The right fit
AFTER breast surgery it can be difficult to regain your confidence and beauty and for Neisha Williams, a friend’s journey through breast cancer inspired her to do more for women battling the disease.
Williams, a registered nurse (RN) for 16 years, told Your Health Your Wealth that between 2005 and 2015, her job exposed her to several breast cancer survivors but other than sheer pain and grief she witness, it really hit home when a classmate from nursing school was diagnosed.
“She was showering, found a lump and was told it was fibrocystic breast disease and that’s common, so no need to worry. She insisted on removing the lump and that’s when she was told it was cancer. I remember when her husband shared that he thought his wife was going to die and that showed me then that you really need people in your corner. I have seen people diagnosed and don’t have a lot of support like my friend had, or the support is overseas and others make the decisions and tell them don’t do this or that. I wanted to be able to, in my capacity as a health-care professional, cater to the needs of Jamaican women who have undergone breast surgery,” Williams said.
And so, in 2015 she formed Pink Flower Breast Care a breast form/prosthesis company which she runs in her capacity as a RN and certified mastectomy bra fitter. Pink Flower is operated through Teshuva Wellness in Montego Bay, which Williams husband, oncologist Dr Andre Williams operates.
According to Williams, while cancer care has improved tremendously in Jamaica and a number of excellent cancer drugs are available through National Health Fund (NHF), the journey post-surgery can be daunting for many women.
“Many women use stockings, some put marble stones with their stockings to keep the stuffing down. There are many who do surgeries and are not aware that a prosthesis is available,” she said.
Further, Williams said apart from breast forms/prosthesis helping with the psychological boost of women, it is also necessary to prevent neck and back pains.
“We recommend that as soon as a decision is made, you get measured and fitted before surgery so once you are fully healed after six to eight weeks, you can be fitted for your permanent prosthesis. The reason we have two breasts is to help with balance as the unaffected breast will tend to shift over to the affected side and you get that imbalance. The prosthesis carries a certain amount of weight to keep you balanced, aligned and still looking sexy. If there is imbalance you can have a lot of neck and back pains and might be unable to stand upright,” Williams explained.
Williams, who is also an Amoena and American Breast Care sales rep, said it is also a cheaper option for those who cannot afford reconstructive surgery.
She said the cost of one prosthesis is JM$29, 000 and through pre-authorisation with Sagicor Insurance, a portion is taken care of. In addition for the month of October, Pink Flower will give five to 10 per cent discounts on prosthesis or mastectomy bras. There are also swim form and lingerie form prosthesis available.
“I want women to feel confident that when they come to Pink Flower they get the right fit. The bras have pockets so the prosthesis won’t fall out or move out of place. It feels like a real breast as well as we measure and fit you before surgery, so post-surgery it has the same weight, is soft and also falls naturally,” she said.
Meanwhile, registered physiotherapist Samantha Davis underscored the need for a prosthesis in women who have done a mastectomy.
“When a woman loses a breast, the centre of gravity shifts over to the side where they have a breast remaining. The effects it would have on the back would be dependent on the size of the breast. Larger breasts might pull you forward and you have a forward posture. Sometimes you may have a lateral posture (lean to one side). With that, the upper to middle back on the side with the mastectomy would be overstretched. The muscles of the back on the side of the remaining breast would be in a constant state of contraction, while the other side would be overstretched as it is going over to that side,” Davis said.
This, according to the physiotherapist, then causes people to develop what is known as trigger points.
“Myofascial trigger points would bring the muscles over to that side of the back where the breast is remaining. With that you tend to have pain, some tenderness or discomfort that ends up into referred pain and it’s often described as myofascial pain syndrome,” she said
Davis also mentioned that there is a possibility of developing scoliosis as without the prosthesis you would have posturing to the side where the breast is. She also said some women might develop a hunched back.
The physiotherapist said women might also experience discomfort in the front of the chest.
“With the shoulders rounded, you’re [leaning] over to the side, back is hunched, the muscles of the chest becomes tight and those people tend to have a hard time sitting up right with the shoulders up and open and the chest open. That can cause pain and discomfort in the front of the chest,” Davis said.
Concerning the neck, the physiotherapist said the muscle that goes from the neck down the back would get some trigger points, which might lead to lower back pain.
Davis said once the entire trunk of the back is thrown off, it affects the pelvis and if it affects the pelvis, the hips, knees and ankles will also be affected.
Further, Davis also said the issues might not be on the side with the remaining breast.
“For some, because they have lost the breast they develop some amount of shyness towards the affected side and because of that they develop a guarded posture to that side. They might put the hand in front of the area the mastectomy was done and because of that, you have some who may develop that same side flexion of the trunk or leaning over toward the mastectomy side. Getting the prosthesis would increase confidence and reduce the development of a guarded posture,” she explained.
Moreover, Davis too encouraged women to get fitted for a prosthesis once they decide on the surgical approach to treating their breast cancer and to also see a physiotherapist before surgery.
“Breast cancer rehab is a big thing. Depending on the stage of cancer and advancement of disease, you may have to remove lymph nodes and might end up with lymphedema, which can create imbalance. It’s easier to rehab when you see a patient pre-operatively. So if you choose mastectomy and can’t afford reconstruction, get the prosthesis but also see a physiotherapist,” Davis said.
