Showing posts with label CANCER SUPPORT. Show all posts
Showing posts with label CANCER SUPPORT. Show all posts

Saturday, April 9, 2016


Online Comfort For Real-World Cancer Can Be Surprisingly Sweet

Steve Julian, a radio host with KPCC in Los Angeles, was diagnosed with terminal brain cancer last November. He and his wife, Felicia Friesema, turned to social media for solace, support and the space to process their heartbreaking journey.
Steve Julian, a radio host with KPCC in Los Angeles, was diagnosed with terminal brain cancer last November. He and his wife, Felicia Friesema, turned to social media for solace, support and the space to process their heartbreaking journey.
Rachael Myrow/KQED
The KQED podcast Love in the Digital Age explores "how technology changes the way we experience love, friendship, intimacy and connection." The most recent episode focuses on two people — a Los Angeles radio host and his wife — who have drawn great strength from their online communities and social media as they face his diagnosis of terminal cancer. You can listen to the podcast here.
Felicia Friesema had seen the signs of brain cancer before. Her husband, Steve Julian, wasn't just forgetting his keys on the kitchen counter, or having another of the myriad brain farts we often associate with middle age. He'd stop in the middle of a sentence, like he'd just hit a brick wall. And that was that.
"It wasn't that kind of gradual onset that Alzheimer's is," Friesema recalls. "It didn't sound or feel like dementia. This was so sudden — and it was very eerily similar to what happened to my aunt, my tia Gloria," Friesema says.
This time, the loved one with cancer was her husband.
Over the years, they've built a cozy life together in a sweet, spacious home in Highland Park, a neighborhood in northeast Los Angeles. She's head of marketing for Foothill Transit. And Julian is one of a handful of trusted voices helping Angelenos navigate the freeways every day, as morning anchor for a public radio station, KPCC-FM. In his off hours, he'd been active for years in local theater as an actor, writer and director.
Steve Julian and Felicia Friesema in easier times.
Steve Julian and Felicia Friesema in easier times.
Courtesy of Felicia Friesema
Now, he was having trouble navigating his way through a sentence.
"Technically, all tumors are operable," Friesema explains. "The question that comes into play is, what are you willing to sacrifice in order to get it out? The position and location of his tumor is such that you would have to completely destroy a lot of healthy brain tissue in order to remove it. You would be creating a situation of paralysis, major cognitive dysfunction, irreversible brain damage — and, ultimately, for possibly very little reward. There's no way of skirting it: I was looking at his death."
Around Thanksgiving last year, Julian was diagnosed with terminal brain cancer at the age of 57. They decided not to try to stretch his last months with chemo and radiation therapy. Julian has less time than he might have, but he can eat what he wants, sleep with their dogs, and squeeze the last juice out of the days that remain with his wife.
She's taking time off from work, thanks to a compassionate boss. In the 20 or more hours a day that Julian now sleeps, Friesema takes care of everything else — the meals, the housekeeping, the medicine, insurance and the emotional management.
Of course, friends and family are helping. Larry Mantle, Julian's dearest pal, comes over for company and a wee dram of whiskey. Friends have delivered dozens of lasagnas to the doorstep and whipped out their credit cards to cover what insurance doesn't. But at the end of the day, Friesema is alone. And every morning, there's a little bit less of Julian.
Reaching Out Online
It was a few months into his diagnosis when we noticed Felicia Friesema's journal onCaring Bridge, a website designed to help families and friends of someone who is ill give updates and get them, and offer and receive encouragement.
We recognized a kindred spirit in Friesema — someone else in the special club of those who have lost or who are losing a close loved one. We had to fly down to Los Angeles and meet this woman who wrote so deeply and thoughtfully, and with such compassion, about a journey no one chooses.
"I know that this is treacherous ground we walk on and that time is of the essence. We wake up to the juxtaposition of joy in another day together and terror at what may come.
"There is no detailed prognosis yet. But we do know that there is no outcome we like. And I have never been so scared. But I have also never been so completely full of love for him."
That was Dec. 2, 2015. At that point, Steve Julian could still help his wife craft a communique to friends:
"I miss being at work and in the studio. I miss being with all the people I love at KPCC. I'm still good at traffic. We chose UCLA for the surgery and treatment, and navigating to the westside can be tricky. The tumor can take away what I had for dinner, but not my memory of the traffic jams I've sat in.
"I am sad. I feel the unfairness of all of this. But I also feel the love for my wife, which grows every day as she balances the technical work of our affairs with the emotional work of our daily life. Like making sure I eat three solid meals. And I mean really solid. Four, sometimes. She tells me I'm loved about a hundred times a day — I remember a few of them. Larry [Mantle, host of Air Talk], my brother in all but blood, is a rock for both of us and has been by our side from diagnosis until now."
Many people facing down the gun barrel of something this awful retreat into family. But Friesema reached out from the beginning to friends online.
"We kind of had to," she explains. "We've kind of got a unique and peculiar situation. I mean, Julian's a very popular radio host in a very large market. He's also incredibly involved in the theater community here. He also used to be a cop. So, you have these seemingly disparate communities that he's connected to. That's thousands of people — his most intimate friends all the way down to the casual listener."
Felicia Friesema is not your regular home cook. She studied at the Ecole de Cuisine in Pasadena.i
Felicia Friesema is not your regular home cook. She studied at the Ecole de Cuisine in Pasadena.
Courtesy of Felicia Friesema
From the peace and quiet of their home on the hill, when Julian is sleeping, Friesema can write about all the medical details that would exhaust her if she had to repeat them to people in one individual conversation after another.
Friesema also uses the blog to process what's happening in her world, "to take this jumbled puzzle-piece of Post-it notes and ideas and thoughts and put them together into something that is like, 'Oh! OK.' "
"Usually, I don't know when I'm going to conclude until I start writing," she says, "and by the end of it, I'm like, 'Oh, that's my "aha" moment. OK. All right.' "
On Facebook, for a smaller, closer audience, Friesema shares bite-sized missives from her daily journey — proof the bees in the backyard are making "So. Much. Honey." Or her desperate wish that MRI machines played Brian Eno instead of frightening clicks and buzzes. Her rage against the insurance company, or her pride in yet another crazy, beautiful meal made for Julian.
And then there are the jokes. If anything, staring down death has heightened the couple's sense of humor.
"Fun with brain cancer:
"Steve: Jen!
Me: Yeah, babe (knowing full well he was calling for me).
Steve: Oh, I'm sorry. I just called you Jen.
Me: Yeah, I know, babe. It's OK. What's up?
Steve: (tells me some stuff he needs).
Me: No problem. By the way (smiling), I'd like to know who the hell Jen is.
Steve: (chuckles) So would I!"
The love has come pouring in from all corners. By Jan. 4, Friesema reported that more than 100 people had made deliveries, run errands or completed tasks around the house.
Julian's had a sandwich named after him at Wax Paper, a local sandwich shop with a thing for public radio. Friends have blogged about Julian. Local Morning Editionhosts across the country recorded their well wishes on YouTube.
Steve Julian of KPCC in Los Angeles gets a studio named after him, and a great big hug from President and CEO Bill Davis.i
Steve Julian of KPCC in Los Angeles gets a studio named after him, and a great big hug from President and CEO Bill Davis.
Courtesy of Felicia Friesema
People "are grateful for being included," Friesema says, "or grateful just to know that Steve's OK for now. Or they're grateful for an opportunity to help. I'd been crying so hard just a few days ago. I just couldn't stop. I was so sad and so dejected. And, at the end of the day, my status update on Facebook was, 'There just aren't enough tissues in the box.' So, the next day, what arrives on my doorstep but a case of Kleenex. And the message was, 'We know that this isn't enough, but hopefully it helps.' "
"One of the things we've been focusing on," Friesema says, "is making sure that every day is about some kind of pleasure — some kind of happy moment, some laugh, something in there that actually makes the day not a routine of caregiving."
Friesema sighs. "You know, something that reminds us that there are all these wonderful pieces to life and that living doesn't stop with a cancer diagnosis."
What remains online from this journey is a whole lot more than the testament to the love that people have for Steve Julian and Felicia Friesema. It's a social network — in the best sense — that will be there for Friesema, waiting to engage and respond anytime she wants.
This story was produced by The California Report at KQED, with production support from California Report's LA Bureau Chief Steven Cuevas.

http://www.npr.org/sections/health-shots/2016/04/08/473143759/online-comfort-for-real-world-cancer-can-be-surprisingly-sweet?sc=17&f=1001&utm_source=iosnewsapp&utm_medium=Email&utm_campaign=app

Tuesday, July 8, 2014

Who Is On Your Cancer Support Team?

 
Contributor: Josette Snyder, RN, MSN, AOCN
Learning that you have cancer can make you feel terribly isolated. Suddenly you find yourself in a new, unfamiliar world. But you are not alone.
Take a few minutes to think about the many people who surround you and want to help support you through your treatment into survivorship. Who is on your team?

Your physicians

Your physicians are the experts who are in charge of your treatment plan. They will discuss the risks and benefits of your treatment plan, answer your questions, and provide information.
Don’t forget that your family physician also is a member of your physician team. Your general practitioner is an important resource for you and your family, by providing an empathetic and credible source of information, support and advice.

Your nurses

Nurses are the ones you can go to with questions about the day-to-day issues and the practical matters of dealing with cancer treatment.
This is someone who can tell you what to expect, how to stay comfortable and how to manage cancer-related pain and other symptoms or treatment side effects. Your nurses also can be an important sounding board for your concerns and fears.
Your nurses are very knowledgeable about the details and nuances of navigating the cancer terrain because they are always talking to patients. With their accumulated wealth of patient information, your nurses are a powerful ally in your cancer experience.

Your social worker

Your oncology social worker is a licensed professional who can address the counseling, support and advocacy needs of patients with cancer and their families.
The counseling your social worker provides can help you or a loved one adjust to the cancer diagnosis, communicate with your children, family or doctors and cope with the changes in self-image and sexuality, among other issues.
Support can include referrals to resources for nutrition, complementary therapies, spiritual guidance and home health care. Your social worker also is your advocate, and can help you navigate the health care system, get prescriptions and access transportation to treatment, among a number of other services.

Your family and friends

Your family and friends represent a wealth of support, in the emotional as well as the practical aspects of your cancer journey.
They are the people you confide in, the people you vent to, the people to whom you can express your fears and frustrations. They can be a source of comfort, joy and reassurance.
In a very practical sense, your friends and family also can be of enormous help with the logistics and the myriad of tasks associated with your cancer treatment. They can drive you to doctor’s appointments, watch your children when you need to rest, make meals that you can freeze for later, or create a Facebook group so you don’t have to constantly tell your story.
You might find it difficult accepting help from others.  But by letting your loved ones help you, you can give them an active role in fighting your cancer, rather than leaving them stand on the sidelines. These acts of kindness will strengthen your relationships and bind you closer together. You will always remember how your loved ones helped you in your time of need.

Other cancer survivors

Connecting with other people who have been through a cancer diagnosis and treatment can be a tremendously helpful and empowering experience.
You might be able to understand your own feelings by learning how others responded to cancer. You also may be better able to cope with special challenges of cancer by learning how others managed similar problems.
How to connect with cancer survivors? One way might be within easy reach: You may have a relative or friend who has been through cancer and has an interest in sharing their experiences with you.
One resource I highly recommend to my patients is the 4th Angel Mentoring Program. 4th Angel offers free, one-on-one, confidential outreach and support via telephone from a specially trained cancer survivor.
The American Cancer Society also has a number of support programs, including online support groups, rides to treatment, patient lodging assistance and cancer education classes, among other offerings.

Friday, July 12, 2013

Why Online Patient Communities are Better than Real Life Support Groups

 
 
 
 
 
 
2 Votes

support group  has many potential benefits, some of which include improving coping skills, reducing anxiety, depression, isolation, ignorance about the condition and others.  Online patient communities (OPCs) are a recent phenomenon.  Some are open (with respect to type of member or fee) and some are more focused and closed.  Irrespective of the type, OPCs have blossomed. It is a major indication of social media’s penetration into healthcare (or vice versa) and why physicians need to establish a presence in social media.  While there are still reasons why support groups are popular, OPCs have definite advantages. I will highlight a few of them.
1.    Many patients and caregivers cannot physically attend a support group.In the early phase of a support group of patients with implantable defibrillators I led for over 20 years, I was informed of scheduling conflicts and transportation difficulties (some patients coming from distances hours away either couldn’t get a caregiver to drive them or couldn’t drive in late afternoon dusk/darkness). In addition, some medical conditions themselves prohibit travel.  My own mother with lung cancer had difficulties getting to her support group in NYC with her oxygen in tow for which she had to ultimately forego meetings altogether.  OPCs afford logistical convenience to both patients and caregivers. OPC conversations may occur in real-time or accessed at the participant’s convenience. I would have to believe that fewer people fall asleep during OPC chats and reviews than during live support group meetings. In addition, full conversations such as those on TwitterTweet chat are available for review.  I participate in a number of Tweet chats which inform and inspire me (breast cancer social media: #bcsm, healthcare leader: #hcldr, death with dignity:  #dwdchat, carpool healthcare: #cphc, treatdiaries chat: #treatdiarieschat, and others.
2.    OPCs represent the same demographics as patients in general.  Questions one may ask about OPCs are: Are they representative of patients with a given condition?One German study looking at patients with scoliosis who participated in a scoliosis-specific OPC found that the demographics were similar to scoliosis patients in general.  Another evaluation, one examining the demographics of a group of fibromyalgia patients of Patientslikeme demonstrated the same result, namely that the patient group was representative of those patients at large. Since support group patients are usually by definition geographically (and therefore more likely socioeconomically and culturally) to be similar within a given group, one might speculate that OPCs are more representative of the general population than a support group.
3. OPCs are more attractive for provider participation.  In my professional experience, physicians rarely take part in support groups.  They are a busy lot and in addition, though they certainly care about their patients, they might not be good public speakers, facilitators, or organizers.  I happened to have loved all of those things and never missed a meeting in over 20 years (the group met quarterly).  While there are guidelines for physicians on social media (emphasizing confidentiality and separation of professional/personal communications), physicians acting as patient advocates addressing general questions about a condition or offering knowledge about navigating the healthcare ecosystem is valuable.  Physicians will also get a more candid, drilled down view of patient concerns raised in OPCs.  Being anonymous or even registered and ‘lurking’ (not verbalizing but just observational ‘listening’ can be extremely useful by helping them see how important OPCs are to patients and caregivers as well as hopefully revitalizing the humanism of their perspective and practice.
4. Caregivers are more apt to participate and share information. According to a recent report on family caregivers, 33% of patients and 52% of caregivers (as defined in the study, 39% of all people over 18 years old are caregivers) participated in online social activity related to healthcare in the past year. In that same survey, 34% of caregivers “Read or watched someone else’s commentary or experience about health or medical issues online” and 22% of caregivers went “online to find others who might have health concerns similar to yours.” From my own experience with ‘live’ support groups, there are usually a few people who dominate the conversations.  Likewise, in OPCs I think there are those who are more ‘vocal’ than others, however there are more participants than just a few. Caregivers are a critical and underappreciated sector of the healthcare ecosystem and we must find ways to support them.  I was impressed on a trip to China how the system encourages and engages caregivers. OPCs can be one way in which caregivers are encouraged and supported with information and resources as well as peer emotional support (the physical and mental tolls of caregiving are also very under-appreciated).  For more on caregiving I would refer you to an excellent book “We’re in This Together” by Rob Harris.
5.    OPCs afford focused access to helpful third parties. Imagine having a pharmaceutical or medical device company or the NIH having deidentified access to conversations and offering clinical trials or informational assistance to group members.  While some may see this as Big Brother, it is going on now on Facebook and elsewhere with respect to marketing which is far less important than what one might envision here.  While there might be ‘opt out’ provisions, I would actually see this as a reason to join an OPC.  There could be no greater type of ‘customer rewards’ program than a potentially lifesaving one.  There will be guidelines surrounding privacy and use of this data (legislation and regulations are being addressed now).  However, if done properly, OPCs can then become much more useful to participants.
          Just as online social media is not a substitute for real life interpersonal exchanges, OPCs will not necessarily replace the real life experiences of support groups.  However, they do offer a different experience which brings together people from all over the world.  In a universe where medical technology approval is estimated to be 4 years behind in the USA compared to the EU, wouldn’t it be refreshing to converse with patients receiving those therapies now?  And the potential to interact with more healthcare providers offers a unique and potentially more rewarding exchange. I was in a breast cancer social media Tweet chat this week and one patient stated that the online group was her only and most treasured source of support.  It was touching and brought to light the importance of OPCs. Let’s use them, develop them, and spread the word.

About davidleescher

David Lee Scher, MD is Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in helping digital health technology companies, their partners and clients. As a former cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he is uniquely qualified to address both clinical and operational concerns of clients. Scher was Chair of Happtique's Blue Ribbon Panel which established standards for certification of medical apps in the categories of safety, operability, privacy, and content. He is a well-respected expert in mobile and other digital health technologies and lectures worldwide on technology and its impact on patients and healthcare systems.