There Oughta Be a Law. Thanks to Janet, There is.

No snow softened the bare outlines of  trees and ground in Ronkonkoma, Long Island in the winter of 1997. Janet Franquet, 32, a new mother and nurse at a rehabilitation center and nursing home, looked forward to celebrating Christmas with her husband, Robert, and their baby, Michael. But in the midst of that festive season, Janet was diagnosed with inflammatory breast cancer (IBC) - rare and very aggressive, diagnosed more often in younger women.

After undergoing chemotherapy in an attempt to shrink the cancer, Janet’s next course of treatment was a mastectomy. Since IBC infiltrates the lymphatic vessels of the breast skin, Janet’s surgeon planned an immediate abdominal flap breast reconstruction, which would use her own abdominal skin and fat to restore her breast and close the wound.

But the day before surgery, her insurance provider denied her coverage, saying the procedure was cosmetic. They suggested her surgeon use a pig skin graft instead. “I was numb,” Janet said later. She and her surgeon, Dr. Todd Wider, began a lengthy appeals process with the insurance company.

Janet Franquet - Christmas 1995
 Photo lovingly provided by her twin sister, Joyce Gagliardi

Some states, including Janet’s home state of New York, had already passed laws barring insurance companies from denying coverage for breast reconstruction after mastectomy. But they didn’t cover self-insured employer plans, which are under federal jurisdiction. Robert provided the health insurance for the family through his job as a truck driver, via his trade union. Unfortunately that fell outside the new state law.

Watching this young mother endure the assaults dealt her by both cancer and her insurance provider, Dr. Wider called upon Carol M. Baldwin, a breast cancer survivor and well-known breast cancer advocate (and mother of several famous actors). Two years prior, she and her family and friends had founded the Carol M. Baldwin Breast Cancer Research Fund. She was able to use her influence to enlist help for Janet from then U.S. Senator Alfonse D’Amato.

Thankfully, Dr. Wider went ahead with the reconstructive surgery, generously providing his services free of charge. Eventually the insurance company reversed its decision.

Janet was determined to fight for the medical coverage to which she believed every woman in her circumstance had a right. Her bravery filled D’Amato with similar resolve. “What happened to Janet Franquet was tragic,” he said. “It should never happen again.” On the floor of Congress, D’Amato championed for passage of a law that would require all insurance companies to cover breast reconstruction. D’Amato said, “I ask you, Mr. President, how many other Janet Franquets are out there? Will they be lucky enough to have a Dr. Wider to take care of them?” On October 21, 1998, the Women’s Health and Cancer Rights Act (WHCRA) was signed into federal law and officially named “Janet’s Law.”

Today, too many women remain unaware of this legislation. They mistakenly believe breast reconstruction after cancer is considered cosmetic and thus beyond their financial means. But Janet’s Law states that if a woman has health insurance covering mastectomy, breast reconstruction and surgery to attain symmetry are covered as well.

Janet lost her battle with cancer in May of 1999. In her obituary, D’Amato was quoted, “She demonstrated great courage during her short time on this earth. She said to me, ‘Maybe God put me here so that I could do this.’” He added, “She was the inspiration for a national law which now says every woman is entitled to reconstructive surgery. If not for Janet Franquet, I don’t think this would have happened.”

Janet’s Law states:

(a) IN GENERAL -- A group health plan, and a health insurance issuer providing health insurance in connection with a group health plan, that provides medical and surgical benefits with respect to a mastectomy shall provide, in a case of a participant or beneficiary who is receiving benefits in connection with a mastectomy and who elects breast reconstruction in connection with such mastectomy, coverage for--
(1) All stages of reconstruction of the breast on which the mastectomy has been performed;
(2) surgery and reconstruction of the other breast to produce a symmetrical appearance; and
(3) prostheses and physical complications of mastectomy, including lymphedemas;
 in a manner determined in consultation with the attending physician and the patient.

Thank you, Janet.

It's House of Blues, Baby!

I’d only been to House of Blues once before, for their famous Sunday Gospel Brunch. Though I was never much of a fan of the Gospel music genre, after that brunch, I was converted. The place remained imprinted on my psyche -- as much an iconic experience of New Orleans as first seeing the massive shadow of Jesus on the back wall of St. Louis Cathedral, hearing the drumbeats of the Voodoo ceremony echoing off the antebellum walls of the Quarter on Halloween night (and I’m talking Voodoo Authentica, not the Voodoo Music Festival), and having my very first taste of heaven (bread pudding) at Pierre Maspero’s. Imagine then, the thrill for this northern girl, as my husband and I entered the venue the afternoon prior to Breastoration’s first big fundraiser, “House of Pink” at House of Blues!

Our mission was to figure out a way to hang the quilt I was donating as an auction item for the event. That’s a whole story in itself. Well, two stories. One about making the quilt and the other about hanging it (an engineering challenge I’d worried over for several months), especially since House of Blues allows nothing to be hung on the walls. But as intimidated as I felt about that, and as nervous as I was about not knowing a soul, I was soon welcomed by the lovely silent auction ladies from the Louisiana Breast Cancer Task Force. They were busily arranging the many donated items to show to their best advantage. I immediately felt a common bond. I’m on the same committee, back home, for our breast center’s annual fundraiser. It’s the committee no one really wants to be on -- asking local businesses to donate items, especially when times have been tough for the last few years. Cheers to the ladies who brave the asking! And of course, we had other things in common -- all of us members of the sorority no woman wants to join. Official color: pink (from cool pastel to hot fuchsia).

Later, standing on the main floor, watching Rockin’ Dopsie Jr. and the Zydeco Twisters boogie with the growing host of ladies who’d joined them onstage, I see that New Orleans gals are way more comfortable “getting down” than their more staid contemporaries up in the frozen climes of Minnesota. While I enjoyed a gin and tonic (to loosen up) from the open bar (wow!), it all felt like a dream. I was standing in these hallowed halls in New Orleans, more than just a tourist this time, celebrating a major milestone for the foundation that, not too many months before, was just an idea. Turning to my husband, shaking my head, I said, “Toto, we’re not in Kansas anymore!”

Funds netted that night: over $70,000. Amen!

Destination: Breastoration

From the balcony of Muriel's - Jackson Square, New Orleans

As I jot notes for the premier (gulp) blog entry for the Breastoration Foundation, melting snow drips off the eaves of my home in St. Cloud, Minnesota, on this unseasonably warm winter day. Each drop catches the sunlight, creating a stunning, dynamic curtain. My little Yorkshire Terrier, Harald, surveys the outdoor scene while stationed by the window, hoping to catch sight of his arch nemesis -- the squirrel who has taken to hanging out in the oak tree just a few feet beyond the glass. I really should take Harald for a walk -- we may not see another above-freezing day for a very long time. I promise to reward both of us with a balmy stroll as soon as I complete a first draft.

Breastoration’s goals are to educate women about their breast reconstruction options after cancer and help women in financially challenging circumstances who desire breast reconstruction in the New Orleans area. My vision for this blog is to let you know how we’re doing with that and keep you up to date on Breastoration news and events. Also, we can explore some of the many issues and experiences women face on their breast reconstruction journeys during and after cancer. And I promise it’ll be more entertaining than it might sound…


Since New Orleans is the headquarters for the Foundation, and since it’s rather a Mecca for breast reconstruction, and since my “girls” (as some of us refer to our restored breasts) were born here, and also because I’ve fallen in love with the place, you can be sure you’ll be seeing as many references to this city as I can possibly fit in. It’s a natural, after all. New Orleans provides the metaphor and the mood, in so many ways: rebuilding after a storm, staying strong, persisting, surviving, celebrating life. For me, it’s a magical destination after a long journey -- metaphorically and literally -- perched as it is on the southern end of the Mississippi River.

Lake Itasca on left, beginning of  Mississippi River on right

The source of that river is Lake Itasca, which happens to be a few hours north of my home. The Ojibwe people called the river “Misi-ziibi” or “Great River.” Its waters glide past, about a mile from here. The drops off my eaves will filter through surrounding wetlands, making their way to that river, which gains strength and depth on its journey south to New Orleans. Thirteen hundred miles away. But so close to my heart.

St. Louis Cathedral - New Orleans

Okay, Harald, time for that walk!