Two decades

July 16th, 2014
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In case you missed it, U.S. News & World Report is out with its latest rankings of hospitals, and for the 20th-stright year, the Cleveland Clinic was tops in the nation for cardiology and heart surgery.

The report ranks hospitals across the nation by specialty and provides an honor roll featuring the 17 Best Hospitals that scored near the top in at least six specialties. The Clinic was fourth in the nation overall and No. 1 in Ohio.

In a news release, Dr. Toby Cosgrove, Cleveland Clinic CEO and president, said:

“This incredible recognition would not be possible without our devoted team of caregivers – 43,000 people who dedicate themselves to putting patients first every day,” says “While these rankings are rewarding, we will continue to work hard to provide the highest quality, most efficient healthcare possible."

Dr. Bruce Lytle, MD, chairman of Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute, said:

“In the midst of the many great things that are happening in Cleveland right now, we are grateful to be recognized as America’s No. 1 heart hospital for the 20th consecutive year. This recognition is a testament to our hundreds of talented and committed doctors, nurses and other caregivers. It is an honor to be considered the best, but the true honor comes from the trust of our physician colleagues and patients, and that trust inspires and drives us to try to improve every day.”

Thirteen Cleveland Clinic specialties placed in the top 10 nationally, including nine in the top 3 nationwide. In addition to top honors in cardiology and heart surgery, the Clinic also topped the ranking in urology for a second time. It was previously No. 1 in 2012.

US News national rankings

The report also ranks hospitals by cities. Closer to home, the Queen's Medical Center was ranked No. 1 in Hawaii followed by Kaiser Permanente Moanalua Medical Center.

Queen's had 10 of it's specialities ranked "high performing" by the magazine, including: Cancer, Diabetes & Endocrinology, Ear, Nose & Throat, Gastroenterology & GI Surgery, Geriatrics, Nephrology, Neurology & Neurosurgery, Orthopedics, Pulmonology and Urology. 

So the silver lining in all of this for me, is that while no one should ever have to go thorough two femur replacements and five heart surgeries in an eight-month period, if it had to happen anywhere, good thing it was in Cleveland!

The Cleveland Clinic has a feature about the rankings on its website.

We believe that we will ...

June 30th, 2014
By

... BEAT CANCER!!!

In the spirit of the, World Cup here is perhaps the most uplifting version of the chant in support of the U.S. Men's National Soccer Team: from 232 kids at Camp Sunshine, a Summer camp for kids with cancer based in Decatur, Ga.

The kids chanted "I believe that we will win" -- the theme adopted by the American Outlaws in Brazil -- every day last week  as the U.S. advanced from the group stage and out of the "Group of Death" into the round of 16.

From the Camp Sunshine website:

Often isolated from their peers due to their illness and the demands of treatment, the children who attend Camp Sunshine programs realize they are not alone in their struggle with cancer. They gain new strength and hope from others who have faced similar problems and the positive effects last far beyond the brief time spent at camp. We believe the friendships the children make through Camp Sunshine will give them encouragement and hope as they face the challenges of childhood cancer.

If you're the superstitious type (and a good patriot) then you'll hope these kids will keep the chant up through 10 a.m. HST Tuesday, when the U.S. takes on Belgium in its World Cup quarterfinal match.

And if you're interested in similar camps for kids with cancer, check out this list from the American Society of Clinical Oncology: www.cancer.net/navigating-cancer-care/children/camps-and-retreats-families-and-children-affected-cancer.

Yes, kids ... you WILL win!

(H/T sbnation.com)

 

 

Cancer killer?

June 20th, 2014
By

It's way too early in the game to start touting this as a "cancer killer"† but researchers at the Cleveland Clinic have discovered a protein that slows the development of new blood vessels and in turn may slow the growth of cancerous tumors.

 

The research appeared Thursday in the journal Cell and on the Cleveland Clinic's web site. Per the CCF report:

A family of proteins called vascular endothelial growth factors (VEGFs) is behind angiogenesis. One protein, called VEGF-A, is the principal driver of the process.

A research team led by Paul Fox, PhD, of the Department of Cellular and Molecular Medicine in Cleveland Clinic’s Lerner Research Institute, discovered that a variant of VEGF-A decreases angiogenesis.

The variant is named VEGF-Ax.

Stopping the growth of new blood vessels cuts off the supply of blood to a cancerous tumor, which needs those items in the blood to survive, expand and travel to other parts of the body. Because tumors cannot grow beyond a certain size or spread without a blood supply, scientists are trying to find ways to block tumor angiogenesis, according to the National Institutes of Health.

The discovery will open new avenues of angiogenesis and cancer research, Fox says, and could potentially lead to new diagnostic tools and improved treatments to reduce the spread of cancer.

Says Fox:

“It is truly remarkable that a small change in a protein sequence leads not just to a protein with a different function, but one with a function completely opposite to the original. In the context of cancer, the small extension changes a very ‘bad’ protein into a very ‘good’ one."

View the full post HERE.

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† - Apologies for the clickbait headline =)

Bionic pancreas

June 16th, 2014
By

In the never-ending quest to become the world's first man-machine cyborg†, now there comes news of the development of  what's being called a "bionic pancreas."

The device is being developed and tested on Type I diabetics.

According to a report Monday on NPR, Ed Damiano, Boston University biomedical associate professor began working on the device to treat his son, who was diagnosed with Type I diabetes when he was 11 months old.

It's not really an organ that gets implanted in the body, though. It's basically a sophisticated app that connects a continuous glucose monitor with a an insulin pump -- both devices that are commonly used, but usually separate from one another. A glucose monitor has a small needle that goes under the skin to continually monitor a person's blood sugar level. Th pump also inserts under the skin via a tiny needle and is programmed to deliver insulin at specific times or on demand.

The bionic pancreas, as Damiano calls it, simultaneously measures blood sugar levels and delivers insulin as needed.

Says Damiano:

"The bionic pancreas is a device that automatically takes care of your blood sugars 24/7. It's a device that comes to know you."

According to NPR, in tests with 52 teenagers and adults, the device did a better job controlling blood sugar than the subjects typically did on their own. The results were reported Sunday at an American Diabetes Association meeting in San Francisco and also published in the New England Journal of Medicine.

You can listen to the report below, or go to the report on NPR.org.

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† - For the record, it's a tongue-in-cheek quest.

Cancer drama

June 13th, 2014
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Cancer sucks.

In this case, that’s not stating a fact (although it is probably provable) it also happens to be part of the promotional campaign for a new show on ABC Family channel, “Chasing Life.

A description, from the show’s official page:

“April is a smart, twenty-something, aspiring journalist whose romantic and professional life is just starting to take off when she receives news that she has cancer.”

The show premiered Tuesday, June 10.

It coincides with last week’s wide release of “The Fault in Our Stars,” the movie adaptation of the best-selling Young Adult novel by John Greene about two young cancer patients’ blossoming romance under the most trying of health circumstances.

Of course, cancer has been around as a dramatic catalyst in films for decades (the original TV movie “Brian’s Song” with James Caan and Billy Dee Williams remains one of my favorites). But in this day and age of media saturation (over saturation?) repetition and social media, it seems we could be on the verge of a new theme in the teen/tween/YA genre.

But are such portrayals helpful, or hurtful to cancer patients and their families?

(Warning: This rest of this post may contain spoilers.)

First, “Chasing Life.” Based on the previews and ads, there seems to be a lot to not like about this show. The taglines “Cancer sucks” and “Giving up is not an option,” are both kind of clumsy. As Mary Elizabeth Williams (cancer survivor) stated in Salon:

“Gosh, thanks, because if people with cancer only knew they had options, I’ll bet more of them would pick the not giving up one.”

Cliché and cheesy, for sure. And this doesn’t even mention the promo ad showing our main character April (Italia Ricci) looking pretty and perched atop an open casket full of lemons. (Williams: "Because you know the old saying: When life hands you cancer, make lemonade.")

It is, however, easier to look past this schmaltz if you consider the other original programming on ABC Family (see also: promos for “Pretty Little Liars,” “Switched at Birth” and “The Fosters”).

After giving it a chance, the pre-show concerns were somewhat confirmed, but it is not unwatchable if you take it for what it is: an ABC Family drama. As Williams quoted from the Los Angeles Times review:

“… (W)hen it's not being completely ridiculous, 'Chasing Life' is very good.”

As for it’s portrayal of a young cancer patient, it’s hard to sit in judgment of anyone, particularly a 24-year-old just starting out in life with a turbulent family situation who learns out of the blue she has cancer. Who’s to say that any of us experiencing our first bit of success in life – work, relationships, etc. – wouldn’t feel the same type of fear and anger that April experiences?

I’ll be the first to admit that during both bouts with cancer I had a lot more going for me than this character.

In 1985, I was only 13, void of a job, bills to pay or any kind of relationship that would have suffered. Schoolwork was do-able from a hospital bed and my cancer, the osteosarcoma, was caught early enough to be treatable and, for the most part, cured. (The harder part has been dealing with the numerous infections after the initial surgery.)

Last summer, thyroid cancer struck at an inopportune time, but aside from being one of the most treatable forms of the disease, was caught and treated very early. (It just happened to come at a time when I was expecting to miss a significant amount of time from work because of the infection in my leg.)

The only thing a bit harder to believe in April’s situation is her lack of anyone in which she feels she can confide her “secret.”† That, and the over-the-top coincidences like hearing her boss complain about a co-worker’s flu or seeing a pair of medical professionals in scrubs as she rides the train just seem unnecessary and manipulative. (And the plot twist during the end credits is truly stupid, and purely ABC Family-manufactured melodrama!)

As for “The Fault in Our Stars,” the movie is on my to-do list. The book was an easy read, which I started on the plane home to Hawaii and finished a few days later.

Where the book succeeds over the one-hour pilot of “Chasing Life” is being able to get into the head of a teen-aged/adolescent cancer patient, while also painting a pretty accurate picture of how every day life and relationships can get strained by the treatment. (I’ve heard the movie does a nice job of staying true to the book.)

For the uninitiated, the book introduces us to Hazel, who seems to be a typical teen-ager growing up in Indiana who has been granted a new, but uncertain future battling metastatic thyroid cancer that has spread to her lungs. At a support group, she meets Gus, a boy roughly her age (late teens) who has lost part of his right leg to osteosarcoma.‡

Again, not to be judgmental, but it was a lot easier to relate to Hazel (played in the movie by Shailene Woodley). Her anger over the unfairness of life, depression over not being able to live like a “normal” kid and her fear about what, if anything, lies ahead was typical of my experience growing up as a teen with a disease that could decide to end your life at any time.

Like me, she has strong support from family who sometimes seem overwhelmed at the injustice of it all. She has her friends who, while not disowning her, perhaps unknowingly keep her at a comfortable distance. (There is no mass head-shaving in her community to show solidarity.) She spends a lot of time watching TV and anything else she can to feel as normal as possible. She meets other patients, not all of whom make it. She gets angry at those who are just trying to help, because as much as they all agree that life isn’t fair, nobody can truly know what she’s going through.

While reviews of both portrayals have run the gamut among cancer patients, survivors, family and friends – check out some of them here, here and here – one thing many seem to say is that it is good to see cancer becoming a disease that is no longer talked about quietly and in hushed tones, as if people, especially young people, who suffer from the disease have to be treated with kid gloves out of fear that they are suffering. This might be true of some, but certainly not for all.

Ilana Horn (another cancer survivor) points out in Time:

“These stories are not meant to be literal representations. What it means to watch them depends on whether we come as outsiders, wanting to understand an experience beyond our own, or as insiders, coming to see our own lives reflected.”

How you interpret them is up to you, but the bottom line to remember is that every cancer patient’s experience is profoundly unique.

Everyone’s experience will be different based on any number of outside variables: What are their familial relationships like? What kind of care are they getting? What is their socio-economic status? What types of friendships have they formed? What life experiences have they had? Etc., etc.

A 16-year-old private school student from affluent suburban Chicago will have an experience vastly different from another 16-year-old public school student in rural Georgia. Just as a 13-year-old who gets treated at the Cleveland Clinic would have a completely different outlook if he were that same 13-year-old treated at a hospital without the same amount of medical expertise and resources.

Regardless, any film, book or TV show that can help bridge physical, emotional or psychological gaps that may exist in the world of a cancer patient is probably a helpful thing.

This effort to bring cancer into the mainstream is laudable (but let’s hope Hollywood stops before it becomes overplayed like the vampire/werewolf romance genre).

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† - What, she doesn’t think anyone in a newsroom full of journalists will keep her diagnosis confidential??!?!  ;-)

‡ - If you’re wondering, YES, the fact that I had both of these cancers gives me some pause before wanting to see the movie.

 

Heart food

June 4th, 2014
By

Following up on Monday's long screed, this one will be rather short, with an info graphic.

With heart health top of mind these days, we could all use a little extra help on how to keep our tickers in top shape. The folks at the Cleveland Clinic Heart & Vascular Institute’s Preventive Cardiology Nutrition Program have put together this handy graphic that lists the top 17 foods to maintain a heart-heathy diet.

Many people know vegetables, fruit, fish, soy, grains, legumes, nuts and seeds all promote heart health, but some have more disease-fighting nutrients than others.

Here, then, are the best foods for maintaining a heart-healthy diet:

14-HHB-406-Power-Foods-for-Heart-Infographic_05.21.2014_04

 

Don't go breaking my heart

June 2nd, 2014
By

Screen Shot 2014-06-01 at 8.16.30 PM

Look who's back, both here and on the pages of the Star-Advertiser.

Finally returning to work after an eight-and-a-half month hiatus exclusively for health issues, some of which were detailed here from August through February, and new ones -- or, rather, one new BIG one -- that came up literally four days before my original scheduled return date.

First, I should say that the leg is OK. Can't say "fine" or "doing great," because truth is, it is still somewhat weaker than I expected it to be at this point, six months after the surgery. But there's a reason for that.

The short answer is congestive heart failure, stemming from a heart block caused by a heart infection.

Treatment was open-heart surgery and roughly two more months of rehab. Because of a month of inactivity in and out of the ICU, rehab on the knee/hip/femur essentially started over.

So what happened? (Settle in, this is long.)

Read the rest of this entry »

Always something

February 27th, 2014
By

So this is a new one, even for me.†

Salivary gland stone. Who knew that you could get stones in your salivary glands?! Apparently this is a residual side effect from the treatment last summer for thyroid cancer.

You may recall, after they removed the thyroid, the treatment to kill any leftover cancer cells was swallowing a pill of radioactive iodine. The main side effect from that, aside from potentially contaminating people with radioactivity, was swelling of the salivary glands leading to dry mouth.

The salivary glands usually take a little while to fully recover, and mine have never truly returned to what they were before taking the pill. Dry foods such as crackers or pretzels still turn to dry, pasty dough in my mouth.

So the lack of saliva production can lead to, you guessed it, a stone in the gland itself. Luckily, these types of stones can often dissolve simply by stimulating saliva production. Recommendations to make that happen so far have included sugar-free gum and lemon drops.

The gum seems to work best, but others have suggested li hing mui or lemon peel. If you have any others, feel free to leave in the comments!

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† - Up until now I didn't think anything could top iritis for ailments I've actually had that sound made up.

 

Bionic presentation

February 26th, 2014
By

For anyone who is particularly interested in what the past five months have been like, you are cordially invited to watch this very poor quality, 40-minute video that is mostly darkness, with below-average audio:

Production qualities aside, the video is of a presentation I gave to the Kiwanis Club of Olmsted Falls, Ohio. One of its members, a former English teacher at my high school, asked me to give a presentation on health and medical issues that I cover in this blog, but also to talk about the recovery process from the various surgeries I've endured. As best as I can recall, it's been 18 surgeries total, including the four in 2013 (three on the leg, plus the thyroidectomy).

Good luck trying to make out the PowerPoint presentation, but here was perhaps the key slide† from it:

Evolution2

There you can see the evolution of the artificial femur. At the far left, you see what the hardware looked like at the beginning of this five-month journey. September 2013 is an image of the antibiotic spacer that was placed to kill the infection. And the December 2013 image is what it looks like now, with the state-of-the-art prosthesis.‡ (The image of my left leg is there simply for comparison purposes.)

If you can somehow get through all 40 minutes of that video, the point I'm trying to make is that surgery does not have to be a terrible experience. There are ways to adjust, cope and come out better. Among the keys is communicating with doctors every step of the way.

With any luck, I may be able to give this presentation again, and if that ever happens, I'll try to be armed with better audio-visual equipment =)

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† - This is actually a variation of the actual slide, which contained an image that may or may not have been copyright protected.

‡ - For anyone wondering, yes, it sets off the metal detectors at the airport, federal buildings and courthouses.

Around the bend

February 20th, 2014
By

This isn't much of an update, but there's a video for it, so there's that =)

Unlike last month, when the knee hand't bent in 17 weeks, now the knee bends fairly well. It's right at the 90 degree mark, which is where my surgeon wanted it to be by this time. Still limited weight-bearing -- haven't ditched those crutches yet -- but it's getting there.

Above is the video my newest hamstring workout, which is basically just bending the knee, but with a slight amount of resistance. Because of the limited amount of exercise that's been allowed, out of caution for tearing down some of the freshly rebuilt muscle and tissue, it's been pretty much a holding pattern since I first bent the knee last month. The range of motion is slowly coming back, and the muscle strength, too.

Things are progressing, though, and there is an end in sight. Maybe not an end to rehab, but an end to looking out the window and seeing snow, not to mention the cold temperatures!