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Archives for January 2014

Can I Have Natural Breast Reconstruction if I Had Radiation on my Right Side?

January 31, 2014 by

This week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: Can I get natural breast reconstruction if I have had radiation on my right side? I have had both breasts removed, but the first time the cancer was found I had a lumpectomy and radiation. The next time I had it removed.

A: Natural breast reconstruction with your own tissue is usually the best option for patients who have had radiation. Sometimes (but not always) it can be difficult to get the radiated side to match the non-radiated side as closely as desired because the radiated skin can be much tighter, but the chances of success are still usually much better using your own tissue than using implants.

We’d be happy to have our nurse Chris or PA Kim call to chat with you more about the specifics of your situation, if you wish.

Dr. Richard Kline

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Filed Under: Ask the Doctor Tagged With: , , ,

Famous People From Charleston and South Carolina

January 29, 2014 by

Scores of famous people have called Charleston or South Carolina “home” at one point or another. Here is a partial list—how many do you know?

Entertainers, actors, musicians

Darius Rucker, singer

Vanessa Minnillo, MTV VJ and cast member of Entertainment Tonight

Stephen Colbert, TV personality and comedian

Bill Murray, actor

Mabel King, actress

Bill Anderson, country singer

Andy Dick, comedian

Dizzy Gillespie, jazz trumpet player

Eartha Kitt and James Brown, singers

Vanna White, game show hostess

Models, authors, artists

Norb Vonnegut, Frank Gilbreth, and Alexandra Ripley, authors

Lauren Hutton, model

David Carson, graphic designer

Arthur Freed, producer and writer

Alice Childress, playwright

Shepard Fairey, artist

Pat Conroy, author

Wilson Casey, newspaper columnist

Sports figures

Isaiah Thomas and Alex English, basketball players

Tara Lipinski, Olympic figure skater

Langston Moore, Roddy White, AJ Green, Harold Green, NFL players

Joe Frazier, boxer

Beth Daniel, pro golfer

Bud Moore, NASCAR driver

Althea Gibson, tennis player

Mark Messier, hockey player

Art Shell, football coach

Business and industry gurus

Samuel Maverick, rancher

Elizabeth Timothy, first female newspaper publisher in the U.S.

Mary McLeod Bethune, educator

Darla Moore, financial guru

Lane Kirkland, president of AFL-CIO

Todd Howard, entrepreneur

Sallie Krawcheck, chairperson and CEO of Citi Global Wealth Management

Political and military personalities

Andrew Jackson, U.S. president

Francis Marion (“Swamp Fox”), American patriot

Benjamin Huger, Confederate Army general

William Westmoreland and Mark Wayne Clark, Army generals

John C. Calhoun, Vice President, and Floride Calhoun, Second Lady

Thomas Heyward, Arthur Middleton, and Thomas Lynch, Jr., signers of the Declaration of Independence

Bernard Baruch, statesman

Strom Thurmond, congressman

Mark Sanford, former governor

Do you know any more famous South Carolinians?

Filed Under: All Things Charleston Tagged With:

Is It Time to Give Up Soda?

January 27, 2014 by

Yes, it is, for several reasons we’ll outline below, and we’ll also give you some tips for giving it up. Coke, Pepsi, soda, pop, tonic…whatever you want to call it, you need to kick it to the curb. Get ready to enjoy life without soda pop!

It’s empty calories.

If you drink regular soda, you’re getting around 150 calories that do nothing for your body. In contrast, drinking water, herbal tea, or even sparkling water diluted with juice will save you at least 100 calories, if not more. Do the math if you drink three or four sodas a day.

Diet soda is no better. Artificial sweeteners confuse your body into thinking it’s getting sugar, which triggers an insulin release, which can lead to weight gain and type 2 diabetes.

Regular pop contains high fructose corn syrup.

This stuff is poison. No one should be taking it in for any reason. Contrary to what the corn industry tells you, HFCS is not metabolized like other sugars. It’s unnatural, and the fructose goes right to the liver, causing fatty liver. It also causes blood sugar spikes, and contains contaminants such as mercury. Any independent nutrition expert will recommend against HFCS, and so do we.

Diet pop gives you an excuse to eat more.

When you’re taking in no beverage calories, you may rationalize eating more, which leads to weight gain.

How to stop pop…

Try some of these steps to reduce your soda intake and start drinking more healthy beverages.

  • Take it slowly. Don’t expect to quit soda cold turkey. Reduce gradually over several months if you drink more than two or three a day. Try reducing by one pop a day for two weeks, then cut out one more pop a day for three weeks, etc. Make a schedule that works for you.
  • Keep substitutes handy, such as flavored water, sparkling water, rice or almond milk, and fruit juice. While these drinks aren’t ideal because they contain sugar, they’re a good bridge from pop.
  • Just don’t buy it. If it’s not in your house, you can’t drink it. Make it hard to get soda. If you have to go out and buy it, you may be less likely to drink it.
  • Don’t allow your family to bring it into the house, either. They don’t need it either. It doesn’t matter if the kids are young—now is the time to break the soda habit.
  • While you may have an initial withdrawal that may not be fun, after a month of no soda pop, you’ll look and feel better. Keep reminding yourself of that when the pop urge strikes.

What’s your best tip to give up soda?

Filed Under: Health and Wellness Tagged With: , , , ,

Can I Have Breast Reconstruction After A Lumpectomy? Will Insurance Cover My Reconstruction?

January 24, 2014 by

This week, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Q: I had a lumpectomy 10 years ago. Can I have reconstruction to fix my breast? The scar is under my left arm and the lump was taken out of the left side of my breast.

A: Thank you for the question! Some women who have had lumpectomy and radiation to treat breast cancer  develop problems with the shape of their breast or problems with one side being smaller than the other. When this happens we recommend breast reconstruction. It is possible to remove the breast tissue and save the nipple and skin. Then at the same procedure  reconstruction with your own fatty tissue is performed. This has the advantage of removing the radiated scar and breast tissue and reduces the theoretical chance of breast cancer coming back in that breast. It should already be very low.

Dr. James Craigie

Q: I had breast cancer in 2002 in my left breast. A lumpectomy was performed and I only had radiation. I had a breast reduction on the right side to match the approxmate size of the left breast, but since then I have gained so much scar tissue around the left breast and it is now much smaller than the right breast. I am 69 years old, but still consider myself to be middle aged and attractive and this bothers me. Will insurance cover these procedures even though it has been over 11 years since the cancer and 10 years since the reduction? I have a Medicare PPO.

A: Insurance will cover almost any reconstruction-related procedures, if you have had the diagnosis of breast cancer.

There are several potential options available to you, depending on your goals. We would be happy to have our nurse Chris or PA Kim call to discuss your situation further,  if you wish.

Dr. Richard Kline

Thanks for your inquiry!

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Filed Under: Ask the Doctor Tagged With: , , , ,

What Are Air Purifiers and Do They Work?

January 20, 2014 by

Air purifiers remove toxins from the air, typically through air movement through specially designed filters. Often, those who have allergies and lung issues buy air purifiers to help them breathe better and have fewer illnesses.

Which toxins does a purifier eliminate from the air?

The list of allergens and contaminants air purifiers can remove from the air is a long one:

  • Pet dander
  • Pollen
  • Mold
  • Dust
  • Dust mites
  • Volatile organic compounds (VOCs) such as paint fumes and gases emitted from new buildings, carpet, or furniture

Purifiers cannot remove 100% of the contaminants, but they can reduce the numbers considerably. The documentation for any purifier you choose should tell you exactly which allergens it captures and how clean you can expect your air to be.

How does a purifier work?

The most common purifiers sold for home use are filter-based, activated carbon, and ionizers.

Filter-based purification forces air through a filter, which traps toxins that are larger than the filter’s holes. HEPA filters typically remove almost all particles that are larger than 0.3 micrometers, so they are effective for larger airborne particles.

Activated carbon systems remove chemicals from the air, but they do not remove large particles. The carbon alters the chemical state from a gas to a solid. It’s typically used along with filter-based purification, but you will sometimes find it used alone.

Ionizers create charged particles, or ions, that attach to airborne toxins and draw them to a electrically-charged plate. Ionizers do produce a small amount of ozone—and possibly nitric oxide—which is unacceptable to some.

How do I know the purifier is worth the money?

Read the documentation and the packaging carefully. Possible considerations may be filter replacement frequency, area covered, air changes per day or per hour, amount of electricity used, and ease of cleaning. Think about these issues before you begin looking for a purifier.

Some purifiers may create more noise than you’d prefer, so when you buy one, ask to plug it in so you can gauge the sound level. The documentation should specify the amount of noise in decibels.

Most portable purifiers use HEPA technology, and the Department of Energy has guidelines companies must follow in order to claim HEPA on their packaging and advertising. If you see “HEPA-like” or “HEPA-type,” look elsewhere, as the manufacturer is not using true HEPA technology.

Do your research on any purifier you are considering. Google it to see reviews, but beware websites that have many reviews, mostly good; they may be trying to sell purifiers. Check Consumer Reports, manufacturer’s websites, and sites that sell many units, such as Amazon and Best Buy. Talk to friends and family who have purifiers to see how they like them.

If you get the right purifier for your home and your needs, you’ll feel yourself breathing better and getting sick less often. You’ll notice a significant difference when you walk into your home from outside. In short, air purifiers ARE worth it, but you need to do your homework first.

Visit our Facebook page and tell us how you like your air purifier!

Filed Under: Health and Wellness Tagged With: , , , , , ,

Should I Get Permanent Sutures to Help My Implant After Lumpectomy?

January 17, 2014 by

This week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: I had a lumpectomy followed by chemo and radiation treatment. The tumor was on the inner edge of my left breast — basically skin and bone. My plastic surgeon (whom I respect and appreciate) used an implant and Neulasta. He formed a sling and sewed in to my sternum and ribs. I’ve had this procedure done twice. Each time the sutures were absorbed, the skin lifted and resulted in symmastia. I am wondering if non-dissolvable stitches along with sewing the neulasta to the area behind my breast which wasn’t super blasted  — forming a sort of “sail” would be an option. I would be interested in what you think and what solution you might have.

Thank you for your time!

A: We primarily do flap, not implant reconstruction, but I can still offer some insight.

Permanent sutures could possibly help, but if there is long-term significant force on them (which it sounds like there may be), they can work their way through soft tissue and still come loose (just like an orthodontist can move teeth through bone over long time periods). Nonetheless, it’s probably worth a try, especially if you liked the way your breast looked before the sutures dissolved.

There are also some potential options using your own tissue. Unfortunately, replacing the defect with free fat grafts, while technically straightforward, is a little controversial, as there is some concern that this could increase the risk of local recurrence (but this is far from definitively established). There are centers (one in Boston comes to mind) who are doing this as part of a controlled study. Also, depending on the size of the defect and the location of your scars, reconstruction with a small microsurgical flap might be a reasonable (although significantly more complicated) option.

It sounds like you have a good relationship with your surgeon, which is great. Please continue to share your thoughts with him, and I’m confident things will work out for you one way or another.

Dr. Richard Kline

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Filed Under: Ask the Doctor Tagged With: , , , ,

Watch “Take Two” by the Charleston Youth Company

January 15, 2014 by

We’d love to announce the Charleston Youth Company’s production of Take Two, an original script written by CYC students.

This lighthearted musical includes tunes from the ‘80s through the present day and is a love story told in flashbacks.

The storyline follows a couple who drifted toward each other and stayed together through life. However, they kept desperately searching for their soul mates, until they finally realized their ideal match was there all this time.

The play runs on January 31 and February 1, 2014, at 7:30 p.m. at the College of Charleston’s Sottile Theatre at 44 George Street in Charleston. Tickets are available at the door one hour prior to the show, or you can call the studio at 843-766-4007 Monday–Thursday from 6:00-7:30 p.m. If you prefer, please leave a message any time of the day.

From the website www.charlestonyouthcompany.com:

“Founded in 1978, The Charleston Youth Company celebrates its 35th year as a high quality performing arts company of the Greater Charleston area comprised of 1st through 12th grade students with support of their families and community members. This Company encourages and develops artistic talent through music, voice, dance, art, drama, and technical production. We promote integrity, self-confidence, self-discipline and team work while encouraging appreciation of the arts.”

For more information, contact our own Gail Lanter, CYC’s marketing contact, at 843-834-5191 or 843-766-4007. You can also email her at cycinfo@gmail.com. Please don’t miss this production—we know you’ll love it!

Filed Under: All Things Charleston Tagged With: , , , ,

Have You Had Your Mammogram?

January 13, 2014 by

diep and mammogramThe mammogram, or x-ray of the breast and surrounding tissue, is the most effective diagnostic tool for breast cancer that we have today. All women should receive annual mammograms beginning at age 40, or earlier with a family history of breast cancer.

According to www.breastcancer.org, mammograms have been shown to lower the risk of death from breast cancer by 35% in women over age 50. It also means that more women who are found to have breast cancer early can keep their breasts.

In 2009, the U.S. Preventive Services Task Force questioned the need for mammograms in women under 50, and they recommended that screening mammograms begin at 50 instead of 40. Several prominent groups, including the American Medical Association and the American College of Obstetricians and Gynecologists, have emphatically stated that screening needs to begin at 40 instead of 50.

One risk of mammography is the rate of false negatives and false positives among younger women or women with dense breast tissue. Dense breasts can hide cancers, and mammograms can identify a perfectly normal variation in breast tissue and raise the alarm that it’s cancerous. Because of these mammogram drawbacks, we recommend that you not only perform monthly self-exams, but you should also have a secondary form of breast screening done, such as an ultrasound or an MRI.

Many women worry about the pain, but for most women it is merely uncomfortable for a few minutes. A mammogram compresses your breast (to reduce the thickness of the tissue) between two x-ray plates that are attached to a camera that takes photos of your breast. More than a couple pictures may be necessary for younger women or those with dense breasts.

From beginning to end, a mammogram takes about 20 minutes and involves much less radiation exposure today than in years past. According to the American Cancer Society, the radiation received during mammogram is about the same amount a person naturally gets in a 3-month period.

Typically, at least one radiologist reads your mammogram, and if two read it, the chances of missing a problem go down. If you are concerned, you can also have your mammogram analyzed by a computer through computer-aided detection (CAD). Software reviews mammogram images and marks areas of suspicion, and then the radiologist examines each area to see if it needs further evaluation.

Have you had a mammogram, and if so, do you have any words of advice?

Filed Under: Health and Wellness Tagged With: ,

How Long Will Radiation Postpone My DIEP Reconstruction?

January 10, 2014 by

This week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: If I am having Mx and immediate DIEP reconstruction surgery that it is determined that radiation will be necessary, is the the DIEP reconstruction continued as planned, or is it postponed until after radiation? If postponed, are tissue expanders temporarily placed until six months later when flap surgery can be performed?

A: We have never, fortunately (as far as I can recall) encountered findings in surgery that caused us to suddenly think that radiation would be needed when we didn’t suspect it previously. The two things that COULD be found intra-operatively and would lead to that would be positive lymph nodes or a very large tumor. The mammogram and MRI are pretty good at seeing these kinds of things preoperatively. Additionally, if there is any suspicion of positive nodes, we routinely have the sentinel node biopsy done as a separate procedure before the mastectomy.

When we DO know that the patient will need radiation, we sometimes offer them placement of a temporary tissue expander if they do not want to go several months without having a breast mound. This has several disadvantages, including 1) doing unnecessary damage to the chest wall and pectoralis muscle, 2) taking up some of the eventual flap’s volume to fill the divet in the ribs left by the tissue expander, and 3) potentially interfering with the delivery of radiation. Some surgeons think the scar pattern can be favorably altered by and expander in this scenario by keeping the skin stretched, but I’ve never been very convinced by this argument, at least not when the expander is ultimately going to be removed and replaced with a flap.

If we did, for whatever reason, unexpectedly determine in surgery that the patient needed radiation, I would probably just do nothing (no tissue expander) and come back after radiation and do the flap(s).

Dr. Richard Kline

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Filed Under: Ask the Doctor Tagged With: , , ,

Fort Sumter’s Role in the Civil War

January 8, 2014 by

Fort Sumter is located in Charleston Harbor, and is known as the site where the Civil War began. On April 12, 1861, the first shots of the war were fired upon the fort.

Built in 1829 (or should we say construction began in 1829, as the fort wasn’t completed by 1861), Fort Sumter was one of several forts built along the southeastern coastline of the U.S. An imposing structure, it is 190 feet long with five-foot thick walls and was built to house over 600 men and 130 guns when filled to capacity.

South Carolina seceded from the Union in December of 1860, and Union forces held Fort Sumter under the command of Major Robert Anderson. Confederate Brigadier General P.G.T. Beauregard was not amused, and demanded the fort be surrendered. Anderson refused, and early in the morning of April 12, 1861, the Confederates opened fire on the fort.

The battle continued for almost 36 hours, and in the end, the weakened Union forces surrendered without bloodshed. However, the terms of surrender allowed the Union to fire a 100-gun salute before leaving the fort, and an accidental explosion took the life of one gunner and critically wounded a second. Fort Sumter was and still is considered the site upon which the war began.

In 1863, Union forces twice attempted to retake Fort Sumter, once under the command of Rear Admiral Samuel Francis DuPont and once under Major General Quincy A. Gillmore and Rear Admiral John Dahlgren, but both attempts failed. The Confederacy had been busily fortifying and arming the fort with slave labor. The fort boasted over 40 pieces of artillery, including some of the deadliest guns known at the time.

During the war, Fort Sumter had been badly damaged and was restored by the U.S. Army. For a time, it was used as a lighthouse, but is now a popular tourist attraction.

Have you visited the fort?

Filed Under: All Things Charleston Tagged With: ,
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