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When you’re not feeling well, sometimes it’s hard to know where to turn. As the Nurse Navigator with Swedish Digestive Health Network, I get these calls every day. Below are a few tips to help you advocate for yourself if you are not feeling well. (Remember to first and foremost get established with a primary care doctor before you become ill!)
1. If you’re not feeling well:
There have been some very exciting recent developments we (the Thoracic Surgery team at Swedish Cancer Institute) are utilizing in the treatment of malignant pleural mesothelioma (MPM).
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.
I have noticed this year that many patients with significant structural anatomic problems will improve or resolve their symptoms without surgery after engaging in a self-directed structured approach. It appears that as the nervous system calms down that the pain threshold rises.
Surgical decision-making
The barometer I use before I help patients make the final decision about whether to have surgery is whether they are sleeping well and their anxiety levels have dropped under a 5 on a scale of 10. My experience with performing surgery on a patient with a “fired up” nervous system has consistently been less than satisfactory. Pain control is difficult and even the longer-term results are marginal. There is often still a significant amount of residual pain.
Robots? Surgery?
The da Vinci® Surgical System is not an R2-D2™ or C-3PO™ robot. It is technology that helps surgeons perform delicate operations. Robotic surgery got its name because the surgeon does not directly hold the surgical instruments.
Robotic surgery is minimally invasive. It allows a surgeon to operate through several tiny incisions, rather than one large incision.
“Robotic surgery instruments are flexible. They mimic the surgeon’s hands and wrists,” says Julie LaCombe, M.D., a surgeon with Athena Urology and Urogynecology who performs robotic surgery at Swedish/Issaquah. “After we place the instruments in the body, we control their movements from the console. We can be very precise because we have a 3-D view inside the body.”
There is nothing more satisfying for a clinician than when a patient understands their ailment, comprehends the nature of the surgical 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. This Primer is an integrated multimedia educational resource produced by residents, for residents, illustrating the fundamental concepts a new learner needs to become familiar with upon entering the arena of cardiothoracic surgery. It is a “primer,” and as such is tailored to the student in the neophyte stage of learning.
SEATTLE – On Saturday, April 13, 2013 an incident occurred involving a woman wearing a scrub top, who posed as an employee and entered two patient rooms on different clinical floors at Swedish/First Hill (747 Broadway, Seattle) and attempted to alter Patient-Controlled Analgesia pumps to obtain pain medication.