Archives for February 2015

Ask The Doctor-What could be causing the cramps in my breast?

5987018633_ca7f1c6f97_mThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I am 70 years old, and 5 years ago had a bilateral with reconstruction. Since then, I have had severe cramps in both breasts and they can even tie a knot in my stomach I can feel knot up when I cough. These are not like stomach pains, they are very painful, hard cramps like one experiences in the calf of their legs….I asked my Plastic Surgeon about them, and he just said he had never heard of cramps in breasts. I can cause my breasts to cramp by simply turning over on. My side, raising my arm or reaching around for something…I’m a tough ole broad, but these cramps make me nauseous they hurt so bad…have you any experience with this? Thank you so much for your time.

Answer: Thanks for your question. I’m sorry you’re having a difficult time. Painful cramping suggests muscles are having spasms. Normally the breast does not have muscle but the chest muscle is underneath the breasts and can have spasms for different reasons. The explanation could possibly be related to the type of breast reconstruction. If you have implant reconstruction the implants are often placed under the muscles. If the body rejects the implants or develops scaring that tightens around the implant the distortion can cause muscle spasm. If you had reconstruction using one of your body muscles to rebuild the breast,  that too could possibly be related to the cramping pain. If the muscles from the tummy wall were used to rebuild your breast or breasts that might explain the “knot in your stomach”. I would need more information to let you know what I would recommend. What type of breast reconstruction did you have? Do you have implants and did you have radiation to the breast? Thanks again.

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

Have Fun While Breaking A Sweat

exercisingThere are rumors rolling around town that there are some new workouts that are (*gasp*) fun!

We don’t know about you, but this just simply goes against everything we know.  Don’t get us wrong—we are always open to new things. But if there were ever a day where we’d see pigs fly, today is the day.

In case you want to try this whole “fun workout thing” with us, we’re sharing the top 5 newest calorie-burning trends.

Bounce the Calories Off

This is the place of your childhood dreams: an entire room made of trampolines for as far as your eye can see. You can literally bounce the calories off and not even know you’re doing it. It’s great cardio AND leg sculpting. And bouncing is great for the lymphatic system!

Our Charleston recommendation: Sky Zone Trampoline Park.

Join the Circus for the Day

Who said you have to work out on the ground? Try your talents at the aerial sling, aerial silks, aerial hoop, or the trapeze! You will definitely feel the burn on this one. Warning: this might not be your thing if you have a fear of heights.

Our Charleston recommendation: Aerial Fit.

Walk on Water

You’ve probably seen Stand Up Paddleboarding (SUP) by now, but have you tried it yet? With a little help from an instructor, you’ll be up on your feet in no time! There are so many great SUP activities for all experience levels, ranging from laid-back tours of rivers and canals to more intense workout classes and races.

Our Charleston recommendation: Nature Adventures Outfitters.

Dance the Weight Off

Have you tried a Zumba class yet? This workout involves dancing off calories to high-energy music. It’s the perfect full-body workout!

Our Charleston recommendation: Pivotal Fitness.

Walk and Talk

Okay so this one isn’t a new trend, but it sure is fun! Instead of meeting your friends for coffee, plan on going for a walk together. You will still get to check in with each other, but you’ll also get to burn some calories too!

Have you tried any of these fun workouts? Let us know what you think!

Ask The Doctor- If you choose natural breast reconstruction as opposed to implants is there sensation in the breast?

multi-colored flowerThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: If you choose natural breast reconstruction as opposed to implants is there sensation in the breast? Is there sensation with nipple sparing? What is the rate of success with natural reconstruction? Thank you.

Answer: As a general rule, there is no erogenous sensation after any type of breast reconstruction, although in isolated circumstances some people do seem to get that back, or something like it. Most of the skin is usually completely numb initially, but may regain some feeling after months, or even years. Even after nipple-sparing mastectomy, there is usually no sensation. While it is theoretically possible for the nerves to grow back, it is rare to get normal feeling back, even after a prolonged period. The flap survival rate after natural breast reconstruction is approximately 98%. Completion of reconstruction usually requires 2 or 3 surgeries in all, but they tend to get sequentially shorter and less involved. Once you have competed natural breast reconstruction, however, your breasts will usually continue to improve on their own for many years. This is in sharp contrast to implant-based reconstruction, where the quality of the reconstruction often tends to deteriorate over time. Thank you for your question.

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

(**Note to our readers: We really do personally reply to all questions sent through our website within 24 to 48 hours directly to the e-mail provided by the sender. We want you to receive your answer quickly, so please assure that you are entering your information correctly so that you receive the personal answer to your question and do not have to wait for it to be published as an Ask The Doctor Q & A.) 

Ask The Doctor-Are the lymph nodes disturbed during DIEP flap reconstruction?

pink flowerThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: After a DIEP flap reconstruction, the top part of my tummy above the incision protrudes over the scar-especially in the evening. Is this a lymph issue or edema? Are the lymph glands disturbed in the abdomen with this kind of surgery?

Answer: Thanks for your question. During a typical DIEP procedure the lymph nodes that serve the tummy area are not removed and the lymphatic fluid can move in the normal direction. It is possible to have lymphedema of the tummy area after a DIEP but it certainly is not very common. It would be more likely if someone had multiple tummy surgeries and scars before the DIEP procedure. In my patients I see that their tummy wall and tummy incision may be swollen for 3-4 months after the surgery. If someone has healing problems, infections or a seroma (pocket of fluid underneath the incision), then swelling can be more prolonged. If someone has persistent swelling and none of the above issues for 6 months then I would consider having a therapist who has experience treating lymphedema see them for possible lymphatic massage treatments. Let me know if you need more information, thanks again.

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

(**Note to our readers: We really do personally reply to all questions sent through our website within 24 to 48 hours directly to the e-mail provided by the sender. We want you to receive your answer quickly, so please assure that you are entering your information correctly so that you receive the personal answer to your question and do not have to wait for it to be published as an Ask The Doctor Q & A.) 

Preventative Measures: Staying Healthy to Stave Off Breast Cancer

fruit pileHave you ever heard that wearing a bra with underwire increases your chances of breast cancer? According to health.com, this has been totally debunked by the scientific community.

There are a lot of myths about what does and doesn’t cause cancer. That’s why we’re sharing 5 ways that the Mayo Clinic has listed as being proven to decrease the risk of breast cancer—and every slight decrease counts!

1.    Exercise Often

Yeah, yeah. Exercise seems to be the answer to everything. But we’re serious. Breaking a sweat will help boost your immune system to fight off cancer cells.

2.    Lower Alcohol Consumption

Limit your alcohol intake to 1 drink. Research has shown that drinking 2 or more drinks increases the risk of breast cancer by 21%. However, according to Women’sHealth.com, grape juice contains properties to help decrease your risk of cancer—just think of it as drinking unfermented wine!

3.    Be Weight Conscious

Being overweight increases your risk for cancer substantially. By staying fit you are able to boost your immune system and lower your levels of estrogen and insulin.

4.    Breast-Feed

According to Dr. Debbie Saslow from the American Cancer Society, some studies suggest that breast-feeding may offer a slight chance of protection against breast cancer.

5.    Limit Use of Hormone Therapy

Long-term use of hormone therapy can increase the risk of a cancer diagnosis. If you are currently taking hormones, ask your doctor about nonhormonal therapies that are available.

Consult your doctor if you observe any changes or lumps in your breasts. If you have a family history of breast cancer, meet with your doctor to talk more about preventative measures.

Did you find this information helpful? Let’s continue the conversation on Facebook!

 

 

Ask The Doctor-What can be done with unsatisfactory reconstructive surgery results.

red flowerThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I am 3 yrs s/p bilat mast, chemo and L radiation for stage 2 lobular cancer. I received good reconstructive surgery, but I am unhappy with the cold temperature of my breasts and especially with the hardness/immobility of the L breast which had radiation. Can anything be done? Thank you!

Answer: Thanks for your question. When breast reconstruction with implants doesn’t work out, or if the breast feels cold or hard, an option may be replacing the implant with your own fatty tissue. The end result with your own tissue is more natural and permanent. The downside to this approach is it requires starting over, and you need to use  your own fatty tissue. That means an incision that has to heal and a longer recovery time. We frequently take that approach for patients with implant problems. If you would like more info, please let me know.

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

How to Be a Friend to Someone with Cancer

two girls, one with cancerYou’re trying to be supportive to your friend with cancer. But are you? Sometimes, even when we have the best intentions, we may hit a sour note.

The women our team sees every day have gone through tremendous challenges to overcome cancer, and are incredibly inspirational to us all. We often have the opportunity to meet their support systems—the loved ones who have been by their side throughout the journey.

There isn’t a defined guidebook about how to talk to your friend or family member battling cancer.  So we came up with a few things to keep in mind when trying to support your loved one:

Minimalizing

When a friend tells you they have cancer, you may think you’re being helpful by saying, “It could be a worse type of cancer” or “Don’t worry; everything will be fine” or “You don’t even look sick.” Although you’re trying to be helpful and positive, you don’t know how they’re feeling inside. They may be having a really bad day, and these comments may unknowingly make them feel minimized.

What to do instead: Sometimes, it’s just best to listen. If they’re willing to share their feelings, let them express how they’re feeling.

Offering to Help

Someone dealing with cancer has a TON on his or her plate. They are likely hearing a lot of “Let us know if you need anything at all.”

While intentions to help are good, remember that your loved one might have so much going on that he or she doesn’t know where to begin to ask for help. Or, they may be too embarrassed to ask for help when they need it.

How do you help? Just do it. If you’re at the grocery, give your friend a call and ask what they need or just pick up some essentials. Or if you do ask, get specific. Offer to pick up the kids from school or bring them to their after-school activities. These small generosities can help relieve a lot of stress.

Don’t Bring Up Insecurities

Women often feel their hair and breasts define their femininity. Asking questions such as “Are you going to lose your hair?” might stir up feelings unknowingly. Also, making jokes such as “I wish my insurance paid for a boob job” may not lighten the mood as much as you’d think. They’re fighting cancer. Not getting plastic surgery. 

What to do instead: This isn’t to say you can’t joke around—but maybe let your friend take the lead! And, above all, if you notice your friend is looking spectacular, be sure to mention it.

Comment on our Facebook page with more suggestions on how to be a supportive friend!

Ask The Doctor- Do you do 3T MRI of both the abdomen and the chest before a DIEP flap?

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

orange flowerQuestion: Hello, I was wondering if you do a 3T MRI of both the abdomen and the chest before a DIEP flap? I would rather not have more radiation, because I had mantle radiation when I had Hodgkin’s 20 years ago and developed breast cancer as a result. Also have you heard of an APEX flap? Thank you for your time.

Answer: Thanks for your great question! We perform preoperative MR Angiograms with an open 3T MRI protocol on all possible patients we have who are undergoing breast reconstruction with a DIEP procedure. We do the same for any of the multiple muscle sparing natural tissue reconstruction procedures we regularly perform. We do not perform MR angiogram of the chest. That would not provide us with any useful preoperative planning information. There are quite a few people who cannot have a MRI. People who have metal knee replacements or breast expanders with metal parts are examples of reasons some of our patients cannot have an MRI. In our practice we have found CT angiograms are not as useful and avoid them if we can because of the increased radiation. As you may be aware, your history of previous mantle radiation may also increase your chances for problems with implant breast reconstruction. I agree that a DIEP may be a very good option for you. I hope I answered your question. If you would like more information please let me know.

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

Date Ideas with an Extra Dose of Love

roseSo “that” day is rapidly approaching.

You know the day I’m talking about…the one with the extra high expectations and all the surrounding hoopla. Yep, that’s the one: Valentine’s Day.

All right, ladies, it’s time to drop some not-so-subtle hints to our significant others.

Sure, carnations and chocolates are nice, but it’s time for a change.

It doesn’t matter if you’ve been happily married for 20 years or just “in like” with someone, you deserve a date that involves truly spending time with one another.

So it’s time to work our female super powers. Here are 5 unique date ideas that—if you spin the right way—your date may think he came up with all on his own:

1. Plan a picnic

This one is an oldie but goodie. If you’re in Charleston and it’s not too windy, nothing says romance like a basket full of food, a blanket, and a bottle of wine.

2. Make an evening of it

Drinks, dinner, and dessert are a classic for Valentine’s Day. But why not make it an event? Have a night mapped out where you go to a different restaurant for each course. It makes the date last longer and shows you put a lot of thought into the occasion. Make sure you hint that he needs to get reservations, or else you’ll be hopping around burger joints!

3. Take a cooking class

Want to get to know someone better? Need to rekindle with your loved one? An activity, like taking a cooking class together, is a fun way to let loose and connect. If you are in Charleston, we suggest Charleston cooks! Maverick Kitchen Store.

4. Go ice-skating

Ice-skating is the perfect date for the two of you to get slightly out of your comfort zone. Not to mention great practice for learning how to support one another! Make sure you check Carolina Ice Palace’s public skating times.

5. Girls’ night

Don’t think we forgot about you, single ladies! Don’t fret if your prince charming hasn’t arrived. Pedicures, wine, and chocolate with your best girlfriends are definitely on the list this Valentine’s Day.

Have other great date ideas? Please share below!