Wendy Harpham on Healthy Survivorship

Surviving "How Are You?"

Debbie commented on my last blog post: "This definitely reminds me of the question 'How are you?' and how tricky a question it can be. Thank you for helping me become a more sensitive friend."

It is I who should be thanking Debbie. Almost two decades ago, our discussions prompted me to write the following essay in an attempt to understand my problem with people asking "How are you?" It helped me. I hope you find it useful.

What Not to Say to a Cancer Patient

Last year Melissa Shultz interviewed me for an article titled, "What Not to Say to a Cancer Patient." Yesterday she received The Texas Medical Association’s Anson Jones, MD, First Place Award for her piece. Here's an excerpt:

Talking about cancer can be painful and awkward for both the patient and the well-wisher. Here’s advice from cancer survivors and medical professionals on what not to say to someone with cancer, as well as helpful alternatives.
 
“My friend died of cancer”
 
Dr. Wendy Harpham, 56, doctor of internal medicine and mother of three from Dallas, learned she had non-Hodgkins lymphoma in 1990. As both a patient and a physician, cancer tales have been the narrative of her life for the last 21 years.
 
“Patients don’t want to hear other people’s bad cancer stories — and sometimes not even good stories — because they’re focused on themselves. It can make them feel badly if you set the bar too high with stories about how well someone did during treatment.”
 
..."In 1992 I had to close my solo practice to receive more cancer treatment, which meant closing the door on my life-long dream and facing a worsening prognosis.”
 
When people told her she needed to be positive it only added to her stress and closed the door to talking about her feelings authentically. “It also put a layer of blame on me: If I don’t get well, it will be because I didn’t have a positive enough attitude,” she says.

Congrats and thanks, Melissa.

[Complete article, click here.]

Dietary Pattern for Health

After a cancer diagnosis, patients ask, "What should I eat? What foods should I avoid?

The answers found in magazines and offered by clinicians and purveyors of alternative therapies often paint a confusing picture of contradictions.

R & R After Cancer

In mid-May I discussed the updated Nutrition and Physical Activity Guidelines for Cancer Survivors.

Let's return to that document to highlight an idea about recovery after treatment for cancer or other illness or injury that can promote healing.

Doctor Says "Stop Whining"

Earlier this summer I was invited to write a guest blog post for cancerwise, a blog sponsored by MD Anderson Cancer Center in Houston. So I submitted a post titled "Doctor Says, 'Stop Whining.'"

A Lesson on Second Opinions - Part II

Dr. Ronan Kavanagh's excellent story -- An Unexpected Second Opinion of Rheumatoid Arthritis -- offers a useful lesson for Healthy Survivors: With time and experience, people become better at making the correct diagnosis. Let's look at this lesson more closely.

A Lesson on Second Opinions

In order to share a 279-word story with a lesson for Healthy Survivors, I'm breaking my 250-word limit. It will be worth it.

Here's the story I found on KevinMD.com blog and written by Ronan Kavanagh, a rheumatologist who blogs at Dr. Ronan Kavanagh’s Blog:

In my first few months working as a rheumatologist a referral letter arrived from a local doctor about a lady with rheumatoid arthritis. She had recently moved to the West of Ireland from the UK, where her original diagnosis had been made. Her GP had originally referred her to a
general physician in a small local hospital who had struggled with her care and
she was looking for second opinion.

After assessing her, it quickly became apparent that original diagnosis had been incorrect. The patient had numerous explanations for her pain other than rheumatoid arthritis and the investigation that was likely to have prompted her original diagnosis (a positive rheumatoid factor test) as due to the fact that she had Sjogren’s syndrome (a condition which causes dryness of the eyes and mouth).

My specialist pride congratulated itself on making such a clever diagnosis and for being smarter than either the physician who had cared for her of late or the rheumatologist who had made the original diagnosis. Gosh I’m good, I thought.

“That’s wonderful news doctor. You mean I don’t have rheumatoid arthritis after all?”

“Not in my opinion you don’t.”

“It’s great to see someone who knows what he’s talking about. Do you mind me asking where you did your training?”

“In the UK. In Cambridge mainly.”

“Really, doctor? In Addenbrooke’s?”

“I was there for 4 years.”    

“That’s amazing. That’s where I was told I had rheumatoid.”

With that she thanked me, stood up to leave, and just before she left the room, turned to me and said, “I knew you looked familiar.”

It’s never a bad idea to get a second opinion. Even if it’s from yourself.

The lesson is that with time and experience, people become better at making the correct diagnosis.

Coming up: A brief discussion.

 

Generativity and Healthy Survivorship

A second lesson on Healthy Survivorship gleaned from a cursory look at the work of psychologist Erik Erickson has to do with so-called generativity.

Epigenetic Principle and Healthy Survivorship

Reading about Erik Erikson's eight psychosocial stages of human development helped me think about Healthy Survivorship in a new way. I'll paraphrase and oversimplify (and not get into the virtue aspect of Erikson's theory) to talk about the first of two ideas that prompted this post: The Epigenetic Principle.

Experience Corps

Recent posts highlight the research of geriatrician Dr. Linda P. Fried that adds to our knowledge. Today let's look at her work that uses current knowledge to take effective action.