Tag: death

I’m coming up on my two year anniversary and I am nervous.

Ok, so, on June 3rd of this year, it will be two years since I was discharged from the hospital after my stem cell transplant for my second cancer. This is about how far I got when I thought I was in the clear from my first cancer, so I am nervous. I just have to make it beyond this point to be able to believe that my cancer free status will stick,

I decided to go big with the second one…brain cancer! Primary CNS lymphoma. Thank the lord it was a treatable one, but still scary and awful nonetheless. I thought to myself at the time what the heck? Two cancers in four years! Something had to be messed up in my baseline so I thought a do over was what was needed. I have to admit I didn’t fully understand what a grueling and terrifying process that was going to be. Let me explain. First, they have to determine that your cancer is fully treated and in remission. That in and of itself is not easy task with months and months of inpatient chemo. Then, you get not long enough of a break before launching into the stem cell process.

The stem cell process needs to be done within a certain time window as to not allow the freshly treated cancer to return. You need to first inject yourself with what’s called granulocyte colony stimulating factor to get you white blood cells/stem cells to rocket themselves into the millions! Then, you have a triple lumen inserted into your chest that you get to mess around with for a long time to make the harvesting process easier. Then you spend the majority of a day getting harvested through that port. It’s kind of like a reverse plasma pheresis machine that is drawing them out of you for hours. I think I broke records that day with how many I was able to donate to myself and how quickly they came out. I think I was only there for about six hours as opposed to the normal 8 or 10 or 12. I think I overshot the donation mark by several million.

Then, you get another little break and then it’s into the hospital you go. You have to stay anywhere from ten days to a full month. Here is where the real danger begins. The goal of this hospitalization is to blast you with chemo until your white cell numbers are so low that they need to be manually counted! This kind of chemo is so fierce it will have you having crazy diarrhea and nausea and having to shower ever two hours so your skin does not peel off. It is real cannon ball type stuff. It drops your hemoglobin and platelets down to transfusion levels as well. Then, here is where the timing gets really tricky. They need to plan your antibiotics actually BEFORE your immune system bottoms out entirely. Otherwise, you start getting all those terrible infections that a normal immune system would fight against.

Unfortunately, I was not so lucky. My antibiotics were started a little late in my opinion and I got three different infections. I was septic, somewhat out of my head. I had a fever. I had rigors, which are the kind of shakes that literally make it hard to talk or move or do anything. They are very scary. You have to do some really strong narcotics to even make a dent in them. Also, when you have all those infections, you are not allowed to leave your room to do the walking necessary to further stimulate your immune system to take the new cells and regenerate. You are kind of defeated at both ends. That just added to the frustration and fear because I was very motivated to help myself in my own recovery and that got in the way of that.

But, even so, I was able to get out of that hospital in ten days anyway! I think it was a combination of all the prayers, baseline decent health, and force of my own inner strength. I am so so grateful for all of that. There is a part of me to this day that would like to be a part of educating the hospital staff further so something like this doesn’t happened to someone else. Unfortunately, no one was up for that education so those attempts went nowhere.

Overall, I am extremely grateful to even be alive to be writing this for you. There is nothing better than getting to open your eyes in your own bed next to your husband and hanging out with your kids and pets. Nothing. I already had a great appreciation for everything around me but now it is magnified even further. So, my final thoughts are to concentrate on my upcoming anniversary with as little fear as possible,and try to embrace all my future possibilities. Cheers to everyone’s good health and embracing what you have!

Have a great day and a Happy Easter!

Dr. Katz

Just gimme 20 min

Hi guys. Dr. Katz here. It has been a minute but my soapbox is begging me to climb back up so I’m gonna. There is just something I have to get off my chest.

The women’s health screening recommendations are trash lately. I mean, they completely suck. All this nonsense about spacing mammograms farther apart, forgetting about yourself after the age of 50, not needing an obgyn exam after having a hyst….all baloney and dangerous on top of that!

First of all, why would we ever recommend something that would decrease our awareness of our own bodies? How does that make any sense? How does that empower us or increase our chances of using our powers to evoke good in the world? I tell ya. It doesn’t. Those recommendations are based on statistics and costs, not people and patients. Those statististics and recommendations are based on how much it would cost to save the lives of 5 or 10 or 20 extra women. Well I say, what is the cost of a human life? Can you really put a cost on it? To me, every single life out there is precious and worth preserving. There is no cost too heavy to at least attempt to save it. For all these small numbers of difference in lives spared, I find these numbers to be at least ten times higher just in my practice. In the last month alone, I have had to give bad news to at least ten women that was preventable or at least treatable at a much earlier stage if someone had been looking. These women were not doing anything wrong. They were not being non compliant. They were just following these recommendations that their physicians were following. None of them even had symptoms serious enough to warrant their seeking medical help. That’s just how sneaky obgyn issues are!

I have something to say to these academicians who make these recommendations. When you are ready to sit down face to face to one of those patient whose diagnosis you missed and tell them how it was too costly to bother with them, then we can talk. If you can’t, and I suspect you can’t, then I am going to continue to ignore those recommendations and advise women to be seen on a yearly basis. You can’t even use insurance coverage as a reason because most insurances are still covering the yearly exam, even with no copay! Why are we wasting the opportunity to make good use of our awesome preventative resources? Why?

Bottom line. I am a fan of the yearly check-up. Just c’mon in will ya?

Some Patients are More Fragile Than Others or, the Importance of the Healthcare Team

Doctors and health care teams listen up! I have something to say! Some patients are more fragile than others. What the hell does this mean? It means that you have to be extra careful what you say to them. It means that you have to be extra thoughtful before you speak to them. It means that you need to do your research before you open your mouth and accidentally freak them out. You as the physician are part of a team and the whole team has to communicate with each other so that everyone has the same information. The patient does not need to hear different and/or conflicting information from each source. This only leads to potential panic and confusion and makes it difficult for the patient to follow through and get the care that they need. To you it may seem like a simple oversight. To the patient, it can seem like the end of the world.

This really applies to all patients, but the group I have in mind at the moment are cancer patients. This group of patients literally has their lives in your hands. They hang on your every word. They are depending on you to help them get to the other side of their illness with an intensity that is greater than patients with other diseases. You have a direct impact on their physical AND mental health, both of which are key to their survival. Think about it for a second. Anything you say to them is regarding a disease that could kill them. You tell them if they qualify for clinical trials. You tell them what chemo or radiation they will get. You talk about costs. You have to talk to them if their cancer is not responding like you hoped. Sometimes you have to tell them they are going to die. Every word out of your mouth carries the weight of their future. One bit of discouraging news may not just mean a bad day for them. It may affect the rest of their lives. No. I am not exaggerating. It is really that important.

The bottom line is that the healthcare team has to be a cohesive, thoughtful, compassionate, comprehensive unit. Patient’s lives, mental health, and physical health depend on it.

Dr. Katz

Please tell your doctor everything…at your actual visit and while you are still in the room if you could.

Hello everyone. This is just a quick public service announcement on behalf of physicians everywhere. Everyone knows that it is our sacred responsibility to care for other human beings to the best of our ability. OK great. What seems to elude everyone is that our ability to be able to care for someone is highly dependent upon the information that we receive from the patient….at the time of their actual visit. I am always talking about the doctor patient team relationship and the communication between the patient and the physician is the absolute pillar and foundation of that relationship. There is no way that I can do my best to take care of you without knowing EVERYTHING there is to know about your health history and the details of the concern that you have. You are master and commander of your own ship. I am just the first mate. I help steer but I am not actually in charge of the course. I cannot act on anything that I don’t actually know about. I need you to tell me all of your symptoms and all of your history in order to help you. Every detail is potentially life or death important. Something you may think is trivial could be the absolute key to your health and survival. It is not safe to think of all the physicians that care for you as separate individuals. We are all on one team and we all need to be on the same page with the same knowledge base so that we don’t do anything that could cause you harm. We may be several different physicians, but we are all working with the same individual and everything that we recommend affects you. You can’t assume that everyone has access to the same information. Most of the time, we are getting our information from you so you need to be an active participant in letting all your team members know what is going on with you. The bottom line is: there is no such thing as too much information. Leave it to me to filter out what I need and what I don’t. Don’t self censor. It could cost you your health. And please, try to mention it while we are still talking in the room if you could. Have a great day.

Dr. Katz