Why is my nurse ignoring me in the grocery store?

Whether you get your treatment in Aberdeen, Centralia or Lacey the chances are pretty good you have run into a member of your care team while out and about. In fact, that’s one of the reasons so many people call southwest Washington home—big city amenities with small-town comforts. So imagine your shock when the same nurse who gave you a chemotherapy infusion just two days ago walks right past you in the cereal aisle. The nerve!

But before you get upset, consider this. People who have chosen the clinical field as a profession are held to a higher standard when it comes to protecting your privacy. They are extremely respectful of how their actions may affect you. By not initiating the conversation this gives you the opportunity to continue going about your day. Maybe you’re with someone who you don’t feel comfortable talking to about your diagnosis, maybe you’re in a rush, or maybe, just maybe, you don’t feel like talking.

We understand! And because your privacy is so important to us we will let you call all the shots. Of course, we would love to say hello. As our patients you hold a special place in all of hearts. It’s the reason we got into patient care in the first place.

So the next time you see someone in the community, say hello—unless of course you don’t feel like it. In which case, just keep on walking. We’ll see you at your next appointment with a warm smile either way.

What can naturopathic care do for me?

As part of its Integrative Cancer Care program, Providence Regional Cancer System offers naturopathic medicine services. Naturopathic doctors emphasize a holistic approach to care that incorporates diet, nutrition, exercise, botanical therapies and vitamin and mineral supplementation. As a board certified naturopathic physician specializing in integrative oncology I see cancer patients at Providence. Want to know more? Here are answers to some of the most common questions I get from patients.

Q. How can I benefit from naturopathic care?
A. Many individuals want to improve their general health in order to remain as strong as possible throughout their cancer treatment. Others want help managing side effects or adverse effects of treatment. Almost all are seeking professional advice on which natural therapies are safe and effective for their unique circumstances.

Q. What types of cancer patients do you see?
A. I work with patients at every stage of diagnosis and treatment – newly diagnosed patients, those in the middle of treatment and those who have completed their therapy. Different care strategies can help people enhance their health at any stage during and after cancer treatment.

Q. How do you help patients reach their goals?
A. I counsel each patient on diet, nutrition and lifestyle changes that can improve his or her health. Many patients also have questions regarding vitamins and mineral supplementation. I help them prioritize each supplement appropriately, while weighing the benefits of supplements vs. healthy nutrition habits. A handful of supplements will never make up for a poor-quality diet.

I also ensure that each supplement a patient is taking will not interfere with his or her current course of cancer treatment, such as chemotherapy or radiation. Although many herbs provide a tremendous benefit, some have the potential to alter treatment effectiveness. For example St. John’s wort, which is a commonly used herb, may potentially decrease the cytotoxic, or cell-killing effect, of a particular type of chemotherapy.

If you would like to learn more about naturopathic medicine services at the Providence Regional Cancer System call 360.412.8951.

Being extra alert ... recognizing the signs of infection

Fighting cancer increases your risk of infection
Whatever type of cancer you are fighting, your body is at an increased risk of developing an infection because your disease is affecting the body’s normal defense against the infection. Since we know drugs and diseases that can decrease the normal body defenses against infection and the types of infection likely to occur in patients, most types of infection are potentially preventable and often treatable.

When your white blood cell count is low you may NOT have the usual signs and symptoms when developing an infection such as:

• Redness
• Swelling
• Pus formation (at the site of an injury or incision)
• Cough
• Sputum
• Nasal drainage (from a sinus or respiratory infection)

It is extremely important to be alert to any change in how you feel and report and discuss what you are feeling with your doctor or nurse. Your health care provider will tell you when you are getting treatment that may cause your white blood cell count to be lowered. Additional information to ask is when the white blood counts will most likely be at its low point. This will give you a gauge as to when your body is less likely to be able to fight off infection.

When to call your health care provider about the possibility of infection
Call immediately if you have: 

• A temperature greater than or equal to 100.5°F. (Check with your health care provider, you may be instructed to call for temperature greater than 100°F).
• Chills (rigors) or shakes
• Sudden onset of a new unexplained pain.

Call within 24 hours if you experience the following:

• Sore throat
• Sores in your mouth
• A white coating in your mouth, especially your tongue
• Signs of a bladder infection
• Burning with urination
• Blood in your urine
• Needing to urinate more frequently than normal

Five things to remember when cooking for others

All over the world, generation after generation, one universal truth has held true … food is comfort. Whether you find solace in cooking, eating or both, chances are you have either given or received the gift of food.

We recently sat down with Gail and Madeleine, our famous soup ladies, to get their take on how family, friends and neighbors can help be part of the support system without adding more stress to the mix.

• Bring the right proportions. If you’re cooking for a couple, and one of them is a patient and the other is a caregiver consider that the patient is probably not eating that much and the caregiver is probably too stressed out to eat much. Bringing the right amount will help make sure the food is not wasted, which means you can bring food more often!
• Include ingredients. Unless you know the person you are cooking for intimately you may overlook a food allergy. Listing the ingredients on a piece of paper will ensure the recipient doesn’t eat food that could make them sicker.
• Include heating instructions. While most people can guess how long to heat something in the microwave or oven, when you’re stressed out you’re not thinking clearly. A quick note will help to make their lives easier and the result makes sure your meal is enjoyed the way you wanted it to be.
• Stay away from high-calorie desserts and creamy things. While it may be your favorite thing to bake the person you are cooking for will more than likely appreciate a hearty meal over a super sweet dessert. Creamy, dairy products often coat your throat and may or may not be a welcome feeling for your recipient.
• Fresh fruit and popsicles are almost always a hit.

Will you be happier with silicone implants?

For women who have undergone a single or double mastectomy plastic surgery is often a very real possibility. I firmly believe that what you (and only you) decide to do with your body your decision. I have known plenty of strong and beautiful women who have decided not to augment postmastectomy but I have known just as many strong and beautiful women who decide to augment.

But today’s post isn’t about that choice (although we can talk about that if you want). Today’s post is about a Nov.8, 2010 study. The American Cancer Society’s peer-reviewed journal CANCER published a study finding that women who opt for silicone implants postmastectomy are more satisfied than women who opt for saline.

672 women were followed and 472 chose to participate in the post-operation questionnaire. 176 women opted for silicone implants and 306 women opted for saline implants. According to the abstract, those women who chose silicone implants reported higher satisfaction than those who chose saline.

However, the results are not necessarily cut and dry. The study also reveals that, of the women surveyed, regardless of silicone or saline choice, receiving radiation therapy post-mastectomy had a negative effect on satisfaction and satisfaction in all women surveyed diminished over time. The leader of the team that surveyed the women, Dr. Colleen McCarthy, M.D., of Memorial Sloan-Kettering Cancer Center in New York City is quoted:

“We now know that women who elect to proceed with the placement of a silicone implant report higher satisfaction with their reconstructed breasts than those who choose saline implants,” said Dr. McCarthy. “It also appears that patient satisfaction with postmastectomy implant-based reconstruction is generally high and that individual treatment variables—such as implant type—explain only a relatively small amount of the variance. Patient counseling should reflect these realities in order to reassure patients that high satisfaction may be obtained with both saline and silicone implants.”

The U.S. Food and Drug Administration is a wealth of information about the “physical health” behind implants. As for your personal decision, well that’s where we come in. You cannot gauge your decision on a study involving just 472 women. What you can do is use it to help trigger some questions that you can ask your doctor, especially your surgeon.