Angels and Heroes

Angel: Someone very good, helpful, or kind. Angels make you smile when you see them. They make your day when you are sad or in pain. They are sweet and help people in need, especially those going through really tough times. The name “Angel” says it all.

Hero: A person who is admired or idealized for courage, outstanding achievements, or noble qualities. A hero knows what needs to be done and does it in a superlative way. Heroes don’t think they are doing anything unusual. It’s just their nature to be that way.

As a cancer patient, I didn’t have to worry about being alone—my life was full of angels and heroes. Today health care employs an amazing number of them. My family and friends also revealed themselves in a new light.

I mentioned in an earlier post that I personally favor teaching hospitals. Some don’t agree. “I want to be close to home. And you’re treated like a number in those big places.” I think these comments are misconceptions that don’t consider level of care.

It takes at least twenty minutes from leaving my house to entering the nearest community hospital. If it takes forty-five minutes instead, my life is worth an extra twenty-five minutes. I waste more than that on computer games and television.

My care at a university hospital has been more personal than what I experienced at community hospitals. The doctors I see have been warm, caring, and generous with their time. I wonder if this is because at community hospitals doctors have to do more themselves, whereas at teaching hospitals residents share the work, leaving my doctor more time to spend with me. Daily contact with students and residents keeps doctors on their toes: they have to stay current to teach. In addition, if needed elsewhere, a resident can see me until my doctor arrives. I think these benefits outweigh spending a few extra minutes on the road.

Bottom line, for any important medical issues I want the best care available, not the most convenient. What could be more important than saving me from cancer? I have worked in both a community hospital and university hospital setting and I think there is a real difference. You will find me at teaching hospitals.

That being said, of course angels and heroes are at all hospitals and good medical care can be found close to home. I just think the high standards that a teaching environment creates ups the numbers.

Let me tell you about my personal Angels and Heroes:

To begin, I was fortunate to have a medical team I really trusted, who never made me feel rushed and answered all my questions truthfully without sugar-coating. There were four doctors involved in my care:
• My internist recognized that the tender “lump” on the side of my neck was not a simple swollen gland or other benign growth, but something that needed further investigation. She saw me the same day I called her and contacted my otolaryngologist while I waited in her office. Before I left the hospital that day I had already had the CT scan that revealed my cancer. This is an example of personal care and how quickly things can happen in a university setting.
• My otolaryngologist greets me with a cheery smile and says, “What’s happening?” He told me my disease was not easy to treat, but it had a high success rate for cure. “We have ways to fix this.” He fit me in whenever I needed him, even when only to set my mind at ease. Once he called me from his car after 8 pm after a long day in surgery. I felt he was watching over me in the background, and under his care things would turn out well.
• My medical oncologist was a quiet and gentle woman. She made me comfortable and patiently listened to my complaints and questions. “Everything tastes the same—BAD!” I ranted once. She is noted nationally for her expertise in the field of head and neck oncology. Since her practice is limited to this field, she surely sees many people who are having the same problems as me, and would quickly recognize anything that didn’t go as expected.
• My radiation oncologist was young, enthusiastic, and charming. I liked him immensely and immediately, and he never let me down. I could tell he wanted my treatment to be successful as much as I did. Not only did he spend long periods of time with me, but was interested in my life and activities. He gave me his email address and invited me to contact him any time. The few times I did, he got right back to me. He looked for ways to make me more comfortable when side effects began.

Other team members gave me phone numbers and email addresses to contact for scheduling, urgent requests, and minor questions:
• A resident physician saw me routinely before, after, or with my radiation oncologist. He was also enthusiastic and knowledgeable, and took particular interest in me and my care. I trusted him completely. I hoped he would be employed by the hospital after he completed his residency in a couple of months. Coincidentally, his last day with head and neck radiation oncology was the same day as my last radiation treatment.
• A nurse clinician met with me weekly prior to my appointment with my radiation oncologist, took my weight, blood pressure, temperature, pulse, and oxygen. We chatted about how I was doing and made suggestions, gave me instructions and sample products for my side effects. He came up with solutions to help my radiation burns and mucositis.
• A nurse coordinator saw me prior to each oncology visit. She not only did a volume of paperwork required to document my condition and care, but managed my prescriptions and suggested remedies to make me more comfortable. Like my oncologist, she was quiet, gentle, and caring.

All members of the Department of Head and Neck Cancer met at weekly “Tumor Board” to discuss the best options for new patients and to review progress of patients under treatment. This brought together not only physicians from radiation and chemotherapy, surgery and research involved in my care, but their nurses and other support staff. I was reassured to know that they talked about me together, as nothing would be missed by poor communication. In addition to my doctors and nurses, present at these discussions were:
• Clinical Coordinator – This was my go-to person whenever I needed quick advice or help with the system. She got priority appointments for me when needed, sometimes multiple appointments back to back for convenience. It was a great help to have someone who knew the system and saved me hours. She also had many helpful suggestions.
• Clinical Research Nurse – I had opted to be treated under a study protocol, and the clinical research nurse had to complete the paperwork and be sure required appointments were scheduled. As another pair of eyes, she ensured that everything was done correctly and on time. She was present at many of my appointments with my doctors and added another level of care.
• Speech therapist/pathologist – I met with a speech pathologist weekly. This was described in my previous post (#10). The benefit was to strengthen muscles that keep my throat, tongue, speech, and swallow functions operating.
• Dietitian – As noted in the last post (#10), adequate nutrition is important for successful treatment of cancer. I also met with dietary services weekly.

Having all these specialists present at tumor board gave them the opportunity to stay current with my progress and to make suggestions along the way.

The next group of angels and heroes were those who actually performed my treatments:
• Oncology nurses performed my eight weekly chemotherapy infusions. In each “pod,” or infusion room three or four skilled chemotherapy nurses administered infusions. Most of the infusions took place in the same pod and the faces became familiar. One would take charge of my care for that day, but all were present and available if needed. They were all friendly, caring, and competent. (See post #5 for details.)
• Radiation therapists positioned me on the radiation table, attached my mask, and ran the machinery that delivered the radiation program written for each day. Most of my care was delivered by three individuals. Some rotation took place so each therapist remained skilled for the variety of cancer treatments that took place in the department. I was fortunate that at least one of my group of three was present at almost all of my thirty-five treatments, and appreciated the familiar faces. (See post #4 for details.)

Because I had been responsible for hiring and training receptionists and medical assistants during my working life, I know there is a tendency to undervalue these team members. They are the first people patients encounter and the way those encounters take place can make or break an impression. People who are dissatisfied generally point not to their medical care but to how the phones are answered, how quickly their registration took place, how they were treated when they arrived, how long they had to wait, etc. It takes very special people to create a welcoming, caring, and competent impression, especially when dealing with the sick and frightened. To undervalue their importance is a huge mistake.

I am happy to say that the staff at my hospital met this challenge.
• Reception staff – they welcomed me, signed me in, verified my identity and appointment details, printed and processed my paperwork, attached my ID bracelet, and gave me a parking sticker and directions, all efficiently, courteously, and with a smile. (See, it’s not as simple as clicking buttons and saying “next.”)
• Phlebotomists: Since weekly blood tests were required to monitor my condition and be sure no dangerous levels would interfere with treatment, a phlebotomist took my blood prior to each oncology visit and infusion. Invariably they were cheerful, chatty, and competent. I never had to be “poked” more than once and bruising was rare and minimal.
• Medical assistants – These staff members escorted me to the examination room and took my blood pressure, temperature, weight, oxygen, brought up my file on a computer screen, and entered the values obtained. It takes a caring and patient person. Although I knew it was far from the truth, there is a tendency to blame the medical assistant when the wait in the exam room is longer than desired. Like most people, what I wanted was not to talk to an assistant, but to see my doctor and get on with it.

ID checks are a routine part of the process. At each step along the way, each time I saw a new member of my team, I was asked to verify my name and birthdate, my ID bracelet was checked, the information was matched to “stickers” that were attached to my paperwork and blood collection tubes, and computer entries were made.

The number of people involved in treating cancer is astounding. I think I’ve identified over twenty-five Angels and Heroes by now…

Integrative Medicine
In addition to traditional cancer treatment, help is available for cancer patients having difficulty handling anxiety, pain, fatigue, side effects, or those who just want to be more in control of their health.

Presently into my second month of recovery, I have yet to feel I need support other than what has been provided by my medical team, my family, and my friends. However, it is reassuring to know that options exist. Some, but not all, of the resources are offered at my hospital, but I was given a list with contact information at my first oncology appointment. Literature about a variety of support groups and organizations was always available in reception rooms as well. It seems that no matter what you may need, someone out there provides it.

Included are:
• Integrative and behavioral medicine complements:
o Acupuncture
o Biofeedback
o Guided Imagery
o Herbal Counseling
o Individual Counseling
o Massage Therapy
o Medical Hypnosis
o Pharmacists
o Yoga

• Non-medical support:
o Social Workers
o Financial Counseling
o Palliative Care
o American Cancer Society
o Community Psychosocial and Support Services (list of specific support and educational groups available to handle emotional aspects of cancer treatment in a range of community settings)

Family and friends
I may be mentioning them last, but that’s no reflection on their importance.

I don’t know how I could have gotten through cancer treatment without my husband, Chris. He drove me to every appointment and waited with me, shopped for groceries or anything I needed, took over the bulk of household chores, and gave me encouragement and compliments. He never complained about our lack of social activities or his meals during therapy. He even let me pick television programs—although he kept control of the remote and I had to keep waking him up to change channels. That’s the short version—you get the idea.

My sons, daughters-in-law, and grandchildren were very supportive too. They called frequently, bought me comfort items, visited when I was up to it, sent cards and gifts to cheer me up. Bob and Dolly, both doctors, were available whenever anything came up. My family all wanted to do more, but there really wasn’t much to do.

I received many cards and emails from friends, neighbors, and organizations I’m members of: my writers’ groups, my library, our historical society, and a community chorus I sing with. I received flowers and gifts. I collected all my cards in one of those decorative photo boxes, and the box is full. Some people sent a card every week. Others have been reading this blog and send emails full of encouragement, prayers, and thanks. Many offered to help in any way, but really, there was little I needed other than their notes and prayers.

When something as life-threatening as cancer occurs, it is very valuable to hear from people you care about. It makes you feel worthwhile. I often thought that, when I die, the most meaningful thing to me would be for everyone who had touched my life to take a moment and think, “How sad. She was a good person and I liked her.” I feel like I had an opportunity to see that in life.