Tag Archives: tumor

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>

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

Sharon O'Hara

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

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Does a tumor mean Cancer? Part 3 of 4

Sharon O'Hara

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

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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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University of Washington Medical Center Educating Patients/vs.Nature and Causes of Disrespectful Behavior by Physicians

Sharon O'Hara

Greetings!

I’ve recently returned from a couple days at the University of Washington Medical Center Hospital going through tests I’d only read about and where they ultimately stuck a very long needle in my belly and pumped one and a half gallons of blackish fluid from a tumor that took over the space.

Did you know that an x-ray of a belly full of fluid shows up as a blackish nothing? I didn’t.

Next time I have a few things to say about that including showing photos of incredible shots taken of the inside of my belly drained of the excess fluid and showing the tumor still taking up an inordinate amount of space.

The attending doctor, Brian Story Porter, MD, took the time to show me the photos on a computer in my room and then showed them a second time when my daughter was there. More proof that UWMC doctor’s not only teach medical students, they educate their patients too and have all along!

My lung doctor, Christopher Goss, MD – looks at the whole patient – not just their lungs. His patients are more than a lung, including his disease passion, Cystic Fibrosis.

That said, I was shocked yesterday to run across the following Perspective: A Culture of Respect, Part 1 and 2: The Nature and Causes of Disrespectful Behavior by Physicians and thought you’d be interested too.

I am running most of it here. I’m also asking what we, as patients, can do to help change it?

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“22 May 2012

Perspective: A Culture of Respect, Part 1: The Nature and Causes of Disrespectful Behavior by Physicians

Leape, Lucian L. MD; Shore, Miles F. MD; Dienstag, Jules L. MD; Mayer, Robert J. MD; Edgman-Levitan, Susan PA; Meyer, Gregg S. MD, MSc; Healy, Gerald B. MD

A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. The authors identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behavior in the health care setting: disruptive behavior; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behavior; passive disrespect; dismissive treatment of patients; and systemic disrespect.

At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognized by health workers as disrespectful.

Disrespect is a threat to patient safety because it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices. Nurses and students are particularly at risk, but disrespectful treatment is also devastating for patients. Disrespect underlies the tensions and dissatisfactions that diminish joy and fulfillment in work for all health care workers and contributes to turnover of highly qualified staff. Disrespectful behavior is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behavior is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.

http://journals.lww.com/academicmedicine/Abstract/publishahead/Perspective___A_Culture_of_Respect,_Part_1___The.99620.aspx

Perspective: A Culture of Respect, Part 2: Creating a Culture of Respect

Leape, Lucian L. MD; Shore, Miles F. MD; Dienstag, Jules L. MD; Mayer, Robert J. MD; Edgman-Levitan, Susan PA; Meyer, Gregg S. MD, MSc; Healy, Gerald B. MD

Creating a culture of respect is the essential first step in a health care organization’s journey to becoming a safe, high-reliability organization that provides a supportive and nurturing environment and a workplace that enables staff to engage wholeheartedly in their work. A culture of respect requires that the institution develop effective methods for responding to episodes of disrespectful behavior while also initiating the cultural changes needed to prevent such episodes from occurring. Both responding to and preventing disrespect are major challenges for the organization’s leader, who must create the preconditions for change, lead in establishing and enforcing policies, enable frontline worker engagement, and facilitate the creation of a safe learning environment.

When disrespectful behavior occurs, it must be addressed consistently and transparently. Central to an effective response is a code of conduct that establishes unequivocally the expectation that everyone is entitled to be treated with courtesy, honesty, respect, and dignity. The code must be enforced fairly through a clear and explicit process and applied consistently regardless of rank or station.

Creating a culture of respect requires action on many fronts: modeling respectful conduct, educating students, physicians, and nonphysicians on appropriate behavior, conducting performance evaluations to identify those in need of help, providing counseling and training when needed, and supporting frontline changes that increase the sense of fairness, transparency, collaboration, and individual responsibility.

http://journals.lww.com/academicmedicine/Abstract/publishahead/Perspective___A_Culture_of_Respect,_Part_2__.99622.aspx

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It all started with Chronic Obstructive Pulmonary Disease and a forty-year smoking habit.

Thanks for reading…. Sharon O’Hara

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