Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

The Lucky One

It was really cold in NYC this weekend. Most of the little Upper East Side dogs were decked out in full coats that matched their collars, some even had booties. I spotted a couple of Italian
Greyhounds looking forlorn and trembling on their leashes. They weren’t
interested in a walk in the park on this day – they just wanted to go home to
their warm condos.

But cold as I was, I didn’t have the option to retreat. I
had come to run in the Colon Cancer Challenge with my friend Seton – a lifelong
marathon runner just finishing her second round of chemotherapy. She was in
high spirits – and laughed at my joke that this was the first race in which I’d
have a “snowball’s chance” of keeping up with her.  You see, I’d always wished I could be an
athlete – but the best my genes could do is prepare me to pull the plow. So I
plod along, hoping for the day when I’ll be invited to join a caber toss – and
actually have a chance of doing something I might be good at.

But I digress.

So thousands of runners took to the 4 mile course – and as I
looked around I doubted that too many of them were actively taking chemotherapy
like Seton. She was bound and determined to run at least half of the way, and
had been training for it between IV infusions of very toxic drugs.

Seton’s husband was beaming with pride as he photographed
her at the start gate. I had vowed not to leave her side, no matter what the
pace… She had about 20 other friends who had joined the race as well and a
small handful stayed with us for the entire time. Amazingly, Seton was able to
run 3 of the 4 miles, her hands cramping in the cold, her thin legs carrying
her tingling feet past familiar landmarks. She held her head high, and never
complained – though it must have been hard for a former track star to watch people
of lesser abilities passing her on the trail. Her friends called her cell
phone every 10 minutes to find out how she was feeling/doing. They didn’t know
that it was so hard for her to even open the phone.

As Seton crossed the finish line, she held her arms up in
the air, as if she were breaking through winning tape. Cameras flashed, people
cheered, and I saw tears well up in her eyes as she tried not to show her
exhaustion. She gathered her friends around her and gave this short speech:

“I want to thank all of you for coming out and supporting me
and the fight against colon cancer today. I can’t tell you how much it means to
me to see all of your smiling faces… Although I certainly had some unlucky news
recently, I want you all to know that when I look at you, my dear friends and
family, I feel like the luckiest woman alive. I am so glad to have you all in
my life. I am truly blessed, and I’m going to beat this cancer with you all by
my side.”

There wasn’t a dry eye among us.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Strawberry Shortcake In Central Park

As many of my regular readers know, my dear friend and Revolution Health administrative assistant (Seton) was diagnosed with stage IV colon cancer after giving birth to her first baby. She is doing well on chemotherapy, and working hard to shrink the liver tumors to a size that will allow her to have them cut out, and possibly be cured. On March 9th she’ll be participating in a Race for Colon Cancer walk/run in Central Park, and I’ll be joining her. This weekend I came to New York to practice the 4 mile run with a girlfriend of mine (Karen). Here’s what happened…

As I set out to meet my girlfriend at the southwest corner of Central Park, I became keenly aware that my light windbreaker/t-shirt combo was ill equipped to protect me against the icy wind chill. It was 8:30 in the morning, and as I bowed my head in the face of frigid temperatures, tears streamed down my cheeks while urban grit blew the very moisture out of my eyes. “Whose idea was this?” I asked myself, marveling at the occasional onlooker, bundled head to toe with hats, mittens and face masks. “Oh, yeah – mine. What was I thinking? Why didn’t I look at the weather report?”

About half a mile between my departure point and destination, I began to realize that my ears were in danger of freezing off. “I’ve got to find a hat” I thought… glancing at Citibank headquarters to the right and Meryl Lynch to the left. Where could one find a hat at this time of day, and in this neighborhood? Hmmm… a 24 hour pharmacy perhaps? As I marched towards what appeared to be a distant pharmacy I began thinking of ways to make a hat from cotton strips, Ace bandages, or maybe a shower cap. Severe cold can make a desperate mind exceedingly creative.

As I temporarily thawed myself in the warmth of the pharmacy, I began my search for a head covering. A fleeting moment of triumph gave way to disappointment when a hot pink Santa’s “little princess” elf hat (buried in a discount bin) proved to have the inelastic circumference suitable for a very small child or canine companion. But if there’s one kiddie hat in here, there must be others, I thought. So I combed through the drug store stock with a hopeful eye.

Ah-hah! I discovered a virtual treasure trove of kiddie hats, pinned to the backside of a pillar near the deodorant aisle. Of course, they were each painfully pediatric – with neon colors, gold stars, and little plastic Hello Kitty and Barney type effigies. But, I could see that they were stretchy, and came with some tiny gloves created to be a “one size fits most.” Worried that my girlfriend would have to wait in the cold for me, I hurriedly made my purchase, tore the tags off the hot pink hat and forced it down over the top half of my ears. The gloves covered my four fingers and half my thumb.

I arrived at our meeting place just in time. My girlfriend approached with a quizzical expression, noting the large “Strawberry Shortcake” girl (inside a plastic heart) emblazoned on my hat. I could see that she wondered if my fashion sense had taken a turn for the worse since my move from NYC to Washington, DC two years prior.

I assured her that I had no intention of wearing the hat again, but that desperate times called for desperate measures. She stood in front of me in a full running suit, complete with a layer of long johns, ear muffs, and two layers of Goretex. I felt utterly unprepared in my light cotton shirt and Lycra pants – but at least now that my head was half-covered, I figured that running would keep me from freezing to death outright.

And so we set off on a 4.5 mile jaunt, a hilly distance that neither of us had run in over a year. I had tried to prepare for this day with elliptical training, but wasn’t sure that my cardiovascular reserves would handle this new form of exercise.

Much to our surprise, the icy wind quickly numbed all sensation in our legs, allowing us to jog without much awareness of potential pain or exhaustion. We soon settled into a nice, slow jogging rhythm and took turns catching up on one another’s news. My uphill breathlessness tended to shorten my usually animated description of life-events, reducing me to caveman-like accounts. “Me take new job at hospital. Good.” Though I did much better on the downhill stretches.

In the end my girlfriend and I felt quite triumphant about the fact that we made it the full 4.5 miles without a break. We both knew that another 3 weeks of training should put us in good standing for the Colon Cancer Challenge, though my friend suggested that if I wore the Strawberry Shortcake hat again, she might pretend that she didn’t know me.

Today, of course, all my leg muscles are sore – but it’s nothing compared to what Seton is going through with her chemotherapy. I wish her all the best in her fight against cancer, and hope that my participation in the Colon Cancer Challenge will provide her with some encouragement, if not comic relief.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Beating Colon Cancer: One Woman’s Journey

A few months ago I wrote about my dear friend who was diagnosed with stage IV colon cancer just after having her first baby. Her optimism and positive focus was inspirational to me, and I marveled at her ability to live life unencumbered by prognosis.

Today I am happy to report that she has completed her 7th round of chemotherapy (with avastin, oxaliplatin, 5FU, and leukovorin) and her liver tumors have already shrunk by two-thirds. She is bothered by neuropathy (burning sensations in her hands and feet – a known side effect of this drug regimen) and has lost the ability to taste food fully, but otherwise she is maintaining her weight and her blood counts are good. She told me that her plan is to complete 12 rounds of chemo and then meet with a liver surgeon to consider surgical removal of the remaining tumors. Miraculously, her doctors believe that she may be a candidate for liver resection and eventual cure.

This couldn’t be any better news and I am so pleased to be able to celebrate my friend’s success. I have learned a great deal myself about the journey, and about how many people are willing to reach out and help those who are struggling. As for my friend, she has greatly benefited from:

1. CarePages – an online gathering place where friends and family can find out the latest news about her progress, and leave well wishes and virtual gifts. CarePages is part of the Revolution Health family.

2. The Colon Cancer Alliance (CCA) – this wonderful non-profit organization linked my friend up with a mentor who has been through a similar treatment regimen and diagnosis and can speak to her about what to expect. The CEO of CCA has even taken time out of his busy schedule to make sure that my friend gets the best support available and has put her in touch with top liver surgeons.

3. Dr. Lenz’s Colon Cancer Blog – Dr. Lenz is a leading medical oncologist and Co-director of both the Colorectal Center and the Gastrointestinal (GI) Oncology Program at USC/Norris Comprehensive Cancer Center in Los Angeles. He also prepares 3 fresh blog posts per week here at Revolution Health, to make sure that cancer patients have access to the latest research and information about colon cancer.

With incredible advances in evidence-based cancer therapies and these terrific online resources, colon cancer patients have a brighter future than ever before. I’m so pleased that my friend is doing well, and I’m grateful for the many people and organizations that have touched her life. Expect another update on her progress in March!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Cancer Isn’t Fair

Physicians see horrible things, tragic injustices caused by unexpected disease and circumstance.  We do what we can to remain compassionate – to be emotionally “present” and yet to keep the professional distance required for our survival and success.  It takes courage to set a bone, crack a chest, to do painful procedures to save lives – there must be no hesitation when minutes count.

And I suppose that our saving grace is that the majority of the patients we meet in tragic circumstances are not personally known to us.   We appreciate their humanity in a general sense, but are not pierced and incapacitated by a family tie or bond of friendship.  We are pained by their suffering – but we can cope.

That is, until we’re confronted with a loved one who is thrust into tragedy.  Two days ago, a dear friend and former coworker called me to say that she had been diagnosed with colon cancer that had metastasized to her liver.  She had just given birth to her first child at age 41.  Her only symptom?  Post-partum fatigue.

My friend is a health nut and athlete – she has lived the “gold standard” life from a preventive health perspective.  I always wanted to be more like her – eating lots of veggies and running regularly.  She has been at her target weight all her life, has the occasional glass of wine, and spends much of her free time in community service projects and charity work.  She has no history of cancer in her family – they are all hardworking, clean-living types who enjoy long, productive lives.

So when she told me about her advanced disease I almost fell off my chair.  How could this happen to her?  She is too young!  She doesn’t fit the right description… Why didn’t I catch this sooner?  Did she ever give me any hint of a warning symptom?

She told me that after having her baby she just felt really tired and was unable to bounce back as quickly as expected.  I was worried about post-partum depression, and she eventually decided to see a family physician about her fatigue.  He was unclear as to its root cause, and ordered a broad range of general blood tests – including liver function tests.  They turned out to be abnormal, and he inquired as to whether my friend might be a drinker.  She denied any such tendencies, so he scheduled an ultrasound.  The ultrasonographer noted the appearance of metastatic cancer – she had a CT scan and a colonoscopy to confirm the diagnosis of colon cancer.  We were both in shock.

And now as my dear friend faces likely surgeries and chemotherapy, I am witness to her journey – the same one that I’ve observed in strangers – but this time I have no professional defenses.  I will watch as her body is wracked by the disease’s treatments, I will understand the individual circumstances behind her bravery, I’ll know and feel everything in a personal way that I can’t control.

I am about to join the millions of cancer patients and their families on the other side of the examining room.  This time I’m not the doctor, I’m the close friend who rages against a disease that is not fair.  And I am ready to fight.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »