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What is Capsular Contracture?

July 15, 2011 by

breast reconstruction

The below question is answered by The Center For Natural Breast Reconstruction team:

I’m considering implant-based breast reconstruction. My surgeon mentioned a “risk of capsular contracture.” What exactly is that?

Capsular contracture is an abnormal response of the immune system to foreign materials in the human body. Medically, it occurs mostly in context of the complications from breast implants and artificial joint prosthetics.
The occurrence of capsular contraction follows the formation of capsules of tightly-woven collagen fibers, created by the immune response to the presence of foreign objects surgically installed to the human body, e.g. breast implants, artificial pacemakers, orthopedic prostheses; biological protection by isolation and toleration. Capsular contracture occurs when the collagen-fiber capsule tightens and squeezes the breast implant; as such, it is a medical complication that can be very painful and discomforting, and might distort the aesthetics of the breast implant and the breast.

Although the cause of capsular contracture is unknown, factors common to its incidence include bacterial contamination, rupture of the breast-implant shell, leakage of the silicone-gel filling, and hematoma.
Moreover, because capsular contracture is a consequence of the immune system defending the patient’s bodily integrity and health, it might reoccur, even after the requisite corrective surgery for the initial incidence.

The degree of an incidence of capsular contracture is graded using the four-grade Baker scale:

• Grade I — the breast is normally soft and appears natural in size and shape
• Grade II — the breast is a little firm, but appears normal
• Grade III — the breast is firm and appears abnormal
• Grade IV — the breast is hard, painful to the touch, and appears abnormal

–The Center for Natural Breast Reconstruction team

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Tricks to Enjoy Yummy Beers and Wine without Packing on the Pounds

July 11, 2011 by

light alcoholWhen you’re watching your weight, one of the first things you normally reduce or eliminate is alcohol. While drinking too much can cause weight gain and other issues, moderate consumption of alcohol is good for your heart. You don’t need to deprive yourself to keep your weight down and stay healthy—you just need to do a little planning.

Often, small changes are all you need to make your favorite drinks healthier. For example, if you enjoy beer, you might like the new low-calorie and low-carb light beers. Most of the domestic beer makers have low-calorie options, such as Budweiser Select, Michelob Ultra, Miller Genuine Draft 64, and Aspen Edge. These beers vary in alcohol content.

If you prefer wine, lighter whites such as Chardonnay, Pinot Noir, and Chablis tend to be lower in calories than reds. White Zinfandel is also a good choice. Sweet dessert wines such as Port and Madeira contain high levels of sugar and alcohol and are high in calories.

The calories in mixed drinks and cocktails often come from the mixers you choose. While sweet liqueurs such as crème de menthe are high in calories by themselves, if you add high-calorie juices or cream, you can go from 100 calories to over 500 in no time. If you choose a drink that combines several types of alcohol, the calories will also climb.

The simpler the drink, the better. An average shot of 80-proof alcohol is around 100 calories before you add anything. Asking for diet soda pop, water, or diet tonic will help keep your calorie count down. Gin and tonic, rum and diet coke, and whiskey and water may not be very exciting, but their calorie counts are low. You could opt for shots of liqueur or flavored vodka, or order them on the rocks.

Some drinks have spawned their own low-calorie versions. For example, a skinny margarita leaves out the syrupy mix of the regular margarita. Ordering the regular-sized margarita instead of the fishbowl-sized margarita will help your weight stay where you want it. Some super-sized drinks can have 1,000 calories or more.

To reduce your consumption of alcohol and related calories, consider drinking a glass of water or simple mocktail between drinks, and skip the munchies at the bar. After a few drinks, your inhibitions are low, which also affects your resolve to watch yourself. If you know you’re going out one night, skip snacks or eat light during the day to save up calories for later. Eat before you go out so you aren’t tempted to eat high-calorie bar snacks.

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Essential Vitamins for Your Health

July 4, 2011 by

vitaminsYou’ve heard about essential vitamins all your life, from health classes to discussions on news and talk shows. Depending on which stage of life you’re in, your vitamin needs may vary, and a deficiency in any single vitamin can cause health issues.

Vitamins are chemicals that aid specific functions in your body. They play a major role inside your cells, and to be healthy you need optimal levels of each vitamin. Except for Vitamin D, which your body can make from sunshine, you need food or supplements to provide the full range of vitamins. Check with your doctor before supplementing. Following is a list of vitamins and their functions in the body.

Beta-carotene converts to vitamin A and keeps eyes, bones, skin, and tissue healthy and strong. Green leafy vegetables and orange-colored foods such as carrots and cantaloupe are high in beta-carotene.

Beta-carotene is part of the antioxidant group, which helps protect cells from unstable molecules in the body called free radicals. Other antioxidants include lycopene, found in tomatoes, and vitamin C.

Vitamin B6 aids in brain function, memory, and metabolism, while vitamin B12 helps cells divide normally. Vegetarians commonly have low levels of B12, as it is found only in animal sources such as eggs, meat, and cheese. Good sources of B6 include bananas, seeds, and beans.

Folic acid, or vitamin B9, is especially important for women of childbearing age because it reduces the risk of birth defects. Food sources of folic acid include dark green vegetables, melons, beans, and eggs. If you smoke, drink significant amounts of alcohol, or use oral contraceptives, a folic acid supplement will help maintain optimal levels in your blood.

Vitamin C helps produce red blood cells and heal the body. Many fruits and vegetables contain some vitamin C, but citrus fruits, peppers, broccoli, and tomatoes are especially high. If you tend to have high levels of stress, you’ll want to eat plenty of foods with vitamin C, or supplement it, because stress depletes vitamin C levels.

Vitamin D keeps bones strong by regulating calcium and phosphorus levels. Sunlight is the most effective way to help your body make vitamin D. Exposing as much skin as possible to the sun (without sunscreen) for 10–15 minutes several times a week will activate vitamin D production. During the winter, or any time you can’t get sunlight, taking cod liver oil is a good source of vitamin D. Carlson’s makes a pleasant tasting oil that can be found in health food stores or online.

Vitamin E maintains cell membranes and red blood cells. Nuts and seeds, cod-liver oil, and wheat germ are good sources of E.

Vitamin K promotes normal blood clotting and maintains strong bones in older people. Green leafy vegetables and fish oil are good sources.

Eating a variety of whole, fresh food is the best way to get the full spectrum of vitamins, but taking a supplement is a good nutrient insurance plan. Keep in mind that the more colorfully you eat, the more vitamins you’ll get. Eat at least five servings a day or orange, yellow, purple, green, and red fruits and vegetables. The nutrients give foods their colors.

What vitamins do you take and suggest for others?

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Is It Normal to Suffer With Abdominal Hernias After Reconstruction Surgery?

July 1, 2011 by

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

Is it routine to suffer with abdominal hernias after reconstruction surgery? Is it possible to correct this so there will be no more hernias or surgeries?

Sorry to hear about your problem.

It’s certainly NOT routine, at least not with experienced surgeons doing muscle sparing reconstruction (such as the DIEP flap). Unfortunately, however, it can occasionally happen under the best of circumstances, and we always warn patients about this risk, although I haven’t had a patient with a hernia in several years. Depending on the particular circumstances, it should almost always be possible to fix it, although in the worst cases it could require the implantation of permanent plastic mesh. A worst-case scenario would be a patient who is significantly overweight, with a large volume of intra-abdominal fat, which would push heavily against the muscular abdominal wall from the inside. However, even this situation should be correctable. If your plastic surgeon isn’t comfortable fixing it, then a general surgeon may be (although general surgeons typically refer the WORST hernias to plastic surgeons).

Good luck, and please feel free to ask more questions if you need more information.

—Dr. Richard M. Kline, Jr.

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New Surgery Performed to Help Cure Lymphedema Resulting from Breast Cancer Treatment

June 29, 2011 by

breast reconstructionA recent New York Times article discussed an amazing breakthrough in breast cancer treatment: curing lymphedema by transferring lymph nodes from other parts of the body.

Lymphedema is obstruction or swelling of the lymph nodes and is commonly caused by mastectomy with surrounding lymph node removal. As lymphatic drainage of the arm flows through the axillary (armpit) area, removal of lymph nodes there causes arm soreness and swelling because lymphatic fluid cannot move or drain normally.

The procedure, autologous vascularized lymph node transfer, replaces the missing lymph nodes with a small number of nodes from another area of the patient’s body, such as the groin. Surgeons must be careful not to harvest too many nodes from any one part of the body, or they risk causing lymphedema in that area.

The riskiest part of the surgery is removing scar tissue to make room for the new nodes and to improve lymphatic drainage. Critics say removing this tissue may affect the blood vessels and nerves in the arm. However, women with lymphedema often report that dealing with soreness and swelling is worse than coping with the cancer. Proponents of the surgery note that doctors often overlook the physical and emotional effects of lymphedema.

As the controversial surgery is still considered experimental, it is typically reserved for patients who do not respond to other treatments. The procedure’s classification as experimental means it is rarely performed in the United States, and insurance is not likely to cover its high cost. While proponents say it cures some patients and improves the lives of others, opponents counter that its results are inconsistent—it works for some and not for others.

A French physician, Dr. Corrine Becker, is the pioneer of the procedure, and claims a high success rate in Europe and other areas of the world. The surgery gives hope to patients with congenital lymphedema as well as cancer. A double-blinded randomized clinical trial of lymph node transfer will begin in the near future to collect more data on its effectiveness.

Doctors from The Center for Natural Breast Reconstruction observed Dr. Becker during two trips she has made to the United States, and they participated in the meeting and live surgery symposium discussed in the article.

Click here to view the New York Times article.

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What is a BRCA Test and Do I Need One?

June 24, 2011 by

Dear Friends,

Since our physicians and staff members are attending The Joining FORCEs 2011 Conference this weekend, we thought we’d answer a question that pertains to this event.  Hope to see some of you at the conference in Orlando this weekend.

According to the American Association for Clinical Chemistry, “In the general population, the lifetime risk of developing breast cancer is approximately 12% and the lifetime risk of developing ovarian cancer is about 1.4%. The risks increase with age.”

So how can you tell if you are at risk for breast cancer? One way is through a BRCA test.

What is a BRCA test?

There are a variety of BRCA-1 and BRCA-2 mutations present in individuals around the world, and a BRCA-1 and BRCA-2 test is used to detect various mutations in the genes. Some of these mutations are seen in individuals who have a high risk of developing breast and ovarian cancer. If you have a relative who has been diagnosed with breast or ovarian cancer, you would be a good candidate to receive a BRCA test to determine if you carry the same gene mutation. However, a BRCA test is not recommended for the general public. It is only recommended for individuals who have a close relative(s) that has been diagnosed with breast or ovarian cancer, especially before the age of 50.

It’s important to note that there are options for individuals who receive a positive result on their BRCA test and there are ways to help prevent the onset of breast or ovarian cancer. Just because someone receives a positive result on their BRCA test, doesn’t mean they will definitely develop breast or ovarian cancer. The positive result means that they are at higher risk of developing these cancers.

It’s also important to note that if an individual receives a negative result from the BRCA test, this doesn’t completely rule out the development of breast or ovarian cancer in the individual for the future. This is because the BRCA test can only detect if a person has a hereditary breast cancer or ovarian gene mutation.

If you found this post helpful and have more questions about breast cancer and testing for breast cancer, click here to contact us.

 

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How to Log Your Workouts and Food Intake

June 22, 2011 by

Nutrition FactsAfter you’ve chosen a method to log your workouts and food intake, it’s time to get started tracking your progress.

Keeping records is a vital part of being accountable to yourself and staying on track. You’ll see your progress every day, week, and month, so you can celebrate your accomplishments. If your program needs changes, or if you’re having trouble in a particular area, your log will alert you right away. The following tips will help you easily track your journey to a healthier you.

Have a realistic goal, and write it down.

Before you begin your program, set your goals in writing. One way to set effective goals is to use the acronym SMART: specific, measurable, attainable, realistic, and time framed. What is realistic and attainable for you? Maybe returning to your weight at age 16 isn’t realistic, but returning to your weight at age 25 is. If you’re just starting a health program and have been inactive for a while, a triathlon may not happen this year—but would be a realistic goal for next year.

When you’ve decided on a goal, log it on your tracking tool. The simple act of writing it down sets it in your mind.

Plan your meals and workouts, and log them.

Setting and keeping a workout schedule and meal plan help you stay on track. The rigidity of the schedule is up to you. You may wish to be very specific and write out a menu and exercise plan every week, or you may simply block out exercise time and decide that day which activity to do. You may want to experiment to see what works well for you.

When you log your workouts, be as specific as you can. Note which machines you used at the gym and for how long, how many reps you did at which weight, or how many miles you walked.

Record not just actions, but also feelings.

When you’re trying to exercise and eat right, your feelings play a major role in your motivation to stick to your program. If you stray from your plan, it’s often because of negative emotions. If you can track those feelings, you can identify when they are likely to occur and plan accordingly.

Use logs to motivate, not discourage.

It’s common to feel discouraged if the scale doesn’t budge or you don’t see any progress. Don’t let it discourage you. It’s common to hit the occasional plateau, which is your body’s way of getting ready to move to the next level of weight loss or to that next exercise goal. Keep going and recording everything, and you’ll hit that next target before you know it. Take pleasure in other numbers, such as your dress size and your blood pressure.

Remember that each day is just that: one day.

You may not hit all your goals each day, and that’s OK. Life happens. The key is to keep a one-day slip limited to that day, and get back on track the next day.

Food intake and workout logs help you to see and understand your behavior, and remind you of your commitment to health. Daily tracking is essential for staying true to yourself and your healthy plan. When you have a system in place for tracking, your results are greatly improved.

How has your healthy progress improved by using tracking tools?

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Don’t Live in Charleston But Still Want a State-of-the-Art Breast Reconstruction?

June 17, 2011 by

Chris MurakamiThe question below is answered by Chris Murakami, RN, CNOR, and Clinical Supervisor (seen to the left) of The Center for Natural Breast Reconstruction.

I live in Florida and would like to come to Charleston to have a bilateral S-GAP by Dr. Kline and Dr. Craigie. Do I need to come in for a consultation first and then come back at a later date to have the surgery or can it be done all in one trip? Please tell me how this is typically handled.

Great question! There are many ways to approach this situation and do our best to try to minimize the number of trips you need to make to Charleston. You are more than welcome to come and have a face to face consult with your surgeon and then make a second trip for surgery. For some women, that is the scenario they prefer. However, since many of our patients do have to travel to access the state-of-the-art procedures offered by our expert surgeons, we’re prepared to perform your first consultation by telephone.

During this call, we talk about the procedure you are interested in and ask some screening questions to ensure you have no medical contraindication. Once this has been established, we’ll set up a time for you to talk with the surgeon of your choice and you’ll both decide which donor site might be the best to use for your breast reconstruction. Your next step would be to notify us when you would like to proceed with the surgical procedure.

When we’ve settled on a surgical date, we order as much of your pre-operative testing in your hometown as we can. The results of this testing is sent to our office two weeks prior to your surgery day. These tests include blood work, urinalysis, EKG, and Chest X-ray. Go ahead and schedule a full physical with your family doctor or internal medicine doctor and obtain a statement of medical clearance for your estimated length of surgical time.

While all of this medical work is happening, our administrative staff has been diligently working behind the scenes, checking insurance benefits and completing all of the pre-certification processes your insurance company may require.

We’d like you to arrive in Charleston a day or two prior to your surgery date. If a breast surgeon is needed to perform a mastectomy we ask you to come two days prior. You would meet with him / her on the day you arrive, in case any testing needs to be ordered by their office.

The day prior to your surgery date is usually the busiest for you, but we try to coordinate all of your pre-operative activities to be as convenient as possible. You would have various appointments scheduled for you, including a pre-operative interview at the surgical hospital, an MRA to map the blood vessels we plan to use for surgery, and a pre-operative marking appointment and consultation with our surgeon that day before surgery.

Once the surgery day arrives, you would report to the hospital at 6:00 am. Our staff and physicians will obtain contact information for your caregivers and keep them updated on the progress of your surgery throughout your time in the operating room. Once the operation has completed and you have recovered from anesthesia, you would be transferred to the women’s services floor of the hospital for the remainder of your four-day hospitalization. Each room is private and has a twin bed in case you have someone who plans to stay with you throughout your hospital stay.

When you have been discharged from the hospital, we ask that you stay in the Charleston area for a few more days, just to assure all is well and we are easily accessible to you. We ask you to come to your first post operative appointment two days after your discharge and again on the day prior to your planned return home. You may still have donor site drains that need to be removed when you return home and we are happy to help you find a medical professional to do that for you if you don’t have a physician in your hometown who is willing to help.

Once you are home, we’re available to you 24/7 to discuss any concerns you may have, but generally, at this point, you have a viable reconstruction that should heal uneventfully. You can look forward to another visit to Charleston only when or if you require a second stage of surgery after a three-month healing period. This procedure would typically be an outpatient procedure and you might just schedule yourself some “tourist time” to enjoy our beautiful city.

—Chris Murakami, RN, CNOR, Clinical Supervisor

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Educate Yourself on Breast and Ovarian Cancer at the Annual Joining FORCEs Conference

June 15, 2011 by

Image to the left taken from FacingOurRisk.org.

For anyone concerned about hereditary breast or ovarian cancer, FORCE is hosting their annual Joining FORCEs Conference with Moffitt Cancer Center to educate individuals on everything from mastectomy options to genetic basics, and reconstruction options to menopause. This three-day international conference will provide attendees with valuable information and tips for cancer prevention and detection.

Attendees will also learn vital skills such as how to cope with cancer, how to make risk-management decisions, how to discuss cancer with family members, and so much more.

The event takes place from June 23 – 25 at the Hyatt Regency Grand Cypress in Orlando, Florida. And we are delighted to inform you that we’ll be attending the event and featured as one of the exhibitors. In addition to exhibiting, Dr. James Craigie will be on one of the reconstruction Q & A panels, and Dr. Richard Kline will be hosting a table at the Networking Breakfast. We hope to see you there!

See below for an amazing video from FORCE:

Click here to register for this amazing event!

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When and Why to Choose Organic Foods

June 13, 2011 by

organic foodOrganic foods, generally speaking, are grown with fewer chemicals or hormone treatments than supermarket foods. Typical chemicals and additives include growth hormone, antibiotics, pesticides, and herbicides.

Obviously, we would all like to eat wholesome, naturally-grown foods for every meal, but they can be hard to find. Livestock animals eat unnatural diets to make them heavier and ship them to market sooner, and they’re injected with hormones and antibiotics. Fruits, vegetables, and grains are genetically modified to grow faster and larger, and they’re sprayed to keep pests and fungus away.

Organic foods can be significantly more expensive than supermarket foods, and you may wish to vary your eating with the seasons, as organic produce in season is less expensive. If you have a farmer’s market in your area, you’ll find very fresh, organic produce for a reasonable price. Local sources for meat and dairy products are often organic as well, but may not be available in some areas.

You might be asking yourself whether you have to buy everything organic. Certain foods are treated with more chemicals than others, and these are the foods that you should consider buying organic. For these foods, washing, peeling, and cooking do not significantly reduce chemical residues, so these foods are called the dirty dozen or the crucial dozen:

  • Peppers
  • Celery
  • Grapes
  • Fruits with pits, such as apricots, peaches, and nectarines
  • Farm-raised meats such as beef, chicken and pork
  • Potatoes
  • Dairy products
  • Coffee
  • Berries
  • Apples and pears
  • Tomatoes and carrots
  • Spinach and salad greens such as lettuce and kale

No matter the source, be sure to wash all produce with a fruit and vegetable wash, which can be found at most supermarkets and health food stores.

For foods with low pesticide residue levels, buying organic isn’t as vital. These dozen foods lose the residue with thorough washing, peeling, or cooking:

  • Onions
  • Bananas
  • Kiwi
  • Corn
  • Mango
  • Melon
  • Grapefruit
  • Pineapple
  • Asparagus
  • Broccoli
  • Cabbage
  • Avocados

While organic is ideal, it’s not always necessary to spend the extra money. Which foods do you buy organic, or not?

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