How One Breast Cancer Survivor Found Hope by Making Informed and Proactive Decisions

breast reconstructionThe team at The Center for Natural Breast Reconstruction is honored to share with you an In Her Words post written by a recent patient of ours, Linda Burkholder. She is an inspiration to all women who are facing breast cancer or who are at risk for hereditary breast cancer.

See below for Linda’s story:

Breast cancer—you can’t say I didn’t see it coming, but being the eternal optimist, I hoped I would dodge the bullet.  Several members of my family have died from breast cancer, including my grandmother, mother, aunt, and sister. After my sister died in 2006, I began to seriously consider prophylactic surgery. I quickly learned that there is little support in the medical community or among friends for this procedure.

After a benign biopsy two years ago I found F.O.R.C.E. (Facing Our Risk of Cancer Empowered) on the Internet.  F.O.R.C.E. is a support group for those with hereditary breast and ovarian cancer. They posted an application for a scholarship to their annual conference. I applied and much to my surprise I was granted an expense paid trip to the conference in Orlando in 2010. I can’t tell you how that changed my life. I learned so much about everything I wanted to know about breast cancer and I met several plastic surgeons who stood out to me, especially Dr. Kline from The Center for Natural Breast Reconstruction. I made a mental note to keep him in mind and took home a beach towel with his phone number splashed across it.

During the next year I struggled with my decision to have prophylactic surgery. Intellectually, I knew what to do, but emotionally I was really struggling. I joined a local F.O.R.C.E. group and kept learning and thinking and meeting cancer survivors, assuming I would have surgery when I felt more comfortable with the idea. Fast forward to June 2011. It was time for my annual mammogram. I told my family doctor I also wanted an MRI, to which she reluctantly agreed. To make a long story short, the mammogram came back normal, but the MRI showed a 1.2 cm questionable spot—a spot, I was told, because of its location, would never have been seen on any mammogram. It was a Stage 1 cancer.

This was almost 2 years to the date from my previous benign lumpectomy. In July, 2011 I had a second lumpectomy performed by one of the most respected surgeons in my area. Without consulting me she automatically scheduled me for radiation. I refused the radiation because I felt that all treatment was my decision and I wanted to consult with an oncologist first. Also, I had learned at the F.O.R.C.E. convention that radiated tissue is harder to reconstruct and I already knew I ultimately wanted mastectomies with natural breast reconstruction, not implants.

When I told the surgeon I didn’t want implants, she hit the ceiling. Clearly, no one had ever before challenged her standard treatment plan. Thanks to F.O.R.C.E., I was empowered. The next convention was two weeks away and I knew this would be where I would make my final decision, and it was. I talked with EVERY plastic surgeon at the conference. I spoke with Kathy Steligo, author of The Breast Reconstruction Guidebook, for 45 minutes at the round table breakfast. I had read her book for the third time on the plane to Orlando two days before. After the conference I came back to my hometown and started chemotherapy. I also scheduled my surgery for November at The Center for Natural Breast Reconstruction.

After consulting with my oncologist, I elected to have bilateral mastectomies with autologous reconstruction. In September my husband and I made a trip to South Carolina to meet with Dr. Kline and Dr. Baron, the general surgeon. I wanted my husband to meet my doctors. I wanted to make sure I had his full support and I wanted to make sure any lingering questions by either of us were answered.

After that meeting I was sure I wanted to go forward with the DIEP procedure. I felt very confident that everything would be alright. On November 30, 2011 I had the procedure. It was an 8-hour surgery, and everything went very well. I was in East Cooper Medical Center for four days. My nurses were great, especially Angela. I thought of her as my special angel since she was able to anticipate what was needed before being asked and was especially kind. She really took good care of me.

After my discharge from the hospital my husband and I stayed in Charleston another 10 days. I got a handicapped room at a local long-stay hotel. There was a handicapped shower and a recliner in the room. I really appreciated that recliner and I slept in it most nights. It helped to keep my feet elevated.  Every day, at least one time, I took a short, slow walk up and down the hall for exercise. I saw Dr. Kline 3 times during the next 10 days and he assured me everything was fine and my breasts looked “beautiful”—although at that time I didn’t think they looked so beautiful. Now, 5 weeks later, I can see how nicely everything is shaping up and I don’t think I will require a lot of revision at the Stage 2 procedure. I am glad I chose the DIEP procedure. The recovery is long, but it is worth it.

Did I ever seriously consider implants? The answer is yes, because implants represented the path of least resistance. I could have had the surgery done locally and I wouldn’t have had the additional expense of the trip from Indiana to South Carolina. Also, I would have had my entire support system around me. In making my decision I talked to many women who had implants and it seemed to me that they either loved them or hated them. Those that loved them seemed to love them only after 2-3 additional procedures due to complications. Everyone complained about the fills being painful and some found the implants to be cold or uncomfortable. Also there was the risk of capsular contracture and the necessity of replacing the implants every 10-15 years. I also talked with many women I met through F.O.R.C.E. who had flap procedures. I saw their results and they were fabulous. Short of a few fading scars, you could not tell that their breasts were not original. All of them seemed quite pleased with their new breasts.

Yes, recovery is a bit prolonged with DIEP. You definitely need someone very devoted to you to help out those first few weeks. I needed help getting up and down, showering, dressing, and emptying my surgical drains. My husband helped me with everything, dispensed my medications and gave me a blood thinning shot daily. I could do very little without his assistance the first 10 days following surgery, and I slept much of the time. Still, I was able to get around slowly and even went out to local restaurants my two weeks in Charleston. I also had pain medication, which made life bearable.

As the weeks have progressed, I feel my strength slowly returning. I am not yet 100% but I am planning to return to my job part-time on January 9th, with hopes of returning fulltime the following week. For anyone considering a flap procedure but fearful of the recovery, I would advise them that it is doable. It’s not as bad as you think. A certain amount of fear is normal if, like me, you have never had a major surgery. But for me, everything went fine, even though I am 59 years of age, older than any one I have met who had DIEP. So, I think if I can do it, anyone can.

My only regret is that I didn’t come to my decision for prophylactic surgery before I got cancer. Time ran out to make that decision but I am thankful my cancer was found early and I am thankful for my husband of 29 years, Larry, was by my side supporting me every step of the way. I would advise anyone facing cancer to not panic, do your homework, and be very proactive in your treatment. Learn everything about breast cancer that you can so you can understand your options. Choose your doctors carefully. Get second opinions and do what YOU think is best for you. You have many options; don’t let anyone take any of them away from you. Make your own decisions.

Having cancer has changed my view of life. It seems much more precious and much more vulnerable than before. I am thankful for a second chance and thankful that I had so many options that my mother and grandmother did not have. My mother had radical mastectomies, which are very disfiguring. I am glad that I still look much like I did before. I had nipple-sparing surgery and when I look at my breasts I still see me in there. I can’t wait to see the results following my final revisions. I am very grateful for Dr. Kline, Chris Murakami, RN and Clinical Coordinator, and all the staff at The Center for Natural Breast Reconstruction for a very positive reconstructive experience.

About Linda Burkholder

My name is Linda Burkholder and I have lived in Kokomo, Indiana the past 22 years. I am the proud mother of two adult children, a daughter 23 years-old and a son age 21. I have been married to my husband, Larry, for 29 years. I work fulltime at Indiana University as an Administrative Secretary to the Dean of the School of Public and Environmental Affairs. I love animals and have two Pembroke Welsh Corgis and four cats. In my spare time I enjoy reading and knitting.

Do you have a question for one of our doctors? Ask us!

Dining Out in Downtown Charleston

downtown charlestonDowntown Charleston is a dining nirvana. You can find everything from Southern comfort food to the finest French and Japanese cuisine. Following are some of our favorite restaurants.

Cru Café
http://crucafe.com/
Quaint Lowcountry Dining $$$$
18 Pinckney Street, Charleston, SC 29401-2006, (843) 534-2434
Lunch and Dinner

Known for its motto, “Comfort Served Daily,” Cru Café features amazing entrees such as Thai Seafood Risotto, Poblano and Mozzarella Fried Chicken, and barbecued beef brisket. Run by famed Le Cordon Bleu Chef John Zucker, Cru Café has been one of Charleston’s top restaurants since its opening in 2002.

Mercato
http://www.mercatocharleston.com/
Fine Italian Dining $$$
102 North Market Street, Charleston, SC  29401, (843) 722-6393
Dinner

Voted Charleston’s Best New Restaurant by the City Paper, Mercato is noted for its incredible Italian dishes, such as Veal Picatta, Housemade Potato Gnocchi, and Prosciutto and Arugula Pizza. Mercato’s atmosphere transports you to Italy with its Venetian plaster walls, fine Italian leather seats, and 60-year-old Italian chandelier.

39 Rue de Jean
http://www.39ruedejean.com/
French $$$
39 John Street, Charleston, SC 29403, (843) 722-8881
Lunch, dinner

According to its website, 39 Rue de Jean is “a refined French café and bar offering the best in classic Brasserie cuisine.” Enjoy delicious wine from France’s finest vineyards as you dine on Trout Beurre Blanc with almond rice pilaf, Lamb Shank with brandied figs, and Duck Confit with goat-cheese potato croquette.

Wasabi of Charleston
http://wasabiofcharleston.com/
Wasabi Sushi and Japanese Fusion Bar $$$
61 State Street, Charleston, SC  29401, (843) 577-5222
Lunch, dinner

With professional chefs trained in Japan, Wasabi of Charleston is quickly becoming the place to go for sushi and fine Japanese cuisine. You’ll have a difficult time deciding what to order with entrees such as Nabe Yaki Udon and Hibachi Steak and Shrimp and over 45 varieties of sushi and sashimi, including tamago (egg custard) and saba (Japanese king mackerel).

Hominy Grill
http://hominygrill.com/
Southern (excellent for brunch and breakfast) $$ – $$$
207 Rutledge Ave, Charleston, SC 29403-5864, (843) 937-0930
Brunch, Breakfast, Lunch, dinner

For some good old Southern comfort food, go to the nationally acclaimed Hominy Grill. Everything is prepared with locally sourced, fresh ingredients, and you’ll love the hearty breakfast with housemade sausage and hominy grits for breakfast. For brunch, try the salmon potato cakes with poached eggs, and for lunch or dinner, indulge in the Low Country Purloo, rice casserole with ham, sausage, chicken wings, and shrimp.

Which amazing downtown Charleston restaurants have you tried?

How to Develop Effective New Year’s Resolutions That You Will Keep

new years resolutions‘Tis the season to make New Year’s resolutions, but all too often they’re broken within a few days or weeks. We came up with a few ways to help make resolutions that you’re more likely to keep.

Do you really need to make resolutions?

For some people, using the word resolution dooms their plans. Maybe you should create a plan, set a goal, or make a decision.

Write it down.

To be successful in hitting your goal or resolution, you need a written plan of action. Take 30 minutes and write down what you want, why you want it, and how you plan to reach it. When your motivation wanes in the coming weeks, you’ll have that to look back on.

Be realistic.

Is losing 50 pounds in 2012 a goal that you can see yourself reaching? How about quitting smoking for the 10th time, or exercising every day? Be honest with yourself and set a goal that you can hit. Maybe 25 pounds, cutting down to ½ pack a day, or exercising three times a week are more realistic goals right now.

Focus on the short term instead of the long term.

Look at what you can do now rather than what you plan to do 6 months or a year from now. Using the examples above, focus on the month of January instead of the entire year. Decide to lose a pound a week, cut down by two cigarettes a day, or take up a new activity like Zumba or walking the dog after dinner.

Break down your resolutions into bite-sized chunks instead of trying to choke down a big goal.

Expect that things may not go the way you planned.

Most good plans have a monkey wrench thrown in at some point, and your New Year’s resolution is no different. Maybe in March you’ll hit a weight loss plateau, or your plan to quit will go up in smoke—how will you handle it? You may decide to make diet or exercise changes, or you may decide to quit smoking again.

You need to be flexible enough to roll with the punches and not feel defeated when things don’t work out as you had planned.

What has helped you to make successful New Year’s Resolutions?

Does Lymphedema Affect Success of Breast Reconstruction?

breast reconstructionThe below question is answered by the team at The Center for Natural Breast Reconstruction:

Does having lymphedema (arm and trunk) affect success of breast reconstruction?

We primarily have experience using perforator flaps for breast reconstruction, so I’ll answer from that perspective. Arm lymphedema does not directly affect breast reconstruction, although there are reports of arm lymphedema improving after reconstruction using your own tissue (such as DIEP, GAP, or other perforator flaps). Trunk lymphedema (including breast), while not affecting the survival of the flap, can result in prolonged edema of the breast skin overlying the flap, leaving the reconstructed breast with a heavy, “wooden” character. We have seen this edema gradually resolve in some patients, however, over a period of up to two years, and it is possible that the flap is actually helping with this.

For more answers to your breast reconstruction questions, visit our Ask the Doctor section of this blog.

Top 3 Holiday Related Activities to Enjoy in Charleston

festival of lightsImage to the left taken from the Charleston County Park & Recreation Commission website.

 

Charleston comes alive during the holidays, and enchanting activities for all ages abound. Here are just a few of the festive holiday celebrations to enjoy right now.

Holiday Festival of Lights
James Island County Park, November 10, 2011–January 1, 2012

With over 2 million lights, the Holiday Festival of Lights is a must-see event. Set up as a 3-mile driving tour or a fun-filled train ride, the Festival of Lights also offers several activities besides twinkling lights, such as marshmallow roasts, gift shops, carousel rides, life-size greeting cards, and a tree lighting.

The driving tour is $12 per car, and the train ride is $3 per person. Children under 2 are admitted free.

Charleston Christmas Sleigh Ride 2011
Charleston Harbor, December 1–31, 2011

Every night in December excluding Christmas, Thriller Charleston hosts sleigh rides by boat to look at the Christmas lights and decorations. You’ll depart from Shem Creek in Mt. Pleasant and see the sights in Charleston, James Island, and Mt. Pleasant. As you drink hot cocoa, you’ll hear charming stories of Charleston’s Christmas customs. You keep your travel mug and rain poncho.

Sleigh rides are $45 for adults and $35 for children ages 5–12. Children under 5 are admitted free, but do not receive the hot chocolate or rain poncho.

What’s your favorite Charleston holiday tradition?

The Importance of Taking Time to Reflect on Your Year

new yearEvery year, we take time not only to reflect on how thankful we are for our families, freedoms, and lives, but we also reflect on what we’ve accomplished during the year. We celebrate our successes and learn from our mistakes, and we decide what we’d like to achieve in the New Year. Here are a few ways to commemorate 2011 and plan 2012.

Make a list of your accomplishments.

What have you done in 2011? What were your successes and your leaps forward? No matter how small your wins may seem, they are still wins and should be celebrated. List them all so you can see what a tremendous year you’ve had. You may want to list them in categories, such as financial, health, family, etc. Rejoice in how long your list is.

Create a second list of your attempted successes that didn’t quite reach the mark. Those are worth celebrating too, even if the outcome wasn’t quite what you had anticipated or wanted. Simply attempting them is a win, and you can always try again.

Pat yourself on the back.

Look over your lists, and ensure you’ve included everything you’ve accomplished and attempted. You probably didn’t realize you made so many strides in 2011. Spend a little while remembering each accomplishment and how it made you feel. Re-create that feeling. Celebrate you and your success!

Use the lists to set your goals for 2012.

With the future in mind, decide what you want to try for next year. For each accomplishment, there is probably a natural next step. For example, if you lost 15 pounds, perhaps you would like to lose 10 more—or maybe you’d like to make sure you keep those pounds off by starting an exercise program.

If you attempted a goal and didn’t reach it this year, do you want to try again? Chances are that you learned something from trying it this year, and your odds of succeeding are even higher now. Give it another shot!

Finally, treat yourself to something special.

You deserve it for all your hard work, and this is the perfect time to treat yourself. Whether you book a spa day, take a trip during the holidays, or buy something you’ve had your eye on, celebrate yourself!

Tell us what you’ve accomplished this year so we can rejoice with you!

Join the Fight to Stop Breast Cancer with These Four Gift Ideas

Grill Charms pink collection

Grill Charms Pink Collection

Breast-cancer research organizations, doctors, and patients are continually amazed at how many people donate to fight this terrible disease. It’s always special when you can donate to a worthy cause when you purchase gifts, and here are four great gift ideas that help stop breast cancer.

Grill Charms:

A perfect gift for your favorite grill master, Grill Charms are dime-sized stainless steel discs with serrated stems that are inserted in food before grilling. The charm stays in place during the cooking process to distinguish each person’s food. Grill Charms are perfect for those who like their food cooked a certain way, or for those who may be allergic to certain foods or spices.

The inventor of Grill Charms, Leslie Haywood, was diagnosed with breast cancer not long after she began the company. She created The Pink Collection and donates 10% of each sale to the Susan G. Komen Foundation.

Yes Ma’am Tees:

“Yes Ma’am, mammograms are a must!” says the pink Yes Ma’am Tee, created by Lee McCracken of Charlotte, NC. Lee was diagnosed with breast cancer and came to us in 2009 for reconstruction. The tees are $20 and can be ordered from the website, and Lee donates 15% of the sale of each tee to help pay for screenings for uninsured and underinsured women through the Carolinas Breast Cancer Fund.

If you would like to partner with Lee to raise funds for uninsured and underinsured women in your city, contact her at sales@yesmaamtee.com.

 

Yes Ma'am Tees

CHI Pink Breast Cancer Awareness Flat Iron Gift Set:

When you purchase the CHI Pink Breast Cancer Awareness Flat Iron Gift Set, you’ll support breast cancer research. The gift set includes the CHI Pink Breast Cancer Awareness 1” Ceramic Flat Iron, a pink comb, pink sectioning clips, Pink CHI 44 Iron Guard, and Pink CHI Helmet Head.

With the CHI Pink Breast Cancer Awareness 1” Ceramic Flat Iron, you’ll add shine and cut hair straightening time in half—without frizz. The ergonomically designed flat iron heat up in 10 seconds or less and has curved-edge plates to straighten or curl. Pink CHI 44 Iron Guard keeps your hair soft while it protects your hair from damage from heat styling and helps your style last longer. Pink CHI Helmet Head provides hold that lasts and adds shine.

NFL Paraphernalia:

You may have noticed NFL players wearing pink lately to bring awareness to breast cancer. The NFL shop has launched their own program, A Crucial Check, a collaboration with the American Cancer Society to bring awareness to the importance of annual breast cancer screenings for women 40 and over.

The pink apparel worn by coaches and players, along with special game balls and pink game coins, will be auctioned at NFL Auction, with the proceeds going to team charities and the American Cancer Society. You can also support the fight against breast cancer by purchasing special merchandise at www.nflshop.com.

If you know of anyone else who is making a difference to breast cancer research, please share their information with us!

Are Overweight Women Better Candidates for DIEP Flap Reconstruction?

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

I’ve read that women who are overweight are better candidates for DIEP flaps since they have “extra” to use, what is your opinion?

Many women with high BMIs (exceeding 40) have enjoyed successful flap reconstructions; however, they are at significantly higher risk of developing post operative complications.

It is well-demonstrated in the plastic surgery literature, that people with a significantly higher BMI are far more likely to experience complications than those with a lower BMI. There is no magical “line-in-the-sand” cut-off point, though—many factors, such as proportion of fat, which is intra-abdominal (vs. subcutaneous, which is what can be used in a flap), undoubtedly play a role in determining each person’s risk. Besides wound-healing problems, increased BMI also increases the risk for blood clots, which can, of course, be lethal.

Some lay-posters on blogs have stated that you shouldn’t worry about blood clots because injectable blood thinners will prevent them. This is a VERY DANGEROUS misconception—blood thinners only REDUCE the incidence of blood clots, and nothing can completely prevent them in all patients. We feel that it is your surgeon’s duty to you to assess your individual risks, and propose a plan that will get you through the surgery as safely as possible. Other surgeons, and other patients, may feel differently.

Our practice has demonstrated that it IS possible to have an outstanding safety record, while simultaneously maintaining a high reconstruction success rate. My personal flap survival rate over the last 10 years exceeds 99%, and the overwhelming majority of our patients are pleased that they went through the procedure at our facility. Our primary goal, however, is not to try and push limits by seeing what we can “get away with” in higher-risk patients. Instead, we strive to give everyone the best possible Natural Breast Reconstruction with perforator flaps, while at the same time doing everything possible to ensure their safety.

Richard M. Kline Jr., M.D.

The Center for Natural Breast Reconstruction

Step 3 in Quitting Smoking: Taking Effective Actions to Stop

quit smokingThe one thing that many people don’t understand when it comes to quitting smoking is that addressing the physical addiction to nicotine is not enough. They must also learn to manage the ingrained habits that led them to smoke. People smoke after meals, while driving, and while under stress, to name just three examples. Those urges do not go away simply because the cigarettes are gone.

Quitters need to have a plan for when the habitual part of smoking raises its ugly head. We discussed that a little in our previous post about the 4Ds, but here are a few more tips to master the mental piece of quitting.

Look at your habits.

When did you have your first cigarette of the day? Was it right when you got up, after your shower, or after breakfast? Breaking that habitual urge can be as simple as changing your routine. If you smoked first thing, try going outside for a quick walk instead, or hop into the shower right away.

If your habits don’t change, your chances of staying quit are dramatically lower than if you consciously alter the path of your day.

Have substitutes handy.

If you can’t stop doing something that triggers you to smoke, keep something handy that you can put in your hand or in your mouth. Driving is a strong smoking trigger for many, and most cannot avoid it. Try putting a straw in your hand or a cinnamon toothpick in your mouth. If you find yourself lighting up at a certain intersection on your way to work, find a new route until you’re more secure in your quit.

Enlist help.

If you live with smokers, see what they are willing to do to help you maintain your quit. Having them smoke outside is ideal, since you were likely to smoke with them as part of your habitual conditioning and it’s easier to have them out of sight, out of mind. If they will not go outside, perhaps they would confine their smoking to one room of the house and keep the door closed.

If those you live with don’t smoke, perhaps they can help you identify your smoking habits and ways to break those habits.

You may need to alter your routine for only a few weeks while you master the initial difficulty of quitting, or you may need to change a few things more or less permanently. The main thing to remember is to never take one drag. This is no different from being addicted to any other drug. You would not suggest that an alcoholic or heroin addict has “just one” . . . and you can’t either.

What are your tips to quitting smoking?

6 Fun Christmas Food and Drink Ideas

holiday seasonChristmas is a great time to experiment with new food and drink. Following are some fun ideas you may not have thought of—and some would make fun gifts for the person who has everything.

Golden Honey Granola

A new twist on breakfast cereal, try this oatmeal granola recipe with sliced almonds, dried cranberries and apricots, brown sugar, cinnamon, and honey.

Parmesan Grissini

These amazing breadsticks work with everything from hearty tomato soup to a fine steak dinner. Crushed fennel seeds, sea salt, and crushed red pepper make them savory and spicy.

Russian teacakes or butterballs

These small cakes are typically served on holidays and are also called Mexican wedding cakes. They are made from flour, ground nuts, and butter and formed into balls before baking. After coming out of the oven, they are coated in powdered or confectioners’ sugar once while hot, and then they receive a second coating after cooling.

See a typical recipe here.

Marinated Goat Cheese

This would make a wonderful gift for the cheese lover on your list. Simply take a log of goat cheese, add spices and olive oil, and allow to steep in a glass jar. Not only is this a delicious gift, but the colorful spices and olive oil make this a beautiful gift too.

Mulled wine

A staple in Germany, mulled wine is typically red wine mixed with spices, such as cloves, nutmeg, and cinnamon, and allowed to heat (but not boil). Heating the wine with the spices brings out a unique flavor, and the drink is perfect for a chilly evening.

The Food Network has a simple mulled wine recipe. Click here to view it.

Hot buttered rum

Another cold-weather drink, hot buttered rum is a timeless favorite that can be made one mug at a time if you choose. Simply place a slice of soft butter at the bottom of a mug and add some brown sugar and spices such as cinnamon, allspice, or nutmeg. Mix the spices and butter well before adding the hot water and rum. Stir and steep for a moment before enjoying.

What are your favorite Christmas food and drinks?