In Her Words

I had my Stage 1 DIEP in Charleston with Drs. Kline and Craigie on May 25, 2018. On a scale of 1-10, I would rate my experience a 12! Before I go into more detail about my Charleston experience though, let me go back in time a little bit. I had my first unilateral mastectomy in 1998 (right side) with a reduction on the left side and immediate expanders.

A while later, I had the exchange for the permanent implants. This was all done in Atlanta, Georgia. The process was painful and inconvenient, took more than a year and was a complete flop. My right breast was half the size of the left, terribly scarred and deformed. The left breast was oddly shaped and had a very bad, fat scar underneath, and was hard.

The consequences of my low self-esteem led to intimacy problems with my husband, which resulted in divorce. Several attempts by different plastic surgeons only made the appearance of my breasts worse. The emotional consequences became compounded. In short, I felt like a freak. Dating was a concept I couldn’t even fathom – I was so self-conscious about my looks.

One day, 13 years after my first botched surgery, I saw a program on TV that discussed new procedures for reconstruction surgery after mastectomy. I immediately went online to research the DIEP procedure and decided to look into the facilities in Charleston. I was certain that Charleston was the right fit for me. Drs. Kline and Craigie are artists, and their highly trained staff made each and every step of the procedure flawless. Their attention to detail made me feel secure before, during and after. I’m about four months out from Stage 1 now. In those short months, my life has been transformed.

I haven’t had my stage 2 yet – that comes next month – but already I’m walking around with my head up and my shoulders back! My breasts look great. They are soft and warm, and it’s great to have those implants out. I would also like to add, if you are a single woman contemplating a location for reconstructive surgery, I highly recommend Charleston. The entire staff has a special sensitivity for those of us flying solo now.

–B.L., Thomasville, GA

Life after Mastectomy: Prosthetic Nipples

Being diagnosed with breast cancer and facing a cancer battle can be a long, draining, and scary experience.

While women who beat cancer find themselves overjoyed and grateful, there’s still a part of having breast cancer that tends to linger—especially if they’ve had to go through a mastectomy.

While we know women feel incredibly grateful that they’ve won their battle with cancer and feel they can begin life again, it’s also very common for them to long to feel like their old selves again.

At The Center for Natural Breast Reconstruction, we want all women to feel confident, radiant, and beautiful after a mastectomy, which is why we were so excited to find out about a new non-surgical solution to breast reconstruction—prosthetic nipples.

We love the product so much, we even carry demos in our office for women to try.

So, how exactly did this product come to be and how does it work?

I’m going to let breast cancer survivor and inventor Randi Johnson tell you in her own words.

Here’s her story…

After the shock of my IDC breast cancer diagnosis in 2007, I was hoping for the least invasive corrective surgery. The lump was too large for a lumpectomy, so a unilateral mastectomy was the choice I made. I had a new full-time job and didn’t want to take 6 weeks off for breast reconstruction.

The mastectomy was not very painful and I had a good recovery, but reality hit as bandages came off and I saw “my new normal” in the mirror. I’m not an especially vain person, but it was hard to feel “pretty” for my husband, even though I knew he loved me beyond the disfigurement.

I found myself wearing my prosthetic mastectomy bra to bed at night.

We happened to hear about Dr. Khouri in Miami, FL  who was doing a less invasive type of breast reconstruction surgery. There were no incisions, it was outpatient, and had a lower risk of complications. I only had to miss 3 days of work for each step (4 fat grafting sessions, for me).

Adding to the appeal, was the fact that they would take fat from tummy, thighs and anywhere else I didn’t want it and make a new breast out of it.

What’s not to love about that!

I was amazed to find that Dr. Khouri was in network for my insurance plan. There were still travel expenses etc., but somehow it all worked out.

It felt like I was growing a new breast and hardly had time to think about not having a nipple on that side, but when Dr. Khouri made an impression of my natural nipple and made up a silicone “rough draft” of a nipple for my recon side (for purpose of photos), my husband asked if he could tinker with the idea.

Dr. Khouri was very impressed with the prototype we brought back to show him a few months later. He invited us to display our Naturally Impressive nipple prosthetics as a vendor at a couple of his fat grafting conferences.

We received a great reception as well as some helpful ideas from the international breast surgeon attending.

I was part of an “MD Rounds” event at one of those Fat Graft Conferences and it was exciting to have MDs ask in disbelief (right after they heard my history). “Did you have a mastectomy?” We have heard countless similar stories from our clients about their Naturally Impressive nipples “fooling” others because they look so natural.

Now it’s become my new body image. If I have it off for a day or two, the asymmetrical image in the mirror doesn’t feel like it’s me.

We’ve been serving women through Naturally Impressive, LLC, since January 2010. As a “Mom and Pop” shop, we keep operating costs low and we also get to know many of our clients quite well. It’s an incredible joy! We love it!

No matter what option women choose regarding nipples, Naturally Impressive can be a way to “feel normal” again. For some, this is a great short-term option while waiting for tissue to settle before making a permanent choice. For others, it’s a wonderful non-surgical long-term solution.

If you or someone you care about is longing to feel normal again in the nipple department, check out our website to see the realism, variety and affordability of choices we offer.

Click here to visit the Naturally Impressive website.

You can also call Naturally Impressive, LLC, at 715-829-4488 if you have any questions.

Do you have a favorite post-mastectomy product that makes you feel confident and beautiful?

Share it with us in the comments below!

In Her Words: Moving Forward in a Post-Surgical World

 Everywhere you look, it seems there are blogs, posters, and articles that talk about how to stay positive while battling breast cancer. This is not a bad thing. It’s important for women to be encouraged and think good thoughts as they are dealing with such a serious illness.

However, when our only focus becomes positive reaffirmations and fuzzy pink boas, we forget to talk about another side of having cancer—a side that needs to be discussed.

We forget to talk about the ugly, dark, painful, uncomfortable, and scary side of having cancer.

We know, this isn’t a conversation that anyone enjoys having.

But it’s important.

Why? Because understanding the “uglier” sides of battling cancer is a part of what helps women move forward after their courageous battle.

Betsi Green, a breast cancer survivor and a patient at The Center for Natural Breast Reconstruction, wants to help women who are in the same situation as she was by sharing her story.

She hopes her story will help breast cancer survivors find peace and comfort as they make the transition into a post-surgical world—despite the challenges and discomforts that come with recovery.

Here’s Betsi’s story in her own words…

“Cancer is ugly.  Cancer is raw.  Cancer is painful.  Cancer is more than simply losing your hair.” – Betsi Green

On the first of November, Dr. Paul Baron did a right skin sparing modified radical mastectomy with lymphatic mapping and sentinel node biopsy. In short that means Dr. Baron removed my right breast and a handful of lymph nodes.

In the operating room, Dr. James Craigie inserted an expander where my breast had been. The expander, as its name suggests, is used to expand the skin and keep the tissue viable for the reconstruction surgery.

During surgery, the expander is filled with air.  Shortly after surgery, in a follow up appointment, the expander is filled with a saline solution.  This is done in the surgeon’s office.  The syringe is inserted in the center of the expander.

Let’s talk about the expander.  It wasn’t painful. It was uncomfortable. It was very uncomfortable.

It was difficult to bend over.  I felt like I had a brick on my chest.  It was difficult to have water from the shower hit my tender skin. It was difficult to have material touching my skin.

Did I say it was uncomfortable?

The skin felt very thin and pulled, which I expected, just didn’t expect it to be as tight as it felt.  Sleeping with the expander kept me to my left side or on my back.

It wasn’t until the first week of December, I noticed something was wrong.  The bottom half of my expander had turned red.

Anytime you have a foreign object in your body, you want to keep a close eye on how it looks and/or feels.  This bright red color told me something, and it was not good.

I did not feel any different.  I had no pain.  The uncomfortableness of the expander remained. These days, I really didn’t care what my chest looked like.  However, in this case, looks mattered and I “kept an eye” on it.  I was hoping it would simply go away on its own.

It turned out my expander was infected.

I share this with you for one particular reason:  SPEAK UP!  If you are uncomfortable, go see your team. If you think something is wrong…it probably is!  There are things they can do to help the comfort level.

Don’t be shy.  You are (or should be) in control of your cancer journey as much as possible. The doctors and their staff are not mind readers.  Let them know if you need an “adjustment”.

Ask them how they can help you be more comfortable.

The cancer dance is an ongoing experience.  My dance has been ongoing since June 2016.  It will continue thru the 2017 calendar year.  One appointment, one diagnosis, one doctor, one surgery, one chemotherapy treatment, and one CT scan does not complete the experience.

There are a lot of ugly things that can happen as you recover from your battle with breast cancer. But if you know about them, and speak up, you will be able to get the help you need.

You can make a huge difference in how your own personal cancer treatments affect you.

Be confident and as comfortable as possible as you move forward thru your own individual journey. And by all means…keep moving forward.

-Betsi Green

Check out Betsi’s blog and read more about her journey here.

Do you have any words of wisdom on recovering from breast cancer? Share them below!

 

Congratulations to the Class of 2016!!

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I’ve been in a bit of a stupor the past few weeks as my youngest is getting ready to graduate from high school and preparing to leave home for college in the fall.  It alternates between rambling on and on about scholarships, financial aid, school choices, to just standing, staring off into space not able to speak because it’s a bit surreal that my baby girl is ready to make her place in the world.  Not to mention, the constant feeling of being on the edge of a very long, very ugly cry.

Given that my current situation is what’s weighing on my mind right now it seemed natural to ask graduates what they want their parent to know and how that might differ from what the parents want their student to know.   I posed this question to a group of college bound seniors who will graduate June 1, 2016.  Some answers were funny, some sweet and reassuring but all in all do address some of our concerns as parents.

What is the one thing that you would like to tell your parent to help ease their mind and assure them that you are prepared and ready to go to college? 

– Parker also assures his parents that “I’m not going to spend all my study hours playing video games! I promise!  God!”

-Terry knows that “Uber saves lives.”  Smart boy!

-J.J. says beer tastes gross and Parker adds that it goes through your system too quickly.

-Alexandria appreciates learning some basic life skills!  “Thanks for teaching me how to do laundry!”

-Zachary tells us that his parent already knows his future college roommate.  We’re assuming that is a positive statement.  

-Simply stated Eli says “I got this!”

-Anizia thanks her parent for helping her become a mature, independent adult capable of taking care of herself.

-Ashton acknowledges the hard work it takes to be a parent. “I appreciate all the hard work and endless nights towards making me become the successful young lady I am today and I will not underestimate my gift and knowledge to surpass all obstacles.

-Bailey affirms that her parents have taught her well and helped her make good decisions and now she knows how to make good decisions on her own.

-Jonathan shares this “It’s time to for me to grow up in a new and unknown world. You have prepared me for this since I was being held in your arms. But it’s now time to find who I truly am. I will make mistakes, I guarantee it. But it’s you who has taught me to learn from every experience. So thank you.”

-Maddie adds with a smile emoticon that she is ready for this time in her life and reminds her parents that she will always be their little girl.

There are conversations that we parents all want to have with our graduates but somehow don’t seem to be able to do so without coming off as overbearing, nagging, or simply more involved than we are desired to be at this point in our students lives.  So, graduating seniors, bear with your parents as we try to make sure we have taught you and told you everything that we feel like you need to know in the next few months before you leave home.

Your well-being and success in college is our only concern.  We just need to know that you are going to be okay.   We need to know that we did a good job raising you and that you are able to make good, intelligent, and safe choices.   We need to know that you understand that you are going to college for a purpose, not just a party.  Have fun but be smart and keep your studies your number one priority.  We need to know that you feel equipped to handle most of the things we have always done for you – kept your schedule posted on the fridge, given reminders of your commitments, emphasized the importance of your schoolwork, handled your finances, filled out your forms, washed your laundry.    We don’t want you to be scared of new experiences.  We want you to make lifelong friends and we want to be confident in your ability to do so.

Ultimately, we hope you come out of your college experience a happy, productive adult ready to embark on a career that is meaningful to you and allows you to support yourself in the manner that you desire.   That is all. – Gail

 

In Her Own Words: Patti Ehrlickman

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The Center for Natural Breast Reconstruction team is passionate about sharing stories of amazing people who devote themselves to the breast cancer cause.

Patti Ehrlickman, a nurse who saw the daily struggle breast cancer patients, had the idea to invent a device to make the quality of life after undergoing a mastectomy just a little bit easier.

The apron-like garment, Poucharoo, holds the multiple post-mastectomy and breast reconstruction surgical drains in place to eliminate the inconvenience of dangling drains and reduce the risk of injury.

Patti’s goal is to make the difficult recovery after break surgery more manageable and comfortable.

To see the impact she’s made on the recovery process for many patients, watch this video.

Poucharoo is a medical support device that is comprised of two pockets and three detachable belts. It comes with a Poucharoo tote bag, and is made of washable poly-cotton that is soft and breathable. This device is worn around the waist and supports 1-4 drains—without the use of safety pins.

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Not only does a portion of the profits go to FORCE (Facing Our Risk of Cancer Empowered), Patti also takes the time to send a personal email to each woman.

We’re proud to share her story, her product, and her passion for helping women with breast cancer. 

For more information about Poucharoo, visit the website.

In Her Words- I am back to “me”

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At the time I came to your office, I was unsure that I would ever feel normal again.  I had undergone a bilateral mastectomy in 2013 and had expanders put in at the same time to plan for my implants.  After waiting for about a year and a half, the surgery for the implants was performed.  Within three months, one of my breast implants had to be removed since the skin would not hold due to the radiation I had received.  My plastic surgeon told me it was possible that I might have to live with only one breast.  He told me I was not handling things right and sent me for counseling.  My counselor said my feelings were normal.

I decided to do some research and found you on the internet.  I liked the fact that in your website you said you used my own tissue and muscle.  I think what was most important was that your website said that you understood and saw my situation as a unique individual.  You actually cared about my feelings and that was something I did not feel my plastic surgeon cared about.  

You accepted my insurance and an appointment was set.  From our first meeting I felt very comfortable with you and your staff.  I felt I had been guided to your hands. 

Now after two surgeries I am back to “me”.  I have my body and my life back thanks to Dr. Craigie and The Center for Natural Breast Reconstruction.  If I had known about you and your procedure in the first place I would have been there sooner and saved myself several surgeries and disappointments.  My husband and I would both like to thank you so much for being there for me.  

D.S. – Myrtle Beach, S.C.

“A Learning Experience” In HIS Words

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

Recovery daze…..

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.

Surgery Day (and other tidbits)

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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)

The Doctor is Out…..

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)