Over the past year we have offered some of our patients deemed appropriate for surgery a more streamlined approach to their overall care. Previously we have tried to offer chemotherapy, surgery, and radiation to all patients who were healthy and strong enough to undergo the three treatments, as mesothelioma is an aggressive cancer requiring aggressive treatment to optimize survival. This new approach still offers both surgery and radiation, but chemotherapy is given only to those found to have cancer in lymph nodes in the center of chest during surgery.
The advantages of this new treatment paradigm are ...
Since my initial LINX blog post 20 months ago, we have been engaged in a dialogue with patients from around the world who suffer from gastroesophageal reflux disease or GERD. Despite my initial trepidation to “blogging”, this has been a rewarding experience to hear about patient’s problems, their concerns about the current treatments (PPI’s and Nissen fundoplication) and simply interacting with them. I thank the patients who have taken time to share their thoughts on the blog.
When our social media manager asked me to provide an update on LINX, I realized that I have been simply responding to patient’s questions and I haven’t posted any of my thoughts or updates on what is happening with the LINX device.
There are some exciting developments for patients who are interesting in having a LINX implanted.
Use of MRI and LINX
- Torax, the company who designed and manufactures the LINX device, has received FDA support for the use of MRI with the LINX device. This conditional approval allows for patients to undergo and MRI that is 0.7 Tesla or less. I am trying to clarify with our radiologists what a 0.7 Tesla MRI will cover.
- For medicare patients, LINX now has a dedicated procedure code that allows for payment to cover the cost of the hospital portion of implanting the LINX device. The surgeon’s fee is a separate code and fee and is usually covered.
- For patients with non-medicare insurance, the ...
In the fall of 2011, Swedish opened the largest, most advanced endoscopy center in the Pacific Northwest. This state-of-the-art unit serves as the procedural space for a broad range of minimally invasive cases performed by gastroenterologists, colorectal specialists, thoracic and bariatric surgeons and pulmonologists on patients with a broad range of digestive and respiratory diseases. As we celebrated this accomplishment, we were reminded of the complexity of digestive disease and that many times, patients and possibly even referring physicians aren’t sure of what type of specialist is best suited to a particular digestive problem.
There is nothing more distressing as a health care professional than hearing patient horror stories about trying to access care. A chronic illness can cause depression and discouragement; an acute illness or a cancer diagnosis can overwhelm the patient and the patient’s family with plenty of unknowns.
To address these challenges, a group of 50+ specialists came together and created the Swedish Digestive Health Network.
The Swedish Digestive Health Network focuses on collaboration to ease the way for ...
There is nothing more satisfying for a clinician than when a patient understands their ailment, comprehends the nature of the pathology involved, and is clear on the treatment/procedure they are about to undergo. This "satisfaction" is a joyous emotion reflecting successful communication -- it is what parents feel when their children first begin to read, and what educators aspire to when their students master the material at hand.
It is a privilege to share our most recent contribution to the cardiothoracic surgery community, the TSRA Primer of Cardiothoracic Surgery...
Recovering from major surgery is an active process that typically takes 6 weeks. Surgical pain is normal and expected, but the pain experience may be different for individuals. Since pain can interfere with your ability to participate in activities to prevent complications (coughing, deep breathing, walking), treating pain is critically important for a successful surgical recovery. Many patients are afraid to take prescription narcotics or “pain killers” because they do not want to become “addicted.” However, untreated pain can lead to the development of permanent pain pathways to the brain, which can delay your recovery and possibly even result in chronic pain.
Narcotic use varies among individuals and there is a big difference between drug dependence and addiction. Dependence is when the body has become accustomed to the medication. This can occur anywhere from a couple of days to a couple of weeks after you start taking pain killers regularly, like after surgery. Addiction, however, generally implies that the medication or substance is interfering with your life in some way. You can become dependent on pain killers during your surgical recovery, but with medical management of your withdrawal from these medications, you will avoid addiction. It is important to use your prescription pain killers as directed to avoid overuse. On the other hand, you do not want to avoid using pain killers when you need them to remain comfortable and active. Stopping your pain killers “cold turkey” can be dangerous and it may cause considerable discomfort. The surgical team will work with you to develop a plan to wean you off your pain killers gradually and safely, at a time when you are ready.
The universal goal is to taper as quickly as your physical, mental and emotional status allows. Since there is ....
Dysphagia - what it is, what can be done, and why you should speak with your provider if you have trouble swallowing
Dysphagia. This is the technical medical term for difficulty swallowing which is a common complaint. Most people have experienced this sensation in their lives. It can occur when you’re eating something doughy like a bagel or French bread and then take few extra bites before swallowing. If you immediately swallow several times in a row you may get the sensation that the food is slowly passing toward your stomach. Your mouth may salivate; you might get a pressure sensation behind your breastbone; you might experience some pain, burning or discomfort. And, then you will feel instant relief the second the food you swallowed passes from the esophagus into the stomach. This is dysphagia.
For most people, this experience occurs very occasionally and usually when we are trying to eat too much, too quickly.
However, for some patients this symptom may occur more frequently such as daily and sometimes as often as every bite of food. It may also occur with solid food alone or with both solids and liquids. Most people will hope that the symptom will resolve by itself. Over time, they will often change the way they eat to avoid the symptom. They will eat slowly and chew their food till it resembles a paste, or they will use water to make things runny which then allows the food to pass.
What is interesting is that patients are reluctant to see or discuss this symptom with their physicians. In the last few months, I have seen patients who have had the symptom of dysphagia anywhere from 1 year to 40 years before they believed it was important enough to seek medical advice. The simple truth is that dysphagia that happens regularly or requires changes in the way you eat should be reported to a physician to determine the cause of the trouble.
What causes dysphagia?