Showing posts with label laryngectomy. Show all posts
Showing posts with label laryngectomy. Show all posts

Thursday, 8 September 2016

Support Network Newsletter September 2016


Support Network Newsletter
September 1, 2016


This month’s talks

Patricia Melville, Dove House



Where do cancer patients go to get relief from the physical and mental shock of diagnosis and treatment? For the people of east and central Auckland, there is a place where they can find wraparound support: Dove House in Glendowie.

Although it is also referred to as Dove Hospice or Eastern Bays Hospice, Dove House is not primarily for people with a terminal illness. It was created to fill the gap between the regular hospices which cater for those who might be in their last year of life and others who have been diagnosed with a life-threatening illness but are expected to survive.

Twenty years ago the people of East Auckland wanted a local hospice but didn’t want to duplicate Mercy Hospice in Ponsonby. They looked at what was missing. They could see that the hospice movement, originally about holism had been “hijacked by the medical model”. Why not, they thought, take the concept of “holism” back? .

Dove Hospice decided to support people who have a serious diagnosis (mostly cancer) but are not dying, as well as people with a terminal disease. (They still see terminal patients but usually see people earlier in their cancer journey when a cure is possible.) Ten years ago the name of the building was changed to Dove House

The Cancer Society used to provide six free massages and lymphedema care but have ceased that support which is where Dove House has stepped in, providing services which are not available elsewhere.

Dove House therapies are geared to “soften” what medical treatment does to cancer patients. Their treatments are meant to offer deep relaxation and stress removal. The organisation is patient focussed.

They offer a number of services provided by well trained professionals. Below are some of them:

  • Nutrition advice
  • Oncology massages
  • Reflexology
  • Skin and nail treatment
  • Lymphoedema treatment
  • Art therapy
  • Chair yoga
  • Psychotherapy
  • Emotional support
  • Spiritual care
  • Three hospital beds for respite or end of life care (in St Andrews Hospital)






These complementary therapies are not an alternative to medical treatment. They are designed to encourage wellness, to empower people. What works for one person might not work for another. They place great importance on training. Their oncology massage therapist also helps at the bone marrow transplant ward at Auckland Hospital because her treatment is gentle enough for the most vulnerable patients. They can be seen as “flakey”, says Trisha. It is important for them to maintain credibility.

Dove House encourages men (more reluctant than women) to seek help from Dove House. The have a male psychotherapist and run regular Blokes’ Nights.

They have no government funding but get most of their funds from their Dove Hospice Shops. Interestingly, these shops do very well because they are situated in an affluent area bordering a non-affluent area.

Where is Dove House? Pictured above, it is situated in the grounds of the St Andrews Retirement Village but is independent. There is collaboration, however, because as stated above, Dove House has access to three hospital beds at St Andrews where they provide respite and end of life care.

Thank you, Patricia, for your informative and thoughtful talk.


Be.accessible



Minnie Baragwanath from Be.Accessible was sick today so could not speak to us. Her TED talk however is on our website. It is an inspiring speech about accessibility for people with all sorts of impairments from major to minor disabilities. Many of us for example need soft food. We have accessibility problems when it comes to eating out and sometimes speech and appearance issues. In a world where appearance is valued to such a high degree, it can be hard to go out with scars and facial defects. It’s inspiring when people can rise above that. 

Minnie is partially sighted and has recently been treated for breast cancer. She is a strong advocate for a world where accessibility and acceptance rule. Be. Accessible is the name of her charitable organisation.

https://www.youtube.com/watch?v=__V07QKguBI&feature=youtu.be


The meeting

We had a small group of 13 this time but were pleased to welcome Vanessa, a nurse at the ORL Outpatients’ Clinic. It was also great to have our speech language therapist, Esther, back. She had been tied to a clinic on Thursday mornings so we hadn’t seen her friendly face for a while.


Alison and Esther, our SLT

Diana updated us on the network’s progress and we took a group photo. This wasn’t for the newsletter but for a “satchell inset” to be provided to medical professionals at the upcoming head and neck cancer conference in Auckland next month. It took a lot of shuffling and trial and error to fit us all in and make us respectable.

Our temporary website (or blog site) is doing very well after a slow start. Some entries spark interest around the world including one uploaded by Diana on the issue of disclosure of surgical outcomes. Should hospital departments disclose the success or otherwise of their surgeries? Interestingly, Waitemata District Health Board has started disclosure.

http://headandnecknetwork.blogspot.co.nz/2016/08/should-we-disclose-surgical-outcomes.html



The Head & Neck Cancer Support Facebook group has over 50 members (increasing slowly all the time) from Invercargill to Whangarei. Twitter, so confusing to so many of us, is flourishing too. Diana showed us how to use hashtags and follow people of interest

Patient Story

Below is the head and neck cancer story of one of the new friends we made on Head and Neck Cancer Day, July 27. Geoffrey runs a support group in the UK. Initially it was for laryngectomees but is now for head and neck people in general. Thank you, Geoffrey for letting us use your account of your cancer.

Geoff’s Journey Through Head & Neck Cancer



In The Beginning. I was coming to the end of my 15-year engagement with British Aerospace in the Kingdom of Saudi Arabia when I started getting a husky voice and was hospitalised for a few days due to flaking out a couple of times. After returning to the UK upon retirement I became bored and went to Baghdad, Iraq for a year or so to help to set up a Private Security Company out there. Again I suffered similar voice problems and my voice would come and go. And again I flaked out a couple of times, once on my flight home to UK. I put all this down to the dusty conditions of the desert. When back in the UK I saw my local General Practitioner who immediately referred me to a consultant at my local hospital.

The Diagnosis. The Consultant took a telescopic look down my throat via my nose and then said “You know what this is don’t you?” I immediately knew and replied “Yes, I think so.” After various scans, x-rays and being prodded and poked, I was informed that the cancer on my larynx was T-4 which meant it was aggressive, was already eating my larynx and was now looking for somewhere else to go. We then discussed the options.

The Operation. I was given a total laryngectomy in January 2009 and they also removed the lymph nodes in my neck and part of my thyroid. This all went well and I healed surprisingly quickly. And soon I was eating, drinking and talking again with confidence.

The Side-Effects.
Some weeks after that operation I was to endure 37 consecutive days of radio-therapy and weekly sessions of chemotherapy. This too went well although I did start to get nauseous and my neck was quite burned. I had to be readmitted to hospital as I was dehydrating badly. I overcame this hurdle and soon I was up and about, and going about my normal daily routine. After a few months I started to suffer frequent problems with my the speech valve in my throat and had to have it changed frequently.

Apparently, the effects of the radio-therapy had badly scarred the tissue inside my throat. I was in and out of hospital over the next few years until 2014 when I was eventually unable to eat or drink by mouth, or talk at all for eight months.

It’s now over seven years since my laryngectomy and the hair under my arms or my chest has still not grown back! And when the sun shines hot, my neck starts to cook again from the radio-therapy effects. Prior to the radio-therapy sessions I was fitted with a PEG in my tummy to enable me to take food and liquid directly into my stomach. I still have the same PEG fitted some six years later!

The Major Pectoral Muscle Flap.
Eventually, in 2014 my consultant referred me to a consultant surgeon in the Northeast of England where I underwent a Major Pectoral Muscle Flap. This entailed taking muscle tissue from my left chest / breast and flapping it into my neck. I no longer have a left man-boob and had eighty metal clips stapled in my chest after the operation, since removed. This all went remarkably well and I was up and running again reasonably quickly. I was again able to eat, drink and talk. I can eat and drink, albeit slowly, and the food must be soft and small. But…

I am now unable to talk at all.

The Way Ahead.
Another operation is necessary to realign my speech valve and it’s not sitting right and this is preventing me from using what voice I have left. However, my consultant seems somewhat hesitant as he’s said to me “That sometimes when we try to put things right, we can make matters worse.” That hasn’t instilled me with a great deal of confidence but I completely in their hands. It may be that I will have to take the choice between eating and drinking or talking. I may not be able to have both. My choice, without a doubt, would be to be able eat and drink!

So… my journey hasn’t finished yet!

Thanks.
Without a doubt, I owe my life to the GP who first saw a problem and immediately referred me to a consultant. That in itself saved my life. And thanks too, to all the surgeons, medical staff and hospital workers who have been there for me for these past seven years.

Geoffrey N. Read

Monday, 25th July 2016




From the Chair



This month we have focused on connecting and supporting the head and neck cancer community. Our Facebook group gained an impressive 46 members. There were 40 posts and too many “comments” and “likes” to count. There is plenty of good discussion, connection and support taking place. We are connecting internationally. Through Twitter there was positive feedback to the content/posts posted on our Website. Welcome to everyone who has joined us in the month of August.

Continuing with our theme of connecting. I have met with Dr Neil Croucher, clinical director of the Oral Health Service, and Dr David Grayson, Clinical Director of the Waitemata, ORL Department. We are now linked to the Ministry of Health, Faster Cancer Treatment programme, including the national tumour stream activities. We connected with Brian Sheppard, who in 2013 was a patient advocate. He sat on the development team for the Head and Neck Cancer Standards of Service Provision. These connections are strong and positive.





Our role is to advocate for you. We are working to strengthen our voice. The more that healthcare professionals, agencies and individuals know about our Network, the more likely we are to be involved in decision making affecting head and neck cancer people.

This month Adam Love resigned from our HNCSSN committee. Adam was the energy behind our move to Facebook and social media. We thank Adam for his contribution, especially his wonderful story published in our newsletter and online. Go well Adam.  ( Adam is still very active on our Facebook page and is one of our go to people on chemo-radiation. Ed.)

We are looking for new people to help the Network. If you are interested in helping us out please do contact us.


Next Meeting


6 October, 9.30 am to 11.30 am at Domain Lodge
Speakers


The team from Domain Lodge, and the Auckland Cancer Society

Your Committee on the upcoming international Head and Neck Cancer Conference.

All are welcome to attend our friendly and informative meetings.


Transport to Domain Lodge


Domain Lodge offers parking for those who attend our meetings. Drive to the entrance and ask at the desk for a parking space to be allocated.


A large number of buses stop at the hospital almost directly opposite Domain Lodge. Grafton Railway Station is just up the road.

Reminder

We are here for people outside Auckland too. You can join us on our blog or on our Facebook site. Watch this space for news of a comprehensive website.






Friday, 12 August 2016

Carlene Perris, Speech Language Therapist

Carlene Perris is one of the three speech language therapists working in ORL at Auckland Hospital. Esther and Jennifer are her two colleagues. Carlene outlined a research project she is currently involved in and a couple of opportunities for involvement in future projects.

Laryngectomy Study

Carlene pointed out that laryngectomees are a relatively small group with approximately 8 per year over the last decade here in Auckland. But they have unique needs.

What is the life experience of laryngectomees following treatment and how can their quality of life be improved? This is the topic for research being conducted by Carlene and a team from Auckland University.

The study has two parts:
  • a retrospective audit of patient notes from 2005 - 2015 yielding 80 people. (This might not be an exhaustive list.).  This will look at information such as age at the time of surgery, length of stay in hospital post-op, number of readmissions, number of SLT appointments etc,
  • semi-structured interviews with participants who have responded to an invitation. This will also involve completion of three questionnaires looking at different aspects of quality of life.  

The team consists of  Alana Brady, SLT Masters student, Dr Anna Miles from Auckland University, Carlene, Alan Spinks a patient advocate and Alex Smedley, a head and neck cancer SLT in Canterbury.

Dr Miles is the expert advisor for swallowing problems in New Zealand and is part of the faculty delivering the Master’s programme to train SLTs at Auckland University. While New Zealand has three speech language therapy learning centres, Auckland University’s course is slightly different. The Auckland SLT students are all completing a two year Masters programme after having graduated in another field, such as linguistics. Each student has to carry out a research project.

pullquotecarl2.png

Dr Miles and her students are keen to be more involved with ORL, hence the collaboration taking place with this project.

It is not too late for laryngectomees treated in Auckland and Canterbury to get involved in this project.

Anna and Alana’s team want to explore the unmet needs of the laryngectomee population. Who are they? What are their experiences? How has the laryngectomy impacted on their communication, their eating and drinking? What can SLTs do better? What different equipment could be used? What information do they need and what further services could be offered?


Progress
  • 80 Auckland electronic notes to audit
  • 30 Canterbury notes to audit
  • 10 Auckland participants for the interviews to date

The Auckland audit is nearly complete. The interview stage is about to commence. Alana has access to travel funds as well as Skype and the telephone.

In October, some preliminary data will be available for the ORL conference in Auckland. They are making a poster which they will bring to us later in the year.

Consistency across DHBs

The team wants to look at nationally funded products. Some DHBs fund certain devices and some do not. There should be a national standard of provision. Do they need to change their practice? Do they need to provide information in a different format? Can they use different stoma covers? How good is the access to follow up? Who should people contact if the valve is leaking? If they present to ED there should be a process in place to have them seen by the right person who understands the specific needs of someone who has had a laryngectomy. Carlene’s wish is for consistency across the DHBs.  Maureen

Consumer Engagement: a comment from Carlene

There are a couple of opportunities coming up to be more involved in the development of the SLT services.  At Auckland DHB we provide a regional, tertiary service which means that patients come to us for treatment from outside of the Auckland DHB catchment area and go back to their local DHB once treatment is complete.  We are currently working on getting together the SLTs across the region (Northland, Waitemata, Auckland, and Counties Manukau) to look at what services are offered to patients with head and neck cancer and address any gaps in those services.  We want to consider where is the best place for people to be seen and who are the best people to provide those services.  Members of the group can contribute indirectly by sharing with us their own positive or negative experiences of accessing SLT services in Auckland or in the greater region.  You are also welcome to be involved more directly by attending the meeting we are planning in September to discuss services as a group.

pullquote carl2.png

We are also planning a national study day on head and neck cancer for February next year.  I would love to have some volunteers from the support group who would be willing to talk at this study day.  It can simply sharing your story first hand or providing us some insight into observations you have made on how your care was delivered and how it could have been a better experience.  The audience would be SLTs from around the country who are already working with head and neck cancer and want to extend their skills or are new to the area and want some education in this topic.  So anyone who has had experience of communication or swallowing difficulties as a result of head and neck cancer would be suitable.  Carlene