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Rock Stars Want To Franchise Specialty Teen Cancer Centers Across America

Rock superstars Roger Daltrey and Pete Townshend of “The Who” have a new cause: sparking a franchise of teen-oriented cancer treatment centers across America. To kick off the launch of Teen Cancer America, Daltrey & Townshend were featured at a conference held at the National Press Club in Washington, D.C. I was fortunate to be invited to sit at the head table next to teen cancer survivor Sarah Sterner – a bright and confident young woman from Atlanta who was cured of brain cancer two years ago.

Sarah told the crowd what it was like to be a fifteen-year-old in a pediatric oncology unit populated by ukulele-playing clowns and screaming infants. The extreme age-related disconnect between her pscho-social needs and that of younger kids and babies served to make her feel even more isolated during her course of treatment. She longed for the companionship of others like her, but without any national cancer centers focused on the special needs of teens, she was on her own.

Roger Daltrey became interested in teen cancer when his personal physician took up the cause in the U.K. and turned to him for support. Daltrey’s decades of playing music to teen audiences made him keenly aware of their unique psycho-social needs. “When you’re a teenager, it’s horrifying if you have a spot on your nose. Imagine what it’s like if you have cancer!” said Daltrey.

Teen Cancer America began as a movement called the Teen Cancer Trust in the U.K. According to Daltrey, preliminary research (comparing teens treated in a typical NHS cancer ward versus a unit sponsored by the Teen Cancer Trust) suggests that there may be as much as a 15% survival advantage in being treated in the special units. Daltrey attributes this to increased morale that helps teens and families find the will to fight through life-threatening treatments.

When asked how American cancer centers compare to those in the U.K. Daltrey immediately responded that he believed the U.S. centers were far superior. He described the incredible resources available at UCLA and Duke, and how the facilities themselves were unbelievably beautiful, sporting plant-filled atria, massive skylights, and high tech imaging and radiation equipment. Nonetheless, he noted, “Teens don’t want to hang out in an atrium. There is just no place that appeals to teenagers at these centers.”

Whether specialized teen cancer treatment environments in the U.S. will dramatically improve survival rates remains to be seen, but there’s no doubt that recognizing the unique psycho-social needs of teenagers would be a boon for patients and families at pediatric cancer centers. Like post-traumatic stress disorder in military personnel, the psychological ravages of cancer may well be under recognized, especially in the teen and young adult populations.

Thank you Roger Daltry and Pete Townshend for bringing this to our attention.

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Find out how to support Teen Cancer America here.

Check out The Who themed cookie from the press club event (delicious!):


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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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