Tag Archives: m.d.

Boob Voyage Party

Cindy - before breast reduction — Cindy – before breast reduction

Boob Voyage Party

According to the American Society of Plastic Surgeons…

“Breast Reduction, Also known as, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.”

http://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation.html

Some women are born with the genes to grow the unwieldy, heavy huge breasts that can work to make their lives challenging and think about surgery, but hesitate. Sometimes hesitate for years, a lifetime.

Cindy Dillion, 62, finally had enough earlier this year and determined to find a plastic surgeon to remove the excess burden of her oversize breasts.

Cindy’s sister had breast reduction done 35 years ago. When the doctor asked what bra size, she wanted to be she answered – her only criteria – make breasts smaller and point my nipples, “nipples pointed at the sky.” Thirty-five years later, Cindy’s sister declares her nipples still “point at the sky.”

Cindy’s body was marked before surgery – sculpted according to her plastic surgeon artistic eye and examination of the patients shape. No to the fancy ‘starburst’ nipple – just smaller, balanced and each boob should be looking ahead. No pointy nipples.

Cindy lost five pounds off her breasts and another four pounds off her body when they liposuctioned the fat around her belly, shoulders and back.

In the six and a half weeks since the operation, she has lost twenty-one pounds and got more than she bargained for when her body rejected the stitches – she was allergic to them. Ten days post operation she developed an opening, by the twelfth day the slight opening was open around the nipple and caused the drain hole to shift. An infection followed, leading to extraordinary effort from her long time husband – the husband she now calls, “Rock Star.”

The couple turned one of their empty nest bedrooms into a spotlessly clean medical wound changing room where twice a day Rock Star follows doctor’s orders, changing the wrapping, and helping his wife heal through his devoted attention to the wounds.

Cindy cannot bring herself to look at her wounds, as her husband does, but noted she can now see her nipples for the first time in fifteen years AND noted her active support group had their “Boob Voyage” party and look forward to the next one – the BraBeque Party! (burning of the old painful reminder bras)

Her bra size at the time of the operation was 42 K and Cindy guesses she may drop back to the 36 D-bra size she has not seen in twenty-five years.

Cindy’s Seattle doctor is surgeon Mary Lee Peters, M.D. I was impressed upon learning the doctor did not ask what bra size Cindy wanted since, it seems to me, a good plastic surgeon should be medically artistic enough to take the patient’s body size and frame, in consideration to make the judgment call for each individual. Hip, hip – hooray!

Insurance did not cover the cost of Cindy’s Breast Reduction – their deductible was too high and the out of pocket cost was $~~13,000~~ .00 $9,000.00 for breasts and $4,000.00 for the liposuction[S1] .

[S1]Cindy Dillion is a professional Realtor working out of the Coldwell Banker Bain office in Gig Harbor. She will talk to anyone who has questions about one of the most underrated medical procedures I know – surgery to get relief from the pain and weight of oversize breasts.

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

to get relief from the pain and weight of oversize breasts.

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Does a tumor mean Cancer

Sharon O'Hara

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 ….

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Surgery – New Hope for Lymphedema Patients

Sharon O'Hara

Lymphedema patients have a new surgery option for arm and leg swelling – would it be available to seniors?

How much is the cost of it compared to the standard treatment that doesn’t work all that well?

Who is a good candidate for the surgery?

“LITTLE ROCK – The University of Arkansas for Medical Sciences (UAMS) is the first in Arkansas and one of a handful of medical centers in the country offering a new surgical alternative to treat lymphedema, the chronic arm swelling frequently associated with breast cancer treatment.

The unique microvascular procedure at UAMS is performed by Mauricio Moreno, M.D., who learned the new surgery during his advanced training in microvascular reconstructive surgery prior to joining UAMS in 2009.

The surgery is the only permanent, effective treatment for lymphedema, which is caused by damaged lymph nodes that can no longer cycle excess fluid out of the arms and legs. In the United States the condition usually is a side effect of mastectomy or radiation therapy that compromises the lymphatic system. The result is swelling, numbness, discomfort and a high risk of infection.

Valerie Davis, of Smackover, the first lymphedema patient to have the surgery at UAMS, said the swelling from her mastectomy four years ago was disabling because it restricted the use of her left arm.

“The swelling was outrageous, even when I wore the compression sleeve,” Davis said. “It was really aggravating; I couldn’t lift things like I wanted to.”

Patients with lymphedema commonly see about a 20-40 percent reduction in swelling using massage and compression therapy, the traditional treatment for lymphedema. Such therapy involves extensive massaging to push the fluid from the extremities back to the torso. It is a temporary solution that has to be performed regularly because lymphedema does not improve over time – it only gets worse.

Davis said she tried the traditional treatments, which helped some but were a big inconvenience. When she heard about the new procedure, Davis said, she couldn’t pass up the chance it would bring relief.

“Dr. Moreno told me it had a 70 percent chance of working, so I took the 70 percent,” she said, adding that she’s happy she took those odds.

Davis saw an 81-percent reduction in her arm swelling within a month from the procedure.

“It was worth it,” she said. “I’m doing so much better now, and Dr. Moreno said the swelling would likely continue to go down.”

Lymphedema surgery involves connecting tiny lymphatic vessels to tiny blood vessels (less than 1 millimeter), giving the excess fluid a new pathway out of the arms or legs. The surgery was developed in Japan in 2003, and Moreno learned it from a surgeon who brought it to the United States from Japan.

Because the surgery is so new in the United States, its cost is not covered by insurance, Moreno said….”

http://www.uamshealth.com/News/NewSurgeryatUAMSProvidesDramaticReductioninArmSwellingforLymphedemaPatients?id=5350&showBack=true&PageIndex=0&cid=4

Thanks for reading… Sharon O’Hara

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Pain Medication Research at UW Medical Center and Washington State University

Sharon O'Hara

Overdosing on pain medication can kill and may cause pain med addiction. For COPDers though pain management isn’t usually a part of COPD (Chronic Obstructive Pulmonary Disease) management. Speaking as a patient – COPD isn’t painful. Patients simply can’t breathe to different degrees and some patients de-saturate enough to be placed on supplemental oxygen allowing them to exercise further and faster for a quality life.

Trouble is – COPD is often the beginning of gathering other diseases – Other Stuff that is very painful. Trouble is – some pain medications are known to adversely affect the respiratory system…so too often COPDers learn to live without sleep and 24/7 pain until the day comes when the thought of facing another day of such pain isn’t worth it and that is when a COPDer will take a pain pill or two for relief and to sleep. Too, our physicians are afraid to prescribe pain meds for fear their patients will become addicted and I understand that.

I lived through the initial crushing left hip pain until now my body is letting me help myself into better hip health through water exercise but the ongoing debilitating cellulitis/Venous Stasis Dermatitis/Lymphedema sweeping lower leg pain finally sent me in desperation to the University of Washington’s Pain Management Clinic. On one visit I listed the pain as a 9 out of 10 being the worst.

Those were a few bad years, now is now and it is better. For the Lymphedema, education was the key. Thanks Melissa. Time and exercise is helping me live in harmony with my hip… all without pain medications.

That said, UW Medicine’s Alex Cahana, M.D., DAAPM, FIPP and the Division of Pain Medicine is doing ground-breaking work in pain management education for the physician and patient. He was deeply involved with the “Washington State Opioid Reform Initiative, which seeks to reduce the over-prescription of narcotics.”

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“Since then, we’ve learned of two initiatives to help providers grapple with the disparate problems of addiction and pain management. ROAM (the Rural Opiate Addiction Management) Collaborative seeks to help manage the widespread issue of opiate addiction in rural Washington. COPE (Collaborative Opioid Prescribing Education) is an online educational tool that helps providers communicate to patients about how best to manage treatment of chronic, non-cancer-related pain.

ROAM and ECHO: Defeating Opiate Addiction in Rural Washington

Until recently, rural physicians have had few tools to help their patients escape opioid addiction — an epidemic health issue in rural areas, with large numbers of unintentional overdoses, even deaths. Methadone maintenance therapy, the most common treatment for opioid addiction, is often unavailable. However, a federally approved medication called buprenorphine (also known as Suboxone or Subutex), is more readily available, and it’s a viable, office-based alternative to methadone.

Despite the potential advantages of buprenorphine as opioid replacement therapy for addicted patients, however, few physicians have taken the eight-hour course that allows them to legally prescribe this medication. As of 2010, only 32 rural doctors in Washington had received the federal waiver that allows them to prescribe Suboxone.

In late March, Roger A. Rosenblatt, M.D., MPH, UW professor and vice chair of the Department of Family Medicine, and UW Medicine’s ROAM (Rural Opiate Addiction Management) Collaborative helped remedy the situation by offering the course to rural physicians and members of their practice staff in Spokane, in conjunction with the annual Regional Rural Health meetings. Physician participants are then eligible to receive a waiver from the Drug Enforcement Administration to allow the prescription of buprenorphine to treat addiction. If they wish, they can also receive further mentoring and instruction from Project ECHO (Extension for Community Healthcare Outcome), a bi-weekly video-conferencing program that covers issues such as patient management, staff training and clinical protocols.

For more information on ROAM — a collaboration between Washington State University and the University of Washington, funded by the state’s Life Sciences Discovery Fund — contact Rosenblatt at 206.685.1361 or rosenb@uw.edu.

COPE: Online Education for Chronic Opioid Therapy

UW Medicine has launched an online medical training tool for doctors and other prescribing providers who treat chronic pain. Known as COPE — Collaborative Opioid Prescribing Education — the tool is designed to improve interactions between prescribers and patients as they make shared decisions about chronic opioid therapy.

COPE was developed over the past six years by Mark Sullivan, M.D., Ph.D., a professor in UW Medicine’s Department of Psychiatry and Behavioral Sciences and adjunct professor of bioethics and humanities, and it has been clinically tested and peer-reviewed. It’s a comprehensive program, one that goes beyond typical factual content by using videotaped clinical scenarios to train providers about goal-setting and communications skills. Tutorial models are in development for nurses and for patients and families to help enhance their engagement in decision-making.

COPE focuses on the management of chronic, non-cancer pain, and its interactive modules are a timely response to legislative changes concerning chronic opioid therapy. Recently, Washington State adopted a bill that requires mandatory education and use of a prescription-monitoring program and clinical tracking tool. In addition, the U.S. Food and Drug Administration intends to issue a Risk Evaluation and Mitigation Strategy (REMS) which likely will call for a coordinated risk management plan for patients taking long-acting opioids. COPE will help prescribing providers nationwide to meet this challenge.”

For more information on COPE, contact Sullivan at: sullimar@uw.edu.

More later … thanks for listening… Sharon O’Hara

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Dogs and Doctors Work Together for the Same Purpose – Keep their Humans Healthier

Sharon O'Hara

I’ll call her Wini. Wini was a horse person and she and her retired Navy husband bred, raised, showed and sold Arabian horses. She was a little woman and her huge husband towered over her. I met them when I joined the local horse club and the meetings were held in their arena clubroom. Wini and her husband loved dogs too and was always surrounded by them.

My focus here is Wini and dogs. She had lost her helpmate and fifty-five year love and lived some years alone with the dogs. Wini began to disperse the horse herd as she became less able to care for them. Their only child, a son, lived far away in another state and they had little contact with him or his family.

I don’t know how it happened but Wini ended up in an assisted living place in another town several hours drive from home and everyone she knew. She told me she begged her son to let her keep just one of her little dogs but he placed her in a place that didn’t allow dogs. The next to last time I spoke with her she thought the management might let her keep one of her beloved little dogs.

The last time I spoke with Wini she sounded depressed, lonely and sick. She wasn’t allowed a dog and few people made the drive to see her. It my opinion that people need something warm to hug and to feel the heartbeat of another living being – something to care for and be loved in return.

Dogs can save lives and give some folks a reason to live.

There is a reason I’m posting a video of the Silverdale Dog Park beyond being a dog person and the fact is that I admire folks who fund their own hobbies such as the dog folks of Silverdale who worked hard to fund and do volunteer work at the Silverdale Dog Park.

I recently visited and took a video and found people of all ages playing there with their dogs… the place is crowed no matter the weather with the friendliest people I’ve met anywhere and neat dogs. Take a look and please forgive my amateurish attempt to show a great place for people and dogs. A great place to socialize with your pets and other like minded folks.

Mike McCown, Silverdale Dog Park Stewardship President and the tribute to the mover and shaker for the park, Anita Bates.

The couple in the video are Robert Smith and Carolyn Farnsworth and “Dobbie” one of the happiest Australian Shepherds I’ve met.

Dogs save lives for seniors, the physically challenged and even children who have been betrayed by adults and horribly abused are soothed and can be adored and loved uncondioningly by the right dog.

Dogs enrich our lives. In some cases, dogs and pets give some of us a life and a reason for living. Caring for them helps us remain physically and mentally fit and active.

There are plenty of studies to prove it and for some our dogs keep us striving to be better people – to become, “the person my dog thinks I am.”

My first dog, Pepy was a herding dog from the Kitsap County Humane Society some sixty years ago.

Man’s Best Friend: Study Shows Lonely Seniors Prefer Playtime With Pooch Over Human Interaction

ScienceDaily (Jan. 9, 2006) — A new Saint Louis University study shows there is some truth in the old cliché that describes a dog as “man’s best friend.”

“Or at least a less aggravating friend,” said study author William A. Banks, M.D., professor of geriatrics in the department of internal medicine and professor of pharmacological and physiological sciences at Saint Louis University School of Medicine.

Nursing home residents felt much less lonely after spending time alone with a dog than they did when they visited with a dog and other people. The research will be published in the March 2006 issue of Anthrozoos 18(4).

“It was a strange finding,” said Banks, who also is a staff physician at Veterans Affairs Medical Center in St. Louis. “We had thought that the dog acts as a social lubricant and increases the interaction between the residents. We expected the group dog visits were going to work better, but they didn’t.

“There is no need for a dog to be a social lubricant or icebreaker in a nursing home. Residents live with each other, eat breakfast, lunch and dinner with each other, play bingo with each other,” Banks says. “The study also found that the loneliest individuals benefited the most from visits with dogs.”

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first M.D. degree west of the Mississippi River. Saint Louis University School of Medicine is a pioneer in geriatric medicine, organ transplantation, chronic disease prevention, cardiovascular disease, neurosciences and vaccine research, among others. The School of Medicine trains physicians and biomedical scientists, conducts medical research, and provides health services on a local, national and international level.

http://www.sciencedaily.com/releases/2006/01/060108215831.htm

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One recent study by a Michigan State University researcher, epidemiologist Mathew Reeves showed that dog walkers are “34 percent more likely to meet federal benchmarks on physical activity.”

To me that means being more physically fit and able to take care of ourselves as well as our dogs and saving taxpayers billions of dollars in health care costs.

“Walking is the most accessible form of physical activity available to people,” Reeves said. “What we wanted to know was if dog owners who walked their dogs were getting more physical activity or if the dog-walking was simply a substitute for other forms of activity.”

Mathew Reeves and his team discovered the walking dog people were more active overall in their lives.

The study appears in the current issue of the Journal of Physical Activity and Health.

“He also pointed out the social and human/animal bond aspects of owning a dog that has been shown to have a positive impact on quality of life. And since only about two-thirds of dog owners reported regularly walking their dogs, Reeves said dog ownership represents an opportunity to increase participation in walking and overall physical activity.

Contributing authors to the research include Ann Rafferty, Corinne Miller and Sarah Lyon-Callo, all with the Michigan Department of Community Health.”

http://www.sciencedaily.com/releases/2011/03/110310151218.htm

More later…thanks for listening… Sharon O’Hara

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Patients Need to be Educated. Are Some Physicians too Ignorant?

Sharon O'Hara

The other day I was shocked to run into a friend I hadn’t seen recently and to see this formally physically fit verbal person limping gingerly with the help of a walking stick sickened me as I listened to the story – and PERFECT example why communication between patient and physician is paramount to that patients well-being.

A few years ago my bone on bone left hip needed a bone doctor. Before I could get to the local appointment with a bone doctor, the pain sent me to a Prompt Care after a call to my primary physician, Karen Eady, M.D. The doctor ordered x-rays – yes, arthritis and didn’t do anything further since I had an appointment with a local orthopedic doctor in a few days.

The orthopedic doctor didn’t say much of anything but talked in terms of an operation and suggested several over the counter meds for the pain. I take meds for my lungs and other medical conditions and know non-prescription drugs can counteract with each other the same as prescription drugs can and cause huge problems. I’m leery. That said and after a non-informative brief discussion, he walked away and I called after him, “Doctor, what do I have?”

“Arthritis” he called back then disappeared around the corner. Okay. But I had expected him to tell me what I didn’t know and give me the type of arthritis – there are more than 100 different kinds of arthritis.

Sometime later I complained to another doctor about the encounter and he laughed and said orthopedic docs never communicate – sort of a ‘rule’ and laughed again. I grinned but told him that’s wrong. By then, I had visited one of the University of Washington Medical Center’s orthopedic surgeons and he educated me what I had and what it was doing and what we could do about it.

I told my laughing doctor the U surgeon DID inform me what was going on and gave me options. He seemed surprised that any orthopedic doc spoke more than 10 words to a patient. I shrugged it off and decided that the performance in the operating room must be all that counted.

Seeing and listening to my friend the other day though made me realize that the problem with doctors who do not/can not communicate with their patients is that they must not DO NOT LISTEN to their patients either! Her complaints were ignored by her doctor and it seems to be a big surprise to him that she now has serious medical problems, not just the replaced hip and another operation to fix what should never have happened had he listened to her!

I suggested that my friend run, not walk to the University of Washington Medical Center for a through exam and get things resolved. That she not waste any more time – that she not do what I did all those years ago.

Do not waste one moment on an ignorant physician, folks.

Without exception, every doctor I’ve met at the UWMC is a communicator…they listen.

Orthopedic doctors who can’t communicate with their patients? Let them operate on themselves. A physician who can’t respect their patient enough to communicate with them is not one who listens to them either – in my opinion as a patient.

More later…thanks for listening… Sharon O’Hara

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Dear Harrison Medical Center Respiratory Department

Sharon O'Hara

Dear Harrison Medical Center Respiratory Department,

I was late. The reasons I was late don’t matter.

The clock on the back wall read 2:40 pm. The brightly lit room was empty. I peered around the corner where the coffee and ice water were served – the ice water container was full but no one was there. A passer-by told me folks were there earlier.

I waited in the doorway 5 minutes until it was clear no one was coming back before beginning the long walk back down the hall from the Rose Room at Harrison Silverdale and out to the gas guzzler.

I have no complaints…I have questions. In the light of the present day horrific life and death earthquake and tsunami disaster in Japan, my comments and questions may seem frivolous.

20 minutes is a lot of time. Japan’s record 9. 0 Earthquake reduced buildings into rubble in less than 20 minutes.

The tsunami that followed scooped up and destroyed miles of buildings, homes, cars and people within 20 minutes.

A doctor can see two or more patients in 20 minutes.

What could I have learned in 20 minutes had anyone been there to teach me?

The Better Breather’s meeting was scheduled for 1:00 – 3:00 pm and no one was there. I understand RT’s respiratory time is valuable and they’re needed but I didn’t see any COPD patients there either.

Why wasn’t the meeting advertised in the Kitsap Sun? Harrison’s MS support group meeting was advertised that same day.

1. Kitsap County has how many pulmonary docs?

2. Capri is a cardiopulmonary rehab group – do they recommend Harrison’s Better Breather’s pulmonary support for their rehab folks?

3. What is the problem?

Are Kitsap lung patients uninterested in further education in living with lung disease? Do they already know all there is to know about lung disease? Or, are they being ignored by the very medical community treating them?

If a support group is advertised to be available during certain hours, they should not leave early. In the years I had a business we advertised being open until 9:00 pm and someone was always there until closing. People knew they could count on those open hours for business.

If pulmonary patients aren’t interested in support group learning and education, there is no point in wasting valuable respiratory employee time from Harrison in meetings no one shows up for.

If the problem is getting the word out then do it!

The Old Guy and I will hand deliver flyers promoting the next Better Breather’s meeting to every heart and respiratory doctor’s office in Kitsap County – if that’s what it takes. I will even print them out if you send me the file in something other than a dat. file.

In turn, stay open and available for the hours you state you will be there. Regular business folks do.

I could have learned a lot in that 20 minutes no one was there. Maybe I did.

I just learned that according to the Yellow Pages in the Kitsap Peninsula “dexknows.com”- the – to July 2011 edition- has only one M.D. is listed under “Lung (Pulmonary)” –page 417.

Doctors Clinic – Kittredge A. Baldwin, D.O. and Benjamin Sy, M.D. on Wheaton Way, Bremerton are the only pulmonary doctor’s listed – why aren’t the doctor’s off Campbell Way listed? Did they change their specialty?

More later… Sharon O’Hara

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Psoriasis is More Than Skin Deep – Clive Liu, M.D. Speaks – RSVP

Sharon O'Hara

Good support groups are invaluable to us – we meet and share information from people just like us – brothers and sisters under the skin – or sometimes, on the skin. Our ethnic background and appearance doesn’t pay a part in the disease we share – psoriasis, in this case.

My psoriasis has been ‘resting’ for a couple years, but it’s beginning to stretch and yawn itself awake again…ask my elbows.

I still wear the slippers I had to cut away to make room for the swollen crusty weepy sores of psoriasis on my upper feet and the sides of my toes. Psoriasis can be nasty and mostly attacks kids.

A professor at the University of Washington Medical Center diagnosed my Psoriasis – called it a ‘classic case’. He stands out as the only M.D. – ever – to recommend an online support group to me and the online support group is how I learned kids gets this…often disfiguring disease. www.psoriasis.org

If anyone needs a ride, let me know…you won’t be sorry you made the effort to go.

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Psoriasis: More Than Skin Deep

Seattle (Bellevue), Washington

Saturday, March 19, 2011

Courtyard Seattle Bellevue/Downtown

11010 NE 8th Street

Bellevue, WA 98004

Speaker: Clive Liu, M.D.

RSVP for this event >>>

Psoriasis: More Than Skin Deep

SCHEDULE

9-9:30 a.m.

Registration and complimentary breakfast

9:30-12:00 noon

Psoriasis: More Than Skin Deep.

Hear from Dr. Liu about current treatment options, get research updates and learn how you can be part of the growing movement to find a cure.

Centocor Orth Biotech, Amgen Pfizer, Abbott, Galderma, Beiersdorf, Neutrogena

The National Psoriasis Foundation gratefully acknowledges Centocor Ortho Biotech, Amgen Pfizer, Abbott, Galderma, Beiersdorf and Neutrogena for their support. The Psoriasis Foundation is solely responsible for all content and development.

call 800.723.9166 events@psoriasis.org www.psoriasis.org

National Psoriasis Foundation

6600 SW 92nd Ave, Suite 300 | Portland, OR 97223-7195

***

More later…. Sharon O’Hara

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Lymphedema, Kissing Frogs and the Right Match

Sharon O'Hara

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

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Seattle’s the Place -Saturday is the Day!

Sharon O'Hara

Alpha-1 Education Day – Seattle

Saturday, 23 October 2010

AARC Accreditation for 6 hours of Continuing Respiratory Care Education.

Emergency Supplemental Oxygen will be available, courtesy of Apria.

Doubletree Guest Suites Seattle Airport/Southcenter Parkway, 206-575-8220

The event begins with a continental Breakfast and Exhibitor displays at 0815 followed by a warm welcome by Marlene Erven, Executive Director, Alpha-1 Association.

Angela McBride, Director of Development, Alpha-1 Founadation will give a foundation update.

The program ends with Alan Barker, M.D., Professor of Medicine, Oregon Health & Science University speaking on Alpha-1 Research Update & Importance of Oxygen and Preparing for Transplant.

The event filled day includes Robert E. Sandblom, M.D., Chief of Pulmonary Service-Respiratory Disease, Eastside Speciality Center.

A Alpha-1 Liver Disorder update will be given by Simon Horslen, M.D., Ch.B., Professor of Pediatrics, University of Washinton School of Medicine and Medical Director, Liver & Intestinal Transplantation, Seattle Children’s Hospital.

Contact 800-521-3025 for more information.

Welcome to Seattle, Alpha-1 Foundation!

More later…. Sharon O’Hara

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