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Does Lymphedema Affect Success of Breast Reconstruction?

December 30, 2011 by

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.

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Feel Confident in the Decisions that You Make with the TalkAboutHealth.com Online Community

December 14, 2011 by

talkabouthealthWhenever an individual is diagnosed with cancer or any other type of disease, they often struggle to find the right information, which, in turn, can make them feel alone and frightened. In an effort to provide personalized answers and a greater understanding for health issues, Murray Jones, founder of TalkAboutHealth, decided to create an online community for people seeking support and medical information and advice.

See below for our exclusive interview with Murray, where he discusses what TalkAboutHealth is and how it benefits individuals seeking support and personalized health advice:

1. What inspired you to start TalkAboutHealth.com?

I was inspired to start TalkAboutHealth based on needs that I saw from being a caregiver to my father, who is a two time melanoma survivor. We had so many questions and it felt impossible to find the right information and then understand it in a limited amount of time. We felt alone and lacked confidence in the decisions we had to make. We needed personalized answers to understand our health situation. We needed perspectives from others like us who had been through similar circumstances. We needed guidance to help find relevant information.

As time passed and I met more people in cancer communities, both medical professionals and survivors, I realized that there was so much knowledge that everyone wanted to share that just needed a place to live and someone to organize it. I thought to myself, I can do that. I can build a website where people can share their experiences.

2. How does TalkAboutHealth.com benefit patients? In other words, what does it offer to patients, survivors, and experts?

Our goal is to help patients get the right information at the right time, so they can understand their health needs and make the right decisions for them. We want to help people feel confident in the decisions they are making, know that they are not alone, and have hope after hearing the stories of others.

To accomplish this, we provide personalized answers from leading medical professionals and experienced survivors. When a patient asks a question, we find and notify the right experts, survivors, and organizations to answer. Each question has answers from several perspectives and provides context and narrative to help the patient.

We then curate and provide structure for all of this information so that it is easy to find. In the future, we will test many different formats to educate—from custom web and email tutorials to working with medical experts on video courses.

3. Why did you decide to make TalkAboutHealth.com a community-based structure, as opposed to a website that featured medical information without the opportunity to ask questions and provide feedback?

For two main reasons:

1. Because the combined knowledge and experiences of the community can have an amazing impact in helping others.

2. Community makes it possible to provided personalized and individualized support.

The purpose of TalkAboutHealth is to be a community where all of us share knowledge, stories, and experiences to support each other.

4. Is there anything else you’d like to add?

I encourage everyone, including medical professionals, to tell their story and share their experiences in whatever format is comfortable for them. It is so important for us to share and support each other. None of us are alone, we need each other. If you share your story, you will help others and find the support you need.

Have any questions about TalkAboutHealth or want to learn more? Visit TalkAboutHealth.com or contact Murray directly at murray@talkabouthealth.com.

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How to Enjoy Christmas Parties without Compromising Your Waistline

December 12, 2011 by

Christmas CookiesChristmas is one of the most challenging times of year when it comes to watching your weight. Temptations are everywhere, and difficult to resist. Here are a few ways to watch your waistline while still enjoying holiday festivities.

Decide which parties to attend.

If you’re invited to three parties in one night, it might be tempting to attend all of them, but if you do, you’ll have three times the food and drink. Perhaps going to one or two is a better idea.

If you can, find out what will be served.

Some parties serve a full meal, while others have only snacks and drinks. If you know ahead of time how much food and drink will be available, you can create a plan and stick with it.

Don’t go to the party hungry.

If you’ll have a meal, eat a light snack before you go so you won’t overindulge in appetizers. It seems like meals are always delayed at parties! If you’ll enjoy snacks only, eat a small meal before you leave. You’ll be less likely to eat too many Christmas cookies.

Decide how many drinks you can have.

If you’re driving, ideally you shouldn’t drink at all—but if you decide to indulge, have no more than one glass or wine, one beer, or one single-shot mixed drink per hour. And yes, watch the clock. Your liver can process approximately one drink’s worth of alcohol every 60 minutes. Wait an hour after your last drink before driving.

Better yet, have a designated driver, or plan to call a cab.

Follow the 30-minute rule.

Take half of the amount you really want to eat, enjoy it, and then wait 30 minutes before you eat anything more. It takes that long for your stomach to signal to your brain that it’s full. In that 30 minutes, you’re likely to get involved doing something else and won’t miss eating more.

Eat two or three bites of anything you wish.

If you can’t resist Aunt Millie’s Mississippi mud pie, have a small slice and eat just a couple of bites. You’ll get the taste you want without too many extra calories. The same applies to high-calorie drinks—order that raspberry margarita, enjoy three sips, and then give it to someone else.

If you overindulge, make up for it the next day.

Don’t skip meals, but if you overindulge one day, eat less the next couple of days, and be sure to drink plenty of water.

What’s your favorite waistline-watching tip?

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Are Overweight Women Better Candidates for DIEP Flap Reconstruction?

December 9, 2011 by

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

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How One Woman Discovered the Positive Outcomes of Reconstruction Surgery and Cancer

November 30, 2011 by

Today’s In Her Words post comes to us from a past patient of The Center for Natural Breast Reconstruction, Jakki Grimball. Jakki is a breast cancer survivor who lived in Columbia, SC and traveled to Charleston to receive her DIEP reconstructive surgery. Today, her and her husband live in Charleston where her husband is the director of The Neighborhood House, an organization providing services for people in need, including food pantry, soup kitchen, emergency assistance, sewing classes, resume writing, and more.

See below for our interview with Jakki:

What type of reconstruction surgery did you have and how do you feel about the results?

I had the DIEP flap procedure done October 2007 by Dr. Craigie. The outcome far outweighs the surgery and recovery time. I am very pleased with the results and having a tummy tuck as an added benefit!

Would you make the same decision again if you could go back?

I would definitely make the same decision. I had a friend who had implants and she now wishes she had done the DIEP flap procedure. She’s had several complications. Of course, I believe I had the best plastic surgeon in South Carolina perform my surgery.

What advice would you give to women who have undergone a mastectomy or double mastectomy and are unsure about natural breast reconstruction?

I would and have advised women to have the DIEP flap surgery. It is far better to have natural breast reconstruction than to have a foreign substance placed in the body. I realize advances have been made in breast implants and there are fewer adverse effects; however, I believe that using my own tissue left little opportunity for infections and other complications. I have never regretted having the surgery or choosing Dr. Craigie as my surgeon.

In what ways has breast cancer both negatively and positively affected your life?

The only negative affect breast cancer had in my life was the mastectomy and the chemotherapy. I firmly believe God has a purpose for everything and having breast cancer made me more aware of how fragile life can be. Breast cancer brought my family and friends closer and I hate to say it, but it weeded out those who were truly not my friends. I found out I had breast cancer three days before my wedding and I gave my fiancé the chance to cancel the wedding. He told me he would marry me at my bedside if necessary. So the diagnosis also brought us closer together. I now cherish every moment and I don’t sweat the small stuff (sometimes not even the big stuff).

You and your husband recently relocated from Columbia, SC to Charleston, SC where your husband is the Executive Director of Neighborhood House. Tell us a little bit about this non-profit organization and how it helps the community.

Click here to view a document from The Neighborhood House, outlining their mission and daily services to the community.

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

November 25, 2011 by

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

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

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

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

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

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

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

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

—Dr. Richard M. Kline, Jr.

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Can Breast Reconstruction Improve A Woman’s Psychological and Sexual Wellbeing?

October 21, 2011 by

DIEP flapIn a recent article, titled Advanced Post-Mastectomy Breast Reconstruction Improves Women’s Psychosocial and Sexual Wellbeing, by CANCER Online Journal, a study found that “After a mastectomy, women who undergo breast reconstruction with tissue from their own abdomen experience significant gains in psychological, social, and sexual wellbeing as soon as three weeks after surgery.” (CANCER Online Journal: http://www.canceronlinejournal.com/newsroom)

The study was performed by Toni Zhong, MD, MHS, of the University Health Network Breast Restoration Program in collaboration with several others at the Memorial Sloan Kettering Cancer Center in New York City. They surveyed 51 women who were preparing for their MS-TRAM or DIEP flap reconstructive surgery during the months between June 2009 and November 2010.

Breast reconstruction is restoring the form of a breast that has been damaged, partially removed, or completely removed. Breast reconstruction is almost always done after treatment for breast cancer, although there are some birth defects that can result in the need for breast reconstruction. Breast reconstruction can be performed with implants (the same ones used for breast augmentation), or with the body’s own excess tissue (usually from the abdomen or buttocks), thus avoiding the need to place foreign objects in the body.

The study found that these women who experienced breast reconstruction “reported significant improvements in psychological, social, and sexual wellbeing just three weeks after surgery,” according to the article.

Although The Center for Natural Breast Reconstruction has not performed a formal study on the feelings that patients experience post breast reconstructive surgery, we have found that many of them feel a sense of improved psyche and self-esteem. Just ask Leslie Haywood who underwent breast reconstruction with the Charleston breast surgeons of The Center for Natural Breast Reconstruction: “I have never been happier with my body and I have never been more in shape in my entire life!”

If you know of someone who would be interested in hearing about this study, visit the CANCER Online Journal newsroom where the article will soon publish to: http://www.canceronlinejournal.com/newsroom

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10 Questions to Ask Your Breast Surgeon

September 16, 2011 by

breast surgeryUndergoing any type of surgery is stressful. But the best way to reduce your fears, stresses, and concerns is to do your research and be prepared both before and after surgery. It’s important to understand possible complications during and after surgery, as well as details on the actual procedure.

For patients who are considering breast reconstruction surgery, it’s important to talk with your doctor about your concerns. Some of the most important questions to ask include . . .

1.     Why are you recommending this procedure?

2.     What are the risks? How do they compare with the benefits?

3.     How do I prepare for surgery?

4.     What type of anesthesia will I have?

5.     What happens during and right after surgery?

6.     Who do I talk to about breast reconstruction?

7.     How long will I be in the hospital?

8.     Are there possible complications?

9.     When can I go back to work and resume normal activities?

10.  What are the risks of lymphedema?

Did you find this post helpful? We’d love to hear from you in our comments section.

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Healthy Brunch Ideas

June 8, 2011 by

healthy brunch ideasBrunch is the perfect time to eat healthy. From fruit to whole-grain muffins and Canadian bacon to turkey sausage, an endless variety of food works for brunch. We’ve come up with a dozen delicious options to help you stay on your healthy eating plan.

Multi-grain pancakes and waffles contain anything you want them to: oat, buckwheat, whole wheat, cornmeal, flax seed, or spelt. Use whole grains as much as possible, and don’t be afraid to add blueberries to those pancakes!

Whole-grain muffins give you the texture and taste you want in a healthier package. Use applesauce or mashed bananas to replace the fat during cooking, and use all-fruit spreads or nut butters on top.

Turkey bacon and sausage add low-fat protein and delicious flavor to quiches, casseroles, and scrambles.

Smoothies are the perfect way to blend your favorite fruits with protein powder, juice, yogurt, or even ice cream. Try several recipes, as there are hundreds of ways to make a tasty smoothie.

Tofu can replace meat in almost any dish. It can also be marinated and barbecued or used in place of cheese.

Canadian bacon has incredible flavor and one-third the calories of regular bacon. It’s also much lower in fat and sodium.

Vegetables of any kind add nutrition, color, and flavor to egg dishes, salads, and side items. Omelets and quiches are an ideal place for a variety of veggies. Try to eat as many different colors as possible to ensure you’re getting the full spectrum of antioxidants and nutrients.

Fruit is a brunch favorite and is used for everything from fresh-squeezed juice to tarts. Like vegetables, be sure to eat a variety to take advantage of the excellent nutrition fruit offers.

Nut and fruit butters and all-fruit spreads are healthy substitutes for butter and high-sugar jellies and jams. Choose from all-natural peanut butter, almond butter, cashew butter, apple butter, and spreadable fruit. All are available in stores, but read labels carefully: nut butters should have only one ingredient: the nut itself. Ingredients on the fruit butters and spreadable fruit will vary, but there should be only a few ingredients with no added syrup, sugar, or oils.

Quiche is a delicious, healthy main course, perfect for any type of food you want to put in it. Eggs, vegetables, meat, cheese, and tofu are common ingredients, and quiche invites experimentation with flavors, ingredients, and spices. A casserole is also a good option for a quick and easy brunch dish.

Wild or game meat adds unique flavor and healthy protein to any dish. Game is naturally low in fat, and does not receive antibiotics or hormones. Game meat includes venison, elk, bison, moose, alligator, and wild boar.

Real eggs are one of the healthiest foods you can eat and full of protein, vitamins, and minerals. Eggs are versatile and can be cooked a number of different ways: fried, scrambled, sunny side up, hard- and soft boiled, and poached.

Keep in mind that how you cook and serve is just as important as what you cook and serve. Stay away from partially hydrogenated oils, such as margarine. Coconut oil and olive oil are good choices for both cooking and serving. Real butter, low-sugar syrup, and cream cheese in moderation add a delightful taste to the table. And of course, stay away from high-fructose corn syrup.

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