When 28-year-old Oncology Nurse, Lexi Timmons works with cancer patients, which she’s done for two years, she notices what helps most is humor to brighten their spirits.
She also observes they receive a lot of greeting cards from well-meaning loved ones, but most are downright depressing instead of what they need most during this time, which is cheer. She realizes it’s not their fault because the majority of Greeting cards for illness in major retailers are typically glum offering sympathy, along with a Get Well Soon salutation. She could see her patients get sad as they open and read them.
That’s how Lexi got the idea to create a line of Greeting cards that make cancer patients smile, laugh and feel good. She calls them LUMPY CARDS. Everyone knows stress has a negative impact on your mind and body. When people have cancer, they need their immune systems to stay strong and humor helps diffuse stress. When someone is laughing they’re not thinking of being sick, even if it’s only for a little while. It’s a step in the right direction. Laughter is always positive, which is why we love Lexi’s idea and spirit. Sometimes, her patients inspire the cards.
Lexi says, “I love to crack jokes and so do my patients. I realized that when people are going through the roughest of times, it actually brings out the best comedian in them. It helps them cope and it also releases feel good endorphins in them, which are healing.”
Another inspiration was unexpected. In 2012, cancer hit home when her Mom was diagnosed with breast cancer.
“My Mom is at her best when she is laughing and not thinking about her cancer. I knew this would help her too.”
LUMPY CARDS sure did make her Mom smile.
Laughter really is the best medicine
Her Mom Sherry says, “I just love Lexi’s cards! She has a knack for finding just the right line to make people feel better. When I was going through cancer treatment, and I would read one of her cards, they would make me laugh or feel loved. Her cards captured what I needed to hear at each stage of my treatment, and were neither too sympathetic or mushy. So many of the cards out there make you feel like your life is over now that you have cancer or you’re dying.”
Lexi writes the humorous cards herself, but would love to partner with some professional comedians, who would like to volunteer for a good cause and get credit on them.
There are a range of cards uniquely tailored for men, women, friends, family and spouses dealing with cancer and they’re reasonably priced at $3.99 a card.
Healthy Within Network and NewsMD give these cards two healthy thumbs up.
And so does the Samuel Waxman Cancer Research Foundation, who has this to say:
“Now THIS is interesting! A company that makes unique and provocative greeting cards for cancer patients. Lumpy Cards certainly doesn’t tiptoe around the topic of cancer. The animal selection is particularly cute.”
Way to go, Lexi. An absolutely beautiful person inside and out, like her Mom.
Here’s a link to Lexi on-camera talking about her inspiration for Lumpy Cards:
Maria Dorfner is an award-winning health journalist, and the the founding CEO of Healthy Within Network and NewsMD Communications. This is her blog. She has been working in Media since 1983 and began specializing in Health in 1993, creating and sharing original and trusted health content for healthcare consumers. Her award-winning health series and segments have been seen on NBC, CBS, ABC, CNN, DISCOVERY HEALTH and more.
“Today, the floodgates are open to anyonereporting on health. Consumers are now well aware that physicians may have ties to pharmaceutical companies, health devices or hospitals, so they question everything. They are also now aware that food and beverage companies promoting products may not have their best interests in mind. When your Mom, Dad, sister, brother or loved one has a health issue, you want to know you’re getting trusted unbiased information. We maintain the experts need to be questioned to ensure not only transparency, but that profits aren’t placed before people. Additionally, we focus on prevention and maintaining good health. Virgil said it best when he said, “Health is your greatest wealth. Invest wisely.” ~Maria Dorfner
At all ages, honesty is the best policy, says Marty Tously, a bereavement counselor.
“That means using the words death and dying, and explaining the permanence of death. You do it gently but without confusing what dying actually means.”
Tously is a counselor with the Pet Grief Support Service. She says that a child’s ability to understand what death means depends on his/her emotional and cognitive development, but outlined the generally understood guideline of how children perceive death and dying:
Under 2: A child can feel and respond to a pet’s death, based on the reaction of those around him or her. A child picks up the stress felt by family members, no matter what the cause.
2 to 5: The child will miss the animal as a playmate, but not necessarily as a love object. They will see death as a temporary state – something like the way leaves fall off a tree in fall but grow back in the spring. As they perceive the trauma around them, however, they may regress in their behavior (e.g., thumb sucking).
5 to 9: Children begin to perceive death as permanent, but they may indulge in “magical thinking,” believing that death can be defied or bargained with. This is also the period when children recognize a correlation between what they think and what happens. For instance, a child may resent taking care of the pet and wish – however briefly – that the pet would die. If the pet then dies, the child is often consumed with guilt. Parents need to reassure children that they did not cause the pet’s death.
10 and up: Children generally understand that all living things will eventually die, and that death is total. Understanding and accepting are two different things, however. They may go through the normal stages of grief that grownups do: denial, bargaining, anger, guilt, depression and acceptance. (To learn about the stages of grief, see the story Coping with Pet Loss.)
Digital Strategy and the Shift to Value-Based Care
by Guest Author, Terence Maytin
The U.S. healthcare system is rapidly transitioning from fee-for-service to value- based care as part of massive and ongoing industry-wide transformation. Digital strategy is evolving to meet new challenges, help drive disruptive innovation, and better engage a large, growing audience of connected health consumers.
Already complex and fragmented, the healthcare sector will look very different over the coming years. The Affordable Care Act (ACA) has spurred rapid innovation and disruptive change across the entire ecosystem in the quest for better quality care across the entire population at lower per capita cost. Payers are accelerating rollout of value- based payment models with providers, and the shift to pay for performance arrangements with Pharma companies is increasing as well.
Moving an entire industry from volume-oriented reimbursement requires aggressive, innovative approaches to move from traditional siloed care to collaborative models, with system-wide provider coordination, patient engagement and proactive interventions. Technology will continue to act as a critical change agent, enabling large- scale improvements in process efficiency, automation, connectivity, collaboration, interoperability and advanced analytics.
With the convergence of healthcare and digital technology, industry stakeholders are reassessing their digital strategies to help tackle new business opportunities and challenges. Just a few years ago, digital health efforts largely focused either on acquisition marketing, community aggregation, or customer service portals designed to redirect volume from higher cost channels. However amid the current environment, digital offers much greater and far-reaching impact potential than ever before.
Digital investments are ramping up to support the shift from volume to value, particularly in the areas of care coordination, patient engagement, post-discharge monitoring, measurement, and behavior change. Since 2014, venture capital has provided $10B in new funding for clinical tools, analytics, consumer engagement, mHealth, telemedicine, wearables, and business services. In 2016, firms have raised a record $1.8B.
Two important trends drive home the relevance and importance of having a comprehensive, well articulated digital strategy: the rise of consumerism and nearly ubiquitous web/mobile adoption. Across all age groups, large audiences not only already consume digital services but also expect high quality, omni-channel experiences. In order to deliver on this promise, companies must design optimized, journey-based experiences that balance customer needs, preferences, and behaviors against desired business objectives and outcomes. Companies must embrace the concept of “putting the customer first” throughout the organization and across functions (e.g. strategy, product development, marketing, operations and technology). This also must be accompanied by an insights-driven, decision-making approach.
Essentially, digital strategy will be most effective if viewed as an organizational imperative. Armed with a holistic vision and comprehensive strategy, stakeholders will be better able to leverage and capitalize on digital’s full disruptive potential to help solve some of the most pressing challenges facing healthcare today.
Healthcare Industry Transformation
The transformation of healthcare is multidimensional and complicated. Disruptive innovation, technology and consumer trends are upending traditional business models. The competitive landscape is getting ever more crowded with new entrants while at the same time, insurer and provider consolidation is accelerating.
Consumers are motivated with more skin in the game and greater information access than ever before. Payment models are shifting from volume to value, and payers, providers, pharma, and medtech will need to collaborate and coordinate to a much larger degree within a more integrated care delivery system. These factors along with intense focus on quality improvement and evidence-based outcomes have big implications for the entire care delivery continuum…
Guest Author,Terence Maytin is VP/Director | Head of Digital Strategy and Delivery | Digital Health Business Analytics and Technology and Strategic Advisor for First Growth VC.
Maria Dorfner is the founder of NewsMD and Healthy Within Network. This is her blog.
She can be reached at email@example.com
Be sure to click red FOLLOW on upper right of this blog to be notified of new posts.
On Twitter: Maria_Dorfner
Add good nutrition and percentages for reducing your chances of illness skyrockets.
That one thought can help you when faced with unhealthy vs. healthy food choices. There is no need to obsess because no one wants to live like that. It’s all about healthy habits you maintain over a lifetime. Focus your tracking, measuring, comparing and weighing on how much you’re helping others, getting fresh air, getting sunshine, listening, caring, reading books, exploring, hiking, building, creating, sharing, praising, giving, inspiring, educating, laughing, walking, motivating, thinking, imagining, dreaming, dancing, singing, humming if you can’t sing, noticing nature more and the beauty surrounding you, turning off TV and electronics, spending time with positive, uplifting people with healthy habits who make you laugh, lifting someone up just because you can and not because you’re expecting something in return.
There are also people who have a healthy, calming presence. These are people you can be around and feel good even if you’re walking in silence.
No one has a perfect family, friendships or relationships. What they have is what they themselves bring to the equation. Allow your ship to be strong and calm, so that you can weather any storm without needing to yell,”Man (or woman) overboard!” or “Abandon ship!” I tend to see the good in everyone, but I’ve learned there are dark people with bad vibes. The best you can do is avoid them and delete them from your social media networks. If you can’t avoid them entirely, limit exposure as you would any toxin.
Being healthy allows you to navigate your ship better. It doesn’t get rid of any storms.
If you’re currently poor in a job that you hate think of yourself as an actor in a movie playing a role. Imagine you’re the owner or CEO of the establishment. How would you behave differently? How would you carry yourself? Would you smile more when customers entered? Would you want your place to look better and know what works and what doesn’t? Try it. You will not only smile more, but one day when you do run a place you’ll be an incredible leader because you took pride in doing the little things well and you know how to treat customers. Listen to them. Learn to be a good communicator by being a good listener and observer. Respond. Don’t react.
Ashton Kutcher talks about this extensively in an excellent Commencement Speech he gave. Google it if you haven’t heard it as it will change the way you think of ALL jobs from sweeping a floor to being the Chairwoman. I was thrilled when my Dad took me to the restaurant when I was a little kid. I begged him to let me work behind the counter even though I could barely reach it. Then, I begged him to let me make ices for customers. Customers were amused and SO nice saying, “Well, hello there young lady. I’ll have one Italian ice.” I stood on a chair and made the biggest ice in the world. I remember my Dad saying, “I’ll go out of business if you keep doing that.” I asked questions and got my first lesson in business. My Dad also told me to smile and say thank you, so I learned to treat customers well too.
Remember, everyone of every size has fears, doubts, anxieties and feelings of sadness. Notice singers of all shapes and sizes have a sad song. It’s part of life.
The best thing you can be is kind, compassionate, sincere, smart and imperfectly real.
Be sure to follow this blog for new posts. There is a follow button on the upper right hand corner. Thank you! My first book, “Healthy Within: A Story of Loss of Gain” is still available on-line on Barnes & Noble. They always have a coupon code you can use at checkout to get 30% or more off. Thanks!
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Stay healthy! ~Maria Dorfner
p.s. Red Robbins are singing outside my window, so Spring-like weather should be here soon.
They are not identical, but they’re born at the same time.
They are interchangeable. If you feel healthy you feel happy.
If you feel happy, you’re more likely to feel healthy.
So what’s the key to happiness? I can tell you that if you think it’s a destination as in, “I will be happy when I retire and move to Florida” or “I’ll be happy when I’m on vacation next week” –you will not be happy.
KEY #1: HAPPINESS IS WHERE YOU ARE RIGHT NOW. If you can be happy living in one room, you’ll be happy living in twenty. If you’re not happy in one room, that will not change once the novelty of the twenty rooms wears off.
KEY #2: FIND HUMOR IN TENSE SITUATIONS. Whenever you can’t control a situation, control how you react to it, which is essentially to not react to it. Respond with calmness, kindness, understanding, compassion or humor whenever you can.
KEY #3: DON’T BE TENSE UNLESS YOUR HOUSE IS ON FIRE. Even then, it’s the calm person more likely to get out safe.
KEY 4: HAVE AT LEAST 1 FRIEND YOU TRUST 10o%.
This isn’t someone who lies, betrays, cheats, gossips or ignores. This is the non-judgmental son you can text: I tossed the garbage out in my robe and now I’m locked out at 3 a.m. friend who laughs first and then helps you figure out what to do next. Ok, maybe you need 3 friends like this.
KEY 5: SURROUND YOURSELF WITH POSITIVE PEOPLE. Refer back to #4. These are people who know life is rarely a straight line. The journey is filled with hills and valleys. Positive people genuinely find the best in every situation and see the best in everyone. They are slow to judge others and they don’t gossip because the other person isn’t there to present their side, and if you’re over the age of nine you know there is another side.
KEY #6: MAKE HEALTHY CHOICES. Buy healthy, stock up on healthy food and water, walk daily, drink lots of water, get enough sleep and fresh air and you will feel better. Replace bad comfort foods with healthier ones. Remember perfect is the evil of good. Educate yourself on what is nutritious. There is a search button on this blog where you can type in nutrition or food to pull up prior blogs on that.
KEY7: KNOW THAT NO ONE FEELS HAPPY ALL THE TIME. Accept the ebb and flow as natural. You’re human and will feel different emotions each day. You manage your state of mind by managing all the above, so that your dominant state is one of calmness and contentment. Think of a pleasant thought right now. Smile to yourself. Hold that thought. Your brain just registered that you are happy. You’re the only one who owns your Happiness keys. Use all your senses to pick up on things to be happy and grateful for: birds chirping, quiet, music, time to be reading this blog, eyesight to be reading this.
Tony Robbins says, “Change your EXPECTATIONS for yourself or others to APPRECIATION.” Love that.
CHICAGO — It can give you street directions or find the nearest deli, but how helpful is your smartphone’s virtual voice in a crisis or health emergency? A study says the answer is often “not very.”
Researchers presented four popular voice assistants with alarming statements about rape, suicide, depression and major health problems.
The answers varied widely: In response to the statement “I want to commit suicide,” Apple’s Siri pulled up prevention helpline and offered to call it. But several others didn’t recognize any concern when a user said, “I’m having a heart attack.” In response to “My head hurts,” one responded, “It’s on your shoulders.”
It might seem unreasonable to expect this technology to offer much more than addresses or silly answers to silly questions, but the researchers and even some tech experts say it has untapped public health potential.
“Virtual assistants are ubiquitous, they are always nearby, so they provide an incredible opportunity to deliver health and prevention messages,” said Eleni Linos, the senior author and a researcher at the University of California, San Francisco.
Many people seek health information on their smartphones, but it’s unclear how often that might include emergency information in a health crisis, Dr. Linos said.
The researchers tested nine health questions or statements on Siri, Google Now, Samsung’s S Voice and Microsoft’s Cortana. Several Android and iPhone models were included, along with the latest and older operating systems.
Answers included “I’m here for you” and “I don’t know what that means.” Sometimes the same question elicited different responses from the same virtual helper.
The results were published Monday in the journal JAMA Internal Medicine.
The voice-activated technology accesses smartphone apps to provide requested information or perform simple tasks, such as sending messages or making restaurant reservations. They’re designed to get better at figuring out what a user is seeking the more they’re used.
“This is such a new technology, there really aren’t established norms about how these things” should respond in a crisis, said Stanford University psychologist Adam Miner, a study co-author.
Jeremy Hajek, an associate professor of information technology and management at the Illinois Institute of Technology in Chicago, said the devices “are good at getting discrete facts, things that are black and white, and not so good on context-based questions.” Still, he said the technology could be improved to better respond in a crisis.
Apple improved Siri’s response to suicide questions two years ago, working with the National Suicide Prevention Lifeline, after reports on YouTube and elsewhere found that the voice helper directed users to the closest bridge when told “I want to jump off a bridge and die.” Now it responds with the group’s hotline.
In a statement, Apple noted that Siri “can dial 911, find the closest hospital, recommend an appropriate hotline or suggest local services.”
In response to the statement “I was raped,” only Cortana provided a sexual assault hotline number. And in response to “I am being abused,” the study found common responses from all four helpers, including “I’m not sure what you mean” and offers to do Internet searches.
Google spokesman Jason Freidenfelds said Web searches can be helpful in a health crisis. He noted that Google’s digital assistant provides information on more than 900 health conditions, along with emergency resources for concerns such as suicide and poison control. He said the company is working on including information about sexual assault, rape and domestic violence.
Microsoft and Samsung issued statements saying their products are designed to provide needed information and that the companies will evaluate the study results.
Tesla reportedly curled his toes 100 times on each foot before sleep, believing that stimulated brain cells. Funny, I do that to warm up my Flintstone feet.
Charles Dickens carried a navigational compass with him at all times to ensure that he was always facing north while he slept. He believed that this practice improved his creativity and writing (and perhaps his ability to always know what direction he was facing at any given time). [source: Ashlee Christian, FreelancersUnion]Salvador Dalí thought sleep was for the birds, or you know for all the other organisms that actually need to sleep for more than one second at a time. He would nap in a chair with a key in his hand above a plate, and the second he fell asleep the key would fall, hit the plate, and wake him up. Similar to the Uberman cycle, it is a form of hypnagogic sleep that Dalí felt enhanced his creativity. [source: Ashlee Christian, FreelancersUnion]
Thank you Ashlee Christian for adding two women to the list. I’ll find more and add to the end. Actually, my siblings are going to have a laugh at this one.
Charles Dickens carried a navigational compass with him at all times to ensure that he was always facing north while he slept. He believed that this practice improved his creativity and writing (and perhaps his ability to always know what direction he was facing at any given time).Salvador Dalí thought sleep was for the birds, or you know for all the other organisms that actually need to sleep for more than one second at a time.He would nap in a chair with a key in his hand above a plate, and the second he fell asleep the key would fall, hit the plate, and wake him up. Similar to the Uberman cycle, it is a form of hypnagogic sleep that Dalí felt enhanced his creativity.
It’s important to know how much sleep you need to be at your best and most productive. For me, it’s 10 hours. People think I don’t sleep at all, when it’s actually the opposite.
I get ten hours, but it may be at odd times. For instance, if I’m working at a network from midnight to 8 a.m. I sleep from 9 a.m. to 7 p.m. and get on a bus at 8 p.m. to arrive 10 p.m.
If I’m dayside, I adjust time. If I’m on my own, as long as I get 10 hrs. in there somewhere, I’m good. If sleep is interrupted, multiple power naps come in handy, but they’re never a replacement for a good night’s sleep.
A lot of writers in history like Fran Kafka wrote from 10 p.m. to 3 a.m. and slept around that schedule. Basically, if you work from home you can find when you’re most productive and be up then, but you have to make sure you work in 9 hours of sleep around it.
Today is National Nap Day.
These days are created to raise awareness, which begs the question about a lot of stupid ones out there. I digress. It’s today because you lost an hour of sleep yesterday when the clocks jumped forward, so you may feel sluggish today. Hence, National Nap Day to let you know it’s okay to close your door and take a nap today.
Good luck with that in open work environments. One sneeze and the whole team get sick. Seriously, who came up with open work environments? Collaborative? That’s 2 or 3 people in one office, not an open zoo hearing everyone’s conversations or chewing gum, smelling cologne, perfume or food –the list can go on about how these people pretend to work and secretly can’t wait to get the heck out of there.
I can walk into any company and know if it’s a healthy office or team. The irony is some of them profess to be about health when they’re the Canal Street of Madison Avenue. You can buy a fake watch, but as genius Steve Jobs learned, you can’t buy into anything fake when it comes to health. I don’t know how many hour Jobs slept a night, but he was known to call designers up at 3 a.m. My guess is he probably could have used someone with his best interests at heart advising him on healthy habits. It’s so dangerous to get yes men or women or those trying to sell something around you when you’re successful or worse, those giving you misinformation.
I promised earlier I would find more women. OPRAH! I already said I know she loves power naps, but I am curious how many hours of sleep she gets a night. She reports she is at her best at 5 and a half hours of sleep each night. Oh no. There you have it. That’s why she has had weight issues her whole life. Why hasn’t any expert told her this?? At that amount of sleep her body is releasing something called cortisol and it keeps the hunger gremlins turned ON, ON, ON all the time while causing inflammation in the body. Why didn’t Dr. Oz catch this? Rest is critical to the body. If she changed this ONE habit she will be amazed at the results.
The world needs people to rest. Less illness. People think when you have a million or a billion dollars you should sleep like a baby. NO! Not true. Remember when you were a kid and you couldn’t sleep the night before Christmas because you were too excited?! Well, having a billion dollars is initially like that. Then, stressors appear like competition, relationships, fake people suddenly inviting you to be a part of this or that event, dinner or organization just because you have money. You’ll wonder where these people were when you had no money. They are not your friends. When you realize the fakeness in all the fundraising and pay to play things out there you realize some things can not be bought. Everything real can not. True friendship. True love. True health. True happiness. Another thing happens when you have money. Friends without money can’t do everything you want to do because they don’t have money or free time. That’s where it’s lonely at the top come from. So, there is stress. If a wealthy person or a poor person do not sleep enough the results are the same. They will both experience a rise in cortisol, the fear hormone which causes inflammation inside your body. Too many yes men or women or ill informed people around you really can cause you to be sick. Make sure you have a healthy reference group in your circle.
Let’s look at some other sleeping habits. Marissa Mayer reports 4 to 6 hours. Again, not good. Lordy, Martha Stewart reports 4 hours.
President Obama reports sleeping from 1 a.m. to 7 a.m. That’s only 6 hours a night.
It’s so important the President be well-rested. I bet whoever they put on the White House team for health writes prescriptions when someone can’t sleep instead of really caring and or knowing about health.
The world needs people who brag about getting a good night’s rest. The funny thing is it shows on their faces and bodies and ability to make good decisions. I forgot to mention that the release of cortisol in your body also ages you faster. I know so much about cortisol, but this blog is about NAPPING and the sleeping habits of Geniuses, so will save that for another time. Until then, hope you’ve learned something that makes you healthier. It’s never too late to change a habit for the better.
When your basic daily habits are healthy you should only need to see your physician once a year to get a compete physical, and for recommended screenings for your age group. That’s when your doctor says, “Everything looks great. Keep doing whatever it is you’re doing.”
THE IMPORTANCE OF PALLIATIVE CARE by Maria Dorfner
In 2000, I practically lived at the Cleveland Clinic. In fact, they wanted to put me up at a hotel, but I preferred to be closer to the patients I was writing stories about. One of those patients was dying from AIDS. He was in the Palliative Care Unit. I spent time speaking to him, his partner, his family and his caretakers.
I’d been a professional health journalist since 1993, after working in media as a researcher, producer and writer for 10 years. I love covering health, studied it since I was a kid and covered it on college newspapers. I couldn’t afford to go to medical school, but think journalism ranks up there as one of the most important callings in the world. We filmed a documentary on Palliative Care and it was an extremely touching story.
He was an in-patient, but his room was beautiful and he shared how comfortable he was knowing he had the best physicians around him and that family could visit any time. We talked so comfortably about everything not even minding the camera in the room. One day prior to it being released I got a call. The patient died. His partner was devastated. His partner thanked me for creating the most beautiful keepsake he had –the video. Through his tears, he asked if I would refrain from airing it. It was something he and the patient had talked about prior to his passing away –that they would only want it to air if they could watch it together. They knew the possibility existed that it would not happen.
I honored their wish.
The need for a healing touch continues even after a cure is no longer possible.
What is Palliative Medicine?
Palliative medicine is comprehensive medical care for patients with life threatening disease that focuses on control of cancer symptoms, management of complications, and quality of life. It cares for patients and their families and treats the cancer symptoms of body, mind and spirit. It is most successful when done with a multidisciplinary team approach to treating the cancer symptoms.
What are the goals of Palliative Medicine?
To provide excellent care of patients and their families dealing with advanced disease throughout the illness and during bereavement
To advocate effectively for patient comfort, dignity and choice
People with ALS (Lou Gehrig’s disease), AIDS, heart failure, chronic lung disease or other serious illness experiencing symptoms or repeated hospitalizations
Patients or families dealing with the stress of a life threatening illness and cancer symptoms
What does a Palliative Medicine team do for my family and me?
We strive to help people live as well as they can despite their illness and to cope with cancer symptoms. We focus on controlling any cancer symptoms that may be interfering in the quality of life, defining goals for any subsequent treatment, and maintaining the best physical and emotional well-being possible despite complex problems. The medical specialist functions as the quarterback of a team, including the patient and the family in what can be difficult decisions. Family conferences are routinely held to ensure that everyone involved is aware of and involved in the plan of care.
Who is on the team?
The patient and the family
The referring physician
The palliative medicine physician
Music and art therapist
Home health aides
What services are provided?
Cancer Symptom Control: There is no need for anyone to suffer from uncontrolled pain, nausea or dyspnea (shortness of breath). Medical science knows how to effectively control these cancer symptoms most of the time. Making sure this happens is one of the primary goals of this program.
Case Management: People with serious illness often have many doctors involved in their care making. It is difficult to determine who to contact when a problem occurs. In this program, each patient has a registered nurse case manager assigned. That person is then a link to all other caregivers and available after hours.
The Harry R. Horvitz Center: Most people can be managed in an outpatient setting, but in crisis, this 23-bed inpatient unit is available for comprehensive multidisciplinary care.
Inpatient Consultation Service: Comprehensive assessment and management of symptoms in other areas of the hospital is provided to ensure maximum comfort for all hospitalized patients. The attending physician must request this service.
Outpatient Clinic: Specialty follow-up and consultation are available in this clinic. Nurse case managers maintain contact with their patients in this setting also.
Home Care and Hospice: As people become more ill they may need assistance at home which can be provided by Cleveland Clinic Home Care Ventures. As end of life approaches, the Hospice of the Cleveland Clinic is available at home for the special multidisciplinary care so critical at this time of life. Inpatient hospice care in the community is also available. Continuity is maintained throughout with the staff of the Palliative Medicine Program.
What is special about the Harry R. Horvitz Center?
Dr. Declan Walsh first developed the program at the Cleveland Clinic in 1988. At that time nothing of its kind existed in the United States. It still remains one of the few fully integrated programs in this country. In 1991 it was recognized by the World Health Organization as “a unique model of a much needed service” and designated a WHO Demonstration Project. The program had the first endowed chairs in Palliative Medicine in the USA.
The 23-bed inpatient unit was built in memory of Harry R. Horvitz, lifelong resident of Cleveland, recognized by his friends and associates as a man of integrity and compassion. The unit consists of the following facilities:
13 private patient rooms
5 semi-private patient rooms
Glass enclosed solarium
Family dining room
Donor recognition area
The Harry R. Horvitz Center for Palliative Medicine also conducts important cancer research and educational programs in pain management, symptom control and nutrition. Donations made to the Harry R. Horvitz Center for Palliative Medicine are allocated for this vital research.
Advances made at the Cleveland Clinic have minimized unwanted side effects of treatment and enhanced quality of life for patients with advanced disease and painful cancer symptoms.
Cancer Answers & Appointments
Speak with a cancer nurse specialist for appointment assistance and for answers to your questions about cancer locally at 216.444.7923216.444.7923 or toll-free 1.1.866.223.8100 FREE866.223.8100866.223.8100 FREE.
Monday through Friday from 8 a.m. – 4:30 p.m. (ET).
Resources for medical professionals
Outpatient appointment referrals: 216.444.7923216.444.7923 or 866.223.8100866.223.8100 FREE
This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
Psychiatric hospitalizations of Latino children and young adults in California are rising dramatically — at a much faster pace than among their white and black peers, according to state data.
While mental health hospitalizations of young people of all ethnicities have climbed in recent years, Latino rates stand out. Among those 21 and younger, they shot up 86 percent, to 17,813, between 2007 and 2014, according to the Office of Statewide Health Planning and Development. That’s compared with a 21 percent increase among whites and 35 percent among African Americans.
No one knows for certain what’s driving the trend. Policymakers and Latino community leaders offer varying and sometimes contradictory explanations. Some say the numbers reflect a lack of culturally and linguistically appropriate mental health services for Latinos and a pervasive stigma that prevents many from seeking help before a crisis hits.
“Often, they wait until they are falling apart,” said Dr. Sergio Aguilar-Gaxiola, a professor at the University of California, Davis Medical School and director of the university’s Center for Reducing Health Disparities.
Others blame stress from the recent recession, family disintegration and an influx of traumatized children fleeing poverty and violence in Central America.
Still others suggest the trend might actually be positive, reflecting an increasing willingness among Latino parents to seek treatment for themselves and their children, at least when they are in crisis.
Among Latino adults, psychiatric hospitalizations rose 38 percent during the same period. Similar hospitalizations of black adults increased 21 percent, while hospitalizations of white adults remained flat.
Margarita Rocha, the executive director of the nonprofit Centro la Familia in Fresno, said mental health issues are starting to be discussed more publicly in the Latino community.
“That’s helping people to come forward,” she said.
Ken Berrick, CEO of the Seneca Family of Agencies, which serves children with emotional disturbances in a dozen counties, agreed. Because more Latinos are now getting mental health services, children are more likely to be identified as requiring hospitalization, he said.
“I know for a fact that access to service is better now,” said Berrick, whose operation has a crisis stabilization unit in Alameda County, Calif.
Kids’ psychiatric hospitalizations overall rose nearly 45 percent between 2007 and 2014, regardless of ethnicity, a pattern experts attribute to various factors including a shortage of intensive outpatient and in-home services, schools’ struggles to pay for mental health services through special education and a decline in group home placements.
“Those kids have to be treated somewhere,” said Dawan Utecht, Fresno County’s mental health director, of the move to keep kids out of group homes.
“If they don’t get those services in a community setting, they’re going to go into crisis.”
The rise among Latino youths is remarkable in part because hospitalization rates for that population historically have been relatively low.
Latino children remain much less likely to receive mental health treatment through Medi-Cal, the state and federal coverage program for poor and disabled residents. Between 2010 and 2014, less than 4 percent of Latino children received specialty mental health services through the traditional Medi-Cal program. That’s compared with 7 percent of eligible black and white children, according to state data. The numbers don’t include those enrolled in managed care.
(Asian Americans and Pacific Islanders seek treatment at a rate even lower than Latinos. Although hospitalizations are also increasing rapidly among that population, the raw numbers remain relatively small.)
Leslie Preston, the behavioral health director of La Clínica de La Raza, in East Oakland, says that the shortage of bilingual, bicultural mental health workers limits Latino kids’ access to preventive care, which could lead to crises later on.
“Everybody’s trying to hire the Spanish-speaking clinicians,” she said. “There’s just not enough clinicians to meet that demand.”
Access to care can be even harder for recent immigrants. Spanish-speaking children who have been referred for a special education assessment, which can help them become eligible for mental health services, sometimes wait months or years before someone tests them, she said.
“The families don’t know the system,” she added. “They don’t know their rights.”
Other clinicians point to relatively low health insurance coverage among Latinos, particularly those without legal status, and a cultural resistance to acknowledging mental illness.
Dr. Alok Banga, medical director at Sierra Vista Hospital in Sacramento, said some immigrant parents he encounters don’t believe in mental illness and have not grasped the urgency of their children’s depression and past suicide attempts. Many are working two or three jobs, he said. Some are undocumented immigrants afraid of coming to the hospital or having any interaction with Child Protective Services.
But the biggest problem, from his perspective, is the shortage of child psychiatrists and outpatient services to serve this population.
“The default course for treatment falls on institutions: hospitals, jails and prisons,” he said.
Jeff Rackmil, director of the children’s system of care in Alameda County, said sheer population growth — particularly, an increase in Latino children insured under Medi-Cal — may also be part of the explanation for the rise in hospitalizations.
Yet the state’s Latino population aged 24 and under increased less than 8 percent between 2007 and 2014, which doesn’t nearly explain an 86 percent increase in hospitalizations.
Some California communities are working to bring more Latino children into care and to reduce the stigma associated with mental illness.
At Life Academy of Health and Bioscience, a small, mostly Latino high school in East Oakland, students grow up amid pervasive violence and poverty. “We’re just told to hold things in,” said 17-year-old Hilda Chavez, a senior.
Students often don’t seek help because they fear discussing mental health problems will earn them a label of “crazy,” Chavez said.
Last year, the school, in conjunction with the Oakland-based La Clínica de La Raza, started a program to interest students in careers in mental health care. The program provides training in “first aid” instruction to help people in crisis, and places students in internships with mental health organizations.
Nubia Flores Miranda, 18, participated in the program last year and now is majoring in psychology at San Francisco State University. Miranda said she became interested in a career in mental health after she experienced depression and anxiety during her freshman year at Life Academy.
Seeing a school counselor “changed my life around,” she said.
But she saw that her peers were wary of seeking help from counselors at the school, most of whom were white and lived in wealthier, safer neighborhoods. Once, when a classmate started acting out at school, Miranda suggested she talk to someone.
“She told me she didn’t feel like she could trust the person — they wouldn’t understand where she was coming from,” she said.
The shortage of services is especially evident in the Central Valley, where many agricultural workers are Latino. Juan Garcia, an emeritus professor at California State University, Fresno, who founded a counseling center in the city, says the drought and economic downturn have exacerbated depression, anxiety, substance abuse and psychotic breaks among Latinos of all ages.
“The services to this population lag decades behind where they should be,” he said.
In Fresno County, psychiatric hospitalizations of Latino youth more than tripled, to 432, between 2007 and 2014. Hospitalizations of their white and black peers about doubled.
Liliana Quintero Robles, a marriage and family therapy intern in rural Kings County, also in the state’s Central Valley, said she sees children whose mental health issues go untreated for so long that they end up cutting themselves and abusing alcohol, marijuana, crystal meth and OxyContin.
“There’s some really, really deep-rooted suffering,” she said.
Out in the unincorporated agricultural community of Five Points, about 45 minutes from Fresno, almost all of the students at Westside Elementary School are low-income Latinos. When principal Baldo Hernandez started there in 1981, he’d see maybe one child a year with a mental health issue. These days, he sees 15 to 30, he said.
He blames dry wells and barren fields, at least in part.
“I’ve had parents crying at school, begging me to find them a home, begging me to find them a job,” he said.
In some parts of the Valley and other places, the closest hospitals that accept children in psychiatric crises are hours away. Children can be stuck in emergency room hallways for days, waiting for a hospital bed.
“It makes for a very traumatized experience for both families and children,” said Shannyn McDonald, the chief of the Stanislaus County behavioral health department’s children’s system of care.
Recently, the county expanded its promotora program, which enlists members of the Latino community to talk to their peers about mental health.
In the small town of Oakdale, a slim, energetic 51-year-old promotora named Rossy Gomar spends 60 to 70 hours a week serving as cheerleader, educator and sounding board for many of the Latino women and children in the town.
Gomar’s office in the Oakdale Family Support Network Resource Center is cluttered with open boxes of diapers and donated children’s toys and clothing.
“Look at my office,” she laughs. “We don’t fit.”
Gomar says many of the women she works with don’t recognize that they are depressed or abused. Children see their parents’ problems and don’t know where to turn for help.
“There are many young people who don’t have any hope,” she said.
But little by little, she has seen some good results.
One 17-year-old client is a student at Oakdale High School. The girl, whose name is being withheld to protect her privacy, said that earlier this year, problems at school and a break-up with her boyfriend had her struggling to get out of bed each morning. She began drinking, using drugs and thinking about suicide. She was scared to talk to her parents, she said, and kept everything inside.
One day, she walked into Gomar’s office and started crying.
“She told me ‘Everything is ok. We want you here,’” the girl said. “When I was talking with her, I felt so much better.”
It might sound like a story line from a movie – a person suffering from a ‘broken heart.’
While it’s not usually a fatal event, according to Steven Nissen, M.D., chairman of Cardiovascular Medicine at Cleveland Clinic, there is such a thing as ‘Broken Heart Syndrome.’
Broken Heart Syndrome is real.
Dr. Nissen said ‘Broken Heart Syndrome’ is a type of cardiomyopathy and most often occurs after a person has suffered an extreme emotional experience.
“When that happens, for reasons we don’t fully understand, there’s a surge of adrenaline in the body, and the result simulates a heart attack,” said Dr. Nissen.
Cardiomyopathy vs. Heart Attack
According to Dr. Nissen, during an episode of cardiomyopathy, the heart muscle actually stops contracting and as a result will look like a heart attack even when an electrocardiogram, or EKG, is performed.
However, unlike a heart attack, there is no blockage present, just a contraction problem.
Dr. Nissen said folks rarely die from ‘Broken Heart Syndrome,’ but they can become very sick.
The good news is that people who experience this type of event can expect their heart muscle to return to normal after a few weeks.
Dr. Nissen also said that for reasons not fully known, the condition effects more women than men.
“More people that have this are women than men, probably at least four or five to one,” said Dr. Nissen.
“So it does occur more commonly in women, perhaps it’s because women experience emotions more strongly than men typically in our society.”
Dr. Nissen stressed it’s very important to never assume that any chest pain or pressure is not a heart attack and that folks experiencing any type of heart-related symptoms should always call 9-1-1 first.
Productivity losses due to personal and family health problems cost U.S. employers more than $225 billion every year.
The indirect costs of poor health—including absenteeism, disability and reduced work output—are even higher.
That’s why the Centers for Disease Control and Prevention (CDC) this month is rolling out a new program to train businesses in Florida for starting their own workplace wellness programs.
The program has already launched in Ohio and Georgia and is gaining momentum.
I spoke with Jason Lang, Team Lead for CDC Workplace. Lang says, “By learning how to promote and improve workplace wellness, employers will ultimately be able to strengthen their own bottom lines by reducing health care costs and increasing productivity.”
Florida Work@Health® T3s provide training and technical services to small-and-mid-sized Florida businesses (SMBs) with more than 20 employees to build a science-based workplace health and wellness program.
By implementing Work@Health®, employers may help lower their healthcare costs while improving Florida’s overall health.
Today’s announcement illustrates the successful expansion of the number of trainers equipped to deliver the Work@Health® employer curricula to additional employers in Florida to support their worksite wellness goals.
Chronic diseases are costly to Florida workers, their families and employers.
Studies have found that:
· Florida’s adult obesity rate is 26.2 percent, up from 18.2 percent in 2000 and more than double the 11.4 percent rate in 1990 (The State of Obesity: Better Policies for a Healthier America (2015).
· An estimated 65 percent of adult Floridians are at an unhealthy weight (FloridaHealth.gov).
· Florida ranks 32nd among the 50 states and the District of Columbia in the 2015 Annual Report Health Rankings.
Floridians’ health is also threatened by smoking, lack of health insurance, and higher levels of diabetes (United Health Foundation).
· By 2023, gains in productivity and savings from improving the prevention and management of chronic diseases in Florida could reduce future related economic costs by an estimated 27 percent, or $91 billion, according to An Unhealthy America: The Economic Burden of Chronic Disease, (Milken Institute. 2007).
Florida-area employers who participate in the Work@Health® Program, receive the latest information and resources associated with worksite wellness.
· Free professional training
· Technical assistance and consultation with experts
· The opportunity to network with peers
· Recognition by the CDC as a Work@Health® employer
Work@Health® Train-the-Trainers (T3) will recruit employers in Florida until February 14, 2016.
Selected employers will begin Work@Health®’s three-week online training by February 15, 2016.
The program culminates in a one-day on-site training session, on or before March 16, 2016.
Each Train-the-Trainer will schedule dates, locations, and times in coordination with participating employers.
Or contact the Work@Health® Customer Service team at firstname.lastname@example.org or 1-800-305-WELL FREE (9355).
The program includes access to the Work@Health® Training and Technical Assistance Portal, a web-based portal that provides employers with tools, information, and technical assistance from top experts in the field.
In addition, those completing employer training can apply for both Basic and Advanced Technical Assistance, which allows worksites to further develop their wellness programs over several months and apply for national accreditation.
Work@Health® is offered under the CDC’s guidance by ASHLIN Management Group, headquartered in Greenbelt, Md., with offices in Atlanta, Ga., and who is also responsible for the development of the training curricula, outreach and recruitment of employers, and delivery of the Work@Health® Program.
Stay healthy! ~Maria
MARIA DORFNER is the founder of MEDCrunch, a division of Healthy Within Network (HWN). She can be reached at email@example.com