Tuesday, July 30, 2013

Dr. Suzanne Klimberg: The Picasso of Breast Surgeons

Marla Crider, breast cancer, Arkansas, invasive ductal carcinoma, patient stories
Picasso's "Woman Flower."
After my recent appointment with Dr. James Yuen, Chief of Plastic Surgery at the University of Arkansas for Medical Sciences, I was disappointed to learn that simultaneous breast reconstruction was not recommended in my case because of possible diabetes­ related complications.  I had done some preliminary research and knew that it would be more difficult for Dr. Yuen to create natural looking breasts after extended healing.  He and my breast surgeon, Dr. Suzanne Klimberg, are well known nationally for their tag-team approach at providing breast cancer surviors, like I am soon to be, with anatomically sculpted breasts and a chance at normalcy after enduring chemo treatments, radiation and life altering surgery.  I trusted Dr. Yuen’s decision to delay the reconstruction for the suggested six months; however, I was concerned that waiting would impact the outcome of the procedure.

Several days after meeting with Dr. Yuen, I had a follow-up appointment with Dr. Klimberg, who counsels with her patients midway through the chemo treatments to evaluate the size of the tumor(s). I was to meet with the good doctor at 4:00 p.m. and by 4:15 I was already in a cubicle.  The exam room door opened and in walked a candy striper without the well known red and white uniform. But it wasn’t a candy-striper.  She was a young doctor with a stethoscope hanging around her neck who looked to be 15 years-old.  She sported a 10-inch waist and long blond hair that was pulled back in a ponytail and secured with a green rubber band. I was stunned when she introduced herself as Dr. Gallagher, an associate of Dr. Klimberg.  Good grief, she was a practicing breast surgeon.  And, I was an aging diva.

Dr. Gallagher asked lots of questions and inquired how I was managing the chemo treatments.  “Splendidly,” I responded.  She wanted to know if I had met with Dr. Yuen about the reconstruction surgery.  I told her that I had but he didn’t tell me what I wanted to hear.  She asked me to elaborate.  I shared the diabetes dilemma and his concern of infection if he performed the reconstruction simultaneously with the bilateral mastectomies.  Dr. Gallagher confirmed that Dr Yuen’s experience with diabetics and prosthesis rejection is a serious consideration.

Dr. Gallagher examined my breasts and was curious about how much the tumor had reduced in size.  When I told her the mass measured 5.6 centimeters prior to beginning chemo, she said it was apparent to the touch that it had decreased in size; however, she was still concerned about its close proximity to the nipple.  According to my own research and numerous conversations with my doctors, saving the nipple can be essential to reconstructing more natural looking breasts. Dr. Gallagher’s comment made me uneasy.  She completed the exam and told me Dr. Klimberg would see me shortly to discuss Dr. Yuen’s viewpoint.

A few minutes passed when the queen of breast surgeons came in accompanied by Dr. Gallagher.  She scanned my chart and asked me to tell her about my conversation with Dr. Yuen.  I told her that he wanted to delay the plastic surgery for six months after the mastectomies.  Without missing a beat she said, “Well, we just don’t like him anymore.”  For a split second her comment surprised me, but then I realized her dry wit was fully engaged. She then requested to exam me.

As I lay bare-breasted on the exam table in a very small room with young Dr. Gallagher on my left side and a very animated Dr. Klimberg on the right, she lifted and tugged on my cancer-ridden breast. I asked if she thought delaying the reconstructive surgery would cause the viability of the skin and nipple to deteriorate.  As she stared at my breast with her chin resting between her thumb and forefinger of her right hand, she quickly made the “Shhhhhh,” sound and said, “I’m thinking.” Her response made my laugh out loud.  Dr. Klimberg was in rare form and her next question proved it. 

“Do you have a pen with dark ink?” she asked her Barbie doll-like associate.  As Dr. Gallagher handed a pen to the senior surgeon, we looked at each other with curiosity and had no clue what was coming next.   Then Dr. Klimberg began drawing imaginary incision lines on my breast in black ink, explaining with each stroke how she was going to customize the surgery in order to save more skin, and especially, the nipple.

Dr. Suzanne Klimberg, UAMS
“I have wanted to try this surgery for a while and you are the perfect candidate,” Dr. Klimberg reassured me.  “The procedure doesn’t have a name yet but I’ll come up with something descriptive and appropriate before we try it on you.”  As I sat on the exam table and analyzed Dr. Klimberg’s newly created masterpiece comprised of circles and curved lines, I realized that I could be part of something medically ground-breaking.  I was thrilled and fascinated.  This, I thought to myself, is why Dr. Klimberg is one of the best breast surgeons in the country. And she’s right here in Little Rock at the UAMS Winthrop P. Rockefeller Cancer Institute.  How fortunate we Arkansans are to have her in The Natural State.

When I refocused on the conversation at hand, both doctors were still bantering about a medical name for the “Marla Crider” surgical technique.  Dr. Gallagher suggested that the new procedure should contain Dr. Klimberg’s name.  “No,” she responded, “I already have an enema named after me and that would be a little too much.”  Besides being a brilliant surgeon, this woman was also a stand-up comedian. 

Before Dr. Klimberg left the room, she said she wanted to see me again a week after my last chemo treatment, which would be in early September.  That’s when we would schedule the date for the bilateral mastectomies.  She gave me a hug and reassured me that I was going to look fabulous when the entire process was complete and suggested that a photo of my new ta-tas might be included in one of her “show and tell” presentations or even a text book. 

When I left UAMS that afternoon, I felt better than I had in months.  I could finally see the light at the end of the tunnel, thanks to Dr. Suzanne Klimberg - the Pablo Picasso of American breast surgeons.


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