I had the opportunity to be a guest on This Week in Oncology’s weekly web radio show with Dr. Richard Just and Gregg Masters.
Enjoy!
chemotherapy
Healthcare a passion of yours? Win an award!
WEGO Health is an online network of people from across the globe who use the internet and social media to connect around health and share health information.
WEGO calls us Health Activists, and they’ve created a special awards program to recognize those Health Activists who are making a real difference in the online health community: click here to find out all about it. Health Activists are doctors, patients, caregivers, family members, any and all folks who care about their own health and the health of their families and communities.
I’ve signed up to be an Awards Ambassador – that means that I’m doing what I can to share the WEGO Health Activist Awards with my audience to make sure that all Health Activists are recognized for the efforts they make every day. Take a spin over to the nominations page and recognize your favorite health leaders. There is no limit to how many people you can nominate so make sure to recognize everyone that you follow, fan, or friend. WEGO Health has 12 different categories so everyone should fit somewhere!
Is there someone who inspires you to get and stay healthy? Is there someone whose online presence helps you manage a chronic condition? Is there a healthcare professional in your life who has guided you, your family, or your community toward better health with their work on the web? Nominate ’em!
There is no limit to how many people you can nominate so make sure to recognize everyone that you follow, fan, or friend. WEGO Health has 12 different categories, so there’s a slot fo any kind of online Health Activist!
So go on – NOMINATE!
How far would you go for medical treatment?
No, 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 …
Beeting Up On Oneself
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…
The Stories We Tell Ourselves
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.. .
Chemo-rama
For those of you who have been paying attention, you know I got breast cancer for Christmas. I had my first chemo treatment on Monday, 2/11
(in keeping with that holiday theme – Happy Valentine’s Day, early!), and so far the after-effects have been weird,
but manageable. I keep thinking of cartoons where some character starts
quivering, and then his head explodes into a Dali-esque fright mask with, oh, a
foot springing out of his forehead.
That hasn’t happened. Yet.
What is happening is that instead of my usual
eat-like-a-garbage-truck self, I’ve become someone who has to think hard about
what might be edible. The data sheet on my chemo cocktail lists this side
effect as “anorexia” – which makes me laugh so hard I can barely breathe. My
name and anorexia in the same sentence? Get outta town.
The closest analog I can come up with for the current
eating sitch is this: back inna day, when I did offshore sailing, there were
more than a few times that the rest of the crew was crawling around on the
deck, beggin’ to die. At those times, my experience was usually, “well, I don’t
feel GREAT, but how about I make some soup?”
The most memorable version of this was twenty years ago,
delivering the schooner ORIANDA from Lauderdale to Tortola.
The skipper decided to leave Lauderdale literally on the tail of a hurricane
(luckily only a weakening Cat 1), just before midnight.
No, it didn’t seem like a great idea to me, either, but a
ship is not a democracy.
Another woman on the crew and I had drawn 12-4 watch,
meaning we were first up, and would be fighting the Gulfstream by 2am. When we did hit the Stream, we had 15 foot
cross-seas and were shipping green water over both bows. Both my watch-partner
and I were literally tied to the boat (as one always should be offshore),
taking turns steering, which was like trying to wrestle an anaconda. At about
3am, the engine started to sputter (we were under engine and sail power – we
needed everything we could get to keep the ship stable!) – the skipper and the
mechanic headed into the engine room to see whassup. Diagnosis: busted fuel
hose.
The engine room was off the pilot house, which was
directly in front of the steering station. In order to work on the engine, the
pilot house light needed to be on. In order to see the compass and steer a
course, the helmsman needed to have the pilot house light OFF. We struck a
compromise – I would hold the pilot house hatch doors closed and shield them
with my body, preventing the light from hitting the helmsman in the face and
thereby risking a course change for Havana.
Or Maine.
So, there I was, holding the doors closed as heavy diesel
fumes rolled past, and the boat tossed around like we were driving through a
washing machine on full agitate. Right about then, the 4-8 crew staggered up on
deck. The first mate, who had asked me every five minutes before we left port
if we had enough Dramamine on board “because sometimes people get seasick on
these deliveries”, took over the helm – which was right behind me, remember? –
asked the skipper for his course, was told zero-nine-zero, responded “aye, aye,
steering zero-nine-….” The rest of his reply was literally drowned out as he
started hacking up everything he’d eaten since the Carter Administration.
He continued this until dawn. My watch-mate had to
re-take the helm, since first-mate-dude was pretty useless. Really hard to
steer while barfing – you tend to drag the wheel over with you as you heave.
I’m still holding the pilot house doors closed. So: diesel fumes, a violently
ill crewmate less than two feet behind me (at this point, he was like a sodden
mass of rags at the bottom of the cockpit…yep, beggin’ to die), and motion so
violent that we’re all literally hanging on for dear life.
What I wanted most right then – other than for things to
settle down, just a bit, or for blessed dawn to break – was some coffee. And
some soup. Which I got, a few hours later, once the dawn did break and I could
get down to the galley (I was ship’s cook), clear away the debris from the
rough passage, and get things going.
So, chemo “anorexia” for me is more like eating like a
10-year-old. PB&J sandwiches, mac-n-cheese with grilled chicken, chicken
noodle soup. My usual chili, garlic, and stinky cheese palate has vanished.
It’s only until June, though – who knows, maybe I’ll feel better about bathing
suit season after this!
That’s my story, and I’m stickin’ to it.
