Women who lose part or all of one or both breasts due to breast cancer surgery may choose to have new breasts created with their own tissue -- a process that also may or may not involve breast implants. A wide range of reconstruction procedures is available, including a variety of flaps and options to use either implants or what is known as autologous fat transfer. Each surgery has its own ...

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T was the last patient of a busier than usual morning. “New patient, establish care” was her reason for visit. As I would soon find out with the help of our remarkable Arabic interpreter, T and her family recently moved to our area after spending the better part of 3 years moving from refugee camp to refugee camp trying to escape the ravages of the civil war in their native ...

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There are some questions in health care that can’t be answered with a randomized controlled trial. We can’t randomize babies to inhale secondary tobacco smoke or not to test its health effects. We can’t randomize people to a different number of hours sitting the ER before receiving antibiotics after the decision is made that the patient has a bacterial infection requiring antibiotics. There are some questions where the best available ...

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Lori Wallace sits on a couch with her 11-year-old son and his new pet snake. It burrows under his armpit, as if afraid. Wallace is sure it’s not. “If he was terrified, he would be balled up,” Wallace said. “See, that is why they are called ball pythons. When they are scared, they turn into a little ball.” Wallace is dying of breast cancer, but a stranger wouldn’t know. She has a ...

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7 a.m. began as it always did; the overnight doc was threatening to quit while rubbing her bloodshot eyes and smearing mascara beneath them. Between heavy sighs, she listed the patients transferring into my care ending with Mr. Mandel. “He’s eighty-something,” she explained, “hospice care. Cancer with metastases. Came in from home because family ran out of morphine and he was in a lot of pain. Anyway, he’s actively dying now, ...

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“Doctor, how would you like your schedule template?” As a hematology/oncology physician in a non-profit hospital group, I am reimbursed by wRVU. This is the standard mechanism of reimbursement for large multispecialty groups and academic centers. In this scenario, the more wRVUs you make, the more you get paid. However, there are only so many hours in the day. One of the first decisions each doctor makes when joining a group ...

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So stated one of our children in their autobiography assignment for school.  I kept reading, curious what would come next. “My dad usually stays home and cleans up, and takes care of the pets.” I thought for a moment.  “That’s very good, honey, but do you think you could write something else about Dad?” I suggested.  “He does other stuff too, add some more nice things.” “OK, how about … ‘And he takes ...

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The diversity of patients seen in any oncologist’s clinic is a microcosm of what makes America so unique. From one room to the next, I am amazed by the various ethnicities, economic backgrounds, and religious faiths that I encounter. Each of these patients forms a composite of beliefs regarding their cancer; just as every tumor we treat is different, so is every patient. This diversity is what makes generalizations in ...

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“How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving and tolerant of the weak and strong. Because someday in your life you will have been all of these.” —George Washington Carver Earlier this week, I walked into the exam room and introduced myself to a 48-year-old male.  As I generally do, I sat in front of him and asked, ...

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asco-logo As an oncologist, I want to provide the best treatment for everyone. That should mean the best chance at a long-lasting remission, if not cure. Whatever that might take. Surgery, chemotherapy, radiation therapy -- a dark tunnel that I hope patients will enter and then exit, with the sun shining on the other side. But, every ...

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