Well, I've posted my Health-Care Cost-Coverage comment, "Private insurance profit - at odds with providing Health Care", as a 'letter' to various local papers. It would be nice if it showed up in one of their editorials/letters sections. But I doubt it.
Senate's bill, with no Public-Based cost-coverage plan, is pretty useless in the long term. And I hear that in bill-reconcilliation (combining different House/Senate versions), the Senate usually gets more weight.
Disappointing.
Tuesday, December 29, 2009
Wednesday, December 16, 2009
Why health care should be publicly funded
Arianna Huffington post Dec 4 on her site, The Huffington Post...
As the health care battle intensifies, insurance giant Aetna says it plans to raise its rates in 2010 and, as a result, expects to lose over 600,000 customers...while boosting profits. It's addition by subtraction, health care style. Aetna President Mark Bertolini justified the move as "ensuring that each customer is priced to an appropriate margin."
-----You can feel the humanity in every syllable.
Tuesday, December 15, 2009
Stories
It's amazing, and yet at the same time obvious.
Everyone has a story. And they are all deep.
The woman coping with cancer survival.
The survivors of the holocaust.
The limo drivers in New Orleans who have their own very personal stories of surviving Hurricane Katrina.
The mother whose child spent her 2nd and 3rd birthdays in Children's Hospital, and died before 4.
The man whose daughter survived uterine cancer, and 3 years later found a tumor in her thigh bone.
It is an amazing collection of the human condition, the human struggle, the human spirit.
Everyone has a story. And they are all deep.
The woman coping with cancer survival.
The survivors of the holocaust.
The limo drivers in New Orleans who have their own very personal stories of surviving Hurricane Katrina.
The mother whose child spent her 2nd and 3rd birthdays in Children's Hospital, and died before 4.
The man whose daughter survived uterine cancer, and 3 years later found a tumor in her thigh bone.
It is an amazing collection of the human condition, the human struggle, the human spirit.
The only path to salvation
whats more...
The current Christian interpretation of Jesus - that "going through him is the only way to salvation", and all others are damned to hell - This is the single most dangerous and deadly element in the entire religion.
It has led to centuries of oppression, abuse, torture, and murder. That history, sadly, *will* repeat itself. It is unavoidable.
I know. Most Christians would read this and think to themselves 'no, that's not where we're coming from.' But the reality is that time is very long. It took centuries for Christianity to evolve its philosophies, as well as it's self-perceived relationship to other religions. Attitudes evolved with it, sometimes benevolent, sometimes oppressive, sometimes murderous. It has ebbed and flowed through Christianity's history.
And time going forward is very long as well. Attitudes that were oppressive and wrong in the past, that are benevolent and harmless now, will continue to ebb and flow - once again into cruel oppression. This philosophy of "mine is the only path" guarantees it.
Please wake up and realize the deadly danger of this attitude. An impossible request, I fear - Let it go.
The current Christian interpretation of Jesus - that "going through him is the only way to salvation", and all others are damned to hell - This is the single most dangerous and deadly element in the entire religion.
It has led to centuries of oppression, abuse, torture, and murder. That history, sadly, *will* repeat itself. It is unavoidable.
I know. Most Christians would read this and think to themselves 'no, that's not where we're coming from.' But the reality is that time is very long. It took centuries for Christianity to evolve its philosophies, as well as it's self-perceived relationship to other religions. Attitudes evolved with it, sometimes benevolent, sometimes oppressive, sometimes murderous. It has ebbed and flowed through Christianity's history.
And time going forward is very long as well. Attitudes that were oppressive and wrong in the past, that are benevolent and harmless now, will continue to ebb and flow - once again into cruel oppression. This philosophy of "mine is the only path" guarantees it.
Please wake up and realize the deadly danger of this attitude. An impossible request, I fear - Let it go.
Christian Mythology
I don't understand how rational, intelligent human beings can believe in the mythology behind Christianity as a literal truth. That a woman was married and was yet a virgin. That she'd already had a son, John, and yet god had somehow made her virgin again. That she became pregnant without having sex with her husband or some other man. That her child was in fact a god.
These are all totally ludicrous fantasies of imagination.
That this man became a god or indeed was a god at birth - this is the most outrageous claim of all. Unless you are able to believe other absurdities like a little statue of Zeus is indeed a god, I find it impossible to see how anyone can ascribe to this.
If you are a believer in monotheism, and that there is no god but god, the idea of a mere human being becoming or being a god is completely blasphemous. No human is god. Ever. In the past, at present, or in the future.
Furthermore, I do not want a King. Not in my temporal, corporeal world, nor in my spiritual or religious world. God is my guide through life. My guide in understanding myself and others. My guide in navigating the path of good. God is not my king, and I neither look forward to nor want his kingdom, on heaven or earth.
And the convergence of God is King, and man can be God, is overwhelmingly dangerous. This danger shows through in numerous Islam dominated countries, where the people, so accustomed to the concept of absolute-rule derived from 'God is King', live under squelching dictatorships or monarchies. It shows in the circles of extreme fundamentalist Christians, who believe in establishing god's kingdom on Earth - literally, replace our government with whatever demented reality that would be (maybe something that reflects the Christian monarchies of the Middle-Ages).
Christianity, and Islam as well, are rich, beautiful religions, with wonderful philosophies on how best to live with our fellow humans, and how to interpret our spirituality. But the mythology should *never* be mistaken for literal truth. Once it does, the mythology becomes the center of focus. Not the goodness.
These are all totally ludicrous fantasies of imagination.
That this man became a god or indeed was a god at birth - this is the most outrageous claim of all. Unless you are able to believe other absurdities like a little statue of Zeus is indeed a god, I find it impossible to see how anyone can ascribe to this.
If you are a believer in monotheism, and that there is no god but god, the idea of a mere human being becoming or being a god is completely blasphemous. No human is god. Ever. In the past, at present, or in the future.
Furthermore, I do not want a King. Not in my temporal, corporeal world, nor in my spiritual or religious world. God is my guide through life. My guide in understanding myself and others. My guide in navigating the path of good. God is not my king, and I neither look forward to nor want his kingdom, on heaven or earth.
And the convergence of God is King, and man can be God, is overwhelmingly dangerous. This danger shows through in numerous Islam dominated countries, where the people, so accustomed to the concept of absolute-rule derived from 'God is King', live under squelching dictatorships or monarchies. It shows in the circles of extreme fundamentalist Christians, who believe in establishing god's kingdom on Earth - literally, replace our government with whatever demented reality that would be (maybe something that reflects the Christian monarchies of the Middle-Ages).
Christianity, and Islam as well, are rich, beautiful religions, with wonderful philosophies on how best to live with our fellow humans, and how to interpret our spirituality. But the mythology should *never* be mistaken for literal truth. Once it does, the mythology becomes the center of focus. Not the goodness.
Sunday, December 13, 2009
BC Survivor T-Shirt
T-Shirt for breast cancer survivors:
:)))
"Hell yea they're fake. The real ones tried to kill me!"
:)))
Saturday, December 12, 2009
Center for Breast Reconstruction Surgery
Here's a sort-of rant I posted to a Facebook BC-Support group tonight...
=====================================
Hi, I'm brand new to this group, so I hope I don't overstep the standard protocol.
This is a long story, but from the experience I/we have been through on this, I feel strongly that it must be told - for the benefit of ALL women currently going through this...
---------
I'm in New Orleans at present for phase-2 surgery for my girlfriend. We're from the Raleigh/Durham area of North Carolina. She was diagnosed back in Dec 2008, and we proceeded with Chemotherapy at Duke Medical in Durham.
Duke had a study on where they would do drug testing on a tumor biopsy to determine if this or that chemo cocktail was effective or not. During chemo, the impact on the tumor was closely monitored.
The plan was that after chemo, she would go for surgery. Her particular situation required double-mast.
So, here, in the decision of where to get the surgery, is where the *real* story begins.....
During the chemo process, we had time to look into surgery options. We found a place online called "The Center for Restorative Breast Surgery" (The Center) down in New Orleans. I was looking to see photos of what we were headed for - so I could be prepared emotionally to best handle it for/with her. Well, not a lot of places post their results in any great quantity, but this NOLA site did. And the results looked rather good.
I forwarded the link to their site on to my GF, and forgot about it for a while. I thought, 'oh. that's the state of this kind of surgery these days.' A month or two later, she was ready to start a similar search. She got an email from her mother (without any input from me) directing her to the same site. When my GF pulled it up and we were looking through them together I mentioned that I'd found the same site myself a month before.
- btw, the photos are all non-identifying.
We looked through literally dozens and dozens of before/after pictures, of various different techniques the Breast-Center does. It wasn't easy, but the Center's results made it easier to keep going.
After that, my GF was off running on research into the Center. This was more difficult than we would have expected - the reason for this is the primary reason I am posting this entry...
Reading the Center's website sounded too good to be true. Their philosophy was amazing, and their surgical strategy is phenomenal. Yet, it was hard to find corroborating websites discussing them. Their techniques were out there discussed at different surgical/medical sites. But none that we found seemed up to their level of sophistication and quality - and none offered the kind of massive photographic evidence of their results.
My GF did find a number of discussion-groups from women who were in various stages of work with the Center. She read these in depth, and I think it was the primary determinant for her.
So now comes the part that drives me to post this here...
We asked her oncology team about this surgical group down in New Orleans (NOLA). In *every* case, we were told they'd never heard of the place. The oncologist at Duke, the surgeon who did her sentinel-node biopsy, the 2nd oncologist in Raleigh (1st chemo round stopped effectiveness after a couple weeks and a 2nd, other type of chemo was needed), even the premier reconstruction surgeon in the Raleigh/Durham/Chapel-Hill area. Every one of them said they'd never heard of this group in NOLA.
Furthermore, more than one of them questioned why on earth would we want to go there when we've got pretty much the best here. Btw, that top reconstr surgeon in our area looked at my GF and said he could try this or that, but there wasn't much 'donor' material to work with. He suggested a procedure which takes donor tissue from the inside of her thighs - a highly painful procedure which leaves unsightly scars in areas typically exposed in the summer. He suggested she should instead go with implants as her solution. - When my GF describes to others, this guy's answer to her questions about the NOLA facility, she always points out that he literally said "why would you want to exchange one deformity for another." I don't know if this 'connects' with anyone else out there, but that response seems to be strongly resonant with her.
So we try to do our job as 'the patient' by asking the oncologists about our research. These are *her doctors*. Their job is to provide her with the best options that fit her situation. Instead, they willfully remain ignorant of the research results, and give no serious consideration to it - brushing it casually aside with very poor arguments against it (like, "What could New Orleans offer, all their doctors left after Katrina").
I could continue about their lack of due-diligence for a long time, it's very upsetting. But I'll wrap up with a couple personal opinion comments and then move on to more detail about The Center in the hope of enlightening some or many who might read it here.
The Raleigh/Durham/Chapel-Hill area is held in rather high esteem as a medical center. In fact Durham holds the nickname of "City of Medicine". Yet, it seems to us now, in hind sight, that the medical community here has been much more than simply uneducated or ignorant of any surgical options outside the area. There has been a willful "closing of ranks" to protect their local oncology and reconstruction surgical colleagues, and to keep the business here - even if that comes at the expense of 'best care' for the patient.
Don't get me wrong. These are good people. They are not of malicious intent. They mean to do their jobs well. But they also mean to protect their local industry.
If you are in the business of breast-cancer treatment, either oncological or reconstructive, and you keep abreast of current research and trends, you read papers, you go to conferences, you talk amongst your peers... it is simply impossible never to have heard of this group in New Orleans. They are too good at what they do, they've been doing it too long now, and they have too many women who have been through there. The only conclusion left is that there is protectionism taking place.
I for one am outraged by it.
I hope I have not lost you yet, because what follows is a description of the Center's work. I come at this from the perspective of one newly fallen in love with an incredibly beautiful and wonderful woman, looking forward to lives together, full of fun, spirit, adventure, and yes even children long denied both of us due to circumstances of life prior. Someone who found the dream shattered 3 months after finally finding each other, from the frightening devastation that I know all who encounter breast cancer in their lives experience as well.
I have no affiliation with The Center. I present this highly personalized recommendation from love of that woman, and to all women and their loved ones facing the multitude of emotional facets that come out of coping with the results of surviving breast cancer.
I'm not sure how the following will be organized and it may ramble a bit. I'm an engineer by trade, so maybe I'll simply start with a short list of definitions...
First of all, the Center does surgery for breast cancer patients. That's it. That is all they do. They don't do noses and chins, or knees and hips also. They don't do any variety of other surgeries as well. Just breast surgeries.
Second, the Center does both reconstruction surgery as well as oncology surgery. In other words, they specialize in removing the cancer tumor (or in the case of full mastectomy, the breast tissue) as well as the surgery needed for cosmetic reconstruction. You can get both done in the one place.
Third, they prefer doing (but don’t have to) oncology surgery and reconstruction at the same time - in the same surgery. This leads to longer surgeries, but my GF is active on all the discussion boards, and I've not heard anyone complain of issues coming from the length. The oncology surgery with immediate reconstruction, results in a greatly improved aesthetic outcome.
Fourth, they prefer and recommend self-donor tissue as replacement, rather than implants and/or muscle.
Fifth, the can do new cases as well as revisions of existing or unsatisfying work equally well. They specialize in microsurgery so the incision lines (scars) are very fine.
Sixth, they work with you on what your insurance will cover. They approach this with a tremendous amount of compassion, and really work to make it affordable for the patient. - e.g. they have a brand new facility in down town New Orleans for their work. My GF's insurance is pretty awful and among other things wouldn't pay for her surgery there. But they worked with her to get it done at an in network facility that they made sure they personally approved of as well. Talk to them, they'll work with your needs and ability.
And finally, did I mention that this is all they do? They make themselves expert at this, and expert at being able to do what most other facilities would give up on and go to implant or muscle-based solutions for.
I don't know all the details of their story, and I may get some of it wrong, but... The doctors who started this practice studied under the tutelage of Dr. R.J.Allen. Dr Allen pioneered microsurgery for breast reconstruction, and has offices in New York, Charleston South Carolina, and New Orleans. I don't want to cast shadow on Dr Allen because I know otherwise nothing else about his practice.
As I understand it, Dr Frank DellaCroce and Dr Scott Sullivan started The Center 5 or 6 years ago, carrying forward with Dr Allen's pioneering work. A third, Dr Chris Trehan, joined the practice some time later. All three are originally from the New Orleans area, and wanted their new practice in New Orleans, perhaps partly motivated by the desire to contribute to the area's recovery from Katrina.
Again, as I understand (and I say this because again, I don't want to imply any negativity towards Dr Allen), DellaCroce, Sullivan, and Trehan have focused exclusively on breast reconstruction, and continuously evolve the science and technique begun with Dr Allen.
My GF's procedure was the Hip Flap, where donor fat is taken from the hips in two single pieces (a left and right, as opposed to liposuction fragments) and used as breast reconstruction material. Keeping the breast-donor material as one piece greatly enhances the aesthetic results, and the survival of the donor tissue. In addition, a "perforator" blood vessel is taken with the donor tissue and micro-surgically grafted to the blood supply in the breast area. This keeps the tissue from dying. Their failure rate for donor tissue is on the order of 0.5% (our top reconstruction surgeon in Durham, by comparison, has a failure rate on the order of 1.5%).
Two of the doctors work on the patient at the same time, as a team - one on each side. This reduces the time between removal of the donor tissue and reattachment to blood supply in the new location, thus further reducing the chance of losing the donor tissue to necrosis.
The dedication and effort this team puts into their work and into continually updating their technique both due to patient feedback and their own deliberations, is matched by very few, if any, other breast reconstruction teams on the planet.
My GR, for example, was originally planned for an S-GAP procedure. But when we arrived for surgery, they said they wanted to do a HIP-GAP instead. It was a fairly minor change, moving the donor site a few inches higher than the S-GAP would have done. Their explanation for why, was that they were less satisfied with the cosmetic outcome of the surgical sights (both breast and lower back) than they wanted to be. They are constantly thinking and rethinking for improvement. - I got the sense in Durham, that the attitude was "well this is how I learned how to do it and this is all there is."
For most cases, as far as I can tell, there are 2 phases of surgery, and sometimes 3. Phase 1 is the (mastectomy and) reconstruction. Surgeries here seem to vary between 4 and 8 hours long. My GF's was 7hrs - she had the mastectomy at the same time. We were in the hospital for 3 days, and then nearby in a hotel for the rest of the week. After a consultation at the end of the week, we were home. The aftermath of the phase-1 surgery seemed to hurt very little. I think this was due to the fact that it was all incisions and excisions, and the micro surgery did an excellent job closing the incisions.
Phase-2 is typically scheduled for 3 to 4 months after phase-1, and is intended to cosmetically 'fix' what needs adjustment from phase-1. This is another of The Center's great strengths. It's not a place where you get reconstructed and sent on your merry way never to bother them again. They want you back to fix what may have settled, or changed, or been left not quite finished in the big picture.
Sometimes there is a 3rd phase, which I understand involves recreation of the nipple, but I don't now much about that.
---------
So yes, this has been a long post, several hours in the composition. But our comparative experience between what The Center has been able to do .vs. what our ‘City Of Medicine’ resources offered, is sincerely, literally, the difference between night and day.
I want other women going through the emotional pain of self image that can come from being treated for breast cancer to know about this option. I hope this reaches some of them.
Research their website: http://www.breastcenter.com/
=====================================
Hi, I'm brand new to this group, so I hope I don't overstep the standard protocol.
This is a long story, but from the experience I/we have been through on this, I feel strongly that it must be told - for the benefit of ALL women currently going through this...
---------
I'm in New Orleans at present for phase-2 surgery for my girlfriend. We're from the Raleigh/Durham area of North Carolina. She was diagnosed back in Dec 2008, and we proceeded with Chemotherapy at Duke Medical in Durham.
Duke had a study on where they would do drug testing on a tumor biopsy to determine if this or that chemo cocktail was effective or not. During chemo, the impact on the tumor was closely monitored.
The plan was that after chemo, she would go for surgery. Her particular situation required double-mast.
So, here, in the decision of where to get the surgery, is where the *real* story begins.....
During the chemo process, we had time to look into surgery options. We found a place online called "The Center for Restorative Breast Surgery" (The Center) down in New Orleans. I was looking to see photos of what we were headed for - so I could be prepared emotionally to best handle it for/with her. Well, not a lot of places post their results in any great quantity, but this NOLA site did. And the results looked rather good.
I forwarded the link to their site on to my GF, and forgot about it for a while. I thought, 'oh. that's the state of this kind of surgery these days.' A month or two later, she was ready to start a similar search. She got an email from her mother (without any input from me) directing her to the same site. When my GF pulled it up and we were looking through them together I mentioned that I'd found the same site myself a month before.
- btw, the photos are all non-identifying.
We looked through literally dozens and dozens of before/after pictures, of various different techniques the Breast-Center does. It wasn't easy, but the Center's results made it easier to keep going.
After that, my GF was off running on research into the Center. This was more difficult than we would have expected - the reason for this is the primary reason I am posting this entry...
Reading the Center's website sounded too good to be true. Their philosophy was amazing, and their surgical strategy is phenomenal. Yet, it was hard to find corroborating websites discussing them. Their techniques were out there discussed at different surgical/medical sites. But none that we found seemed up to their level of sophistication and quality - and none offered the kind of massive photographic evidence of their results.
My GF did find a number of discussion-groups from women who were in various stages of work with the Center. She read these in depth, and I think it was the primary determinant for her.
So now comes the part that drives me to post this here...
We asked her oncology team about this surgical group down in New Orleans (NOLA). In *every* case, we were told they'd never heard of the place. The oncologist at Duke, the surgeon who did her sentinel-node biopsy, the 2nd oncologist in Raleigh (1st chemo round stopped effectiveness after a couple weeks and a 2nd, other type of chemo was needed), even the premier reconstruction surgeon in the Raleigh/Durham/Chapel-Hill area. Every one of them said they'd never heard of this group in NOLA.
Furthermore, more than one of them questioned why on earth would we want to go there when we've got pretty much the best here. Btw, that top reconstr surgeon in our area looked at my GF and said he could try this or that, but there wasn't much 'donor' material to work with. He suggested a procedure which takes donor tissue from the inside of her thighs - a highly painful procedure which leaves unsightly scars in areas typically exposed in the summer. He suggested she should instead go with implants as her solution. - When my GF describes to others, this guy's answer to her questions about the NOLA facility, she always points out that he literally said "why would you want to exchange one deformity for another." I don't know if this 'connects' with anyone else out there, but that response seems to be strongly resonant with her.
So we try to do our job as 'the patient' by asking the oncologists about our research. These are *her doctors*. Their job is to provide her with the best options that fit her situation. Instead, they willfully remain ignorant of the research results, and give no serious consideration to it - brushing it casually aside with very poor arguments against it (like, "What could New Orleans offer, all their doctors left after Katrina").
I could continue about their lack of due-diligence for a long time, it's very upsetting. But I'll wrap up with a couple personal opinion comments and then move on to more detail about The Center in the hope of enlightening some or many who might read it here.
The Raleigh/Durham/Chapel-Hill area is held in rather high esteem as a medical center. In fact Durham holds the nickname of "City of Medicine". Yet, it seems to us now, in hind sight, that the medical community here has been much more than simply uneducated or ignorant of any surgical options outside the area. There has been a willful "closing of ranks" to protect their local oncology and reconstruction surgical colleagues, and to keep the business here - even if that comes at the expense of 'best care' for the patient.
Don't get me wrong. These are good people. They are not of malicious intent. They mean to do their jobs well. But they also mean to protect their local industry.
If you are in the business of breast-cancer treatment, either oncological or reconstructive, and you keep abreast of current research and trends, you read papers, you go to conferences, you talk amongst your peers... it is simply impossible never to have heard of this group in New Orleans. They are too good at what they do, they've been doing it too long now, and they have too many women who have been through there. The only conclusion left is that there is protectionism taking place.
I for one am outraged by it.
I hope I have not lost you yet, because what follows is a description of the Center's work. I come at this from the perspective of one newly fallen in love with an incredibly beautiful and wonderful woman, looking forward to lives together, full of fun, spirit, adventure, and yes even children long denied both of us due to circumstances of life prior. Someone who found the dream shattered 3 months after finally finding each other, from the frightening devastation that I know all who encounter breast cancer in their lives experience as well.
I have no affiliation with The Center. I present this highly personalized recommendation from love of that woman, and to all women and their loved ones facing the multitude of emotional facets that come out of coping with the results of surviving breast cancer.
I'm not sure how the following will be organized and it may ramble a bit. I'm an engineer by trade, so maybe I'll simply start with a short list of definitions...
First of all, the Center does surgery for breast cancer patients. That's it. That is all they do. They don't do noses and chins, or knees and hips also. They don't do any variety of other surgeries as well. Just breast surgeries.
Second, the Center does both reconstruction surgery as well as oncology surgery. In other words, they specialize in removing the cancer tumor (or in the case of full mastectomy, the breast tissue) as well as the surgery needed for cosmetic reconstruction. You can get both done in the one place.
Third, they prefer doing (but don’t have to) oncology surgery and reconstruction at the same time - in the same surgery. This leads to longer surgeries, but my GF is active on all the discussion boards, and I've not heard anyone complain of issues coming from the length. The oncology surgery with immediate reconstruction, results in a greatly improved aesthetic outcome.
Fourth, they prefer and recommend self-donor tissue as replacement, rather than implants and/or muscle.
Fifth, the can do new cases as well as revisions of existing or unsatisfying work equally well. They specialize in microsurgery so the incision lines (scars) are very fine.
Sixth, they work with you on what your insurance will cover. They approach this with a tremendous amount of compassion, and really work to make it affordable for the patient. - e.g. they have a brand new facility in down town New Orleans for their work. My GF's insurance is pretty awful and among other things wouldn't pay for her surgery there. But they worked with her to get it done at an in network facility that they made sure they personally approved of as well. Talk to them, they'll work with your needs and ability.
And finally, did I mention that this is all they do? They make themselves expert at this, and expert at being able to do what most other facilities would give up on and go to implant or muscle-based solutions for.
I don't know all the details of their story, and I may get some of it wrong, but... The doctors who started this practice studied under the tutelage of Dr. R.J.Allen. Dr Allen pioneered microsurgery for breast reconstruction, and has offices in New York, Charleston South Carolina, and New Orleans. I don't want to cast shadow on Dr Allen because I know otherwise nothing else about his practice.
As I understand it, Dr Frank DellaCroce and Dr Scott Sullivan started The Center 5 or 6 years ago, carrying forward with Dr Allen's pioneering work. A third, Dr Chris Trehan, joined the practice some time later. All three are originally from the New Orleans area, and wanted their new practice in New Orleans, perhaps partly motivated by the desire to contribute to the area's recovery from Katrina.
Again, as I understand (and I say this because again, I don't want to imply any negativity towards Dr Allen), DellaCroce, Sullivan, and Trehan have focused exclusively on breast reconstruction, and continuously evolve the science and technique begun with Dr Allen.
My GF's procedure was the Hip Flap, where donor fat is taken from the hips in two single pieces (a left and right, as opposed to liposuction fragments) and used as breast reconstruction material. Keeping the breast-donor material as one piece greatly enhances the aesthetic results, and the survival of the donor tissue. In addition, a "perforator" blood vessel is taken with the donor tissue and micro-surgically grafted to the blood supply in the breast area. This keeps the tissue from dying. Their failure rate for donor tissue is on the order of 0.5% (our top reconstruction surgeon in Durham, by comparison, has a failure rate on the order of 1.5%).
Two of the doctors work on the patient at the same time, as a team - one on each side. This reduces the time between removal of the donor tissue and reattachment to blood supply in the new location, thus further reducing the chance of losing the donor tissue to necrosis.
The dedication and effort this team puts into their work and into continually updating their technique both due to patient feedback and their own deliberations, is matched by very few, if any, other breast reconstruction teams on the planet.
My GR, for example, was originally planned for an S-GAP procedure. But when we arrived for surgery, they said they wanted to do a HIP-GAP instead. It was a fairly minor change, moving the donor site a few inches higher than the S-GAP would have done. Their explanation for why, was that they were less satisfied with the cosmetic outcome of the surgical sights (both breast and lower back) than they wanted to be. They are constantly thinking and rethinking for improvement. - I got the sense in Durham, that the attitude was "well this is how I learned how to do it and this is all there is."
For most cases, as far as I can tell, there are 2 phases of surgery, and sometimes 3. Phase 1 is the (mastectomy and) reconstruction. Surgeries here seem to vary between 4 and 8 hours long. My GF's was 7hrs - she had the mastectomy at the same time. We were in the hospital for 3 days, and then nearby in a hotel for the rest of the week. After a consultation at the end of the week, we were home. The aftermath of the phase-1 surgery seemed to hurt very little. I think this was due to the fact that it was all incisions and excisions, and the micro surgery did an excellent job closing the incisions.
Phase-2 is typically scheduled for 3 to 4 months after phase-1, and is intended to cosmetically 'fix' what needs adjustment from phase-1. This is another of The Center's great strengths. It's not a place where you get reconstructed and sent on your merry way never to bother them again. They want you back to fix what may have settled, or changed, or been left not quite finished in the big picture.
Sometimes there is a 3rd phase, which I understand involves recreation of the nipple, but I don't now much about that.
---------
So yes, this has been a long post, several hours in the composition. But our comparative experience between what The Center has been able to do .vs. what our ‘City Of Medicine’ resources offered, is sincerely, literally, the difference between night and day.
I want other women going through the emotional pain of self image that can come from being treated for breast cancer to know about this option. I hope this reaches some of them.
Research their website: http://www.breastcenter.com/
Wednesday, November 25, 2009
Interesting Point on the Health-Care Debate
I often find myself browsing for news on the web-pages of "The Economist". It's a clearly business biased news publication, but happily it seems to avoid being a 'corporate' biased magazine. They bias towards capitalism, but are often willing to admit and even argue for social concerns as well.
While I don't always agree with The Economist positions, I find their 'news' to be apolitical, and a refreshing break to most of the major US news outlets.
Recently, they had an article about the US Senate health-care bill, and opened a 'discussion thread' on the topic, which I read through. So often the opponents of a Public-Option solution give arguemnts that are Red-Herring diversions, and at any rate thoroughly unconvincing. Occasionally I come upon one that makes some sense.
So it was with the following entry. I don't know if the author "OpenYourMindQuaid" is opposed to a Single-Payer Public-Option solution or supportive of it. Interestingly for his comment, that doesn't matter.
An exquisitely interesting point made, I have copied the entire entry here, and made BOLD the sections most significant.
While I don't always agree with The Economist positions, I find their 'news' to be apolitical, and a refreshing break to most of the major US news outlets.
Recently, they had an article about the US Senate health-care bill, and opened a 'discussion thread' on the topic, which I read through. So often the opponents of a Public-Option solution give arguemnts that are Red-Herring diversions, and at any rate thoroughly unconvincing. Occasionally I come upon one that makes some sense.
So it was with the following entry. I don't know if the author "OpenYourMindQuaid" is opposed to a Single-Payer Public-Option solution or supportive of it. Interestingly for his comment, that doesn't matter.
An exquisitely interesting point made, I have copied the entire entry here, and made BOLD the sections most significant.
OpenYourMindQuaid wrote: Nov 23rd 2009 6:04 GMT.
To even begin contemplating the passage of such a bill with the current debt boggles my mind. Don't people realize that debt approaching the total value of annual GDP is a serious problem?
The money that would fund this bill is not based on real value, so we can expect to see a substantial boost to inflation as a result. As if explicit taxes were not enough, implicit inflation taxes will now hurt every American.
I encourage people to ask why we got to this point where health care is such an issue and to not discount the relationship of any factor.
Consider this: If corn was not subsidized, then cheap, unhealthy food would not be as accessible. Healthy food would be relatively cheaper and perhaps the high rates of obesity and obesity-related illnesses would not be as prevalent.
If oil was not subsidized, then walking, biking, and less fuel-intensive modes of transportation would be relatively cheaper, so people would probably exercise out of necessity more often.
These two economically unjustifiable government subsidies add to the health problem, inevitably leading to increases in premiums paid to health insurance companies.
I encourage all to think about the interplay between governmental actions (and inaction) and supposed free market capitalism in the realm of health care. If something can be done to address the root of the problem instead of the symptoms, we should enact meaningful reform in those identified markets that adversely affect those reliant on health insurance. But continuing to throw illusory money at a problem whose depth anyone has yet to comprehend is a grossly oversimplified treatment of a much deeper problem.
I am deeply disturbed by this state of affairs. How dare anyone even consider spending money that doesn't exist on a problem they don't understand.
Wednesday, November 4, 2009
On Illness
Hippocrates cautions:
“The sick must battle both their illness and their doctors.”
....yep!
“The sick must battle both their illness and their doctors.”
....yep!
Sunday, November 1, 2009
Monday, October 26, 2009
A Love Story for Fall
Love Story
I will seek and find you .
I shall take you to bed and have my way with you.
I will make you ache, shake & sweat until you moan & groan.
I will make you beg for mercy, beg for me to stop.
I will exhaust you to the point that you will be relieved
when I'm finished with you.
And, when I am finished,
you will be weak for days.
All my love,
The Flu
I will seek and find you .
I shall take you to bed and have my way with you.
I will make you ache, shake & sweat until you moan & groan.
I will make you beg for mercy, beg for me to stop.
I will exhaust you to the point that you will be relieved
when I'm finished with you.
And, when I am finished,
you will be weak for days.
All my love,
The Flu
Wednesday, September 30, 2009
Monster Truck owners - a little bit of respect
I *really* don't like obese SUVs and oversized trucks. I find them very boring aesthetically, having absolutely no decent sense of style. And from an efficiency perspective, they're very selfish. I simply do NOT understand the appeal.
My dislike of them, I find, is heightened by the perception that the "mainstream" likes them so much. I prefer well styled cars, and particularly coupes. I own a coupe, and have for many years. Not everyone likes my styling preference, but - and here's the part that comes to my point - there's a certain degree of self-satisfaction and pride in going in a direction that is NOT mainstream, that's Different.
Maybe somehow I'm declaring, 'Hey check it out! I've actually used my mind and thought about my choice rather than run like a lemming to get an SUV like everybody else - giving no conscious thought to if it's in fact a good looking vehicle.' A little over the top, I will admit. And I try to keep from letting it get the better of me :).
This morning as I arrived at work, and saw the usual array of parked, obese SUVs and Trucks that so many of my co-workers here drive, I found myself thinking once again, "how can these people not see how dull looking those things are?". A few of them were the 'monster-truck' types. Suddenly I grasped it...
I found myself for the first time *ever*, with an increased level of respect for those drivers.
...I think that only applies to monster truck drivers though. Obese SUV drivers are still on my shit-list ;)))
My dislike of them, I find, is heightened by the perception that the "mainstream" likes them so much. I prefer well styled cars, and particularly coupes. I own a coupe, and have for many years. Not everyone likes my styling preference, but - and here's the part that comes to my point - there's a certain degree of self-satisfaction and pride in going in a direction that is NOT mainstream, that's Different.
Maybe somehow I'm declaring, 'Hey check it out! I've actually used my mind and thought about my choice rather than run like a lemming to get an SUV like everybody else - giving no conscious thought to if it's in fact a good looking vehicle.' A little over the top, I will admit. And I try to keep from letting it get the better of me :).
This morning as I arrived at work, and saw the usual array of parked, obese SUVs and Trucks that so many of my co-workers here drive, I found myself thinking once again, "how can these people not see how dull looking those things are?". A few of them were the 'monster-truck' types. Suddenly I grasped it...
Those who get ridiculously oversized trucks are simply doing the same thing I am:
declaring themselves not part of the Boring, Mindless Mainstream.
I found myself for the first time *ever*, with an increased level of respect for those drivers.
...I think that only applies to monster truck drivers though. Obese SUV drivers are still on my shit-list ;)))
Monday, September 28, 2009
On Having Kids
Not having children by choice is no big deal.
But facing the reality that you can not have children of your own is painful even if you would have chosen not to.
But facing the reality that you can not have children of your own is painful even if you would have chosen not to.
Sunday, September 6, 2009
On History
Quote:
Quoted of Carl Marx by James Caroll.
In Carolls' book "Constantine's Sword: The Church and the Jews"
The above quote is a fascinating commentary on how history can unavoidably lead to following history. Suggesting that awareness of history can sometimes be as equal a curse as the curse of being ignorant to it.
Btw, Caroll's book, 'Constantine's Sword' is a stunning trek through the history of (mostly Catholic) Christianity from the perspective of its relationship to Judaism and the development of that relationship in western society - from the simple rivalry of very similar but competing 'sibling' religions; to the seemingly protective philosophy of 'survive but not thrive' arising in the eventually more dominant Church; to the grotesque perversion of murderous antisemitism that slowly but seemingly inexorably evolved out of each preceding century of repression and dehumanization, sometimes explicitly promoted , always quietly approved of by the Church.
Men make their own history.
But they do not make it just as they please;
They do not make it under circumstances chosen by themselves,
But under circumstances directly found, given and transmitted from the past.
The traditions of all dead generations weigh like a nightmare on the minds of the living.
Quoted of Carl Marx by James Caroll.
In Carolls' book "Constantine's Sword: The Church and the Jews"
The above quote is a fascinating commentary on how history can unavoidably lead to following history. Suggesting that awareness of history can sometimes be as equal a curse as the curse of being ignorant to it.
Btw, Caroll's book, 'Constantine's Sword' is a stunning trek through the history of (mostly Catholic) Christianity from the perspective of its relationship to Judaism and the development of that relationship in western society - from the simple rivalry of very similar but competing 'sibling' religions; to the seemingly protective philosophy of 'survive but not thrive' arising in the eventually more dominant Church; to the grotesque perversion of murderous antisemitism that slowly but seemingly inexorably evolved out of each preceding century of repression and dehumanization, sometimes explicitly promoted , always quietly approved of by the Church.
Wednesday, September 2, 2009
Coincidence
Coincidences in life are sometimes so stunning.
Last night at dinner with Pam at the Cardinal Club downtown, we sat with a couple brand new members (just joined a couple days before). While talking, we found that the woman's husband is down in Slidel, LA for his new job while his wife stays up here until their daughter graduates high school. Pam and I were in Slidel last week for her surgery - who's ever heard of Slidel unless you've lived or visited there?
One of the woman's older daughters was with her. She is finishing up a degree in nursing. She and Pam got to talking and it turns out that the girl was just talking with a colleague of hers about Pam's "boss". Too funny.
------------------
I was thinking on my way into work this morning, how much I like those two songs by Nina Simone I discovered within the past year. The first one from the movie I liked so much, Before Sunset - possibly one of the best endings to a romantic movie I've seen (but maybe I'm biased ;). I'd never heard of Nina Simone before that.
Then within 2 or 3 months of that, I'm in my new, wonderful relationship with Pam, and we're at a Swing-Dance party in Raleigh. The first one we went to together, and the only one we've been to since. Yet on that single chance occurrence, late in the evening after most dancers had long gone home, the music changed and one or two couples start dancing Blues-Dance, this incredibly sensual new dance neither of us had ever seen before. The music is another track by Nina Simone. I think the tune is interesting, and then I recognize her style/voice. Another fabulous production of Nina's and a new favorite.
What are the odds of such a coincidence? Before-Sunrise/Before-Sunset are fairly old movies. Pretty amazing stuff.
Last night at dinner with Pam at the Cardinal Club downtown, we sat with a couple brand new members (just joined a couple days before). While talking, we found that the woman's husband is down in Slidel, LA for his new job while his wife stays up here until their daughter graduates high school. Pam and I were in Slidel last week for her surgery - who's ever heard of Slidel unless you've lived or visited there?
One of the woman's older daughters was with her. She is finishing up a degree in nursing. She and Pam got to talking and it turns out that the girl was just talking with a colleague of hers about Pam's "boss". Too funny.
------------------
I was thinking on my way into work this morning, how much I like those two songs by Nina Simone I discovered within the past year. The first one from the movie I liked so much, Before Sunset - possibly one of the best endings to a romantic movie I've seen (but maybe I'm biased ;). I'd never heard of Nina Simone before that.
Then within 2 or 3 months of that, I'm in my new, wonderful relationship with Pam, and we're at a Swing-Dance party in Raleigh. The first one we went to together, and the only one we've been to since. Yet on that single chance occurrence, late in the evening after most dancers had long gone home, the music changed and one or two couples start dancing Blues-Dance, this incredibly sensual new dance neither of us had ever seen before. The music is another track by Nina Simone. I think the tune is interesting, and then I recognize her style/voice. Another fabulous production of Nina's and a new favorite.
What are the odds of such a coincidence? Before-Sunrise/Before-Sunset are fairly old movies. Pretty amazing stuff.
Friday, August 21, 2009
Gotta Love New Orleans People
Local 'rag' newspaper...
Title: The Local Levee
Subtitle: We Don't Hold Anything Back
It's a satirical newspaper on local events and people.
Gotta love that New Orleans spirit!
Title: The Local Levee
Subtitle: We Don't Hold Anything Back
It's a satirical newspaper on local events and people.
Gotta love that New Orleans spirit!
Monday, August 17, 2009
Hospitals
My girlfriend's mother commented that she's convinced that when you get into a hospital, they try to "do away with you" - referring to all the meds, and the food which is often not terribly healthy.
:) :) he he!
:) :) he he!
Private insurance profit - at odds with providing Health Care
The center of the issue on "health-care reform" is profit .vs. care. Private industry has only one natural motive - profit. Normally this is good because that motive typically aligns with providing the right product or service I want to buy.
In health care, this concept fails. Profit in private health-insurance is completely at odds with providing care. Private insurance will do all it can to eliminate providing care because health care cuts into its profit.
o) Private insurance establishes massive and wasteful bureaucracies to make it difficult to get approval, and to evade paying for service they should.
o) Private insurance restricts our choice of doctors to their 'approved provider' lists.
o) Private insurance rations our health care by telling our doctors what treatment to give.
o) Private insurance costs us more and more every year, at a rate that far outstrips inflation, and puts increasing downward pressure on our business and family economies.
Profit-motive in the health-care insurance industry causes all the above inefficiencies, because the profit is naturally in opposition to cash outlay for health care. A public cost-coverage system will have far fewer of any of the above because the 'natural' motive is to enable health-care, not to increase profit.
Private health insurance can never be trusted to look after our health-care interests. All arguements in opposition to public health care cost-overage fail to overcome this single, overarching reality.
Americans can not afford to keep it.
In health care, this concept fails. Profit in private health-insurance is completely at odds with providing care. Private insurance will do all it can to eliminate providing care because health care cuts into its profit.
o) Private insurance establishes massive and wasteful bureaucracies to make it difficult to get approval, and to evade paying for service they should.
o) Private insurance restricts our choice of doctors to their 'approved provider' lists.
o) Private insurance rations our health care by telling our doctors what treatment to give.
o) Private insurance costs us more and more every year, at a rate that far outstrips inflation, and puts increasing downward pressure on our business and family economies.
Profit-motive in the health-care insurance industry causes all the above inefficiencies, because the profit is naturally in opposition to cash outlay for health care. A public cost-coverage system will have far fewer of any of the above because the 'natural' motive is to enable health-care, not to increase profit.
Private health insurance can never be trusted to look after our health-care interests. All arguements in opposition to public health care cost-overage fail to overcome this single, overarching reality.
Americans can not afford to keep it.
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