By Elaine Shattner with Forbes
Sometimes a simple, low-tech device can improve the quality of patients’ lives. The Shower Shirt, designed so that women can safely shower after mastectomy, is a perfect example. The device took its inventor, Lisa Crites of Cocoa Beach Florida, to second place at the U.S. Small Business Association’s 2015 InnovateHER Challenge in Washington DC. The contest was sponsored by Microsoft.
For some women who have mastectomy, one of the most unpleasant aspects is not being able to shower. With chest bandages and tubes draining fluid, a good wash-up can be refreshing. But many breast surgeons advise patients not to let non-sterile water run directly over the drains sites. Typically, the flexible tubes with bulbous endings are in place for one to three weeks after surgery. To get around this restriction, women wear large-sized trash bags cut with holes to accommodate the head and arms. The “garbage bag method” has been ongoing for decades.
“I’m thrilled to receive this prize,” Crites said after winning the InnovateHER award, by phone. “It was an idea that came to me in the shower years ago. It’s taken so much time and effort to move this invention forward. I hope it will help many women.”
The Shower Shirt is made of waterproof parachute material on the outside, with microfiber on the inside of the neck, a water-resistant zipper, flap, and Velcro all the way down in front. The openings for the neck and arms are elastic, Crites said. Inside there are three pockets, where a woman might insert drains, and also a strap to secure tubing on each side. “It’s loose around the armpits,” Crites explained. “So let’s say you’ve had a mastectomy on just one side, you could pull the sleeve up on the other side to wash that arm.”
Sherry Palmer, a breast cancer survivor who lives near Melbourne Florida, recalls wanting to take a shower after her mastectomy in 2008. “It was the garbage bag or nothing,” she said. A few years later, she needed a follow-up procedure. “What a difference,” she said. “It was such a pleasure to just put that on, take a shower, and not have to worry.”
Palmer found out about the shirt through a volunteer group she directs called Breast Friends of Florida. Palmer and the group disclose no financial ties to the Shower Shirt company. “Lisa Crites has been kind enough to donate some of the Shower Shirts,” Palmer said. “She’s just so passionate that no one should have to go through the humiliation of wearing a garbage bag after breast cancer surgery.”
“A lot of patients can’t afford anything extra. They can barely pay for treatment,” Palmer said. “We have one volunteer who takes the shirts and cleans them,” she said. The organization keep a stock of four or five Shower Shirts in each size.
Palmer, who is in her early sixties, works part-time processing data for a Florida tumor registry. Through her volunteer work she’s had had contact with over 1,500 women with breast cancer, she said. “Everybody that’s tried the Shower Shirt has said it’s awesome. Some who’ve bought it have passed it on to another woman,” she said. “It makes an unfortunate situation bearable.”
The local Breast Friends group, which began in 2009, is affiliated with a national non-profit organization, Breast Friends. The chapter focuses on hands-on and emotional support, she emphasized. “It’s very word-of-mouth,” she said. “Sometimes it’s helpful listening to someone cry, offering adjustment, holding out a hand out to somebody that needs it.”
Women in the Melbourne area are typically referred to the Breast Friends organization by surgeons, oncologists and nurses at nearby hospitals, she said. “We guide the gals when they first get diagnosed,” she said. “What women need when they get diagnosed is to know that they’re not alone. And they need to know to take charge of their health care.”
Crites had a bilateral mastectomy in the spring of 2009 after a breast cancer diagnosis. Due to complications, she wound up having multiple operations. “My surgeon was adamant about my not getting the drain sites wet,” she said. “So I started working on this shirt. I don’t want one more female after mastectomy to have to wear a plastic trash bag, to go through the humiliation of that.”
Crites’s brother, an architect, helped her with the design and sketches. An aunt and cousin constructed the first prototype using material from a nylon hair-salon cape. Crites tried to engage a U.S. manufacturer, she told me. “But no one was interested in producing these at an affordable price. It would have been around $140 wholesale, and over $200 retail,” she said. “I wanted to make a shirt that all women can afford.” She settled on the M Garment company in Guangzhou China, which has been producing the shirts since 2010. Now the shirt sells for around $75.
Crites created a small business, The Shower Shirt LLC. The first batch of shirts became available in late 2010. In April 2011 Crites took the product to an Essentially Women exposition in Phoenix, Arizona, and joined that larger purchasing group. “It was the perfect opportunity to introduce the product to mastectomy boutique stores,” Crites said.
Annette Kuhlman noticed a Shower Shirt ad in a magazine. She works in a mastectomy boutique in Defiance, Ohio. Since 2004, when her mother died at 61 years from breast cancer, she’s been determined to help others affected. At Okuley’s Pharmacy and Home Medical, she fits women for mastectomy bras, prostheses and soft forms (for swimming and leisure, post-mastectomy) and helps them select wigs, scarves, turbans and other supplies for living with cancer and side effects of treatment.
The Shower Shirt drew her attention because she, who’s a registered nurse and had seen patients after surgery, recognized an unmet need. Kuhlman contacted Crites and invited her to give a presentation at the 2012 annual luncheon for breast cancer awareness arranged by the Zonta Club of Defiance, a local branch of the international Zonta organization for women.
The Defiance Zonta group purchased some Shower Shirts with funds raised through the luncheon. They decided to include the shirts in bags donated to women in the community after breast cancer surgery. Typically these bags include the shirt (if a woman has had mastectomy), an underarm “heart pillow” for support and relief after surgery which may involve lymph node removal under the arm, a journal, Mary Kay® personal care supplies, a breast cancer (ribbon) pin, and a few other items.
The shirts have been a hit, Kuhlman said. “Women can get in the shower and feel human again.” I’m not aware of anything else on the market. The drains are in usually for one to three weeks, depending on the surgery and how it goes. “If you want to shower then, the alternative is still the garbage bag. Doctors say, just use a garbage bag with electrical or duct tape to seal it,” she said. “Women who’ve gone through that surgery deserve more than that.”
The Shower Shirt comes in either of two colors: black and white; and three sizes: 4-12 (s-m); 14-22 (l-xl); and plus size (2x-4x). “The plus sizes are selling well,” Crites noted. Earlier and current shirts have a pink ribbon sewn in. “But we’re phasing it out,” she said. “The embroidery of the shirt cuts into the integrity of the material.”
Walmart.com picked up the Shower Shirt in August 2011. Crites established a relationship with CureDiva, a company that specializes in lifestyle needs of women who’ve had breast cancer treatment. Amazon picked it up the shirt in late 2014. Still, under 4,000 have been sold as of this date, Crites said. Some of the difficulty comes from Medicare’s lack of coverage, Crites considered. “Mastectomy boutiques generally cover breast prostheses, mastectomy bras and camisoles. Those are all covered by Medicare.”
The number of women who might benefit from the Shower Shirt is large; each year over 100,000 U.S. women undergo unilateral or bilateral mastectomy. In an effort to get Medicare – and eventually other insurers – to cover the Shower Shirt for women after mastectomy, Representatives Bill Posey (R) and Debbie Wasserman Schultz (D), both of Florida, introduced the Post-Mastectomy Infection Risk Reduction Act of 2014 before the U.S. Congress.