Tag: news

No news is good news!

I hear this cheerful sentence from the vet and doctor’s offices all the time. They say it with a smile as if you are supposed to find it amazing and reassuring if you do not hear from them. You are supposed to rejoice at the lack of bad news, or any news whatsoever.

You know what I hear when they say that? I don’t need to take the time to reach out to you personally to let you know that you are ok. I have just saved myself a ton of time in my busy day. Nothing about this statement lets me know that they are actually concerned about me or my pet, or that I can actually be sure that they didn’t miss something and forgot to call? That could happen too ya know. How long do I wait before I know it really is no news is good news? Are we sure after a week, two weeks, a month? See where I am going with this?

You see, at my office we call, or if we can’t get through, we text or leave a message about every darn thing, good, bad, ugly, sideways, or fantastic. That way we almost eliminate the chance of missing anything and the patient or customer has no question in their minds that they are worth our time and investment in their care. So, what if the majority of the calls are just to say that something is normal. Awesome! Then you are also making sure that you are giving yourself little to no chance of missing the few abnormal or bad news ones. To me it’s a no brainer. Inform everyone about everything. You tend to miss less this way and it shows that you give a crap. Ok diatribe over for now. Have a great day everybody.

Dr. Katz

” The Good Kind” of lymphoma

Today’s the day. Today I go for excisional biopsy of the lymph nodes around my neck so they can study it and determine if I have ” the good kind” of lymphoma, Hodgkins, or the aggressive kind, diffuse large B Cell Non-Hodgkins. Good kind? Bad kind? I am just not sure what to root for here. Isn’t all cancer “the bad kind?” My doctor also told me with a smile that he has never lost a patient with Hodgkins. Awesome! But wait! What about Non-Hodgkins patients? He meant to be reassuring. Instead of taking that as good news, I immediately panicked that he had somehow over bragged to the universe and karmic retribution had to be on it’s way.

Sorry, I couldn’t help a bit of sarcasm there. I know what the doctors mean. One kind has really high cure rates and one not so high and tougher to get through. Yes. Of course I understand. However, it is tough for a patient to embrace the clinical perspective right after hearing a diagnosis. Sometimes they just need a minute to try to start processing before they are able to realize whether they are actually “luckier ” than they thought or not. The moment you hear the words “we think you have cancer”, everything kind of stops. No other words have a chance to register. That dirty C word just hammers in your ears like an obnoxious bell and your mind starts racing. You need to just let it sit a minute before you start comparing stats and trying to tell them how to think about it. I know this first hand. I do it too as a doctor. I am always trying to temper my need to tell a patient that it’s not so bad and flood them with good statistics to reassure them with their need to just sit a second and take in what I said first.

Bad news is never easy to deliver, even when a patient is expecting it. I don’t really think that there is one best way to do it. I tend to vary my presentation depending on my knowledge of the patient and what I think they can handle. I was expecting this news, based on everything that I knew, but I still wasn’t instantly ready to prioritize and tier the possible types of cancer and how one was better than the other. I just needed to take in the fact that I could have cancer. That was as far as my mind could go at the moment. For me as a physician, if I know that I have to deliver bad news, I deliver the news and then I am quiet for a minute. I deliberately try to let the patient be the first one to start the next part of the conversation. I have just told them something that may soon launch them into a life-changing scenario in which they have little control. I figure that the least thing I can do is let them have control over how the conversation goes in the next few minutes. If I let them speak first before bombarding them with statistics or trying to mold how they should perceive the news, I can more clearly gauge how to tell them more and what to tell them. I think that it is really important to let them at least take control of this initial conversation. It may be the only decision that they get to concretely make for awhile. Sometimes I can’t reassure them right away. Sometimes they just aren’t ready. They are scared, angry, and confused. Sometimes you have to let them be for a minute.

I think it is tougher for my doctors to let me be for a minute. They know that I am a physician too and they figure that I can handle all the stats and details. They care almost too much because they know me. They know that I can understand the information. They know that I am interested in being my own advocate. I get all that, but sometimes it is a little too much. This time, I am the patient. I am not in charge, although I am trying to act like I am. I am putting on a brave, calm, collected face. Sometimes I think I am doing that more for others than for myself. I don’t feel very calm and collected when I am sitting in my bathtub, overreading about lymphoma and trying to give myself an anxiety attack…lol. I want to be Wonder Woman, but right now, I am just me, Laura Katz, the patient. I am waiting for news just like everybody else. I am waiting to see how my life is going to change. That will have to be good enough.

Dr. Katz

Listen to the WHO

Hey everybody! Show of hands…who is stressed out right now?…..Ok yes. I see all of your hands….and that is perfectly NORMAL right now. We just don’t want to convert that stress into panic and do something stupid. So, let’s look at some advice on how to not let that happen. The WHO(World Health Organization) Director-General Tedros Adhanom Ghebreyesus said it best during a daily press briefing on COVID-19 at the WHO headquarters in Geneva on March 11th. He was giving out tips on how to stay physically and mentally healthy while living under quarantine. His advice was simple and did not involve any rocket science….Don’t smoke, limit alcohol, exercise and try not to watch too much news!

Actually, he broke it down even further. Let’s go over it. Remember this is right from the WHO so I feel like we can trust it. I will add some of my personal touches as well.

Eat healthy to boost your immune system. Now is not the time to max out on junk food in a nervous binge. I have been fighting this myself. I have also turned to my favorite Amazing Grass Immunity Blend for a little extra immune support.

Limit alcohol and sugary drinks. Particularly avoid sugar alcohols like maltitol. Your body cannot really digest most of them. With regard to alcohol, you have to remember that your body reacts to it essentially as a toxin and devotes all it’s energy into getting rid of it. You just don’t need the extra stress on your body right now. Ok. I get it. Drinking some alcohol may be part of your stress reduction plan right now, but I would advise you to at least keep it in moderation ( A drink or two at most). The term sugary drinks refers to any beverage with added sugar or other sweetener like high fructose corn syrup, sucrose, etc. This includes soda, pop, cola, fruit punch, lemonade, powdered drinks and sports drinks. According to the T Chan School of Public Health at Harvard University, these add calories only and increase your risk of type 2 diabetes, heart disease and other chronic disease. Really, your body does not need the extra stress right now. Save money! Drink water!

Don’t smoke. It can make COVID symptoms worse and increase your chances of getting really sick. I get it. The number of nicotine addicts in the world has not suddenly decreased and this may not be realistic for everybody, but try your best. This includes vaping and Juuling btw.

Exercise at least 30 minutes a day for adults and an hour a day for kids. Make sure it gets your heart rate up and your blood pumping. Physical activity can hep flush bacteria and viruses out of the lungs more quickly. Exercise causes changes in white blood cells and antibodies. These are key elements in fighting infection. The brief rise in body temperature during and right after exercise may help fight bacteria. This is similar to what happens when you have a fever. Also, exercise slows the release of stress hormones.

If you are allowed outside, go for a walk, go for a run or go for a bike ride…remember to keep a safe distance from others ( 6 feet is the magic number for now). Social distancing is very important right now. The concept of social distancing is deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people decreases your chances of catching COVID. Remember that the biggest reason for trying to practice preventative measures now is to decrease the spread of the virus and hopefully not overwhelm the healthcare system to the point that we have to turn away people for treatment like other countries have had to do.

If you are not allowed outside, run the stairs, dance, do some yoga. I am going to add pull out an ancient exercise dvd or the Wii and get playing! There are a startling amount of free exercise and dance classes on the internet right now. Take advantage of it! They won’t be free forever.

Attention to everybody working from home! Don’t sit too long in one position. Get up every 30 minutes or so and stretch and change position to keep your circulation moving.

Take a 3 minute break every 30 minutes…and I don’t mean a 30 minute break to watch the news!

Get your mind off of all this crisis. Find your spot of zen. Listen to music. Read a book. Play a game. Light a candle. Meditate. You are probably saying right now meditate? I don’t know how to meditate! Let me let you in on a little secret. There is no right or wrong way to meditate. The definition of meditation is to think deeply or focus one’s mind for a period of time, in silence or with the aid of chanting, for religious or spiritual purposes or as a method of relaxation. If you are finding yourself too much a newbie to get started, may I suggest the apps Calm or Headspace. They are pretty amazing.

Be aware of what is going on in the world, enough to know what restrictions etc are necessary, but don’t watch the news incessantly enough to freak yourself out. If you do tune it for an update, tune in to a reliable source like the WHO or the CDC, not your neighbor or the latest Facebook messenger forward that you cannot verify. I have gotten countless forwards from unverifiable sources. These are all from well-meaning people just passing it on, but really all they are doing are making me more anxious. Tedros suggests that you check in maybe once or twice a day, again, only to reliable sources.

I just wanted to put together some ideas and include the reasoning behind them. I think that too often lately we are just barking out instructions and people are either listening to them or balking at them, but not really understanding the “whys.” Hopefully, this will help. I often find that it is easier to follow through with something if you understand why you are doing it.

Dr. Katz