Archive for cancer

I had the opportunity/privilege to participate in a conversation with other health activists and e-patients about a Digital Patient Bill of Rights recently.

I’ve posted an overview of the conversation on the Cancer for Christmas blog. Give it a read, and tell me what you think. Really.

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medical tourism imageNo, not how far you’d go in the Denzel Washington/John Q/hold-a-hospital-hostage sense. In the get-on-a-plane-toward-care sense.

Medical tourism has seen an exponential rise with patients in the US as health care costs and the number of uninsured patients have risen over the last 15 years. In a TIME magazine piece in 2006, Curtis Schroeder, CEO of Bumrungrad Hospital in Bangkok – somehow, I don’t think he’s Thai – said that in 2005 their census of US patients rose 30% (to 55,000).

That trend has continued, even with the advent of “health care reform” – health insurance reform, really – since health care costs have continued their hockey-stick rise, with no end in sight, for two decades.

50 years ago, patients from across the globe saw health care in the US as the holy grail. Now, US patients are traveling to Costa Rica, Thailand, Mexico, New Zealand, even Cuba to get access to high-quality, low-cost care.

US companies have started to explore medical tourism, and some are offering  incentives to their employees – incentives including getting to pocket some of the savings gained from traveling abroad for treatment. Not enough, however, to make medical tourism a healthy industry here in the US of A.

An August 2011 article in Workforce Management includes a story about a nurse in Louisiana (irony is our favorite thing here at Mighty Casey Media) who traveled to Costa Rica a few years ago for dental work, including oral surgery. She paid $2,700 out of pocket for what would have cost her $10,000 at home, with her employer covering $1,500 of her care expenses. Her net cost for the procedures was $1,200, plus her travel expenses – which travel was negotiated and arranged by a broker, Companion Global Health Care Inc.

I’m sure that, even after travel expenses, her savings were still solidly in the thousands of dollars.

So why aren’t more US companies encouraging their employees to take advantage of medical tourism? According to the CEO of Companion Global, David Boucher – who certainly has a dog in this fight, and who is quoted in the Workforce Management article linked above – the rising costs of health care make the health-tourism choice a no-brainer. He says that their customers are seeing a 2- or 3-to-1 return on investment for medical tourism, and patients – their customers employees – are very satisfied with the quality of their care.

However, according to Joe Marlowe, senior VP of health and productivity at the risk-management and HR consulting firm Aon Hewitt who’s also quoted in the WM story, employers are risk-averse, particularly at the idea of making themselves liable for medical care far from home that turns out badly for the patient.

What do you think? Would you travel 8,000 miles for a knee replacement, or 3,000 for chemotherapy, to save a significant amount of money and still receive high-quality care? Or would you want to be closer to your support system – family, friends – while receiving care?

I would most certainly travel to Bangkok or San Jose for a knee replacement. Not sure about oncology, since that follow-up can be so long-term.

You? I really would like to know.

That’s my story, and I’m stickin’ to it …

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I had my 15 minutes of internet fame recently, with a "My Take" essay on BusinessWeek.com. To say that made my month would be an understatement!

Social media played a part in bringing me this opportunity. If you're not a believer in the power of the Holy Trinity of SM (Twitter, LinkedIn, and Facebook)…you need to be.

That's my story, and I'm stickin' to it…

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Dec
26

Cancer for Christmas – One Year Later

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I had my annual mammogram this last Tuesday – remembering how last year’s formerly routine event wound up, to say I was a little nervous is a vast understatement.

Here’s the news: I’m now officially a survivor.

Looking back at the last 372 days, I have to say it’s been quite a ride. So many people have helped me, have lifted me up, have kept me from feeling that terrible aloneness that’s part of fighting a life-threatening disease.

‘Thank you’ sounds inadequate, but it comes from the deepest and most tender part of my heart.

I will finish the first draft of "Cancer for Christmas" by New Year’s Day. Then it’s on to finding an agent, a publisher, or – best of all possible worlds – both. I’ll be reaching out to Save the Tatas and the Susan G. Komen Foundation, offering them a piece of the cover price in exchange for helping promote the book once it’s published.

My goal is to help anyone in the fight – against cancer, or any other life-changing disease – navigate the medical car-wash and manage their medical care for their benefit.

Because if you don’t, no one else will.

2008 has been quite a journey. I’m in an incredibly wonderful place, which I don’t know that I would recognize had I not had my dance with the Cancer Troll.

2009 is already a mortal lock for my best year yet – I wish you the same!

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Mar
30

Beeting Up On Oneself

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As a person participating in the fun-filled romp known as chemotherapy, your ‘umble correspondent has been able to make all sorts of wonderful discoveries.

There was "anorexia", wherein our heroine was introduced to the practice of picky eating. Not something she had been familiar with previously, at all.

There was "chemo brain", wherein she learned just how stupid "dumber than a box of rocks" really was. Is. Whatever.

Today, she learned that the two can be combined in new and interesting ways.

Say, f’rinstance, one learns that one’s blood is dangerously low in something called neutrophils – due to the aforementioned chemotherapy’s Sherman-like march through one’s bloodstream toward whatever cancer cells might have the temerity to remain within one’s corpus. (Note – there ain’t none, one just has to run the bases, like any other home-run hitter.)

One reads up on neutrophils, and white blood counts, learning that a diet rich in beef, cooked mushrooms, and red/orange/yellow wegetables is just the ticket for getting that neutrophil level back up to the mark that will prevent our heroine from getting hit with Neulasta. That being the drug used to hammer one’s marrow into manufacturing neutrophils, while also apparently causing bone pain – IOW, not something our heroine is inclined to entertain the deployment of, since she’s got entirely enough chemicals runnin’ ’round her veins, thank you very MUCH.

Anywise, the thought of some yummy beets seems like a good thing, and she hits the local Kroger in search thereof. What ho! Organic beets! With greens on top! On Wednesday, the beets are steamed and enjoyed, with a steak and sautéed ‘shrooms. Yum. She feels better already.

The greens were left in the weg crisper, and today’s lunchtime seemed like just the time to wilt ‘em, butter/salt ‘em, and get outside ‘em. So she did.

Oh – has it been mentioned that a regular side effect of chemo involves the, um, acceleration of elimination of the alimentary sort?

We think she set some kind of land speed record around the time from beet-green ingestion to beet-green removal. The old aphorism about what goes fast through a goose came to mind.

Beet feet, indeed.

The things one learns when one isn’t paying attention.

That’s my story, and I’m stickin’ to it…

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Mar
11

The Stories We Tell Ourselves

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Last week, I discovered just what the storied chemotherapy side-effect called "chemo-brain" feels like.

Stupid. On the short bus. Intellectually disabled. Whatever you call it, it sucks.

Now that I’m emerging from the fog, I find myself reflecting on the stories we tell ourselves – the internal monologue of our lives, if you will. The stories that we carry with us wherever we go, whatever we do, and that truly define us – no matter what stories we tell to mask what we’re telling ourselves.

We all have our "stuff" – those pieces and parts of ourselves that we reallyreally don’t want anyone else to see, the "stuff" that holds our darkest selves. Most people manage their "stuff" well enough, only giving their most intimate circle any glimpse of darkness in their inner story.

Look around, and find the happy people you know – my firm conviction is that their inner and outer stories are very much the same. That’s not to say happy people are simple creatures. What I’m saying is that finding happiness – that "happily ever after" thing – is only possible if you live life authentically. Out loud, walk your talk, live your brand – pick your aphorism. To be happy, I firmly believe you must reveal, and live, your true self.

Now, I’m not recommending that you vomit out all your innermost thoughts at the next project team meeting. That’s a great way to live authentically unemployed. What I DO recommend is that you start listening to the voice in your head. Unless your shrink has given you medication to STOP the voices in your head, in which case…can I get you a glass of water? Listen to what you’re saying to yourself, and see if that might not be a source of much of your "stuff" – it’s "stuff" you’ve given yourself.

Think about the stories you’ve heard or read about people who’ve triumphed over adversity: escaping a childhood in a terrible neighborhood, surrounded by crime and drugs, to become a doctor; surviving horrific physical and emotional abuse to become an inspiring writer and speaker. For every person who has navigated past horror to success, there are countless others who did NOT make it past the bad stuff, who got stuck on the corner or who succumbed to despair.

What separates the successful from the also-rans? That internal story. They tell themselves a story that takes them where they want to go – out of the darkness, and into whatever light shines on "happy" for them.

So – what story are you telling yourself? Listen to it…and learn. And if it isn’t serving you, start telling yourself a story that does.

A highly cautionary tale is unfolding this week as Elliot Spitzer slowly turns on the roasting spit he shoved up his own glory-hole…by telling himself a story that he hid from the rest of the world. This was a BIG story, folks. Spitzer was called "Elliott Ness" for his prosecutorial zeal in going
after consumer fraud, Wall Street, the mob…and call-girl rings.

I’ve watched many people, over a number of decades now, who stridently spoke out of one side of their mouths while – thinking no one would ever notice – speaking silently to themselves a story that was in complete opposition to the story they were telling publicly.

Ladies and gentlemen…Larry Craig! Bill Clinton! Jim McGreevy! And now…Elliot Spitzer!

By the way, in the interest of fairness I did try to find a woman who had instigated a sex scandal – no soap. Must be the wiring.

Shakespeare said it in Hamlet. Twice.

[The lady] doth protest too much.

Hoist by his own petard.

Watch carefully those who rail against the actions of others – particularly if those rants include the word "moral". In my experience, the ones shouting the loudest are almost always trying to drown out an inner voice…the one that’s telling on them.

Sorry, Elliot – I thought you had a stick up your a**. Now I know it was a barbeque spit.

That’s my story, and I’m stickin’ to it..   .