many foods, such as avocados, nuts and seeds, and fish. Moderation is the key. Don’t be afraid to cook in olive or coconut oil, which are more stable at high temperatures than vegetable oils. Go ahead and put real butter on your toast, and eat nut butters, olives, and fatty fish such as salmon. Put some real cream in your coffee.

The bad fat you want to avoid

Trans fats are found in stick margarine, vegetable shortening, and most packaged or processed foods. Trans fats are created in a laboratory by forcing hydrogen through vegetable oil to make it solid at room temperature. These fake fats increase inflammation in your body and can raise cholesterol.

Food manufacturers can claim a product has no trans fats if it has less than 0.5 grams per serving, so reading labels is vital to avoiding trans fats. If you see the words “partially hydrogenated” or “hydrogenated,” don’t eat it.

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How Can I Alleviate Scar Pain and Tightness After Surgery?

The question below is answered by Charleston breast surgeon, Dr. Richard M. Kline, Jr. of The Center for Natural Breast Reconstruction.

I had a Phase 1 SIEA flap reconstruction in February 2010, and a Phase 2 in November 2010. Abdominal and drain scars were revised in November 2010, but I’m still having severe pain, tightness, and discomfort, including bad scarring on part of the big abdominal incision and on both abdominal drain sites. I’m assuming that I need another surgery (I’m seeing my plastic surgeon soon). Is it correct to assume there’s a chance any new revisions might not work? And are there any techniques that could alleviate some of the abdominal tightness?

I’m sorry that you are experiencing a rare, but, unfortunately, persistently recurring, complication – not specifically of breast reconstruction surgery, but of any surgery.

Any time skin or other body structures are cut, myriad nerves, a few named, most unnamed, are unavoidably divided, or at least damaged. Most of the divided or damaged nerves “wither away,” and cause no problem. A very few of the damaged nerves stay “irritated,” and some of the divided nerves form “neuromas,” or very tender balls of nerve tissue. These account for much of the chronic pain, which some people experience following surgery. Why this occurs when it does, and how to predict or prevent it, are questions all surgeons would love to know the answer to. It is not preventable – the best a surgeon can do is warn patients that it could happen.

As a practical matter, re-operating for painful scars may not be very productive. When our patients have chronically painful surgical sites, we refer them to pain management specialists for treatment. Usually this involves injections of local anesthetics, steroids, or other agents. We have generally been pleased with the results we have seen from this.

If there are other reasons to revise your surgical site, it is not completely unreasonable to think that more surgery may favorably affect the pain, and we wish you the best of luck in that scenario.

–Dr. Richard M. Kline, Jr.

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