The Other Side

The Other Side

I have been at Green Bay Oncology caring for patients for nearly eleven years. I am used to being in charge, having the answers, the results, the plan.

Since I have always been a perfectionist and need to control things, part of empathizing with my patients is treating them the way I’d want my family treated. I love dotting the i’s and cross the t’s for them.

I have had some pretty emotional days at work. Lots of them, in fact. But despite delivering hard news to countless others, I still never thought I’d be on the other side with my father getting this news.

But now I know the other side is filled with emotions one can only explain when they’ve been there. There’s overwhelming worry. Tears consume quiet moments in the car. But there’s also the battle to stay positive, to not worry, and to balance faith, hope, and reality. And there’s that darkness back there where you don’t want to go…the worse case scenario.

This is the struggle, the minute by minute, day to day of what being on the other side is like.

And though all I really want to do is control everything, I realize there is really nothing I can control. Suddenly the bloodwork, talks of scans, pathology, biopsy… are all so fast. These words are common to me, they are my everyday lingo. It is getting thrown at him so fast but he doesn’t understand what the biopsy means? Who cares about the grade? What the hell is adenocarcinoma anyways? We review the guidelines…then the real question, “Can it be cured?” he asks “How will this change me and how will my life be different?”.

But you know what? I really just want to be his daughter. I want to pretend everything is ok.

The fact is that we really haven’t even started treatment yet, and there are way too many uncertainties about the future. But I know everything has changed. I have been walking around in a “bubble” thinking it couldn’t happen to us. Well, here we are, on the other side. The side where you have very little control of anything. The side where you don’t really sleep well anymore. The side where your brain makes you come face to face with possible loss and the perpetual “What if?”. The side where you choose hope and faith EVERY TIME because it’s really the only thing you have.

I have learned a lot from this moment on the other side. Even when he beats this, we will still have appointments, labs, “stuff” that will forever make us to some degree worry about cancer.

As I treat patients, I will always try to remember what it is really like to be on the other side.

What is Convenient Cancer Care?

What is Convenient Cancer Care?

Our patients want and deserve convenience, but what is convenient?

I thought about this recently while evaluating a hospital patient. She’d been diagnosed recently and so wanted a plan NOW that she’d driven two hours for an earlier appointment. She’d wrestled with all the associated questions – Where do I go? Who’ll drive me there? Will I feel well enough for the trip? Is snow in the forecast? And what about the next appointment?

From my perspective, as a non-patient, non-afraid, non-recently-diagnosed person, a four-hour round trip sounded more inconvenient than waiting another two or three days for something closer to home.  Living in the Green Bay area I’ve  always taken for granted the convenience of having everything 10-15 minutes away.  Many health care clinics, 4 different hospitals, in fact I often have to argue with my family as to which grocery store we are going to.  Everything is an easy 10-15 minutes and perhaps if there is a little traffic maybe 20 minutes, however, my friends from large metropolitan areas find our idea of “traffic” laughable. But fear sometimes trumps mileage when you’re a cancer patient. I was glad we could get her in that day. I was even happier to tell her about our locations in Escanaba and Manistique, which she didn’t know about.

So was she. Her next appointments would only be twenty minutes away, and you could feel her relief – but there was a catch. She’d have to see a different doctor from now on. I was afraid that might be a deal-breaker.

We’ve got a dedicated team of providers at Green Bay Oncology, and they’re happy to spend hours commuting to ten different locations from as far south as Chilton to as far north as Manistique – and I mean who else is willing to do that? How valuable is that?

But not every provider can drive everywhere. The doc she knew didn’t go there, and she’d have to pick another.

Now when my insurance plan suddenly forces me to choose a different doctor (yes, it happens to providers too) I find that VERY inconvenient. It’s an outrage, and I’ve lived it. I was in full-on apology mode and I braced for her objection.

Know what? She didn’t mind, not at all in fact. She did the quick math (four hours vs. twenty minutes round-trip) and minded not at all. Convenience trumped familiarity.

Turns out, I maybe don’t know that much about patient convenience after all. Or maybe what I think is convenient isn’t always what they think is convenient.

But I’m not the important one here, and maybe we ought to let the patients tell us what is and isn’t convenient – and design our systems accordingly – rather than the other way around.

Reducing Hospitalizations

Reducing Hospitalizations

Green Bay Oncology is dedicated to reducing hospitalizations through patient education and prompt triage. We understand that patients usually prefer to be in the comfort of home and loved ones. We strive to maintain a low hospitalization rate.  Every attempt is made to keep patients educated and prepared in the event that a new or unusual side effect appears.  In case of a life threatening emergency, we encourage patients to call 911 or go to their nearest emergency room.  For non-life threatening emergencies often times patients can be evaluated and treated at GBO, thus helping avoid emergency room visits and hospitalizations as often as possible.

Contacting our office as early in the day as possible allows GBO a better opportunity to review patient concerns and address them in clinic.  We have a dedicated team of triage nurses trained to evaluate patient needs promptly and effectively. These nurses have direct lines of communication with all of the Green Bay Oncology providers.

Some examples of when to call GBO include:

  • Temperature above 101 or shaking chills
  • Inability to drink or retain four 9 oz glasses of liquid in a twenty-four hour period
  • Uncontrolled pain
  • Persistent nausea and vomiting
  • Sudden onset of shortness of breath or a change in your normal breathing status
  • Unusual bleeding or bruising
  • Uncontrolled diarrhea

In many cases, patients can be seen by the doctor or nurse practitioner and be treated with supportive measures such as intravenous fluids for rehydration purposes or medications to control stomach upset.  It is our goal to get all patients safely through treatment. By keeping patients and their care team educated on when to contact Green Bay Oncology, we can together reduce unnecessary hospital admissions, emergency room visits, and continue to strive for a symptom-free or an improved clinical state.

What is a Nurse Practitioner, and Why Do I Need One?

What is a Nurse Practitioner, and Why Do I Need One?

All nurse practitioners (NPs) must complete a master’s or doctoral degree program in nursing, and have advanced clinical training beyond their initial professional degree as a registered nurse. Green Bay Oncology now employs seven nurse practitioners. As a nurse practitioner, I view myself as an extension of my collaborating physician. Each physician here at Green Bay Oncology is paired with a nurse practitioner to be an integral part of the care team. The NP is skilled to examine and treat patients independently as a part of the care team.

Often during my day as an NP at Green Bay Oncology, I am asked, “Wow, this job must be really hard? I could never do this job.” I open the discussion with my patients as viewing this job as a gift, a window into a person’s life, often into his or her most vulnerable state. It is a very personal, emotional, and rewarding position to be in. I am given the opportunity to be a part of my patient’s and their family’s journey through treatment. It is my job to assist them in any way I can; whether it be with a physiologic, emotional, or social need. I always try to find out what is important to my patients. Is it their job, their family, a special event? By doing this I can individualize each and every patient’s overall plan of care.

The nurse practitioners at Green Bay Oncology help facilitate care at all of the outreach sites, provide care at the Saturday clinic at our east side location, and are dedicated to giving back to our community by speaking at and supporting many local events.

By having nurse practitioners at Green Bay Oncology it has allowed the group to take a more holistic and collaborative approach. We truly do look at each interaction as a group effort. As a group, we continue to focus on how our patients’ needs can best be met. The NP is a key component of the communication that occurs not only between the staff here at Green Bay Oncology, but also with our partnered local and state providers. Here at Green Bay Oncology, rest assured we are here for you, and look forward to being a part of your care team.

High Risk Lung Screening Clinic Opens at Green Bay Oncology

High Risk Lung Screening Clinic Opens at Green Bay Oncology

Lung cancer kills more people every year than breast cancer, prostate cancer, and colon cancer combined.

Unfortunately, lung cancer has historically been diagnosed at a more advanced stage; individuals typically do not have symptoms in the earlier stages of lung cancer. Up to 60-70% of people diagnosed with small, early stage lung cancer could be expected to be alive five years after the diagnosis; only about 10-20% of patients with more advanced lung cancer would be expected to be alive five years after the diagnosis. The United States Preventative Task Force 2013 recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in persons at high risk for lung cancer based on age and smoking history. This new recommendation came from the results of the National Lung Screening Trial (NLST). The NLST identified that screening current and former heavy smokers with low-dose CT scanning at least once yearly for three years resulted in 20% fewer deaths from the disease compared with a yearly chest x-ray. It is important to recognize that there are still potential risks that come along with the screening–a high potential for false positives (a screening test that is positive, but ultimately the abnormality is found to NOT be cancer); unnecessary follow-up procedures (with a risk of complications); radiation exposure; and anxiety related to an abnormal test result.

Green Bay Oncology is committed to the community and we are happy to provide a comprehensive High Risk Lung Screening Clinic, where individuals at high risk for developing lung cancer are able to receive the necessary education on the NLST data and make an informed decision on low-dose CT scanning.

Individuals at risk would include all of the criteria below:

  • Between the ages of 55 and 80 
  • Have a significant smoking history (30 pack/years). The formula is number of packs per day multiplied by the number of years smoked. For example, 1 pack per day times 30 years equals 30 pack/years; 2 packs per day times 15 years equals 30 pack/years. 
  • Currently smoking or have quit smoking less than 15 years ago

The High Risk Lung Screening Clinic offers an appointment with one of our nurse practitioners. The appointments are offered at all of our locations. At this visit, the nurse practitioner will discuss the program and evaluate the individual.  If it is decided to proceed with a low-dose CT scan of the lungs, this will be ordered for a convenient date and time at the Prevea Radiology Department, Webster Avenue Site-Green Bay. A dedicated radiologist with knowledge specific to lung screening criteria will interpret the scan. A follow-up appointment with the same nurse practitioner will be scheduled to review the low-dose CT results and further outline an individual screening plan. All of the individuals entering the screening program will, at minimum, have three yearly screening scans.  This can vary based on the individual results.

To make an appointment or referral call 920-884-3135.