December 12th, 2007 by Dr. Val Jones in True Stories
Tags: Cancer, Colon Cancer, News, Oncology, Personal, Research
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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.
December 8th, 2007 by Dr. Val Jones in Medblogger Shout Outs, True Stories
Tags: Hospitals, Palliative Care, Parenting, Pediatrics
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There’s nothing sadder than the death of a child. Young hopes and aspirations are snuffed out long before they can ignite their potential. That’s why the Make-A-Wish Foundation is doing their part to make sick childrens’ dreams a reality – to bring a sense of joy and fulfillment to kids whose days are cut short by illness.
I had the chance to participate in making a child’s wish come true earlier this year. I blogged about it here. It was a really moving experience for me and all involved – we helped a young terminally ill boy fulfill his dream of being President of the United States for a day. Amazingly, the White House even provided a real motorcade to shuttle him around. I got to play the role of paparazzi.
An EMT student blogged about another Make-A-Wish recipient whose dream it was to become a fireman. This story is also very touching. Here’s an excerpt:
There he stood, a father watching his son’s fantasy come to life. Sometimes, the deepest pain brings the greatest happiness.
William is usually outgoing and exuberant. Not Saturday. Saturday, he was awestruck.
Powers gave William a badge and the firefighters lined up to shake his hand. As they finished introducing themselves, William lifted the badge a few inches off his lap.
“He’s showing you to let y’all know he’s a fireman now,” said his mother, Marion Bussey.
Powers reached into a bag, pulled out a hat, and gave it to William. Then he gave the boy a shirt and yellow helmet as the rest of the firefighters looked on.
William leaned toward his mother and smiled. “Mom, I like this,” he whispered.
Tears formed in Bussey’s eyes and rolled down her cheeks.
“William is our hero and you guys are his hero,” she said to the firefighters. “He doesn’t have to say he wants to be a fireman anymore.”
What happened next wasn’t scripted. Maybe it was coincidence. Maybe no explanation exists.
William’s parents and the dozen firefighters looked at William and said the same words at the same time: “You are a fireman.”
William lifted his right hand and placed it on his forehead.
“I am William McKay,” he said, “and I’m an official fireman. Thank you.”
Then he saluted.
The firefighters looked at each other, tears welling in their eyes. They began crying. Some left the room. Others dabbed their eyes with tissues. William’s family began crying. Hospital staff began crying. Almost everyone began crying.
But not William. He had no reason to cry. He was the happiest boy in the world.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
November 8th, 2007 by Dr. Val Jones in True Stories
Tags: Cancer, Emergency Medicine, Hospitals, Illicit Drugs, Pain Management
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Today a dear friend of mine told me a horror story about her recent trip to a hospital ER. She has kidney stones, with rare bouts of excruciating pain when they decide to break off from their renal resting place and scrape their way down her ureters.
My friend is a stoic person who also doesn’t like to cause trouble for others – so when she was awoken at 4am with that same familiar pain, she decided not to call an ambulance but rather drive herself to the ER. She also chose not to call her doctor out of consideration for his sleep needs.
She managed to make it to the triage desk at her local hospital and was relieved to see that the ER was quite empty. There were no ambulances in the docks, no one in the waiting area, and no sign of any trauma or resuscitations in the trauma bay. She approached the desk trembling in pain and put her health insurance card, driver’s license, and hospital card on the desk and let the clerk know that she was in incredible pain.
The clerk responded,
“Lady, I saw you walk yourself in here. There’s no way you’re in that much pain. Sit down and fill out this paper work!”
My friend replied in a soft voice,
“Please, can you help me fill out these forms? I can barely see straight and can’t concentrate well. I have a kidney stone and it’s excruciating.”
Tears fell softly from her face as the clerk rolled his eyes at her.
“Yeah, I’m sure you do. And I bet you’re allergic to everything but Demerol.”
My friend started becoming frightened, realizing that she was being pegged as a “drug seeker” and would be punished with a long wait time for pain medication. “Please let me just speak to the triage nurse.”
“Sure, sweetheart,” hissed the clerk. “I’ll get him when you’ve finished your paperwork.”
And so my friend sobbed as she tried to fill in her address, phone number, insurance information, etc. on the paper form at a hospital where she had been treated for over 7 years for ovarian cancer. All of that information was in their EMR, but the registration process would not be waived.
The triage nurse slowly emerged, still chewing a bite of his steak dinner. “What have we got?” He said to the clerk looking out into a waiting room populated only by my sobbing friend.
The clerk replied to him under his breath. The nurse rolled his eyes and sighed heavily. “Alright lady, let’s get you back to an examining room. Follow me.”
My friend followed him back to the patient rooms, doubled over in pain and was put on a stretcher with a thin curtain dangling limply from the ceiling.
She couldn’t control her tears. She couldn’t get comfortable and she moaned softly as she took short breaths to explain her past history. She handed him her business card, explaining who she was and that she was not faking her pain. The nurse made no eye contact, jotted down some notes in a binder, and prepared to leave the room.
“Listen, your crying is disturbing the other patients,” he said, yanking the curtain across the front of the room to block her visually, as if the curtain would make her disappear.
Hours passed. My friend had no recourse but to writhe on the stretcher and cry out occasionally when the pain was too intense too bear. She asked for them to order a CT scan so they could see the stones. The nurse ordered it, a physician never came to examine her.
Four hours later my friend was greeted by a physician. “You have kidney stones. One is in your right ureter, and there are others sitting in your left kidney. Do you need some Dilauded?”
“Yes please!” said my friend, hoping that some relief was in sight.
“Alright, the nurse will be here shortly.” Said the doctor, glancing at her chart without completing a physical exam.
The shift changed and a new nurse came in to place an IV. She was gruff and complained that my friends veins were too small. “I’ve never seen anyone with a kidney stone need this much pain medicine” she snapped with a suspicious tone.
Five hours after her arrival at a virtually empty ER my friend received pain medicine for her kidney stone. She is a cancer survivor and national spokesperson for patient advocacy. In her time of need, though, she had no advocate to help her. No, she received nothing for her years of service, for her selfless devotion to helping others, for her tenderness to patients dying of a disease with no cure.
That night, my friend did not even receive the benefit of the doubt.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
November 3rd, 2007 by Dr. Val Jones in Expert Interviews, True Stories
Tags: Hospitals, Obstetrics And Gynecology, Veterans Affairs
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I had lunch with an extraordinary physician today. She came to the US from Pakistan 30 years ago with a medical degree, a little girl and a baby on the way. Since she was a foreign medical grad, she had to accept a position at a less competitive residency program in New York’s inner city (even more violent and dangerous then than now). She made it through, with several near muggings and death threats but longed to work at a hospital where she and her girls could be safe.
One day she came upon a large, clean naval hospital and on a whim decided to join the military so she could work there. She served for two decades as a navy physician, and learned many life lessons along the way.
As I hung on her every word, my friend told me about her experience with navy pilots. She said that one of the scariest maneuvers is landing a plane on a dark aircraft carrier on a rolling sea. The pilots dreaded these drills, and truth be told, the officers were more worried about losing a 3.2 million dollar jet to the ocean waves than the life of one of the pilots. “There will always be another pilot. They’re not in short supply. But the planes are expensive.” This was the attitude drilled into the young aviators.
In order to land the plane in the dark, the pilot had to learn to trust completely in his optical landing system. It more or less consists of a pin icon with a ball on top, and a series of red, yellow, and green lights. The goal is to keep the ball well centered so that it remains green for landing. Achieving this is called “flying the ball.” In total darkness with crashing waves and a rolling deck, a successful arrested landing is difficult and perilous.
As I looked at my friend, a petite and beautiful woman, I tried to imagine what life was like for her as a young Pakistani resident – pregnant and alone in a concrete jungle filled with graffiti, trash, and drug addicts. Her life has been an incredible journey with ups and downs, and amazing success against all odds.
“How did you do it?” I asked her, shaking my head. “How did you get where you are today through all that adversity?”
She paused for a moment, then grinned slowly as she replied: “I learned how to fly the ball.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
October 14th, 2007 by Dr. Val Jones in True Stories
Tags: Hospitals, Internal Medicine, Surgery
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I had dinner with a physician friend of mine who works in New York City. She told me an interesting story about her last couple of days at work…
A patient of hers was in the hospital on a fairly high dose of steroids to treat an autoimmune disorder. He was generally a very even tempered and friendly person, but was a little bit grumpy when she visited him on rounds that evening. He was complaining of slight shortness of breath and some mild stomach pain – and that the hospital food was bad. His labs from that morning were all normal, and he had no fever or abnormalities in blood pressure or heart rate.
On sheer gut instinct, my friend ordered a CT scan of his abdomen right away. Lucky she did, because this gentleman had a perforated colon (from ruptured diverticulae) with air under his diaphragm, causing shortness of breath. Because he was on steroids, the body’s usual response to early sepsis was blunted. He was rushed to the OR where surgeons corrected the problem. In this situation, if it weren’t for a gut instinct, this patient may have died.
I think this case illustrates how important it is to know your patients, to take their concerns seriously (especially when they’re on medicines that could minimize serious symptoms), and if something doesn’t seem right (even if lab tests and vital signs argue otherwise) you should listen to your gut. Sometimes instinct is smarter than science.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
