You’re Invited to Grand Rounds

National Library of MedicineI am hosting Grand Rounds on Tuesday August 10th and want to invite all health-related bloggers to submit a favorite post. I’m hoping to get posts on doctor-patient communication in any of its forms, but any post you are fond of is welcome. I landed on this issue because I have a personal interest and because it generates such strong feelings.

I should add that nurses play a critical role in communication. I’ve had nurses explain what the doctor is talking about. One of my family doctor’s nurses let me know that the surgeon he recommended for my first-ever surgery was a great guy and that all his patients really like him. This was good to hear, and she was right. 

What if you’re not a blogger? Grab some coffee and settle in for some great surfing. And please feel free to weigh in with comments; don’t be shy. Those of us who blog really hope we’re not just talking to ourselves. You can visit Grand Rounds archives to see who else has hosted and what kinds of posts have been submitted. I will warn you: it can be highly addictive. The posts are as individual as snowflakes and range from hilarious to haunting. I’m very honored to have had a couple of my posts included, on MD Whistleblower and GlassHospital.

And I’m super excited to get to host, and get my very own “I Hosted Grand Rounds” badge. I’ve only recently come to realize that badges are kind of a big deal in the blogosphere. It’s like the flair they collected in that restaurant in Office Space, only a lot more fun. 

How to submit: Please send your entries to fromzero at cox.net. (Another thing I recently learned–not using the actual @ and e-mail address should discourage spambots.) Put Grand Rounds in the subject line, and include the URL of the post in the message with a sentence or two about the post’s topic. I will confirm receipt of all entries so if you don’t hear from me, ping me.

If you wish, let me know why this post is near and dear to your heart. Not mandatory, I just like to know that kind of thing.

UPDATED DEADLINE: Sunday August 8th at 3 p.m. Eastern time. Earlier submissions are encouraged.

Can’t wait to hear from you and read and share your work!

Need topic help? Doubtful, but on the off chance anyone reading this needs a nudge, maybe this will help. If you’re a doctor or nurse: How much did they teach you in school about communicating? What did you pick up on your own? What’s the best tip you ever got? How do you communicate a big diagnosis? What advice do you have for patients on communicating with you? How are the Internet/electronic records/social media affecting communication with patients? (Should you friend patients on Facebook?) Is healthcare reform going to help or hurt? Is the dr/pt relationship going to heck in a handbasket? Why or why not? If you’re a patient: How do you make sure you understand what a doctor is telling you? Do you take notes? Have you ever accompanied a family member or had a family member accompany you? Did it help communication?  What are some tips you’d like to share from your own experience?  Are you shy around doctors? If you are formerly shy, how did you get over it? Have you ever changed doctors because of communication styles? If so, how did you know when you found the right one? What makes a doctor a good fit for you? Do you have a family doctor you have a relationship with? How important is that to you?

Anniversaries

Thursday was the second anniversary of my mastectomy. I always think of my survivor status as beginning from that date, because it’s the day I became cancer-free. Opinions vary on this. The National Cancer Institute and others say you become a survivor on the day you’re diagnosed (in which case my two-year anniversary was April 4th). I did a post about when you become a survivor back in January that discusses this in a bit more depth.

I’m amazed that two years have gone by so quickly, and very grateful to have had two clean mammograms since then. I opted for the single mastectomy, not a preventive bilateral. I was always of the opinion that I’d rather deal with one breast at a time, because that’s what worked best for me. I know others who have chosen differently. There’s no right or wrong choice here; just as there’s no right or wrong way to mark our survivor anniversaries. Some women would rather forget about it and move on. Others see it as an excuse to party. I definitely see it as cause for celebration, although “celebrating” sometimes means stopping to reflect and give thanks my cancer was caught early.

But my survivor anniversary isn’t the only one I want to celebrate. Today is Bruce’s and my 35th wedding anniversary. No, I”m not actually blogging on our anniversary. That would be a good way to ensure I don’t see my 36th. Thanks to the magic of WordPress, I was able to draft this ahead of time and post it today.

One could argue that after 35 years, you’re also survivors of marriage. You’ve made it through the initial relationship ups and downs to the other side, where you’re just grateful for the time you have with each other. You’ve been through birth and death and perhaps cancer or some other significant illness.

Our 33rd wedding anniversary was two days after my mastectomy, and I will always remember it as one of our most special. On the day you get married, you really don’t have a clue. Going through something like breast cancer together makes marriage worth the price of admission. I never could have gotten through this adventure without Bruce. He was my nurse, chef, chauffeur, confidant, ombudsman, and partner in witnessing the absurd theater called cancer. (We actually found a lot to laugh about, which may surprise you if you haven’t been through something like this.) He was and is my rock.

Mark Twain said it much better than I could: “Love seems the swiftest, but it is the slowest of all growths. No man or woman knows what perfect love is until they have been married a quarter of a century.” In our case, plus 10.

How Did Your Doctor Break the News About Your Breast Cancer?

There was a jarring story in HealthDay recently about a survey that found doctors do a poor job telling patients they have cancer. One woman got the news in a voice mail; another heard when she was told she needed to schedule an appointment with a neurosurgeon. When she asked why, her doctor said because she had a brain tumor and hung up. Two words–bedside manner.

The HealthDay article said that doctors often drop this bomb on people in public settings or over the phone. My doctor told me over the phone because I wanted him to. They didn’t get the results until the day before I was scheduled to leave on a business trip, and I didn’t want the uncertainty hanging over me for a second weekend (my biopsy was on Friday of the previous week–not real swift scheduling on my part). He called me around 6 that evening so we could talk without interruption.

I really didn’t mind getting the news over the phone. I mean, if he had said come in so we can talk he would have given it away–so just tell me. Voice mail would be a different story. You don’t drop something like that on someone in a voice mail. That’s just common sense and common courtesy.

Disclosure: I wasn’t the best about telling my husband Bruce when I flunked my second mammogram and found out I needed a biopsy. I was trying to figure out how to tell him after work that day when he happened to mention a colleague’s wife needed a biopsy. I thought, “Great, here’s my opening,” and blurted, “I need a biopsy too.” While a biopsy isn’t quite the shock the cancer diagnosis is, it might be good to preface news like that with a bit of a warning.

I’m curious to hear how this went for others. If anyone has stories you’d like to share about how you got the news–whether it was cancer or another big diagnosis–please feel free to share your comments.

Update: In a post several weeks ago, I talked about how I didn’t agree with the coding for my most recent mammogram. They had coded it as a diagnostic mammogram instead of a routine screening, so I was responsible for the full covered amount. The screening would only require a co-pay. I asked them to audit the code, and they did. I just got a revised bill that says I am responsible for $14.50 instead of $145. The moral of that story is to keep your eye on those bills.