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Show The Garfield County Insider December 17, 2009 mEverylCounts Okay, I think I'm presently flying somewhere over Colorado en route to San Diego having just left Chicago and before that Philadelphia. It's been a long and exhaustive week, but also an excellent and informative one where I must have spoken to well over a 100 or so medical professionals and their staff at Family, Primary, OB-GYN, Oncology, and Surgeon practices. My mission? To educate about hereditary breast and ovarian cancers otherwise known as HBOCs. As most of you know, I am a breast cancer survivor. I was diagnosed at 31 and two of my four sisters were also diagnosed in their 30s. All five of us tested positive for BRCA1, one of the breast and ovarian cancer mutations. But what SHOCKED me most about my visits to these practices were the excuses I heard. You're going to need to sit down to hear a few of them. Ready? Okay, here are the top 10: 1.) My patients don't want to know. 2.) It's not my job. 3.) I don't want to scare them. 4.) My patients can't afford the test [to find out if they have an HBOC] so I don't tell them about it. 5.) HBOCs are in such a small number of patients so it's not something I discuss. 6.) I don't have time. 7.) We don't see those kinds of patients. 8.) It's too complicated. 9.) Myriad Genetics is the only one who tests so I'm not going to test. 10.) It's the genetic counselors job. Seriously? And so on and so forth and I'm not kidding. These excuses were hard for me to stomach. I even heard, "You don't look like someone who would get cancer." Okay, any one of you has my permission to let me know when you find someone that LOOKS like they will get cancer. This, I've Listen, only 10% of breast and ovarian cancers are hereditary. But when you're one of the 10%, you matter. You count. What if that 10% included your wife, sister, mother, daughter, father, brother, son, uncle (yup, you read that correctly. Men get breast cancer, too, and can even carry the BRCA mutation and pass it onto their children just like women can. And that's exactly what my father did, unknowingly of course. He passed the BRCA mutation onto his five daughters. Three who actually developed breast cancer and all five who tested positive for the BRCA mutation which puts us all at incredibly higher risks of developing both breast and ovarian cancer). Perhaps if I had been initially asked about my family history, in Japan where I was diagnosed, and not only on my MATERAL side, I could have been a previvor inside of a survivor. (NOTE: A previvor is someone who tests positive for a BRCA mutation and can PREVENT cancer. More about previvors below). Where cancer could have been prevented all together. And maybe I wouldn't have needed the chemotherapy, radiation and lumpectomy that I underwent. Instead, perhaps, the best course would have been solely a preventive double mastectomy which is what was done after I tested positive for BRCA 1 . Yet, the radiation damaged not only the skin, muscle and tissue of my left breast, but my left lung and possible my heart. And that was only the radiation damage. I'll never forget what one chemotherapy nurse said to me the first time she administered one of my chemo drugs, "I have to be careful not to get this on your skin because it will burn it." Yet, this drug was going inside my body. I was sick from the excuses I heard from the physicians and their staff from my visits. What helped maintain my sanity though were those that "got it." "It's our obligation," said one OB-GYN whose entire staff is trained to get patients COMPLETE family history simply by having the patient fill out a questionnaire while sitting in the waiting room. Yup, this includes both the maternal AND paternal side. Then the doctor reviews this sheet with the patient to identify if HBOCs are present or not. The doctor then informs the patient about the blood test or mouthwash to determine if an HBOC is present. Please don't rely on verbally asking a patient's family history. Physicians that "get it" tell me so. For some reason they say there's a disconnect between verbally asking for family history opposed TO PLAY: COMPLETE THE GRID 50 THAT EVERY Row, EVERY COLUMN AND EVERY 3)0 BOX CONTAINS THE PIC ITS 1 TO 9 v; 6 6 9 7 9 9 1 8 2 3 v, 8 1 7 4 2 8 2 4 6 8 7 4 8 9 3 7 3 8 to having them WRITE it down on a form. For those that don't know, here are the "red flags" for HBOC: 1.) Breast cancer under the age of 50. 2.) Ovarian cancer at any age. 3.) Male breast cancer at any age. 4.) Multiple primary cancers. 5.) Ashkenazi Jewish ancestry. 6.) Family BRCA mutation carriers. If you have ONE of these "red flags" you fit the criteria to take either a simple blood test or a mouthwash to find out if you have HBOC. Let's inform patients about HBOCs and tests that find them, have patients update family history on a questionnaire EVERY time they visit your office, and FIND previvors to PREVENT cancer. Another essential is not to assume another practice is taking down a patient's family history. That's one of the BIGGEST misconceptions. One more is to ASK BEYOND 1st degree relatives. After all, I had NO 1st degree relatives with breast or ovarian cancer yet I tested positive for BRCA1 and found a long history, five generations worth, of breast and ovarian cancers on my PATERNAL side. Please, PLEASE practice good medicine. Become informed and give that knowledge to your patient. Be known for EDUCATING your patients. Practice BEDSIDE MANNER along with SKILL. COMMUNICATE. SMILE. DON'T look at your watch throughout a patient's visit. Get to KNOW them. And work with patients on fees so that they can afford to see you. By doing the above, you will find "previvors" one of the new buzz words, as mentioned above, which are men and women who test positive for HBOC and can PREVENT cancer by working with their physician under the medical treatment management tree which include such options, to name a few, as preventive surgeries, surveillance and testing. Do the right thing. Practice good medicine. Knowledge truly is power. For the medical professional, the patient, the family, even the extended family. Take family history on a form, save a life. Find a previvor. Prevent a cancer. After all, wouldn't it be better to find a previvor and PREVENT a cancer then diagnosis a cancer when you could of done something about it in the first place? I think you know the answer to that one. And I didn't even discuss a physician's liability for not informing a patient about HBOCs and testing when there are ACOG (American Congress of Obstetricians and Gynecologists) guidelines about them. We'll save that topic for another column. For information on coaching, consulting, speaking or training contact: Cynthia Kimball Humphreys, Vice President, Every 1 Counts, LLC, P.O. Box 574, Hatch, UT 84735. Ph: 435.632.1489, Fax: 435.735.4222 or Email: kimball@everylcounts.net. Website: www.everyl counts. net. Connect with Every1Counts on Face book, Twitter, Plaxo, Linkedln, and Echo Loops. © 2009 EverylCounts, LLC. All rights reserved. the lAuGhiNg pOiNt!! Blind Date After being with her all evening, the man couldn't take another minute with his blind date. Earlier, he had secretly arranged to have a friend call him to the phone so he would have an excuse to leave if something like this happened. When he returned to the table, he lowered his eyes, put on a grim expression and said, "I have some bad news. My grandfather just died and I have to leave." "Thank heaven!" his date replied. "If yours hadn't, mine would have had to." Modern Art Museum Visiting the modern art museum, a lady turned to an attendant standing nearby. "This," she said, "I suppose, is one of those hideous representations you call modern art?" "No, madam," replied the attendant. "That one's called a mirror." Sharing the Fortune Joe was a single guy, living at home with his father and working in the family business. When he found out he was going to inherit a fortune when his sick father died, he decided he needed a wife with whom to share his fortune. One evening at an investment seminar he spotted the most beautiful woman he had ever seen. Her beauty took his breath away. "I may look like just an ordinary man," he said to her, "but in just a few years, my father will pass, and I'll inherit his large fortune." Impressed, the woman took his business card. Three months later, she became Joe's stepmother. Women are so much better at estate planning than men!! Breakfast Out We went to breakfast at a restaurant where the special was two eggs, bacon, hash browns and toast for $1.99. "Sounds good," my wife said. "But I don't want the eggs." "Then I'll have to charge you two dollars and fortynine cents because you're ordering a la carte," the waitress warned her. "You mean I'd have to pay for NOT taking the eggs?" my wife asked incredulously. "I'll take the special." "How do you want your eggs?" "Raw and in the shell," my wife replied. She took the two eggs home and baked a cake. New Car A husband, the owner of a new car, was somewhat reluctant to allow his wife to drive his prize possession. even to the Supermarket which was a few blocks from the house. After she insisted, he finally relented, cautioning her as she departed, "Remember, if you have an accident, the newspaper will print your age!" It Makes Sense...By Veda Vale The only hint to come to me this week was to rub washed hands over carom to remove onion smell. Like your sink faucets. Not too interesting. So I offer the following: It makes sense to put certain disturbing, noncomprehendable things on an imaginary shelf and wait for understanding. I have done that with the Mountain Meadow Massacure and John D. Lee's part in it. I just couldn't tolerate thinking about how he had had a second choice, that being to have refused to carry out the task, and he didn't take it. Then I read a book, the whole thing in one day, unusual for me. It was titled A SECOND AFTER, by William R. Forstchen. This kind of fiction isn't my usual choice. In fact I have hardly read any other dooms-day or alarmist novel. I read it because I happened to hear an interview with the author and then went to the library and there it was doing what some books do--staring me know in the face.. But it isn't the that at the message of what could hap- time. Oh yes, some of these pen if an electrical-mag- understandings should have netic pulse from the sun or penetrated my head, what from an atomic bomb being with all that is out there in detonated high in the atmo- history books and that has sphere by terrorists could crossed my path through do. The blast of new under- the years, but not much did, standing came from reading not in a way to make me about how a small group of want to forgive Lee for his people bonded together for plan to protect his chosen survival could think when group. It seemed so cowthreatened from outside and ardly. A trap. And such a how the man put in charge terrible one! against his will has to But I suppose my nose had weigh terrible decisions--- never been so thoroughly Fight the conventional way, rubbed in facts of survival which means just winning and what we humans are the present battle to the like under extreme circumpoint where the enemy is stances. Whatever the case, scattered or withdraws, and I felt a click near the end which does not do much of the book and thought I to change the future of the understood a little better. survival or to stop a future About time at my age. Oh fight, or choose survival and the power of fiction! ! It the ultimate solution--death makes sense to read. You to all the enemy and with a never know when someway that wouldn't take men thing valuable will come to and resources needed for you to help unravel an old group survival. The great tangle. Send suggestions to Veda tragedy is that the threat to Hale Box 956 Panguitch Utah the Mormons turned out not 84759 or email vedahale@hoto be real. But they didn't tmail. corn ADMINISTRATION'S OWN HEALTH DEPARTMENT ANALYSIS WARNS AMERICANS ABOUT THE REID BILL The $2.5 trillion Tax-and-Spend Bill Would Increase Costs, Reduce Access and Cut Benefits Sen. Orrin Hatch (R-Utah) brought to light the recent findings contained an analysis conducted by the U. S. Department of Health Human Services. According to the official scorekeepers at the Department, the Reid Health Care Bill will actually not only increase our national health care costs by $234 billion over the next ten years, but will also reduce access and cut benefits for our seniors. "This non-biased report from the chief actuary at our country's Health Department simply proves what I have been saying all along — you cannot reform a $2.2 trillion health care system simply by spending another $2.5 trillion of hard-earned tax payer money," stated Hatch. "Spending and taxing does not equal reform." Senator Hatch, a long time supporter of the Medicare Advantage program, offered an amendment on the Senate floor to strip nearly $120 billion in cuts to the program that provides comprehensive health care benefits, including vision, dental and reduced costsharing for almost 11 million seniors. Unfortunately, despite reports from both the Congressional Budget Office and now the Department of Health and Human Services, that these cuts would result in reduced benefits for seniors enrolled in Medicare Advantage, Democrats in the Senate voted to keep the cuts in the package to finance more federal spending. "I am especially concerned about the findings in this report concerning the impact nearly half a trillion in Medicare cuts will have on access to doctors and hospitals for millions of seniors, all to finance more government expansion," noted Hatch. "Poll after poll, and study after study is warning us that this is the wrong solution for our nation," added Hatch. "This unknown bill which continues to change by the day behind closed doors is a direct violation of the President's own pledge to only support reform that would reduce costs, protect benefits and not raise taxes. "I sincerely hope that Democrats will step away from their arrogance of power and listen to the will of the American people. It is not too late for us to push the reset button and work on health care reform in a truly bipartisan manner. I am eager and willing, as I have been all year, to work on a responsible solution that every American can be proud of." |