Wendy Harpham on Healthy Survivorship

Doing My Best Post-Radiation

Recent posts (June 22, 23, 25 and July 4) have dealt with the risk of carotid artery disease following irradiation of the neck for cancer. I made suggestions without explaining the back story that led to my conclusions. Let's look at how I came to my conclusions.

Late Effect of Radiation - Qualified

We need to revisit a prior post, so I can qualify what I said. On my June 22nd post, I mentioned the high incidence of changes in the carotid arteries in patients who received radiation years earlier. But I didn't provide any details.

Reacting to Post-radiation Risks

How did I go from rattled to relaxed in a matter of hours after learning about my risk of carotid disease due to radiation therapy I received 18 years ago? First, by putting the piece of information in perspective, as outlined in my last post. Second, by making a plan of action.

Late Effect of Radiation

Many of my friends and family assume that the further away I get from the mini-mantle irradiation I received in 1992, the more I can relax about my developing any complications of that treatment. Not so.

Cancer Survivorship Research: Recovery and Beyond

What a three days I've had here at the 2010 Biennial Conference. While packing my suitcase for the return home, I'm thinking about all I've heard.

"Right" or "Best"

Healthy Survivors make the best decisions, not the right ones. They take the best steps, not the right steps.  Right? Best? Is there any difference?

A Work in Progress

When I was a child, I thought people over 40 years of age were very old. I believed they were done growing up and knew everything one needs to know. Wrong.

Now over 50 years old, I often say, "I'm a work in progress." 

Letting Go

A prolific blogger on survivorship has decided to pull back from her popular blog. She still has cancer. So why now?

White Coat Hypertension

White coat hypertension (white coat syndrome) is when patients' blood pressure (BP) readings are high in clinical settings and normal in other settings.

Patient 2.0

Patients obtain medical information not only from their healthcare team but also from the Internet. Time Magazine's Bonnie Rochman discusses one potential benefit of this phenomenon in a fascinating article entitled, "When Patients Share Medical Data Online."

Valuing PCPs

What does it mean to "value" the time and expertise of primary care clinicians (PCPs)?

Update on Radiation-based Medical Scans

On January 26th I blogged about the risk of patients being accidentally injured by overdoses of therapeutic radiation therapy. I brought it up for many reasons, one of which was to lead into a post of mantras for dealing with bad news. Another was to point out that "bad" news can lead to good news.

Healthy Survivorship 101

Problems can arise when people have lengthy and passionate discussions without realizing they are talking about two (or more) different things. So to keep us all on the same page, periodically I will provide a refresher post about the basic tenets of Healthy Survivorship.

What are we talking about when we say "Healthy Survivor" or "Healthy Survivorship"?

Lost in Translation

Let's stop and think about one of the great challenges of being a physician: translating.

Too Upsetting

Healthy Survivors use language that helps them get good care and live as fully as possible. In the case of challenges, it is usually better to say "very" instead of "too." For example, "This newspaper article is too very upsetting."

What if a topic really is "too" upsetting? What's a Healthy Survivor to do? 

Mantras for Upsetting News

Yesterday's post introduced a front-page NYTimes story about the risks of receiving the wrong amount of radiation when undergoing treatment for cancer.

A Lifesaving Tool Turned Deadly

In Sunday's NY Times cover story, "Radiation Offers Powerful New Cures, and Ways to Do Harm," Walt Bogdanich reports on the risk of patients being accidentally injured by overdoses of therapeutic radiation. Computer glitches and inadequate oversight lead to mistakes that cause patients serious harm, including death. How are you supposed to respond to such news reports in the context of Healthy Survivorship?

A Silent Epidemic

Imagine a 75-year-old man at a new-patient appointment with a young physician. The patient is meticulously dressed and groomed, and he walks somewhat awkwardly with a cane. His medical history is significant for a fall five months earlier that resulted in two fractures of his pelvis. The fractures are healing nicely, but he now needs help with a problem that developed as a consequence of his treatment.

The Pain of Practice-Changing News

News Flash: "The results of a study prove a promising new treatment to be less toxic and more effective than today's standard therapy. Experts are calling these results 'practice-changing findings.'"

While most people rejoice, some feel upset. Why?

"Ask" or "Suggest"?

A patient learns about a treatment for his condition. So he goes to his physician to suggest the treatment as an option. Is there anything wrong with that?

Watch and Wait

Imagine being diagnosed with a life-threatening disease. Now imagine being told by consulting physicians that you should not begin any treatment yet. Instead they advise you to "watch and wait." They explain that only if your disease progresses or causes other problems should you consider starting treatment.

Mid-treatment Scans

If the diagnosis has been made and you are in the middle of a course of treatment, why might your physicians order scans?

Your Friend's Keeper?

You've survived cancer. Now a friend develops the same type of cancer and is making horrible decisions (in your opinion). She's declining conventional therapies for a treatable cancer or deciding against telling her children she is sick. What's a good friend to do?

Antibiotic Resistance

Soon after penicillin became commercially available (1940s), "bugs" became resistant. It was war: Researchers kept developing new antibiotics. "Bugs" kept developing adaptations to resist the antibiotics and flourish. Today's microbes are gaining the upper hand from one of the hallmarks of our modern age:

Paying for Complementary Therapies

As a Patient Money columnist, Walecia Konrad provides financial advice for those patients choosing to pursue complementary therapies.

The Art of Survivorship

Last evening I was interviewed by Betsy de Parry on Lymphomation Live, a weekly webcast sponsored by Patients Against Lymphoma. In this show entitled "The Art of Survivorship," we discuss how knowledge, hope and action help people become Healthy Survivors. The information and advice are addressed to patients dealing with any medical challenge (not just cancer) who want to get good care and live as fully as possible.

The hour-long interview is available online by clicking here.  I hope it helps.  With hope, Wendy

Mind Game of Hope

Why would a patient pretend that a temporary debility (such as a colostomy) is permanent?

 

The Toughest Stage

Which is most challenging: The day you are diagnosed with cancer? The day you begin treatment? The days in the middle of treatment? The days after you complete treatment and begin your recovery?

Facing Facts, At Least Briefly

Right or Wrong? extols the benefits of good communication between doctors and patients. But what if a patient makes the request, "Doctor, if a time comes that I'm dying, please don't tell me I'm dying." 

It seems a reasonable request, if knowing "would only increase my anxiety and make it impossible for me to hope for future better days," as described in the post's comments by Bint Alshamsa. 

Knowledge is Power?

The 21st century is the age of connectivity. What does this mean for Healthy Survivors?

In sharp contrast to the days when people spoke of "the Big C" and when diagnoses and medical details were kept secret from patients, today you are are inundated with information.