Cell 2 Soul: The Humane Health Care Blog

"Over the Hill and Picking Up Speed"

At 100, Still Running for Her Life
by Noah Remnick, NY Times, April 23, 2016

"On a cloudless Sunday afternoon in April, a 100-year-old woman named Ida Keeling laced up her mustard yellow sneakers and took to the track at the Fieldston School in the Bronx. Her arrival was met without fanfare. In fact, no one in the stands seemed to notice her at all."

This is a fine piece about healthy aging. Ms. Keeling is an outlier; but it is important to study (and celebrate) the lives of exceptional people. If you click on the article, don’t skip the one minute video!

The Dangers of Polypharmacy

Graphic from Times article

"The Dangers of ‘Polypharmacy,’ the Ever-Mounting Pile of Pills"
By Paula Span, NY Times, April 23, 2016

Although geriatricians and researchers have warned for years about the potential hazards of polypharmacy, usually defined as taking five or more drugs concurrently; it continues to rise in all age groups, and has reached disturbingly high levels among older adults.  A recent study showed that 39% of people over age 65 in the U.S. take 5 or more different prescription medications a day (not yo mention other over-the-counter meds and supplements).

This is a concise, lucid and useful article by one of the Times best health reporters. It might pay to read it and remember its warnings.

See: Dangers of Polypharmacy.

It's Not Cancer: Doctors Downgrade a Thyroid Tumor

“There’s a growing concern that many of the terms we use [when labeling a tumor] don’t match our understanding of the biology of cancer.” Calling lesions cancer when they are not leads to unnecessary and harmful treatment, he said.

A new study clarifies that: “it is not the presence of nuclear features but the presence of invasion that can make the difference between cancer and noncancer,” Nomenclature Revision for Encapsulated Follicular Variant of Papillary Thyroid CarcinomaA Paradigm Shift to Reduce Overtreatment of Indolent Tumors.

An April 15th NY Times article by Gina Kolata explains this paradigm shift well.

This is an important step; but there are many other tumors that likely fall into the same category. As practitioners and as patients when we receive a diagnosis of cancer, it behooves us to question the necessity of aggressive treatment for indolent tumors. Breast, prostate and a number of skin cancers quickly come to mind, but there will be many others. The study reported in JAMA Oncology hints that we have a ways to go and that we are in the infancy of this endeavor.

Waiting Room Diagnosis

According to our waiting-room security cam you're figity and have a constant head itch.

David B. Oliver's Reality TV

Ellen Rand writes us: "What’s the reality of caring for loved ones in decline? We’re not likely to see the rawness, the intimacy, the messiness, the profundity of it in the movies or on TV – except for a few rare  pathfinders. David B. Oliver was one of them.

David and his wife, Debra Parker Oliver, possessed a deep knowledge gained over their professional lives researching and teaching about aging and end-of-life issues. That he responded to his own deadly illness in a meaningful way is tied both to his character and to his life’s work."

Ellen's beautifully written introduction to the Oliver's moving and instructive videos will interest many of you.  We are grateful to her for having sent us her essay (which you can access here: Download Reality TV

You can find the Oliver's presentations at: David Oliver's Cancer VideoBlog -- Episode 1: David Reveals Diagnosis

 

Ellen Rand has been a journalist for more than 40 years, including five years as a housing columnist for The New York Times. She is a hospice volunteer with Holy Name Medical Center in Bergen County, New Jersey, a member of the Hospice Volunteer Association and the Association of Health Care Journalists. Her essays have appeared in several medical humanities publications, including Pulse—Voices from the Heart of Medicine; KevinMD; and Life Matters Media. She blogs at http://lastcomforts.com.  Ellen is the author of the recently published:  Last Comforts: Notes from the Forefront of Late Life Care  which has been called "a must read for caregivers, individuals with serious illnesses, their loved ones who care about their care and elected officials. A must read for caregivers, individuals with serious illnesses, their loved ones who care about their care and elected officials. "

April's Foolin'

April 3, 2016

april came with promise:
gay blossoms on the cherry.
These flurries mock us.

Open Notes: What and Why?

patients and providers on the same page

As a patient, you have the right to read the notes your doctor or clinician writes about you during or after your appointment. Having the chance to read and discuss those notes with your doctor or family member can help you take better control of your health and health care.

As a healthcare professional, you may build better relationships with your patients and take better care of them when you share your visit notes.

OpenNotes is a national initiative working to give patients access to the visit notes written by their doctors, nurses, or other clinicians.

Evidence suggests that opening up visit notes to patients may make care more efficient, improve communication, and most importantly may help patients become more actively involved with their health and health care.

Smart Patients

 

"Smart Patients is an online community for motivated patients and their families and friends. You can learn at your own level about scientific developments related to your condition, share your questions and concerns with other members, and use what you learn in the context of your own life.

We believe patients are the most underutilized resource in healthcare. We've watched patients become experts in their conditions — and we see that their knowledge improves the care they receive. With the right tools, you and other patients can do the same."

This is an interesting and valuable tool for motivated patients, care-givers and health care providers.

Also see: Roni Zeiger's TED Talk in Smart Patients