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January 6, 2006     Barnstable Patriot
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January 6, 2006
 
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Hope for breast cancer patients HEALTH5CAP£... By Pamela R. Higgins news@barnstablepatriot.com Today, a diagnosis of breast cancer does not mean women have to face the possibility of livingwithout a breast or breasts. In fact, in some cases they may have reconstruction surgery the same day a mastectomy proce- dure is performed. "My whole life I thought a mastectomy would be the worst thing that could happen to me," said Mary Kehoe Moynihan of Marston 's Mills, who was di- agnosed with invasive lobular cancer in 2000. "It was unbeliev- ably great given the situation I was in and the surgery was no big thing." The worst time for Moynihan, who is the mother of four boys, was when she was debating on the type of surgery she would have. Though initially scheduled to have a bilateral mastectomy with no reconstruction , she chose another avenue, to have a single mastectomy with recon- struction. There are two popular types of reconstruction surgery. One involves flap reconstruction and the other is implant surgery. Moynihan settled on flap recon- struction and chose to have her surgery performed at the Gillette Center of Massachusetts General Hospital in Boston. "At that time the TRAM flap was not something that was used a lot on the Cape," said Moynihan. Her choice also focused on the teamwork between her surgical oncologist , Dr. Barbara Smith, and her plastic surgeon , Dr. Michael Yaremchuk. "They did the surgeries to- gether so it would cut down on surgical time," said Moynihan. Flap Reconstruction ver- sus Imp lant Flap reconstruction surgery offers the benefit of having re- constructive surgery the same day as removal and involves two types of tissue relocation. The most popular is the TRAM flap on transverse abdominis muscle where fat, skin and muscle from the abdominal area are relocated to the breast. "It is popular for two reasons," said Dr. Robert R Yoo, a plastic surgeon at Cape Cod Hospital . "We are taking skin and muscle from the abdominal wall and what you get is a free tummy tuck. The problem is the tummy tuck you get is not quite as good as a regular tummy tuck." Moynihan begged to differ. "The tummy tuck was awe- some." The second reason according to Yoo is that patrients do not need an implant with the TRAM and the relocated tissue is very similar to breast tissue. The down side to this procedure is the scar. In Moynihan's case, it runs hip to hip, but for her this is an irrelevant thing as she looks at her life. Another procedure is the latis- simus dorsi flap, where the back muscle, tissue and fat that lie below the shoulder are swung to the front through a tunnel under the skin to the breast area. "We bring it through the arm- pit," said Yoo. "The problem is there is not enough tissue and women still need an implant." Yoo explained that the major difference between the TRAM and latissimus dorsi surgery is that the rectus abdominus muscle has two blood supplies and the latissimus dorsi muscle has one. Another option for breast cancer patients are silicone gel or saline gel filled breast implants. "Weuse atissue expander where you put the implant in a pocket under the skin or muscle and that expander has a port," said Yoo. "You can put a needle through the skin to expand the implant until you get a breast mound. We usually go oversize by 150 cc and leave it for a few months and then reduce it by the extra 150cc to create a softer breast." Silicone feels more like normal breast tissue, he said, whereas a saline implant can feel a bit like a water-filled balloon. "The goal of breast recon- struction is volume symmetry," said Yoo. The idea is to obtain a sym- metrical look in clothing. For Moynihan, her goals were a little simpler. "My thought was I don't want to leave mykids,"she said. "Every fiber of my being said I'm going to survive this." Caveats "If the patient is a smoker or diabetic no flap surgery," said Yoo. Diabetes or smoking increases the risk of narrowing the blood vessels and may lead to tissue death and another surgery to remove the dead tissue. "Ifyou are more than 20 percent overweight the risk of doing a TRAM flap goes way up," said Yoo. "The fat is so thick that the blood vessels have a long way to go and the longer the vessel, the greater the risk of not getting blood flow." Yoo added that they typically avoid bilateral TRAMs because the mastectomy is an enormous surgery and it would leave the patient with not enough abdomi- nal strength. However, you can do a bilateral lattisismus dorsi but this may not be for you like to row a scull said Yoo. For those who choose implant surgery the average is 2.8 op- erations and Yoo reminds his patients that "an implant is a foreign body and it can become infected, it can leak , and the tis- sues can contract around it." Finishing Touches "After creating the breast mound we create a nipple ," said Yoo. "We take a skin graft from the groin and create color by tattooing. At the time we put on the nipple we take out the expander and put in the final prosthesis." His final fiddling involves scar revision and implant place- ment. "Was it what I expected? Yes, according to the pictures my doctor showed me," said Moyni- han. As far as the addition of the tattoo, Moynihan has not ruled it out, but asks herself , "What month do you want to have more surgery?" She added a final note by say- ing, "There is hope , people are surviving and it'snot an absolute nightmare." >^ Advanced Eye Caref or the Entire Family m $**«- ¦BHKBHII d I t\ % ^# | BOARD CERTIFIED OPHTHALMOLOGIST 1 t «" * ' ^ mm^ RoutineExams • Promp t & Convenient I ' Staiiter ^^p l • General Op thalmology Earl y Evening App ointments ^_^ ^ m li • Glaucoma & Cataract Consulta tion • Accep ting New Patients HBSBHK_L_-^"2*ki *s\ I -866-888-5800 ( ^ SjtU/^L www.comfortkeepers.com , ,,„ ,,„„„ , „„/,.,,,,„,,„,;, 0 ./ .< »,,¦,„ .: Subscribe Today (508) 771-1427 Know the Market. Know the Town. 0nix in Z\\tBarnstable patriot 396 Mam Street .Suite 15,Hyannis.MA 02601 • 508771-1427 • Fax SOS 7W-.W7 E-mail: barnpat@cape.com • www.barnstablcpatriot.com HEALTH REPORT ? Talk on arthritis Hyannis rheumatologist Dr. Raymond Partridge will speak on arthritis and re- lated diseases Jan. 12at 11:30 a.m. at St. Mary's Episcopal Church on Route 6A in Barnstable. All are welcome. ? Moran renews CDE status The National Certification Board for Dia- betes Educators announced that Dot Moran has renewed her Certified Diabetes Educa- tor (CDE) status by successfully completing the continuing education renewal option process. She is a registered dietician and has been employed by Cape Cod Hospital for 10 years. She works for the Medical Nutrition Therapy and Diabetes Program in the Diabetes Education Center of Cape Cod, 109 Main St. in West Dennis. ? Train to end stroke The American Stroke Association is recruiting participants for its Train to End Stroke marathon training program, which combines a five-month fitness program with the opportunity to support stroke research and education. For details on the marathon, attend an information session Jan. 21 at 10 a.m. at the Falmouth Public Library or stop by the Yarmouth Public Library at 6 p.m. on Jan. 25. ? Yuen demonstrations Elle Pechet, M.Ed., LMHC,demonstrates the Yuen method to eliminate physical and emotional symptoms at the cellular level every first Monday of the month at Phoenix Rising Counseling & Energy Healing Cen- ter, 271 Main St. in Buzzards Bay. ? HIV/AIDS testing, counseling The Cape Cod Free Clinic & Community Health Center offers free , confidential test- ing for HIV/AIDS.The tests are available at the health center's Falmouth and Mashpee offices. Appointments are required; call 508-540-2949. ? Stress management workshop The Cape Cod Chapter of the Inter- national Association of Administrative Professionals sponsors a Managing Stress Through Humor workshop Jan. 10 at 6 p.m. at the Barnstable MiddleSchool Library. 895 Falmouth Road, Route 28 in Hyannis. ? Veterans, take note The Department of Veterans Affairs is offering prescription refills over the Internet via the VA's MyHealtheVet , a personal on- line record system for veterans that tracks not only prescriptions but health records, in- surance andmore. For information on these services , goto www.myhealth.va.gov ? Bereavement groups The Visiting Nurse Association of Cape Cod Hospice Bereavement Program offers a support group designed for men who have lost a loved one. The group meets at the South Dennis office of the VNA . 434 Route 134.Call 800-978-0838 for details.A Bereaved Parents Support Group for those who have lost children meets Mondays at 1 p.m. at the VNA , 67 Ter Heun Drive in Falmouth where volunteers will be available for child care of other children in the family. Call 800-978-0838. Other bereavement support groups include loss of a pet. par- ent, grandchild, friend and many others. Call 800-978-0838 for details. ? Melanoma Foundation looking for volunteers The Melanoma Education Foundation i i seeking volunteers to raise melanoma awareness in the community. Needed are a grant writer , outreach coordinators , and a videoconferencing technical advisor. Call 978-535-3080 or go to http://www skinchcek.org. ? Support at Independence House Independence House in Hyannis spon- sors a domestic violence support group at the office in Falmouth Hospital on Mondays at 6:30 p.m.: a children 's empowerment group on Wednesdays at 5:30 p.m at the office in Hyannis: and a self-esteem focus group on Thursdays at the Hyannis office at 5:30 p.m. Call 508-771-6507. ? Health and well-being programs for winter Cape Cod Healthcare 's Center For Health Education offers classes such as 'Kick Butts." a stop-smoking class. Heart Healthy Eating; " a walking program ; techniques for relaxation of the mind and body; supermarket shopping; and more.To register , call 877-729-7200 or go to www. capecodhealth.org. ? Hospice education ¦ To learn more about just what a hospice is and to be informed about end-of-life services , you can schedule an informative program for your organization presented by Hospice & Palliative Care of Cape Cod. Call 508-957-0200. ext. 306. ? A little time for yourself Stop by the Visiting Nurse Association in Dennis on Route 134 to take part in the Young at Heart/PACE exercise program. A minimal fee is charged and a doctor 's note is necessary. Call 877-267-7700 ? Driver Rehabilitation Program Those whose driving ability has been compromised by illness, injury or nor- mal aging are invited to take part in the roadSMART Driver Rehabilitation Program being offered through the Rehabilitate., Hospital of the Cape and Islands in East Sandwich. Call 508-833-4000. ? Women 's free health screening The Women's Health Network of the Visiting Nurse Association of Cape Cod in cooperation with local health care pro- viders is offering free breast and cervical cancer screening services to uninsured and undennsured. low-income women age 40 to 64. Call 888-557-9994 ? New access center telephone line Cape Cod Healthcare 's mental health arm . Behavioral Health Services of Cape Cod Healthcare , has a one-stop telephone line (888-986-4BHS) allowing easier access to comprehensive mental health services. The service offers help for those dealing with anxiety, depression substance abuse, and other concerns. ? VNA has home health technology The Visiting Nurse Association of Cape Cod offers in-home telemonitonng technol- ogy. The Honeywell HomMed monitors collect vital signs including heart rate, blood pressure, oxygen saturation and body weight , all in three minutes. Call 800-631-3900 ? Adult exercise class in Hyannis Get in shape by joining Live for Life classes offered by the YMCA Tuesdays and Thursdays from noon to 1 p.m. at the Barnstable Senior Center. 825 Falmouth Road in Hyannis Admission is S25 per month. ? VNA offers van, interpreters The Visiting Nurse Association of Cape Cod has a 28-foot van that travels throughout the Cape to link underserved individuals and families with health educa- tion and preventative screening services. Call the VNA for details. Blood pressure , cholesterol , blood sugar and more may be tested at the van. Another unique service the VNA offers is interpretation and tele-in- terpretation infive languages: Portuguese , Spanish , Haitian Creole , Persian and Italian Sign up to have a class to get your staff trained in Choke Saver Certification. Call 888-557-9994 , ext. 7620. ? Reduce stress now Cape Stress Reduction is offering an eight-week program in "Mindfulness Based Stress Reduction " Wednesday evenings at the Ramada Inn in Hyannis or Thursday mornings at the West Barn- stable Community Center on Route 149. Call 508-420-3300 or send an e-mail to info@capestressreduction.com. ? VNA has exercise class and more Join a Young at Heart exercise class for a 10-week run and improve your ticker in just one hour, twice a week. A small fee and doctor 's approval are needed. Senior Care Management Services are offered by the VNA. For an assessment of an individual's health care needs, call 877-267-7700. A Young at Heart Senior Weight Training program is held twice a week for 12 weeks. Call 877-267-7700. ? Alzheimer's support in Dennis Eagle Pond Rehabilitation and Liv- ing Center of South Dennis hosts an Alzheimer s Support Group on the second Wednesday of the month from 3:30 to 4:30 p.m. Call 508-385-6034. ? Parents helping parents Parents Helping Parents , a self-help support group, offers free weekly meetings for parents to share understanding, infor- mation , ideas and support. The Hyannis meetings are held Wednesday evenings. The group is looking for volunteers with good interpersonal skills. Training is avail- able. Call 800-882-1250. ? Rehabilitation Hospital offerings RHCI. 311 Service Road in East Sand- wich, hosts a fibromyalgia support group the fourth Thursday of the month. A stroke support group meets the second Wednes- day of the month at 1:30 p.m. The aphasia community group meets the first Saturday of the month from 2 to 4 p.m The Well- Spouse Support Group meets every third Thursday of the month at 7 p m. Healthy Hearts outpatient cardiac rehabilitation programs are offered at 6 a.m. ? Cancer support in Mashpee Cape Cod Healthcare has a Living With Cancer education support group that meets Tuesdays at the Mashpee Health Center, 5 Industrial Road. Call 508-539-6215. ? Respite program for caregivers The Caregiver Support and Companion Program at the Barnstable Senior Center offers caregivers age 60 and up caring for a loved one. and also younger caregivers who are caring for seniors 60 and up, a free respite program two mornings a week providing supervised care for their loved one. Other opportunities are available,call 508-862-4750 ? Support group for smokers Join the Dennis Free at Last Group, a support group for smokers who want to quit. It meets Wednesdays from 7 to 8 p.m. at the West Dennis Graded Schoolhouse on School Street ? Experience Reiki, free A free Reiki clinic is held every third Thursday of the month at the Center for Healing Therapies/Reiki By the Sea, 15 West Bay Road in Osterville. No appoint- ments are necessary for this light hand treatment geared to relievepain,stress and mental distress. Call 508-888-7788.