What’s the Connection Between Heart Disease and Breast Cancer?

It may seem like the ultimate insult, but having survived breast cancer can put you at higher risk of additional health problems later in life. The National Cancer Institute reports that the average five-year survival rate for breast cancer is now about 90 percent, thanks to advanced treatment protocols. However, some patients who’ve had radiation treatment and chemotherapy may be at higher risk of developing cardiovascular disease in what’s called a late side effect of treatment for breast cancer. This means that the heart problem may not surface for months or years after the conclusion of treatment. According to a report in the journal EJC Supplements, an open access companion journal to the European Journal of Cancer, cardiovascular disease is already the leading cause of death “accounting for 30 to 50 percent of all deaths in most developed countries. Because of this high background rate, even a minor increase in risk of CVD [resulting from cancer treatment] will have an important impact on morbidity and mortality.”

According to a 2016 article in the Cleveland Clinic Journal of Medicine, ischemic heart disease (a reduction in blood supply to the heart) is the most common cause of death after radiation treatments. Valve disorders and diseases of the heart muscle and the pericardial sac that encases it are also common. A disruption to the electrical pulses that make the heart pump can also occur. “Overall, compared with nonirradiated patients, patients who have undergone chest radiotherapy have a 2 percent higher absolute risk of cardiac morbidity and death at five years and a 23 percent increased absolute risk after 20 years,” the article notes.

Anju Nohria, director of the cardio-oncology program at Brigham and Women/Dana-Farber Cancer Institute in Boston, says the problem stems from radiation’s ability to kill healthy cells that are located within the field of radiation being administered to a breast cancer tumor. Radiation “essentially destroys the cancer cells preferentially because they’re rapidly multiplying and therefore more susceptible. But [radiation can] also cause some damage to any healthy tissue” nearby. She says this is particularly true for patients having radiation treatments on the left breast, as the heart sits under that breast and is therefore closer to radiation beams in some cases. “If the tumor is on the left side but in your armpit, maybe you’re fine. But if it’s right over the heart, you have a higher risk,” of developing CVD later on because of that proximity to exposure, Nohria says.

In an effort to avoid exposing the heart as much as possible, many doctors now deliver radiation treatment while patients are lying prone, “meaning that they’re lying on their stomachs with their breasts hanging down." That way, the breast is sort of separated from the chest wall, and the heart is less in the radiation field.” Radiation is delivered from the underside of the table. Some doctors are also using “very sophisticated radiation techniques where they can map out the tumor and try to exclude the heart from the radiation field to the extent possible,” she says.

Even so, some patients will experience problems while others won’t, and the risk of developing cardiac problems after radiation treatment is dependent on a number of factors, including the location of the tumor and dose of radiation administered. “If you need a lot of radiation because you have a large tumor or it’s a particularly malignant tumor,” then the higher the dose the heart may receive, Nohria says. A patient’s age and preexisting cardiac risk factors like high blood pressure, high cholesterol and diabetes can also elevate risk. Smokers or people who already have heart disease are also at higher risk, “because in a way the heart has already sustained some damage and now you’re giving it an additional kick, so to speak.”

Certain chemotherapies including anthracycline drugs and certain drugs within the Herceptin family of HER2 agonists have also been linked with an increased rate of cardiovascular disease in some breast cancer patients, Nohria says. Adriamycin, an anthracycline chemotherapy, causes a “weakening of the heart muscle in 8 to 9 percent of women. In the majority of these cases, it happens within the first year of treatment,” she says. So if you’re taking this drug, expect your doctor to keep tabs on your cardiovascular health. “As we’ve begun to realize this [risk], we’re being more vigilant looking for it in the first year after treatment.” If this cardiac toxicity is noted early, “you can put people on heart medicines that help the heart recover in a certain proportion of patients.” But a change in cardiac health won’t always be obvious early on, she says. “Sometimes you’ll have an asymptomatic decline in your cardiac function – the squeezing of the heart muscle – and it only manifests when the person comes up with symptoms, which can be a several-year lag.”

With some of the HER2 agonist drugs, cardiac problems may actually be reversible in some patients, Nohria says. “If you stop the drug, there’s a high likelihood that your heart will get better. But in a few cases, like 30 percent, it doesn’t get better. For those people, you have to manage them with cardiac medications to try to prevent it from getting worse.” Combination therapies can present additional challenges to managing cardiac disease risks. Again, as with radiation, dosage makes a difference in whether a patient will develop cardiac issues after chemotherapy. “The higher the dose, the higher the likelihood that you’ll have a problem. For instance, if you have metastatic disease and you’ve had many, many doses of the drug, your risk is higher.” Similarly, “women over the age of 60, women with preexisting risk factors and women with preexisting heart disease” all have a higher risk of developing CVD after chemo. Patients who receive a combination of chemotherapy and radiation, particularly if it’s on the left side, “have a double whammy. Plus if you’re older and have a lot of risk factors, that sort of magnifies your risk because they’re additive,” Nohria says.

As more doctors have become aware of the connection between breast cancer treatments and heart health later in life, many are taking steps to reduce the risk, particularly in patients who have other risk factors for cardiovascular disease. In many patients, this means some prep work before therapy begins. “If you’re in a good medical center, before they start you on these things they should be getting a good cardiac history and trying to optimize your cardiac risk factors before starting you on these medications,” Nohria says. Breastcancer.org also recommends that, “no matter how old you are, it’s a good idea to ask your doctor about your personal risk of treatment-related heart problems and whether or not visiting a cardiologist before treatment starts is a good idea for you.” In addition to evaluating your baseline heart function and assessing your risk factors, “you also may want to ask your oncologist how your heart function will be monitored during treatment.”

Lymphedema and Breast Cancer: When Is Risk Greatest?

The time course for developing lymphedema depends on the type of breast cancer treatment, but the risk peaks between 24 and 36 months post therapy, regardless of treatment type, according to new research. Receipt of radiation therapy (RT) is also a key to the timing. "Lymphedema develops earlier in patients who receive radiation, especially those receiving regional lymph node radiation," said the study's lead author, Susan McDuff, MD, PhD, a resident in radiation oncology at the Massachusetts General Hospital (MGH) Cancer Center in Boston.

Lymphedema can be "an incredibly morbid" complication following treatment for breast cancer and is an ongoing source of anxiety for survivors, she said here at the American Society for Radiation Oncology (ASTRO) 2016 Annual Meeting. To help patients know when they may be "out of the woods," Dr McDuff and colleagues undertook a cohort study to determine whether there is a period when patients are at greatest risk. First, they looked at cumulative incidence.

The team analyzed the records of 1495 patients seen between 2005 and 2016 in a prospective lymphedema screening program at MGH. The time it took to reach 5% cumulative incidence by treatment group was 32 months for surgery alone and 15 months for RT (P = .02) However, a further look at the data revealed that patients who received regional lymph node radiation (RLNR) reached the 5% cumulative incidence in only 6 months vs 37 months for those who received local RT (P < .0001). There was a median follow-up of 3.9 years and a cumulative lymphedema incidence of 11.4% in the study population. Nearly three quarters (73%) of the patients received RT as a component of their treatment. To pinpoint risk over time, the researchers looked at the percentage of patients in various treatment groups who were diagnosed with lymphedema in each year during the first 5 years post therapy. This was done by plotting the annual hazard rate for the treatment groups. All patients received some mix of axillary surgery and RT.

The groups were as follows: no axillary surgery (n = 180); sentinel lymph node biopsy (SLNB) plus or minus local RT (n = 899); SLNB plus regional lymph node radiation (RLNR) (n = 46); and axillary lymph node dissection (ALND) plus or minus local RT (n = 132); and ALND plus RLNR (n = 264). "The timing of the risk appears to be the most significant within the first 2 to 3 years after treatment," summarized Dr McDuff.


The new study addresses an important clinical question, said Abram Recht, MD, professor of radiation oncology at Harvard Medical School in Boston, who acted as an adviser to the study authors. "If you are going to do surveillance, how long do you have to do it?" he commented to Medscape Medical News. "You can expect that most patients who undergo sentinel lymph node biopsy with or without local RT, which is the largest treatment group, may not need active monitoring past 2 years," he concluded. "The period of the greatest risk is the first 3 years," said Dr Recht, echoing Dr McDuff. "If lymphedema hasn't developed by 5 years, then it probably won't happen," he added. The new results are an argument for "personalizing" a lymphedema monitoring program, said Dr McDuff, adding that more follow-up is needed for high-risk groups.

The goal is early identification and intervention. Shannon MacDonald, MD, associate professor of radiation oncology at Harvard, who acted as discussant of the study, said that the hope with monitoring is "that an earlier intervention for lymphedema would improve outcome." Dr MacDonald told Medscape Medical News that the new study results will also "allow patients to have some alleviation of anxiety as to when to expect lymphedema if it occurs," she said. The findings could also influence "when clinicians have patients come in for monitoring," Dr MacDonald added. This "very large" study makes a "meaningful contribution" to clinical knowledge, in part because there are "limited" data on timing, she said. Lymphedema is less common than in the past, owing to improvements in surgical management, but inaccuracy of measurements has plagued estimates of the incidence of lymphedema, Dr MacDonald said.

The new MGH study used a perometer, a tool that employs infrared technology to objectively measure the limb, which is "more likely to be accurate than a tape measure or other modalities," she said. The perometer was used to perform prospective arm volume measurements of the study patients preoperatively and then postoperatively and in follow-ups at regular intervals. Lymphedema was defined as a >10% relative volume increase occurring >3 months postoperatively. The treatments for lymphedema in the cohort included compression sleeves (88%), manual decompression (52%), and physical therapy–directed exercise (89%). "Patients worry a lot about lymphedema" concluded Dr Recht. "It's a really hard thing in survivorship," agreed Dr McDuff.

Shannen Doherty begins radiation treatments in breast cancer battle: 'I hate it'

Since being diagnosed with breast cancer in 2015, Shannen Doherty has shared each step in her battle against the disease — from hair loss, to "chemo days" to the lessons she's learned. On Monday, the actress opened up again, this time telling fans about the latest step and the anxiety that comes with it.

“Game-Changing” Study Links Cellphone Radiation to Cancer

Robert Piras/Shutterstock

It's the moment we've all been dreading. Initial findings from a massive federal study, released on Thursday, suggest that radio-frequency (RF) radiation, the type emitted by cellphones, can cause cancer.

The findings from a $25 million study, conducted over two and a half years by the National Toxicology Program (NTP), showed that male rats exposed to two types of RF radiation were significantly more likely than unexposed rats to develop a type of brain cancer called a glioma, and also had a higher chance of developing the rare, malignant form of tumor known as a schwannoma of the heart. The effect was not seen in females.The radiation level the rats received was "not very different" from what humans are exposed to when they use cellphones, said Chris Portier, a former associate director of the NTP who commissioned the study.As the intensity of the radiation increased, so did the incidence of cancer in the rats. (The highest radiation level was five to seven times as strong as what humans typically receive while using a phone.) Although ionizing radiation, which includes gamma rays and X-rays, is widely accepted as a carcinogen, the wireless industry has long noted that there is no known mechanism by which RF radiation causes cancer. 

The researchers wrote that the results "appear to support" the conclusion that RF radiation may indeed be carcinogenic.The findings should be a wake-up call for the scientific establishment, according to Portier, who is now a contributing scientist at the Environmental Defense Fund. "I think this is a game changer," he said. "We seriously have to look at this issue again in considerable detail.""The NTP does the best animal bioassays in the word," Portier added. "Their reputation is stellar. So if they are telling us this was positive in this study, that's a concern."Past animal studies have been inconclusive. Most of those suggesting a connectionbetween cellphone radiation and cancer had first exposed rodents to toxic chemicals to induce tumors, which were then shown to grow in response to radiation exposure. But the new study did nothing in advance to stimulate cancer in the animals.The NTP first decided to investigate the carcinogenicity of cellphone radiation in 2001, partly in response to epidemiological studies showing a correlation between gliomas and cellphone use. Some of the studies even showed that the cancers were ipsilateral—meaning they tended to appear on the same side of the head where users held their phones. But other epidemiological studies haven't found links between cancer and cellphones.

The Food and Drug Administration, which is charged with regulating the health aspects of consumer products, says on its website that there is "no evidence linking cell phone use with the risk of brain tumors." It does acknowledge some riskassociated with carrying cellphones too close to the body, but only due to the phones' heating effect. The NTP findings cast doubt on that conclusion: The study was designed to control for heating effects by ensuring that the body temperature of the exposed rats increased by less than 1 degree Celsius. "Everyone expected this study to be negative," a senior government radiation official toldMicrowave News, which was shown partial results from the study earlier this week. "Assuming that the exposures were carried out in a way that heating effects can be ruled out, then those who say that such [carcinogenic] effects found are impossible are wrong."

The study was expensive in part because it required the construction of special exposure chambers that allowed thousands of mice and rats to receive standardized dozes of radiation. For about nine hours per day, for periods ranging from two months to the lifetime of the animal, the rodents were exposed to the RF radiation frequencies used by second generation (2G) phones—the standard at the time the study was initiated.Only the test results for rats have been released so far. Female rats didn't experience significantly higher than normal cancer rates. However, among male rats that received the highest radiation exposures, 2 percent to 3 percent contracted gliomas and 6 percent to 7 percent percent developed schwannoma tumors in their hearts, depending on the type of radiation used. None of the male rats in the control groups developed those cancers.Potentially confounding the results, the rats exposed to radiation on average lived longer than those that weren't. Some outside reviewers argued that the study's authors should have given more weight to that caveat. Reviewers were also puzzled that the unexposed control rats didn't exhibit the usual number of brain tumors. "I am unable to accept the authors' conclusions," wrote Michael Lauer, the deputy director of the National Institute of Health's office of extramural research.In the United States, of about 25,000 malignant brain tumors diagnosed each year, 80 percent are gliomas. Malignant brain tumors are the most common cause of cancer deaths in adolescents and adults ages 15 to 39. 

The authors of the NTP study did not say how their results might translate into cancer risk for humans. But "given the extremely large number of people who use wireless communication devices," they wrote, "even a very small increase in the incidence of disease resulting from exposure to RFR resulting from those devices could have broad implications for public health."

The wireless industry and many media outlets—particularly tech sites, which depend on the industry for advertising—have confidently proclaimed that the science on cellphone safety is settled. You "can't choose to 'believe' in facts because they are, well, facts," Charlie Sorrell wrote in Wired in 2011, after detailing the results of a Danish epidemiological study showing no link between cellphone use and cancer. "So there you go, people. Finally you can ditch that dorky Bluetooth headset. Your brain isn't being microwaved after all."But Portier says there still isn't enough data to consider the case closed. "There are arguments in the literature now that we are at the beginning of an epidemic of cancers," he told me. "There are arguments against that. It is not clear who is right. I have looked through it. It's a mixed bag."

"We spend as a nation god-awful billions of dollars using our cellphones," he adds. "We are significantly exposed on a constant basis and yet we spend almost nothing on research in this area. We need an influx of research dollars if we want to understand what may be happening, and hopefully be able to prevent it while we still have the time."

All Natural Skin Cream - Protect Your Skin Through Radiation Treatment

In our latest video, Ricky talks about My Girls Skin Care cream. My Girls Skin Care cream is non-greasy, free of perfumes, dyes and parabens. We carry this line of skin cream to help our clients who are going through radiation treatments for cancer. It's all natural and great for protecting your skin from peeling and soothing redness.

Treatment allows patients to keep hair during chemotherapy

Read the story here http://bit.ly/1EpXRSE

Lymphedema Challenge

Actress and Academy Award winner, Kathy Bates recently kicked off theLymphatic Education & Research Network's Face of Lymphedema Challege. She proclaimed, "I'm Kathy Bates. I had a double mastectomy 2 years ago and as a result I have lymphedema in both arms. I didn't have a clue what would be involved after surgery and it was hard to find a doctor who would help me deal with, not only the physical effects, but the psychological effects as well. Struggling alone with lymphedema can feel like a punishment for having cancer. That's why I hope to bring awareness."

It's great to have such a high profile spokesperson help to bring awareness and hopefully a cure to lymphedema. Take the Face of Lymphedema Challege: http://lymphaticnetwork.org/get-involved/face-of-lymphedema-challenge/

Winter Tips for Lymphedema Patients

With the arctic blast in full swing, we thought we would share some tips for our friends with lymphedema!

1. Be very careful of ice. Remember you can’t always see ice, it can be what they call black ice, a very fine coat. Walk on surfaces very carefully. You don’t want to  fall.

2. Dress appropriately. Keep your limbs comfortably warm but not  too warm or too tight. Remember that you can swell in wintertime as  well.

3. Always wear appropriate footwear. Make sure you have  worn and broken in your boots, sneakers or your winter wear before you  tread out. Awkward foot gear can cause falls.

4. Moisturize! Remember in wintertime skin can be extremely dry with the heater blowing.

5. Make sure if you happen to get your  garments or socks wet, change them as soon as possible to avoid skin irritations or fungal infections.

6. Wear mittens instead of gloves. They provide more warmth and gloves can also become tight on the fingers if you swell.

7. Keep a winter lymphedema survival kit in your car.  Try to carry extra medications, bandages, extra blanket, batteries,  flashlights, etc with you in case you are stranded somewhere.

Nominate Women in Cancer Treatment to Receive Free Wigs

5 more days to enter Wigs for Wonderful Women! bit.ly/1xzBvt9 

Read what the daughter of our client said about our work in creating a customized wig for her mom while she was going through chemotherapy treatment:

"THE BEST! Words can not describe the expierience we had with Ricky and Kristen. Hearing the words cancer and chemo are devastating. The first thing my mother thought about was loosing her hair. As her daughter I did the research and Ricky Knowels kept on coming up. So we traveled to Houston. WOW, what a great decision!! In 2 days Ricky ordered, colored, and cut a beautiful new wig. He spent so much time talking and listening. And Kristen, well what can I say, the patience of a Saint. always talking about the health side, what to look out for, how to manage expectations...so much that the Dr never covered!!!

I am filled with Gratitude that we have Ricky and Kristen in our lives they are truly ANGELS!!!" - Debra

10 Tips for While Going Through Cancer

10 Tips for While Going Through Cancer

1. Adopt a fighting spirit.
2. It's okay to discourage false cheerfulness and to share how you're feeling.
3. Seek support from your family and friends.
4. As a member of your health care team, learn about your disease and ask questions.
5. Be an active participant in your treatment and recovery efforts.
6. Make positive changes in your lifestyle that will improve your outcomes, such as quitting smoking, incorporating exercise and getting good nutrition.
7. Find something to laugh about each day. Good humor is healthy for the body and soul.
8. For safety's sake, when not feeling your best, ask for transportation assistance to your medical appointments.
9. Participation in a support group can help you learn from others.
10. Pay attention to how you are feeling and get plenty of rest, good nutrition, and take time for personal care.

Enter Our Free Contest for a Chance to Win Wigs!

A Houston-Area woman with any type of cancer can enter by writing about her personal journey with cancer, or a friend or family member of a Houston-Area woman with cancer can share how their loved one inspires them. 

All stories must be submitted by 11:59 pm on Sunday, November 2, 2014. 

Stories can be submitted via email to kristen@hairandwellness.com, or by US mail to: Ricky Knowles Hair and Wellness 4141 Southwest Freeway, Suite 315 Houston, TX 77027 

Contestants will have a chance to win several great prizes, including: 

The grand prize of a completely customized human hair wig, beautifully designed and styled by world-renowned hair duplication master stylist, Ricky Knowles. 

Two (2) - second place winners will receive a completely customized synthetic hair wig, beautifully designed and styled by world-renowned hair duplication master stylist, Ricky knowles. 

Ten (10) - third place winners will receive a beautiful pre-tied head scarf and Neuma travel size shampoo, conditioner and organic scalp treatment. 

Grand prize, second and third place winners will be announced Friday, November 7th at 
www.facebook.com/RickyKnowlesHairAndWellness. 

Grand prize, second place and third place winners will be chosen by an independent judge. 

Every contestant will be automatically entered into a special weekly drawing for a chance to win a beautiful pre-tied head scarf. 

The weekly drawings will be announced every Friday on www.facebook.com/RickyKnowlesHairAndWellness from Friday, November 7th through Friday December 19th for a total of 7 weekly winners. 

For more information about the contest, visit: http://www.hairandwellness.com/winwigs.html 

Women's Cancer Wig Giveaway!

Are you or do your know a wonderful woman going through cancer treatment? Then enter our giveaway contest by emailing Kristen at kristen@hairandwellness.com and tell us your story or your loved one's story. We are looking to give away a free human hair wig like the one our client, Rosemary is wearing. She loved her fully customized wig so much that she named it "confidence!" Our world-renowned hair duplication master stylist will color, cut and customize your new hair to give you extra confidence while going through cancer treatment. Our contest is open to women with any type of cancer. We are thrilled to give away "Wigs for Wonderful Women!" For more information, visit www.hairandwellness.com

8 Skincare Tips For Cancer Patients And Survivors

CLEANSE WITHOUT STRIPPING SKIN
Avoid cleansers that use harsh surfactants or sudsing agents that actually strip the skin of its environmental protective barrier. Creamy cleansers are less alkaline than soaps and gels and may be used at night to wash the face. Consider eliminating your morning cleanse and opting instead for a gentle splash of tepid water.

RETAIN MOISTURE AND AVOID TRANS-EPIDERMAL WATER LOSS
In non-science speak TEWL is the loss of water from skin through evaporation. You can make a mist with green tea or white tea that is safe to use whenever your skin needs hydrating. In hot weather, refrigerate the tea and spritz it on cold—very refreshing! Since green teas have catechins and polyphenols that provide UV protection take a big bottle with you to the beach. Spray it on or drink it, it’s all good.

USE YOUR SUNSCREEN
Wearing sunscreen every day is the best way to prevent basal and squamous cell carcinomas, and non-nano zinc oxide is the ingredient you want to see in your sunscreen. Zinc oxide because it is safe, even for babies, and it provides full spectrum UV protection. Non-nano because the larger the particle the smaller the risk that the zinc oxide will penetrate past the epidermal barrier. Nano-particles are often coated to achieve greater stability, but the coating can break down to generate free radicals that cause cellular and DNA damage.

READ THE LABELS ON YOUR PERSONAL CARE PRODUCTS
Because we absorb 60 to 70% of what we put on our skin it stands to reason that topical substances will have an impact on our health.

This is a short list of the chemicals/ synthetics to avoid and what you can use instead:

• Triclosan. Lab studies link this ingredient to cancer. It is found in many products, including anti-bacterial hand washes and wipes. Plain soap and water works just as well.
  
• Fragrance or “parfum.” Most contain contaminated aromatic hydrocarbons that are carcinogenic. Look for fragrance-free or products with essential oils only.
  
• Parabens. Used for preservative purposes, ingredients belonging to the paraben family are endocrine disruptors. Look for paraben-free products.

AVOID DRYING INGREDIENTS AND PROCEDURES
Products containing alcohol can dry skin that may already be extra dry due to certain medical procedures. Sometimes even “moisturizers” contain denatured alcohol. Avoid this ingredient, but don’t confuse it with fatty alcohols like cetyl and stearyl alcohol, which are fine. Creamy cleansers are less alkaline than soaps and gels and may be used at night to wash the face. In the morning a splash or two of tepid water is enough.

EAT WHOLE FOODS
By whole foods, we mean foods that are not processed. Eat these as much as possible. Whole foods provide better nutrition to your body and contain the least amount of preservatives and other harmful chemicals. Quick tip: when eating out, stick to fresh salad bars and food that is grilled or steamed.

EAT A BALANCED DIET
According to the Mayo Clinic, it is important to vary your diet to include lots of fruits and vegetables, as well as whole grains. When it comes to selecting your entrees, the American Cancer Society recommends that cancer survivors:

• Eat five or more servings of fruits and vegetables every day.
• Choose healthy fats, including omega-3 fatty acids, rather than saturated fats or trans fats.
• Select proteins that are low in saturated fat, such as fish, lean meats, eggs, nuts, seeds and legumes.
• Opt for healthy sources of carbohydrates, such as whole grains, legumes, and fruits and vegetables.

This combination of foods will ensure that you're eating plenty of the vitamins and nutrients you need to help make your body strong.

LIMIT ALCOHOLIC BEVERAGES
Studies have found a link between alcohol intake and the risk of getting a number of cancers: Mouth Throat Larynx, Esophagus, Liver and Breast.

Alcohol use may be linked to colon cancer, too. In people who have already been diagnosed with cancer, alcohol intake could affect the risk for new cancers in these sites. Alcohol intake can also increase levels of estrogens in the blood. In theory this could increase the risk of estrogen receptor-positive breast cancer coming back after treatment, but studies so far have not addressed questions like this.

I Am Scheduled To Undergo Mastectomy Surgery. What Are Some Recovery Tips?

Going through mastectomy surgery can be extremely taxing on both your body and your emotions.  Here are some tips to help you when you get home.

Follow Your Doctors Instructions
Follow all your Doctor’s instructions in regards to wound care, rest, lifting restrictions, driving, surgical bras and garments etc.  Most importantly if your Doctor says don’t do something – listen and don’t do it!

When discharged from hospital ask all your questions (to Doctors and Nurses) no matter how insignificant you may think they are and have contact numbers for when you get home and have another question or concern.

Rest, Rest and then Rest Some More
Take it totally easy the first full week.  Take multiple naps, watch movies, read books and relax.  Have people do almost everything for you to avoid overdoing it.  Be warned it is super easy to overdo it when you first get home.  Even opening the fridge, opening drawers, picking up stuff and carrying laundry is too much!  Also washing your hair is too much in the first week as you can’t lift your arms so book into the hairdressers.  If you do too much you will pay for it that night and the next day with muscle pain and a very sore body.

Fatigue is normal.  Gradually increase your activity and ease back into your ‘normal’ routine.  Remember most women require four to six weeks off work to recover.  A mastectomy is a major invasive surgery and body tissues need rest to recover and repair from the procedure.  By over doing it you are slowing down your recovery and healing.

Remember no strenuous activity or lifting for approximately six weeks following your surgery (your Doctor will tell you when you are ready).

Medication and Pain Control
Get all your scripts filled immediately (with non child proof caps – you will find the push down and turn type difficult to open with limited arm strength) and in a notebook write down what you take and when.  It is easy to lose track of whether you have taken your medication or not and writing it down ensures you have and have taken it at the right time (and haven’t taken a double dose).  Writing down your pain medication is also useful as it allows you to slowly reduce the amount and strength over a few weeks.   

When it comes to pain management take your pain medication regularly.  The job of the medicine is to avoid pain.  If you get in too much pain you will feel miserable waiting for the pain medication to kick in.  Also studies have shown that a patient who has less pain recovers better.

Medical Supplies
It is useful to have the following at home:

• Laxatives as the pain medications/general aesthetic can make you constipated
• Ibuprofen
• Acetaminophen
• Post scar treatment (although you won’t need this until your tape/bandages have been removed)
• Spare dressings (although in some cases you won’t need these as your Surgeon will remove your tape/dressings at your first follow up appointment)

Sleeping
You will most likely need to sleep on your back for at least three or four weeks (definitely the case if you have had a double mastectomy).  This is actually harder than it sounds if you are used to sleeping on your stomach or side and getting sleep is really important for your recovery (and feeling rested and able to cope in general).

Exercise
Follow your Surgeon’s instructions regarding exercise.  Usually you will be encouraged to walk and have been doing laps of the hospital.  When you get home walk a bit further each day.  Listen to your body and stop if you get tired or dizzy.  Resume more physically active exercise, running, swimming etc. once your Doctor gives approval and gradually build back up to your pre surgery levels.

It can be frustrating, for example if you were a runner and feel great but still have bruising and swelling and your Surgeon says no running (raising your heart rate/pulse slows down healing) – listen, grit your teeth and DON’T RUN.

Get Comfortable
New clothes may be necessary to accommodate your surgery.  Specialty camisoles are a great option because they provide a light layer that can hold drains.  Many styles have pockets to hold forms and can be worn under your clothing.  You may also opt for a robe that is made with pockets for breast forms or ice packs and also can support the weight of fluid from drains.

You will want to get a prosthesis or breast form around six weeks after surgery.  Typically at this time the swelling will have reduced.  Make sure that you see a BOC or ABC certified fitter.  These certifications ensure that you are fitted properly.  A certified fitter can also help you find a well-fitting bra to act as a good foundation for style and comfort.

Drink Water
It is very important that you drink plenty of water during your mastectomy recovery.  While having surgery, a lot of blood and other fluids are removed from the body and you will have to reinstate these in the days following surgery for getting the best recovery results.

Eat Well
To assist your recovery each a diet rich in nutrients – in other words eat healthy.  For your cells and tissues nutrients are the building blocks and will assist your recovery.  So eat a well balanced diet of to help your body.

Support and Talking to Others
Regardless of your level of support from family and friends, you may find it helpful to talk to others who have gone through a mastectomy.  Talking to others who have gone through the same decision making process and procedure will give first hand understanding and support.  It is a major deal both physically and emotionally to undergo a mastectomy and it helps to connect with other women who have gone through what you are feeling.

You have just come home from major surgery and most likely haven’t finished your reconstruction so be aware that your chest/breasts/body will not look perfect/normal and you still have recovery and further surgery to go – however you have just achieved something amazing so try to be proud of your body.

Our team at Ricky Knowles Hair and Wellness is here to support you through your journey.  We can connect you with a support group that fits with your schedule, fit you for a mastectomy prosthesis, help you with with lymphedema preventative care, and serve as your patient advocate by untangling the insurance benefit web.  We have a BOC, ABC mastectomy prosthesis fitter and an insurance specialist on staff.   In addition to mastectomy forms, we also carry post mastectomy products such as camisoles, bras and robes.  If you are ready for us to partner with you, please call us at 713-623-4247.

I Just Finished Breast Cancer Treatment, Am I at Risk for Lymphedema?

Women who have undergone breast cancer surgery and/or radiotherapy are particularly at risk for developing lymphedema.  An individual who has had any type of breast cancer surgery or therapy is at risk of developing lymphedema. The National Lymphedema Networks 10 Precautions for Women at Risk of Lymphedema include the following:

1. Do not ignore any slight increase of swelling in the arm, hand, fingers, neck, or chest. Call your doctor. The sooner treatment begins, the more effective it will be.
   
2. Never allow an injection, needle stick, or blood pressure cuff in the affected arm. Breaks in the skin allow infection causing bacteria to enter. Pressure on the arm may damage existing lymphatics.
   
3. Avoid heavy lifting with the affected arm. Never carry heavy handbags with over-the-shoulder straps. Be especially careful lifting children and groceries. Do not lift more than 15 pounds at a time as excessive weight lifting can place a burden on the lymphatic system.
   
4. Do not wear tight jewelry or elastic bands on the affected arm/hand as these may obstruct the lymphatics.
   
5. Avoid injuries to the arm such as cat scratches, cuts, sunburn, insect bites as these may serve as a portal for bacteria to enter and cause infection.
   
6. Avoid extreme temperature changes when bathing, washing dishes. Stay out of the sauna and hot tub. Keep the arm protected from the sun. Temperature changes may lead to increased swelling.
   
7. Wear gloves while performing gardening or housework. This will prevent any type of minor injury that could result in increased swelling.
   
8. Maintain a healthy diet and lifestyle. Light exercise is beneficial.
   
9. Wear well-fitted supportive bras that are not too tight and without wires. Avoid a heavy prosthesis. These may put extra pressure on the collarbone and shoulders.
   
10. Wear a compression sleeve in airplanes, as the change in pressure may  increase the risk of swelling. Remember to drink plenty of water.

For more information about breast cancer treatment and lymphedema, contact Kristen at 713-623-4247. She is a certified BOC, ABC custom garment fitter and can help you find the right compression garment for your needs.