Do women have access to breast reconstruction?

Doctor holding X-ray film and woman in pink braFewer than half of women who undergo mastectomy for breast cancer have breast reconstruction. A new study from the University of Michigan Comprehensive Cancer Center finds 42% of women who were surveyed had breast reconstruction.

The study, published in JAMA Surgery, looked at 485 women treated with mastectomy for breast cancer, following up with them an average of four years after their diagnosis.

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Six heart-healthy seeds

Boost your heart health with these nutrition-packed seeds

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Seeds provide a variety of nutrients that are good for your heart.

Seeds are packed with nutrients. In their most natural form, seeds are tiny embryonic plants inside of a shell. Besides a little sun, water and TLC, seeds contain all of the nutrients they need to grow. The outer layer is packed with minerals, vitamins, and plant-based chemical compounds known as phytochemicals, while the endosperm is filled with high-quality protein, complex carbohydrates and heart-healthy fats. This makes them a wonderful addition to our well-balanced diet! So the question is, which heart-healthy seeds should you choose?

Variety is key. All seeds provide protein and fiber, but each type of seed has something special it brings to the table. Consider incorporating some of these seeds into your diet: Continue reading

Advantages of warfarin and Coumadin alternatives

All drugs have both advantages & drawbacks based on individual medical needs

Anticoagulants like Coumadin or Jantoven are prescribed to prevent the formation of blood clots.

Three new drugs were recently approved as warfarin and Coumadin alternatives.

Up until recently, when physicians treated patients for thromboembolism (blood clots) or patients who might be at risk for the development of a blood clot, the only oral drug available was warfarin. Warfarin (brand names Coumadin or Jantoven) has been around for years, and when used appropriately is a safe treatment plan for reducing the risk of stroke and blood clots. Like any medication, there are always potential side effects or risks. Also, like any medication, those risks are weighed against its potential benefits, thereby allowing a treating physician to make the most appropriate treatment plan for an individual patient.

Warfarin drawbacks

There are four main drawbacks to taking Coumadin or Jantoven:

  1. Regular blood draws are required to be sure the right dose is being administered (every patient’s dose is specific to their body’s response to the drug).
  2. There are many potential drug interactions with warfarin that may lead to either an increase or decrease in its blood levels.
  3. All the cruciferous vegetables (those foods high in Vitamin K, such as cauliflower, cabbage and broccoli) counteract warfarin, making dietary guidelines for anticoagulants very important.
  4. There is a narrow therapeutic index for warfarin, which, in some patients, may lead to very difficult warfarin dosing. If the blood level is too low it will not be effective and if it is too high, there is an increased chance of bleeding.

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Do you want to know about financial ties your doctor may have with drug and medical device companies?

Sunshine Act surveyA new federal law requires that financial relationships between doctors and pharmaceutical (drug) or medical device companies be shared with the public on a government website.

Anyone will be able to use this website to see if their doctor has received such payments or other transfers of value.

This law is officially called the “National Physician Payment Transparency Program” or “Open Payments.” It is part of the Affordable Care Act. It is most often referred to as the “Sunshine Act.”

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Connecting Cognitive and Movement Disorders

Sami Barmada, M.D., Ph.D., is a scientist, lecturer, and clinician in the University of Michigan Cognitive Barmada labDisorders Program. He was recently in the news for the discoveries that he made in the laboratory with his colleagues in California and the United Kingdom. Their research findings focused on a protein, TDP43, which accumulates in the brains of individuals with ALS and dementia. We had a chance to sit down with Dr. Barmada to understand more about the connection between ALS, dementia and other related diseases.

You are a clinician in the U-M Cognitive Disorders Program but your research focuses on ALS. Are cognitive disorders related to ALS?

The short answer is yes. Years ago, we believed that ALS was a disorder that only affected movement, Continue reading

Listening to her dad never felt so good: a metaplastic breast cancer survivor’s story

Renee Javonsky with her parents and kids.

Renee Javonsky with her parents and kids.

Renee Janovsky never expected her mammogram to reveal breast cancer. After all, she was simply establishing a baseline at age 40. Instead, in September 2006, following an initial biopsy and tumor review, the diagnosis revealed triple negative metaplastic breast cancer, stage 1 with a high grade – a rare and aggressive form of breast cancer. She was referred to the University of Michigan Comprehensive Cancer Center by her father, Adrian Kramer. He was treated there previously and he insisted that she be treated at U-M.

“At the time, my children were two and four years old, so I had way more life ahead of me. I listened to my dad and went to Ann Arbor,” says Renee.

Lisa Newman, M.D., M.P.H., director of the U-M Breast Care Center, met with Renee, her husband and parents. Renee was immediately put at ease with her knowledge and manner of presenting information. Ten days later, Renee had a lumpectomy.

“Dr. Newman explained that because little was known about tumors that were both triple negative and metaplastic, there was no defined treatment protocol. She recommended Continue reading