By Barbara Ficarra, RN, BSN, MPA
For Health Consumers and Medical Professionals
Heartfelt accounts of cancer treatment documented with humor
“I must say, good-naturedly, that the physicians and nurses are reluctant to give you an exact answer to a question. It’s always, “It depends.” I realize that things vary, but if a Martian came to earth and asked how tall humans were, it’s not particularly helpful to say, “It depends.” I’ve asked Lisa to purchase a box of Depends, and every time one of the staff answers a question in that way, I am going to hand them my Depends Award.” – Bruce Dan, MD
Bruce Dan, MD, recently diagnosed with Acute Myelocytic Leukemia (AML), started a blog to chart his journey during his course of treatment at Johns Hopkins.
His blogs are accounts of his cancer treatment which are documented with feeling and humor. Bruce’s words are heartfelt and real, and through his eyes as a patient he brings lessons and hope.
I’m privileged to know Bruce through the Freddie Awards, the National Association of Medical Communicators (NAMC ) and as a guest expert for Healthin30. During the proliferation of swine flu and media madness surrounding it, Dr. Bruce Dan offered the readers expertise and insight in an accurate and easy to understand manner.
Dr. Dan’s blogs not only offer his accounts of what he encounters physically and emotionally, his blogs become a teaching tool for doctors, nurses and hospitals to learn from. He becomes an advocate. (This area will be addressed in Part 2.)
Dr. Dan begins…
Dr. Dan blogs about his progress for family and friends that are divided into 3 sections consisting of status, how he’s subjectively feeling on a scale of 10, events, what has transpired, and comments – his thoughts and explanations.
I highlight only a few areas here. By reading Dr. Dan’s blogs you’ll see firsthand his real life accounts of his cancer treatment.
Cancer journey begins…
Dr. Dan, the teacher
Dr. Dan has a special way to take medical information and to break it down into very easy to understand information. Here are a couple of examples:
“White blood cells contain chemicals that they usually reserve for attacking foreign micro-organisms. When they do so, it is usually targeted, directed, and in small numbers. Imagine if you will an orchestrated fireworks display, a rocket here, a rocket there, well timed and controlled. But in my case, perhaps hundreds of thousands of the abnormal leukemic cells burst open quickly, releasing a barrage of these toxic chemicals. It’s as if all those fireworks went off at once; you wouldn’t be surprised if the onlookers got singed. But the good news is, that only happens because a lot of leukemic cells met their end.”
“Officially, I am now neutropenic, which means essentially no white cells. I will remain that way for the next two weeks or so. Although I am currently receiving oral and IV antibiotics, if I spike a fever during that time, they will add additional antibiotics,” he writes.
Dr. Dan, the comedian
Humor, through difficult situations can make the world of difference.
What better way to describe blood drawing than to make a reference to vampires. “Lots of blood drawing throughout the day as they test the levels of drugs and the effects they have (it is after all part of a clinical trial). Although I must say with all the blood they’re sucking out, I’m going to try to get more insight by ordering some of the Twilight series. Tomorrow, more of the same and hopes for good results,” he writes.
Duct Tape can’t fix everything
“Yesterday evening (after my first day of chemotherapy), I had a shaking chill, muscle aches, and what I knew was shortly to develop into a sudden fever. Most likely a reaction to the chemo, but the staff doesn’t fool around with that kind of stuff around here. Wanting to make sure it wasn’t a reaction to a bacterial infection they immediately ordered a chest x-ray (looking for pneumonia), blood and urine cultures, a physical exam, and IV antibiotics. I was able to finally get to sleep (but not without frequent awakenings for vital signs during the night) and feel better this morning. There are few things in life that can’t be fixed with either duct tape or a good night’s sleep.”
Through the eyes of his loved one
“Status: 9.0/10. Feeling much better this morning after quite a night. Since my observing skills were diminished, I’ll let Lisa do the reporting she’s so good at.
Events: It wasn’t exactly Linda Blair in the Exorcist – since there was no projectile vomiting, in fact no vomiting at all, thank goodness. But as I sat with Bruce last night after his last chemotherapy dose of Mitoxantrone – it certainly looked as though he were possessed. The doctors had warned us that about 15 minutes after the last drop of the toxic substance, patients often get the shakes.
Let me digress here for a moment – the drug Mitoxantrone is the startling color of deep, dark, blue-black ink. Nothing you’d want to even get on your hands or clothes, but that’s what they had been pouring into Bruce’s veins … drop by drop … over two hours last evening. If you remember your primary colors (mix blue and yellow) – you get the idea of what happens to the color of your – uh – output – after you take the drug. Quite astonishing.”
“Well, they were right on target about the shakes. And not just any shakes. Think of the craziest, wildest, teeth-chattering, roller coaster ride. As Bruce explained in an earlier day’s blog, it’s called rigors. He got it big-time. His body was shaking uncontrollably, and his fever was going up and up. Shake and bake. Luckily the wonderful nurses here are prepared with Demerol at the ready. One syringe in the IV and the shaking momentarily stopped. But then the shaking continued. Then a second syringe 15 minutes later. It slowed again, for just a moment. They don’t like to give the third and final syringe unless they have to, for fear of respiratory depression. It was a close call – but ultimately they decided his rocking and rolling was slowing down enough that a 3rd wouldn’t be needed. I kept putting cold compresses on his head and feeding him ice chips. He was just totally worn out – but I have to say, even in the midst of all of it we both got a good laugh. When Bruce asked the nurse between breaths how long it would last, she answered (you guessed it), ‘It depends.”’
Strength and Humor
Amazing, 8.75 out of 10 is the lowest he scored himself throughout his course. Strength, humor and loved ones by his side are the anchors that help him cope and mend.
With adversities come strength and power. Thank you for sharing your story so others can learn.
Your uplifting spirits are truly amazing.
For any health professional who has taken Bruce’s class, they know the importance of staying on message. My message for you Bruce, thank you for being a shining light in media and medicine.
Bruce B. Dan, MD Chief Medical Officer and Executive Medical Editor, Hospital Networks, NBC Digital Health Networks will be awarded the NAMC Lifetime Achievement Award. The Medical Communications Conference will take place August 20-22, 2010 in Atlanta, Georgia. I hope to see you there Bruce.
To read a complete bio, please click here.