A Get Well Card for Warren Buffet

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photo: jparadisi

As an oncology nurse, if I listened to the family members of an affluent, elderly patient debating at his bedside his right to receive cancer treatment, insisting he is too old, I would suspect elder abuse, and call for a social service consultation. Yet, this very scenario is occurring throughout the media in response to Warren E. Buffet’s announcement last week that he has stage I prostate cancer and will undergo eight weeks of daily radiation treatment, beginning in July.

The hullabaloo is in regards to guidelines established by the U.S. Preventive Services Task Force (USPSTF) recommending that men over age 75 not receive prostate cancer screening, aka the simple PSA blood test. 81 year-old Buffet not only received the PSA test, but when the results came back raised, he under went a prostate biopsy, which is also a no-no for a man his age per USPSTF guidelines. This is how his prostate cancer was diagnosed.  USPSTF recommendations for treating slow-growing stage I prostate cancer consist of a digital rectal exam (DRE), and PSA test every 3-6 months, with annual prostate biopsy (see link above). Mr. Buffet’s choices for cancer treatment drives at least one oncology urologist batshit. By the way, the USPSTF is the same task force that presented new mammogram guidelines in 2009, sending women’s health groups to arms.

I’m no expert on prostate cancer, hell; I don’t even have a prostate. But if I did, I would consider it my right to choose how to treat it if it were diseased, assuming I am presented with appropriate choices. There are a few things I do know: Warren Buffet is one of the good guys. An outspoken advocate of fair play, he proposed The Buffet Rule a $47 billion tax increase on the nation’s richest households, which the House voted down earlier this month. He is also one of 81 billionaires pledging to give away more than half their personal wealth to philanthropy when they die.

Do I believe Warren Buffet deserves special health care privileges because he is powerful, wealthy, and generous? No. I believe everyone has the right to their informed health care choices, and have those choices respected by their providers, families, and friends, without scrutiny. A cancer diagnosis and treatment is difficult enough without this added burden, whether the patient is unemployed, homeless, or the third richest man in the world.

A man with the power and affluence of Mr. Buffet is most likely unconcerned about the opinions of the media, and even less with mine. But for what it’s worth, Mr. Buffet, from an oncology nurse in Portland, Oregon, I wish you the best throughout your cancer treatment, and send positive thoughts for a speedy recovery.

The Rise of Blogs in Nursing Practice

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Joni Watson presents blogging’s validity as a useful tool for the professional growth of nurses in her article, The Rise of Blogs in Nursing Practice, published in the Clinical Journal of Oncology Nursing (CJON, April 2012, Vol. 16, No. 2). In the article, Watson guides nurses through integrating blog information into their practices.

Joni Watson authors the blog Nursetopia, and contributes posts for the ONS blog Re:Connect.

Joni opened her article with paragraph from a JParadisiRN post (used with permission). Citing blog posts in journal publishing indicates the growing legitimacy of the medium.

Other blogs noted in the article are Emergiblog, Nursing Center’s In the Round (Lisa Bonsall), The Nerdy Nurse, and of course, Off the Charts, the blog of the American Journal of Nursing.

Knitting for Communication This Week at TheONC

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This week, I blog about Knitting and Communication for TheONC. It’s a confessional post about lacking the right words for a friend with cancer, and finding a way to communicate through the craft of knitting. Sometimes pushing through frustration is necessary in creativity and relationships.

TheONC is an online community for oncology health care teams. Follow on Twitter @The_ONC and Like us on Facebook!

When Mondays are Sundays and Pie is for Healing

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photo: jparadisi 2012

1. One of my favorite things about being a nurse is my weird work schedule. For instance, today is Monday, but I worked the weekend. So, while many on Twitter bemoan Monday morning, I am in my jammies, drinking coffee. Outside, the steady fall of rain adds to the illusion of a leisurely Sunday morning. There’s something appealingly decadent about having time off when most people work. It almost makes up for the nights, weekends, and holidays I’ve worked the past twenty-five years.

 

Rain is the color of introspection, and grief.

2. A friend died last week. It was not unexpected, but it was a complex relationship, and there was no fairy tale ending. In an odd coincidence, earlier in the week I’d attended a book signing at a local bookstore. The author, Beth Howard, wrote Making Piece, a Memoir of Love, Loss, and Pie (Harlequin, 2012) and blogs at The World Needs More Pie.

I tried Howard’s approach to healing through pie making. I have made pies since I was twelve. As my hands worked the pastry for an apple pie after work on Saturday, I realized I make pies for holidays or birthdays, but never as an event of its own, never just for myself. David and I skipped over dinner for dessert. It was the first time I enjoyed one of my pies warm from the oven.

I do feel better. Maybe the world does need more pie.

Stains Update: Share Your Advice

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Yesterday I wrote about efforts to remove yellow Easter candy dye stains from my favorite pair of white jeans. Today I’m happy to report after four washings, heavy doses of Shout, and gentle touches of bleach, the jeans are restored to pristine status.

Had my efforts failed, however, I had a back up plan. I received this advice from a reader and pass it on to you:

Mix some laundry detergent with white vinegar and rub on stain.  Let set – like over night.

Soak the stained area in white vinegar over night.

Wash.

Do not dry.  Check stain. 

Repeat.

If you have helpful stain removing tips,  please share them in the comments. Stains of an unusual variety plague nurses regularly. We can use all the help we can get!

By the way, Visualizing Your Creative Life is my latest post included among this week’s blogs at TheONC. The suggestions are easily adapted for use by oncology patients too.

Stains

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Stains photo: jparadisi 2012

It’s a rare night that I can’t sleep. I’m trying to remove, without waking David, yellow vegetable dye stains of crumbled bits of a bunny-shaped chocolate truffle I ate yesterday, from my favorite pair of white jeans. Undergoing their third washing, they appear permanently stained. Perhaps it’s time to pronounce them, but I’m not ready to let go yet. Why is it easier to remove bloodstains from clothing than yellow Easter candy dye? Sigh.

Not a single car or pedestrian moves along the street outside. If not for David’s rhythmic breathing I might consider I was left behind after the post-apocalyptic rapture.  I’m too much of an optimist to convince myself of this, however. I remember hearing of a boy, home alone, who locked himself in a closet, fearing the rapture occurred and he’d been left behind. His parents found him crying in the closet when they came home.

The yellow dye clings to the white denim like sin; evidence of enjoying a chocolate treat (gluttony), or simple sloppiness (sloth)? I only care because I really like these jeans.

How simple is my life, that a pair of stained jeans is the topic of a post?

I wonder if any of my patients are also sleepless tonight, wrestling with pain, fear or nausea? Are they afraid of being left behind, or more afraid of what they leave behind? This thought makes me sad. I’d rather think about removing yellow candy stains from my white jeans.

Is that a sin?

New Creativity Blog Post Up at TheONC

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This week’s blog for TheONC is The Art of Subtraction: More Thoughts on Clutter. The topic is based on my experience of watching a professional sculptor make a likeness of a model’s face, by removing clay, not adding. The experience opened up my eyes to a new way of living a creative life.

I am the guest at the baby shower who always wins that game where you shove a bunch of bubble gum in your mouth, chewing and chewing until you get a big, pink glob, which you are required to mold into the shape of a baby. The best sculptor wins. Here’s my secret for winning: put a tiny butt crack in the back of the bubble gum baby; it is irresistible to the woman judging it.

Clutter Be Gone! Mental Clutter Off Switch at TheONC & AJN Releases iPad App Tomorrow

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Shutting down the mental clutter of work after your shift is over is the topic of my post for TheONC this week. Included are Ideas for creating a “mental clutter shut-off switch,” and readers are responding with their own methods too. You can follow TheONC on Twitter @The_ONC and Facebook.

Going digital cuts down on physical clutter, and I am excited the American Journal of Nursing releases its iPad app tomorrow on iTunes. Tomorrow only, April 28, the app is free!

Shift Observations: The End of The Dinosaur

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photo: jparadisi 2012

With the care of an archeologist sifting for fossils, I hold his right arm for a second time, turning it to and fro, sliding my fingers up and down searching for a vein suitable to accommodate an IV catheter.  I’ve already looked once, and now return after a fruitless search of his left arm. Decades of chronic illness, medications, and simply old age have done their work, leaving my patient with a spindly network of fragile veins shifting loosely under his skin.

“Everyone should be born with a spigot,” I think silently to myself. “Why doesn’t this patient have a port?” I know the answer without consulting his physician: he is very old, and his illness will likely overcome him. The IV infusion I will eventually administer will not save his life, only limp him along a bit longer.

Outside, cold grey clouds shower a mix of horizontal rain and snow beyond the window of the infusion clinic. An unseasonal storm threatens what promised to be an early spring.

With a slight shiver, my patient asks if I believe in a climate change so powerful it could wipe out life on Earth. Before answering, I take in the wrinkled, reptilian-like skin of his forearm, which I continue to study. Without looking up, I respond to his question, “You mean, like the Ice Age that killed the dinosaurs?” He nods.

Magically, I feel a small, but plump vein. The IV goes in slick as oil on the first stick. I can’t believe our luck. “Yeah, I believe in climate change, but this storm will not be our extinction.”