A HOSPITAL NAVIGATOR - MORE THAN WHERE'S THE ICU

Twitter led me to the STAT news article: 

 In a Byzantine health system, navigators help at-risk patients find their way

Interesting article with many good stories of extreme help some navigators may provide, and times they seem to go beyond business as usual.  Also a bit about widely varied training for this position (the training part was a little uncomfortable for me since I've had a social worker or two who only seemed to be working on hours for their senior year college internship.)

This field can have many different definitions, and the navigators may have wide functions.  Headlines don't always tell it all:  I haven't interviewed the local navigator, but she did introduce herself at the lumpectomy surgeon's office and invite us to some educational lunch meetings for breast cancer patients and perhaps some 'survivors' still in treatment or with issues like lymph problems after surgery.

I loved the stories about navigators helping patients with little or no English.  However, facile English speaker patients are mentioned.  We who speak English can be permanently lost in giant hospitals with lousy signage if any.

ONe danger of the system was mentioned, and it's a va.lid  one:  patients, because of the wide varieyty of navigator duties may (easily) gget the ideea that the navigator is a medical professional (often not so.)  

Even our own doctor may be unaware of our hospital's navigator, if there is one, or the navigator's duties or expertise.

I suggest, if you ask for a navigator, be clear on what you want.  If one approaches you, or the hospital sends one, we can ask politely "Is she a cancer nurse?  What will she plan to do for me?"

As I read the article, I learned a lot of things the navigators sometimes do.  

Any way, it's a good read.  And worth knowing about - Even a friend may sometime ask us about them.  

PS  My wonderful NP Carol Hennessey was a perfect navigator for me when she helped me plot which doctor visit first, second, third.  And since I still use the great cream she prescribed. 

WHAT HAPPENS IN A WAR WHEN A DOCTOR MUST SAVE THOSE WHO HATE HIM?

Sunrise Rounds brought another forgotten medical issue for this season: Please read it and tell one person about this courageous doctor and what his country has given him to fear.

Is anyone here willing to protect his family while he is protecting members of our families?

http://sunriserounds.com/an-american-muslim-physician-goes-to-war/

I wish you, doctors, and your loved ones in the service HEALTH

PHRASES EVEN MORE IMPORTANT THAN "HAPPY HOLIDAYS"

This wonderful lesson in courtesy and accuracy! was on twitter with credit to Dr. Pamela Wible, MD,  I hope she will forgive me for passing it on.

It caught my eye partly because this is a season when I remember a work friend who died by suicide. Some abuse was heaped on his memory due to that very concept ("commit") and the time (Christmas.).

The list also got me because the statement "patient is non-compliant" usually makes me want to throw something and/or scream even when the speaker is not pointing at me.


http://www.

As for health professionals, I flinch when a receptionist asks "Who's your PHP?"

And of course, Health Professional takes a couple more syllables, but my two main doctors deserve far more respect and praise than PCP.  And so do the others who take care of me.

So I"ll be watching my mouth instead of going with the slang (much as I love slang in other situations.)

I wish you health.


VISUAL FROM idealmedicalcare.org/blog

Is Prolia good news for cancer?

I was thinking of ways to get a vacation from Prolia.  I had come to it by a roundabout way - I can't take the osteoporosis pills due to a list of problems.  My oncologist offered to handle the Prolia shots. (I didn't like the bit in the Prolia leaflet about my immune system including:  "Stay away from sick people.")  Makes a person want to leave Starbucks when anyone coughs...

My tamoxifen appointment with him is Thursday (already had my mammo and bloodwork.)

Then I read on Twitter:

Lisa M Guzzardi, RN ‏@LguzzardiM  Nov 26

RANKL/RANK: From bone loss to the #prevention of #BRCA1 #breastcancer Is it possible? #HereditaryCancerNews #bcsm https://www.ncbi.nlm.nih.gov/m/pubmed/27881737/?i=5&from=brca1 …

There's a pile of pages on bone loss in my medical file - full of "In the absence of estrogen" it seems RANK/RANKL destroy not only bones that need replacement, but eagerly move onto bones we're still using.  Siccing Prolia on the RANK/RANKL was the answer...

The study covered here says RANK/RANKL also work in "formation of a lactating mammary gland in pregnancy'"  And the authors say:

 "Based on their normal physiology, RANKL/RANK control the onset of hormone-induced breast cancer through the expansion of mammary progenitor cells." 

For some reason, the abstract seemed to gloss over that or over-simplify, and I don't have the complete test. 

 The abstract concludes: "we propose that anti-RANKL therapy could be a feasible preventive strategy for women carrying BRCA1 mutations, and by extension to other women with high risk of breast cancer.

I wonder what my oncologist will say about this...

"Immune System Unleashed...can attack"

nytimes.comBy MATT RICHTELDEC. 3, 2016

"Immune System, Unleashed by Cancer Therapies, Can Attack Organs"

Read the article. Google it.   I was unnerved by the points of view.  And I urge you to follow the links.  There may be more news on this later from NYT or more encouraging news.  Or not.

The weight of the findings there may be counteracted by different findings.  Or we may be feeling cheated by science's haste.

If I were known to be dying of cancer, (instead of crossing my fingers for my yearly diagnostic mammo,) I would probably be desperate.  If I were in horrible pain, I would be very desperate.    Maybe I would wish I hadn't read this article.  Maybe I would be grateful I did read it. 

Don't we all need to start asking A LOT MORE QUESTIONS?

Continue reading the main storyShare Th

NOW WHAT WAS CRISPR AGAIN?

STAT news brings a very short and CLEAR beginners idea on CRISPR gene editing - how it works.

This video is cool.  Very well done.



https://vimeo.com/144876420 utm_content=buffer24d3c&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer.

 Love it when somebody can clarify.

When I get out of Twitter, I have to use this whole link above to get the video.

Study - ANOTHER BLOW TO TRIPLE NEGATIVE TUMORS

Some tumors can hide out and quietly repair their own DNA. "Without such repairs, the cells can become so genomically dysfunctional that they have little recourse but to die."

Drugs called PARP [or poly (ADP-ribose) polymerase] inhibitors looked like the answer.
But some tumors have been impervious to PARPs from the start.
Some tumors became immune to PARPs.

Dana-Farber scientists have been working on triple-negative breast cells using an enabler to boost PARP effectiveness.
One of these "boosters" is dinaciclib.

" with a PARP inhibitor and dinaciclib, 

tumors that previously hadn’t responded to PARP inhibitors stopped growing "

As a team, the two drug types can also work on tumors that originally had responded to PARPs, but had become resistant.

Also " the addition of dinaciclib had an especially dramatic effect: 

tumors whose growth had merely been stymied by the PARP inhibitor

 now began to durably shrink."

(Ovarian cancer is also mentioned in this article, but at the moment I don't see specific mention of Dana-Farber working with this pair of drugs on ovarian cancer.)

http://www.dana-farber.org/Newsroom/News-Releases/novel-agent-restores-breast-tumors-vulnerability-to-promising-class-of-drugs-study-find.aspx

 "as posted in Cell Reports today"

I'm way out on the diving board with this cell process - suggest you get the TW link to the article, or
When I  just Google Dana-Farber right now, I get the whole headline of release..