What is palliative care? Life-enhancing, supportive care

We hear the words Palliative Care and think end-of-life, hospice, impending death. Then we stop listening all together. Many think there are two separate roads in cancer care, one curative and one palliative with no intersection; that when health care providers recommend palliative care they have given up on us.

Even some providers equate palliation with hospice. Unfortunately, limited understanding of what palliative care can offer has limited the care that cancer patients receive. Palliative Care is patient and family-centered care that focuses on reducing the severity of symptoms and promoting quality of life for patients with a life-threatening disease. And it may be offered at the same time as life-prolonging chemotherapy or radiation. Palliative Care is truly comprehensive care that addresses the physical, psychosocial, practical and spiritual dimensions of cancer and its treatment. Palliative care can provide effective pain management to patients who have years to live. Patients have the most to gain from palliative care when it is started earlier in the treatment process. A recent article in The New England Journal of Medicine found that lung cancer patients who received palliative care had a better quality of life, fewer depressive symptoms, and a mean survival of 2.7 months longer than the group that received chemotherapy alone. An accompanying editorial states, “Perhaps unsurprisingly, reducing patients' misery may help them live longer.” Next time you hear the term Palliative Care, think life enhancing, supportive care.

Free tool: Charting your family health history

Happy Thanksgiving from Providence Regional Cancer System.

While Thanksgiving has traditionally been (and will continue to be) about giving thanks and celebrating family we’re pretty excited about the Surgeon General’s declaration of Thanksgiving Day also being National Family History Day. It is the hope of the U.S. Department of Health and Human Services that families start to talk about their family health history. What better place than the Thanksgiving table! Well actually, we can think of better places, but that doesn’t matter. What matters is that you talk.

A recent survey found that 96 percent of Americans agree about the importance of knowing their family history…yet the same survey found only 1/3 of those same Americans had ever tried to write down the facts. 

Health care professionals have known for a long time that common diseases - heart disease, cancer, and diabetes - and rare diseases - like hemophilia, cystic fibrosis, and sickle cell anemia - can run in families. If one generation of a family has high blood pressure, it is not unusual for the next generation to have similarly high blood pressure. Tracing the illnesses suffered by your parents, grandparents, and other blood relatives can help your doctor predict the disorders to which you may be at risk and take action to keep you and your family healthy. Reference >>

The great news is the surgeon general has made it incredibly easy to compile this information in one place using their My Family Health Portrait Web tool. The secure website asks the same health information your doctor would ask, creates a "pedigree" specifically for you, gives you the chance to download it and then deletes the information. Yes that's right. The government does not keep a record of what you typed in.

So this Thanksgiving, enjoy your turkey (or your tofurkey), sit down with your family and talk about your health history ... it could be the greatest gift you ever get and give.

"I take one blue pill and three pink pills twice a day."

You would be surprised to learn just how often our clincial staff hear those same exact words. Or maybe, "I take 10 mg every day for my blood pressure." Our next question is almost always, "10mg of what?"

It may not seem like a big deal but the importance of knowing the medications you are on can never be stressed enough. With thousands of drugs being prescribed every day, not to mention the availability of natural remedies you can understand how confusing it may be for us to narrow down your drug just by color or mg. So why do we care? Medication reconciliation helps us to optimize the drug therapy you are on while also reducing the adverse side effects that can occur when two drugs are mixed (ie: taking St. John's Wort during chemotherapy reduces the effectiveness of the chemotherapy).

 What falls under the category of things we want to know about?

• Prescription medications (including any sample medications you have been given)
• Vitamins
• Over-the-counter drugs
• Vaccines
• Diagnostics and contrast agents
• Radioactive materials
• Respiratory therapy-related medications
• Blood derivatives
• Intravenous solutions
• Any other produt the FDA has designated as a drug

In all honesty, if you're putting it in your body we want to know about it. Need a place to put it all? You can pick up a personal pocket medication card in any of our clinics or you can request we mail you one by sending us your address.

The inside of the "Personal Pocket Medication Card" provides space for you to write all the information your care team needs.

What happens if I ignore my lymphedema?

Unfortunately, ignoring lymphedema won’t make it go away. Once you have it, your only options are to manage it to the best of your abilities or allow it to get out of control. The biggest risk to not treating lymphedema is an increased risk of infection. Because fluid and waste products are slow to leave your involved extremity, your body may not be aware of bacteria and viruses until they have had a chance to multiply. By the time your body is aware of the “invaders,” your infection may require oral or IV antibiotics. These infections cause further damage to the lymphatic system and repeated infections can progress lymphedema quickly or lead to sepsis (whole body infection).

The other risks to non-treatment are heaviness or the involved extremity, leading to joint pain, limited motion, reduced strength, and nerve damage. Because of the reduced immune system, there is also an increased risk, although minimal, of certain types of cancers.

Do I have to deal with lymphedema for the rest of my life?
Lymphedema is a progressive disease. Once you have had lymph nodes removed via surgery or damaged via radiation, you are at risk for lymphedema. Because lymph nodes do not regrow, you will remain at risk for developing lymphedema for the rest of your life and need to follow precautions from that point on. If swelling has started, you will need to use some type of management for the rest of your life. If treated early on, your chances of easily keeping it under control down the road are better. Treatment options in the earlier phases may only require occasional use of a compression garment, exercise or a self-massage. Without treatment, this condition will progress at a faster rate. Management in later phases requires consistent use of a compression garment as well as self-bandaging on some or all nights.

How do I refill a prescription?

All medication refills/request require 2 business days notice but it's always a good idea to allow more time for processing on holidays and weekends.

The medication request lines:

• Aberdeen: 360.533.6909 ext. 1708
• Centralia: 360.330.8939 option #2
• Lacey: 360.754.3934, ext. 2520

For any prescription that requires a physical/hard copy (narcotics) call your clinic's medication request line and leave a message with the following:

• Spelling of your first and last names
• Medication name, dose, directions and quantity
• When you will be able to pick up the written prescription. NOTE: You will be notified when the prescription ready to be picked up.

For all other medication refills please call your pharmacy and ask them to fax a refill request to your physician. This is for any refill request, including if your medication bottle states "No Refills".

Any requests received after 4 p.m. may not be processed until the next business day.