Undaunted courage

Going the distance after cancer

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Robert Boston

The Missouri River 340 is not your father’s float trip. This grueling race pits paddlers against a swift 340-mile stretch of the Missouri River that winds from Kansas City to St. Louis.

Among the 2014 competitors was Joan Twillman, 60, a retired high school chemistry teacher who lives in St. Charles, Missouri. She and seven other women completed the August race by paddling 55 hours non-stop in a 30-foot canoe. The “Ladies &  Clark” team placed second in its division; typically a third of the race competitors do not even finish.

Navigational challenges — fog, the hot sun by day and darkness at night, parked barges, submerged trees and floating obstacles — quickly cull the pack. Fatigue, pain and stress take their toll.

Twillman, a Missouri Master Naturalist, has competed regionally, led daylong kayaking excursions for a local canoe club and even ziplined in Costa Rica, all while undergoing reconstructive treatment following breast cancer.

“He (Dr. Myckatyn) worked with me every step of the way during recovery and my return to competition.”
- Joan Twillman

She credits surgeon Terence M. Myckatyn, MD, associate professor of plastic and reconstructive surgery and director of cosmetic and breast plastic surgery at the School of Medicine, with understanding her active lifestyle and offering personalized treatment.

Following a mastectomy in 2010, Twillman, a wife, mom and grandmother, had no plans for breast reconstruction, fearing that additional surgeries would prolong her ordeal. But, traveling and exercising with prosthetics proved too cumbersome.

Myckatyn explained reconstruction options, including an advanced surgery not widely available — transplantation of fat, skin and blood vessels from the patient’s abdomen.

After consideration, Twillman and Myckatyn took a “less is more” approach, deciding saline implants would better spare the critical muscles needed for kayaking.

She underwent a surgery to insert tissue expanders, a series of saline fills and, finally, a surgery to place permanent implants; all of the procedures were built around her busy schedule.

“He worked with me every step of the way during recovery and my return to competition, even going at a slower pace or taking breaks as needed. Going to
Costa Rica, he realized, was more important.

“The reconstruction was a big part of making me feel that I am no longer a cancer patient.”

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