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“A Learning Experience” In HIS Words

April 30, 2015 by

by:  Richard M. Kline Jr., M.D.

learning is a giftI think the biggest thing I learned was how important it is to have providers you trust when you are facing surgery. For me, this was relatively easy, as my wife worked with these people all the time, and I found them immediately likeable when I met them. But how is a lay person to know who to place their trust in? I think the initial step is selecting your surgeon. He or she should immediately look you in the eyes, really listen to everything you say, answer questions honestly, and never be afraid to say “I don’t know.” I think it can help if they have already operated on people you know (as I mentioned, this surgeon had operated on my Dad), but that’s usually not going to be the case. Once you have found a surgeon you trust, the rest should start to fall into place, because they will select the best team they can to help them take care of you. As it turned out, my surgery took longer than expected because it they couldn’t do it laparoscopically, and had to “open me up.” This bothered my surgeon, but it didn’t bother me. I had trust in my team, and felt that however it worked out, it was for the best.

 

I also noticed that, by and large, everyone I came in contact with on the day of my surgery seemed to be “tuned in” to how I was likely feeling at an unusually vulnerable time. I had previously lacked firsthand experience of the importance of that empathy to patients.

 

I think that I also gained some appreciation for how the patient can sometimes contribute to a good outcome. I think my preoperative efforts to lower my blood pressure and improve my overall fitness were helpful.  On the morning of surgery my blood pressure was normal, and I think my postoperative course might have been a little easier because I was in a little bit better shape due to the exercise.

 

And I will still prescribe to my patients those Lovenox shots, because I care about their safety – but I will do it with much more sympathy.

Hey doc how are you

Filed Under: In Her Words, Uncategorized Tagged With: , , , , ,

6 Steps to Rock a 5K

April 28, 2015 by

lady jogging on sidewalkYou’ve decided you want to run a 5K. (Whoo hoo! Good for you! Pat yourself on the back!)

If it’s your first 5K, or it has been a while since you’ve run a race, it’s difficult to determine just where to start and how to properly prepare.

With races, such as Susan G. Komen Lowcountry’s Rock Pink 5K coming up on May 23 here in Charleston, we thought it was the perfect time to share 6 steps to rocking out a 5K!

1.    Register for a run

Why register for a run that you haven’t started training for? This ignites the fire under you to get your rear end in gear. When you have a clear-cut goal to work towards, you are less likely to cop out of your runs.

2.    Create a training calendar working up to 5k

Especially if this is your first 5k, create a training calendar to work up to this distance. Each week, add extra distance to your run.

Be sure to pencil in stretches and muscle building exercises, which are also an important part of training. Building up endurance is the key to a successful 5k, but don’t forget to include a rest day each week so your muscles can recuperate.

3.    Choose appropriate gear

Just as a football player needs the best helmet and shoulder pads, runners need the appropriate gear as well. Worn-out running shoes can cause damage to your joints and muscles. This being said, don’t show up to race day with a fresh-out-of-the-box pair of shoes—be sure to break them in a bit before a big race. Don’t forget to check the weather the week up to the race, so you’ll be prepared with the appropriate workout clothes to wear.

4.    Create a music play list

Create the ultimate playlist that will keep you moving! Make sure this playlist lasts for the duration of the run. Our recommendation: make a few, and alternate them so you’re not tired of the songs by race day.

5.    Find a running buddy

When you’re not feeling like jumping out of bed before dawn or dragging yourself out after work, it makes all the difference when you have a running buddy. You’re more likely to head to a workout when you know someone else is counting on you. When choosing your exercise partner, be sure you are both at about the same running level so that you can push each other.

6.    Eat the right food before and after runs

What you put into your body is the fuel for your workouts. Your body needs different things before a run versus after a run. However, this isn’t marathon training—no giant bowls of mashed potatoes and macaroni and cheese on these lists! Just small, healthy snacks to boost your energy.

Pre-Run:

  • Berries and low-fat cottage cheese
  • Honey and Greek yogurt
  • Carrots and hummus

Post-Run:

  • Bananas
  • Protein bars
  • Fruit smoothies

Support the Susan G. Komen Lowcountry Foundation, at the Rock Pink 5K on May 23.

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

Ask The Doctor-Do you accept Advicare Medicaid?

April 24, 2015 by

monsoon white flowersThis week, Gail Lanter, CPC, of The Center for Natural Breast Reconstruction answers your question.

Question: Do you accept Advicare Medicaid?

Answer: Thanks for reaching out to us.  We only recently heard of Advicare and have not been approached to contract with them.  I’ve tried calling them and haven’t received a response to my inquiry yet.  I’ve also asked them if they can tell us who is currently within their network that might perform the types of breast reconstruction surgeries that we do and can’t seem to get them to give me a list, they just tell me to have the member call in to inquire.   I am hoping to get a call back from one of their representatives very soon in the hope that I might be able to give some good alternatives to ladies who’ve contacted us.  I will be certain to keep on my list to contact as soon as I know something more. Thanks again!

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

 

 

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

Recovery daze…..

April 23, 2015 by

By:  Richard M. Kline Jr., M.D

 

pain scaleI woke up and wasn’t sure where I was. I thought about it a while, and finally asked. A nurse said “the recovery room.” I asked how long I had been there, and she said “30 minutes.” I asked how long the surgery took, and they said “about two hours”. I knew this was longer than was planned, but I didn’t worry about it, as I felt pretty intact. They asked what my pain was on a scale of (0-10), and I said “3.5.” She asked if I wanted some Dilaudid, or if I wanted to go back to the room without it. I said I wanted it, so they gave me 1 mg i.v. While the pain hadn’t been terrible, it was significant, and the Dilaudid did a great job of reducing it. It didn’t get rid of it completely, but it did produce a kind of “warmth” that made me not care too much about the residual pain.

I then went back to the same room I’d been in before surgery, and stayed only briefly before deciding I was ready to go home. When I got up to get dressed, I immediately got nauseous. The bubbly i.v. specialist nurse was there again, and she came over and held an alcohol wipe to my nose until the nausea went away. Then home I went, happy that it was over, and not feeling too badly.

For the first few days it hurt to get out of bed. I would lie there thinking about getting up for several minutes, planning the best way to do it, and only then proceeding. Once I was up, though, moving around wasn’t bad.

About two weeks postop, I noticed that coughing or sneezing didn’t make my incision hurt any more. I started walking on the treadmill at the gym. It hurt a little, but not bad. After that, I started to forget about the surgery.

The final installment of this 4 part series will post April 30.

Filed Under: In Her Words, Uncategorized Tagged With: , , , , ,

What’s New In Breast Reconstruction: Online Event

April 21, 2015 by

logo pink flowerRound up the girls, bring the cheese and wine, and join our doctors, Dr. Kline and Dr. Craigie, on Thursday, April 30, 2015, at 6:30 p.m. Eastern to hear all about what’s new in breast reconstruction and have your burning questions answered LIVE by the doctors.

We understand all the information on breast reconstruction out there is overwhelming. Our commitment at The Center for Natural Breast Reconstruction is to provide you with the information you need so you can decide if natural breast reconstruction is right for your unique situation.

When you register for this online event, we will update you on the latest options for breast reconstruction, answer your specific questions, and help you understand all of your options.

During this hour-long, no-cost event, you will discover:

  • What’s new in natural breast reconstruction, including new donor sites and tissue expanders.
  • Exactly how fat can be removed from your body and used to reconstruct your breast.
  • How natural breast reconstruction can correct implant problems and help women who have undergone mastectomies and who are unhappy with the results.
  • The concept of multiple donor site breast reconstruction, and if this is an option for you. 

**BONUS: You can ask questions before the webinar for the doctors to answer—or simply show up and ask your questions LIVE.

Ask your question here, and you’ll gain access to the live call and maintain access to watch the replay at your convenience!

Filed Under: Upcoming Events Tagged With: , , , , ,

Ask The Doctor-Can I have reconstruction surgery with a low immune system and infection?

April 17, 2015 by

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

Question: I have had three surgeries already: 2 to remove cancer and 1 reconstruction. I can’t have the last one because of infection in left breast where the cancer was, plus I keep getting sick because my immune system is low. Is this common if I just had radiation in the infected area?

Answer: I’m sorry you are having problems. If you are having an infection after radiation it would definitely be best to hold off on your reconstruction until your immune system has recovered and the infection is gone. Radiation treatments definitely increase the chance of getting an infection. If you have an implant in place already it may need to be removed to resolve any infection. Once that has occurred you can still proceed with breast reconstruction at a later time when you have recovered.

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

*Before we post to the blog, we double check to ensure we respond to each person who submits a question personally so that you receive the information you need first.

 

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

Surgery Day (and other tidbits)

April 16, 2015 by

hospital sign

By:  Richard M. Kline Jr., M.D

My wife took me to the hospital at 6 a.m., and I sat in the preoperative waiting room with the other surgery patients. Eventually my name was called, and I was taken by a female technician to a room to be weighed. I wanted to say “NOT FAIR!” when she weighed me with clothes, shoes, and cell phone, but I realized it didn’t really matter. Next she took me to a private preoperative room, handed me a gown, and told me to take off “everything”, use the bathroom, and put on the gown. This was definitely unsettling, as I’m not used to taking off my clothes in front of strangers, but I realized I was going to have to comply if I was going to get through this. As I put on the gown, I couldn’t help but think about Jack Nicholson with his butt sticking out of his hospital gown in “Something’s Gotta Give.” After I had changed, the young lady returned, and directed me to lie on the stretcher. She then announced she had to “remove my hair,” and mentioned that others would be coming to check her work. I was a little surprised because plastic surgeons have learned that there is really no need to remove hair before surgery, but the last thing I wanted to do at this point was upset the routine. As I lay there trying to be calm while she trimmed my lower abdomen and groin with clippers, she chatted pleasantly, asking at one point if I wanted the “full Brazilian wax.” After she finished, her female supervisor came in, lifted my gown and inspected the job, then told her to trim another inch of hair off the bottom.  After this was done, I got a short reprieve, after which a third woman came in and “checked my prep” again. At this point, I was starting to get over being inspected, and just wanted to move forward.

Another nurse, the self-proclaimed “i.v. specialist,” entered. She was very bubbly and chatty (perhaps even more so after I told her I was terrified of needles). She complained about me grinding my teeth when the local anesthetic went in my hand, but after that I didn’t even feel the i.v. catheter go in, which was a relief. At that point I thought I was safe, but then she pulled out a syringe, smiled, and said “Lovenox!” That needle went into the left side of my freshly prepped abdomen. I didn’t realize until then that Lovenox burns going in. Ouch.

At last I was prepped, and my wife was allowed in. What a relief to see her again! Soon the anesthesiologist came in to see me. I’d never met him, but I knew my wife worked with him frequently and thought highly of him. He was very calm and matter-of-fact, exactly what I wanted. The surgeon then entered for the final preoperative visit, confirmed the procedure, and marked the surgical site. He was calm and reassuring.

Before they wheeled me from the preoperative room to the operating room, they gave me a dose of i.v. Versed, to “take the edge off.” This was a good thing, as the process of being wheeled down to the O.R. in a stretcher was, for me anyway, surreal. I’m usually the one pushing people down these hallways – this was too weird! As the team wheeled me down the hall I said “this is a very different vantage point from down here,” and they all agreed. Once we got in the OR, they had me move myself from the stretcher onto the table. The oxygen mask went over my mouth and nose, and the last thing I remember was the slight burn of the Propofol anesthetic going into my hand and wrist.  —Lights out—

(Part 3 of this series will post April 23)

Filed Under: In Her Words, Uncategorized Tagged With: , , , , , ,

7 Ways to Fit into Your Itty-Bitty Bikini

April 14, 2015 by

girl in yellow polka dot bikiniOkay, do you hear that ominous music in the background? It sounds a lot like “dun dun dunnn.”

Oh wait, that’s just the sound of bathing suit season rapidly approaching!

Don’t fret—we’ve come up with 7 ways to get you back in that itty-bitty bikini in no time!

These aren’t crash diets either. They are just 7 easy and healthy tips to incorporate into your day to lose those extra winter pounds.

Here’s to being bathing-suit ready this year!

1.    Fill up on vegetables

Waiting to eat until you’re absolutely starving can lead to bad cravings and poor eating choices, so it’s important to eat consistently throughout the day.

Recommendation #1: don’t skip meals.

Sure, you might not be hungry right then, but that hunger will come back with a vengeance later—and it might be in the form of a pizza.

Recommendation #2: fill your plate up with veggies. Vegetables are incredibly filling, and you can pile your plate full of them.

2.    Start the day on a healthy note

Yes, you’ve probably been beaten over the head with this one. Why? Because it is SO important. The National Weight Control Registry, which monitors people who have been successful at weight loss of 30 pounds or more, reports that eating breakfast is one of the weight loss behaviors that most successful participants share (78%).

Starting the day eating something healthy will also help you stay on the right track for the rest of the day. A good rule of thumb is keeping breakfast to 300 calories or less. Try whole grain toast with natural peanut butter. If you’re not usually hungry around breakfast, a fruit smoothie will still stave off snacking later.

3.    Get rid of temptations

Are you serious about cutting the calories? Rid your house of temptations. Trash or donate anything in your cabinets and fridge that call your name in moments of weakness.

Instead, fill up your kitchen with easy go-to healthy foods. Keep ready-to-grab cut-up fruits and veggies always in hand. Using pre determined serving-size tupperware containers are a great way to prevent over-snacking.

4.    Eat less, exercise more

Sure, this one is kind of a no-brainer. But think about it as a math equation. Calories in=calories out.

You can’t lose weight if your calorie intake is substantially more than what you work off. Keep track of how many calories you take in throughout the day and compare to how many you’re burning at the gym.

5.    Stay away from sodium

Foods and beverages with a large concentration of salt make your body retain water. Skip the margarita and salty snacks, and shoot for something with lower amounts of sodium.

Be careful—make sure to check the label; sometimes it’s surprising which foods have a large salt content. In addition, make sure to drink lots of water to flush out impurities in your body.

6.    Hydrate, hydrate, hydrate

Staying hydrated is the golden rule of weight loss. The Mayo Clinic recommends women drink 2.2 liters and men drink about 3 liters. When you drink plenty of water, your body is able to flush out toxins, and you’re able to stay fuller longer.

7.    Burn calories throughout the day

By just making a few changes to your daily routine, you’d be surprised how many calories you can work off! Here are a few recommendations:

  • When you wake up in the morning, do a five-minute exercise routine of jumping jacks, squats, and sit-ups.
  • Park in the back of parking lots so you can walk a little bit farther.
  • Take quick breaks after 45 minutes at work to walk around your building or do some jumping jacks—it’ll help you stay more focused, too!

Join us at the Breast Friends Forever Pink Ribbon Run March 6-7 in Myrtle Beach. Click here for more information…

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

Ask The Doctor-What can be done about infected implants?

April 10, 2015 by

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

Question: I had implants, and they got infected. I had six operations I’m in New York right now, but I’m on my way to South Carolina. I would like to come in so I could see what can be done. Thank you.

Answer: I’m sorry your having problems with your implants. We have helped many women who have lost implants due to infection. Let us know when your in town, and I’ll be glad to see you.

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

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

The Doctor is Out…..

April 9, 2015 by

the doctor is outNo worries – he’s back already!  Dr. Kline shares with us his personal experience as a surgical patient and what he has learned from being on the other side of the exam table that will enhance the personal care of his own patients.

“The Doctor is Out” is part 1 of this 4 part series.  Enjoy and have a happy day! – Gail

Three weeks before my surgery, everything was fine. I felt good, a little heavier at 56 than at 26, but still hale and vigorous. Then, while operating late one afternoon, I felt a pain in my groin. “Probably just too much strenuous exercise,” I thought, and dismissed it. It didn’t go away. The next day, it was worse. I felt a bulge. DAMN. I had a hernia.

The whole concept of needing to get treatment, instead of needing to deliver it, was foreign and unsettling. For decades I’d been used to helping other people. Now, whether I liked it or not, I was potentially going to have to sit down and let others help me.

I called the same general surgeon who fixed my 86 year old Dad’s hernia last year (why did mine have to come 30 years sooner?). He told me there was no danger in watching the hernia for a while, and that if I wanted to try and lose some weight it might get better, but it was a long shot.  As it turned out, I didn’t actually have time to try and lose weight, because it started to get worse hurt towards the end of long workdays. I turned over all my long cases to my partner, and I started looking for the soonest, least disruptive time I could find to get it fixed.

I greatly respect the people I work with daily, but I didn’t want to have surgery at the hospital where I usually worked, because I wanted things to be as routine as possible for everyone. I felt that it would be much less stressful on me (and probably everyone else) if I wasn’t in an environment where I was used to giving the orders.

Fortunately for me, my wife is a surgeon, and she regularly works at a hospital I rarely visit. I thought this might be the best place to go – my wife could kind of “watch over” things, but I would not know anyone involved in my care personally.

When I visited the surgeon for my preoperative appointment, he examined me and confirmed that I did in fact have a hernia.  We discussed options, and decided to attempt a laparoscopic repair of the hernia. He advised me that it might turn out that it was too difficult to do the surgery laparoscopically, and that they might have to “open me up.” I assured him that after 20+ years of practicing surgery, I was well aware that things are not strictly predictable, and I asked him to please do whatever he felt he needed to at the time. This was the first time I started to “loosen up” a little bit, and I was actually kind of glad that it would be him, and not me, worrying about the details in surgery that day.

I also found out in his office that I had high blood pressure, for which they put me on medication. I began to limit my salt intake, and cut back on calories. Fortunately, jogging did not aggravate the hernia, so I also increased my aerobic exercise until two days before surgery. Yes, I was “in training” for this.

On the night before surgery, I went to bed early, woke at 2 a.m., and didn’t sleep the rest of the night.

(Part 2 of this series will post April 16)

 

Filed Under: In Her Words, Uncategorized Tagged With: , , , , , ,
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