Tag: team

Taking Ownership

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My colonoscopy experience was awesome!

Ok. Ok. I know what you’re thinking. Eeew. How is that possible? There is nothing good about a colonoscopy. Am I right? Well, yes, you are right. A colonscopy is kind of shitty…pardon the pun. What I am really referring to is the experience and how I was treated. Let me explain.

I chose to have my colonoscopy NOT incognito, but at my local hospital Promedica Monroe Regional, where I go to work every day. Trust me, these people have seen the best and the worst of me for over 20 years now. They have saved my life multiple times, helped me in the OR, helped me deliver babies, etc. We have listened to each other. We have complained together and rejoiced together. Sometimes I see them more than my own family. But wait, they are part of my family! They are just not the family I live with. So, why not let them in on my health too?

From the moment I walked in, all crazy haired and no make up on,(yikes) they greeted me like family. We joked and laughed while they checked me in, while still making sure that all the proper protocols were followed. They managed to treat me like a patient, a doctor, and a family member all at the same time. Bravo! I almost cried…literally. Everybody stopped by to see me. They explained things as if I was fresh off the street with no medical knowledge. That might annoy some people/docs but I love it. We should explain everything to everybody. You never know if you might have a total brain fart about something you do every day….when it’s actually YOUR turn! As a matter of fact, I was stressing more about this stupid colonoscopy than I did about all my cancer stuff and chemo and procedures for the last year and a half. What the heck?! It was as if I just couldn’t handle the thought of maybe even one more thing being wrong. Thank God they treated me like family. It put me at ease right away. They went over and above. I have never considered myself on any sort of VIP terms because that’s just who I am. I even asked them why the special treatment? You know what they said?

Doc, you been through a lot and we all love you. We just want to take care of you like you take care of us. You are one of our own. I think my heart about burst out of my chest, in a good way, right at that moment. I realized then that they do see me. They see how much I care. They see how hard I try every single day, because I want to not because anyone tells me too. We have a mutual respect. I try to treat everyone well in the hopes that they treat me well. That’s what a team should be. It’s what I love about what I do. Well, I have to tell you, the ProMedica Monroe Regional Hospital team was the best I’ve ever seen! See you at work Monday guys! I love you!

Dr. Katz

Do NOT apologize for advocating for yourself!

To advocate is to publicly recommend or support. In terms of healthcare, it means speaking up for yourself and feeling more confident about the choices you make with your doctor. It means not letting someone else make all of your health care decisions without your input. It means being an active player in your health care team and helping drive your outcomes in a positive direction. It means asking questions when you don’t understand. It means keeping track of the course of your care. It means knowing your history and your family history and any other details pertinent to your health. It means following through with your doctor’s recommendations and taking your medications as directed. It means emphasizing an honest, team-oriented relationship with your physicians. It means being honest about your preferences or concerns. Let me clarify. This does not mean being rude or inappropriate or deliberately obstinate with your physician or constantly being on the lookout for a mistake that you can capitalize on. It is exactly the opposite. That kind of behavior really does nothing but insure a negative outcome.

You get the picture? Advocating for yourself requires action! You are representing you! You are the only one who knows you intimately and is with you 24 hours a day. This is something that you should never have to apologize for. For me personally, I love it when patients ask questions and get involved with their care. It shows me that they are actually interested in getting better. I have some colleagues that would strongly disagree. They hate it when they have to spend extra time answering questions. They view it as more of an act of belligerence or a personal attack, doubting their expertise. To me that is just a sign of their own insecurity in their recommendations. I say ask away and don’t leave the office until you feel comfortable.

Did you know that studies show that people who advocate for themselves are healthier and tend to live longer? Sounds like another bonus to speaking up if you ask me. Self advocacy is important because it helps you to be able to make your own decisions. It helps you gain self-respect and self-confidence. It helps you form an alliance with your physician. It helps you be a part of the doctor patient team relationship. It helps you learn to express yourself properly to attain the goals that you want. From what I can see, there really isn’t a down side so speak up why don’t ya?

Dr. Katz

It’s Not Over Just Because Chemo is Over

Wow! There are so many things they don’t tell you about being a cancer patient! When I say “they” I am referring to a proverbial all-inclusive group of people that includes everyone that is in charge of your care and even other patients who are unable or unwilling to share their experiences. I am learning a lot as I go and I am convinced more than ever that it is my mission to pass on what I know or have experienced to all of you. I am still determined to be the flashlight that helps guide patients through both their cancer experience and what comes after.

So, here is what I have realized. It is not really over until it’s over. What the heck do I mean? Let me explain. Most of us logically assume that when the last drop of chemo has coursed it’s way through our blood stream and the most recent scan confirmed that we are cancer free, at the moment, that we are, in fact, done! Yay! Hooray! Whooo! It is time to party, right? That’s what I thought. I really truly thought, or at least hoped, that the moment I got that final good news that this warm and fuzzy feeling of overall cleansing and good health was going to wash over me, my energy and health would be renewed and I would be ready for anything that came my way! Nothing could have been further from the truth. Now I am not blaming anybody. Nobody told me that that was going to happen. I am solely responsible for my own rose-colored glasses personal patient vision. However, nobody counselled me to the contrary either. I was just kind of left to figure it out after my perfunctory but heart felt congratulation speech from my health care team.

Here is what really happened. I got my good news. I was elated at the moment and kind of skipped out to my car( and then got short of breath from skipping..lol). Then I got into my car and, ironically, We are the Champions by Queen came blasting on the radio. I then proceeded to sob hysterically for about 20 min before driving home. I want to believe that the tears were all happy, but now I am not so sure. My mind started racing with all kinds of different thoughts ranging from yeah, I’m free to omg what do I do now and who is going to look out for me? My head was completely spinning. I had to take a minute before my head was clear enough to drive home. I started to realize that this was not really over. I had the next five years of my life mapped out with repeat scans and follow ups. Was it going to really be over then? What if I got some weird symptoms or twinge in the wrong place? Should I ignore it or should I worry because something else might be wrong?

I spent some quality time trying to talk myself down from the ceiling and rationalize the fact that I would need to give myself some time to be able to process information from my body normally again. That lasted all of a few minutes before I was on the phone to my therapist, making sure that I had regular appointments scheduled for the next several months. I was not going to be able to do this alone and I wasn’t allowed to restart my anti depressant for another month or so.

Ok, so now I had my therapy appointments in place. I rebooted my calm app on my phone. I reached out to my friends and fellow patients. I felt like I was doing everything right, or at least what I could do at the moment. Everything was going to be ok right? Nope! Then, the later complications of chemo started rolling in. My liver and kidneys took some hits and had to recover and my thyroid died completely. All the symptoms I was having that I was trying to assume were psychosomatic were actually real! Some of the stuff could have actually killed me! Thank goodness that we have modern medicine and options for all of them, but still scary nonetheless. There was no room for relaxing! There WAS still stuff to worry about! I knew it! My doctor said that some of these complications and side effects could be a factor for years afterward. Fantastic! I understood going in that there was going to be a risk trade off in exchange for curing my cancer, but on some level, I don’t think I fully understood just how significant the risks would be. I don’t think any patient does.

Here is where I think we need to do better for patients. We need to do better than handing someone a stack of papers several inches thick to read over and sign. We need more than just one chemo teaching session. We need to counsel patients that complications are real and that we need to have a reasonable level of vigilance after treatment is over. We need to recognize that PTSD is real and affects people that have experienced any kind of trauma, whether it is casualties of war or cancer. There needs to be a plan in place for those kind of things BEFORE they happen. We need to shape patient’s expectations for their treatment and for themselves BEFORE things happen. We need to give the a glimpse into what can happen and what they can expect and let them know that we have tools to address all of it. I have to believe that being proactive could potentially save a lot of suffering, both physical and mental, for patients. It has to be better than being behind the eight ball and struggling to deal with all of these issues when they are already full blown and both your mental and physical energy is already depleted.

Here is the bottom line. I am proposing a new plan. First, start with detailed one on one counselling before treatment starts for as many sessions as necessary with the key goal of shaping expectations and making preparations. Second, assign each patient a mentor who has actually gone through the process that can be a touch stone throughout treatment and beyond and who can offer encouragement, and more importantly, guidance and reassurance as things happen. Third, anticipate the possibility of PTSD, complications, and side effects after and during treatment and try to prepare the patient as best as possible. Set them up with therapy from the beginning. Start them on medications if possible during treatment. Be vigilant for side effects and try to catch them early. This all sounds like common sense but I am willing to bet that it is NOT common practice. I truly feel that implementing these few extra steps would have a tremendous positive return on patient recovery and outcomes that would far outweigh any additional healthcare costs incurred. I guess it boils down to what the true goal is : patient survival in terms of numbers versus patient survival in terms of whole health, mental and physical. Last time I checked, we are all more than just a number.

Dr. Katz

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

Takin it easy is not the same thing as being a prisoner.

Oh man am I having trouble with that distinction lately! First of all, limitations have never really been my jam to say the least. I have been a patient more than I care to admit in my lifetime. You know, multiple surgeries, medical emergencies, accidents, time off work, the whole nine yards. I am usually the one who is walking the halls just hours after emergency surgery. I am not a stay tied down kind of person. Now that the universe decided that cancer with chemo plus a pandemic was a good idea, I am looking at a whole lot more than just some temporary limitations. There is no way around it. I feel like I am looking at house arrest for months. Let’s face it, I will be immunosuppressed, on top of having cancer, in the midst of an ongoing pandemic. I can’t afford to take chances so I need to suck it up.

Yes, I exaggerated. I won’t exactly be on house arrest. I am going to work when I can. I will need to leave the house for doctor appointments. I just won’t be going out of my way to go out to dinner or take unnecessary risks. I probably won’t be doing any hospital procedures either. It’s just being smart. To be honest, it won’t be that different from what is going on now, except for the fact that the chemo I will be on shoves me from the mild risk category to the top of the highest risk category when it comes to death from infection and Covid. Yippee! This is not the kind of line that I wanted to cut to the front of.

In my rational moments, it all makes sense. There is no point in fighting hard to dodge the cancer bullet if I am just going to open myself up to the Covid one. That would be ridiculous. The restrictions are in place to help keep me safe and see this thing through to the end. I choose to follow them. I know that. And, it’s not as if there isn’t enough Netflix to go around to entertain me.

There are other things that I worry about though. Yes, believe it or not I worry about being bored, even though I am working on a book, a podcast, a blog and I try to post daily updates. I worry about having too much time to think which runs the risk of being counterproductive and focused on worrying with nothing to distract me. I worry about resenting my family and friends as the pandemic restrictions lift and life resumes again while I watch vicariously through a proverbial window. I worry about being consumed with guilt from letting people down. I realize that everyone is being tremendously understanding now, but everybody has their limits. See! I wouldn’t have so much time to overthink all of this unless I was on restrictions!…lol

Oh who am I kidding? No one really has to enforce my restrictions. My body takes care of that nicely. I never know which version of me is going to lift her head off the pillow in the morning: the one that is raring to go for several hours or the one that gets short of breath after about three steps and has to sit back down. It is a real Wheel of Fortune going on around here and I am definitely not the big winner the majority of the time. I am kidding myself to think that I could really change that even if I wanted to right now. It is what it is. The only real choice that I get to have control over is my attitude and my willingness to accept the advice of my doctors. I have to realize that this is not their first rodeo and that they do actually know what’s best based on experience, knowledge, and training. Like I am always saying, I need to be a team player in my healthcare. If coach says I need to sit on the bench for a bit, well then I better just sit.

Dr. Katz