Health and Wellness

When is the Ideal Time for Reconstruction Surgery?

April 11, 2019 by Gail

Some breast cancer patients require a mastectomy, the removal of a breast affected with cancer. Many choose to then have reconstruction surgery in an attempt to rebuild the breasts back to a normal look and shape. But when is the best time to have this surgery – at the same time you are having your mastectomy or at a later time?

Well, it depends on a variety of factors.

During the Mastectomy

Ideally, reconstruction begins at the same time that you have the mastectomy. This is especially important for earlier stage breast cancers. There is an advantage to having immediate reconstruction: Breast cancer patients do not have to wake up to the stark change of a removed breast. Instead, the reconstructed breast is already in place. This often helps with the breast cancer patient’s self-esteem and recovery.

Months After the Mastectomy

However, breast cancer patients who must undergo chemotherapy or radiation may choose to delay their breast reconstruction. Breast reconstruction cannot be performed until around six months after a patient’s final radiation treatment. However, chemotherapy varies. Some women have mastectomy and reconstruction immediately and do not start chemotherapy until after that is completed. Some women have to do chemotherapy first and then have mastectomy and reconstruction. Others have their mastectomy, have chemotherapy and wait to have reconstruction. Planning and timing is based on the type of cancer, pathology, oncology recommendation and the patient preference.

You might also decide to have reconstruction at a later time because, as a breast cancer patient, you are also dealing with a lot and may just want some time to make this decision and prepare for the surgeries.

Preparing for a Delayed Reconstruction

For those who do choose delayed reconstruction, the surgeon can put expanders in during the mastectomy that will help to keep the skin preserved to accommodate an implant or autologeous breast flap at a later time.

There are many decisions to make when you are undergoing breast cancer treatment and possible reconstruction. Patients and their team must consider timing and which reconstruction procedure is best. The patient can choose from implants or autologous breast procedures. Autologous breast reconstruction uses the patient’s own body tissue to recreate the breast. The tissue can come from the belly, buttocks or thigh.

It is important to note that if radiation therapy is indicated it’s best that occur before undergoing autologous breast reconstruction. Whether you decide to have autologous breast reconstruction or implant reconstruction will also depend on several factors, including your age, health status, location of the tumor, previous surgeries and the availability of extra tissue in your body. There are pros and cons of each procedure, so it’s important to talk to your doctor about which one is best for you.

The Center for Natural Breast Reconstruction believes in good health for everyone. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Filed Under: Health and Wellness

Know the 5 Steps of Breast Reconstruction Before Your Mastectomy

April 9, 2019 by Gail

If you’ve been diagnosed with breast cancer and will have a mastectomy, your doctor has probably discussed what comes next. Often, if you choose breast reconstruction, the process starts at the time of your mastectomy, but it can also be done at a later time – even years later.

Once the reconstruction process starts, it’s typically two or three stages – restoring the breast, refining the shape of the reconstructed breast and then reconstructing the nipples if desired. But every breast reconstruction procedure should start with a consultation with your physician.

Step One: Consultation with Your Team
Not every woman chooses to have reconstruction after mastectomy, so it’s important to weigh your options with your team, which should include your breast surgeon, plastic surgeon, radiation oncologist, medical oncologist and anyone else who is part of your treatment.

If you do choose reconstruction, your physician should discuss whether you will have your procedure at the same time you are having your mastectomy or at a later time. Your physician may recommend delaying your breast reconstruction based on the course of your treatment. Sometimes chemotherapy and radiation can delay the ability to have immediate reconstruction. Your surgeons should discuss the risks and benefits associated with all breast reconstruction procedures to allow you to make the choice that is best for you as well as helping you understand when the right time is for you to successfully complete the procedure of your choice.

Step Two: Mastectomy and Reconstruction

Choosing immediate reconstruction, at the time of mastectomy, is a great choice if it’s possible for the patient to do so. Those who opt to have breast reconstruction at a later time and have their mastectomy completed first can still choose from the wide variety of breast reconstruction procedures offered to all patients. At the time of mastectomy, tissue expanders can be inserted to help preserve the shape of the breast and conserve breast skin should definitive reconstructive surgery be scheduled for the future.

Step Three: Restoring the Breast

Now it’s time to rebuild your breast. The two most common reconstruction procedures are autologous breast reconstruction and implant reconstruction. During autologous reconstruction, a plastic surgeon uses your own tissue, skin and fat from another place on your body – typically from your buttock, abdomen or thigh – to recreate your breast mound. Should you choose implant reconstruction, our surgeons at The Center for Natural Breast Reconstruction utilize the most state of the art techniques to achieve the most natural result. Direct to implant and above the muscle implant reconstruction with acellular dermal matrix are examples of the procedures we offer.

Step Four: Refinement
Sometimes the shape of the reconstructed breasts need to be refined a bit, so another surgical procedure might be necessary. Some patients also choose to have the unaffected breast modified to achieve even closer symmetry, and that can be done at this stage.

Step Five: Nipple Reconstruction

If you have chosen to have a nipple-preserving mastectomy, you may only need one or two stages of surgery to complete the restoration process. However, if you need nipple reconstruction, it can be done either during Stage Two or Three. We typically like to wait at least three months between all procedures if possible to allow for healing before making further modifications. A few months after the nipples are reconstructed, you may also undergo a tattooing procedure to add more natural coloring to the nipple. Some women choose only 3-D tattooing as their definitive choice for nipple reconstruction.

Recovery time will vary from patient to patient. Your individual surgery timeline may also differ depending on your particular needs.

Filed Under: Health and Wellness

Finding the Right Surgeon

March 18, 2019 by Gail

5 Key Attributes to Look for in a Plastic Surgeon

You’ve been diagnosed with breast cancer and had a mastectomy. Now you’ve made the important decision to have reconstructive surgery to rebuild your breast. Your next important decision is to make sure you have the right plastic surgeon to do the job.

Finding the right surgeon isn’t always easy. But you need to put the same time and effort into it that you would put into hiring a real estate agent to find you a home or finding the right school for your children. After all this is your health we’re talking about and you deserve the best.

So what should you look for when choosing a surgeon?

1. Make Sure the Plastic Surgeon Specializes in Your Procedure

Some plastic surgeons specialize in implants, while others do tissue flap procedures, such as TRAM or the newer microsurgical procedure, the DIEP flap. Perhaps you already had a reconstruction procedure and need it revised. You need someone who has extensive experience with revision surgery. Ask how many procedures the surgeon has performed and the success rate for the specific procedure you are considering.

2. Make Sure They are Board Certified and Well Trained.

Plastic surgeons are certified by the American Board of Plastic Surgery (ABPS) which means that they have completed residency training specifically in Plastic and Reconstructive Surgery at an accredited institution. They have passed comprehensive written and oral examinations covering all plastic surgery procedures. You can visit the ABPS website to find out if your plastic surgeon is an up-to-date certified member. Fellowship training in a specialized field such as Breast Microsurgery is desirable if you are considering muscle sparing autologeous reconstruction procedures such as DIEP, GAP, PAP etc.

3. Make Sure the Surgeon’s Record is Clean

There are licensing boards for each state where you can check a surgeon’s background for any malpractice judgments or disciplinary actions. Visit the Federation of State Medical Boards’ website for more information.

4. Make Sure You are Comfortable

Once you find a plastic surgeon that specializes in your chosen breast reconstruction procedure, make sure to meet and ask a variety of questions. For example, how many procedures have you performed? What is your success rate? What is your background? What will the surgery entail and what is recovery going to be like?

Even if you have done your research and know the answers, see if you are comfortable with how the doctor communicates with you during this meeting. Does the surgeon answer your questions thoroughly and address your concerns? If the answers are off-putting or you feel uncomfortable in any way, that surgeon may not be the one for you.

5. Make Sure They Take Your Insurance

It might sound like an obvious thing to ask, but some surgeons will require that you pay out-of-network fees. You don’t want to be surprised with a big bill at the end of the procedure, so make sure that your plastic surgery procedure and the surgeon’s fees are covered at in-network rates by your insurance plan. Work with the surgeon and their staff to make sure everything is covered and you know all of the out-of-pocket costs prior to the procedure.

Autologous vs. Implant

March 6, 2019 by Gail

Benefits of Autologous Breast Reconstruction vs. Implants

If you had a mastectomy as part of your breast cancer treatment, you may be considering reconstruction to get back the look and feel of your natural breast. The two reconstruction options that patients normally choose between are autologous breast reconstruction and implant reconstruction.

Autologous breast reconstruction involves using your own tissue to recreate your breasts and can be done either when you have your mastectomy (immediate reconstruction) or at a later time (delayed reconstruction). Autologous breast reconstruction typically involves multiple stages; however, implant reconstruction often requires several stages as well.

With autologous reconstruction, a plastic surgeon uses the tissue from another place on your body (called a donor site) — typically from your abdomen, buttocks, or thighs – to recreate natural looking (and feeling) breasts. Using microsurgery, the surgeons attach vessels from the donor site to vessels in your chest to provide adequate blood flow to your new breasts.

Many patients who undergo autologous reconstruction, after having implants placed previously, state that their new breasts look and feel more like their old breasts compared to when they had implants.

Women who need radiation therapy before or after their mastectomy may also want to consider autologous breast reconstruction instead of implants because of the higher rate of failure associated with placing an implant under radiated skin and tissue. However, it is important to note that radiation must occur before undergoing autologous breast reconstruction.

Whether you decide to have autologous breast reconstruction or implant reconstruction depends on several factors, including your age, health status, location of the tumor, previous surgeries, and the availability of extra tissue in your body. There are pros and cons of each procedure, so it’s important to talk to your doctor about which one is best for you.

Implant reconstruction carries its own unique set of risks. Risks include inflammatory reaction, leaks, and mechanical implant failures. There is also a chance that excessive scar tissue can form around the implants (capsular contracture) and cause pain and malposition necessitating removal or revision of the reconstructed breast. Due to these possibilities, implants may have to be surgically replaced or exchanged at a later time.

Filed Under: Health and Wellness Tagged With: autologous, breast implants

Breast Cancer and Younger Women

February 18, 2019 by Gail

Most breast cancer is found in women who are over 50 years old, but lately it is becoming more common for younger women to be diagnosed with the disease. As a matter of fact, the Centers for Disease Control and Prevention (CDC) states that about 11 percent of all new cases of breast cancer in the United States are found in women who are younger than 45 years of age.

Young women who have been diagnosed are often confused and angry. Here are some stories from younger women (their last names have been withheld to protect their anonymity).

Jamie always felt like she had a higher risk of breast cancer, but never thought she’d be diagnosed at 38. “I thought if I ever got cancer it would be much later in life – when I was in my 60s or 70s,” she says.

Sarah was diagnosed two weeks shy of her 37th birthday. An otherwise healthy young woman, she was angry when the doctor told her she had breast cancer at such a young age.

Anna was diagnosed when she was only 34-years-old and, as a young mom to a 17-month-old daughter, she felt like her future family plans were quickly fading away.

Kristen has a three-year-old daughter, but her breast cancer diagnosis and chemo treatment wiped away her dreams of having another child. “This is the time when all my friends who had babies at the same time as me are having their second child,” she says.

According to the CDC, younger women are at a higher risk for breast cancer if they have close relatives who have also been diagnosed at a younger age, if they have the BRCA1 and BRCA2 gene, are of Ashkenazi Jewish heritage or have been treated with radiation therapy to the breast or chest in childhood or early adulthood. If they are diagnosed, the breast cancer is often found to be at a later stage and more aggressive.

Once diagnosed, younger women must make a variety of decisions concerning their treatment and their future. That includes decisions to have a mastectomy and reconstruction surgery, as well as deciding about childbirth. That is because some breast cancer chemo treatments might damage the ovaries, which can sometimes cause immediate or delayed infertility.

Dana says the hardest part of being a young breast cancer patient was going into the chemo room where the average age of the patients was about 60. “They look at me with such pity and said, ‘At least I’ve had a long life, saw my kids and grandkids grow up,’” she says. “But I will survive and will also see my kids grow up.”

The Center for Natural Breast Reconstruction believes in good health for everyone, regardless of their age. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at (866) 374-2627.

Filed Under: Breast Cancer Awareness, Health and Wellness

Love Yourself

February 4, 2019 by Gail

February is the month of love! As we celebrate Valentine’s Day and show those who are special to us how much we love them, why not do the same for yourself? As a breast cancer patient, you’ve been through diagnosis, surgery, treatment and possibly reconstruction and, of course, all the emotional ups and downs that have gone with it. This month, make sure you take some time to love and pamper yourself because you deserve it!

Love Your Bod

With breast cancer comes scars, hair loss, weight fluctuations and other changes to your body. Sometimes they are hard to accept, so the best way to start off a month about loving yourself is by loving your body and how it looks now. Yes, it’s changed, but it is hard at work fighting a disease, so be more confident about how beautiful you look. Maintain your beauty routine if it makes you feel good, accept compliments and wear clothes and hats that make you look and feel better.

Indulge

This month, millions of Americans will buy heart-shaped boxes of chocolates and indulge on rich desserts. It’s OK for you to indulge, too. If that occasional decadent dessert, piece of chocolate or dinner out makes you feel better, enjoy it!

Go Outside

In some parts of the country, it’s too chilly to take a walk, but if you can get outside for a bit, go for a walk. Many cancer patients stay inside during treatment and recovery and can suffer from winter blues. Going outside for some fresh hair and daylight can help your body to fight depression, sleep better and feel better. Even 15 minutes can make a difference.

Relax

Sometimes loving yourself means shutting out the world and enjoying your version of relaxation. Maybe it’s putting on your favorite music or romantic comedy movie. Perhaps it’s a long hot soak in a tub, reading a New York Times best-selling novel or filling in their crossword puzzle. Whatever it is, take time to do it. Your body and mind will appreciate it.

Pamper Yourself

Loving your bod, indulging and relaxation are all ways of pampering yourself, but if you need a few more ideas, how about a day at the spa? Buy that dress you always wanted or, depending on how you feel, take a quick weekend getaway from the hustle and bustle of tests and doctor appointments.

Breast reconstruction after mastectomy has been proven to help women feel better emotionally and physically. If you’ve recently gone through breast reconstructive surgery, loving yourself will help you to feel better about your breast cancer journey and how you look and feel. Also, talking to others who have gone through the process before you will also help.

Buddha once said, “You yourself, as much as anybody in the entire universe, deserve your love and affection.”

The Center for Natural Breast Reconstruction believes in good health for everyone, regardless of the season. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at (866) 374-2627.

Filed Under: Health and Wellness

How to Stay Positive During the Winter Blues

January 14, 2019 by Gail

Robert Frost once wrote, “You can’t get too much winter in the winter.” While its shorter days, colder temps and beautiful snow falls put a smile on the faces of some, others would disagree with the famed poet about winter. To them, the season makes them eat more, sleep more and generally feel down in the dumps. They can’t wait for it to be over and for spring to arrive.

If that sounds like you, you might be suffering from more than just cabin fever. Known by its more medical term, Seasonal Affective Disorder (SAD), it is categorized by the National Institutes of Mental Health as a medical condition that really does just last through the winter.

SAD is thought to be caused by the lack of sunlight from shorter days that lowers the serotonin or “feel good” hormones in your body and raises your melatonin levels, which causes you to feel more tired. According to Yale University’s Winter Depression Research Clinic, other symptoms of SAD include carb cravings, difficulty waking up in the morning, reduced work productivity, and withdrawal from social contacts. Those who live in northern and colder climates or who have a family history of depression may also be at a greater risk of suffering from SAD.

The good news is that there are treatments available to help turn the blues around, including daily physical activity, which raises your endorphins and counteracts the signs of depression. So if you can bundle up and get outside, do it, even if it’s just for 15 minutes a day.

Or you can bring the light inside. Sitting in front of a light box with 10,000 lux for 30 to 45 minutes in the morning mimics outside light and can reduce your SAD symptoms. You can also obtain a light box through your medical insurance plan or online, starting at $35. Unfortunately, light boxes might not work for everyone and counseling and anti-depression medications such as sertraline or bupropion might be necessary.

If your idea of dealing with winter blues is pulling the covers over your head and hiding from the world until the snow melts and spring thaws, think again. This is the best time to be more social and make plans with your friends and family, even if it’s just going for a walk together, going shopping or sharing a dinner and a movie.

Most importantly, having a positive outlook can help to reduce your symptoms. You can do this by keeping a gratitude journal or creating a vision board that provides a visual of your dreams and goals for the year. Having something to look forward to can help you to get through the winter blues.

The even better news about seasonal affective disorder is that once spring does start, your symptoms will typically start to wane and SAD patients begin to feel better.
The Center for Natural Breast Reconstruction believes in good health for everyone, regardless of the season. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Filed Under: Health and Wellness Tagged With: winter blues

Seeing Friends and Family for the First Time Since Surgery

December 10, 2018 by Gail

There is nothing like a support system to help you get through cancer diagnosis and
treatment. After you have surgery, your family members and friends will probably want
to stop by and visit. They may also want to cook for you, clean your home or just keep
you company as you recuperate.
While seeing friends and family can be a positive part of your recuperation, it can also
be overwhelming. You might not feel up to having company or you might feel self-
conscious about how you look. Here are some tips on how you should handle seeing
friends and family for the first time since surgery:
1. Talk About it Ahead of Time
If friends and family know when you are having surgery and want updates, use that time
to tell them what you expect about having visitors. For example, you—or the person
updating everyone for you—can say, “Mary is out of surgery and recuperating. If you’d
like to stop by and visit, please text or call us ahead of time so Mary can pick a time
when she’ll be up to enjoying your visit.”
2. Limit Time
Once you know when someone is going to stop by, it’s okay to limit how long they
spend with you. Visits can be fun, but they can be tiring. Let your friend or family
member know how much time you have to spend with them before you have to lay
down, change a dressing, etc. This is especially important for those who just drop by
without calling ahead of time. Feel free to say something like, “Thanks so much for
stopping by to see me. We can chat for a bit and then I’m going to lay down for a nap.”
3. Keep the Sick Away
You just had surgery and should be doing what you can to avoid getting sick. Let your
guests know that if they are germy or feeling under the weather in any capacity, they
should change their visit to another time. If they show up sick, it’s okay to tell them
you’re not feeling up to their visit and plan it for another time. For example, you can say,
“I’m excited to see you now that surgery is over, but it sounds like you’re getting a cold.
Can we reschedule your visit until you’re feeling better so I don’t catch it?”
4. Say No When You Need To
It’s okay to say no if you’re not up to having visitors on any particular day or only want
certain family members or friends to visit. This is your surgery recuperation and,
honestly, you have the right to handle it however you want. Simply say, “Thank you so
much for caring enough to visit, but I’m really not feeling up to guests right now. Can we
get together at another time?”
5. Don’t Let Feeling Self-conscious Get in the Way of Enjoying Visitors
Some women are self-conscious about having visitors, especially after surgery. While it
is normal to feel this way for a little while, think about who is visiting you and whether
they are worried more about how you look or how you feel. In most cases, your friend or
relative is there to see you and do what they can to help. They probably don’t care
about how you look, so it’s best to remind yourself why they are really there.
To learn more about natural breast reconstruction and find out if it might be the right
choice for you, contact The Center for Natural Breast Reconstruction at
NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Filed Under: Breast Cancer Awareness, Health and Wellness

Opening up the Conversation on Family Cancer History

December 10, 2018 by Gail

At the doctor’s office, you are given pages upon pages of paperwork to fill out about
insurance information, medications and past illnesses and surgeries. When you get to
the family history page it can be a bit overwhelming or you might even draw a complete
blank. Did your Aunt Mabel have breast cancer? You vaguely remember your father
telling you something about your second cousin’s diagnosis, but you can’t remember,
and now some family members aren’t talking, so the facts are elusive.
It’s important to open up the conversation on family medical history with your family
regardless of how difficult it may be. Why? Whether Aunt Mabel or your second cousin
had breast cancer is important to determining your own risk and your children’s risks.
With this information, you can make decisions about your own health, breast cancer
prevention and potential treatment, if you are diagnosed.

Unfortunately, starting a conversation with family about medical history, and especially
one about cancer, can often be difficult. While some family members may open up,
others may consider this private information, or they might get upset talking about
cancer. Others might not even know their own history.
So how do you find out what you need to know?
1. Make a List
Your medical history should include information from at least three generations of family
members — grandparents, parents, uncles, aunts, siblings, cousins, children, nieces,
nephews and grandchildren. Make a list of who you need to approach.
2. Explain What You’re Doing
Contact each family member – whether in writing, by email or by phone – and explain
that you are trying to obtain family medical history. If they are still reluctant to talk about
everything, try to ask specific questions about breast cancer. Some information is better
than none.
3. Ask Pertinent Questions
You should have a list of questions that you need answered. A complete family medical
history includes the age of the relative and any diagnosis or, if you are asking about a
deceased relative, the age and cause of death.
4. Keep it Confidential
Assure your relatives that the information you are compiling will be kept confidential —
and then keep it confidential.
5. Use Additional Resources
If your relatives are deceased or difficult to talk to, there may be other resources you
can use, such as public records – marriage licenses or death certificates.

Once you have all the information compiled, make sure you give a copy to your doctors
and update it regularly. They are bound by law to keep the information confidential.
To learn more about natural breast reconstruction and find out if it might be the right
choice for you, contact The Center for Natural Breast Reconstruction at
NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Filed Under: Breast Cancer Awareness, Health and Wellness

I Tested BRCA Positive, Now What? 7 Things You Should Know

November 18, 2018 by Gail

If you have a family history of breast cancer and want to know if you’re at risk of getting it, too, a genetic test might provide the answers. A simple BRCA blood test can determine if there are changes in your genes, known as BRCA1 and BRCA2, which show you are at a higher risk of getting breast cancer. But what happens if your test results come back positive?

A Positive Test Does Not Mean You Have Cancer: First, understand that a positive BRCA test result does not mean you already have breast cancer. Not everyone who is “BRCA positive” will get breast cancer down the road. There are many other factors that determine your ultimate breast cancer risk, including alcohol consumption, body weight, breast density, physical activity levels, age, and reproductive history, and this test result is just one. It is normal to worry about any positive test result, so the best thing to do is to inform yourself about what a positive BRCA test result means and what the next steps are if you test positive.
A Positive Test Indicates You May Be at Risk: Statistics show a BRCA1 or BRCA2 gene mutation diagnosis means you have a 45 to 65 percent chance of getting with breast cancer by the time you turn 70. Remember, this doesn’t mean you will get cancer. It means you have a higher chance than someone else.
A Positive Test May Alter Your Treatment: If you already have breast cancer, knowing you have a BRCA mutation may change your course of treatment as many breast cancers in women that are BRCA positive result in more aggressive tumors. Armed with this information, you should talk to your doctor about your current cancer treatment plan and determine what, if any, changes, should be made.
You May Need Further Screening: If you have not been diagnosed, a BRCA positive test result should prompt you to create a screening plan with your doctor. You will probably have more breast screenings including mammograms, ultrasounds, and MRIs, starting at a younger age.
Better Overall Health Improves Your Odds: Whether your test was positive or negative, taking steps to improve your health will reduce your risk of cancer. Eating right, not smoking, and avoiding the sun and other things that cause cancer help to improve your odds.
You May Opt for Preventative Surgery: Depending on the genetic test results, your own health history and your current health, some women who are BRCA positive have undergone a preventative double mastectomy, which is the surgical removal of both breasts. It’s important to note that this reduces, but does not eliminate, your risk of developing breast cancer.
You Need to Alert Your Family: Getting a positive BRCA test result naturally leads to concern about the breast cancer risk for children and other family members. Notify them of your positive results and talk to the genetic counselor about getting other family members tested.

To learn more about natural breast reconstruction and find out if it might be the right choice for you, contact The Center for Natural Breast Reconstruction at NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Filed Under: Breast Cancer Awareness, Health and Wellness Tagged With: BRCA, BRCA 1 positive, BRCA mutations

When is the Ideal Time for Reconstruction Surgery?

Know the 5 Steps of Breast Reconstruction Before Your Mastectomy

Finding the Right Surgeon

Autologous vs. Implant

Breast Cancer and Younger Women

Love Yourself

How to Stay Positive During the Winter Blues

Seeing Friends and Family for the First Time Since Surgery

Opening up the Conversation on Family Cancer History

I Tested BRCA Positive, Now What? 7 Things You Should Know

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