Kristy’s Scholarship Story

Kristy’s Scholarship Story

I have always known that I wanted to do something to help people, although it took me a while to figure out what that meant.

When I was younger, I always thought I would be a veterinarian. I then shifted my focus to helping people as I grew older. When I was sixteen, my mother was diagnosed with ALL, and all of the hours I spent on the ninth floor of St. Vincent Hospital helped turn me to nursing. I actually never thought I’d be able to work in oncology; I once had to float on ninth floor and absolutely dreaded returning back to that place. However, the way it made me feel to be able to help these patients and provide a sense of security for them completely changed my life. It was shortly after that experience that I saw an opening at Green Bay Oncology and felt compelled to apply.

My favorite Green Bay Oncology value is “Embrace the Difficult.” We are so quick to tell others to “focus on the positives” but tend to forget that the negatives are not going away. By doing so, they are only being pushed aside to build up and come back later. By embracing the difficult situations, we can help to solve these problems and make them into learning experiences. 

I look forward to being able to make my patients’ cancer journeys easier in any way I can. Until you’ve lived through it, it’s hard to truly know how easy it is to get lost in the diagnosis. I especially look forward to being able to help the families of my patients in any way possible, as they often need support and guidance as well.

I am driven to pursue further education because it’s in my nature. I always want to excel and improve; I tend to compete with myself. I am recently completing my second bachelor’s degree and have now been in college as many years as I spent in grade school and high school combined. I may take a semester off here and there, but I don’t know if I ever see myself really being “done” with school.

The JULES BLANK Oncology Knowledge SCHOLARSHIP allowed me to focus on school, work, and my family, while easing the stress of tuition and book costs greatly.  It’s always an added stressor when you suddenly add thousands of dollars to your bills, and it honestly can be such a deterrent from taking classes at all. Because of this scholarship, I was able to take classes each semester and now am only a few weeks away from graduation.

Paddleton: Being There is Everything

Paddleton: Being There is Everything

“I’M the dying guy!” Mark Duplass’ character screams at his best friend, played by Ray Romano.

“I’m the OTHER guy!” Romano’s character screams back.

Paddleton, a low-budget independent movie about a middle-aged loner facing down a terminal cancer diagnosis with his upstairs neighbor, debuted on Netflix on February 22nd, 2019. While most such movies focus on the patient’s experience, Paddleton is about cancer as a shared journey and a testament to the healing power of human companionship.

FAIR WARNING: if you haven’t seen the movie yet and want to avoid spoilers, stop reading now!

The film opens with Andy (Ray Romano) accompanying his friend Michael (Mark Duplass) to the doctor. There’s a tumor in Michael’s stomach and it’s already spread to his liver. The doctor’s recommending referral to an oncologist but won’t answer questions about prognosis.

Andy isn’t satisfied and pushes the issue on behalf of his friend. “How about this? How ‘bout I’m gonna make a statement, and if it’s a true statement you don’t have to correct me?” he asks the doctor, who’s obviously annoyed.

“Is what Michael has…incurable?”

“Dude, that’s a question. It has to be a statement,” deadpans Michael.

And that’s how it goes with the two of them. They take their liquor straight, and with a wry smile.

They’re an awkward but endearing couple – though they’re absotively posolutely not that kind of couple (as clearly spelled out in two awkward and hilarious scenes). They’re just neighbors. They just happen to have adjoining apartments…and spend most of their free time together, heating up frozen pizzas, watching Kung Fu movies, and playing a homegrown paddle-ball variant (which they call paddleton) in their every spare minute.

They’re something much more important.

Their relationship is uncomplicated and placid, because neither really likes to talk all that much. They don’t trouble each other with messy emotions. Michael is aloof about his cancer diagnosis -“It’s just meh” he says. He’s determined to maintain their normal routine as long as he can, and opt for physician-assisted suicide when he can’t.

It’s impossible not to love them, because they ask for very little and demand even less. We sense they both took a hard look at life a long time ago and came to terms with it in their own peculiar way.

The movie doesn’t condescend to them, or to us. There’re no epiphanies or dramatic gestures, nor is there a last-minute miracle. The end goes down just as Michael planned it. The story is simple, bordering on predictable. But yet we can’t stop watching these two oddballs fighting through the day as best they can.

The suspense comes from wondering how these two emotionally stunted people will handle something as devastating as death. And this is where Ray Romano really shines.

It’s beautifully painful to watch Romano’s face. He’s agonized to be there, watching his friend fade. It’s agonizing for him to bear witness. But he knows that not being there would be much worse. There’s never a moment of suspense about whether he’ll see his friendship through to the end. The suspense is in wondering what it’ll cost him.

Watching him, I couldn’t help wondering about what being involved in caring for the dying does – and maybe should – cost me.

Medical professionals involved in end-of-life care are often urged to “maintain healthy boundaries”. We’re not supposed to make the patient’s suffering our own, or mistake their family’s grief for our own – though in a very real way we never can. The patient is never our spouse/parent/sibling/child. The pain of losing a patient can never approach that level of personal loss no matter how much affection we’ve developed during our professional relationship. But yet we’re counseled to keep emotional distance.

It’s for our own mental health, we’re told.

And we cannot realistically sit 24/7 vigil with the dying. There simply isn’t the time. We have much work to do. And we cannot presume to take the seats of those whose grief takes primacy over our own.

But Paddleton reminded me how absolutely critical it is to stay with people emotionally at such times – no matter the cost.

Dying is sacred. There’s ritual and ceremony to it. And whatever the faith tradition, there’s a chalice brimming with grief that patients and their loved ones take turns drinking from. The cup is deep, and they need help getting to the bottom of it.

And I think we, as medical professionals, have to be willing to take a sip ourselves from time to time.

 

Clinical Trial Award

However, only one in five U.S. oncologists participates in the NCORP – the National Cancer Institute’s pipeline that delivers clinical trials from the academic centers to the community cancer clinics – and it’s easy to understand why: it’s lot of grant-writing, administrative work, and staying informed enough to match patients to trials that might help them.

But if you’re dedicated, you make time for the important things – and Green Bay Oncology physicians are dedicated to clinical research.

Though only a minority of NCORP physicians get recognized (81 physicians) for excellence in patient enrollments, this year FOUR Green Bay Oncology physicians received this honor:

●  Dr. Anthony Jaslowski – Gold Certificate

●  Dr. Brian Burnette – Silver Certificate

●  Dr. Sigurdur Bodvarsson – Silver Certificate

●  Dr. Matthew Ryan – Silver Certificate

    

Recognition is nice, but doing the right thing for people facing cancer is even better – and that’s why our physicians keep at it.

It’s the right thing to do.

Less Chemo for Breast Cancer?

Less Chemo for Breast Cancer?

Nobody likes chemotherapy: not patients, and not oncologists.

We’d all rather avoid it if we can – and now we’ve identified another group of women who can safely do without it.  

Some early-stage breast cancers can spread throughout the body before the tumor is removed surgically– even before the cancer is diagnosed. Those small, spreading cells (called micrometastases) aren’t detectable by current technology. But micrometastases can seed tumors that show up a few years later in the bones, liver, or brain – and ultimately cause death.  

If we give chemotherapy to patients who have micrometastases, we can kill off those little seeds before they take root and improve the chances of cure. But it’s only worth it if the risk of having micrometastases in the first place is sufficiently high – usually around 18% or more. That’s why accurately predicting risk is so critical in treating early stage breast cancer. 

So for people at high risk of having micrometastases (e.g. those with lymph node involvement, or high-risk mutations on the Oncotype test), we recommend chemotherapy.  

For people at low risk of micrometastasis, we don’t. 

So what’s the news flash?  

The Oncotype test reports a patient’s risk of micrometastasis as low, intermediate, or high. We’ve always known what to do with the low and high risk patients, but we’ve been less certain about the intermediate risk group.  

But the largest trial of its kind was just reported in the New England Journal of Medicine, and it looks like we can safely skip chemotherapy in Oncotype-intermediate patients. 

Bottom line: 

  • Women with early-stage breast cancer only seem to benefit from chemotherapy if they have lymph node involvement, or if the Oncotype test indicates they’re at high risk for micrometastases. 

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.

Caregivers: Put on Your Own Mask First

Caregivers: Put on Your Own Mask First

You know those safety demonstrations at the beginning of a flight, where they go through the plane’s safety features?

Remember what they always say about the oxygen masks?

“If you’re with someone that needs assistance, always put on your own mask first.”

You’re thinking that’s selfish maybe, but it’s critical advice – and not just for airline passengers.

US Engineer Destin Sandlin simulated the experience of losing cabin pressure in-flight, and found out how little time it takes to become mentally incapacitated. Within two minutes of trying to breathe in low-pressure, Sandlin could no longer identify basic shapes or perform simple tasks. He couldn’t have put on his or anyone else’s mask if he’d wanted to.

How long do you think you’d have between realizing the pressure was dropping and fumbling your mask on? It’s probably less than two minutes, even if you’re moving efficiently and thinking clearly, and by the time you notice the symptoms it’ll be too late. If you put yours on first you’ll have all the time you need for theirs, and you’ll save two people; but try to take care of them before yourself and you’ll both be lost.

There’s an important lesson there for caregivers. Our internal caregiver resists the advice to “care for yourself first” because it seems selfish. We frantically try to help those around us, neglecting ourselves until we’re incapacitated before we realize it.

How long do you think you’ll have before becoming so exhausted you can’t take care of yourself OR your loved one? Maybe you won’t notice it until you lose your balance and break a leg, or fall asleep behind the wheel, or develop a sudden pneumonia and wind up in the hospital.

Caregivers wear many hats and must often learn new skills, which is stressful and increases our need for rest. Skimp on rest in that situation, and you’re set up for depression and deteriorating physical wellbeing – leading to what is known as Caregiver Burnout.

What is Caregiver Burnout?

According to WebMD, Caregiver Burnout is the state of physical, emotional, and mental exhaustion that can occur when caregivers don’t get the time to care for themselves. Signs of Caregiver Burnout can include: fatigue, stress, change in sleep patterns, getting sick more often, and withdrawal from friends and family.

Thankfully, having a solid self-care foundation can prevent this from happening.

What is Self-Care and how do I do this?

Simply put, self-care is budgeting time to make sure your own needs are met, in four critical areas: physical, emotional, social and spiritual.

Examples:

  • Physical Self-Care: exercise, taking walks, trying yoga, following-up with your primary care provider, hiking, meeting with a nutritionist
  • Emotional Self-Care: journaling, joining a support group, finding a mentorship program, practicing mindfulness, counseling
  • Social Self-Care: going to the movies, volunteering in your community, joining a club, spending time with your friends, taking a mini-vacation
  • Spiritual Self-Care: reaching out to the faith community, meditating, spending time alone with yourself and reflect on life goals and accomplishments, spending time in nature and enjoying a sunset, reading spiritual literature

If you take care of yourself first you’ll have the strength and energy to care for your loved one. But if you neglect yourself in favor of your loved one, you’ll both be lost.

So remember to put on your own mask first.

Sources:

https://www.huffingtonpost.com/refinery29.com/why-youre-instructed-to-p_b_11201778.html

https://www.webmd.com/women/caregiver-recognizing-burnout#1

https://www.merriam-webster.com/medical/self-care

Clinical Trial Award

Clinical Trial Award

Getting the most advanced cancer treatment to patients requires that cancer doctors do two things: support the process that develops these treatments, and give their patients access to these trial-phase treatments.

However, only one in five U.S. oncologists participates in the NCORP – the National Cancer Institute’s pipeline that delivers clinical trials from the academic centers to the community cancer clinics – and it’s easy to understand why: it’s lot of grant-writing, administrative work, and staying informed enough to match patients to trials that might help them.

But if you’re dedicated, you make time for the important things – and Green Bay Oncology physicians are dedicated to clinical research.

Though only a minority of NCORP physicians get recognized for excellence in patient enrollments, this year five Green Bay Oncology physicians received this honor:

●  Dr. Brian Burnette – Gold Certificate
●  Dr. Sigurdur Bodvarsson – Silver Certificate
●  Dr. Anthony Jaslowski – Silver Certificate
●  Dr. Matthew Ryan – Silver Certificate
●  Dr. Ruth Warren – Silver Certificate

Recognition is nice, but doing the right thing for people facing cancer is even better – and that’s why our physicians keep at it.

It’s the right thing to do.

Remembering Becky

Remembering Becky

I first got to know Becky through my wife, since she worked with Becky’s fiancée. They had bonded over a shared love of professional hockey, something that is not common in Wisconsin.

We’d invited them to our home for a game between our two clubs in late 2006 – but it became the night everything changed.  On a snack run to the kitchen, Becky quietly tagged along and started asking me questions about something called mesenchymal chondrosarcoma – and was I familiar with it? Even though I’d been a cancer provider for years by this point, I’d never heard of it. Then she confided that she’d been diagnosed with it, and it was already metastatic.

Naturally I started reading up on the condition, and what I found out wasn’t reassuring. Mesenchymal chondrosarcoma is exceedingly rare. It was first described in the 1950’s, and less than a thousand cases have ever been reported. Even worse, it usually responded very poorly to chemotherapy or radiation therapy, though surgery could be somewhat successful – and at first Becky seemed to be one of those surgical successes. She underwent extensive operations to remove the multiple tumors from her lungs. After that, she went through aggressive chemotherapy to kill off any cancer left in her body. It was harsh, difficult treatment and she spent a lot of time in the hospital, but she recovered. And for ten years after that, it seemed like she’d beaten the odds – every checkup and every scan looked good – and she felt good, with no apparent side effects of the treatments she’d gone through.

My wife and I thought we’d won, too, because our friendship grew during that time. We got to know the rest of her family, and she became an aunt to my two older daughters.

But in 2010, she developed pain in her left side and sudden kidney failure; the cancer was back, and had so overgrown her left kidney that it needed to be removed – and the echocardiogram she had as part of preoperative evaluation showed the cancer had even grown into her heart itself. Her care team then proposed a more radical approach: open heart surgery to remove the tumor there, followed by removal of the kidney once she’d recovered enough. Though it was an extreme thing to undergo, Becky prepared for surgery as she did for all her battles – with incredible strength and dignity.  Both of these surgeries took a huge physical toll on her, but her spirits and love for life remained firmly intact.

After all that, it was time for more chemotherapy and Becky asked Green Bay Oncology to direct that part of her care so she could be closer to home. That was when I had the honor of not only being her friend, but of participating in her care.

Over the next 16 months she went through two different chemotherapy regimens without a break, and. I was amazed how she was able to differentiate her two lives, the treatment side and the normal life side.  When we met socially, away from the cancer clinic, she never brought up her condition.  She told me once that her cancer might dictate the length of her life, but it wouldn’t define her life – and that she wouldn’t even give it more space by talking about it.

And it did dictate how long she lived, unfortunately. The cancer eventually spread to her other kidney. I know, because I was the one who told her about it. I was the one that told her time had run out. But even then she kept living – after several failed attempts to call her to set up hospice care, I found out she was at work training her successor – and this was four days before she died. That’s how Becky was, unselfish and dedicated, and that’s how we remember her: Becky the loving sister, aunt, and stepmother; not Becky the cancer patient. My oldest daughter still talks about Auntie Becky, and something of Becky still lives in the stories she tells her sisters who didn’t get to meet her, and in the memories I still share from time to time with Becky’s sister.

I’ve known and befriended many patients and their families during their care, but Becky was the only patient I’ve ever had who was first a friend. There was something about that perspective that made me better appreciate how important end-of-life care is for people, and helped me grow as a healthcare professional. I hope Becky knows how grateful I am for her friendship over the many years, and what she taught me professionally.

Special thanks to the family of Becky.

The Puppy

The Puppy

12 years ago the sweetest 3 year old girl gave my mom her favorite puppy.

She told mom that when she feels bad, it always makes her feel better.  For the next 2 months that puppy was always within arms reach, and I truly believe it did make her feel better when many of the things she was going through with breast cancer did not.

A week after mom left us way too soon, that little girls favorite puppy was returned to her.

During those precious final two months, we had many long conversations about life and the future. One thing she told me was that my hurt in losing her will begin to fade when I have children.  While she was somewhat right, knowing how much joy she would have given our two girls and how much joy they would have given her; I miss her more, not less.

A week after our first daughter Iris was born, in a nondescript box, and without a letter; the same puppy arrived in the mail for her.  That same 3 year old who’s now nearing her drivers license could never know how much a simple act means to me and my family and how much it meant to my mom.

Children should not grow up without a grandma. 

Open your hearts. Open your wallets. Support the American Cancer Society where they work every day to help women with breast cancer become grandmas without.

Donate to Team Brian

Don’t Forget Uterine Cancer (even in pink October) 

Don’t Forget Uterine Cancer (even in pink October) 

Uterine cancer is the fourth most common cancer type in women – not that you’d know it from the (nonexistent) press coverage.

Almost 3% of women will be diagnosed with endometrial cancer at some point during their lifetime. 

It’s also called endometrial cancer since it usually starts in the inner lining of the uterus (called the endometrium). Most cases occur in women aged 45-74 and present with unusual vaginal bleeding or pain in the pelvis. 

The most common risk factors include obesity, certain inherited conditions and taking estrogen alone (without progesterone). Women who take Tamoxifen for breast cancer also have an increased risk of developing endometrial cancer.  

Uterine cancer is often curable, but women may have to go through surgery and/or radiation and/or chemotherapy to achieve cure. As with most cancers the earlier it’s diagnosed the better the chances. Approximately 80% of women who are diagnosed with endometrial cancer can be expected to survive for 5 years or longer.  

Even though breast cancer grabs all the headlines (especially in October), women need to be aware of the signs and symptoms of uterine cancer. It is especially important that post-menopausal women who experience vaginal spotting or bleeding seek medical attention.  

Early diagnosis is key to a good outcome!