Eastern Idaho Regional

Medical Center presents

The Pink Pages

Sunday, Oct. 13, 2013

Fighting
together
Support makes
all the difference in
the battle against
breast cancer

2 Sunday, Oct. 13, 2013

Breast Cancer Awareness

Post Register

Fighting together
When Kari Green lost her hair during chemotherapy treatments, her husband Jared shaved his head to match. (Submitted photo)

Support makes winning the battle easier

By Casey Archibald
carchibald@postregister.com

would laugh because I would

turn my head and sit on my
hands. I thought that was really
ari Green married her
great of my husband [to stay on
husband on Sept. 9, 2009.
the phone with me]. Even though
Nine months later she
he was busy and he was out there
was diagnosed with breast cancer.
supporting us and doing what he
She was just shy of her 35th
needed to do, he was still worried
birthday.
about being there to support me.
At the time, the couple was
Green said Doctor Shull
living in Pinedale, Wyo. working
warned her that one of the hardin the oil fields, although Green
est parts of the experience would
was originally from the Idaho
be losing her hair. At the time
Falls area.
she didnt believe it, but when
Green said in the weeks prior
it happened it was difficult to
to her diagnosis she felt some
overcome.
pain in one of her breasts but at
You know that [losing your
first she assumed it was a bruise.
hair] is going to happen, but
She mentioned the pain to some
nothing can prepare you for
of her co-workers who assured
when you look down and see all
her that it was no big deal. They
that hair, said Green.
said it couldnt be breast cancer
She said the process started
breast cancer isnt painful.
gradually right before round
One morning, Green asked
three of her chemotherapy. At
her husband to feel the area to
one point her husband was away
determine if it felt different than
and she remembers hoping he
the other breast. He stood behind
would see her one more time
her and she watched him in the
with her hair. He did, and the
mirror. She saw the blood drain
morning after he came home
out of his face when he found
Green was in the shower and
the 3.5 centimeter lump. I dont
looked down to see the floor covknow what that is, but something
ered in her hair. She screamed.
is wrong, he said.
My husband was so sweet, he
A while later, Green drove to
just ran right into the bathroom
Idaho Falls for her yearly check
and pulled the shower curtain
Casey Archibald/carchibald@postregister.com back and just grabbed me and
up. A mammogram and an ulGreen, left, inspired Nathan, the lead radiation therapist at Eastern Idaho Regional
trasound concerned the doctors, Kari
lifted me out of the shower and
Medical Center, to install a disco ball as part of patients celebration to mark the complewho then scheduled a biopsy of
said Its okay, its okay. I told him
tion of their radiation treatment.
the area.
there was a mess and I had to go
A few days later, Green and her serious, said Green.
clean it up. He told me he would
the cancer center.
husband were on their way back
take care of it, said Green.
Doctor Shull went through the
This is their jobthey have
to Pinedale when they got the
Green went to her hairdresser
pathology report with Green and lives that are separate from this,
call.
her family. She said he was pabut they were always great to talk shortly after that experience to
[The doctor] said I am sorry
get her head shaved. Her husband
tient and caring and took things
to me, reassure me and take the
to tell you this but you have
came with her for support, but
slowly to allow everything to sink time to make me feel like I was
breast cancer. I just kept going.
in. Shull was able to fit her in at
special, said Green. They really he surprised her by saying Ill
She said I had an appointment
the end of the day and missed
cared about what was happening go first. The stylist shaved both
in the morning with Judy Jones
heads that day.
dinner with his family so he
in my life. Sometimes that was
and she told me to turn the car
Green wore her wig out in pubcould take his time with his new
the only thing that could get me
around. My leg was ramrod
lic
for the first time when she and
cancer patient.
through the doors and back into
straight on the gas. My husband
her husband took her stepson,
One of the hardest things
that chair.
was rubbing my leg and trying
Tray, to the movies. She didnt
[about having cancer] is that you
Green had chemo every three
to get me to stop the car. I didnt
think you have control over your weeks. She said her husband tried realize how tight it was until
want to acknowledge that this
life, but you dont, said Green.
to be home during her treatments then. She lasted about halfway
was happening and that my life
through the movie, but the pain
One day everything is fine,
as often as he could so he could
was going to change. I tried to tell and the next day you have this
and discomfort became too much
take care of her, but when he
her that this was not going to fit
to handle.
life-changing event that comes
couldnt be there in person he
into my plan.
My stepson knew that I had
out of nowhere and changes
tried to be there in other ways.
Green met with oncologist Dr. absolutely everything.
cancer, but I was trying to be
We had a little thing we did
Christian Shull. Green was surbrave and I didnt want to scare
Green said one of the hardest
when the nurse came over to
prised to see her fathers truck in things about her chemotherapy
him or anything like that, said
access my port for the day. I
the parking lot of the office.
Green.
treatments was simply getting
would call [my husband] on the
I never anticipated him
Her husband told her to take
through the door, but one thing
phone and that was our way of
being there because I know how
the
wig off so she could feel
that helped was the relationship
doing it together. I was deathly
important work was to him. That she had with the staff members at afraid of needles and the nurses
better, but Green was concerned
was when it hit me that this was
about embarrassing her ten-year-

old stepson.
I leaned over and asked my
stepson, Would it be okay if I
took the wig off? I dont want to
embarrass you. And when we
leave you can walk in front of me,
its okay. Tray said No Mom, its
okay, you can take it off. I took it
off and he was like, Oh cool! No
hair, this is awesome.
When the movie was over, the
Greens started to walk out toward
the doors and Tray reached back
and grabbed his stepmothers
hand. Green said she whispered,
You dont need to hold my hand,
its okay, Im alright, to which
Tray replied, No, I want to.
After chemotherapy, Green
underwent six weeks of radiation,
starting in November and ending
in January.
When we started radiation I
was kind of taken aback when
Nathan walked in the door one
day, said Green. Heres a young,
good-looking kid and I am
supposed to take my shirt off and
line up under a laser and he is going to see everything. I felt a little
uncomfortable, but whenever I
was on the table and whenever I
had to take my cape off, he always
looked me in the eye and always
made me feel welcome and like
everything was going to be okay,
almost like a big brother would.
Green remembers feeling alone
in the room when the laser was
working. There was one instance
in particular when she was wondering if anyone was really there.
She heard Christmas music in
the distance between the popping
sounds of the laser.
Green said she thought to herself, How weird is this? I am listening to Rudolph the Red Nosed
Reindeer and here I am fighting
for my life. The world keeps going, and that is sick and twisted.
The world is going and people
are out Christmas shopping and
planning parties and I am laying
in here with a laser.
She couldnt move, but a few
tears slipped out that day.
I still remember the first thing
Nathan did was walk up with a
tissue and wipe my tears, said
Green. I thought wow, I am not
in here by myself, he really does
watch. It is more than a job for
these people. They really care
about what they are doing and
See Green, page 3

To schedule an appointment
at the EIRMC Imaging Center

Call 227-2612

Eastern Idaho Regional Medical Center

Breast Cancer Awareness

Sunday, Oct. 13, 2013 3

The ins and outs of mammography:

Plastic
surgery Straight from the Imaging Center Experts
after
I
Breast Self-Exam:
cancer:
A Better Approach
Is it right
for you?
By Brian Bruggeman, M.D.

here are a lot of options these days for

breast reconstruction
after cancer. Many choices
can be a good thing. However, this also can make for
a difficult time immediately
after having been diagnosed with cancer. Losing
a breast to cancer is always
hard. Making difficult
decision
about
reconstruction
doesnt
have to
be.
Whether or
not to
proceed
with
reconBruggeman
struction is a
womans choice. Once that
decision is made, the plastic surgeon can help guide
you through the maze of
decisions regarding reconstruction. A good place to
start is whether or not to
use implants or your bodys
own tissue for reconstruct
ion.
Implants are a popular
choice because there is
no donor site. Usually a
tissue expander is used to
prepare the breast for an
implant. This requires a
second operation after the
mastectomy to exchange
the expander for the implant. All implants are
made from silicone, but
what is inside them can
differ. You can either have
them filled with silicone
gel or saline. Silicone gel
is the most popular for
breast reconstruction. Saline implants are available
for use in breast reconstruction, but without any
breast tissue they dont
appear as natural.
Using your bodys own
tissue to build a breast
is a good option in the
right patient. The skin
and tissue removed in a
tummy tuck can be used
to rebuild your breast
at the same time as the
mastectomy. While it is
nice to wake up and be
finished with the process,
its often not known until
after the operation is complete whether radiation
treatment will be needed.
Radiation can ruin the
reconstructed breast.
About 65% of women in
the United States choose to
use expanders for reconstruction. This is likely due
to the fact that for most
women the whole process is
less difficult. And with the
availability of new materials to work with the end
results can be excellent.
A consultation with your
physician will help you
determine which option is
the best for you.
Dr. Brian Bruggeman is
a Board-Certified plastic
surgeon working at East
Falls Plastic Surgery in
Idaho Falls. He specializes
in reconstructive surgery,
cosmetic surgery, breast
augmentation, face lift,
tummy tuck and breast
reduction. Bruggeman is
a member of the American
Board of Plastic Surgery.
He earned both is Fellowship and Residency at
Albany Medical Center and
attended Medical School at
University of Utah.

ve had a screening mammogram

and Ive been called back for
additional images. What does
this mean?
Everyones breast tissue is different. What appears
to be normal
breast tissue in
one patient may
not be normal in
another patient.
The ideal situation
in reading mammograms is to be
able to compare to
a prior study. This
is not possible
if it is a baseline
Celia McKenzie
mammogram (first
mammogram), or if the prior images
are not available. If youve had prior
mammograms performed elsewhere,
please provide us with the facility
name and address so that every attempt can be made to acquire these
studies.
If there has been a change from
one mammogram to the next, the
radiologist may request additional
imaging. When the patient returns
a different exam is performed. The
images acquired are positioned
differently, may be magnified, and
special compression paddles are
used. Ultrasound may also be utilized. Most cases are resolved at this
point and result in a normal study.
A small percentage of cases cannot
be resolved and biopsy is recommended.
It is also not uncommon for a patient who has had a baseline mammogram to be called for additional
imaging because a comparison cannot
be made, and the radiologist needs to
establish the patients normal breast
tissue pattern.
When a patient is scheduled for
additional imaging, this appointment is
set up for a time when the radiologist is
available to direct the specific imaging
needed and review the images at the
time of the appointment.

According to the American Cancer Society, this procedure for doing breast self-exam is
different from previous recommendations. There is evidence that this position (lying down),
the area felt, pattern of coverage of the breast, and use of different amounts of pressure
increase a womans ability to find abnormal areas.

Step 1: Lie down on your back and place your right arm behind your
head. This spreads the breast tissue evenly over the chest wall, making it
much easier to feel all the breast tissue.
Step 2: Use the pads of the 3 middle fingers on your left hand to feel for
lumps in the right breast. Use overlapping dime-sized circular motions of
the finger pads to feel the breast tissue.
Use 3 different levels of pressure to feel all the breast tissue: light
pressure closest to the skin; medium pressure to feel a little deeper; and
firm pressure to feel the tissue closest to the chest and ribs. Use each
pressure level to feel breast tissue before moving on to the next spot. It
is normal to feel a firm ridge in the lower curve of each breast, but you
should tell your doctor if you feel anything else out of the ordinary.
Step 3: Move around the breast in an up and down pattern starting at an
imaginary line drawn straight down your side from the underarm and
moving across the breast to the middle of the chest bone (sternum or
breastbone). Be sure to check the entire breast area going down until you
feel only ribs and up to the neck or collar bone (clavicle).
Step 4: Repeat the exam on your left breast, putting your left arm behind
your head and using the finger pads of your right hand to do the exam.
Step 5: While standing in front of a mirror with your hands pressing firmly
down on your hips, look at your breasts for any changes of size, shape,
contour, or dimpling, or redness or scaliness of the nipple or breast skin.
(The pressing down on the hips position contracts the chest wall muscles
and enhances any breast changes.)
Step 6: Examine each underarm while sitting up or standing and with
your arm only slightly raised so you can easily feel in this area. Raising
your arm straight up tightens the tissue in this area and makes it harder
to examine.
Guidelines provided by The American Cancer Society at cancer.org

- Celia McKenzie,
B.S. RT (R)(M)
EIRMC Imaging Center

Green

Continued from page 2

they care about you as a person.
At some point, Nathan, the lead radiation
therapist at the EIRMC cancer center, mentioned
to Green that on the last radiation treatment they
turn on a bubble machine for the patient as a
celebration. Green joked that they should have a
disco ball and music as well.
I totally forgot that we had that conversation, said Green. When we were done with the
last treatment they started pulling me off the
machine and all of a sudden the room lit up and
there was a disco ball up there spinning and they
were playing disco music. You wouldnt understand it unless you have walked that walk, but it
is really an accomplishment to get through that.
It is just a few minutes every day but it is the
concept of what you are doing and what you are
fighting and that it is a daily battle. It was neat
to have them acknowledge the battle I had gone
through.
The disco party is now a tradition for every
cancer patient that finishes their radiation
treatments.
Within a week of her last radiation treatment, Greens father was diagnosed with
malignant pleural mesothelioma, an incurable
type of cancer.
Green said besides her husband, her father was
her strongest support system throughout her cancer
treatments. He passed away last June.
I went through a lot of survivors guilt
because I was able to get better and my dad
wasnt, but then I had to realize that every day
is a gift, said Green. I am grateful for every
day that I am alive. I hope that I can make my
dad proud.
Green has been cancer-free since June 15, 2011.
Since then she has been able to help another EIRMC
breast cancer patient get through her treatments. The
two have become very good friends.
I am grateful that I got cancer because I am
a different person than I was when I got sick.
It used to be about work and the car and the
house and stupid, stupid stuffstuff that just
seems so trivial and stupid now. And now it
is about relationships and moments with your
family and giving somebody a smile that you
normally wouldnt. It made me realize what
is important in my life. For that reason I am
grateful it happened to me when I was young
enough so I could make changes in my life
going forward.
Green often uses the word we when talking
about her experience with cancer. She said it is
because it is something that she and her husband
went through together.
I thought my husband and I were close before,
but it is different when you battle something like
cancer together and you realize what is important together.

Mammo Mondays!

Girls Day Out for Education and Early Detection.

October 7, 14, 21, 28

Bring you and your friends for complimentary:

Education and
information about
breast cancer and
self-exams

Lip waxing
Skin care and
make-up consults
Giveaways

Enter to win a $500 giftcard to East Falls Plastic Surgery.

Call 535.4556 to book your

mammogram today!

EIRMC Imaging Center

1670 John Adams Pkwy,
Idaho Falls, ID 83404

Date:
Time:
Place:

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EIRMC

Community
Cancer Screenings
Free screenings for
breast, skin, oral, and
colon cancer.
Risk factor analysis for
cervical, ovarian and
other gynecological
cancers.
Reduced-cost PSA for
prostate cancer.

The best hope for treating and

beating cancer starts here,
with early detection.
Take advantage of our FREE
and reduced-cost cancer
screenings.

Reduced-cost
mammogram voucher.
Pre-registration begins October 1.
Call 535-ICAN

3245 Channing Way Idaho Falls