Tag Archives: patient

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Peggy_newPeggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete, currently in training for major surgery
 

“Hi. How are ya?”

“I’m great, thanks! How ’bout you?”

This typical Canadian greeting is repeated millions of times daily across our country, part of our polite character, and our culture. There may be acceptable variations on the reply, depending on how well the two people know each other.

“I feel a cold coming on, but I’m fine.”

“I didn’t sleep well last night, so I’m tired.”

It would be totally unacceptable to say, “I have a touch of lung cancer, but, other wise, I’m fine!” Simply. Not. Polite.

It is interesting that we ask each other this question so frequently, but we do not actually expect to listen to an honest answer. It is just the culturally accepted standard greeting. For me, when my honest answer was, “I’ve just been diagnosed with lung cancer, thanks,” I could not break cultural expectations and say that!

When I initially learned of my diagnosis, and people asked, ‘How are ya?’ I felt like a deer-in-the-headlights; ...continue reading

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Peggy_newPeggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete, currently in training for major surgery
 

I’m Pissed Off!
I’m really, really Pissed Off! It isn’t Fair!
Shall I tell you how I really feel???
I’M PISSED OFF!!! IT ISN’T FAIR!

There, I’ve said it out loud, and in black and white!

Here’s the story of how these two urchins finally penetrated my stability barricade.

Recently, I had my ‘Pre-op’ appointment at the General Hospital. This was a day where ten soon-to-be lung surgery patients were being prepared. First, we had an excellent two hour presentation by a nurse, called ‘Lung Surgery Education’, giving all the details of preparation for the surgery, what to expect during the surgery day, and recovery both in the hospital and at home. Then, individually, we met with a pharmacist, a nurse and an anaesthetist. The purpose was to exchange clinical information and also possibly provide an opportunity for the staff to assess our level of craziness! Would each of us be a compliant patient, or a difficult one?

At my final meeting with the anaesthetist, she did a thorough clinical question-and-answer session, again asking for my previous experience under anaesthetic, and telling me what to expect.

She ended with, “Do you have any questions?”

My burning concern about all of my upcoming treatment has been, “What will my lung capacity and lung function be after 25% is removed?” ...continue reading

Peggy_newPeggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.

 

As a member of the Busting Out dragon boat team for nine years, I made many breast cancer ‘thrivor’, friends. Most of our paddlers were living healthy ‘after cancer’ lives, but there was always the ongoing anxiety of recurrences, and too many of the women did have them.

Ten years after her original diagnosis and treatment, my very close friend, 50 year old Chris, had some symptoms, and was put through a battery of tests. Chris asked me to go with her for the follow up appointment with her Oncologist, to receive test results. With extreme gentleness and kindness, her oncologist explained some medical terms, but we both knew he meant that her breast cancer had metastasized and spread to several parts of her body. Chris wanted to be told the truth, and reluctantly the doctor said, “The rest of your life will be counted in years, not in decades,” and the three of us cried together. After living life to the fullest for two more years, Chris died at age 52, and I gave the eulogy at her funeral ...continue reading

Peggy_newPeggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

I soon discovered that, "You have highly suspicious nodules”, also means, “You will have many appointments!”

"Don’t make any travel plans for the next 3 – 6 months," said my GP as he put my name into The System. The phone began to ring - MRI, PET scan, Nuclear Medicine, biopsy - to a total of ten schedules for scans, biopsies and doctors. My calendar became peppered with appointments.

One appointment was to see a Respiratory Specialist at the Cancer Assessment Centre at the General Campus of the Ottawa Hospital. I often walk or bike past the hospital, and have visited patients from time-to-time. But it has been nearly 22 years since I was a patient there, with a broken leg. Since then, I have grown to have confidence in my health. But, there I was, on the elevator, approaching the Cancer Assessment Centre.

I was trying to be very casual and nonchalant, pretending that I was going for a coffee at Bridgehead. After all, I didn’t really have cancer; I only had a ‘suspicion’, and Denial was a very comfortable place to be! But when I exited the elevator and saw the Big Lettering, CANCER ASSESSMENT CENTRE, some confidence slipped and my nonchalant attitude wobbled. ...continue reading

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Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

In 1985, when I was diagnosed with breast cancer, the disease was private and hushed. Other than a campaign for SBE (Self Breast Exam) there was no publicity or awareness. Feeling ashamed and embarrassed, and thinking that I had somehow caused this, I kept my diagnosis secret and silent from all but a very few close friends. After my treatment, my fears and feelings were repressed and locked, and I got on with my life, my family, my career and my health.

Twelve years later, I was one of the founding members of the Busting Out dragon boat program, and suddenly I was surrounded by other survivors and the steadily growing ‘Pink Ribbon Culture’! I found kindred sisters in these women, and my deeply secreted feelings found an outlet and an expression. My silence was broken, and relief came flooding in.

This year, when I finally accepted the ‘highly suspicious for Lung Cancer' report, I realized that I would not, and could not, be secret and silent about my disease. Learning from experience, I was concerned for my mental health as much as for my physical health ...continue reading

Guest blogger, Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

So, the CT report found nodules that are ‘highly suspicious for lung cancer”. Now what am I supposed to do with that news? How am I supposed to react? How am I supposed to feel? There is no rehearsal for this, I thought. No class to take, no website to consult. I realized that I was alone in figuring out how to deal with this.

I needed several days to digest this information, to accept it, to find the courage to make it real by saying it out loud. Eventually, I was able to speak the dreaded words, to tell my two adult children. Because we are a very pragmatic family, and not given to drama, they were very calm, and declared their support. I also think, because they had been through Breast Cancer with me 29 years ago as children, there was a certain familiarity for them, and they had faith in a positive outcome.

I realized that I had to learn from them, and that the best way to handle this was to carry on with my normal life and my daily routine. In my daily life, I am a Swimmer. ...continue reading

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Guest blogger, Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

I enjoy a healthy, active life style and activities with my family and friends. In my fourteen years of retirement, I have climbed Kilimanjaro, hiked the Inca Trail and the West Coast Trail, cycled in many countries, and won medals at Provincial and National Masters’ swimming championships.

I have survived Breast Cancer, (age 41), a broken leg (age 49) and Melanoma (age 52).

On June 8, 2014, I celebrated my 70th birthday with a swim across Meech Lake in Gatineau Park, Quebec, with my daughter and friends. Five days later, June 13, I woke up with a sore throat and laryngitis. My third cancer story begins there. ...continue reading

Rich-Roberts preferredRichard Roberts is Professor and past Head of the Department of Family Medicine at the University of Wisconsin School of Medicine and Public Health. He is immediate past president of the World Organization of Family Doctors (WONCA) 2013-2016. He is a family physician and an attorney.

During my term as President of WONCA, I toured hundreds of hospitals and clinics in more than 70 countries. I never expected to be a patient in one.

In June 2012, I was excited to be attending another national conference of the Spanish Society of Family and Community Doctors (semFYC). I looked forward to reconnecting with good friends and mingling with the several thousand family doctors in attendance . My three flights from Wisconsin, USA to Bilbao, Spain were uneventful. The real excitement began as I was settling in to my hotel room.

About 7 pm, I had the sudden onset of several fleeting episodes of lightheadedness. There were no other symptoms and I felt well between episodes. With a regular rhythm and heart rate in the 60s, I concluded that I had jet lag and dehydration. I pushed fluids and rested the remainder of the first evening.

Although I felt well the next day, I was determined not to be the stereotypical physician trying to be his own doctor. I sought the advice of the semFYC President. Within moments, I was ushered to a nearby health center where my exam and electrocardiogram were normal.

The following day, I had several more episodes while touring another health center. A quick electrocardiogram revealed atrial fibrillation with a controlled ventricular response of 92 beats per minute. My rhythm converted spontaneously to sinus in a few minutes. Even so, my hosts insisted on driving me to a major teaching hospital. Their faces betrayed a mix of sincere concern and worry that an esteemed guest would die on their watch.

My memories of my experience in the Bilbao hospital remain vivid. The 4 hours I spent there seemed an eternity, and yet passed by in a flash. I remember the 40 minute registration process, for someone with an acute cardiac condition! Bureaucracies are the same everywhere. The bright ceiling lights all seemed positioned strategically to make it impossible to keep one’s eyes open while supine. These minor annoyances were much less memorable than the people who looked after me.

Mostly I remember the nurses. The emergency physician breezed by me several times, but it was the nurses who made certain that I knew that someone cared, that I was in good hands. Perhaps that is why I found myself humming the Leonard Cohen song “Sisters of Mercy.” I did so quietly, not wanting to add to the suffering of those around me.

My exam, blood tests, chest x-ray, and electrocardiogram were all normal. The hours of waiting enabled me to call my wife, my family doctor, and a cardiologist back home to inform and to seek advice. Even before I left the hospital, they made arrangements for a more extensive evaluation on my return home.

I later reflected on the miracle of modern telecommunications and on the privilege of being a physician. Mobile telephony instantly connected me across the world to those at home, where I really wanted to be. My colleagues at home made certain that my eventual treatment was swift and skillful. The paroxysmal atrial fibrillation resolved after catheter ablation. Yet, it did not feel right that the system moved faster for me than I was able to make it move for my own patients.

Writing this blog prompted me to look back on the lessons learned and on the priorities I reset for myself as I went through the first major health episode of my life. As a physician, I understood well my condition and the murky state of the science that guided therapy. I was annoyed at the interruption in my busy life and anxious about the risks and possible failure of treatment. As a patient, I assumed and received clinical competence and technical prowess. Better communication and empathy were the two qualities that were sometimes lacking.

As a result of this experience, I resolved to work harder to spend more time with my family and to listen longer, and better, to my patients. A candid self-assessment confirms that I remain a work in progress.

 

* This blog is part of a series that CMAJBlogs is publishing in the lead up to the International Conference on Physician Health #ICPH2014 to be hosted by the British Medical Association September 15-17 in London, UK

Gordon Giddings. Editorial Fellow, CMAJ.by Gordon Giddings, Editorial Fellow (2013-14), CMAJ

One of the benefits of attending conferences is in getting to share knowledge and in meeting colleagues—seeing how things are done in other places and settings. It is, however, less frequent that we have the benefit of direct patient experience at these conferences. It should not be underestimated how powerful that is.

I had the distinct pleasure of meeting Canadian classical guitar legend and multiple Juno Award winner Liona Boyd at the General Practitioner in Psychotherapy Association Annual Conference in Toronto on May 24. Liona was one of the keynote speakers and opened the morning session with a talk on focal dystonia. This was a very personal story for her as someone who had reached the heights of an internationally celebrated career, having played for England’s royal family and American presidents, and living a jet-set lifestyle in Beverly Hills. She began to notice several years back that she was having increasing difficulty in playing some of the more difficult passages on her guitar, specifically a technique called ‘tremolo’, a way to produce a sound likened to 2 or 3 guitars playing at the same time. Her fingers were not painful, but stiff, and wouldn’t seem to want to do the tasks that she had so effortlessly done over the years before.

She was subsequently diagnosed with focal dystonia, a diagnosis that she resisted for several years, as she was told that it was incurable. The implications of this for her were immense, as the guitar had defined her career, livelihood, aspects of her marriage, and in a very broad sense, her life as a whole. After struggling through several performances, she stepped down from the professional guitar stage at the level she had been performing. She moved to Miami, and after a period that she refers to as ‘la vida loca’, began looking at potential treatment options, for other ways to further her career, and ultimately to re-engage with her life.

To a large extent she has done that, by launching a singing career with multiple vocal recordings to her credit, moving back to Canada (yay!) and picking up the guitar again and giving concerts, albeit with a different technique and the assistance of a guitar partner who often accompanies her during live performances.

Liona stated during her 90-minute talk that this was the first talk (and PowerPoint presentation) that she had ever done. It was indeed a very admirable and inspirational presentation. However, her presence did bring something else—a reminder of the reasons why we travel to conferences and spend endless hours on continuing education, read numerous journal articles and immerse ourselves in rigorous research and scholarship.

The experience reminds me to immerse more fully with patients in their experience. Physicians often control what transpires during a patient visit. This may have the effect of rendering them more passive in their health care experience. It is important to remember to see patients as more than just their disease, but placing their experience in the context of their lives. Specifically looking at:

How is this illness affecting your life?

What do you think is causing it?

Why do you think that is happening?

What are you concerned that it might be?

What were you hoping we might be able to do for this?

Liona spoke of the difference for her in being seen by medical professionals who truly wanted to understand her illness experience and see how they could improve her condition. What proved most successful for her was a transdisciplinary approach that acknowledged the limitations and losses that she had experienced, but that also gave her a sense of hope and purpose. Though she still suffers from focal dystonia, she is optimistic about her diagnosis and her future. As well, myself and 100 other physicians who heard her speak that morning were enriched for it. Thank you Liona!