Archives for April 2018

Ask the Doctor – Could Odd Pains In My Body Be The Consequence Of an Old Abdominal Flap Surgery Following A Halstead Radical Mastectomy?

Poppy in a feild

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

Question:  In 1987, I had abdominal flap surgery following a Halstead radical mastectomy. I keep wondering what is NOW going on in my body! When I feel odd pains I wonder if it could be repercussions of that surgery so long ago.

Answer:  Thank you for your question. If you had your surgery in 1987 and you had reconstruction using your abdominal tissue then I will assume that you had a Tram procedure. That surgery relies on partially removing the muscle from the abdominal wall. Not having the muscle in place can cause problems later in life. People can have pain or bulging of the tummy and even hernias. Of course not all patients have those problems. If your problems are in the tummy area then that is a possibility. If your problems are in the area of your breast or mastectomy then you should consider seeing a breast surgeon that specializes in doing mastectomies to make sure all is well with regard to your breast area. You could also see the doctor who follows you regarding your breast cancer history. Scaring from a “Halstead” mastectomy especially after radiation could cause aches and pains later in life. Regardless of what it might be you should definitely be seen by your doctor so they could do a complete evaluation of your symptoms. After an evaluation they could make more specific recommendations. I hope his information helps. Let me know if you have further questions.

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

 

The Ultimate Guide to Breast Reconstruction Insurance Questions

There are a lot of questions out there regarding insurance costs for reconstructive surgery.

Because breast reconstruction surgery can be expensive, it’s important that you know as much as you can about whether the procedure will be affordable for you, and what your insurance coverage options are.

Keep reading to check out some of the most common breast reconstruction insurance questions we receive.

Why Won’t Insurance Pay for Reconstruction?

Yellow Lily
Question: I don’t understand why insurance company doesn’t pay for reconstruction if you’ve had a lumpectomy. With radiation, your breasts shrink a lot and you are all out of proportion. I finally did get them to pay for prosthesis and bra.

Answer: That’s not always the case with a lumpectomy. If the surgery results in a significant defect or radiation negatively impacts the tissue, most times we can submit your case to your insurance company along with photos of the affected area, and they will indeed cover a reconstruction surgery for you.

Read the full post here.

I’m Looking for a Plastic Surgeon That Specializes in Microvascular Breast Reconstruction. Are You in My Insurance Network, and Do I Have to Make a Huge Down Payment before Surgery?

Question: I am looking for a p.s. who specializes in microvas. breast recon. I had dcis in 2014 lumpectomy with 6 weeks rads followed by bilat mast. 2016 with immed. recon with expanders then implants in March. Then I got a serious infection in the left (rad) breast, had implant removed and refused to do have lat flap done.

I am thin and one PS said I might be able to do a body lift type or one where they take from my backside and use an implant on both sides. I do not want the implant I have now. It is subpec and is painful. Can someone help? I have anthem BC/BS and you are out of network.

I do not have 8500 to have this done at another location. My insurance is agreeable to a pay if it is in network. I can’t afford much out of pocket. We are low -middle class, but don’t qualify for help.

Answer: Hi, and thanks for your inquiry. Glad you found us – you’ve definitely found a team that specializes in microvascular breast reconstruction. Regarding your insurance, does your card have a little suitcase on the lower corner of your card? If so, we’re actually in network for your, utilizing the Blue Card program through our contract with BCBS of S.C.

Read the full post here.

Does Insurance Cover Breast Reconstruction for Poland Syndrome?

Purple flower in a green field
Question: I was wondering what insurance would cover breast reconstructive surgery that’s due to having Poland Syndrome? My case I where I was born without having my right breast muscle and a smaller areola.

Answer: The good news is that we’ve been able to get breast reconstruction for Poland syndrome covered for past patients and certainly know how to navigate the process to make that happen for you.

Read the full post here.

Will My Insurance Cover a Prophylactic Mastectomy If I’ve Had Gene Testing?

Bright pink lily on water

Question: I did the gene testing in February; tested positive for BRCA 2. I want to go full steam ahead and be proactive with prophylactic mastectomy. I am a 31-year-old single mom.

However, in regards to insurance, I am in a pickle. I just switched jobs and will be obtaining new/different insurance with a new company. Will the new insurance I am obtaining most be okay with the gene testing from the prior company and proceed to pay for the mastectomy/reconstruction? I can provide all the results and positive test results as well to them to suffice.

Answer: Most insurances do pay for prophylactic mastectomies when you have a gene conferring increased risk. While I cannot tell you with certainty, the companies that offer the tests are pretty standardized, and there is no logical reason not to accept the results of a prior test.

Read the full post here.

How Much Will Insurance Cover?

Question: Hi, I am 19 years old and 13 months ago I had a benign lump removed from my right breast. Since then, my right breast has increased in size significantly but my left one has not. My left breast is a full size smaller than my right breast and I’m very self-conscious about it.

I want to get a procedure done that will even them out. I’m just having a hard time finding the right doctor to do it, and I’m unsure how much the insurance will cover. If you could help me with the insurance policies and what your surgeons could do for me, I would greatly appreciate it. Thank you so much.

Answer:  Thanks for your question!

It is difficult to sort out exactly what is going on and what would need to be done based on your brief description. While your insurance company may not be obligated to cover any treatment without the diagnosis of breast cancer, that does not automatically mean that they won’t.

Read the full post here.

Ask the Doctor – Can I Have Large, Under Muscle Implants Replaced With Smaller Ones? Will This Make Them More Comfortable?

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I’ve had my breast tissues removed and I now have implants. They are under my muscles, too large and very uncomfortable. Is there anything you can do to fix this and make a smaller implant? I am very unhappy with the way my breasts look, This is contributing to already very low self-esteem issues. Can you help me? What are my options?

Answer:  There is an excellent chance that we can help you. The country is currently undergoing a paradigm shift in implant-based breast reconstruction, with more and more surgeons placing the implants in front of the muscle, rather than behind. This allows for numerous potential advantages, and few disadvantages. We have been converting patients with unsatisfactory sub-muscular reconstructions to reconstructions in front of the muscle for a few years, with generally good-to-excellent results.

Another option is to remove your implants and re-build your breasts only with your own natural tissue, usually from tummy or buttocks. This is a larger operation than implant reconstruction but obviously results in an even more natural result.

I would be happy to discuss your situation further with you by phone, if you wish, or see you in my office when convenient.

Thanks for your question.

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

Earth Day: How to Reduce Harmful, Cancer-Causing Waste from the Environment

Earth Day–a day in which we reflect on how amazing our planet is and how we should care for it–is just a few days away on April 22

With the holiday just around the corner, we thought we’d share a few simple ways to keep toxic pollutants out of our air and keep our planet clean so we don’t destroy the earth and endanger the lives of friends and family.

Pick Up Cigarette Butts

Smoking cigarettes releases harmful carcinogens that pollute our air. And these carcinogens affect more than just the people who are smoking the cigarettes.

In fact, Lung.org states that secondhand smoke causes approximately 7,330 deaths from lung cancer every year. If that’s not bad enough, many smokers feel it’s ok to throw their cigarette butts on the ground.

Not only does this make our streets dirty, but it puts small animals–like birds or chipmunks–in harm’s way as they often mistake this waste for food.

Although we advise against it, it’s your personal choice to smoke. But, that personal choice shouldn’t hurt others via air pollution or waste on the ground.

If you’re going to smoke, be responsible. Don’t smoke in public outdoor areas. And certainly, don’t leave your trash on the ground for small animals, or even children, to pick up and eat.

Recycle Plastics

Many people don’t think twice when burning waste, especially when it comes to plastics.

However, the fumes that are emitted into the air can contain dangerous materials like mercury, polychlorinated biphenyls, and dioxins.

Over time, these harmful chemicals bioaccumulate. This bioaccumulation often occurs in our water and food sources.

Eventually, these pollutants can cause cancer, deformities, reproductive failure, and immune diseases in both humans and animals.

Instead of burning your plastics, be sure to sort them out and recycle them.

To help remind you, grab a special plastic recycling bin and place it in your kitchen. If you have kids, get them involved by decorating the bin as a fun Earth Day activity.

Avoid Barrel Burning

A lot of people burn their own trash in burn barrels because it’s easier than hauling it to the local disposal site or to avoid paying for a waste collection service.

We understand the importance of saving time or pinching a few pennies. However, what you might not understand is that burning your own trash is dangerous and not good for the environment.

In fact, the chemicals that are released while burning trash can…

  • Cause heart disease.
  • Aggravate respiratory ailments such as asthma and emphysema.
  • Cause rashes, nausea, or headaches.

Loose pieces of trash also often fly away and end up as trash that gets buried in the ground.

Last but not least, burn barrels have the potential to cause fires, especially during times of drought. When a forest fire occurs, thousands of animals and plants are destroyed.

In order to protect the earth, we advise that you let garbage disposal specialists take care of your trash for you.

They know how to properly sort trash and safely burn it so that it doesn’t cause major damage to the earth.

What do you do to help keep the earth clean? Let us know in the comments below!

Ask the Doctor – What Are My Chances With DIEP Flap Surgery After Several Failed Reconstructions With Tissue Expanders and Implants?

Sunflowers

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I have had several failed reconstructions with tissue expanders and implant. I have also been put on IV antibiotics due to a staph Infection. I am wondering what my chances are with the DIEP Flap.

Answer:  Great news! Your prior failures with implants does not in any way decrease your ability to get soft, warm breasts with DIEP flaps. Many, many, many of our patients have histories of prior failures with implants, some with (10-20) prior failed surgeries, and we have been able to successfully 99+ % of them with only their own tissue. Once the infection from prior implants is eradicated from your body (if you have been healed for at least 6 months, you can generally assume that all the prior infection is gone), then subsequent reconstruction with your own tissue carries only a minuscule fraction of the infection risk of reconstruction with implants. You didn’t mention if you were radiated, but it makes no difference, breasts reconstructed with your own tissue are still extraordinarily unlikely to have problems with infection.

We would love to chat with you and discuss your options further. Looking forward to speaking with you, and thanks for your inquiry.

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

The 5 Best Plants for Improved In-Home Air Quality

Aloe vera

It’s important to know what we’re putting into our bodies, and that includes the air we breathe.

After all, the oxygen we breathe (even inside our own homes!) is often polluted with formaldehyde, sulfur, and carbon monoxide–just to name a few things.

If you’re someone who spends a lot of time inside and are worried about your home’s air quality, keep reading, because today we’re going to walk you through some of the best, easy-to-maintain houseplants that naturally filter the air.

Here’s what we recommend…

Spider Plants

spider plant

Spider plants are one of the easiest indoor houseplants to grow and maintain and can easily be found at your local greenhouse or plant nursery.

The plant is native to southern Africa, but due to its pretty leaves and air-filtering properties, it can be easily found all over the world.

This plant in particular is amazing at removing formaldehyde from the air. In fact, NASA, which tested the abilities of three common houseplants to remove formaldehyde from the air, found that spider plants were able to remove 95 percent of the toxic substance from a sealed chamber in less than 24 hours.

It’s also a superstar at removing a chemical called xylene from the air.

Aside from these particular chemicals, spider plants continuously recycle and clean the air we breathe.

Peace Lily

peace lily on a side table

If you love decorating your home with beautiful, fresh flowers, a peace lily might be right up your alley.

Not only does this plant blossom with a stunning white lily on a yearly basis, the plant itself is a pro at removing ammonia, benzene, formaldehyde, and trichloroethylene from the air in your home.

This plant is able to quickly remove toxins from the air by absorbing them in and filtering and neutralizing toxic gases through its root system.

While this plant originates from Southeast Asia, it can now commonly be found in grocery stores and greenhouses all across the U.S.

Bamboo

bamboo stalks

If you’re someone who doesn’t have a green thumb, a bamboo plant is a great option for your home. As long as you keep it watered, it is almost impossible to kill.

Aside from their hardiness, bamboo plants are also great at filtering benzene, formaldehyde, and trichloroethylene from the air.

In fact, bamboo can filter and neutralize many chemicals that come from ovens, carpets, glues, cleaning solutions, and plastics.

The best part…bamboo is very cheap! It won’t cost you an arm and a leg to purchase a small plant for each room in your home! You can find bamboo in most grocery stores, Asian markets, or plant nurseries.

Aloe Vera

aloe vera plant

Most people think of aloe vera as a green goo that’s used to soothe sunburns. Yet, not everybody realizes this plant has a superpower that’s far greater than relieving sunburn.

Aloe vera plants are highly effective at removing formaldehyde–a chemical that becomes very toxic when you’re overexposed to it.

The plant also has a knack for removing a chemical called benzene which is commonly found in paint and home cleaners.

Whether you’re suffering from a burn, are worried about your air quality, or are experiencing digestive issues (yes, people cook with it!), it’s a houseplant you simply can’t go wrong with.

You can find aloe vera plants at farmers markets, greenhouses, and grocery stores.

Boston Fern

boston fern frond

A Boston fern is one of the most classic houseplants that exists. And it’s no surprise as to why many people have this plant in their homes.

First and foremost, Boston ferns are able to filter air and remove harmful toxins like formaldehyde out of the air like every other plant we’ve discussed thus far.

However, what makes this plant extra special is its ability to restore moisture into the air. This plant is nature’s natural humidifier.

If your hair, skin, and lips are dry, try introducing some water back into your air with a Boston fern.

On average, a decent size fern costs less than $20! Now that’s an inexpensive home air purifier and humidifier package deal!

What’s your favorite indoor air purifying plant? Let us know in the comments below!

Ask the Doctor – How Far in Advance Should I Begin Planning and Scheduling Surgery and is Travel Afterward a Problem?

Roses and orchids

This week, Gail Lanter, CPC Practice Manager, of The Center for Natural Breast Reconstruction answers your question.

Question: I had a phone consult with Dr. Kline in December and was very impressed with our conversation.  After researching several microsurgeons, I keep coming back to this center as the perfect fit for me. I had bilateral mastectomy in Jan. 2014 due to DCIS and have saline implants under the muscles. I experience constant inflammation, burning, and the right implant has “shifted” (as my PS said) and feels like it is under my armpit. Due to life situations I am not considering surgery until the end of this year or January, 2019.

How many months ahead should I contact you to schedule the surgery? Also, I’d like to talk to someone about getting insurance approval. I have BCBS of Alabama.

Is it possible to come from Decatur, AL to have this done? I do not feel comfortable using anyone closer at this point. Just worried about the travel afterwards. Thank you.

Answer:  We have many women who travel to have surgery so we know how to help you navigate that hurdle.  As far as your timeline, one thing to consider is that this is a staged procedure – typically the first stage is inpatient for 4 days and then outpatient for Stage 2 a few months later.  Sometimes a 3rd stage (outpatient or in office) if you require nipple reconstruction or further revision to get the result you desire. Taking into account your deductible and out of pocket expenses – you may want to make sure you can get all of those stages done within one plan year.  I’ll be happy to run an eligibility inquiry through your insurance plan and we can find out exactly what your benefits are so you’ll know what to expect. Insurance approval should be no problem at all as we are in the Blue Card Network for BCBS plans. Check your insurance card and see if you have a little suitcase on the front with some letters within it.  That will tell you that your plan is a member of that network. If you’d like to send me some basic demographic information i.e. full name, date of birth, address and a copy of your card, I can get that process started for you. We typically have openings within a 2-3 month time period but to reserve the date you really want, I’d choose it as soon as you know what will work for you.  We operate on Tuesday, Wednesday, and Thursday.

Here is a blog post from September discussing the stages of surgery and how we work with patients out of our area.

http://breastreconstructionnetwork.com/ask-the-doctor-how-many-trips-are-required-to-have-reconstruction-with-your-doctors/

I’ve forwarded your e-mail to Dr. Kline to discuss post- operative travel with you.    Have a great day and I’ll look forward to your reply.

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

Delicious and Nutritious Early Spring Veggies to Add to Your Meal Plans

spring vegetables at a farmers market

Spring has finally arrived, the weather is warming up, and we can finally get excited about fresh spring vegetables hitting the market!

That’s right! Although it may seem a bit early for planting gardens and harvesting crops, early April is actually peak season for many delicious veggies.

If you’re tired of microwaving frozen green beans or purchasing canned corn, listen up! We’re about to share with you our top 5 favorite early spring vegetables that you can buy fresh in your local grocery today!

Check them out…

#1 – Artichokes

artichoke

Artichokes are the buds of a plant that comes from the thistle family. They have been given their name due to a small, inedible, fuzzy center of the vegetable that would likely cause you to choke if you attempted to eat it.

The peak growing season across the U.S. is typically in March, and they can be harvested anytime from April through May.

Artichokes contain up to 28% of your recommended daily fiber intake, which make them a great vegetable for keeping your system clean and regular.

They also contain high levels of vitamin C and K.

Recommended Cooking Strategy: We personally recommend roasting artichokes. Simply clean the vegetable, toss in oil, salt and pepper (or your favorite seasoning), and bake until the artichoke is tender and delicious.

#2 – Asparagus

asparagus

Asparagus is a herbaceous, perennial plant and is native to most of Europe, northern Africa, and western Asia.

This particular veggie enjoys growing in cooler climates and is ready to harvest in most places, including the U.S., starting in February.

Because April is the peak season for this vegetable, you may notice prices on this pricey veggie begin to drop. If you’re looking to pinch some pennies, we suggest buying the veggie in bulk when it’s cheap, blanching it, and then storing it in your freezer for a later date.

Asparagus is low in calories and sodium. This makes it a great side dish option if you’re watching your waistline.

It’s also a good source of vitamin B6, calcium, magnesium, and zinc, and a very good source of dietary fiber and protein.

Recommended Cooking Strategy: We believe that asparagus tastes best when cooked on the grill. Marinate this veggie in a little oil, salt and pepper, and then throw it on your grill for 15 minutes, and it will be ready to eat.

#3 – Beets

beets on a cutting board

Beets are a root vegetable that have been enjoyed in food dishes since the Middle Ages.

Fun fact: During the middle of the 19th century, wine was often colored with beetroot juice.

Like most root vegetables, beets prefer the cool seasons of fall and spring. They are typically ready to harvest in the U.S. by late March or early April.

Besides tasting great, beets are often eaten due to their unique source of betaine–a nutrient that helps protects cells, proteins, and enzymes from environmental stress.

They are also high in immune-boosting nutrients like vitamin C, fiber, and essential minerals like potassium.

The only downside to eating beets is that they are high in sugar. For this reason, we recommend you eat them in moderation.

Recommended Cooking Strategy: Steaming beets is one of the best ways to preserve the vegetable roots’ nutrients. Simply steam this vegetable in a veggie steamer and follow your veggie steamer’s guide for optimal results.

#4 – Chicory

Chickory growing in rows in a field

Chicory is member of the endive family.

Because chicory is a leafy green vegetable, it grows best during the cool seasons and is often planted so that it can be harvested in the early spring.

This leafy veggie contains a natural source of inulin, a strong prebiotic. For this reason, many people consume chicory in order to ease their digestion problems and heal their guts.

Chicory leaves also contain a large amount of vitamin K–a vitamin that’s essential for healthy bone growth.

Recommended Cooking Strategy: Get the most out of consuming chicory leaf by simply adding it to a salad. Be sure to add in other leafy greens and veggies as this veggie often has a bitter taste when left unbalanced with other veggies.

#5 – Rhubarb

rhubarb stalks

Believe it or not, most rhubarb that we eat in the U.S. is grown in hothouses and is called “hothouse rhubarb.” Every year growers plant hothouse rhubarb in the fall, and it’s ready to harvest and sell to consumers in early spring.

The reason this veggie is grown in abnormal conditions is because, when it’s grown in a hothouse over the winter months, the rhubarb stalk ends up becoming sweeter and less bitter.

In the past, the Chinese would often use rhubarb for medicinal purposes. Today, many people enjoy eating it roasted, in pies, or shredded on top of salads.

Rhubarb is full of antioxidants. In fact, it’s a fantastic source of beta-carotene and other polyphenolic compounds that work to protect the skin and eyes from free radicals.

Aside from antioxidants, it’s also packed with vitamins and minerals that are essential for a healthy diet.

Recommended Cooking Strategy: If you have a sweet tooth, we advise you to try making a rhubarb pie. Not only will it be sweet and delicious, but your will also be able to feel good about eating a pie that’s made out of veggies!

Click here to check out one of our favorite rhubarb pie recipes!

What is your favorite spring vegetable? Let us know in the comments below!