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Breast cancer survivor Tammy Murdock of Ona, W.Va.

InsIDE tHIs sEctIOn FOLLOWING HER FEELINGS Breast cancer survivor acts on intuition, encourages others to be informed, advocate for selves / 1H

Two breast cancer survivors share their stories

Women credit early detection for success stORY By BEtH HEnDRIcKs / the Herald-Dispatch bhendricks@herald-dispatch.com

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BREAST CANCER EVENTS

Check out our special two-page spread featuring a calendar of upcoming breast cancer-related events in the Tri-State area / Pages 4G-5G

ichelle Robertson and Tammy Murdock were both model patients. Both went to regular doctor’s appointments and completed all the recommended screenings. They’re both also survivors of breast cancer found during routine mammograms suggested by their physicians.

“I found out at my first mammogram, and I only went because that’s what the doctor says to do. That’s what you always hear: ‘When you turn 40, it’s time to start having mammograms,’” said Michelle Robertson of Fort Gay. She was diagnosed July 8, at age 40, at Cabell Huntington Hospital’s Breast Health Center. “I was at a routine visit, and my doctor said, candidly, it was time to start mammograms, so I told him to get me scheduled.”

Murdock had a similar experience.

“I had no lumps and no family history; it was just a mammogram as the result of my yearly check-up,” said Murdock, 47, of Ona. She was diagnosed in May at St. Mary’s Medical Center.

“When they told me, I could’ve really fallen off of the table. I was just in shock.”

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Please see SURVIVORS/2G

Breast cancer survivor Michelle Robertson of Fort Gay, W.Va.

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“I was at a routine visit, and my doctor said, candidly, it was time to start mammograms, so I told him to get me scheduled. … I just put it all in God’s hands and let him take care of me.”

Michelle Robertson

cancer survivor

Survivors

n Continued from 2G

Robertson described her feelings after hearing her diagnosis as “a bundle of nerves.”

“I just put it all in God’s hands and let him take care of me,” Robertson said.

In short order, both women underwent lumpectomies with radiation for their stage I breast cancers. Both were caught early, thanks in part to routine tests and examinations.

“When they did my regular mammogram, they called three days later because they wanted an extra compression. Because I’d never had one, they didn’t know what was normal for me.

They didn’t have anything to compare it to,” said Robertson, who completed her surgery Aug. 15 and began radiation in mid-September.

“When I left the appointment after they told me I had breast cancer, I called my sister, who is four years older than me, and asked her if she’d had a mammogram yet and she said no,” Robertson continued. “I told her, ‘Sister, I need you to go. I have breast cancer.’”

Murdock had surgery June 11 and was finished with her radiation by June 21.

She credited new 3D mammography technology at St. Mary’s with saving her life.

“My doctor said a regular mammogram might not have picked mine up

FOcus On WOmEn’s HEaLtH

THINK PINK

Sunday, September 29, 2013

and I’d seen an ad on TV one day for the 3D mammogram, and I thought, ‘The insurance is paying for it, why not get the best?’” Murdock said.

Robertson got through with the support of her husband, Herbert, the rest of her family and her faith.

“What got me through was God and my family, looking at my little grandbaby and knowing I can’t leave her,” Robertson said.

Murdock said her family, including husband, Paul, and sister and brotherin-law Rita and Dan Shriver, helped her through, as did the care and concern of co-workers. Even a conversation with a neighbor raised her spirits and reminded her she’d made the right decision to seek regular medical care.

“My neighbor and I got to talk one day and I discovered she’d had stage three cancer 16 years ago. She was living proof to me that even at a later stage, fear is not a reason not to go,” Murdock said. “You always hear that early detection is key and you put it off as a cliché, but it is so true. My first appointment, from start to finish took about 30 minutes. We’re all busy, but that was a half-hour out of one day.

Anyone can make time for that.”

For Robertson, who admitted she became somewhat of a recluse in the weeks following her diagnosis, has found her silver lining.

“It’s very empowering to be able to say to you, ‘I survived cancer. I am a cancer survivor,’” she offered.

Therapy can ease joint problems linked to breast cancer surgery

Many know October is National Breast Cancer Awareness Month, so it is timely to take this opportunity to specifically discuss the role that physical therapy can play after oncological breast surgery.

In an effort to bring a surgeon’s perspective and knowledge of breast cancer surgery, I interviewed Dr. Robert Gabordi, graduate of the Marshall University School of Medicine (and Huntington High School) and currently a breast surgical oncology fellow at the University of Texas - Southwestern Medical Center (UT - Southwestern) in Dallas.

According to Gabordi, the type of breast surgery performed varies depending on the surgeon’s recommendations, stage of disease (i.e. size and whether or not there is lymph node involvement) and patient preference.

Breast cancer treatment has become a multidisciplinary approach, utilizing several breast cancer specialists working together for a cure.

With improvements in surgical techniques, imaging and screening guidelines to allow for early detection, breast cancer surgery has evolved into a much less invasive procedure, as is true with many other surgeries.

Gabordi stressed the importance of yearly mammograms and breast self-exams for early detection. Although there are modifications of each, lumpectomy and mastectomy are the two primary methods of surgical treatment for breast cancer.

In the event women undergo lumpectomy (or partial mastectomy), meaning the surgeon does not take all of the breast tissue, radiation is an important adjunct to this procedure. A mastectomy involves taking all the breast tissue and the overlying skin. Both may lead to some element of decreased mobility of the skin and soft tissue, particularly in the early post-operative period. Often this is self-limited and resolves.

First, let’s look at the potential musculoskeletal issues associated with the partial mastectomy. Because this procedure will require radiation following surgery, there tends to be tightness of the muscles and skin around the area. Radiation is important to decrease cancer local recurrence rates, however the skin loses some of its elasticity following radiation treatment and this may decrease range of motion in that arm or shoulder. Physical therapists combat radiation effects with an exercise program and manual stretching techniques.

“I would recommend physical therapy to those patients if they experience decreased range of motion, and they are usually able to regain function over time,” Gabordi said.

John

OXLEY Patients who undergo mastectomy can also experience some degree of tightness in the shoulder but for different reasons. It is important to note, regardless of mastectomy or partial mastectomy, lymph nodes are often removed at the time of surgery as well.

Whether or not the lymph nodes contain cancer provides valuable information regarding the extent of disease, prognosis and whether additional therapy is required after surgery.

Lymph nodes are an important component of our immune system and act as a drainage system for infection Occasionally, patients may develop arm swelling after lymph node removal, called lymphedema. Depending on the amount lymph node tissue removed, patients may experience varying degrees of pain, breast or arm swelling, or decreased range motion after surgery. Physical therapy or lymphedema clinics are available options to help minimize lymphedema.

Physical therapists are routinely involved in the post-operative care at UT Southwestern. A physical therapist will explain and encourage stretching exercises that can be performed at home. Gabordi explains that most patients do not require formal physical therapy because they instruct their patients to begin this exercise regimen soon after they leave the hospital.

If you have had breast surgery and are experiencing limitations with motion of the shoulder or arm, it is important to know that there are options. Most of these problems can be treated successfully and allow women to return to normal life and normal activities. A conditioning exercise program that is approved by your surgeon can improve quality of life and hasten return to normal activity.

Let me encourage women who are suffering from limited range of motion to talk to their doctor or a knowledgeable physical therapist.

I hope this was educational and if there are questions please feel free to contact me at Huntington Physical Therapy (304) 525-4445 or email joxley@hptservices.com.

John Oxley is a Doctor of Physical Therapy with HPT Physical Therapy Specialists.

“What got me through was God and my family, looking at my little grandbaby and knowing I can’t leave her.”

Tammy Murdock

cancer survivor Photos by Lori Wolfe/The Herald-Dispatch

Providing healthcare for you and your family is a privilege to us. It’s not only about diagnostic tests and doctor or visits, it’s about spending time with family, mily ily, making the most of each day and d having every second count. It’s about the e little things in life and the big things, too.

At Holzer, we want to make sure you experience everything life has to offer and that Life is Lived Well.

Holzer is a multi-discipline health care system of over 150 Board Certified Physicians providing care in more than 30 areas of medical specialties.

Establish with a Primary Care Provider today!

1-855-4HOLZER www.holzer.org 269886

Michael Black, MD Family Pracitice

Diane Allen, CRNP

Obstetrics & Gynecology

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Focus on Women’s HealtH

THINK PINK

Sunday, September 29, 2013

october events

n Free manicures, pedicure and mini-massages to women having mammograms at Our Lady of Bellefonte’s Women’s Center. Call 606-836-PINK for available dates. n Mobile mammography appointments, Our Lady of Bellefonte Hospital. For a schedule of dates and times, visit www.olbh. com. Appointments can be made by calling 606-836-PINK. n Catering for a Cure, Qdoba, Huntington Mall, 10 percent of all catering orders will benefit the West Virginia Breast and Cervical Cancer Diagnostic and Treatment Fund.

Oct. 1-7 n Queso for a Cure, Qdoba, Huntington Mall, $1 from every order of chips and queso donated to the West Virginia Breast and Cervical Cancer Diagnostic and Treatment Fund.

Oct. 1, 15 and 29 n Free clinical breast exams, Our Lady of Bellefonte Women’s Center, 1000 Ashland Drive, Russell Ky. Free mammograms available any day for uninsured or underinsured Kentucky women 40 and older. Mammograms sponsored by Susan G. Komen Breast Cancer Foundation. Call 606-836PINK for appointments. n Wreath hanging, 11 a.m., Mason County Courthouse, Point Pleasant, W.Va. n Breast education event, 6 p.m., Bruin Baptist Church. How to perform a self breast exam, sponsored by King’s Daughters Medical Center.

Friday, Oct. 4 n Fifth Annual Breast Cancer Basics and Beyond Conference (for health care providers), 7:30 a.m. to 3:15 p.m., Marshall University Medical Center, Harless Auditorium, 1340 Hal Greer Blvd., Huntington. Cost of $25 includes handouts, refreshments and lunch.

Call 304-526-2271. n Wreath hanging, 10:30 a.m., Branchland Public Library, Hamlin, W.Va.

Saturday, Oct. 5 n Think Pink Zumbathon Event, 11 a.m. to 1 p.m., Macy’s Stage

Focus on Women’s HealtH

THINK PINK

Facts about breast cancer

at the Huntington Mall. For details please contact the mall office at 304-733-0492 ext. 109. To register for the Zumbathon stop by the mall customer service center for a registration form, show up the day of the event, or visit the Huntington Mall’s Facebook page where a link has been provided to sign up. n Think Pink Fashion Show, 1 p.m., Huntington Mall. For details please contact the mall office at 304-733-0492 ext. 109. n Breast Cancer Awareness Health Fair, 9 a.m. to 1 p.m., Holzer Center for Cancer Care, 170 Jackson Pike, Gallipolis. Free health screenings, “Ask the Nurse” booth, information displays.

Refreshments and door prizes.

Call 740-446-5351 for more information. n Walk for Women, noon, Righteous Brew, Williamson, W.Va. Registration begins at 11:30 a.m. No entry fee; $20 donation receives a walk T-shirt. Donations benefit the West Virginia Breast and Cervical Cancer Diagnostic and Treatment Fund.

File photo/The Herald-Dispatch

Beverly Burgess of Lavalette gets her hair cut by stylist Alex Smith, also of Lavalette, as part of “Cuts for the Cure” on Saturday, Oct. 8, 2011, at Lee David Salon in Huntington. Cuts for the Cure and Pamper for Pink will be from 11 a.m. to 3 p.m. at Lee David Salon, 148 W. 8th Ave., Huntington on Oct. 13

Total Woman Girls Night Out is planned for 5:30 p.m. Tuesday, Oct. 15, at Marquee Cinemas in Pullman Square. The movie is “Letters to Juliet” and begins at 7 p.m.

Park. For more information or to donate or join a team, visit www. makingstridesashland.org n King’s Daughters Day of Beauty, noon to 2 p.m., KDMC Health Education Center, 2201 Lexington Ave., Ashland. Education for KDMC breast cancer survivors. Manicures, skin care, door prizes and free gifts. To register, call 888-377-KDMC. n Rockin’ for TaTas benefit for Jennifer Finch Eaves, 9 p.m., Willie’s Lounge, 6007 Rt 60 East Suit 300 River Place Plaza, Barboursville. Live music by local woman singers, including Julie Westlake of Hydrogyn. Door prizes and drink special. $5.S

Tuesday, Oct. 8

Friday, Oct. 11

Sunday, Oct. 13

Sunday, Oct. 20

n Ladies in Pink Luncheon, noon, Guyan Golf and Country Club. Featured speakers Robin Rowe, Crystal Welch and Ronna Woods. Shopping in the parlor beginning at 11 a.m. Tickets are $35. RSVP to 304-526-1349. All proceeds benefit St. Mary’s Pink Ribbon Fund.

n Free Breast Cancer Screening, 8 a.m. to noon, St. Mary’s Breast Center. Free breast exam with coupon for discounted mammogram. Call 304-526-1492 to register.

n Cuts for the Cure and Pamper for Pink, 11 a.m. to 3 p.m., Lee David Salon, 148 W. 8th Ave., Huntington. Services included hair cut, massage, facial or express manicure and pedicure. No appointment necessary. $30 donation per service. Door prizes and drawings. All proceeds benefit the St. Mary’s Pink Ribbon Fund. n Walk for Women, 2 p.m., Mason County Court House, Point Pleasant. Registration begins at 1 p.m. No entry fee; $20 donation receives a walk T-shirt. Donations benefit the West Virginia Breast

Sunday, Oct. 6 n Brunch at Tiffany’s, 12:30 to 2:30 p.m., Marshall University Medical Center, atrium, 1340 Hal Greer Blvd., Huntington.

Presented by the West Virginia Affiliate of Susan G. Komen for the Cure and the Cabell Huntington Hospital Breast Health Center. Free breast educational events focused on the risks of breast cancer for uninsured and underinsured women. Free lunch provided. Door prizes including a $500 pearl necklace set, giveaways, breast cancer screening scheduling, mammogram scheduling assistance and risk factor education. RSVP by calling 304526-2440. Seating is limited. n Walk for Women, 2 p.m., Lincoln Primary Care Center, Hamlin, W.Va. Registration begins at 1 p.m. No entry fee; $20 donation receives a walk T-shirt. Donations benefit the West Virginia Breast and Cervical Cancer Diagnostic and Treatment Fund.

Monday, Oct. 7 n Breast education for students, 2 p.m., Russell High School.

Sponsored by King’s Daughters Medical Center.

Sunday, September 29, 2013

Sholten Singer/The Herald-Dispatch

Thursday, Oct. 10 n Breast Cancer Support Group, 6 p.m., St. Mary’s Regional Heart Institute, Room 204, 2900 1st Avenue, Huntington.

Saturday, Oct. 12 n Biketoberfest, noon to 8 p.m., Charlie’s Harley Davidson, 408 4th St., Huntington. Bands from 1 to 4 p.m. and 5 to 8 p.m. Raffle items, breast cancer awareness literature, custom bike contest. All proceeds benefit St. Mary’s Pink Ribbon Fund.

and Cervical Cancer Diagnostic and Treatment Fund.

Tuesday, Oct. 15 n Total Woman Girls Night Out, 5:30 p.m., Marquee Cinemas, Pullman Square, Huntington.

Movie, “Letters to Juliet,” begins at 7 p.m. Food and a signature “mocktail.” Women’s health information. Vendor booths. Seating is limited. Register by calling 304526-1271. n Breast Cancer Survivor’s Dinner, 5:30 p.m., New Baptist Church, Huntington. For more information, call 304-526-2440.

Thursday, Oct. 17 n Breast education and mobile mammography, 8 p.m., Kroger, Russell, Ky. Sponsored by King’s Daughters Medical Center.

Friday, Oct. 18 n Free Clinical Breast exams, 9 a.m. to 3 p.m., Edwards Comprehensive Cancer Center, 1340 Hal Greer Blvd., Huntington. Call 304526-2440 for an appointment.

Saturday, Oct. 19 n American Cancer Society’s Making Strides Against Breast Cancer walk, Ashland Central

n Breast Cancer Survivor Reunion, 2 to 4 p.m., St. Mary’s Conference Center, St. Mary’s Fifth Avenue Campus, 2825 5th Ave., Huntington. Featured speakers Amy Marcum, daughter of a breast cancer survivor, and Josh Waginger, son of a breast cancer survivor.

Monday, Oct. 21 n Sisters of Hope Breast Cancer Support Group, 5:30 p.m., Edwards Comprehensive Cancer Center, 1340 Hal Greer Blvd., Huntington.

Call 304-526-2443 for more details.

Tuesday, Oct. 22 n Breast Cancer Support Group, noon, Our Lady of Bellefonte Hospital, Bellefonte Centre, 1000 Ashland Drive, Russell, Ky. Call 606-833-CARE or visit www. olbh.com to register for the free support group n Look Good … Feel Better meeting, 3 p.m., Our Lady of Bellefonte Hospital, Bellefonte Centre, 1000 Ashland Drive, Russell, Ky. Class helps women cope with the appearance-related side effects of cancer treatment by teaching beauty tips. To register, call 606-833-CARE.

Saturday, Oct. 26 n Colors of Cancer 5K run/ walk, 9 a.m., Ritter Park, Huntington. Opportunity to show support for loved ones by wearing ribbons in colors that represent particular kinds of cancer. Event helps build awareness, offer encouragement and raise funds to beat cancer. Participants are invited to wear any and all of the colors of cancer to the event to symbolize unity and celebrate survivors. A memorial balloon release will take place at the conclusion. Registration begins at 7:30 a.m. Call 304-399-6742 to register or visit www.tristateracer. com.

In the UnIted StateS n There are over 2.9 million breast cancer survivors in the United States. n A woman has a little less than 1 in 8 chance of developing invasive breast cancer in her lifetime. n Breast cancer is the second most commonly diagnosed cancer in women. Skin cancer is the most common. n The American Cancer Society estimates that 232,340 new cases of invasive breast cancer will be diagnosed in women. n A woman’s chance of dying from breast cancer is 1 in 36. n Breast cancer is the second leading cause of cancer related deaths in women, trailing only lung cancer. n Approximately 39,620 women will die from breast cancer. n Breast cancer mortality rates are declining. This decline is probably due to early detection through screening, increased awareness, and improved treatment.

In WeSt VIrgInIa n Approximately 1,324 women will be diagnosed with breast cancer in 2013. n Approximately 282 West Virginia women will die of breast cancer this year. n Breast cancer continues to be a leading cause of cancer-related deaths among West Virginia women. rISk FactorS n Gender — being a woman is the main risk factor. n Age — risk increases with age. n Family history of breast cancer. n Personal history of breast cancer. n Menstruation at an early age — before age 12. n Menopause at a late age — after age 50. n Childbirth — having no children or first child after age 30.

Sources: American Cancer Society, www.cancer.org; WV Bureau for Public Health — WV Cancer Registry, http:// www.dhhr.wv.gov/oeps/cancer/Documents/Cancer_Incidence_in_WV_2009. pdf *For additional information about risk factors for breast cancer go to www.cancer.gov/cancertopics/wyntk/ breast/page4 or www.cancer.org/ Cancer/BreastCancer/DetailedGuide/ breast-cancer-risk-factors

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When it’s breast cancer, you need care.

Don’t let cancer beat you.

fight The true power of the group. cancer

Rebecca Conaway, CFNP Women’s Services

Tevin Gillette, OT/RL Women’s Services

Dr. Erica Barringer Women’s Services

Dr. Damian Silbermins Hematology / Oncology

Denise Russell, NP Hematology / Oncology

Dr. Gerrit Kimmey Hematology / Oncology

Anna Gibson, NP Hematology / Oncology

October of every year is the time when we renew our focus on the issues that surround women and breast cancer. Unfortunately, breast cancer and every other form of cancer doesn’t follow a calendar. At HIMG, we are focused on the diagnosis, treatment and defeat of the disease every day of the year.

When it comes to cancer care for women, we provide you with a truly comprehensive experience within the HIMG Regional Medical Center. Our Women’s Services team is devoted to the issues surrounding women’s health in a private, comfortable setting. The team has complete and immediate access to the specialists throughout the facility.

The Women’s Services team, along with other primary care providers, have immediate access to the Oncology team for their expertise, compassion and treatment should the need arise.

Dr. Matias Valsecchi Hematology / Oncology

Dr. Arvinder Bir Hematology / Oncology

Dr. James Morgan, III General Surgery

Dr. Ben Moosavi Plastic & Reconstructive Surgery

Dr. Tim Robarts General Surgery

Dr. Tucker Jennings General Surgery

Janis Rule, NP Hematology / Oncology

The Oncology department is focused on the delivery of effective and advanced care of cancer and it’s side effects. Together with the surgical team, and the recent addition of Plastic & Reconstructive Surgery, the Oncology team strives to provide patients and families with the best care they can receive anywhere, not just in Huntington.

At HIMG, we understand that when it’s cancer, you need care. We deliver on that.

At HIMG, we do.

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FoCus on Women’s health

Sunday, September 29, 2013

October is Breast Cancer Awareness Month

According to the most recent medical statistics, one of every eight women will get breast cancer at some point during her life, so it is essential for women to be aware of the signs of breast cancer and take proactive steps for early detection of breast cancer.

Courtesy of Green Shoot Media

Tuesday, Oct. 8

What is Breast CanCer? Courtesy of Green Shoot Media

Do you know eight women?

According to the most recent medical statistics, one of them will get breast cancer at some point during her life.

A more alarming statistic may be that one out of 36 women will die of breast cancer. “You have cancer” can be a staggering statement to receive from your doctor, so it is important to have at least a common knowledge of the disease and its potential impacts, even if you are completely healthy.

Arming yourself with information on recent studies, survival stories and basic statistics can help you better understand breast cancer.

Ladies in Pink Luncheon

Guyan Golf & Country Club 11 a.m. – Shopping in the parlor Noon-1 p.m. – Luncheon Speakers: Robin Rowe and Breast Cancer Survivors Crystal Welch and Ronna Woods Tickets: $35 • RSVP to (304) 526-1349 All proceeds benefit St. Mary’s Pink Ribbon Fund

The basics

Thursday, Oct. 10

The American Cancer Society defines breast cancer as a malignant tumor that starts in the cells of the breast and can grow into surrounding tissues or spread to distant areas of the body.

Most breast cancers begin in the cells lining the breast ducts, while others start in the cells that line the milk-producing glands or other tissues.

If cancer cells spread into lymph nodes — small collections of immune system cells -— there is a higher chance

Breast Cancer Support Group

6 p.m. • St. Mary’s Regional Heart Institute • Room 204

Friday, Oct. 11 Free Breast Cancer Screening

8 a.m.-noon St. Mary’s Breast Center Free breast exam with coupon for discounted mammogram Call (304) 526-1492 to register

Saturday, Oct. 12 Biketoberfest Charlie’s Harley Davidson

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408 4th St., Huntington Noon-8 p.m.

Bands: 1-4 p.m. and 5-8 p.m.

Raffle items Breast cancer awareness literature Custom bike contest All proceeds go to St. Mary’s Pink Ribbon Fund

that the cells could have also spread into other sites in the body, according to breastcancer.org.

The signs

Although sometimes completely normal and non-cancerous, breast lumps deserve evaluation by a medical professional to rule out the occurrence of cancer.

Experts advise women to be familiar with their normal breast consistency, because detecting a change early in the process can make a big difference in effectively treating the disease.

Other signs of breast cancer can include breast pain, thickening of the breast skin, nipple discharge or change in breast shape or size, according to the National Cancer Institute.

The sTaTisTics

Breast cancer is the secondmost common cancer among women in the United States next to skin cancer and is the secondleading cause of cancer death in women after lung cancer.

The American Cancer Society estimates that in 2013: n More than 232,000 new cases of invasive breast cancer will be diagnosed in the United States. n There will be more than 39,000 breast cancer deaths.

FOCUS ON WOMEN’S HEALTH

Sunday, September 29, 2013

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BREAST CANCER AWARENESS MONTH Courtesy of Green Shoot Media

Organizations, individuals and business alike have come together every October to make the month as pink as can be.

The color has become the heroic hue catalyzing the worldwide effort to raise funds, awareness and support for battling breast cancer and its debilitating effects.

Twenty-five years and running, National Breast Cancer Awareness Month (NBCAM) is an effort that has accomplished much but still has aggressive objectives in the fight against cancer.

COLLABORATIVE EFFORT

NBCAM is a multi-faceted partnership between national public service organizations, medical associations and government agencies working toward a common objective: to promote breast cancer awareness, share disease-related information and provide greater access to services.

Founded in 1985, the initiative has also aimed to promote mammography as the most effective weapon in fight against breast cancer.

Check NBCAM.org for a list of participating organizations and also to find a low-cost screening location near you.

PLAN YOUR OWN EVENT

Do you have an idea for a local event that could help raise breast cancer awareness? You may find that planning it for October may garner large-scale support, as the national spotlight is centered on the disease.

Just be sure to properly plan, promote and execute the event for the greatest possible impact.

Local newspapers, radio and television news crews are likely suitors to provide positive coverage for your event. Utilize tools like Facebook and Twitter to gain national and international attention.

Websites like the U.S. Department of Health and Human Services’ www. healthfinder.gov are continuously looking for events to highlight and share with the public.

FOR MEN

More than 2,200 men will be diagnosed with breast cancer this year and 410 will die, according to estimations made by the American Cancer Society.

That’s why the third week of Breast Cancer Awareness Month is being devoted to generate attention to the rare but dangerous disease.

Events, walks and public announcement efforts have helped raise awareness to male breast cancer, helping many men in identifying potential symptoms and following up with their doctors.

October is Breast Cancer Awareness Month Sunday, Oct. 13 Cuts for the Cure and Pamper for Pink 11 a.m.-3 p.m.

Lee David Salon 148 W. 8th Ave., Huntington $30 donation per service Services: haircut, massage, facial or express manicure and pedicure No appointment necessary All proceeds from the event go to St. Mary’s Pink Ribbon Fund Door prizes and drawings www.leedavidsalon.com

Tuesday, Oct. 15 Total Woman Girls Night Out

FINDING BREAST CANCER Finding breast cancer early is important.

Women who find breast cancer early have more choices for treatment and a greater chance of being treated successfully.

HOW CAN I FIND BREAST CANCER EARLY? There are three things you can do to find breast cancer early: n Conduct a monthly breast self-exam, n Have a doctor or nurse check your breasts every year, and n Get a mammogram.

WHAT IS A MAMMOGRAM? A mammogram is an x-ray picture of the breast. It is used to find small cancers as early as two years before you or your health care provider can feel them.

WHEN SHOULD I HAVE A MAMMOGRAM? n Women age 50 and older should have a mammogram at least every two years. n If you are 40 to 49 years old, you should talk to your doctor or nurse about when you should start having mammograms and how often.

WHERE SHOULD I GO FOR A MAMMOGRAM? Ask your nurse or doctor about where to go for a mammogram. All mammography facilities must be certified by the Food and Drug Administration. For more information about where to get a mammogram and how to get a free or low-cost

mammogram, call the West Virginia Breast and Cervical Cancer Screening Program at 1-800-642-8522.

HOW WILL I PAY FOR A MAMMOGRAM? Most health insurers in West Virginia cover mammography. If you have health insurance, check to see if it will cover the cost of a mammogram. Note: If you have insurance and have not met your deductible, the cost of a mammogram may not be covered.

Medicare will pay for a mammogram every year.

If you do not have insurance or if your insurance does not cover a mammogram, you can get help to pay for a mammogram. For more information: n Call your local health department or clinic and ask about the West Virginia Breast and Cervical Cancer Screening Program. This program offers free and low-cost Pap tests, pelvic exams, clinical breast exams, and mammograms to women who qualify. n Call the West Virginia Breast and Cervical Cancer Screening Program directly at 1-800-642-8522 to find out about free or low-cost mammography programs in your area. n Go to www.wvdhhr.org/bccsp to get program information and a list of WVBCCSP providers.

Sunday, Oct. 20 Breast Cancer Survivor Reunion

2-4 p.m. • St. Mary’s Conference Center St. Mary’s Fifth Avenue Campus 2825 Fifth Ave., Huntington Featured speakers: Amy Marcum, daughter of a breast cancer survivor, and Josh Waginger, son of a breast cancer survivor

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Courtesy of Green Shoot Media

October is National Breast Cancer Awareness Month, and throughout its 31 days a variety of groups and agencies come together to raise awareness of the disease.

Marquee Cinemas, Pullman Square, Huntington 5:30 p.m. – Event opens 7 p.m. – Movie starts (“Letters to Juliet”) Food and a signature “mocktail” Women’s health information Vendor booths Seating is limited.

RSVP to (304) 526-1271

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– Crystal Welch, Huntington, WV “When I was told I had breast cancer I was so frightened. I couldn’t imagine having a masectomy, much less reconstructive surgery. However, my first visit to Dr. Mozaffari’s office changed all of that. Dr. Mozaffari’s expertise and the kindness of his staff soothed my fears and set my mind at ease about the reconstructive process. I would recommend his services and staff to anyone in need of reconstructive breast surgery.”

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Sunday, September 29, 2013

“Sometimes I feel like I’m the luckiest person in the world because we found everything we did, and then there are days I look at myself with the scarring and the changes in my body and there’s kind of a moment of sadness. But, it’s not pity.”

— Marielle Madden, cancer survivor

FOLLOWING HER FEELINGS Breast cancer survivor acts on intuition, encourages others to be informed, advocate for selves

By BETH HENDRICKS The Herald-Dispatch

bhendricks@herald-dispatch.com

HUNTINGTON — Marielle Madden’s persistence may have just saved her life.

Madden was 40 in early 2010 when she found a lump in her left breast. The discovery prompted a doctor’s appointment and a mammogram, which failed to detect the mass.

“The doctor could feel it, but it didn’t show up on the mammogram,” Madden said. “He said we could follow it for six months or he could send me to the breast center at St. Mary’s. I didn’t want to wait, so I made the decision to go.”

Tests at the breast center were inconclusive as well.

“It didn’t show up for them either, and because I didn’t have any signs or symptoms and no family history, they weren’t too concerned,” Madden explained.

“But, I was. I knew.”

Doctors decided on a surgical biopsy six weeks out for Madden, and, finally, delivered the news she expected to hear.

“When I went back the next week, he said, ‘Well, you have breast cancer,’ and I said, ‘I know,’” said Madden, who attended that appointment with her mother. “We talked about all the different posMadden sibilities from that point, and it was being suggested that I have a lumpectomy with radiation, but I wasn’t satisfied with that.”

Madden presented her idea — a double mastectomy — to her physician.

“He asked why, and I told him I just felt like if there was one in there we could feel but wasn’t showing up on a mammogram, what if there’s more? How could I ever be comfortable with a mammogram being negative in the future when this one was negative, and it turned out to be cancer?” Madden offered.

Five words following surgery validated Madden’s decision.

“He said to me, “You just saved your life,’” she recalled. “The right side was clear, but there were three more tumors on the left side.

“It was almost surreal, but I thought, ‘OK, I really made a good decision.’”

Madden underwent her double mastectomy in April 2010 and chose to have reconstructive surgery afterward. She completed four rounds of chemotherapy over the next three months and lost all her hair. In a show of solidarity, her father, Raymond Pollard, shaved his own head to match his daughter’s.

“We met at Shoney’s for lunch one day, and he walked in completely bald. He was awesome. My whole family was. They dealt with it extremely well,” said Madden, whose son and daughter used the experience to organize a “Pink Out Day” at their school.

The outpouring of support Madden received was key during her recovery, she said. She is a member of the Sisters of Hope breast cancer support group and has been actively involved with several cancer survivors in her church. Wigs and scarves from the American Cancer Society, as well as the “Look Good, Feel Better” program were a welcome blessing.

“They have everything you can imagine. When you’re going through this, all of it is very new, but there are so many resources and so many different support groups out there for you,” Madden said. “The Look Good Feel Better program was just fun. We had a blast.

And, you look around the room and realize everyone else is at some stage of cancer, and it’s just a very good place to be to have that support around you.”

Now in remission, Madden said she has good days and bad days when she looks in the mirror.

“Sometimes I feel like I’m the luckiest person in the world because we found everything we did, and then there are days I look at myself with the scarring and the changes in my body and there’s kind of a moment of sadness. But, it’s not pity.”

Madden’s advice for other women: Advocate for yourself.

“Trust your instincts and go with your gut. You have to advocate for yourself and really know yourself,” Madden said. “If you feel like something’s not right, keep going until you feel like it is. Go until you feel like you have your questions answered and feel comfortable.”

Courtesy of Marielle Madden

ABOVE: Breast cancer survivor Marielle Madden is pictured with her father, Raymond Pollard, following her treatment and recovery.

BELOW: Madden is shown with her father, who shaved his hair in support of Madden when she lost her hair from chemotherapy treatment.

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Sunday, September 29, 2013

FIGHTING THE GOOD FIGHT

Myriad resources available to help join the fight against breast cancer Courtesy of Green Shoot Media

Opportunities to join national organizations in their fight against breast cancer can be found with the click of a mouse.

With mailing lists, online calendars and instant social media announcements, awareness-focused groups hoping to make a big difference in cancer prevention are more accessible than ever.

Individuals, companies and nonprofit institutions plan and coordinate innovative studies and powerful events that have helped make major headway in the mission to find a cure.

Walks and rides Events like the Making Strides Against Breast Cancer walk or the Avon Walk recruit thousands of participants who take steps — literally — to improve health and raise money to help fight breast cancer with research, information-sharing and access to mammograms.

Many similarly spirited bike-ride events are sprinkled throughout the country and allow cycling enthusiasts the opportunity to pedal toward a great cause.

Courtesy of Green Shoot Media

Opportunities to join national organizations in their fight against breast cancer can be found with the click of a mouse. Local, regional and national events and groups offer ways to help raise awareness of breast cancer and funds for breast cancer-related agencies.

Professional sports Pink football cleats, batting gloves and jersey patches have made their

way into the professional sporting world, offering a sign of solidarity in finding a cure for breast cancer.

Major League Baseball’s “Going to Bat Against Breast Cancer” is held every Mother’s Day and features pink bats, wristbands, necklaces and ribbons.

The National Football League’s “A Crucial Catch” is a partnership with the American Cancer Society focused on promoting the importance of annual screenings.

Games throughout October are comprised of players, coaches and referees wearing pink game apparel, on-field pink ribbon stencils, special game balls and pink coins.

Local events Odds are, there are events on the schedule for your own back yard.

Reach out to local gyms, health experts and hospitals for information on event locations, times and ways to get involved. Local activists are always looking for volunteers to help with planning, fundraising and on-site execution.

You may find that participating in a regional event instead of one with more national backing may help you feel more invested in your community and the people around you who may be facing breast cancer.

EARLY DETECTION CAN MAKE THE DIFFERENCE American Cancer Society continues to recommend annual breast cancer screenings for women older than 40 Courtesy of Green Shoot Media

The earlier breast cancer is found, the better. Although a topic of much debate, the American Cancer Society still recommends annual breast cancer screenings for women older than 40.

Mammography is a screening and diagnostic tool that uses low-energy X-rays to examine the breast. Screening mammograms are used to check for breast cancer, as they are effective in detecting tumors that cannot be felt.

Diagnostic mammograms are used to check for breast cancer after a lump or other symptom has been found.

Mammograms During a mammogram, breasts are compressed between two firm surfaces in order to spread out the tissue for the optimum X-ray image capturing. Doctors then analyze the black-and-white images to detect changes and cancer.

Mammograms play a vital role in early breast cancer detection, as many studies have shown.

The recent findings of the longest-running mammogram study ever completed found that 0 screenings cut breast cancer deaths by 330 percent, saving more than 20,000 lives every year.

Further recommendations The American Cancer Society also recommends that some

Courtesy of Green Shoot Media

A radiology technician is pictured performing a mammogram. Mammography is a screening and diagnostic tool that uses low-energy X-rays to examine the breast. Screening mammograms are used to check for breast cancer, as they are effective in detecting tumors that cannot be felt. women be screened with an MRI along with mammograms.

This population makes up less than two percent of all women in the United States and is comprised of women who may face an increased

risk for breast cancer because of family history, a genetic tendency or other related factors.

Women are urged to talk with their doctors about their history to help guide their individualized screening strategy.

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FOCUS ON WOMEN’S HEALTH

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Sunday, September 29, 2013

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Courtesy of Green Shoot Media Courtesy of Green Shoot Media

Men can suffer from breast cancer, but it is rare. Cases of male breast cancer comprise less than one percent of all cases of breast cancer. Men at any age are susceptible to developing breast cancer, but it is usually detected in men between 60 and 70 years of age, according to the National Cancer Institute.

One screening mammogram every 12 months is fully covered for all women ages 40 and older with Medicare, the government-funded health insurance program.

Talk to your doctor about your risk for breast cancer to help determine other coverage allowed under Medicare.

Men not completely immune to the risks of breast cancer

Frequency of government-paid screenings depends upon risk Courtesy of Green Shoot Media

Medicare spends almost as much money screening for breast cancer — $1.08 billion annually — as it does treating it — $1.36 billion, according to a study published in JAMA Internal Medicine in January.

One screening mammogram every 12 months is fully covered for all women ages 40 and older with Medicare, the government-funded health insurance program.

Women can also receive covered digital mammograms, as well as a baseline mammogram between ages 35 and 39.

Covered Medicare pays for a clinical breast exam once every 24 months for women at average risk of breast cancer.

Exams are also covered once every 12 months for those at high risk and women of child-bearing age who have had an exam that showed cancer or other changes in the past three years, according to www.medicare.gov.

Not covered Medicare’s screening coverage infor-

Courtesy of Green Shoot Media

A sometimes overlooked aspect of breast cancer is the fact that men can also suffer from the disease. It is rare, making up less than one percent of all cases of breast cancer.

But it happens. Men at any age are susceptible to developing breast cancer, but it is usually detected in men between 60 and 70 years of age, according to the National Cancer Institute.

mation does not presently include covered MRIs along with mammograms.

Be aware also that any additional pictures that may be needed to further check changes in your test results may require you to pay your deductible and co-pay for a diagnostic mammogram.

Also, be sure to consult your physician regarding your breast cancer risk. If it is found that you are high risk, you may be able to find additional coverage for more frequent exams and breast MRI.

Symptoms Lumps or thickening of the breast tissue are signs and symptoms of male breast cancer, as are various changes to the breast’s skin covering.

These changes to look out for include redness, dimpling, puckering or scaling, according to the Mayo Clinic. Men are urged to consult their physicians if any of these symptoms are persistent or worrisome.

Other coverage Medicare Part B covers external breast prostheses, including a post-surgical bra, after a mastectomy, according to medicare.gov.

Also covered (Medicare Part A), are surgically implanted breast prostheses after a mastectomy if the surgery takes place in an inpatient setting, while the Part B covers the surgery in outpatient settings.

For more information on these changes or other Medicare-related topics, check with your insurance representative or visit medicare.gov, as the system’s requirements and coverage change often.

Risk factors The American Cancer Institute defines several risk factors that can be attributed to a male developing breast cancer.

Exposure to radiation or having a disease linked to high levels of estrogen in the body, such as liver disease, are two such factors.

West Virginia Breast and Cervical Cancer Screening Program health information specialists

Region B (Boone/ Braxton/Cabell/Calhoun/Clay/Gilmer/ Jackson/Kanawha/Lincoln/ Mason/Putnam/ Roane/ Wayne/Wirt) Anna Reno P.O. Box 490 Elizabeth, WV 26143 Phone/Fax: 304-2750339 Email: areno@hsc.wvu.edu

Region D (Barbour/ Berkeley/Grant/Hampshire/Hardy/Jefferson/Mineral/Morgan/ Pendleton/Preston/ Randolph/Taylor/ Tucker/Upshur) Ruthie Watts, RN 12 Maple Hill Avenue, Suite 3 Petersburg, WV

26847 Phone: 304-257-5419 Fax: 304-257-9374 Email: ruwatts@hsc.wvu.edu

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Region C (Brooke/Doddridge/Hancock/Harrison/Lewis/Marion/Mar-

shall/Monongalia/Ohio/Pleasants/ Ritchie/Tyler/Wetzel/Wood) Shelly Dusic Cancer Prevention and Control PO Box 6886 Morgantown, WV 26506 Phone: 304-2932370 Fax: 304-293-9211 Email: sdusic@hsc. wvu.edu

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Region A (Fayette/Greenbrier/ Logan/McDowell/Mercer/Mingo/Monroe/Nicholas/Pocahontas/Raleigh/ Summers/Webster/Wyoming) Thelma Workman 307 Federal Street, Suite 220 Bluefield, WV 24701 Phone: 304-324-2841 Fax: 304-324-2859 Email: thworkman@ hsc.wvu.edu

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The institute also identifies a risk factor related to having several female relatives who have had breast cancer.

Testing Doctors use general physical exams and health history assessments when trying to detect and diagnose breast cancer in men.

Exams will include checks for lumps or any other unusual physical features. When conducting a patient health history, doctors are looking to identify health habits, past illnesses and treatments.

A range of other medical tests and strategies can also be used, including clinical breast exams, ultrasounds, MRIs or various biopsies.

Next steps Once male breast cancer is detected and diagnosed, doctors rely on a bevy of treatments depending on the disease’s progression.

According to the National Cancer Institute, most cases of male breast cancer are diagnosed at a later stage compared to female breast cancer. The chance of recovery depends on many factors, including the stage and type of the cancer, as well as the patient’s age and general health.

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Sunday, September 29, 2013

FINDING EMOTIONAL SUPPORT Having a group in your corner can make a world of difference Courtesy of Green Shoot Media

Breast cancer brings with it many physical, emotional and practical challenges that can be difficult to overcome.

This is true for patients as well as their family members and friends by their side.

Sometimes having a group of supporters in your corner can make a world of difference, and many organizations throughout the world are here to fit that bill.

Find spiritual help

CancerCare

For nearly 70 years, CancerCare has Many breast cancer patients and been offering life-changing services to survivors rely on their faith in guiding cancer patients, survivors, loved ones, them through the relentless process of caregivers and the bereaved. treatment.

The organization facilitates counselThe power of prayer is palpable in ing and support groups, publications, their journeys to find the strength and workshops and financial assiswillpower to battle through tance. rounds of chemotherapy, radiaParties interested in pursuing tion and emotional valleys.

CancerCare’s services can rest Many religious communiassured that all of its offerings CancerCare: ties host support groups, conare provided by professional 1-800-813vey close-knit environments oncology social workers free HOPE and foster a congregation of like-minded citizens willing to of charge. Call 1-800-813-HOPE Susan G. offer a helping hand to anyone for more information.

Komen for the in need of support.

Cure: Susan G. Komen 1-877-GOKO- Hospice for the Cure MEN Hospice is a philosophy of patient care that aims to This global leader of the improve the quality of dying breast cancer movement has invested nearly $2 billion since its by providing pain relief, general care and spiritual support for the ill and inception in 1982.

Not only does the organization pro- their families.

The choice of hospice can be a diffivide funding for crucial research and services, it also offers emotional sup- cult one because it correlates with one to stop anti-cancer treatment. Breastport to anyone who needs it.

People are urged to call 1-877-GO cancer.org urges all patients to ease KOMEN for more information or free the transition process by having a plan support from the group’s trained pro- in place to handle such demanding decisions. fessionals.

Finding Support

Emotional support is important for a patient facing a breast cancer diagnosis as well as the family members, friends and loved ones by their side.

Courtesy of Green Shoot Media

Educational resources WV Breast and Cervical Cancer Screening Program (1-800-6428522) Contact your local Health Information Specialist (Page 11) or call (304) 293-2370 or go to www.wvdhhr. org/bccsp National Cancer Institute 1-800-4-CANCER (1-800-422-6237) www.cancer.gov American Cancer Society 1-800-ACS-2345 (1800-227-2345) www.cancer.org

National Alliance of Breast Cancer Organization (NABCO) 1-888-806-2226 www.nabco.org The West Virginia Breast and Cervcial Cancer Screening Program offers free or low-cost clinical breast exams, mammograms, pelvic exams, and Pap tests to women who qualify. The services are offered through most local health departments and many primary care centers.

To find a WV Breast and Cervical Cancer Screening Program provider near you, call 1-800-642-8522 or visit www.wvdhhr.org/bccsp.

Questions about this media kit? Call Cancer Prevention and Control, Mary Babb Randolph Cancer Center, at (304) 293-2370.

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Susan G. Komen for the Cure 1-800-IM AWARE (1-800-4629273)

www.komen.org

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The following organizations have free educational materials about breast health and/or breast cancer:

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Focus on Women’s HealtH

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Sunday, September 29, 2013

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FINDING HER WAY

Woman finds her own way to weight loss and health The Advocate

BATON ROUGE, La. — People who have worked for years with Monica Esnault passed her in the hallway, at first not recognizing her new, slimmer profile.

Others have introduced themselves and asked how she lost weight, because they want to do it, too.

Esnault, 46, lost 160 pounds over the last two years after she methodically changed her lifestyle.

From her highest weight of 3 43 pounds, she now weighs close to 180 pounds and is deciding where she’d like the scale to settle.

“The promise I made myself was to do it in a way I could live with the rest of my life,” said Esnault, an assistant director with LSU’s office of bursar operations.

Esnault said she struggled with weight all her life, but had gotten it under control with diet and exercise in college and into her mid-20s. But, at some point, she began to feel she Monica was losing the batEsnault tle.

Forty-six- She enjoyed eatout with friends year-old ing and, early in her Baton career, she traveled Rouge, La., enough to throw resident who off an exercise roulost 160 tine.

Over the next two pounds over decades, she’d have the past two some success with years dieting and exercising, but it wouldn’t last.

“It just seemed, in my mid-20s, when I started gaining, I couldn’t get things back on track,” Esnault said. “It’s sad in a way. You don’t want to be overweight. Sometimes you feel like you can’t get control again.”

Her turning point came a few years ago, when Esnault learned she was pre-diabetic.

“It was like a jolt,” she recalled.

Esnault had seen her beloved grandmother, who was diabetic, have to go on dialysis at age 88, in the final years of her life.

Today, Esnault has turned her health around. She is no longer borderline diabetic. Her doctor has also dramatically lowered the dosage of her blood pressure medicine, and Esnault hopes to soon be able to get off it entirely.

Esnault’s cousin Charlesetta Nganga of Macon, Ga., encouraged Esnault to share her story with others.

Nganga, who has Type 2 diabetes and is trying to lose weight, said that, as Esnault has worked to lose weight, she has reached out and supported others on that path.

“She’s my ‘she-ro,’” Nganga said.

“It can be a lonely journey at times,” said Esnault, adding that her faith helped her through the challenging moments of changing her life. “I just encourage everyone (trying to lose weight) to do it in a way they can live with.

“I want everyone to know it is not impossible,” she added.

This is how Esnault lost weight and is keeping it off:

“The promise I made myself was to do it in a way I could live with the rest of my life.”

Menu change No more sodas.

Esnault, who used to drink five or six Cokes a day, went “cold turkey” and now drinks only water.

Find what you like to eat Esnault tailored her own diet, incor-

No more sodas

Monica Esnault, an assistant director of the LSU Bursar’s office, poses for a photo in Baton Rouge, La. Esnault, 46, lost 160 pounds over the last two years after she methodically changed her lifestyle.

The Associated Press

porating “only things I like because you can live with that.”

On previous weight-loss programs that focused on high-protein, lowfat or low-sugar diets, Esnault found that eating the same foods all the time (foods she didn’t much like anyway) didn’t last and she regained the pounds.

Among her “likes” are low-sodium, turkey-bacon sandwiches with fatfree cheese on wheat bread; fresh and canned fruit; frozen low-calorie meals; lean beef; red beans and turkey wraps.

“I build enjoyment into my meals,” Esnault said.

Esnault avoids fried foods and sweets. She doesn’t often eat between meals, but if she’s very hungry, she’ll enjoy something like a handful of cashews.

Dine in, not out Cut back on eating out.

Esnault, who used to go out for most meals, now dines out just once or twice a week. Her friends at work have begun bringing their lunches, too — one of them sets up a card table in an office, and they visit and enjoy lunch together.

It’s OK to eat Allow for flexibility.

“If it’s somebody’s birthday, I eat cake,” Esnault said. And, if she gets a craving for her favorite candy, Hot Tamales, “then, it’s on,” she said.

Step it up Exercise five to six days a week.

Esnault began exercising a couple of years ago by going to a local gym and walking on the outdoor track.

The first time she went to a gym, she said, she told herself, “I’m going to come every day and walk around one time, if it’s all I can do.”

Before long, she was lapping the track several times to make a mile.

Today, Esnault works out at two different gyms, using weight-training machines twice a week at one gym, and doing cardio work on the treadmill, elliptical and bike on the other days.

Her exercise plan has built up and evolved over time, she said.

Just do it anyway “I promised myself no excuses” to miss workouts, Esnault said, no matter how little time she had on any given day.

“If I had only 20 minutes, if I had 15 minutes, I went,” she said. “I refuse to let circumstances limit what I can do.”

All in your mind Take one step at a time.

Esnault said she, “never said in my mind” how much weight she wanted to lose.

“I could not allow myself to think about it,” she said, “even though I knew I needed to lose 150 pounds.”

T h a t wo u ld h a ve b e e n ove r whelm i ng. Instead, Esnault sa id, she “always set 5- to 10-pound goals for myself.”

For example, she’d plan to lose a few pounds before a vacation trip or by the time an LSU football season kicked off.

“Then you get to enjoy successalong success along the way,” she said.

“That was key for me.”

Dr. Destiny Maxson has a desire to share her knowledge of gentle pediatric care, pregnancy and women specific care programs to families across the region.

She commonly sees ailments such as: Chronic Fatigue Menstrual Cramps Menopause • Pregnancy Postpartum Pelvic Floor Rehab Incontinence • IBS Constipation Headaches • Migraines Digestive Dysfunction Weight Loss Back Pain Leg Pain • Neck Pain

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By ELLYN COUVILLION

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Sunday, September 29, 2013

us HealtH care overHaul

Changes to health care under new law, at a glance Under the law, health insurers must cover 10 essential benefits. This will make health plans more costly, but also more comprehensive. Starting next year, the rules will apply to all plans offered to individuals or through the small-group market to employers with 50 or fewer workers.

The Associated Press

An overview of some of the key changes to health care services under the Affordable Care Act:

Essential health benefits

Dental-vision Need a teeth-clea ning or eye exam? You still could be reaching into your own wallet

File photo/The Herald-Dispatch

Under the law, the amount of money people will have to pay out-of-pocket each year for medical and prescription drug costs will be capped at $6,350 for individuals and $12,700 for a family. These limits are separate from the monthly premiums people pay. The limits take effect in 2014 for those buying insurance on the state health insurance exchanges. For those with employer-based coverage, the restrictions will be fully in place in 2015.

In addition, most insurance plans will be prohibited from setting lifetime cost limits on coverage for essential health benef its . T h is mea ns you r insurer cannot deny you coverage because your medical bills have gone over a certain amount.

Age 26

to cover the cost even after the Affordable Care Act takes full effect next year. Dental and vision care is considered an essential benefit for children aged 18 and younger whose parents or guardians get insurance through the individual or small-group plans. The law does not mandate this coverage

for adults, but some states could choose to have them covered.

Still, getting dental coverage for children and teenagers might be a bit complicated depending on where you live.

States can choose to offer those items as stand-alone plans, and federal subsidies would not help pay for the costs.

Key consumer questions about new health care law The Associated Press

Out-of-pocket spending/ lifetime limits

How do I know whether “Obamacare” applies to me?

Polls show many Americans remain mystified by the Patient Protection and Affordable Care Act, or “Obamacare” as it is commonly known. But there’s an obvious starting point: Do you have health care coverage?

If your employer provides health insurance for you, it’s likely you don’t have to do anything on Oct. 1, when enrollment begins. The president has said you will be able to keep your doctor and your plan.

For others — those without insurance — it’s more complicated. The law requires virtually all U.S. citizens and legal residents to have coverage or pay a penalty. That will happen either through an expanded government Medicaid program, which would cover costs for lowerincome people, or by requiring people without coverage to buy it. Financial help will be available for those who qualify, based on income.

When do I have to decide whether to buy health insurance and what happens if I don’t?

Beginning in 2014, virtually all Americans will be required to have health insurance or pay an annual penalty to the government. For an individual, the fine begins at a minimum of $95 in 2014, stepping up annually to a minimum of $695 by 2016. The fine for uninsured children in 2014 is $47.50 for each child, although the maximum a family would have to pay in penalties next year is $285. Those fees climb each year.

Federal researchers predict that about 6 million people could be hit with fines by 2016.

Those who owe penalties would see their tax refunds docked. Not everyone who fails to buy insurance will be forced to pay up — those exempted from the requirement to have insurance, such as prison inmates, would not be penalized, for example. That also would be the case with people who earn so little that they are not required to file a tax return.

According to the government, the IRS plans to hold back the amount of the penalty fee from future tax refunds, but there are no liens or criminal penalties for failing to pay.

What are health insurance exchanges and how do they work?

Exchanges are the online markets on which individuals and small businesses will buy private health insurance. Think of them as onestop-shopping destinations similar to Amazon. com that are supposed to give consumers a quick way to compare insurance policies. But they might not be available to some consumers until later. That could leave many who lack job-based coverage to enroll by mail or through call centers. Still, consumers are expected to be able to see all their options in the exchanges and choose their health plans

based on price, benefits and other features.

Many participants will qualify for federal subsidies in the form of tax credits to help ease the cost. The amount is based on income and is available to individuals making up to $45,960, or $94,200 for a family of four. Shoppers will have different buying experiences depending on who is running their exchanges — the state, federal government or a combination of the two. Enrollment begins Oct. 1, with health care coverage starting Jan. 1.

How will actual health care coverage and services be different under Obamacare?

Coverage in the exchanges will be more comprehensive than what is typically available to individuals in the current health insurance market, which is dominated by bare-bones plans. It will resemble what a successful small business offers its employees. All plans in the exchange, and most outside it, will have to cover a standard set of benefits, including hospitalization, doctor visits, prescriptions, emergency room treatment, and maternal and newborn care. Under the law, insurers can’t turn away people or charge them more because of health problems or chronic illnesses. Insurers also are banned from setting different rates based on gender. Middle-aged and older adults can’t be charged more than three times what young people pay, but insurers can impose penalties on smokers. Most health insurance plans have to cover certain preventive services. Those include routine vaccinations, vision and hearing tests for children, and screenings for diabetes, high cholesterol, colon cancer and high blood pressure.

I currently have insurance through my employer. Will anything change?

For many people who have health insurance through their employer, the Kaiser Family Foundation says not a lot is expected to happen right away. Some workers may receive a financial break from the new cap on out-ofpocket expenses and free preventive care. But some larger companies, those with 50 or more employees, already are looking for ways to cut costs and avoid getting hit with a new tax set to take effect in 2018 on so-called “Cadillac” insurance plans. Those are defined as plans valued at $10,200 or more for individual coverage and $27,500 for family policies. United Parcel Service, for example, informed its white collar employees that it will no longer cover spouses if they can get coverage through their own employers. Delta Air Lines, meanwhile, recently predicted its workers may have to help shoulder the cost of various new mandates under the Affordable Care Act, such as coverage for employees’ children until they are 26 years old and coverage for workers who had previously opted out but will now be required to have health insurance.

Pre-existing conditions

This is a major change under the law. Starting in 2014, most pla ns — whet her obta i ned through an employer or on the marketplace — cannot deny coverage or charge more money because of a pre-existing health conditions.

However, if you have what

One popular provision of the health care law already is part of most insurance plans — allowing young people to stay on their parents’ insurance plans until age 26. This also covers dependents, including step-children, adopted children and some foster children. This benefit will be required of all plans that provide dependent care. Starting in 2014, younger people can remain on a parent’s or caregiver’s plan even if they have an employer option of their own.

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Under the law, health insurers must cover 10 essential benefits. This will make health plans more costly, but also more comprehensive. Starting next year, the rules will apply to all plans offered to individuals or through the small-group market to employers with 50 or fewer workers. The essential-benefits requirement does not apply to plans offered by larger employers, which typically offer most of these, already.

The covered benef its are: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabi litative ser vices a nd devices; laboratory services; management of chronic diseases, and preventive and wellness services; and pediatric services, including dental and vision care.

People will be able to pick from insurance plans with differing levels of coverage and varying costs for co-pays and premiums. But insurers will have to cover a certain percentage of the services’ cost.

“Most of the important services people need are covered, though there may be a slight variation (from state to state),” says Jennifer Tolbert, director of state health reform for the Kaiser Family Foundation.

is known as a grandfathered individual plan — a plan you buy yourself that was in existence before March 23, 2010, and has remained unchanged — then this rule would not apply. So check the details on your plan and consider shopping around.

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