Bra Day in Toronto

We at Bressante know that it is important for those experiencing breast cancer and mastectomy to know the options available to them after breast surgery. Attending Bra Day Toronto is one of the ways to gain insight, knowledge and hear of first-hand experience from real women who have been through it all. We had a great time making connections and networking when we attended in 2015, and we are sure looking forward to the event again tonight! We hope to bring awareness to our fitting event happening in Toronto on November 29th and 30th where we will be fitting women with prosthetics and bras and providing education about our products. Please stay tuned for more info on this event soon, and enjoy Bra Day tonight, Toronto!

Questions and Answers with Lymphedema Expert Dr. Emily Iker

Interview with Lymphedema Expert Dr. Emily Iker

Dr. Emily Iker

Dr. Emily Iker is director of the Lymphedema Center in Santa Monica. She is a well regarded Physical Medicine and Rehabilitation specialist focusing on the diagnosis, management and treatment of lymphatic disorders. 

 

Iker teaches and lectures annually, nationally and internationally, and is an instructor for Lymphedema Management courses. She is a member of the Scientific Committee for the 26th World Congress of Lymphology taking place in Barcelona, September 25 to 29, 2017 [http://www.lymphologycongress2017.com/]. Here she will lead the Lymphedema Management course as well as present several lectures on Lymphedema and Lipedema.

 

We interviewed Dr. Emily Iker over the phone.

 

Q What is Lymphedema?

 

A According to the International Congress of Lymphology lymphedema is “an external or internal manifestation of lymphatic system insufficiency and deranged lymph transport.”

 

Q How does it manifest physically?

 

A Swelling, pain, fatigue and a diminishment of joint mobility.

 

Q I don’t think a lot of people understand how important the lymphatic system is …

 

A I don’t think a lot of physicians understand how important it is …

But it is very important, paralleling the circulatory system. In layman’s terms the lymphatic system has several functions. Its number one function is to filter impurities, the debris and toxins on the plasma level. And, it is also functions as an immune system.

 

When we have primarily secondary lymphedema (secondary meaning the condition is due to some intervention, such as breast cancer surgery, where the lymph pathways were interrupted), there is a stagnation of the lymph system and the lymph vessels become engorged. Their transport capacity is delayed. And then we have the increased permeability of protein cells into the tissue along with the fluid, which then becomes lymphedema or swelling.  In early phases the swelling may not be so visible or the patient’s sensation may be lacking because they just had surgery. And especially after breast cancer, the area of the axila, or armpit, may be numb. So they may not feel it yet. But then when it becomes a little bit larger there is a sensation of pressure, tension, heaviness – and then it is true lymphedema.

 

Q Is it inevitable that everyone who has to undergo surgery for breast cancer or any surgery that interrupts the lymphatic system will get lymphedema?

 

A There is a variation in the statistics. Up to 50% of patients may end up with lymphedema.

 

Q Is there any way to prevent it from happening?

 

A Well today we have better technology in surgical approach than we had maybe 20 years ago. Now we have what we call sentinel node – where a blue dye is used on the first lymph node that’s involved so the surgeon is able to recognize it during surgery and remove a lesser number of lymph nodes. This is a good development for breast cancer patients, very good for melanoma patients (Dr. Morton in Santa Monica is the one who developed the sentinel node strategy). But just recently I had a patient who had prostate cancer, a fairly young man, and 80 lymph nodes had to be removed; 63 of those were positive. So we still don’t have sentinel nodes for all cancers.

 

In the old days there were many lymph nodes sacrificed and maybe 1 or 2 were positive. Now we can be a little more precise. 

 

Let me also point out too that once a breast cancer patient has had surgery (lumpectomy or mastectomy) and then radiation, the incidence of lymphedema onset is far greater than if the treatment is just surgery and chemo.

 

Q Why is that?

 

A Scarring from the radiation treatment makes the patient more prone to developing lymphedema.  The combination of those two things almost guarantees that you’ll get lymphedema.

 

Usually it develops very shortly after surgery and radiation treatment. But I’ve seen patients who came down with lymphedema 30 years later. Most likely they had a very good lymphatic system and it was able to be compromised but keep going.

 

 

Q Before we go on with these questions, would you talk a little bit about your own journey and career?

 

A  I started in surgery – my aspiration was to be a surgeon and I went through pre-med while on chemotherapy – because I had lymphoma. Unfortunately, I had two episodes of lymphoma, the second 6 months after the first one and I had surgery and radiation and chemo – this was my undergraduate time. Then I went to medical school while I was in remission. During my surgical residency in my second year, I experienced excruciating pain and my right leg swelled up and that was the onset of my lymphedema.

 

The reality was I couldn’t continue my surgical training and I went into rehab medicine instead, which I completed in New York. After completion my lymphedema continued. At that time no one really understood the lymphatic system. I practiced a little bit on my own and, when I moved to California, I was fortunate to meet Professor Albert Leduc, an authority in lymphology. He is from Belgium and he was able to come to the US to give a lymphedema management course. I was a student and it was enlightening because finally I found someone who really understood the lymphatic system. It was wonderful that I could take the course and shortly after I started to practice lymphedema management. Now I work with a diagnostician, a clinician and we do lymphedema management for all kinds of lymphedema, even lipidema.

 

Q What is that?

 

A Lipidema is a fat disorder. Unlike those with lymphedema, these patients have symmetrical enlargements, especially in the lower extremities but the feet are spared, they’re tiny and not involved in early phases. The tissue consistency is very soft, buttery and is essentially a fat. There is a genetic component involved, mostly for women and there is hormonal influence. We see early onset in puberty and then it progresses if it’s not treated.

 

Q So how does one treat lymphedema?

 

A I’ll tell you my routine. I do still have lymphedema, but I am fortunate in that I can practice and be active – but I do wear a compression stocking on a daily basis. Without it my lymphedema would expand much more than it has.

 

 I am blessed because I have almost 10-year old twins later in life (unfortunately my husband passed away when they were 2) – I am both mother and father. I get up early in the morning and I spend a few minutes massaging my leg – every day. And then I put my compression stocking on and go about my day. Even though I would say I am between stages 1 and 2 of lymphedema, at the end of the day my leg is swollen more than in the morning – even though I wear a compression stocking with 30 to 40 ml mercury pressure. I am active, I walk my little dog and I do like jogging, I love to swim, which is the best exercise for both lipidema and lymphedema. Because of the pressure of the water and moving every single muscle in the body plus moving the diaphragm – it helps to move the lymph from one segment to the other faster. So for all patients I highly recommend swimming as much as possible. And then at the end of the day I massage my leg and I do stretching exercises and once in a while I do a compression pump treatments at home and in my office as well. My staff treats me.

 

Q What is compression pump treatment?

 

A It involves a special sleeve attached to a pump. From distall to proximal it applies external pressure in segments. It presses on the involved site and there is a period of inflation and a period of deflation so it induces gentle pressure in sequences that stimulates and increases the flow of the lymph. This is very gentle pressure, more gentle than say a blood pressure cuff, which can be painful. With this treatment many patients simply fall asleep during the treatment. The key for lymphedema and for lipidema is compression and that can be via bandaging or compression pump treatment. In my practice I’ve found when we use the compression pump we can get 30% more reduction in volume in stage 1 or 2 lymphedema in about 2 weeks with daily treatment.

 

The other key is to have early diagnosis and early intervention. And in early phases after surgery (lumpectomy or mastectomy) it is important to start the treatment right away, before the patient is complaining about arm sleeves being too tight, or their clothes don’t fit and so on. With early intervention we have much better outcomes in the long run. And we don’t get disability or poor quality of life.

 

Q In your opinion, is there sufficient information circulating about lymphedema among surgeons and doctors treating women?

 

A It is much better than it was 20 years ago. I started to practice in 1992, back then they didn’t even know how to spell the word ‘lymphedema’. I remember way back when one insurance company refused to pay for the treatment and their explanation was that their policy was to not pay for prevention. We have much better awareness now, and I would attribute that to the women’s movement around breast cancer and the consequences of breast cancer. We now have much better awareness about what lymphedema and what lymphedema treatment is. Unfortunately though, even some of my colleagues still downplay the importance of the lymphatic system. They may look at the legs and say ‘oh well it’s a little bit swollen, no big deal’.

 

Q And it’s not something that can be cured or eradicated once a patient has it?

 

A   Probably not. In my practice and in my decades of treating patients with lymphedema I’ve observed that upper body lymphedema is much easier to treat than lower body or facial or genital lymphedema. At the Center we see it all and we treat it all. It can be a lifelong condition.

 

Q How do undergarments and prosthetics figure into how you might treat a breast cancer patient who has developed lymphedema?

 

A It is absolutely essential for these patients to have the correct garments.

There are some studies where they are measuring the volume of the extremities even before surgery and then right after surgery so they can predict who will get lymphedema. But again it’s not only removal of the lymph nodes, it’s also the issue of disturbing the lymph pathways. After surgery it is essential that the patient wear an appropriate compression garment that has been properly fitted. For breast cancer patients, choosing the right undergarment and prosthetic is also important. I love the lightweight one that Bressanté makes. I don’t want to sound chauvinistic but it takes a woman to design one.

 

Q What about things like flying? Do you remove compression garments for travel?

 

A For long distance driving, yes. If compression stockings fit well they should not give any problem when flying. For long distance flights, patients are encouraged to walk during the flight, not just sit.

 

Q It can be difficult for patients to get the kind of information and advice that is really helpful. Can you recommend any reliable resources?

 

A  You know they are so much better now than a decade ago and there are so many companies that make these products. The most important thing for the patient is to wear the compression sleeve and when there is  too much swelling in the armpit area I recommend Danskin, something with a longer arm that covers the armpit area. I would also recommend the book on nutrition that I co-authored: The Lymphedema and Lipedema Nutrition Guide available from Amazon.

 

 

RESOURCES

 

Lymphedema Center in Santa Monica

http://www.lymphedemacenter.com/

 

With lymphedema spokesperson, actress Kathy Bates discussing lymphedema on The Doctors:

http://www.lymphedemacenter.com/blog.html

http://www.thedoctorstv.com/videos/kathy-bates-secret-health-struggle

Full list of clips: http://www.thedoctorstv.com/search?query=lymphedema

 

Lymphatic Education & Research Network (Le&Rn)

http://lymphaticnetwork.org/

 

Facebook page: https://www.facebook.com/LymphaticResearch

 

Canadian Lymphedema Framework (CLF)

http://canadalymph.ca/

 

Lymphedema and Lipedema Nutrition Guide available on Amazon

 

 

 

Dr. Jen Gunter Speaks Out Against Misinformation About Women’s Health

JUSTIN SAMANSKI-LANGILLE / WINNIPEG FREE PRESS
California-based doctor Jen Gunter poses Friday in her hotel lobby. Gunter is fighting medical quackery and pseudo-science in her spare time.
170811 – Friday, August 11, 2017.

 

The internet is a vast world of information. Sometimes it can be a challenge to sift through all of the false information to find the truth. Dr. Jen Gunter is one woman putting true, fact-based information out there about women’s health that we can feel certain is coming from an expert. She is a Winnipeg-raised obstetrician-gynecologist who has often spoken out against Gwyneth Paltrow’s website Goop, where Paltrow shares information and sells women’s health items such as a $55-66 jade egg for “vaginal cleansing”.

Read the Winnipeg Free Press article here.

 

 

 

Post-mastectomy fashion: 5 things I wish I’d known before my mastectomy

This article is from anaono.com check them out!

 

You were prepared for your treatment. You were prepared for your surgery. You read everything you could get your hands on when you were diagnosed with cancer. But nothing prepares you for the day when the post-mastectomy haze clears and you are standing at the mirror, wrapped up like a mummy, convinced the doctors accidentally stitched an elephant to your chest.

You blink at your new body and try to wiggle out of the robe that has become your go-to outfit of choice. Then you stare into your closet. This is not like those pre-cancer days of sighing about not having anything to wear; this is real. As you rack your brain, you realize there wasn’t anything in your research that talked about living life after the mastectomy.

But don’t worry, because I’ve been there. Many of us have. And we’re happy to share all the things we wish we’d known when it was time to ditch the flannel and start dressing like a woman again.

The first thing I noticed post-mastectomy and reconstruction was traditional lingerie no longer fit me. I had no idea putting something as simple as a bra on would be so challenging. I would say I wish I’d known that ahead of time, but in hindsight, not knowing is what put me in a position to change the lives of others and start dressing women after cancer with my lingerie line, AnaOno. Now I get to listen to a lot of women talking about their challenges after a mastectomy, and I know I am not the only one. And neither are you.

Read the rest of the article here.

Breast Changes. What is Normal?

We all know to regularly check our breasts for odd or new changes, as they can be a sign of something much more serious.

Most women have changes in their breasts during their lifetime. Many of these changes are caused by hormones or can be caused by the normal ageing process. Most of these changes are not cancer; they are called benign changes. However, if you notice a breast change and you have suspicions or are uncertain, don’t wait until your next mammogram. Make an appointment to get it checked.

  • Young women who have not gone through menopause often have more dense tissue in their breasts. The Dense tissue has more glandular and connective tissue and less fat tissue. This kind of tissue makes mammograms harder to interpret–because both dense tissue and tumours show up as solid white areas on x-ray images. Breast tissue gets less dense as women get older.
  • Before or during your menstrual periods, your breasts may feel swollen, tender, or painful. You may also feel one or more lumps during this time because of extra fluid in your breasts. These changes usually go away by the end of your menstrual cycle. Because some lumps are caused by normal hormone changes, your healthcare provider may have you come back for a return visit, at a different time in your menstrual cycle.
  • During pregnancy, your breasts may feel lumpy. This is usually because the glands that produce milk are increasing in number and getting larger.
  • While breastfeeding, you may get a condition called mastitis. This happens when a milk duct becomes blocked. Mastitis causes the breast to look red and feel lumpy, warm, and tender. It may be caused by an infection and it is often treated with antibiotics. Sometimes the duct may need to be drained. If the redness or mastitis does not go away with treatment, call your health care provider.
  • As you approach menopause, your menstrual periods may come less often. Your hormone levels also change. This can make your breasts feel tender, even when you are not having your menstrual period. Your breasts may also feel lumpier than they did before.
  • If you are taking hormones (such as menopausal hormone therapy, birth control pills, or injections) your breasts may become denser. This can make a mammogram harder to interpret. Be sure to let your healthcare provider know if you are taking hormones.
  • When you stop having menstrual periods (menopause), your hormone levels drop, and your breast tissue becomes less dense and fattier. You may stop having any lumps, pain, or nipple discharge that you used to have. And because your breast tissue is less dense, mammograms may be easier to interpret.

To read more, click on the link below!

https://www.cancer.gov/types/breast/understanding-breast-changes

Take This Survey and Make a Difference for Cancer Survivors Worldwide

Last year, Denise Stewart coordinated the first online Breast Cancer Summit. Experts from around the globe gave talks on subjects relevant to those who are facing changes and challenges after their breast cancer diagnosis and surgery. Many people took part in the online learning and now she is doing it all again! Answer a few of the questions from this online survey so that the Summit can offer what you need most!

“The Breast Cancer Rehabilitation & Wellness Summit being launched July 31 and the goal is to help people across the world take action to recover well after breast cancer.

Can you help guide us? We want to deliver the best online health Summit for breast cancer survivors. It will be the first ever online Breast Cancer Rehabilitation & Wellness Summit. We need to know your thoughts about what information you need to help you recover better.

Women and men across the world have similar difficulties during their recovery stage and when trying to achieve their best health and well-being after the intensive breast cancer treatment.

The Summit is a health awareness project to help people learn more about specific health problems and in this case, it is the many side effects and problems that arise after having a breast cancer diagnosis and medical treatment.”

Click the link below to enter the survey. It will only take about a minute to click through the questions.

https://docs.google.com/forms/d/e/1FAIpQLSdC826-UUB4qsewPzUjSBQGrzp80Guq1nYi0b75rgLGNMShHw/viewform?c=0&w=1

Popping Up In A Town Near You!

So far Bressante has had TWO successful Pop Up Shops in Selkirk and Brandon, Manitoba! 

The Pop Up Shops have been led by the wonderful Linda and Jeannette. Our first Pop Up was at Home Health Care Pharmacy in Brandon.

Then we hooked up with Jeanie, the owner of Bella Ragazza Lingerie and Swimwear Boutique in Selkirk. 

Both were a great success! We fitted a few ladies with their new Bressante prosthetics and we had even more referred to our clinic in Winnipeg!

Thank YOU for making these Pop-Ups a great hit. We hope to put on many more! 

If you want us to put together a pop-up shop in your establishment, give us a call @ 1-800-607 -7645

Breast Cancer in Young Women

 

Young women can have breast cancer. It’s not as shocking as it once was when the news comes out that a woman in her twenties is diagnosed with breast cancer. Chances are slim, but it does happen. Young women who develop breast cancer so early have the stress of possibly becoming infertile from the chemotherapy, radiation and anti-estrogen medication to handle when diagnosed with cancer that is hormone sensitive. Having eggs frozen, possibly not being able to ever breastfeed are both painful to come to terms with, and exhausting. 

It’s not as shocking as it once was when the news came out that a woman in her twenties was diagnosed with breast cancer. The chances these days are still slim, but it does happen. Young women who develop breast cancer so early have the stress of possibly becoming infertile from the chemotherapy, radiation and anti-estrogen medication. Having eggs frozen, possibly not being able to ever breastfeed are both painful to come to terms with, and exhausting. 

Lindsey Hope Finkelstein was diagnosed with breast cancer after she noticed her right nipple bleeding. She had an ultrasound and then a biopsy. She was tested negative for five genes linked to breast cancer. Somehow she still developed a tumour behind her right nipple. The doctors still don’t know what caused her cancer, and so she has donated her tumour to research. Read more about her inspiring journey at the link below.

 

 http://montrealgazette.com/news/local-news/when-young-women-get-breast-cancer

Spring Allergies and Remedies

 

Canadians are often very happy to see Spring around the corner, but roughly 25% of us have to deal with some form of sinus discomfort once grass and tree pollen become more prevalent in our environment. Allergies in the springtime not only affect your productivity and your ability to go outside but can also affect how well you sleep and your energy levels overall. Having the right ways to treat your allergies can make all the difference when it comes to enjoying the warmer weather with friends and family. 

Always make sure you get a proper diagnosis. You’d be surprised by some of the less well-known symptoms of allergies and hay fever.  

Natural Treatments for Seasonal Allergies: 

  • Stinging Nettle Extract is said to reduce symptoms better than over the counter medication by 48%.
  • Multistrain Probiotics such as Lactobacillus and Bifidobacterium may prevent allergy reoccurrences. 
  • Vitamin C either taken orally or intravenously significantly reduce histamine levels.
  • Diets high in fruits and vegetables have been shown to elevate antioxidant levels in the body, which may have protective effects against hay fever. 

 

Information is taken from Sage magazine.

New Beginnings: The Triumphs of 120 Cancer Survivors Review


Bill Aron
is a photographer whose photos have been exhibited in major museums and galleries throughout the United States and Israel, including the Museum of Modern Art, the International Centre for Photography and several other galleries worldwide. Aron lives in Los Angeles with his wife and two sons, where he is most likely the only photographer with a PhD in sociology.

His most recent book, “New Beginnings: The Triumphs of 120 Cancer Survivors,” focuses on survivors who have not let their diagnosis prevent them from living their lives to the fullest; in many cases, the diagnosis has served as motivation to better their lives. The book invokes strength, resilience and a positive outlook for anyone beginning their cancer recovery journey. Aron himself said he wanted to create a book that encouraged even the most cynical individual.

The book is worth a look; there is a story on just about every page of courage and overcoming one of life’s most difficult curve balls. You’ll enjoy the stories and will probably want to share them with your friends. 

A selection of Bill Aron’s work can be seen on his web site, www.billaron.com.

His book can be found here