“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)

hospital sign

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)


How to Be a Friend to Someone with Cancer

two girls, one with cancerYou’re trying to be supportive to your friend with cancer. But are you? Sometimes, even when we have the best intentions, we may hit a sour note.

The women our team sees every day have gone through tremendous challenges to overcome cancer, and are incredibly inspirational to us all. We often have the opportunity to meet their support systems—the loved ones who have been by their side throughout the journey.

There isn’t a defined guidebook about how to talk to your friend or family member battling cancer.  So we came up with a few things to keep in mind when trying to support your loved one:


When a friend tells you they have cancer, you may think you’re being helpful by saying, “It could be a worse type of cancer” or “Don’t worry; everything will be fine” or “You don’t even look sick.” Although you’re trying to be helpful and positive, you don’t know how they’re feeling inside. They may be having a really bad day, and these comments may unknowingly make them feel minimized.

What to do instead: Sometimes, it’s just best to listen. If they’re willing to share their feelings, let them express how they’re feeling.

Offering to Help

Someone dealing with cancer has a TON on his or her plate. They are likely hearing a lot of “Let us know if you need anything at all.”

While intentions to help are good, remember that your loved one might have so much going on that he or she doesn’t know where to begin to ask for help. Or, they may be too embarrassed to ask for help when they need it.

How do you help? Just do it. If you’re at the grocery, give your friend a call and ask what they need or just pick up some essentials. Or if you do ask, get specific. Offer to pick up the kids from school or bring them to their after-school activities. These small generosities can help relieve a lot of stress.

Don’t Bring Up Insecurities

Women often feel their hair and breasts define their femininity. Asking questions such as “Are you going to lose your hair?” might stir up feelings unknowingly. Also, making jokes such as “I wish my insurance paid for a boob job” may not lighten the mood as much as you’d think. They’re fighting cancer. Not getting plastic surgery. 

What to do instead: This isn’t to say you can’t joke around—but maybe let your friend take the lead! And, above all, if you notice your friend is looking spectacular, be sure to mention it.

Comment on our Facebook page with more suggestions on how to be a supportive friend!

Resolutions 101: How to Actually Keep Your Resolutions This Year

8242590657_89f52abeee_oDon’t shoot the messenger, but it’s that time of year again. You know what I’m talking about—it’s time to make this year’s New Year’s Resolution. Before you start groaning about resolution failures of years past, we are here to help. We have set up 4 methods to SUCCEED this time.

Honestly, this time of year can be really refreshing. It’s a whole new start. If you had a not-so-stellar last year, here’s your chance to shake it off (excuse the Taylor Swift reference) and be a new and improved you!

Make It with a Friend

When someone else is holding you accountable, it’s much easier to stay motivated. Choose a friend who has a similar goal, and be each other’s support group! If your resolution is to go to the gym 3 times each week, going together will raise the odds of sticking to your mission. The two of you could even come up with a rewards system. After 4 weeks of going to the gym 3 times a week, treat yourselves to a mani/pedi or a round of golf!

Make It Realistic

Did swearing off all foods except fruits and vegetables not turn out how you planned last year? Make this year’s resolution something that is challenging but still maintainable with your lifestyle. Instead of giving up everything, try eliminating just soda and sugar from your diet. And what happens if you blow it on week 2? DON’T STOP, just because you feel defeated! Realize that there may be slip-ups, but what matters is getting back on track right away.

Make It New

Have you not succeeded with the same resolution year after year? Get creative! Your resolution doesn’t always have to be about dieting or exercising. It can be as simple as vowing to be more patient with your in-laws (easier said than done!) or even keeping up with old friends. Choosing something you’ve never done before can help shake things up and help make your goals feel attainable.

Make It Your Own

Who says your resolution has to start January 1? Actually, that may not the best day to start a lifestyle change. If you’re a little under the weather from the parties the night before or if you still have a lot of holiday food lying around, you’re not setting yourself up for success. Choose a date like January 2 or the day you go back to work to start your resolution, so that you’re prepared and in a positive mindset.

Have a New Year’s Resolution Success Story? We’d LOVE for you to share it on our Facebook page!

Happy Thanksgiving!

Thanksgiving - What Are You Thankful For?

Happy Thanksgiving to all of our faithful blog readers, Facebook friends, and Twitter followers.  

We sincerely hope you have the most blessed of days, safe travels, and happy hearts as you celebrate.   

  Most of all we are thankful for you!   

Charleston’s Best Running Trails

We’re fortunate in that we can run, bike, and walk year-round here in Charleston. We love finding new places to explore and imagine you do too. Here are a few we like and hope you’ll try.

Awendaw Passage

Distance: 7 miles

For an amazing sensory experience of the Lowcountry’s salt marshes, take the Awendaw Passage. Part of the Palmetto Trail, the passage meanders through a forest of palmetto trees along the Awendaw Creek.

Sawmill Branch Multi-Use Trail

Distance: 6.5 miles

Walk or ride this wide trail, and follow the Sawmill Branch Canal. You can start at either of two entry points, Gahagan Road or Ashley Drive in Summerville. This trail is safe, as most of the road crossings go under the roads. The quiet brings out the wildlife, so keep an eye out for animals, but beware—alligators have been known to live in the canal.

Swamp Fox Passage

Distance: 42 miles

One of the area’s oldest trails, the Swamp Fox Trail courses through the swamplands and pine forests of Francis Marion National Forest. It is named after Francis Marion, the Revolutionary War office who was known as the “Swamp Fox” because he hid from the British in the swamps of the Lowcountry.

While the trail itself is 42 miles long, only 27 miles are recognized as a National Recreation Trail. Expect to see turkeys, birds of all kinds, and deer along the trail.

West Ashley Bikeway

Distance: 2.5 miles

The West Ashley Bikeway runs in a straight line from the Ashley River to Wappoo Road, giving the families in the area a short yet lovely 2.5-mile running and cycling trail. The trail is not regularly maintained and does have one hazardous intersection: cyclists and runners must cross St. Andrews Boulevard without a crosswalk or a light. The West Ashley Greenway is nearby—simply cross over Savannah Highway on Wappoo Road.

West Ashley Greenway

Distance: 10.5 miles

The West Ashley Greenway goes from suburban Charleston to the wetlands and is a favorite of runners and mountain bikers. The greenway begins at South Windermere Shopping Center and connects several neighborhoods via a 100-foot-wide trail. After coming to Johns Island, the trail narrows into gravel, so after this point, you’ll need a bike. However, the breathtaking views are worth taking your bike along.

Which trails are your favorites?

Lowcountry Cancer Survivors Celebrate at Dragon Boat Festival

Dragon Boat CharlestonDid you know that the Chinese sport of dragon boat paddling is alive and well right here in Charleston?

Founded in 2003, Dragon Boat Charleston (DBC) aids mental and physical wellness for cancer survivors through dragon boating. According to DBC’s website, the group’s goals are . . .

  • To encourage healthy healing and healthy lifestyles through goal oriented exercise, good nutrition, education, and fellowship.
  • To support the beneficial effects of physical activity in survival through research.
  • To provide a positive model for our community demonstrating courage, determination, and team cooperation.
  • To advance the sport of dragon boating.

For many of its participants, dragon boat paddling is a celebration of life. They love becoming one with the river, using the paddles to break the surface, and experiencing the cool evening air or the sun’s empowering warmth. Paddling any time of day is energizing and helps them celebrate life as cancer survivors. DBC also helps them promote their own health through other programs, such as yoga and nutrition education.

Research shows that physical activity and an active lifestyle may improve breast cancer survival rates as well as help survivors heal emotionally from their ordeal. Dragon boat paddling is unusual, pleasantly strenuous, and a lot of fun!

DBC participates in several races each year, and its members enjoy the camaraderie of other breast cancer survivors and friends year-round. If you walk along the Ashley River, you’re likely to see DBC members doing what they enjoy—paddling hard to prepare for their next race, which is the 6th Annual Charleston Dragon Boat Festival on May 4.

Dragon Boat Charleston

The Festival will be held on the shores of the Ashley River at Brittlebank Park, off Lockwood Drive. You’ll enjoy dragon boating races along with a cancer survivor celebration that includes plenty of food, costumes, and tents. The first heat begins at 8 a.m. While registration is now closed, there is a wait list you can add yourself to by emailing melabriola@gmail.com.

DBC is attempting to raise $100,000 this year, and they are almost halfway there. The funds pay for cancer survivors’ participation in races around the country, year-round paddling several times a week, and the Carolina Celebration Cup.

The sponsors of Dragon Boat Charleston include The Center for Natural Breast Reconstruction, MUSC, Pure Insurance, Roper St. Francis Cancer Center, Piggly Wiggly, and Trident Health.

To find out more, please visit http://www.dragonboatcharleston.org or www.charlestondragonboatfestival.com.


Have you ever paddled on a dragon boat, and what did you think of it?

Happy Holidays!

We at The Center for Natural Breast Reconstruction wish you and your family a holiday season full of peace and love!