Tag Archives: Cancer

Lymphedema = Pain = More Pain = Avoidance = Get Educated = Get Fit

 

Lymphedema = Pain = More Pain = Avoidance = Get Educated = Get Fit  

National Lymphedema Network – Educating Patients Online 

Part 3b of 3b 

Exercise and Compression Garments:

Lymphedema Remedial Exercise as a part of CDT requires compression garments or bandages.3-5 There are no studies on the use of compression garments when performing stretching or flexibility exercise alone.

Our visiting young cousin from Norway rode her first recumbent trike in Silverdale and wore "What is COPD" tee shirt while she was here.
Our visiting young cousin from Norway rode her first recumbent trike in Silverdale and wore “What is COPD” tee shirt while she was here.

My young cousin, Malin from Norway is included here because COPD (Chronic Obstructive Pulmonary Disease) began in 1997 for me and led into my long ride into medical conditions – one after the other and my gathering weight attracted lymphedema as surely as fresh bread and butter sticks to peanut butter and strawberry jam. 

“The NLN Medical Advisory Committee (MAC) recommends using the guidelines for aerobic and resistance exercise to guide use of compression during flexibility exercise since flexibility exercises may be combined with other forms of exercise. 

The amount and type of compression for exercise should be decided with input from a professional knowledgeable about lymphedema. There is no strong evidence basis for the use of compression garments during exercise; however, most experts in the field of lymphedema advise the use of compression during vigorous exercise for people with a confirmed diagnosis of lymphedema.

Melissa showing me the latest fast, protective lower leg support
Melissa showing me the latest fast, protective lower leg support

Melissa Mercogliano, Center for Orthopedic & Lymphatic Physical Therapy in Port Orchard, WA. recently showed me a new and easy way to add support stockings…easy except for we Tub’ettes.

“One study suggested that individuals with lymphedema who do resistance exercise without compression may increase swelling. 

20 Resistance exercise may reduce limb volume when used as an adjunct to compression therapy in people with confirmed lymphedema.

8 One study showed that aerobic and weight-lifting exercise was safely performed without compression in women at risk for breast cancer-related lymphedema.

9 That study showed patients who developed lymphedema could continue to exercise with compression garments. Compression garments should be measured by an individual trained and experienced in fitting compression garments for lymphedema and should be at least Class I compression for upper extremity. Higher classes may be required for more severe lymphedema and for lower extremity lymphedema.

 1-IMG_29033-IMG_29074-IMG_2909

Custom sized, each leg. This pair is old...notice the crinkles below the rubber dotted band. The replacement compression stockings are black.This pair is about one year old.
Custom sized, each leg. This pair is old…notice the crinkles below the rubber dotted band. The replacement compression stockings are black.
This pair is about one year old.

I throw the stockings in a little zippered mesh cloth bag and into the washer on a short cycle, regular soap, extra rinse – cold water and smooth out and let them hang to dry.

I prefer the toe less stocking so my toes don’t get scrunched up and have two different kinds. The little rubbery tips around the tops of both help them from sliding on down my leg and cutting off circulation.  Ask your doctor. 

“A hand piece (gauntlet or glove) is recommended when exercising with a sleeve to avoid causing or exacerbating hand swelling. 

Definition of Individuals At Risk for Lymphedema:

Individuals at risk for lymphedema have not displayed signs and symptoms of lymphedema but may have sustained damage to their lymphatic systems through surgical lymph node removal or radiation therapy.

Additionally, individuals at risk may have surgical incisions in the vicinity of lymph transport vessels.

Individuals who have family members with hereditary lymphedema may also be at risk.

An individual’s risk of lymphedema may change over time depending on factors such as weight gain, age, and changes in medical condition. 

It is the position of the NLN that:

Exercise is a part of a healthy lifestyle and is essential for effective lymphedema management

Before starting any exercise program, individuals should be cleared for the program of activity by their physician.

Lymphedema Exercises (also known as Remedial Exercises) are specific rhythmic muscle and breathing exercises used as a part of lymphedema treatment in Phase I and Phase II

Complete Decongestive Therapy (see the NLN Position Paper on Diagnosis and Treatment). http://www.lymphnet.org/pdfDocs/nlntreatment.pdf 

In Phase II lymphedema maintenance, these exercises can be combined with or integrated into a regular exercise program.

After intensive treatment with CDT, the person with lymphedema should work with the certified lymphedema therapist or qualified lymphedema specialist provider (MD, NP) to adapt their remedial exercises into their fitness and weight management program at the time they are moving from Phase I (treatment phase) to Phase II (self-management).

Individuals with or at risk for lymphedema can and should perform aerobic and resistance exercise in a safe manner.

The individual with or at risk for lymphedema may benefit from working with an Exercise Physiologist and/or Personal Trainer. The person with lymphedema should inquire if the trainer or exercise physiologist has experience working with lymphedema and other medical conditions. Certification for personal trainers varies. Patients who are unsure of about the qualifications of a community exercise practitioner should work with a certified lymphedema therapist or health care provider to assist them in finding a community exercise program or professional.

In general, individuals with a confirmed diagnosis of lymphedema should utilize compression garments or compression bandages during exercise.

Individuals at risk for lymphedema may or may not utilize compression garments during exercise; this is an individual decision to be made with guidance from a care provider and/or therapist based on risk, activity, and conditioning level.

Individuals at risk for lymphedema will benefit from most forms of exercise tailored to their individual needs.

Individuals at risk for or with a confirmed diagnosis of lymphedema should avoid repetitive overuse of the affected part. Sudden increase in an individual’s usual exercise duration or intensity may trigger or worsen lymphedema. It is likely that a program of slowly progressive exercise for the affected body part will decrease the potential for common daily activities to result in overuse.

Exercise should be started gradually, increased cautiously, and stopped for pain, increased swelling, or discomfort.

The risks of exercise for the individual with or at risk for lymphedema must be balanced against the risks of deconditioning that undoubtedly results from not exercising. A deconditioned body part with or at risk for lymphedema can do progressively less without risk of overuse. As a result, exercise is recommended for those with and at risk for lymphedema.

The NLN cannot specifically determine the safety of exercise for any individual. The guidelines in this Position Paper provide general principles, but do not substitute for medical evaluation and recommendations from a health care professional. It is the responsibility of all individuals with or at risk for lymphedema to consult with their health care provider regarding their own specific needs. 

References:

1. Tidhar D, Katz-Leurer M. Aqua lymphatic therapy in women who suffer from breast cancer treatment related lymphedema: a randomized controlled study. Support Care Cancer. 2010;18(3):383-392.

 2.Moseley AL, Piller NB, Carati CJ. The effect of gentle arm exercise and deep breathing on secondary arm lymphedema.Lymphol. 2005;38(3):136-145.

3.Boris M, Weindorf S, Lasinski B, Boris G. Lymphedema reduction by noninvasive complex lymphedema therapy. Oncol (Williston Park). 1994;8(9):95-106; discussion 109-110.

4.Földi E, Földi M, Weissleder H. Conservative treatment of lymphoedema of the limbs. Angiol. 1985;36(3):171-180.

5.Földi M, Földi E, eds-in-chief. Foldi’s Textbook of Lymphology for Physicians and Lymphedema Therapists, 2nd ed. Munchen, Germany:Urban & Fischer; 2006.

6.Bergmann A, Mendes VV, de Almeida Dias R, do Amaral E Silva B, da Costa Leite Ferreira MG, Fabro EA. 

Incidence and risk factors for axillary web syndrome after breast cancer surgery [published online ahead of print October 17, 2011].

Breast Cancer Res Treat. doi:10.1007/s10549-011-1805-7.

7.Fourie W, Rob KA. Physiotherapy management of axillary web syndrome following breast cancer treatment: discussing the use of soft tissue techniques. 

Physiotherapy. 2009;95(4):314-320. 

 

NLN • 116 New Montgomery Street, Suite 235 • San Francisco, CA 94105

Tel: 415-908-3681 • Fax: 415-908-3813

Infoline: 1-800-541-3259 • Email: nln@lymphnet.org •

Online: www.lymphnet.org 

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Several years ago, I called Harrison Medical Center and asked if non-cancer patients with lymphedema could attend their support group meetings.  At that time, it was limited to cancer patients.

Yesterday I called the following number to be certain it was still up to date.  It is and the closest Lymphedema Support Group I know about.

If anyone knows of more, let me know – I can post it here.

 

Kitsap County Closest Support Group 

Northwest Lymphedema Center

Kent, WA (24.11 miles * Meeting times: Date varies  Phone: (206) 575-7775 

 

Tub’etts! 

I’d like to be part of a support group of fatties who NEED to lose weight for their health’s sake – with or without current medical issues. No dues – a scale and occasionally health professionals willing to talk to us – to educate us – to motivate us – guest speakers. 

I have been told that I’m not a good candidate for bariatric surgery…so, before I push that particular button – is there anyone beside me, who wants to be part of an obese/tubby support group to work together for weight loss and good health? 

To lose weight through good nutrition and exercise is my goal. 

We are dying of too much fat, fellow Tubby Ones.

Will you join me in our battle to shed the fat and live healthy?  Let me know…

 

Thanks for reading… Sharon O’Hara familien1@comcast.net

Kitsap County Library System has educational Lymphedema books for the layperson – just ask.

Reduce risk of developing some forms of cancer – drop to a healthy weight

Tubby’etes … Somehow I’ve seriously packed on an excess of thirty pounds or so since my tumor operation and I’m back to seriously climbing stairs.  I began again this morning. The possibility that obesity increases the risk of ‘developing some form of cancer’ is a call to cut obesity loose and off this short frame.

Poulsbo women, if any of you are 100 or more pounds overweight, you are welcome to join me in a health quest of diet and exercise.

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  • From: National Heart Lung and Blood Institute.

“ Your weight may be affecting you more than you may think.

Even a few extra pounds each year can affect your quality of life.

There are many benefits to achieving and maintaining a healthy weight that will improve your health and life in the short-term. These include:

If you are overweight or obese, losing weight and being physically active can help you control your blood sugar levels.

Weight loss of at least 5 percent of your body weight may decrease stress on your knees, hips, and lower back.

Weight loss often improves sleep apnea.

Not only can extra weight cause joint pain, it can lead to serious chronic diseases. If you are overweight or obese, losing just 5 to 10 percent of your weight can lower your chances of developing heart disease, type 2 diabetes, or having a stroke. Other long-term health benefits of having a healthy weight include:

 

    Reducing your risk of developing some forms of cancer.

    Lowering your risk for developing gallstones and fatty liver disease.”

http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/onepound.htm

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Thanks for reading …. Sharon O’Hara <familien1@comcast.net>

 

Does a tumor mean cancer? Part 4 of 4 Harrison Home Health

Does a tumor mean cancer?  Part 4 of 4

Harrison Home Health nurses.

My surgeon, Dr. Urban, assistant professor at the University of Washington Medical Center and surgeon at Seattle Cancer Alliance gave me a choice – Martha & Mary in Poulsbo or be home with Harrison Home Health.  Much as I enjoyed my four-week stay at M & M’s a few months ago, I wanted to go home – even if I had to learn wet to dry wound wraps and do my own wound changes.

Luckily, I got Harrison Home Health.  That meant every three days a nurse came to the house to change out the wound wraps and check on the vac inside belly tube and stuffing.  The following photos will show better than I can explain, what they do – Bless them. 

Meet Karl…whose expert, experienced hands and manner quickly put me at ease and set the tone I found with Harrison Home Care nurses.  They were all different, uniform in their professionalism and competence, yet cheery and friendly.

The V.A.C.Therapy  System is like a small sump pump that you wear or carry close by.  The tube tether is just long enough and runs from the closed, suctioned  wound to the empty container connected to the pump.  The first night home the alarm went off – the container was full a day or two early.   I called the Harrison Home Health (HHH) emergency number and tried not to panic describing the problem.  Minutes later a nurse called back, but by then I have changed it out myself – thanks Gretchen!

Above is the old dressing.  Following are the steps Karl and the other Harrison Home Health nurses took to clean up and change out the wound.

 

The sponge cut to fit, placed inside the wound, and taped down.

The seal secure, cutting the membrane allows the suction tubing to fit in the wound

 

Time to seal the wound

Ready for the vac tube

Tube in place, machine turned on, and the vac proved good suction and connection.  The suction held and the excess fluid began its flow out of my belly and into the tube.  The VAC  tube, suction and good nursing care made the wound heal properly from the inside out.

Lisa, RN, MSN

Kris Feldon, LPN

Danny – one of HHH treasures and the only one I had the pleasure of meeting before.  Danny is a stellar nurse who tried to help with my lymphedema wrap.  Danny had even met me at Dr. Halligan’s office in the Doctor’s Clinic in Silverdale to learn how the doctor wanted my leg wrapped.  As it happened, my husband who learned to wrap from Melissa and did a great job, finally decided he would continue wrapping and Danny was freed up to help another patient.  Going the extra step, Dr. Halligan and Danny are extraordinary in their patient involvement.

One of Harrison’s shy nurses allowed me to photograph her helping hands at work.  I am using this photo of her hands showing the white strips the professionals removed each visit because the day came, (4 July) when the suction failed and eventually that evening, I was told the nurse on call would come out or I could try to fix it myself.  I opted to try to fix it myself.  By phone the nurse gave me several options to try to get the suction restored.  The supplies were here so it was only a matter of taking the materials upstairs to the bathroom mirror and applying the tape seals until I got a tight seal and reestablished the seal unit and tube to the V.A.C.

Pursed Lip Breathing (PLB) works when you need it.  The white strips across the clear material would not budge when I tried to remove them and had to stay until the HHH nurse came again to clean and change out the wrap.

Almost closed!

The face of the wound healing V.A.C.

These petite staples held the upper part of the wound in place and stayed intact until it healed and the staples  removed.

Paul, HHH rehab physical therapist showing me different ways to work out using things I already have.  He lifts weights for a hobby.

Paul and his counterpart were terrific in that each brought a new idea to the table.  Paul’s partner had me keenly aware I’d let my left leg and foot straddle out to the side instead of straight ahead and we worked on it.  She was terrific.  I didn’t get a chance to ask for her photo because she went on vacation and I didn’t see her again!

M, the occupational therapist,  wouldn’t let me photograph her and wouldn’t be interviewed for one of her big wins this year, winning the 2012 Cancer Society Barrel Racing Championship with one of her horses!  M is a professional barrel racer in her spare time – super fit, horses and herself.

HHH has amazing people dedicated to helping others who need them….and glad I had the opportunity to meet some of them.

One nurse I have not mentioned is someone who had me laughing so hard I grabbed my staples so they could not pop out.

Harrison Home Health nurses are a Godsend to those who unable to get out…patients heal in the best of company.

Knock; knock … Harrison Home Health calling….

Thanks for listening.  Takk for Alt!   Sharon O’Hara

Does a tumor mean Cancer? Part 3 of 4

Does a tumor mean Cancer?  Part 3 of 4

Glimpses of a patient’s life and the medical folks who helped save my life.  The University of Washington Medical Center(my lung doctor is here) and the Cancer Alliance of Seattle worked together to give me a life again.

One of the cheeriest technicians I have been around is right there at the University of Washington Medical Hospital.  Washington State first class teaching hospital.  The U – students and staff – alike is loaded with inquisitive, open minded, brilliant medical doctors teaching students to seek answers to patient’s medical woes.

Of the tremendous group of my tumor surgical medical team, this superb doctor stood out by his mention and appreciation of my first iPad covered Otter when he spotted it at my bedside table.  I appreciated his comments and conversation about a non-medical related product.  Btw… I think younger people are generally surprised many of us older folks appreciate and use new technology.

The view from my window was of one of my favorite bridges, the Montlake Bridge by the U. Beautiful views helped lessen the pain.

Need you ask?  This is without doubt the best-arranged toilet area of any I have had the privilege to know and love. The shower is just on the other side of the low wall.  The toilet was at a comfortable height and I let go of the walker, hung on to the low wall, and grasped the support bar on the other side.  I gently lowered myself and my new equipment onto the throne.

The day I was standing by the bathroom door when my incision opened and the blood flow began through the popped seal to the machine.  The bloody fluid flowed through the fingers I had pressed against the gaping open belly wound trying to hold stuff in where it belonged.   Instead, bloody fluid flooded the floor and formed running rivers downhill through my room.

The professionals who answered my call light moved swiftly to stem the bloody flow and no one raised a voice in alarm – not one.  I was immobilized in place hanging on to the pole with one hand and feeling the warm blood rush through the fingers of the other.  The warm blood flowed on down my legs while they quickly, quietly told me where to move.  They did their job with aplomb and took care of a horrified patient…like another normal day.  I had an incredible feeling of well-being in spite of the thought other belly parts and stuff might flow past my open fingers over the wound trying to hold back the blood flood.

Checkout day… the dried remains of one of the bloody flows remain under my soon to be vacated bed.

…Inhalers are important to lung patients.  The order we take them is also important.  I mention it here because my inhalers are rarely dispensed in proper order for the full benefit of my lungs.  Luckily, I know the right order to take them and do pass on that information.

I take Foradil first – a fast acting inhaler few nurses have heard of.  It is one of the best for me – opens my airway fast.  Spiriva is long lasting and second, while Qvar (inhaled steroid) is third.

Harrison Medical Center, University of Washington Medical, and  Martha and Mary in Poulsbo – none dispense Foradil…and I do not understand why.

I hope patients and med dispensing folks using other inhaler combinations see they are taken properly.

One nurse told me she did not know there is a proper order to taking inhalers.  Why not?   One possible answer…  If I were in the cancer area recovery, the nurses would be cancer oriented, not lung patient oriented for inhalers.

One of the terrific and friendly docs from my informative medical team.  Another super University of Washington/Seattle Cancer Care Alliance doctor that I cannot name due to misplacing my notes/business cards.

 Kristin, physical therapist…

 

Meet Gretchen, one of the outstanding nurses I had and now, my discharge nurse.  She is putting together the little vac machine that will collect the fluid from the tube sealed inside the unstapled lower belly surgery site.  I will wear it day and night for the next few months…while Harrison Home Health nurses will change it out every three days, per doctor orders.

Gretchen showing how the vac – the entire devise works.

 

Gretchen read directions and showed me how to change the container when it got full of the bloody belly fluid.  I was told an alarm would sound first giving me plenty of time to take care of it.

…Goodbye Nurse Gretchen …another patient going home – another patient tomorrow.   Thanks for your care and kindness.

Thank God for nurses like you…and…your detailed instructions on the belly vac came in handy the very next evening at home.

I am very lucky.  They found no wingding blooming cancer – only some strange looking cells that bear watching every four months for a while.

Please understand – Kitsap County has first class cancer docs and treatment  – I’ve talked to enough cancer survivors to know it.

That said…My first and primary medical condition involves my lungs – COPD first and Sarcoidosis second.  I will not do any surgical procedure that involves anesthesia without my pulmonologist as part of the discussion as a consultant.  While Karen Eady, MD, is my wonderful primary doctor, right here in Kitsap County,  Christopher Goss, MD is my lung doc  at the U .   Thanks to you all!

Harrison Home Health.  Part 4 of 4,  next time.

Thanks for reading… Sharon O’Hara

Good-bye and thank you, Lisa Marie.  You’ve moved on to a  fabulous person and  forever home, and we’re grateful for the eight years we had with you.  Mom S

 

 

Does a tumor mean Cancer – Part 2

Christopher Hooper Goss, MD, UWMC is my lung doctor at the University of Washington and was part of the team preparation for my operation.  It was clear to me that this operation was mandatory.  The huge and growing tumor was killing me and it might be cancerous.

I could and did live with the bone on bone left hip problem.  A hip operation is not mandatory.

The growing tumor I hadn’t known about was choking the life out of me.  Quality of life had turned into an existence – an existence squeezed with the tumor that filled my belly.  As a lung patient, I believe the best chance for a good outcome requires my lung doctor involvement.  Luckily, wonderful surgeon and Assistant Professor, University of Washington Medical Center Dr. Urban and her team agreed.

I know Kitsap County has wonderful cancer doctors and professionals.  I have been told by survivors and written about them.

In my patient point of view, however – my lung diseases were primary and meant that my best chance for survival and a good result – was including Dr. Goss, my lung doctor with the operating team.  I believed then and now that his involvement was vital to my waking up after the operation.

Christopher H. Goss, MD and Sherryl Davey, Medical Specialties Center, Scheduling/Appointments UW Medicine

The aftercare machine was large and the University of Washington Medical Hospital nurses regularly changed out the container holding the fluid.  My camera was usually ready whenever I heard the ‘okay, shoot’ from the nurse or technician.

The machine’s tube stuck in my belly pumping the excess fluid away.

To come home the ACTI  V. A. C.  is the device that let me come home after six days at the University Hospital and into the capable hands of the Harrison Home Health Care folks.  Otherwise, I was willing to learn the wet to dry method of wound care and do it myself.

The University of Washington Docs and nurses were universal in their patient interest and I enjoyed listening to the different ideas flow until there was a consensus for treatment.

I have misplaced most of the business cards I had asked for – including for this photo.  The girl here was extraordinary in her care and helpfulness.  Interesting too, she is a shop steward for the local union – a bright girl.

 

I write this blog for reasons I have stated many times before.  As hard as it is sometimes I have to tell the whole story or I cannot write about them at all.

The fact is there were too many times I had to pull myself into the doorway of my room out to the hall to find someone to help me.  It was hard not to notice all the folks at the end of the hall doing nothing but talking together ignoring the light I had on – time after time.

I progressed quickly into pulling myself and whatever I was attached to into the bathroom.  I could not wait long enough for the light to get someone there to help me and remember feeling surprised that the aides at Harrison are incredible in their zeal to help patients while the U aide folks were different.  Most of the aides I encountered at the U were just the opposite.

One person told me “If you don’t trust me, I can’t help you.”  He wanted me to let go of the bed and hang on to him while he lifted me into the bed. (A rule of thumb…a patient needs to be able to get into and out of the bed before they can go home)  At that point, another person had helped me discover I could get into bed using the other side of the bed and just needed help lifting my legs up at the same time to lessen the left hip pain.

Trouble is, if he dropped me, I was the one to get hurt not him. I could not do it.  Patients need to do for themselves as quickly as possible to heal quickly.   Often times, after a while, a nurse answered my call light…not their job – but I’m grateful they did.   Incidentally, I rarely called for help.

Truth be told, had those folks worked for me, I would have fired every one that refused to do their job and hire folks with empathy and concern for the patient – such as the aides at Harrison.

On the other hand – the flip side of this coin – if wanting to do things for myself makes me a difficult patient…?  I hope not.

This person was wonderful in her care.  The plastic is part of the machine that steadily drew the excess fluid and blood out of my belly.

My left leg was still healing from Lymphedema and traces of the recent bloody waterfall show on my upper legs.  The machine had apparently lost its suction when I strained in the bathroom.

When I stood up and moved, the backed up fluid burst like a waterfall through the opening in my belly.  My hands tried to help the wound close and stem the tide but the bloody fluid burst like a waterfall through my fingers and formed little rivers over the floor.

 

The portable machine had arrived and the plan was for me to go home the next day.  However, after the bloody waterfall I wouldn’t leave until I knew it would stay in and so I stayed one extra day.   The doctors, nurses and many of the staff are extraordinary, fun caregiver professionals but I wasn’t comfortable about leaving.   The next series of photos show the machine connected in the opening below my staples.

Seeing the gloves go on, I knew the suction tube was ready to be inserted into my belly and the machine turned on.

The tidy row of staples above the opening to be soon filled with the black sponge and suction tube.

Measuring the opening width

…and depth

The black sponge is cut to size and placed inside the open wound with an empty clear tube inside to gather the fluid and run it into a small reservoir on the side of the machine.

The black sponge is inside the wound.

The tube is inside and the plastic type sheet, cut to size will help seal the opening

All finished, the tube and little machine and I were new best friends and almost ready to go home.

More later – Part 3 of 4 next time.

Thanks for reading… Sharon O’Hara

Does a tumor mean Cancer

Yesterday I graduated from Harrison Home Health services; an organization I didn’t know existed two months ago and where I learned firsthand that Kitsap County has the greatest group of  RN’s and LPN’s                     on this planet for medical home care.

My June 11, 2012 belly tumor operation at the University of Washington was a rip roaring success, thanks to surgeon, .Renata R. Urban, MD and her superb medical team.

Six days after the operation I returned home to husband and dogs and into the caring, capable hands of the Harrison Home Health services team.

The Harrison Home Health services team followed doctor’s orders exactly – a team care RN or LPN came every three days to change the dressing, including weekends.  The vacuum machine hooked to and inside my belly became my best friend 24/7.

At 73, I am lucky to be alive.  I’ve learned several health lessons along the way since 1997 – the key one being to continue to do whatever I can to promote early detection Spirometry testing for COPD.(Chronic Obstructive Pulmonary Disease) the third leading cause of death behind heart disease and cancer.

Getting COPD for many of us means taking a nosedive into the immune system and developing other unpleasant medical conditions. COPD is slow developing, taking about twenty years to develop symptoms enough to tell your doctor.  By then usually 50 % of the lungs have flipped from the healthy state – they are destroyed.

The fact is I was a healthy physically fit person until I was hospitalized with COPD in 1997.  Since then I have gathered one disease after another.

This latest – a fluid filled belly tumor squeezed my lungs making it harder to breathe.  It squeezed everything in its path and seemed to shut down my system with a growing hard belly and pain especially in my bone on bone left hip until I reluctantly shuffled from place to place. I canceled and rescheduled doctor appointments thinking the pain would ease with time.

As time passed and my ability to get around decreased, Chuck called various agencies in Kitsap County thinking Kitsap County must have public transportation with a lift available for patients trying to get to medical appointments.  The problem was I could not lift my left leg to step up and couldn’t use the right leg either – too painful on my left hip.  I could not lift it…only pull it after me.

We discovered one source in Kitsap but it would cost us over $400. to drive around from  Poulsbo through Tacoma to the University of Washington Medical Center for my lung appointment.

It felt like something was growing in my belly but the only possibility was impossible so I shrugged it off to imagination.  I never imagined a tumor nor mentioned it to my doctors.

Funny thing, a complete physical might well have discovered the hard as a rock-growing belly and tumor, had I not sworn off getting physicals.

It was only when I tried to cancel and reschedule my third week canceled appointment in a row with my pulmonologist, Christopher Goss, MD at the University of Washington Medical Center that I was told ”…couldn’t reschedule for the foreseeable future…” ( the doctor was off to Europe the end of the week)

I told my husband we had to make that appointment no matter what happened because I didn’t think I could manage much longer.  We HAD to make that appointment and I asked him to get what I thought would help get me into the Suburban.

It included tying a rope across the back of the front seats to pull me into the back seat once I shuffled my way up the dog plank and it should balance me into turning to sit down.  The plank was supported by the borrowed Poulsbo Wal-Mart milk crates he placed underneath the plank.

I shuffled up the plank aided by my walking sticks but the rope failed after I pulled myself inside and let go of one end.  The rope wasn’t tied off and I fell forward and twisted with my neck strained across the top of the back seat.

As soon as I could talk, I asked Chuck to get in and drive “We’re making my lung appointment…we’re going to Seattle and ferries don’t wait.”

At the UW’s parking garage, Chuck ran to get a wheelchair and I pulled myself out of the car and into the chair.  He raced us to my appointment on the third floor.

I told Dr. Goss about my hard belly and the pain.  Thank heavens he looked.  When my hard belly wouldn’t budge, Dr. Goss scheduled an x-ray and blood testing.  The x-ray showed up black and by the time Chuck wheeled me out of the blood lab, Dr. Goss was there and told us I had a room and that an ultrasound was scheduled in a few hours..

Most medical folks are cool about letting me take photos and allowing me to use them here once I explain about my purpose –  COPD and Other Stuff.

Its important that people understand that COPD is only the beginning – an opening door to really nasty, painful medical conditions that follow for too many of us.

Ask your doctor for an early detection Spirometry test.  Please.

COPD itself is a long slow smother – not painful.  Some of the medical Other Stuff can be really nasty.

Renata R. Urban, MD – Assistant Professor 

Department of Obstetrics & Gynecology – Division of Gynecologic Oncology

Seattle Cancer Care Alliance

Following are the photos Dr. Urban sent taken during the operation.

Tumor weight: 1,881 grams

Tumor weight:  1,881 grams

Somehow, I thought of operations as messy and bloody – see the tumor?

The pain from the tumor and the 1.5 gallons of black fluid they drained out twice had taken over my life.

The wonderful team of doctors – and their ability to verbalize with patients was superb…

Great doctors and teamwork

Dr. Urban and team – thanks!

I think this was the pain medicine machine that was available to me checked by a helpful nurse.

I had super docs with a great patient connection.  The gowns were worn by everyone who came into my room – MRSA.

Molly Blackley Jackson, M.D. – Attending Physician

Medicine Consult Service, Division of General Internal Medicine.  UW Medicine

Dr.Salahi will be a wonderful Radiologist if patient rapport matters.  He did a super job of making me feel at ease during an intensive pre-patient interview.  I am glad for the opportunity to meet him on his last day in Internal Medicine.

Dr. Jackson was a bright spirit this day and every time she visited after the operation.  She and the other docs were incredibly verbal, friendly and informative…Just what this patient would order.

Thanks for reading…Sharon.

Part 2 of 4     Next time… the machine that acts like a sump pump was inserted into my belly and more ….

Cancer Loses – Kathi Trostad of Poulsbo Wins

Cancer Loses – Kathi Trostad Wins

13 Jun e 2011 marks six months cancer-free for survivor Kathi Tronstad of Poulsbo!

After four operations in five and a half months, after times being told, “You have Cancer”, Kathi celebrates six months CANCER FREE.

Where does the Kathi Trostad cancer story begin?

Did her childhood add to the someday-adult Cancer risk?

1. Kathi’s mother took DES to avoid miscarriages when she was pregnant with her.

2. Kathi was sexually abused as a young child that turned her as an adult into an outspoken child advocate

3. Kathi took HRT and lived with stress.

5.  Female

6. Kathi’s mother’s aunt died of breast cancer about 1942.

7. Kathi’s mother had breast cancer, developed Lymphedema and lived another 27 years with COPD and the Pulmonary Fibrosis that killed her brother.

8.  Kathi’s father had prostate cancer, and it spread later to his bones and lungs.  His stomach ruptured and he bled to death.

9.  Her uncles died of lung and prostate cancer. Each of Kathi’s parents had a sibling female with uterus cancer in their 30′s but both survived to their 70′s.

“Then cancer came to my cousins but still I was told I had only a small risk.”

 

Following is Kathi’s story

In April of 2010 after feeling rotten and in treatment for a UTI and kidney stones, I went to the ER in Silverdale.  An urgent care doctor said I might have Diverticulitis. Of course I said oh, no wouldn’t I know if I did?

2 1/2 weeks in the hospital to drain the abscess in my colon then home to rest and of course I had a hole although it didn’t show up on the test so then I had a fistula.  I was making 3 dozen krumkake one night and was on #30 when I thought I was getting too warm from the iron, so I put on summer pajamas.

On the #34 krumkake, I went in the bathroom, saw a red round circle on my tummy, and took my temperature,   102ᵒ.   After doing #35 and #36 krumkake, I told my husband to get me to the Silverdale ER fast. Emergency surgery drained the wound.  They left it open for a colon resection the next week.  I was feeling lucky, feeling great and could eat for the first time.

I was on 4 West and I love those people – they were so good to me!  My surgeon is Dr. Halligan and what an angel of a man.  I had 18 inches of colon removed – all old abscess scars – so how I am alive is a miracle.

Of course, I had to change my check up with my gyn doctor and to get my regular mammogram so when I was well enough in August, I had no idea what was ahead.

December 13th I was diagnosed with breast cancer and then again on the 21st so I had a double lumpectomy on the 22nd.  I had one node involved.

Hearing it was cancer 3 times is a tad much.  I felt sorrier for Dr. Halligan than for myself but he did a fabulous job.  It looks more like the cosmetic mini-breast reduction that I was wanting.

Two years ago without all these new tests now available, they would not have found the spots.   I had tumor tests so did not need chemo and the 60 dose4s or radiation left me only a little tired.

The day after my last radiation treatment, I started my work on the NK Relay For Life.  Claudia Kilburn has joined the team too.  I spoke for a couple minutes at Poulsbo’s Daughters of Norway, they donated $100 to the ACS, and another member gave me a check for $25.  We have lost too many members to breast cancer.

Dr. Halligan has ordered two low key years for me -maybe a tad boring!!!  4 surgeries in 5 1/2 months is a bit much but it is all on the same deductible so it is all good!  I have met so many wonderful people it has been a blessing and I have renewed passion for some things I do.

My tumors were found in a regular mammogram and could not be felt by me or any of my doctors.

I was shocked when my doctor told me that the Norwegian community in the PNW has a lot of MS and breast cancer.  I have heard of pockets of both here.  They do not know why.  My brother just passed away May 29 of Muscular Dystrophy at 42 years – most of those years in a wheelchair.

I now have about 36″ of scars on my torso!  The cancer center has a knitting class for us to help us think after all the meds, drugs and such.  I was new that day and we were of course discussing things.  We were thinking of all the positive things that had happened to us during treatment.

Breast Cancer survivors is a real sisterhood (men get it too).  Cancer does not care who you are or what your plans are.  Nobody cares how much or how little money you have, what kind of house you live in, or if you have many degrees or none.

One of the funny comments was that now I have no need for dental records!

The NK Relay For Life is July 8-9. God is good.  Our team name is the Peninsula Cancer Center.  Dr. Madsen asked me to join on one of my first visits to her, which to me was a good sign!  The good Dr. thinks I will be here to do it!

The morning of Dec. 13 when I went for the first report after having a biopsy at the hospital I was planning lunch with my husband and then some more Christmas shopping for the grandkids.  The sun was out and the sky was blue!  When my doctor told me I just got light headed and thought, he is saying something I do NOT want to hear, but I simply said how much of this can you do before the end of December so I can get it on the same deductible as my resection!  The blessing here was I had already had 3 surgeries with Dr. Halligan and so I knew I was in good hands and could trust his judgment.  My breasts look great, the incisions are pristine, and fine lines almost the same color as my skin.

I saw three doctors at the Peninsula Cancer Center in a calm atmosphere instead of me driving around the County to different appointments.  They had met before I arrived to discuss my case and the plan. The bottom line is I am not maimed.  When I count my blessings, I count Dr. Halligan twice!

I am in the best health of my life after 60 doses of radiation and I have met so many wonderful and helpful people in this past year.

We have a wonderful health community here.  Dr. Halligan, Dr. Truong, Dr. Chiricella, Dr. Madsen, Dr. Meeks and Dr. Esser all got me the best care right here at home.  I know me and if I had to go to Seattle every weekday for six weeks for radiation I would not be this far along to recovery!  In addition, my tumors were tested so I did not need chemo because of the type they were.  I do need to say that Harrison Hospital, AMI, the 4 WEST staff, Kristen Bakke at KPT and KPS did so much to make my recovery seem easy.  My husband of almost 44 years, Rob, did everything he could to make recovery easier.  There are so many people to thank.

Over the last year, I have learned so much about myself.  So many people have helped along the way.

The day after my last radiation treatment, I met with Brie Storset at Starbucks to discuss the NK Relay For Life.  Brie oversees the Relays in Kitsap and Mason County.

I know I am blessed and I do count my blessings every morning. I thank God for life.

While 4 surgeries in 5 1/2 months is a bit over the top, I do know lots of prayer and God given skill by my caregivers set me on a better path.  I feel great, which is new to me but I am adjusting after feeling so awful for so long.  I believe there is purpose in all of life’s experiences and I intend to spend the rest of my life doing things to help find a cure.  Cancer still makes me grit my teeth.

I have had too many friends and family die from it and some at a young age.  My daughter said that cancer will be sorry it paid me a visit.

One of the staff at the Center told me that I know how to make lemonade out of a basket of lemons.  I do indeed!

Today I am a six-month survivor of Sequential Breast Cancer.  I intend to have many more birthdays!!

One of the North Kitsap Cancer activities is the NK Luminaria Ceremony honoring those still fighting and those who have passed away.

Melanie Cena is the Luminaria Chair for this year’s North Kitsap Relay For Life.

moalie43@hotmail.com

American Cancer Society | www.RelayForLife.org |1.800.227.2345

Following are faces of cancer.  The photographer for the first 5 is Kathi’s husband, Rob Trostad – 6th photo was taken by son-in-law, Marshall Menne.

Photos:

 

1.  Me in the radiation room with Anthony, a radiation therapist.  It was not scary or embarassing. He was showing my husband and they let Rob see the computer and watch while they did the treatment.

2.  Me in front of the Peninsula Cancer Center

3.  Me ringing the bell to celebrate my lst treatment, it is a tradition in cancer centers and let people in the clinic know that one more person has graduated.

4.  Sometimes I wore costumes.  One the second day Anthony said he could see me in a Vking helmet and my hair braided!  The cake is a Boob Cake to celebrate the best breast care anywhere.  Dr. Madsen loved it!  You need comnedy relief during treatment.  I went as the first day of spring,a leprechaun and a Viking Warrior princess and I wore hats.

5. Me with my radiation therapists, Cheri and Anthony

(these might me out of order as my memory is still a little off)

6. Life goes on.  Be with my grandchildrens who are teenagers first cousin on their daqd’s side.  I look healthy and holding newborn mattox was a healing experience.  This is the best photo I have had of me in years!!!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thanks, Kathi!  Your inspiring story is a Shout Out – why so many people are so passionate about cancer.  My own daughter led a Federal Way Cancer team last night.

Thanks for reading….  Sharon O’Hara

Lymphedema, Kissing Frogs and the Right Match

Greetings!

And another reminder that I am a patient – not a medical person.  My comments are based on my own experiences and others and I take full responsibility for my opinion and perceptions.   My hope is that patients will speak up and question the medical people trying to help us when need be.  They can’t help us without an open and honest dialog.

That said, Lymphedema treatment is available.  Finding the right help at the right time is not easily available and getting the right treatment for the right diagnosis is sometimes difficult.  So is finding the right medical help match for a patient yet both are key to a patient’s survival and the best quality life possible.

Did you ever wonder how many frogs the fabled Princess kissed before she found the right frog?  Well, if frogs were medical providers, patients occasionally need to kiss lots of frogs to get the right match.

Lymphedema is nasty stuff and I was sorry to learn lymphedema can be a real problem for cancer patients, especially breast cancer.

Lower leg lymphedema disease is apparently different though since cancer caused lymphedema support groups don’t allow ‘regular’ lymphedema patients to join.   I know because I looked for close by lymphedema support groups and learned Harrison Medical Center had one.  I called to ask if I could attend a lymphedema support group session and the Harrison spokesperson didn’t think so.  She did promise to ask at the next meeting and let me know.  That was several months ago.

During the pleasant phone conversation, Harrison’s spokesperson asked how I knew I had lymphedema and I had to say I assumed it was caused from years of ignoring edema and pitted edema.

Her question stayed with me though and I recently asked my pulmonologist at the University of Washington Medical Center what caused it and his answer surprised me “Sleep Apnea”  …something to do with ‘insufficiency’…wow, Dr. Christopher Goss, I need to learn more about that!

Lymphedema is lymphedema or isn’t it?  When is lymphedema not lymphedema if

Harrison Medical Center’s Lymphedema Support Group is limited only to cancer patients?

I’m happy to say there is good news for ‘Breast Cancer-Related Lymphedema.’

***

http://www.lymphnet.org/pdfDocs/nlnexercise.pdf

JAMA. 2010 Dec 8. Weight Lifting for Women at Risk for Breast Cancer-Related Lymphedema: A Randomized Trial.

Schmitz KH, Ahmed RL, Troxel AB, Cheville A, Lewis-Grant L, Smith R, Bryan CJ, Williams-Smith CT, Chittams J.

University of Pennsylvania School of Medicine and Abramson Cancer Center, Philadelphia (Drs Schmitz and Troxel and Mss Lewis-Grant, Bryan, and Williams-Smith and Mr Chittams); Department of Dermatology, University of Minnesota Medical School, Minneapolis (Dr Ahmed); Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (Dr Cheville); and Department of Physical Medicine and Rehabilitation, University of Pennsylvania School of Medicine, Philadelphia (Drs Cheville and Smith).

Abstract

Context Clinical guidelines for breast cancer survivors without lymphedema advise against upper body exercise, preventing them from obtaining established health benefits of weight lifting. Objective To evaluate lymphedema onset after a 1-year weight lifting intervention vs no exercise (control) among survivors at risk for breast cancer-related lymphedema (BCRL)

. …

Weightlifting May Not Increase Risk for Lymphedema in Breast Cancer Survivors  http://www.medscape.com/viewarticle/734429

Laurie Barclay, MD

December 17, 2010 — A slowly progressive weightlifting program for breast cancer survivors does not increase the risk for lymphedema, according to the results of a randomized controlled equivalence trial reported online December 8 in the Journal of the American Medical Association.

“Breast cancer survivors at risk for lymphedema alter activity, limit, activity, or both from fear and uncertainty about their personal risk level, and upon guidance advising them to avoid lifting children, heavy bags, or other objects with the at-risk arm,” write Kathryn H. Schmitz, PhD, MPH, from the University of Pennsylvania School of Medicine and Abramson Cancer Center in Philadelphia, and colleagues. “Such guidance is often interpreted in a manner that deconditions the arm, increasing the potential for injury, overuse, and, ironically, lymphedema onset. Adherence to these precautions may limit physical recovery after breast cancer and, for some women, result in lost employment.”

The goal of the study was to compare onset of lymphedema after a 1-year weightlifting intervention vs a no-exercise control group among survivors at risk for breast cancer–related lymphedema (BCRL) who were enrolled in the Physical Activity and Lymphedema trial.

“We specialize in the treatment of acute and chronic orthopedic injuries and the evaluation and treatment of swelling disorders including lymphedema and vascular insufficiency.”

http://colpt.com/about.html

FREQUENTLY ASKED QUESTIONS ABOUT LYMPHEDEMA:

1.     What is Lymphedema?

Lymphedema is an abnormal accumulation of protein-rich fluid (lymph Fluid) and specialized cells (fibroblasts, keratinocytes) in the spaces between tissues throughout the body. When the lymphatic Fluid cannot be readily moved from the extremity to the trunk swelling is seen in the limb.

2.     What causes Lymphedema?

Lymphedema may be primary or secondary. Primary is when swelling is the result of lymph vessels that are too small, too few in number or too wide so the valves cannot work properly.  Secondary occurs from some kind of damage to the system. This could include surgery for lymph node removal, radiation to treat cancer, trauma or parasites that block the lymphatic vessels.

3.     What are the symptoms of Lymphedema?

Symptoms include tightness, swelling or thickening anywhere in the trunk or extremity, feelings of heaviness in the extremity, difficulty fitting into clothing in one specific area. Swelling may increase with activity and decrease with rest.

4.     Why did I get Lymphedema?

Medical science is not able to determine why one person gets lymphedema and the next person does not. It probably has to do with the number of lymphatics you had originally and what percentage are not working.

5.     Is Lymphedema curable?

Lymphedema is not curable; however, it is manageable with treatment.

6. What kind of treatment is available for Lymphedema?

There is a treatment approach called Complex Decongestive Physiotherapy(CDP). This method consists of several parts including manual lymphatic drainage, bandaging, proper skin care, compression garments, remedial exercises, and self-manual lymphatic drainage and bandaging. This treatment can be done by a physical therapist that has extensive training in the subject.

6.     What happens if Lymphedema is not treated?

Lymphedema is chronic and progressive. If it remains untreated the protein-rich fluid continues to accumulate which could lead to increased swelling and hardening (fibrosis) of the tissues.  The protein-rich fluid is a perfect environment for bacteria to flourish which could lead to recurrent infections. Untreated lymphedema can also lead to skin breakdown and loss of motion in the joints of the affected limb.

****

We have one life and, my opinion, a patient’s best bet is to get educated about whatever we have and learn how to best handle it.

Kitsap County Library System has a book on Caregiving for Lymphedema at the main library.

There are other helpful books the Silverdale Library (360-692-2779) had donated to them:

100 Questions & Answers about Lymphedema

Lymphedema: An Information Booklet

Lymphedema Management:  The Comprehensive Guide for Practitioners

Melissa at the Center for Orthopedic & Lymphatic Physical Therapy in Port Orchard mentioned using a soft baby brush to clean the affected skin and it worked fine once my husband duck taped the baby brush to a section of pvc pipe.  The extra length makes leaning over easy for a lung patient and he made two – the second one I use to apply the skin lotion.  Dry skin cracks too easily for lymphedemia’ites.

I thought you’d enjoy seeing this old car photo.  December 2009 I was rushing to Harrison Silverdale ER but had to stop to take this photo! I don’t know why the old car was there, what kind of car it is, who owned it or why it was parked with the stuffed critters outside the ER.

Part 4 of 4

More later… Sharon O’Hara

University of Washington Medical Center Excellance v Danish Air Pollution Study

Ah HA!  Ah, YES!  Air pollution does matter – finally a study proving it.

I like teaching hospitals – the attitude, the open and curious mindset that the body is more than one organ and the friendly, hospitable attitude of the medical professionals and employees is key to a patients – THIS patient – sense of wellbeing..

One of the best teaching hospitals in the nation according to US News and World Report is the University of Washington Medical Center, right across the pond from us here in Kitsap County and where I go for several medical conditions.

In all the years I’ve gone there and parked in the underground parking garage, I’ve never had a reaction to the normal car emissions.  The air seems to flow and dissipate the normal car smells.  Not so at the UWMC’s Roosevelt Building 11.

Yesterday, I had an appointment at the UWMC’s Roosevelt Building 11 and for the first time did not park in the underground parking but asked my husband to drop me off at the street level front door.

The past odor of the warm choking toxic stench in the underground garage is so bad, my eyes water.  My husband says he has never noticed the poor air quality down there but I do.

What does an air quality test show?  I called to ask.

I didn’t call to complain about the warm choking smother and forced inhaled sting of the air toxins the first or even second time we parked there – after all it IS underground parking.  When I did finally call  and did get the right person to ask when they had their last air quality check, I was politely told no one else had ever complained about it but she would find out for me.

About a month later she called to tell me what I smell must be from the helicopter landing emissions and that sometimes she even smells it in her office.

Well, how about a better filter on the helicopter or the parking garage to protect the people who park there AND work in the offices who sometimes smell it…although once inside the building, I’ve never smelled those toxins.

***

Air Pollution Exposure Increases Risk of Severe COPD

ScienceDaily (Nov. 5, 2010) — Long term exposure to low-level air pollution may increase the risk of severe chronic obstructive pulmonary disease (COPD), according to researcher s in Denmark. While acute exposure of several days to high level air pollution was known to be a risk factor for exacerbation in pre-existing COPD, until now there had been no studies linking long-term air pollution exposure to the development or progression of the disease.

The research was published online ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

“Our findings have significance on a number of levels,” said lead researcher on the study, Zorana Andersen, Ph.D., post doctoral fellow at the Institute of Cancer Epidemiology of the Danish Cancer Society in Copenhagen. “Patients, primary care physicians, pulmonologists and public health officials should all take not of our findings.”

Dr. Andersen and colleagues used data from the Danish Diet, Cancer, and Health Study, which consisted of more than 57,000 individuals between the ages of 50 and 64 who lived in Copenhagen or Aarhus, the first and second largest cities in Denmark, between 1993 and 1997. A self-administered questionnaire provided data on smoking, dietary habits, education, occupational history and lifestyle. They then used the unique personal identifiers to link the cohort to the Danish Hospital Discharge Register to identify hospital admissions and discharges due to COPD, and estimated pollution exposure by linking residential addresses to outdoor levels of NO2 and NOx levels, which were used to approximate the overall level of traffic-related pollutants since 1971. They looked at exposures over 15-, 25- and 35-year periods to assess the effect of different exposure lengths on COPD incidence. Data for more than 52,000 were available from the start 1971 to the end of follow-up in 2006.

“We found significant positive associations between levels of all air pollution proxies and COPD incidence,” said Dr. Andersen. “When we adjusted for smoking status and other confounding factors, the association remained significant, indicating that long-term pollution exposure likely is a true risk factor for developing COPD.”

These associations were slightly stronger for men, obese patients and those eating less than 240 grams of fruit each day (approximately eight ounces, or just more than a single serving). But notably, the effect of air pollution on COPD was strongest in people with pre-existing diabetes and asthma.

“These results are in agreement with those of other cross-sectional studies on COPD and air pollution, and longitudinal studies of air pollution and lung function, and strengthen the conclusion that air pollution is a causal agent in development of COPD,” said Dr. Andersen.

Because the study used hospital admissions for COPD to assess incidence, it is likely that the true incidence was underestimated, and that the cases represented severe COPD, as mild and moderate COPD does not often require hospitalization. This means that the reported increase in risk associated with air pollution is probably an underestimate of the true increase in risk for COPD in general. Furthermore, while smoking is known to be the primary cause of COPD in developed countries, and majority of COPD cases were smokers or previous smokers, the effect of pollution exposure was also observed in the group of non-smokers. “This result refutes the possibility that the observed effect of air pollution was due to inadequate adjustment for smoking in our data and supports the idea that air pollution affects COPD risk, irrespective of smoking status,” said Dr. Andersen.

The enhanced association between increased risk of COPD and air pollution in asthmatics and diabetics suggests the possibility of an underlying link. “It is plausible that airflow obstruction and hyper-responsiveness in people with asthma, or systemic inflammation in people with diabetes, can lead to increased susceptibility of the lung to air pollution, resulting in airway inflammation and progression of COPD, but more research is needed in this area.” said Dr. Andersen.

“In any case, sufficient data, including the results of this study, provide evidence that traffic-related urban air pollution contributes to the burden of COPD and that reductions in traffic emissions would be beneficial to public health.”

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Thoracic Society, via EurekAlert!, a service of AAAS.

Journal Reference:

1. Z. J. Andersen, M. Hvidberg, S. S. Jensen, M. Ketzel, S. Loft, M. Sorensen, A. Tjonneland, K. Overvad, O. Raaschou-Nielsen. Chronic Obstructive Pulmonary Disease and Long-Term Exposure to Traffic-Related Air Pollution: A Cohort Study. American Journal of Respiratory and Critical Care Medicine, 2010; DOI: 10.1164/rccm.201006-0937OC

http://www.sciencedaily.com/releases/2010/10/101019111536.htm

More later (part 1 of 3 photo story of one patients Lymphedema)  Sharon O’Hara

Health Care Not Color Blind?

Disease crosses borders. Disease lacks discrimination between races…or so I believed until yesterday. Something is very wrong and we must fix it.

Early detection of some diseases, COPD (Chronic Obstructive Pulmonary Disease) for one is a key to survival. Early detection for Colorectal Cancer is another. Recent statistics show a health care gap giving blacks late diagnosis for Colorectal Cancer thus raising their death rate.

“… the disparities identified in their study may be due to differences in the quality of health care. Compared to whites, blacks underwent less colorectal cancer screening and their cancer was detected at more advanced stages…”

Bishop Larry Robertson of the Emmanuel Apostolic Church in Bremerton should consider adding an `adult Wellness Health Clinic to the planned community center.
Bishop Larry Robertson said the first phase of the project will provide recreation and education room for organizations trying to improve individual and family well-being.

(A `youth wellness center is already being planned for Bremerton Mayor, Patty Lent’s huge scale community center on the east side)

Read more of Steven Gardner’s article… http://www.kitsapsun.com/news/2010/mar/04/downtown-community-center-to-be-named-for/#ixzz0yZxGJspU and

http://www.kitsapsun.com/news/2010/aug/29/mayor-unveils-preliminary-plan-for-former-junior/

In this country today, how is it possible that health care isn’t color blind and gender blind?

“Researchers analyzed national colorectal cancer death rates between 1960 and 2005. During that time, there was a 54 percent reduction in deaths among white women and only a 14 percent reduction among black women.

The disparity was even more striking among men. While the death rate for white men decreased 39 percent, the death rate for black men increased 28 percent, the researchers reported.

The study also found that black patients had worse rates of stage-specific survival and life expectancy. For example, in the 1970s, the life expectancy for a 60-year-old white man with localized colorectal cancer was 1.01 years more than for a black man the same age. By the 2000s, that gap had increased to 2.7 years …

Soneji and colleagues said the disparities identified in their study may be due to differences in the quality of health care. Compared to whites, blacks underwent less Bremerton Mayor, Patty Lent, screening and their cancer was detected at more advanced stages.

The study was released online Aug. 19 in advance of publication in the October print issue of the American Journal of Public Health.”

http://www.nlm.nih.gov/medlineplus/news/fullstory_102589.html (*this news item will not be available after 11/23/2010)

More later…. Sharon O’Hara