Q&A with Barbara Zarrell, RN, BSN, Woman’s Personal Health Resource, Inc.
Q. I will be undergoing a double mastectomy, and I haven’t yet made up my mind about reconstruction. I’ve heard that there are now many prosthetic options available in breast forms and clothing. Can you describe what some of the most popular are?
There is a variety of options for breast prostheses in the same way there are options when it comes to a prosthetic arm or leg. Generally, one can choose from breast forms made from regular-weight silicone or lightweight silicone or from various types of poly-fil forms. Some of the poly-fil forms are actually weighted to offer a nice mix between a superlight form and a silicone form.
After a double mastectomy, the issue of weight in a breast form is important. For the bra to stay in place and fit well, some weight is needed. In this case I might choose from one of the newer, lightweight silicone forms or the weighted poly-fils.
Q. Are there specific clothing items or undergarments that I should consider purchasing to wear following my surgery to make my recovery easier or more comfortable?
An important garment to choose prior to breast surgery is a postmastectomy camisole. There are several on the market. This garment will provide support and comfort immediately after surgery and throughout your recovery. It has various pockets for the drain that your surgeon will place. The drain will remain in place for approximately seven to 10 days and can be uncomfortable and cumbersome. The pockets in these garments enable you to anchor the drain and have it hidden from your outer clothing. In addition, the camisoles are very soft, can be pulled up from your feet, come with two “puffs” that can be reconstructed by you to match the remaining breast, and are covered by insurance.
Along with a camisole, I highly recommend purchasing one or two leisure bras. These bras close in the front, can be used with the puffs from the camisole, and are a great addition right after surgery. One particular postmastectomy camisole has removable Velcro pockets that can also be anchored to your leisure bra. This offers a unique way to accommodate the drain.
Q. I’m a very active person—I swim, run, and spend a lot of time outdoors. Are there breast forms that will accommodate my active lifestyle?
The wide variety of breast forms on the market today enables active women to continue their lifestyle. For swimming, we have swim forms that are silicone shells. These are light, reasonably priced, covered by insurance, and can be used in hot tubs, saltwater, and chlorine. Several of the lighter poly-fil forms or casual/leisure forms would work comfortably during exercise. Additionally, there is a wonderful new garment we call the bathing suit bra that can be worn under swimsuits and tank tops or used as a sports bra. It is constructed of a Lycra material similar to that of a bathing suit, and it enables women to feel confident and active as it keeps the forms in place.
Q. I’m going to have a mastectomy, and I’m worried that no matter what kind of breast form I get, it won’t look the same as my natural breast. How should I go about choosing a breast form to make sure I get the right fit and match?
After a mastectomy it is wise to wait four to six weeks before being fitted for a silicone form. It takes time for the swelling to decrease and for your chest area to feel comfortable so that you can wear a regular bra. The many silicone forms on the market today, ranging from very light to more weighted forms, and the skills of a certified fitter who can show you various types of forms will allow you to find one with which you’re comfortable. By trying on various shapes and weights and using your eyes and a tape measure to compare, you will be able to choose the one that feels right. I always encourage my customers to think about comfort first. One must also allow for small imperfections. Remember, our natural breasts are not identical in size and shape.
Q. I have been experiencing terrible night sweats as a result of my treatments. Do you have any ideas for sleepwear solutions that might keep me from waking up soaked?
Recently, several manufacturers have developed beautiful, comfortable sleepwear made from wicking fabric that pulls the excess moisture away from your skin. You can choose among nightgowns, nightshirts, and pajamas that have either long pants or shorts. There are also pillowcases and robes available that are made from the same type of fabric.
Q. My hair has just started to really fall out fast, and I’m considering a wig. Are there different kinds of wigs I should consider? What other attractive options are available if I don’t feel comfortable in a wig?
Hair loss as a result of chemotherapy and radiation can be one of the hardest side effects of treatment to handle. But the good news is that there are many options today for all types of women depending on your personal choice.
In the wig category, one can choose synthetic fibers, human-hair blends, or 100 percent human-hair wigs. The synthetic wigs are the easiest to care for. Many of these are made so well that one cannot tell they are synthetic. You will never have a “bad hair day” with a synthetic wig. The main drawback to these is that no heat can be applied. (That means not opening that oven door with your wig on and not using a hair dryer.) These wigs are prestyled and should not need any special treatment. The human-hair blends are 70 percent human hair and 30 percent synthetic, which allows the wig to act as a human-hair wig with the bonus that the synthetic fibers keep it perfectly styled. You may use a hair dryer with this type of wig. The 100 percent human-hair wigs are more costly and require a bit more care, although many women prefer them.
Not all women wish to purchase a wig. We have some wonderfully fashionable options. There are hats with hair, Velcro bangs, hoops of hair, and attractive scarves and turbans that can be layered for a chic, elegant look.
Q. All of these innovations in clothing and prosthetics seem great, but I just don’t have any extra money with all of the medical bills left to pay. Are any of these items covered by insurance or Medicare?
Most commercial insurance companies cover wigs. Each policy is different, and I encourage you to call and check with your insurance company. All insurance companies, including Medicare, cover prosthetics and bras. Medicare covers one silicone prosthesis every two years, one foam prosthesis every six months, and up to six bras per year. Camisoles and bras with built-in forms are also covered.
Q. I was diagnosed with lymphedema after lymph nodes under my arm were removed during my breast surgery. The doctor has recommended a compression sleeve. Can you tell me what they’re all about?
Women who have had breast surgery with lymph node removal are more susceptible to arm swelling. If you notice a change, you should be evaluated by a lymphedema specialist who has experience in lymphatic massage.
There are many types of sleeves, compressions, and products available. Your physician and lymphedema specialist can assist you in making the best choice. An excellent Web site for information is www.lymphnet.org.
Q. I am undergoing radiation treatments, and my clothes are uncomfortable because my skin is extremely sensitive. What is the best type of clothing to wear? Also, I’ve heard that I shouldn’t use deodorant while receiving radiation—is this true?
The effects of radiation can be extremely irritating to skin. Radiation is also cumulative, which means that it continues to work after treatments are completed. I recommend wearing a cotton or cotton-blend camisole that will not irritate the area being treated. Several of the immediate post-surgical camisoles would work. During this period it is best to avoid tight-fitting garments and those with tight elastic.
A non-metallic deodorant is recommended during radiation. One good alternative is Alra deodorant, which has no aluminum or metallic salts to irritate the skin or interfere with medical treatments.
Barbara Zarrell, RN, BSN, has a background in oncology nursing and had a strong desire to create her own business when she developed the concept for Woman’s Personal Health Resource, Inc., in 1998. Now, almost 10 years later, the successful business, which offers products for women undergoing breast surgery, chemotherapy, and radiation, is thriving. With a hospital boutique and two Web sites, Barbara is able to offer top-of-the-line products to women around the world in a sensitive and caring manner. Featured on several satellite radio programs, including the Group Room, Barbara delights in delivering personal customer service and products that make a difference for women.