Friday, May 15, 2009
Last week you learned that the Ultrasound Technology has greatly improved making it a viable option for identifying breast related-breastfeeding difficulties.
Ultrasound imagery has also revealed the following:
1. Breast tissue changes are significant during pregnancy and lactation. Previously it was believed that the glandular breast tissue - rather than adipose (fat) tissue- became the dominant tissue during pregnancy/breastfeeding. Studies show that proportion of glandular tissue increases more than adipose tissue; however, it is not necessarily true that a pregnant/breastfeeding breast has more glandular tissue than adipose tissue. Evidence shows that the proportion of glandular tissue to adipose tissue varies greatly among women; in fact, only 20% of a select group of women had more glandular tissue than adipose tissue.
2. Breast investigation requires using the highest resolution of the imaging technologies.
3. Ultrasound research does not need to compress the lactating breast; in fact, compression interferes with the ultrasound results. Compression is a major discomfort of mammograms.
4. Ultrasound technology should first survey the entire breast for any abnormalities. When an abnormality is detected, targeted ultrasound zeroes in on the problem area.
5. Nipple piercing and nipple surgery can affect the milk flow; these procedures can reduce the necessary blood flow within the lactating breast. In fact, research demonstrates that mammary blood flow, necessary for milk production, can decrease by 66% of what it should be. Ultrasounds of the nipple- areola can reveal reduced blood flow.
6. Lactating mothers should breastfeed her baby or express milk prior to an ultrasound; an “emptier” breast produces better results.
7. Mammary blood flow doubles by 24 weeks into a pregnancy; this blood flow continues to be elevated throughout full lactation. The average mammary blood flow varies with women.
8. It is normal to experience mammary blood flow variation between the breasts of one woman. Breasts are frequently asymmetrical in size, shape or milk production.
9. The 24 hour mammary blood flow required to produce one liter of milk is believed to be similar to other mammalian species. The ratio is 500:1 (500 liters of blood flow per 24 hour period to is required to produce 1 liter of milk).
10. Milk ejection signs include: sensations of pins and needles in the breast, milk leaking from the nipple, pain pressure, and the maternal feelings of warmth or nausea.
11. "There has been little investigation of the lymphatic drainage of the lactating breast despite its importance in engorgement and mastitis. "
Stay tuned for more next week....
Monday, May 11, 2009
The pastor’s words during the funeral homily are worth noting - I will try to capture some of them in this posting.
Giselle spent her whole life serving God and the family that He helped her "co-create" with Andy. She lovingly, joyfully, and willingly served her family and God - she knew that this mattered. She knew how to love and trust. While we frequently and erroneously try to canonize people at their funeral- her pastor believed that in this case it was ok - he believed that Giselle is already enjoying the presence of our Lord. I think so too. Why? There were many signs…
Giselle exuded joy, peace, love, faith, charity, fortitude, temperance, self control, and, patience in life and also during her battle with cancer. She readily offered up her suffering- and it was real- for some very special intentions. She didn’t look back when asked to forfeit her life despite leaving behind a loving husband and five young children who will miss her greatly. Regardless of her undying love for them, she loved God more. This is the life of a saint.
Furthermore, Giselle died with great dignity, acceptance and peace. She understood what it meant to offer up her suffering - she commented that if it helps anyone or anything (and she believed it did) she would gladly do it all over again. The last hours - when told there was nothing else they (doctors) could do - she wrote down that she was ready to see God face to face. When asked if she was afraid, she wrote that she wasn’t – and she wasn’t! She welcomed death knowing that in dying she would be born to eternal life.
Her battle against cancer was mounted courageously even while accepting the fact that death was highly probable. Giselle told us that she could accept God's plan whatever it was ; furthermore, she accepted His plan without asking "why me?"
Giselle painstakingly wrote thoughts and love notes in a journal after learning that her odds weren't that great. She did this for several reasons- she knew that her words would provide a testimony to her faith, a lasting legacy to her husband and children, and an encouragement to her family after she wasn't there to talk to them directly. She loved Andy and the children.
Giselle had a devotion to Our Lady- she died in May - the month traditionally dedicated to Mary.
It has been said that God asks mothers especially - to not look back- to let go of their babies. Giselle did that - she let go because she loved God. She also was able to let go because she had fully experienced authentic love on earth with her husband and children - she had no regrets. She had learned to love with her whole heart, mind, and will. She had learned to love righteously – her love and life became ordered by faith-filled priorities.
The priest issued a warning to all of us who grieve her passing – but especially to Andy and the children. He reminded the children that they have received the faith from their mother; they are now responsible for growing this faith in the days, months and years ahead despite bearing enormous loss and the pain of separation. They are called to be saints like their mother. Surely, they will be tempted by Satan to despair of God’s love in the days ahead. They will be tempted especially on days when the loss hurts so badly. Surely, Satan will tempt all of us by reminding us that God took Giselle when she was young and active - we will be asked to consider why God couldn't have waited. Satan will paint God as missing in action (MIA) or AWOL (absent without leave) or even selfish for taking Giselle to Himself before we were ready to let her go. He will remind the children that God took Giselle before their graduation, their wedding day, the birth of Giselle's first grandchild.... He will tempt them to be angry with God for taking her before they were ready to let her go.
In truth the real question is this: are we ever ready to let someone go? Truth be told, the answer would be no. God, in His wisdom, took Giselle when she was ready. The rest of us need to get ourselves ready.
God will ask all of us in the days and months ahead: do we love Him? Do we trust Him? Will we honor Him? Only God understands why Giselle died May 3, 2009 and was dedicated to Him on May 8, 2009. May none of us despair or grow bitter with her departure. May God Bless Andy and the kids with grace and hope during their intense mourning. May they grieve like St. Peter. May we all mourn with righteousness.
Andy and Giselle demonstrated authentic love- they helped countless marriages with their NFP instruction in class, in person and on the air waves. What they did mattered to God. He blessed Giselle with countless gifts of grace that enabled her to endure the suffering and accept her death.
Andy and the kids can surely know God's love because He graced them for a little while with a saintly wife and mother. What more could they ask for or have received?
On a final note, after the reception we were gently reminded by a faith-filled old man (he describes himself as old- he's 85) as he witnessed to the beauty of marriage. Dr. Busam told us that we will not be able to fully experience Andy's pain unless we have also lost a spouse. He went on to say that " it is true - when we marry, we become one body. When our spouse dies, we are literally cleaved in half! Oh the pain is tremendous and the suffering untold. Furthermore, we never really heal from the loss. "
So let us all pray for marriage which is under attack today. Let us pray for all widows and widowers. And let us pray especially for Andy and the kids in the days and months ahead.
The Art of Breastfeeding advocates that breastfeeding is best for baby, mother, father, and society. Nevertheless, some women will encounter difficulties with breastfeeding due to either mechanical or behavioral problems as outlined in the book- what about them?
Mechanical breastfeeding problems can involve the breast itself including engorgement, mastitis, or other situations. The International Breastfeeding Journal recently published an article, dated April 29, 2009, on the effective use of ultrasound technology to identify breast problems while lactating. The title of the article was Ultrasound Imaging of the Lactating Breast: Methodology and Application.
The article points out the problems of using Mammography or Galactography to analyze breast/lactation problems. In the first case, increased glandular tissues and secretion of breast milk during lactation make radiographs difficult to interpret accurately. Furthermore, Galactography – which involves injecting contrast material into the duct orifices of the breast nipple- offers only limited information / views of the ductal system decreasing its usefulness. Also, Galactography; which injects foreign "dyes" into the breast; increases the possibility of breast infection. Previously, Ultrasounds weren't any more helpful for investigating lactating breast complications. Increased breast densities and accumulation of the milk during lactation rendered the older ultrasound images useless. Today however, improved ultrasound image resolution makes it possible to identify breast problems -even for lactating women.
The article cited many interesting facts that I thought you might be interested in reading. For example, recent breast research has revealed the following :
1. Many women may have far fewer main breast ducts than previously thought- most text books cite that women normally have at least fourteen.
2. Furthermore, dissections of breasts of women who had died while breastfeeding did not support previous assumptions made about the lactiferous sinus ; rather, the dissections revealed that the ductal branches merge into one main collecting duct very close to the nipples.
3. Milk ducts only distend at the time of milk ejection accommodating the transport of milk to the infant rather than storing milk for removal.
4. These new findings provide clarity to the operation, anatomy, and purpose of the various parts of the breast. You may wonder why this type of information is important. It is important that the various pathways of breast milk be identified and understood in order to accurately assess lactating breast problems. Furthermore, this information is necessary when reading and interpreting mammograms or ultrasounds; this furthers disease identification and resolution of breast problems. In the next several blogs about ultrasounds, you will read how ultrasound technology has helped identifty problems of the breast during lactation.