Wednesday, December 19, 2012

Ready to be Restored





Since Breastoration launched in 2010, eighteen women have benefited from grants to help cover costs associated with breast reconstruction after cancer. The total dollar amount is not yet final from our most recent fundraiser in New Orleans on October 29th - An Evening with Jewel - but we are fairly certain it will be at least $100,000! This month I'm writing about a real woman who is being helped by dollars donated. Her name has been changed to protect her privacy.

Wendy remembers the date she was diagnosed with breast cancer, even though it was almost two years ago. It's a shock for any woman, but especially when you're only 34 years old, with a 7-year-old child. The cancer was so extensive in her left breast that doctors recommended six months of chemotherapy prior to any attempt to remove it surgically. After completing chemotherapy, she underwent a modified radical mastectomy, which also included removal of lymph nodes. Wendy - along with her husband and child - then traveled from their home about 20 minutes outside New Orleans to Houston's MD Anderson, one of the three original comprehensive cancer centers in the United States, where she underwent 44 radiation treatments, two times per day. After she returned to Louisiana, and with only a one month respite, Wendy began an additional round of chemotherapy that lasted four-and-a-half more months.

Between the day of Wendy's initial diagnosis until her last chemo treatment, 15 months passed. Her life and her family's lives were physically and emotionally uprooted, and their finances took a beating. Her husband, so loyal and supportive throughout Wendy's ordeal, had taken 4 weeks unpaid leave from his job, under the Family and Medical Leave Act. They'd incurred a whole host of expenses in Houston, including travel back and forth, rent, food, and child care, not to mention insurance deductibles, prescriptions, and all the other bills piling up on a desk at home.

Now Wendy is ready to face the next phase of her battle by taking back one thing that cancer took away from her - her breast. In Wendy's words: "When I found out about Breastoration from a friend and from the Jewel concert, I decided to look into it and see if this program was an option for me to apply for. My skin is stuck to my chest wall and the scar tissue from the surgery and the radiation feels like concrete. There are so many issues that I have about only having one breast right now. The body image disturbance that I carry with me every day is a challenge. The fact that these procedures need to be performed by excellent doctors who specialize in microsurgery is key. Implants were not on the table for me as an option due to the extensive radiation I received. This kind of reconstruction is basically my only option. So, when you don't have many options, you try to figure out what is going to work best.

"Many times my husband and I sat down and looked at the financial part of reconstruction and we did not think we would be able to afford it. The surgeons that I wanted to perform my surgery were local to me, but were out-of-network on my insurance policy. This procedure is definitely yet another financial burden on my family. Decisions become even more difficult to make when you find out about out-of-network fees, the time you have to recover from the procedure, the help you need with housework, my 8-year-old child at home, help with meals, grocery shopping, and many more things that are needed. We are also still recovering from the financial hardships of 2011.

"The funding from Breastoration has definitely helped make things easier for us to manage our finances for this surgery and to keep up with our other bills. I am thankful that Breastoration made a difference and is opening a new chapter in my life to move forward. I am ready for it. I have been ready for 16 months, but I am just getting the opportunity to have it."

In early 2013, Wendy is scheduled for delayed DIEP flap reconstruction of her left breast and immediate skin-sparing mastectomy and DIEP flap reconstruction of her right, in New Orleans. Best of luck, Wendy! Thank you so much for generously sharing your story. May the new year see you restored and healed, in body, mind, and your beautiful spirit!


Tuesday, November 27, 2012

Breast Reconstruction Awareness Day: South and North!


The "flash mob" dancing to "Man! I Feel Like a Woman!" on St. Charles!


Breast Reconstruction Awareness Day South!
(New Orleans) The official national BRA Day kick-off was absolutely awesome, judging from the reports I've heard, the photos and videos I've seen, as well as the pink feather that I found still blowing around on St. Charles Avenue two weeks later! Let the pictures do the talking. Enjoy!


Kim Sport, one of Breastoration's founders and co-organizer of
the BRA Day event, addressing the media and attendees.

Breast reconstruction thrivers, Mary Frisch and Kathy Sanders Meyers 

Most Artistic Design Award goes to
"Save the Gems" by Sandy Falcon-Thielman
Breast Reconstruction Awareness Day North!   
(St. Cloud, MN) I highly recommend that everyone consider launching a B.R.A. Day event in their neck of the woods. What a fun and highly rewarding experience! It's especially great if you can partner with care providers who may have resources to magnify the message. I worked with Midsota Plastic Surgeons here in St. Cloud, who enlisted 25 area businesses, via the Chamber of Commerce, to showcase the bras prior to BRA Day, along with educational information. We also partnered with Visual Arts Minnesota and lots of amazing, talented artists who created 31 art bras. But you could collaborate with an area cancer center, an oncology nurse navigator, a local Komen or Making Strides Against Breast Cancer team, or a breast cancer support group. Maybe you also have a local artist organization or friends you can ask to decorate some bras.

Most Inspirational Design Award goes to
"A Penny for..." by Kym Durant
Or maybe you're not enamored with the bra idea (say what?). Like I mentioned last month, if you've experienced successful breast reconstruction yourself, contact your local paper and volunteer to tell your story. We had great coverage in our local newspaper - that article, for sure, reached more people than were even actually at the events - and we had a good turn-out. It made front page feature article in the "Up Next" weekly insert, which focuses on entertainment in the area. There was even a side-bar (top-bar?) about it on the front page of the newspaper. An event is a hook for an article that likely will provide the biggest opportunity to educate women about their reconstruction options, in the personal context of your own experience. But having a big (or even little) event isn't a prerequisite. For sure, don't let it stop you. But at this point, you've got lots of time to dream up something you can do next year!

"Rosie Lends Her Support" by Karen Krey


We had a number of male bra artists, too!
Here's Brandon Anderson with his "Untitled" decorated outside and in.

"Live Long and Prosper" by Gary Wallinga
"Mother Earth and the night Sky"
by Megan Ehresmann Martinez


At Le St. Germain Hotel






Julie Sanner
Awesome nurse navigator/educator from Coborn Cancer Center

Look at "The Girls"!






"The Girls" at Making Strides Against Breast Cancer at St. Cloud State University

A new idea for next year????????





Monday, October 8, 2012

Put the "US" in BRA DAY USA!





The official, national BRA Day USA kick-off will be in New Orleans on October 17th (if you don’t know what I’m talking about, please see my September blog post). It would be so cool to see the press conference and especially the flash mob in the neutral ground on St. Charles Avenue! (If any of you are going, send me some photos/video to post.) I'll be in New Orleans in spirit, though I’ll be here in Minnesota. But that's okay. Women all over this country need to hear about breast reconstruction after mastectomy, and often the best place to advocate something is right where you live.

"Under Construction" by Pam Evgen
Obviously breast reconstruction awareness doesn’t begin and end on October 17th, any more than breast cancer awareness ends on the last day of October (fitting it’s Halloween, huh? Kind of an inadvertent, symbolic reminder that breast cancer is a scary proposition, despite it being dressed up in pink ribbons all month). But having the day does offer an opportunity to unite everyone in focusing on one thing at one time. There’s real power in that. Hopefully a woman somewhere who didn’t know she could regain her lost breast will hear BRA Day mentioned on the news or read a newspaper story, and it will start her thinking and asking questions. By year's end, she may have a whole new lease on life. Just what she needed to put the bounce back in her, um… step.

About a month ago, I happened upon some bra art. Yes, bra art. Google it. OMG! Who knew?! It got me thinking. I contacted the nurse educator at our area cancer center, where I was treated, to see if there were any BRA Day plans afoot. Then I contacted the plastic surgery practice that has a doc who performs microsurgical DIEP flap reconstruction.
"Mardi Bra" by Pam Evgen
I’d heard he’d experienced frustration in trying to convince doctors in outlying areas and the Dakotas to inform patients that he was offering another reconstruction option that previously had been unavailable here. Illustrative of an all-too-common problem--local surgeons not telling women about recon techniques other than the ones they perform.
"Rhinestone Cowgirls" by Linda Marie





"Phoenix Rising" by Eve Wallinga
"Breast Nest" by Char Hopela
I would like to announce BRA Day USA - St. Cloud, Minnesota! Art bras will be displayed at area businesses for a couple of weeks, along with an informational poster and brochures, and then will migrate to the central locale on Bra Day. We're not looking to raise money this year, just awareness. We’ll have a lunch, an educational discourse, an art bra exhibit, and some publicity. Since this is our debut in Central Minnesota, we didn’t get too wild. If no one faints this year, maybe we can crank it up next year. I've noticed that in some parts of the country, women are even  modeling the art bras!

I’ll keep you abreast of Breastoration - North BRA Day USA developments, in addition to those in New Orleans, of course. Wait 'til you get a load of ALL the bras. Coordinating the art bra part has been challenging, but fun. (Thank you to my NOLA sistah, Pam Evgen, my husband, and my writer's group and everyone else I PLEADED with to make a bra.)

Does this sound like something you might want to do in your hometown next year? You can start with an eye-catching art bra, an educational poster, some Breastoration pamphlets, and a venue willing to display them. You can easily change someone's life. And next year, lets all have our own flash mobs, too, like in New Orleans. But maybe ours won't just be dancing, if you know what I mean, and I know you do.
"Show Girls" by Pat Nelson


Friday, September 21, 2012

Yay for BRA Day! October 17, 2012





Bring on the first annual Breast Reconstruction Awareness (B.R.A.) Day! Launched in Canada last year, it's now gone international - recognized in the U.S. and many other countries around the world. Another of those awareness days, this one's smack in the middle of pink October, but specific to the issue of breast reconstruction. I remain stunned that so many women (70%) know little or nothing about breast reconstruction after mastectomy, but BRA Day embodies our resolve that we're not going to take it anymore! :-0

My first October, I hated PINK. It was six months after I was diagnosed, and PINK was everywhere. Perky PINK ribbons. Products peddled in PINK packaging. Reminders of what I wanted to forget. Personally, I was peeved.
:-(


By the following October, I saw the color through new eyes. No longer did I associate it primarily with the detested disease. Instead it reminded me of a legion of warriors: other survivors, those who support them, those who treat them, and the people in my own life who’d had my back (and front) the previous 18 months. :-)


I was completing my own breast reconstruction that second October. Not an easy journey. But definitely a positive one, given the poor, battered body cancer had left me. I became more than just the victim I’d been - the passive recipient of medical intrusions to my physical and psychological self. I took charge of who I was and who I wanted to be again. :-D



We’re lucky to be living in times of great medical advancement. Hopefully, in the future, people will be even luckier, able to prevent or cure breast cancer without the current slash and burn and poison techniques. We’re not there yet, but we have many more treatment alternatives than our mothers and grandmothers. And breast reconstruction is part of that treatment - a part that gets little notice or press, but which is so important. :-[

The official logo for B.R.A. Day builds on the traditional pink ribbon, along with the phrase, “Closing the loop on breast cancer.” So appropriate (though a bit harder to crank out the lapel pins). Here’s the website that tells all about it http://www.bradayusa.org/ as well as providing ideas of what you can do in your community to lend your support. You may find events already planned where you live. If not, try to get something going. Write a letter to the newspaper. Post something on Facebook. Do what you can to honor the day. And if you’re a successful breast recon patient yourself, flash someone! (o)(o)

Tuesday, July 31, 2012

There Oughta be Another Law! - H.R. 5937



Sculpture Garden - New Orleans City Park
A bill that could significantly empower breast cancer survivors was introduced by Rep. Leonard Lance (R-NJ) on the floor of the House of Representatives on June 8th. It’s the Breast Cancer Patient Education Act of 2012 or H.R. 5937 and if passed, its implementation would be spearheaded by the secretary of Health and Human Services.

The Act would require that women be informed of the availability and coverage of reconstruction, prostheses, and other options, and about such choices as immediate vs. delayed procedures and the right to choose a surgeon who provides reconstructive care. For a full reading of the bill (the “Findings” section is very interesting), see: http://www.gpo.gov/fdsys/pkg/BILLS-112hr5937ih/pdf/BILLS-112hr5937ih.pdf

Since we already have the Women’s Health and Cancer Rights Act (see my March and April blogs) saying women have a right to breast reconstruction after cancer, shouldn’t we also have the right to know what our reconstruction choices are? But as it turns out, only 30% of us actually do.

The bill is currently comatose in the Committee on Energy and Commerce. Govtrack.us gives it only a 4% chance of survival--mainly because that’s the percentage of all House bills in the last couple of years that have actually become law. But I think it has a better prognosis, if Committee members hear from us. And election season is often a time when their hearing improves.

HR 5937 enjoys support by professional organizations, such as the American Society of Plastic Surgeons and many advocacy groups. Perhaps more important these days, it was introduced by a bipartisan team of legislators. If one of them is yours, you can call, text, tweet, post, mail, e-mail, or fe-mail him/her a hearty thumbs up: Marsha Blackburn (R-TN), Donna Christensen (D-VI), Hansen Clarke (D-MI), Gerald Connolly (D-VA), Michael Honda (D-CA), Leonard Lance (R-NJ), Barbara Lee (D-CA), John Lewis (D-GA), Gwen Moore (D-WI), James Moran (D-VA), Eleanor Holmes (D-DC), Charles Rangel (D-NY) and Ileana Ros-Lehtinen (R-FL). If they’re not on the list, maybe you can convince them to become supporters. FYI - The entire committee membership can be found at this link: http://energycommerce.house.gov/about/members.shtml

On Decatur - You know these guys.
They just stand still.
But ultimately it’s the chair of the Committee on Energy and Commerce, Fred Upton (R-MI), who determines whether the bill will continue to just lie there or gets some legs and moves on to the House. Michigan t'ain't too far from Minnesota. I think I oughta give him a holler. Hey wait, seems he only accepts messages from constituents in his 6th Congressional District in Michigan! Anybody out there?




http://www.youtube.com/watch?v=twRAJ0IHwT0

Friday, June 29, 2012

Breast Cancer and Depression or Even Warriors Get the Blues



Sculpture Garden - New Orleans City Park
You've been through hell and back. You've dealt with the shock of being told you have cancer and the realization that your life will never be the same again. You endured the barrage of doctors' appointments, tests, scans, surgeries, and various other assaults on your body. You were so busy, so focused, that it helped distract you from the deeper fear that this thing in your body wanted to kill you.

You were a warrior. People said they could never be as brave as you. And even though hearing this got to be annoying sometimes (as if you volunteered to get cancer and deserved some kind of a medal), you were proud of yourself for being able to charge through all your treatments (most of the time, anyway) and even joke with the medical staff.


Now that's all behind you. You expected you'd be happy. Ecstatic. Many other women with breast cancer weren't nearly as fortunate as you've been. You feel guilty when you think about it. Not just guilty that you're alive and they may not be, but guilty that you're not out celebrating life, living in the moment, appreciating the world you're still here to enjoy. Instead, you have all you can do to get out of bed in the morning. You can't summon up the energy or enthusiasm to do any of the things that used to make you happy before cancer. You feel hopeless, useless. You're thinking, Why can't I get a grip? 

Many of us have been there. I've been there. Try not to make it worse by beating yourself up. You have plenty of valid reasons for not feeling like yourself, including the effects of all those treatments on your body chemistry -- the chemo, maybe tamoxifen or surgery-induced menopause, all the anesthesia from perhaps multiple surgeries. And to top it off, you may have been laid up for weeks or months after those surgeries. Your body is still healing and your immune system taxed. That doesn't leave much physical or mental energy for anything else, even though you’re sick of feeling sick.

What you're going through may be temporary, related to any or all of the above. But even if you can point to many reasons for feeling as you do, it is possible that your body has gotten stuck there physiologically. And you might need some help getting unstuck.

If your symptoms go on too long and are interfering with getting on with your life, call your doctor. He/She will talk to you, run some tests, try to figure out what might be causing the problem. It's possible you're suffering from major depression. This is different than just “the blues.” It's brain chemistry, and it isn't something you can just snap yourself out of, any more than cancer was. Why continue to suffer, if it's not necessary? It's well-established by research that combining therapy with medication yields the fastest results and best prognosis when dealing with major depression. 

You'll see that some of the symptoms listed below could be associated with cancer treatment or “chemo brain.” Causes and effects are complicated. But don't rely on self-diagnosis. According to the American Psychiatric Association, having five or more of these symptoms for two weeks or more (including the first or second ones listed) can indicate major depression:

  • Depressed mood most of the day, nearly every day, such as feeling sad, empty or tearful
  • Diminished interest or feeling no pleasure in all or almost all activities most of the day, nearly every day
  • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite nearly every day
  • Insomnia or increased desire to sleep nearly every day
  • Either restlessness or slowed behavior that can be observed by others
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness, or excessive or inappropriate guilt nearly every day
  • Trouble making decisions, trouble thinking or concentrating nearly every day
  • Recurrent thoughts of death or suicide, or a suicide attempt
You may not have major depression, but it still might help to have a professional to talk to about the traumatic life experience you've just lived through. Or maybe it's time to join one of those breast cancer support groups you previously ruled out. Whatever the cause, you can get through this, just like everything else you've gotten through. After all, you're a warrior!




http://www.youtube.com/watch?v=OEdVfyt-mLw






Wednesday, May 30, 2012

Reconstruction, Rebirth







When I need an energy infusion here in Minnesota, I listen to a certain NOLA band cranked up loud on my stereo. Months ago, enjoying the annual Halloween pilgrimage my husband and I make to New Orleans, my energy was high -- even before we strolled into Vaso Club on Frenchmen Street. But for only a $5 cover, and with an icy Abita Purple Haze in hand, the music lifted me to new heights. The notes tight, complex, everywhere at once. Throbbing with life -- my life -- the one I plan to ride for many years, now that cancer is gone from my body more than half a decade. The jazz screamed joy. Two trumpets, sax, tuba, trombone, snare and bass drum. The t-shirted guy’s t-bone hung loose at his side, his front tooth glinting diamond in the red stage lights that painted the brick wall behind him hot, as he sang, “I feel like funkin’ it up! Feel like funkin’ it up!”

Beating breast cancer can inject your life with a new level of passion, purpose, and energy. Part of it, I hate to admit, may be related to that spectral little wisp of a dark cloud that never totally dissipates, no matter how rosy your prognosis or how many years pass since the sun reappeared on your horizon. I’d rather credit my feelings to other things, but sometimes the shadows, by their contrast, do help highlight the heady largesse a healthy life offers. Part of that happy life, for me, is having all my body parts back. I highly endorse keeping as many as you possibly can. And if you can’t, then I recommend replacement. The studies back me up, too.


A few years ago, Dr. Andrea Pusic of Sloan-Kettering and some of her colleagues interviewed several thousand women to learn about the most important issues following breast surgery. From this they developed and refined the BREAST-Q questionnaire, which measures patient satisfaction and quality of life after breast reconstruction. They found that successful outcomes are not only based on what reconstructed breasts look like, but also involve physical, social, and sexual well-being, as well as process of care. This included the woman's satisfaction with the information and expectations provided, and her interactions with her medical team and surgeon. This assessment tool is now the worldwide gold standard for quantifying breast reconstruction satisfaction, which has greatly aided research looking at type, technique, and timing of surgery.

So what have we learned from some of this research? Well, judging from my quick and dirty Internet perusal of the literature, I found that women report higher satisfaction from autologous (using your own tissue) reconstruction rather than implant reconstruction -- over the short-term (three weeks) as well as eight years out. Among women who chose implant reconstruction, they were more satisfied with silicone than saline. But regardless of type or timing of breast reconstruction, it is a well-established finding that women who choose some form of breast reconstruction over none report better body image, greater self-esteem and sexual functioning, improved mental health, better emotional well-being, and higher energy levels.

One of the studies I read, which struck a personal chord, compared patients who had delayed versus immediate reconstruction. I should preface the results by saying it’s generally accepted that, other things being equal, immediate reconstruction provides a better aesthetic outcome than delayed. But eighteen months out from surgery, seventy-six percent of women who had delayed reconstruction were satisfied with their outcomes, as opposed to fifty-nine percent with immediate recon. Half of the delayed reported feeling sexually attractive versus one-third of the immediate.

In the discussion of the results, the researchers surmised that satisfaction with breast reconstruction outcome is often not so much a function of the quality of the work, as it is about what the woman is using for comparison. With immediate reconstruction, she is comparing her new breast to her original and seeing what she has lost. With delayed reconstruction, she is comparing her new breast to a scarred, empty chest and seeing what she has gained. I can personally attest to the experience of the latter. I call it magic. Even a resurrection. Definitely a rebirth.

And back on Frenchmen Street, who dat band? Rebirth! Rebirth Brass Band!



http://www.youtube.com/watch?v=CbtAoOp6_UM