Advances in technology and surgical techniques are giving women more post-mastectomy reconstruction options. One that is on the rise nationally and locally is the so-called “TRAM flap” procedure being done by CosmetiCare and Plasticos Institute, both in Newport Beach.
TRAM,for “transverse abdominal myo-cutaneous muscle”,uses a patient’s own abdominal fat tissue to re-create natural-looking breasts, according to Dr. Michael Niccole, medical director of CosmetiCare.
TRAM, says Niccole, greatly reduces the possibility of infection or rejection, as it uses the patient’s own tissue. Other benefits: less need for blood transfusions, fewer complications associated with radiation or chemotherapy after surgery, reduced recurrences of cancer and, of course, a better look.
The drawbacks of the procedure, he notes, are that it is more expensive than reconstructions using silicone or the newly approved saline implants (generally $8,000 to $10,000 per breast for TRAM, vs. $4,000 to $6,000 for implants), and it involves more surgery than the more-common implant procedures.
But, Niccole says, “no matter how good of a surgeon you are, implants don’t always look exactly right.”
And, he adds, “some patients just want their own tissue in there. … You have to give people several options.”
Niccole also notes that the growing number of reconstruction alternatives and their increasing use has spurred another positive trend: in more cases, reconstruction after a mastectomy is part of the planning process for the removal surgery. Many oncological surgeons will try to use “tissue-sparing procedures” to aid the subsequent reconstruction, he said.
AAHP Taps TriZetto
Newport Beach-based TriZetto Group Inc.’s healthcare e-business services will be offered to members of the American Association of Health Plans under a strategic alliance announced at the AAHP’s national conference in Orlando last week.
TriZetto will develop an AAHP member portal online that will highlight the group’s policy initiatives and provide educational offerings, information, quality-improvement programs, consumer involvement and compliance programs. The portal also will give AAHP members access to TriZetto’s healthcare-management products, including: its application service provider (ASP) software offerings; HealthWeb, its business-to-business e-commerce portal; and consulting services in such areas as e-business strategy and Web development.
The AAHP is composed of more than 1,000 HMOs, PPOs and utilization review organizations that together cover more than 140 million Americans.
Payne on Pain
Peggy Payne, director of health education at the Santa Ana office of Universal Care, reminds us that June is National Headache Awareness Month. When someone named Payne talks about headaches, it’s best to take notes.
Payne says not all headaches are created,or cured,equal. The four main types are tension, sinus, migraine and cluster.
Tension headaches, three-fourths of all chronic pains, are what we’re all used to,throbbing forehead, muscle strain, etc.,and generally can be cured with good posture, exercise and 20 minutes of relaxation a day.
Sinus headaches involve pressure build-up in nasal cavities. They usually can be alleviated by humidifiers or by drinking water, but may require a visit to a doctor.
Migraines are recurring and episodic, like “Who Wants to Be a Millionaire.” They usually last several hours and in many cases include nausea, also like … oh, never mind,it’s a cheap shot.
Anyway, a migraine is best treated with rest in a cool, dark and quiet place until the pain subsides.
Cluster headaches are the most painful of all, and occur most often in men and during sleep. Think blinding, excruciating pain.
Universal Care is a health plan with 265,000 members, a network of 6,700 primary-care physicians and 18,000 specialists at 160 hospitals in Southern California. It also owns 10 multi-specialty groups, 14 dental offices, eight pharmacies and two optometry offices in Orange and Los Angeles counties.
Bits and Pieces:
The ER at Orange Coast Memorial Medical Center received the 1999 Emergency Department of the Year Award at the 25th Annual California Emergency Physicians’ Meeting, beating out 44 other crews … The Starlight Children’s Foundation donated a Starlight Fun Center to the pediatric unit at Western Medical Center/Santa Ana. The system includes a 13-inch television, a VCR and a Nintendo 64 with video games. Radio station Star 98.7 (FM) also presented a check to the Foundation … Lake Forest-based I-Flow Corp. said its Paragon Epidural Delivery System is ready for use. The company says the product manages labor and delivery pain better as a “unique solution to the delivery of a continuous epidural” … The UCI Medical Center has a new on-line maternity guide at its existing Web site: ucihealth.com … Monarch HealthCare, Mission Viejo, has adopted the new liquid-based ThinPrep Pap Test as a replacement for the conventional Pap smear for detecting cervical cancer. Monarch says it more effectively detects low-grade and more severe lesions in patients. Almost 13,000 women a year are diagnosed with cervical cancer.
