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What To Do If Fear Is Keeping You From Undergoing Breast Reconstruction

November 25, 2011 by

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

I am scheduled for reconstruction on the 29th. I feel as though I shouldn’t go through with it because, for one, I am 58 years old and secondly because I am scared that I will not be pleased. Thirdly, I heard that it is very painful and is worse than the bilateral mastectomy I had. I am so confused as to what to do.

Firstly, if you are scared, and feel strongly that you shouldn’t do it, then DON’T—END OF DISCUSSION! We’re talking about a quality-of-life surgery, not life-saving surgery. Attitude about the outcome is far too important to risk going into it feeling like you shouldn’t.

Having said that, unless you have a serious medical condition making the surgery dangerous, diabetes, or inadequate donor sites (I assume we’re talking about DIEP or GAP flaps), statistics suggest it might not be as bad as you fear.

Age is of no consequence—some of our happiest DIEP patients (and best healers) have been in their 70s.

Satisfaction with the final outcome is critically dependent upon realistic expectations, which can only be arrived at through careful preoperative discussion with your surgeon, and ideally, also through discussion with other patients.

Perforator flap surgery IS more painful than mastectomy, but pain is a relative thing. A few patients say it is terrible, most say it was about what they expected, and a few say they had almost no pain, even the day after surgery. I can think of one patient out of hundreds who suggested she might not have gone through it if she knew how bad the recovery would be.

Best of luck to you, and please feel free to ask any more questions.

—Dr. Richard M. Kline, Jr.

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

Enjoying the Glorious Outdoors of Charleston: Best Parks in Charleston County

November 23, 2011 by

charleston county parksCharleston County parks offer some of the best scenery, activities, and fishing in the area. With water parks, dog parks, play areas, and campgrounds, the opportunities for quality family time are limitless. The following parks are three of our favorites.

James Island County Park:

A short drive from downtown Charleston, the James Island County Park is open year-round, with something for everyone. Kids love the Splash Zone Waterpark, while adults enjoy the Climbing Wall and boat and bicycle rentals. With over 100 sites and 10 cottages, the Campground offers peace and quiet among the beauty of the park, and anglers will find plenty of opportunity for crabbing and saltwater fishing. Dogs and their owners enjoy the freedom and open space of the off-leash dog park.

The park’s location also makes it ideal for events such as concerts and festivals. Highlights include the Reggae Nights Summer Concert Series, the Lowcountry Cajun Festival, and the Holiday Festival of Lights.

Mount Pleasant Palmetto Islands Park:

With its tropical beauty and lush nature trails, Mount Pleasant Palmetto Islands Park is almost like a trip to Hawaii. Ideally suited for groups and families, this 943-acre park was designed around nature and its splendor, and the peaceful tranquility of Nature Island is well worth the price of admission.

In addition to the island, visitors can ascend to the top of the 50-foot observation tower and take in the spectacular view while the kids enjoy themselves in the tower’s play area. With Splash Island Waterpark, nature trails, tidal creek fishing and crabbing, boat rentals, and volleyball courts and horseshoe pits, the park offers hours of fun and excitement.

Mount Pleasant Pier:

Over 1250 feet long, the Mount Pleasant Pier gives visitors an amazing view of Charleston Harbor and the Arthur Ravenel, Jr. Bridge. Kids and adults alike enjoy fishing off the pier, and the Cooper River Challenge fishing tournament takes place several times during the summer and fall. Prizes are awarded for largest game fish catch in several categories. Rods and tackle are available at the Pier, and after the tournament, you can grab a bite at the River Watch Café and Gift Shop.

Throughout the summer, the Pier shows classic movies at sundown, and admission is free. Spring and summer are the time for Shaggin’ on the Pier, the perfect opportunity to dance the night away to live music.

All of Charleston County’s parks offer amazing views of the beauty of the Lowcountry. Which park is your favorite and why?

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

Healthy Thanksgiving Dinner Tips

November 21, 2011 by

thanksgiving dinnerMany of our patients express concerns about eating a healthy Thanksgiving dinner. They don’t want to overindulge, but they do want to enjoy dinner with their friends and family. You can have your cake and eat it too if you’re careful.

Have plenty of fresh, raw veggies available.

These will play a major role on your Thanksgiving plate, so make sure you have plenty of raw vegetables and salads on the table. Good choices include broccoli, peas, beans, cauliflower, cucumbers, cabbage, and romaine lettuce. If you cook sweet potatoes or squash, use butter, not margarine, and keep fat to a minimum.

Eat an appetizer.

Don’t go to the Thanksgiving table ravenously hungry, as you’ll overeat. If you’re going to someone else’s home, have a small snack before you go, or serve appetizers if dinner is at your house. A small amount of fat will help tide you over until dinner, so try sliced avocado, nuts, or smoked salmon with a little cheese on a cracker.

Bake the turkey and eat the white meat.

Instead of deep-frying, bake the turkey and avoid eating the skin or visible fat. Eat mostly the white meat, which is lower in calories and fat than the dark meat.

Use less of the pan drippings to make gravy.

If you use half of the pan drippings in your gravy, you’ll have all of the flavor and half of the fat.

Mentally divide your plate in quarters.

Put fresh vegetables on half your plate, turkey on one quarter, and potatoes and stuffing on the remaining quarter. You’ll be able to taste everything, but with half your plate full of veggies, you’ll eat fewer calories. Eat slowly, and stop when you’re comfortably full—long before you feel stuffed.

Drink water.

Avoid the high-calorie drinks and have a simple glass of water. Dress it up with a splash of juice or a slice of lemon or lime.

Don’t go back for seconds unless it’s for veggies.

When you’ve eaten what’s on your plate, wait for a while before you go back for seconds. It takes time for your stomach to communicate with your brain that you’re full. If you’re still hungry, have more vegetables, preferably raw.

Share dessert, or have just a nibble.

If Aunt Shirley’s cheesecake is too hard to resist, have a small piece, or take a couple of bites from Uncle Dave’s piece. If you like to try several desserts, take small spoonfuls and savor them.

What are your favorite tips for eating healthy at Thanksgiving?

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

Answering Your Breast Implant Questions

November 18, 2011 by

dr. richard klineThe question below is answered by Dr. Richard M. Kline, Jr., of The Center for Natural Breast Reconstruction

I had cancer in my left breast 15 yrs. ago, had the lump taken out, then developed a rather large cyst in the same breast. I had the cyst removed, which left me with only half a breast. I also had 8 weeks of radiation. I wanted a breast implant but the doctor said I couldn’t get one. Since it has been so long, could I now get one? I am 75 but still don’t feel good about my breast. I wear a breast form, but it’s not the same.

It is sometimes possible to reconstruct a lumpectomy defect with an implant, but your history of radiation makes success less likely. To some extent, the size of the implant you would require, and the amount of radiation injury you have sustained, influence the chances for success. Flap surgery, while significantly more involved, is ideal for use in radiated tissues, as it allows us to use healthy, non-radiated tissue to replace what is missing. Age, in and of itself, does not affect the success of either surgery, as long as you are generally healthy.

—Dr. Richard M. Kline, Jr.

Do you have a question about breast implants or natural breast reconstruction? Ask the doctor by emailing us at blog@naturalbreastreconstruction.com.

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

5 Tips for Reducing the Appearance of Cellulite

November 16, 2011 by

reduce celluliteCellulite is body fat that dimples the skin, and it typically shows up on females of any age. Having cellulite does not necessarily mean you are overweight; in fact, many normal-weight and underweight women have it. Cellulite can worsen as women age simply because we all tend to gain fat as we get older.

Unfortunately, nothing completely eliminates cellulite, but you can take steps to improve its appearance. Following are tips to reduce the appearance of cellulite and smooth out your lower body.

Exercise.

If you exercise, you’ll boost your metabolism, reduce fat, and add muscle, which will help the area appear taut. Work the muscles from all angles to ensure you’re reducing the cellulite evenly.

Stay hydrated.

Your body can burn and remove fat more easily if you drink plenty of cleansing, fresh water. Aim for eight glasses, spread throughout the day, and filter your water or add lemon juice to improve the taste. Cut down or eliminate carbonated beverages and replace them with water.

Eat a healthy diet and watch sugar.

Contrary to popular belief, you need a certain amount of fat in your diet, and good fats such as nuts, avocados, and salmon do not make you gain weight unless you eat too much of them. However, eating too much sugar and simple carbohydrates can make you fat, and many fat-free foods contain sugar in place of fat. Eat as naturally as possible, with a variety of protein, raw vegetables, and fresh fruits.

Stay away from monosodium glutamate (MSG), high-fructose corn syrup, and trans fats, which you’ll know by the word hydrogenated in the ingredient list. Exercise, water, and a healthy diet will not reduce cellulite overnight, but over time, you’ll see an improvement.

Try body wraps.

When you have a body wrap, your skin is massaged and covered with cloth soaked in any of a variety of natural extracts. The combination of the massage, the wrapping material, and the soaking solution soften and smooth problem areas. A wrap will not get rid of cellulite, but it will reduce the appearance and improve the smoothness of your skin. Body wraps are most effective when done at regular intervals.

Use liposuction and laser treatments to help reduce the appearance of cellulite.

As much as I wish it were true, you can’t get rid of cellulite with liposuction or laser treatments. These techniques may tend to improve the look of an affected area but often never completely eliminate cellulite.

Liposuction is a surgical procedure that removes fat cells from the body using a tiny hose similar to a vacuum cleaner. Laser treatments, often with massage or suction, break up the fat and improve circulation.

Have you successfully improved the appearance of cellulite, and how did you do it?

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

Stop Smoking Series: the 4Ds

November 14, 2011 by

stop smokingQuitting smoking can be challenging, but if you know what to do when a craving hits, you’ll be ready to conquer any urge. The 4Ds are a good guideline to follow when you desperately want a cigarette. The order we show them is a general guideline, so modify it to work for you.

Delay.

The moment the craving hits, tell yourself you can have a cigarette in 10 minutes. Then when the 10 minutes are up, tell yourself what a good job you did and challenge yourself to go 20 minutes. Any craving will go away in a few moments as long as you don’t keep thinking about it. After you delay, the next thing to do is . . .

Drink water.

In fact, get up and get a glass of water as you’re telling yourself to wait 10 minutes. And you want to drink water, not pop, coffee, or alcoholic beverages. First, while you’re quitting, your body is trying to get rid of the toxic materials you’ve inhaled all these years, and it needs water remove the junk from your system. Second, for many women, other drinks are triggers to smoke, especially coffee and alcohol. Third, the water will change the taste in your mouth and help to break the craving.

Please don’t make the excuse that you don’t like water. You can filter it or flavor it with fruit or small amounts of fruit juice. Find what works for you, and do it.

Do something else.

Your success in quitting may be determined by how well you shift your focus when you have an urge to smoke. The more you think about a craving, the worse it will become. After you’ve had your glass of water, find something else to do. If you were watching TV, move to another room and read a book. Take the dog for a walk. You need to break the association with whatever you were doing when you felt the craving.

Try keeping a bag of entertaining distractions with you, which could include puzzle books, books, art projects, or needlepoint. The main thing to remember is that you need to abruptly and quickly change what you’re doing and thinking to survive the craving.

Deep breathing.

This step can be done at any point in time, as many times as necessary. Deep breathing will release endorphins, which will help you feel better. It will also show you how well your respiratory system is healing during your quit. Take at least 10 deep breaths in through your nose—your stomach will move if you’re truly taking deep breaths. Exhale through your mouth with pursed lips, as if you’re kissing someone. Blow out hard, and imagine you are forcing out all the air in your lungs.

The 4Ds will feel awkward at first, but as you get used to them, you’ll find they are very helpful during cravings.

 

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Common Breast Reconstruction Questions Answered

November 11, 2011 by

dr. richard klineThe below questions are answered by Dr. Richard M. Kline, Jr., of The Center for Natural Breast Reconstruction.

1. I had my second part to breast reconstruction and had necrosis removed, but I still have the hardness. How can it be treated? They did liposuction.

If necrosis was removed and there is still hardness, then it is most likely from either 1) additional / remaining fat necrosis, or 2) edema (can feel hard, especially likely in radiated tissue). In either case, resolution is likely without additional surgery, if you wait long enough (may take 1 – 2 years), although breasts will be smaller in either case. If pain is present, and fat necrosis is still present, then surgery to remove the rest of the dead fat may be indicated.

2. I am considering silicone implants for breast reconstruction. What should I know before I proceed—what questions should I ask?

Silicone or saline implants, while generally very safe from a medical perspective, are still subject to some complications. The most common problem is that either type implant can develop a hard capsule of scar tissue around it (capsular contracture), which is sometimes painful, and makes the breast mound hard (and often unattractive). Generally speaking, the thicker and more normal the soft tissue covering around them, the better result implants tend to give when used for reconstruction. The presence of radiation injury greatly decreases the chances of success when using either silicone or saline implants for breast reconstruction, and flaps may be a better alternative in that case.

—Dr. Richard M. Kline, Jr.

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

Hearts for the Arts Foundation: Helping the Creative Children of the Lowcountry

November 9, 2011 by

hearts for the arts foundationToday’s post is very dear to me. I’ve interviewed Morgan Downing of the Hearts for the Arts Foundation, an amazing initiative, based in the Charleston area of South Carolina, that works to financially and emotionally support artistic children.

See below for the interview and learn how you can help the Hearts for the Arts Foundation and cause:

1. Tell us a little bit about Hearts for the Arts. Specifically, who are the leaders and founders behind it, and what is the foundation’s mission?

The Hearts for the Arts Foundation was established by Kelly James, Jared James, Shelly Downing, and myself, Morgan Downing. We have set out to fund one of the most attacked activities offered by public schools: the Arts. From ballet to creative writing, we support any form of expression.

2. What was the inspiration behind starting the Hearts for the Arts initiative? In other words, what moved you to start this project?

Kelly James, one of the founders, teaches at an arts-infused school. The money for the programs runs on grants, state money, and donations. However, in the recent economic crisis, the state sees their programs like “finger painting” if you will. Thus, the funding is cut short—yet AGAIN. I, Morgan Downing, am an avid representative for the vitality of the arts in children’s growth and development. We knew there was a need so we all found a solution, the Hearts for the Arts Foundation.

3. The Hearts for the Arts foundation is in direct affiliation with The Art Closet Thrift Store, which is opening soon on Dorchester Rd. in Charleston. What types of things can individuals purchase from The Art Closet Thrift Store, and how does their contribution support the Hearts for the Arts initiative?

The Art Closet Thrift Store is currently the blood and life of our foundation. 80-85% of the money made from our store is directly given to the foundation. We have absolutely fabulous items of all variations there. We have seasonal items, clothing, furniture, books, house ware, jewelry, and much more! However, we must have support from the community to keep this wonderful organization up and running.

4. How can individuals become involved with the Hearts for the Arts foundation and support its cause?

For anyone who has fallen in love with our cause, here are some ways to help:

  • Bring your donations to us! We need all that we can get.
  • If you or the company you work for would like to give, they can. We take monetary donations as well.
  • VOLUNTEER!!!
  • Spread the word and tell EVERYONE. Word of mouth is the best form of advertisement!

If anyone has questions or would like to donate, you can contact us at 843.460.0001 or 843.789.5544. Our e-mail is hearts4thearts@ymail.com.

Thank you for being a part of “The key to a creative education.”

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

How to Reduce Stress by Managing Your Time

November 7, 2011 by

time managementTime (or lack of) is a big stressor for many of us, and managing our time can reduce that stress significantly. Time management is something most of us lack, and just a few ideas can help you get a handle on your time and spend it wisely.

The following time management tips are simple but effective:

Get a planner.

Part of the reason we are so stressed is because everything we need to remember is scattered: sticky notes here, cell phone memos there—and then we try to commit important tasks and dates to memory. Everything needs to be in one place, preferably in something you can carry with you at all times.

A planner is the most efficient and easiest way to keep track of everything. It doesn’t have to be large or complicated—you’ll be surprised at how many different planners you’ll find once you make the decision to use one. Some planners are very low tech, while others will also update your computer or other electronic devices. Get whichever makes sense for you. The main goal is to use it.

Plan your day and prioritize your tasks.

Use the planner to decide what you’ll do each day, and determine which tasks have high priority. Those are the tasks you should be focusing on. This is not to say the low-priority tasks are not important, but those with high priority should take precedence. Track your progress each day so you can see how efficiently you’re working.

Quit trying to remember everything.

The planner will become a significant part of your brain once you start to use it. You’ll be amazed at how free you’ll feel when you don’t have to try to remember everything. Just consult your planner each morning, and live your life.

Learn to say no.

Here’s another great use for the planner—it’s a great way to tell someone no easily and gracefully. If you’re asked to do something you don’t want to do or don’t have time for, pull out your planner and consult it, and then tell that person you’re booked on that date.

Delegate when and where you can.

Do you really need to go to the store, or can you send your teenager?  Look at your to-do list and see who could take over some of your low-priority tasks. Maybe it’s time to teach others in your household to do some laundry, or to allow your assistant to help you with your work email. You don’t have to do it all.

Analyze how you’re doing.

At the end of each month, take 10 minutes to look back and see how well you managed your time. You’ll see where you have improved and where you still need help. Adjust accordingly.

Did you find these stress and time management tips effective? Is this a topic you’re interested in hearing about in the future?

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

Nerve Recovery and Breast Reconstructive Surgery

November 4, 2011 by

breast reconstructionThe below question is answered by the Charleston breast surgeons at The Center for Natural Breast Reconstruction.

How long does it take for nerves to recover and for full skin sensation to return after reconstructive surgery?

During any surgery, numerous sensory nerves, generally too small to have names, are invariably cut. Depending on the extent of the surgery, this can result in numbness of the skin or other areas. This is not typically regarded as a complication, but rather an essentially inescapable result of making an incision in the body. Most of the little divided nerves literally “wither away,” and other sensory nerves eventually grow in to take their place, restoring sensation once again. This process can take anywhere from a few months to 1 – 2 years. There is no limit on how late sensation can be regained, but the longer, beyond 1 – 2 years numbness, lasts, the less likely it is that sensation will spontaneously return. Occasionally, numbness can persist indefinitely, although this is uncommon.

In addition to numbness, other symptoms such as discomfort, hypersensitivity, or chronic pain can also result as a consequence of nerve damage following any surgery. Thankfully, these complications are much rarer then numbness. While it can be very difficult to ascertain exactly what mechanism is causing discomfort, some possibilities include traction or tethering of nerves by scar tissue, or formation of a “neuroma,” which is a painful little ball of tissue at the end of a regenerating nerve.

Nerves irritated by adjacent scarring may be helped by massage, injection of local anesthetics, or simply the passage of time. Neuromas, which are thankfully extremely rare following breast surgery, usually result in pain when pressure is applied to a very specific location, and can be much harder to treat. Surprisingly, additional surgery is often not effective in treating these rare cases of chronic pain, and referral to a Pain Therapist for injectable nerve blocks may be the most effective option.

If you want to learn more about breast reconstruction, visit us on Facebook.

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