Editor’s Note: A new report today from the Institute of Medicine of the National Academies addresses improving the health of people with chronic illnesses. Karen Basen-Engquist, Ph.D. , professor in MD Anderson’s Department of Behavioral Science , is one of 17 experts nationally who co-authored the report. By Karen Basen-Engquist In fighting the war on cancer, emphasis has been placed on detecting disease early and, hopefully, curing it. Many battles have been won, and because of this we have more than 12 million Americans living today who have had a previous diagnosis of cancer.
Archive for January, 2012
By John Chattaway, MD Anderson Staff Writer Part II of Monday’s post- Short Circuit: MD Anderson Robots Provide Safety in the 21st Century “Autobots, roll out!”… and into the next lab “I am a robot.” If you’ve traveled Floor 4 of the Main Building, you may have heard those words spoken by “Tess,” the Swisslog SpeciMinder used by Laboratory Medicine to transport specimen batches between labs. The robot is on loan from Swisslog while Pathology and Laboratory Medicine determines if it’s a technology we want to invest in. Laboratory Medicine technicians have a button or “bell” they push to call Tess. The robot has a pre-programmed map of our facility that it uses, along with external sensors, to find its way to the technician. Once Tess arrives, the technician loads specimen batches into it and tells it where to go. Once Tess delivers the specimens to the required destination, if that destination has nothing to send, Tess returns to a docking station in the central specimen processing area. “Tess minimizes the need for manual transport of specimen batches between labs. This enables our lab employees to stay focused on high value and patient-oriented work,” says Lila Pulido, director, Pathology/Laboratory Medicine Operations. “It’s also fun because you can program what Tess can say. I once heard it say, ‘Sorry, I haven’t had my morning coffee,’ when it bumped into a wall.” Don’t be fooled by Tess’s simple, R2-D2-like appearance. The robot can hold up to 150 tubes of blood and a bag of microbiology specimens, or up to 50 pounds of cargo. At three feet tall and 100 pounds, Tess rolls at normal human walking speeds. Unfortunately, Tess still needs help opening doors and is contained to the Floor 4 labs while it’s being tested. But if MD Anderson decides to pursue this technology in the future, don’t be shocked to find Tess on the elevator with you, asking you to push the button for another floor. These are the droids you’re looking for While our robots don’t travel through time or space, or morph into cars, they help make our operations more efficient. So don’t go poking the nearest doctor, checking for mechanical parts. We don’t have androids working in the hospital … yet. Resources The Robots of MD Anderson (video) Related story Short Circuit: MD Anderson Robots Provide Safety in the 21st Century
My name is Deserie Johnson and I am a lung cancer survivor. I am still challenged with living with high blood pressure, high cholesterol, ankylosing spondylitis and sarcoidosis for which I take about 15 prescribed medications daily not including oral chemotherapy weekly. Friday is my chemo day (normally drained, nauseous, not feeling well) and this week of January 23-27th is my second week drinking Le Vive Red. The last two Friday’s, I have been energetic, talking nonstop about Ardyss and no nausea! This is an answered prayer and I thank Nichole Jefferson for allowing God to use her and Ardyss to give me my life back! I AM ARDYSS!
By John Chattaway, MD Anderson Staff Writer Robots. The word conjures images of science fiction characters from movies such as The Terminator, Star Wars or Transformers. But those characters actually are androids, forms of human-like artificial intelligence. Robots are machines that, when programmed or operated by a person, can perform specific tasks. At MD Anderson, we’re using them to improve the safety and efficiency of our care. “I’ll be back”… with your medication Pharmacy has been taking advantage of robot technology since 1998. The first outpatient robot was installed in the outpatient pharmacy on Floor 2 of the Main Building. Now, all three outpatient pharmacies use the ScriptPro SP 200 prescription dispensing system. Our outpatient pharmacies dispense approximately 1,300 prescriptions a day. According to Lori Bertrand, manager, Pharmacy Operations, the robots account for almost 55% of our prescription volume. The SP 200 robot can fill and label 150 prescriptions an hour. “It would be closer to 95% except that chemotherapy , narcotics and investigational drugs can’t go into the ScriptPro robot,” Bertrand says. If you walk through one of the outpatient pharmacies, you might not notice the ScriptPro robot. It looks like a big, glass bookcase attached to a file cabinet, computer and conveyer belt. But instead of books behind the glass case, there are 200 cells, each filled with a fast-moving drug. “The robot is easy to use,” Bertrand says. “When an order comes in for the ScriptPro, it uses barcodes to locate the right cell. A robotic arm holds an empty vial, while lasers are used to count and fill the appropriate dose. The robot then prints and labels the vial and delivers it, uncapped, down the conveyer belt for a technician to check.” It’s showtime for Dexter In the inpatient pharmacy on the first floor of the Main Building, you’ll find “Dexter,” the McKesson ROBOT-Rx automated medication dispensing system. Similar to the ScriptPro robot, Dexter’s job is to fill unit dose medications for inpatients. Its appearance, however, is much different. Dexter is a large, octagon-shaped room with a robotic arm in the middle. The arm can rotate 360 degrees and pull medications off the walls. “When an order comes in, Dexter uses a barcode system to locate the drug, retrieve it, label an envelope and drop the drug into the envelope,” says Phuc Dang, manager, Pharmacy Operations. “Dexter then slides the envelope down a conveyor and into a holding bin. Dexter dispenses 850 doses a day — 8% of inpatient’s non-sterile doses — and can hold about 450 line item drugs.” “Use the force!”… with just a flick of the wrists Renaissance artist Leonardo da Vinci once said, “Simplicity is the ultimate sophistication.” If he saw Intuitive Surgical’s da Vinci Surgical System, he might change his mind. The da Vinci system is a state-of-the-art surgical platform used for minimally invasive surgeries. The system comprises a surgical console that controls the robot, the patient-side unit with four robotic surgical arms, and a video tower that includes the system processors. Our surgeons use three of these mobile robots, fondly nicknamed, “Deuce,” “The Beast” and “The Twins.” Deuce and The Beast are wheeled to different operating rooms as needed, while The Twins is a dual-console system located in Operating Room 31. Here’s how the system works: A surgeon sits at the console and looks into a 3-D video display. The video feed is from a 3-D high-definition camera located on the robot. The surgeon places his or her hands into the fingertip controls, which direct the robotic arms. The controls mimic the movements of a surgeon’s wrists, while eliminating the natural tremors that occur in human hands. The feed from the camera also is displayed on the video tower screen so the entire surgical team can see what’s happening. The touch screen allows notations to be seen by the surgeon to enhance communications. “What makes The Twins’ dual-console system unique is that it allows for collaboration and teaching between surgeons,” says Nadine Turner, nurse manager, Main Operating Room Nursing. “It’s like a driver’s education car with a wheel and pedals on the passenger side. There are two consoles that can control the robot, and control can be passed between surgeons.” Surgery has been using the da Vinci Surgical System since 2006. Initially, it was used only for urologic procedures, but now it’s used for most types of surgery, excluding brain and arthroscopic surgeries. “The main benefit of using the robots is to provide a quicker recovery time for the patient because it’s more precise. So the incisions are smaller, and there’s less blood loss and trauma around the tissue,” Turner says.
By Andrew Griffith Andrew Griffith has mantle cell lymphoma and has had an auto (November 2009) and an allo (August 2011) stem cell transplant . He lives in Canada and is married with two young adult children. He blogs at www.lymphomajourney.wordpress.com and can be followed on Twitter @lymphomajourney . Most of us find it challenging to make sense of the wave of information when we enter our cancer journey. This is foreign territory, with its own language, culture and routines. It takes time to absorb and understand. We’re not oncologists or hematologists. However, we can learn to improve our discussion with our medical team. Tips to help Build your knowledge: By the time you start your treatment, you’ll likely have searched the web and read brochures on your cancer. Ask your medical team which sites have reliable and up-to-date information to avoid old and possibly discouraging information on treatment outcomes. While blogs and support forums help give a real-world view of the range of experiences, you’re an individual, and too much thinking about what happens to others, good or bad, increases worry further. Moderation! To save time, set up Google Reader for news sites, blogs and forums, and use the search function (general terms like cancer or lymphoma ) to narrow down articles of interest. Keep a notepad: At each appointment, take notes. Chemo brain or not, this is new territory and hard to master. Come with someone, either as a listener or a scribe. My wife played the first role and it helped ensure that we both heard and understood the consequences the same way. Start a binder: As you go through treatment, you’ll get more and more paper. I started a binder, organized with these categories: contact info (first page), treatment plan, test results, background information and drug information. The purpose is to have all reference material in one place, to consult and take to hospital and clinic visits. Be prepared: Prepare a list of questions for the medical team for your clinic check-ups (I found it harder during the daily hospital routine). My doctors are busy people. However, they always take time to answer my questions. If I weren’t prepared, the appointment would be limited to a brief summary of my condition. As treatment varies depending on the doctor, having detailed notes and questions helps track any changes. Given my group practice, I questioned my team about changes (scan or not to scan, when to stop immunosuppressants) — not to challenge their judgment but to ensure I understood their rationale for the change. While every patient gets good care, an empowered patient becomes a partner in treatment, one that my medical team appreciated, and may have resulted in better care. Go electronic: I started with a paper system. My second time around, I switched to an iPad (initially to have a new toy). This included the following apps (equivalents available for Android): Evernote for clinic notes and questions, as it kept everything easy to findo
Did kids or siblings call you names when you were little? Did you have stomachaches and begin to develop an eating disorder including bulimia when you were in school? Did people beat you up after school? Did you answer yes to any of these questions? If you answered yes to any of these questions, you need to know that bullying leads to children’s eating disorders or other dysfunctional behaviors. More and more children are finding they need treatment for an eating disorder who are younger than 12. Bullying is dangerous and can even lead to suicide. The internet has exposed the terrible truth about the effects of bullying. Remember, Phoebe Green, who hung herself at age 15 because of cyber bullying. Only recently have we as health care professionals begun to look at the seriousness of bullying particularly after reported teenage suicides. Does your child use the internet? If so, be alert. Know that the internet has exposed the terrible truth about the effects of bullying, severe enough to drive some kids to self-harm or suicide. Bullying effects millions of students but parents and teachers don’t understand the serious outcomes. When professionals or parents tell kids to ignore teasing, or to just get on with it, this not the kind of advice or understanding they need. What does bullying looks like? 1. Emotional or verbal abuse looks like “Fatty fatty two by four, can’t get thru the kitchen door” or Piggy, piggy! 2. “Hey Jew boy.” 3. Cyber abuse is on Facebook where everyone from your school can see it. 4. Cruel emails can be sent from anywhere. A person can be picked on by an individual or group with more power. Someone with more power may be peers, older kids, even teachers or parents. Bullies choose their victims because they look different, have a different religion, or are disabled. Bullies pick on a person simply because the person is shy or is gay or is a lesbian. We must never forget that bullying is a severe form of abuse, i.e. emotional abuse, verbal and sexual abuse. Being excluded socially is a form of abuses. Verbal bullying, cruel email, or cyber-bullying (posting insults online) are forms of abuse. Bullying like most forms of abuse is ongoing, like water dripping on a stone. The person being bullied lives in a constant state of fear. Everything in his or her life is affected. School work and health are both affected. A person being bullied can get stomach-aches, diarrhea, and headaches from the stress. Kids abused by peers or family members can suffer from depression, low-self-esteem, and anxiety occasionally or a great deal of the time. They might even consider suicide! Here are 8 tips to help you protect yourself from bullies. What advise will help if you feel bullied or know someone who is being bullied? 1. Tell someone about it, a teacher, a friend, a parent — tell anyone but tell right away. 2. Stick together with your friend who is being bullied — never leave him or her alone. 3. Learn to ignore the bully. Don’t add wood to the fire. 4. Don’t get physical (or angry) with the bully. 5. Practice feeling and looking confident. Posture is a give-away. 6. take small steps to be in charge of your life. This is where a good coach can help. 7. Talk about the bully and bullying to anyone and everyone. The more public you are, the bully will hide out. 8. Find true friends, friends that can offer you unconditional friendship. If you’re a kid, find an adult who can guide you step by step through the process of taking charge of your life. As you grow in confidence, you’ll stand taller knowing that no one will bully you again.
I am Executive President Danisha Thomas from Mitchellville MD. Prior to using Ardyss products I struggled with my skin care routine. I could never find anything to work on my blemish prone skin. Every month, during my cycle I would suffer with painful, irritated, red, and even bleeding acne. It was embarrasing and depressing. I even tried infomercial products including proactive, but nothing would work. When I started taking Levive, 3 oz in the morning of the red, and 3 oz in the evening of the green, I finally began to see a difference. When the Armida Skin Care line came out, I was reluctant, but knew I wanted to give it a shot. Since I have normal skin, I used the cleanser, rejuvenating night cream, purifying mask, and eye cream on a regular basis. That’s when my dark spots from previous breakouts started to even out, and clear up, and my skin got an even brighter glow. Once I completed my ultra body cleanse, I couldn’t believe the effect it had on my skin. Now, people always think I have foundation on. But I don’t. I have Ardyss on! In fact, I AM ARDYSS! Thank you Mrs. Armida. What would I have done without you!
By Isaac Van Sligtenhorst Isaac van Sligtenhorst is a physician-in-training in the Texas Medical Center. He blogs about his training, as well as battling cancer from the perspective of a caregiver . Read more about his approach to grief, hope and life in general at heartofalonelyhunter.blogspot.com .
I began my journey about five years ago when I had some temporary blindness. I went to the doctor and my blood counts were low, so I was sent to a hematologist oncologist. After a bone marrow biopsy, I was diagnosed with myelodysplastic syndrome (MDS). Once I got my diagnosis, I went straight to MD Anderson. My doctor at MD Anderson was Guillermo Garcia-Manero, M.D., in the Department of Leukemia. I can’t say enough good things about this man. From my first appointment with him, I knew he was the best doctor in the world. It turns out he’s considered the leading authority in the world on my disease. I never doubted him, did everything he told me to do and constantly sought his advice. When my MDS became more vicious and progressive last spring, I became transfusion dependent and my quality of life was deteriorating, he decided it was transplant time. It was now riskier not to have the transplant than to wait. He also told me that after the transplant and when I no longer had MDS, he would no longer be my doctor. I cried.
Ardyss begins the year delivering big checks. On Saturday January 21st we welcomed our new Platinums Presidents Pattian & Michael Bartley and Bernardette Selby to the city of Las Vegas who received directly from the hands of our founders Antonio Diaz de Leon and his wife Armida Diaz de Leon Fonseca their amazing checks for the month of January . Our Platinums pledged to continue working hard to continue to reap 6 figure checks and get their teams to reach the top!
