Category: Human Spirit

Hope for sale

Joanne Dragun, M.D.

Following Black Friday and Cyber Monday the next shopping enticement is the after Christmas sale. This subject came up as I visited with Beth last week and we discussed the festivities of the holidays. Its been a challenging six months with a diagnosis of pancreatic cancer for this lovely 62 year old. She had great joy visiting with family including several grandchildren- fully aware that next Christmas may be quite different.

“Doc, listen to this: I found a way to express faith that this year will go well for me. I went after- Christmas shopping and bought beautiful cards and ornaments. I especially like the ones with this year’s date because it’s a time I will never forget”. Beth is doing well and her last scan was stable if not improved. “Doc, my sale shopping gave me something tangible. Each time I look into the closet, I will see a sign of my faith”. I ask if I can share her unique idea with others. She said that when she didn’t have strength, she believed there was a mission for her to complete, even if just to inspire others. “I made a decision to write out my cards now for next year. I can enjoy crafting a note of love to my family and friends and if I am unable, then I will ask my husband to mail them next Christmas. Won’t everyone be surprised?!” I thought, what courage!

“After all Doc, what’s the sense of buying something on sale then not using it? That would be throwing money away and I’ve always been thrifty. I often look through my box of treasures and mementos. I like sending something tangible- people aren’t going to store emails for years. As I go through boxes of pictures and reminisce, I pull out pics to tuck into the cards too. What do you think?”

“Beth, every card you send will be a gift to your loved ones, so I agree the idea is wonderful.” Writing good wishes and sending love to others is a clever way for Beth to boost her immune system, perhaps enough for her to mail them herself next year. Never doubt the value of faith and hope. We cannot buy them; we cannot invest in them; and we cannot gift them to someone. We can only feel and believe. Faith and hope are never on sale but always priceless.

2020 Vision

Joanne Dragun, M.D.

“Future is fantasy“, Yogi Caryn softly reminds us to pay attention and be mindful, a requirement to avoid falling over in the balancing poses. Her words resonate and have everything to do with life off the mat. But many of us resist the idea that projecting into the future is fantasy. Isn’t this refreshing new year and decade all about expectations? Are all resolutions flights of fancy? Is it conceit to think we can conjure a future based in desires? 2020 vision is perfection, so it’s exciting to anticipate “seeing” the best in our lives this year.

The lesson from Caryn is that living mindfully now influences the future. Moving toward a vision with passion adds excitement and commitment to our lives. But over investing in tomorrow, steals the present moment.

This 20’s decade provides us with a new starting point. As with any goal, preparation is key to success. While we focus on the year ahead, may we consider the concept that centering our minds prepares us for a better future with clarity? Caryn is encouraging us to be here right now and the benefits will follow. It really is not hard, we can re-train our thinking with meditation. It is a way to control thoughts and help us cultivate a habit of mindfulness.

“Oh Doc, I barely have time to make a meal or do the laundry; you expect me to sit still?” Yes I do. My sister Marie (who is a bundle of energy) thoughtfully gifted me a meditation app and I am taking time to sit quietly everyday, so lets do this together. There are several meditation apps that can guide you toward enhancing your well being far beyond what making a list of wishes can do. It only takes 5 minutes per day.

This new year’s commitment can benefit us the entire year. All those years of making and breaking of resolutions just led to frustration anyway. Let mindfulness be your new steady state and expect greatness to enter your life.

If you need convincing, meditation benefits you because it reduces inflammation in the body which is the root cause of cancer, heart disease, diabetes, arthritis, autoimmune disease, hypertension, dementia and memory loss and so much more. So, doctor’s orders: close your eyes, follow the breath and enjoy a new vision for 2020. You deserve this.

Happy 2020. My vision sees a perfectly wonder-filled year ahead for you.

Angels and Elves

Joanne Dragun, M.D.3 Comments

A brick row home in Philadelphia set the stage for brilliant excitement of the season. Large bulb colorful lights framed a doorway as a beacon of warmth and love. The chubby Douglas Fir tree was tucked into a corner of the living room as space magically appeared to accommodate. A Lionel train chugged thru the carefully and lovingly placed tiny colorful houses lit from within. “Merry Christmas Happy New Year” banner was anchored over the arch into the dining room announcing a welcome to all and a cardboard fireplace in another corner with stockings attached. Relatives arrived regardless the weather, filling the home with love and cheer Christmas Eve and later in the evening an open house began. Mom passed her homemade pizza and Christmas cookies to joyful neighbors and friends who, in this mostly Jewish neighborhood adopted the holiday for the evening.

Twenty years later while working at Fox Chase Cancer Center in Philly, I witnessed a similar phenomenon. The hospital was well loved and developed a wonderful tradition. Permitting as many staff as possible to be home with families on Christmas, it opened its doors to the community for help. Barreling in, long before ugly Christmas sweaters were a thing, the excited Jewish community arrived in festive attire and joyfilled hearts. There were no HIPPA laws so they could help at the nurses stations, the kitchen was buzzing and no one cared if the orders were correct. Two elderly ladies struggled and giggled to work the industrial bucket wringer until they gave up and swiped the sheet from a gurney for a large spill. Men carved the meat in the busy cafeteria as if they were tailgating, the dessert slices were generous and the festive cafeteria gave the doctors, nurses and staff, who were necessary in a busy hospital, a chance to enjoy the excitement.

I cannot tell you how very grateful I am and I want to personally thank everyone who contributes to helping others treasure their holiday time with family. A colleague from Pakistan routinely covers another physician and I have a wonderful Doc caring for patients so I can visit grandchildren. When I was an intern on call and working 100 hours a week, my request for Christmas day off to be home for my sons and husband was ignored. When the schedule came out, tears sprung to my eyes and I could hardly get thru morning report. I was crushed with one more sacrifice; 36 hours on call. It was all just too much. A fellow intern put a hand on my shoulder as we headed out the door. “Joanne, out of 40 of us, you are the only one with children ( I was 12 years older having started school in my thirties) my girlfriend is out of town for Christmas but wants to celebrate New Year’s Eve. Lets switch!” And just like that my own Christmas was saved by a magical 6’4″ elf.

Christmas isn’t just a religious holiday. It holds excitement as children that evolves as we age, to anticipation of togetherness, gifting our hearts and love to each other. The emotions are fierce.

To those who celebrate and those who make it possible, my heartfelt wishes for every blessing. My thanks for your support, hope for those deployed for safe return, health for those who are ill, comfort for those who suffer, food for those hungry and warmth for those who are cold, memories in our heart for those no longer here to celebrate. Love for us all knowing that we are a community of people faithful to each other and God has given us a season to celebrate the miracle of our sacrifices and love.

Happy Hanukkah, Merry Christmas and Happy Holidays. May your every wish come true.

Comfort and Joy

Joanne Dragun, M.D.2 Comments

There is a new trend in holiday gifts. No, not the 72″ plasma TV. Shelves are packed with cozy comfort. Embrace the trend and hopefully find that gifting yourself and others some of these “doctor recommended” items will enrich your holiday, while soothing some “doctor-induced” side effects to treatment.

Oh so hot! Women with breast cancer and men on hormonal therapy suffer with hot flashes even long after menopause. Cooling sheets, pillows and towels are now available, a small fan to place by the bed and even peppermint bath and lotion can cool them down.

Have the tingles? peripheral neuropathy in hands and feet after chemo may be helped with tens units now available (often used for pain- but stimulation works) , foot massagers and hydro baths help too.

Work it out! Following a few weeks of physical therapy, keep the activity going so exercise bands, squeeze balls and rollers are useful.

Pampering is welcome! Certificates for massages, reflexology, scalp stimulation,makeup application and salon services can boost a mood.

Snooze alarm. Physicians are limited in our ability to prescribe pain and sleep aids. I recommend trying CBD oil and creams, chamomile tea, eye masks, meditation apps or CDs and a new favorite: weighted blankets.

On the scent. Scented oil diffusers or essential oils for topical use are calming. Lavender infused wraps and stuffed animals are always appreciated.

Change the mind and the mood. When my mother was not active, my sister gifted her with a beautiful scarf to lay over the blanket and add cheer to the room. Another sister advises continued learning and mind stimulation and with a subscription to “The Great Courses”.

Reminisce. Gifting memories with booklets or albums.

Can’t open a jar? Arthritic issues abound so copper infused compression gloves, knee braces, hot wax hand therapy and hemp infused creams may help.

Applause. Tickets to a show or game shake the doldrums and remind them life goes on.

Comfort food. Any homemade dish or cookies please.

Feel free to add your ideas here to inspire others. We are all about the wellness, but the true gifts of comfort and joy are not my “favorite things”. It is your presence in their lives. That gift is priceless and always the most appreciated.

ps: suggestion: print, highlight favorites and leave for Santa to discover!

Note: If you click the website link URL below, you get to see the adorable picture with each post – love this one!

About Face

Joanne Dragun, M.D.

“Doc I am thinking about getting a face lift.” Jane was treated for cancer four years ago and is in for a check up and doing well. “The cancer took a toll on me. I don’t even recognize myself. I saw a plastic surgeon and she recommended a partial face and neck lift, brow lift, blepharoplasty, fat injections and cheek enhancement”. Wow. Of course I ask the obvious question, “Jane are you going into witness protection?”

While Jane’s plan seems rather extreme, recently I am seeing patients choose less invasive procedures even trending toward a more natural look. Just last week the NIH reported an increase in breast cancer with permanent hair dyes and straighteners. Expect to see more grey heads. Its important to always consider the risk/benefit ratio. General anesthesia for radical procedures, while very safe, can have side effects. As we age, we will require some healthcare, but we should protect our brains from insult whenever possible. After a certain point (say 70) we should more carefully consider any elective procedures.

POCD (postoperative cognitive decline) following general anesthesia is a real phenomenon especially in people with heart and lung disease, stroke, Parkinson’s and Alzheimer’s. At 73 Jane already has “senior moments” and may want to reconsider her aggressive plan.

All procedures have some risk. Personally, I tried Botox to erase a frown line that can send a message of concern to patients even when I have good news. Unfortunately my eyebrow dropped (a rare complication). My internist said, “Joanne we should test you for myasthenia gravis with that eye droop”. A pulmonologist friend told me to get a chest x-ray looking for a Pancoast lung tumor that causes ptosis (droopy eye), A neurologist said “I know you are healthy but could you have had a stroke?” It took six long months to revert to normal and the frown was still there.

“Jane, I will support your decision but be sure you are well informed. Perhaps you could start with less invasive procedures and injectables that do not require anesthesia, it may be just enough to refresh you.”

My best advice is to guard your overall wellness, even while you may seek physical or cosmetic improvements. The spirited, clear, happy mind behind your beautiful eyes is what matters most. Wonderful youth enhancers readily available with no down time or recovery include a quick smile, joyful demeanor, sparkle in the eyes even with laugh lines and rosy cheeks from exercise. People will not notice your wrinkles if you listen and give them attention. Let your glow from within project a youthful mind and vitality. Trust me, you look Marvelous!

Rudolph

Joanne Dragun, M.D.3 Comments

We all have favorite Christmas carols and hymns, but even if you love the holidays, we can have fatigue for “BuBuBuBlue Christmas” quickly. I was reminded of my least favorite this morning. I stopped in the dark morning run to admire a full bright starry sky and big dipper. Thank goodness I did. A second later two large dear dashed across the path directly in front startling me, then a possum scurried in the opposite direction. My peace was disrupted but at least my heart rate was up.

Radio stations and malls start at Halloween and people feel pressured to decorate, shop and make travel plans two months ahead. This extended season causes many modifications in healthcare as well. People hold off on elective procedures, and often therapy is interrupted for travel. Patients pull out calendars filled with doctors visits interspersed with activities. Many cancel their plans to travel with a new diagnosis. “Doc, I wish I didn’t have the biopsy last month. I could have enjoyed Christmas more. Now I can’t stand hearing “I’ll be home for Christmas”.

Its a trade off- not just modifying the cancer journey but moving from hearth and home to live a warmer life in Florida. We all miss our relatives this time of year and face- time replaces the hugs. For those who can travel they will brave the cold, ice and snow to be close. What I experience with patients is how emotional the season can be. Many realize that time is marked by these holidays. Mary asks, “Doc, do you think I will be here next Christmas?” You know by now how important hope is. “Mary, I can say with absolute certainty that you will be here next Christmas, even if you are the Christmas angel”. She smiles sweetly.

Of course as always I have a recommendation. Cancer really doesn’t grow overnight. Some forms take years. You can postpone breast and prostate biopsies, scans, Mohs surgery, or starting radiation. Holidays are full enough- why invite more drama? Take control. Enjoy friends and family when you can. Too often I see patients dug into the therapy as if its the only thing important in life- it isn’t. There are empty seats at all of our tables this holiday. We won’t recall our loved one’s therapy. We will joyfully remember a time they celebrated with us. Make some memories for yourself and others. As a cancer physician I am giving you permission to celebrate and forget everything related to any illness. Do not forgo interactions because you don’t feel up to it- others will give you the energy you lack.

If you are already well into treatment and cannot get away, deliberately play the carols on the car radio and sing out loud- you know every word. Let them wash over you and smile at the memories. Indulge in corny holiday movies, make some cookies, brew Christmas coffee or sip some eggnog. You can still participate in the warmth and cheer. I love to do my shopping on line but then head to the mall to see the decorations and watch the anticipation the little ones have as they wait their turn for Santa.

Just remember when you hear the holiday music to smile and enjoy, unless of course it’s “Grandma got run over by a reindeer“. It was a close call!

Break with Tradition

Joanne Dragun, M.D.1 Comment

Do you have some special holiday traditions? Have you found them changing over the years? A comical one in my family for 18 years had us driving our Bichon Frise up and down the East coast to be sure he was part of the festivities. Scooter was worth every effort, but he probably dreaded holidays. When I see cute Christmas napkins with the doggie in the car I know pet lovers understand. What are your traditions now? Often modifications are necessary and can happen quickly.

This week many patients describe their upcoming Thanksgiving plans, some with trepidation. “I need a doctor’s note to get out of it this year. My kids, grand kids, babies and dogs all come into town and I am just not up to it!” I tell Miss Thelma that she can turn her kitchen over to them and just enjoy the visit. A few days later she is excited because she invited another patient who is without family to come to her busy home. “My grandson is going to pick up Mrs. Evans and I can’t wait for her to see my great grandchildren!” A new tradition is forming.

Marco is a big burly man who finished therapy and loves to cook. He just needs someone to cook for. “Doc I feel so blessed because I am done with you (what?) Since my wife died a few years ago and the kids are out of town, I decided to help at the church kitchen this year. I make a mean cornbread stuffing!” Mr. Griffith is handling treatment for prostate cancer very well and since he retired, busy with household renovations. “My wife added a job to my ‘honey-do’ list: make a reservation for Thanksgiving dinner!”

What these and so many other conversations have in common is a break from former customs. Although we love the comfort and familiarity of traditions, holding them too close can result in melancholy for times lost. The people I have the fortune to see have a new perspective with this health battle. Acceptance. Change what you can to still enjoy yourself. Looking forward instead of pining for the “old days” opens us up to many opportunities.

Karen said, “While my husband is deployed and with no family nearby, I am so happy that a few of us wives are getting together. We are all bringing a special dish and ordering the turkey. Thanksgiving sure has changed for me but now I can’t wait!” Since ‘the only constant in life is change’ (Heraclitus), be open to new experiences. You may be surprised how your day can welcome peace when your mind and heart are seeing the world so differently now.

What did cancer teach you? I am sure it was to accept, modify and be grateful. Scooter never could speak up for himself. I bet for all those years he wished he could just stay home but tradition kept us on a path. Changing your routine and customs may come as a relief for you and others, so explore options. It’s your life, your holiday. Be true to your own ability and desire. Be bold to make a new memory or be peaceful and tucked in. Whatever you do is right for you. Since Thanksgiving is about gratefulness, let transformations in your traditions bring you contentment. Life isn’t about the holiday. Its about celebrating you.

Happy Thanksgiving everyone- just remember to make it your own.

Healing words

Joanne Dragun, M.D.

“Doc, I want your opinion. The medical oncologist told me I had a 50-50 chance of beating this. What do you think? ” I am often faced with these conversations but wondered how to help fearful Gertrude who has metastatic disease and is still doing well with aggressive treatment.

“Do you have a coin in your purse?” She pulls out a quarter. “So Gertrude, the other Doc essentially described your survival as a flip of the coin. Why not try it, OK?” First she is dismayed but timidly hands me the quarter. “Here we go, heads you are a survivor and tails you live a good life. Call it!” I says these words so fast and flip quickly before she processes that I didn’t say live or die. It hits the floor and we both look down. “Tails it is! you live a good life!”

Did I negate Gertrude’s concern and misguide her? She is 80 years old, the disease will take its toll and some side effect from it will shorten her life- how long? I don’t know. She keeps tolerating therapy and does well. She already is a survivor so “heads” is right. She can still live a good life so “tails” is as well. Docs shouldn’t be in the business of scaring people to death.

“Gertrude, everyday we each have a zero or 100% risk or hope for survival. No body lives 50% and so as long as you do well, you are living your best life.” Worry and fear will only ruin what time she has left. Careful to not ignore end of life discussions, I often send patients to hospice who are finishing the fight. What I object to is the vagueness of percentages that have no meaning but to insight fear. And so, our little game today gave Gertrude a lift and I am reminded how words can heal. Speech “therapy” comes in all forms. Physicians may hold the tools for wellness but we do not hold the key for life and so for my practice, I refuse to steal what isn’t mine to give or take away.

It is important to think, read and speak healing words over our drama. My best advice is to give yourself 100% chance everyday.

Goal Oriented

Joanne Dragun, M.D.

What goals have your set for yourself? Is one to beat cancer? Probably in there somewhere, but usually our goals are more tangible: get to work, exercise 30 minutes per day, eat healthy. Very simple objectives. If you are on chemo right now, the goal may be to do all of these without being sick.

Every goal starts with an intention then action. Will you choose to set one today? Finish a project or start one? Mix up your routine, sign up for a course, go to a social? What all of these have in common regardless the objective is movement from inertia. “Hey, Doc I have cancer over here-leave me alone!” Remind yourself that you are not living for the cancer, you are living for you.

How about if we make a deal? There are 48 half hours in a day. If you haven’t exercised, then start for 30 minutes. That still leaves you 47 half hours to do other things! When we think about time in this way, it opens so many opportunities. It’s not some enormous commitment. Its 2% of your day.

Out of 1440 minutes in a 24 hour period, 30 is almost nothing, but the impact on you can be everything. Find something enjoyable or challenging. That’s it. Do this for you. When it becomes a part of your routine, find something else for another 30 minutes. It may be as simple as a walk in nature or visiting or calling a friend.

There are many opportunities to enhance your life that cancer has no control over. Take your power back thirty minutes at a time. Watch yourself gain strength. Allow intention to find destination. If you can remember to smile while you do it, even better!

Reminder: Monday is Veteran’s Day. We do not take you for granted. Thank you for your service.

“This is my fight song

Joanne Dragun, M.D.6 Comments

Take back my life song” (Rachel Platten,2015) . What a moving uplifting and powerfully energetic anthem when over 100 women hit the stage to sing out “I might only have one match, but I can make an explosion“. Yes they can and did in front of over 800 people in Cherry Hill N.J. last weekend. Everyone on stage was a survivor of cancer- most breast and ovarian for the million dollar fund raiser for Pink Roses Teal Magnolias brunch to benefit MD Anderson, Cooper Hospital Foundation.

My family and friends were present to witness this phenomenal event as our son, Anthony the Chair of Radiation Oncology was honored with the a “Hero’s Award”. Yes we are the parents bursting with pride. The day was magical on many levels.

Participants in the audience became joyful and overwhelmed. The survival stories were heartfelt and fearless, delivered by these inspiring women, expressing the drama of their own personal journeys, and the atmosphere was absolutely electric. There were tears and cheers and memorials as well.

The 10th anniversary celebration was lead by the former Mayor with her own ovarian cancer diagnosis who shared her mother’s journey as well. Her teal boots a physical sign that she will stomp out cancer with passion and funk. Of course our hearts burst as they honored our son- for his work at the hospital and also his research on the national protocols designed for the treatment of breast cancer. He has even cared for my own friends in this our former home town.

While everyone cheered the heroes, they also found encouragement, wisdom, love, compassion and a bond with the hundreds affected. They are NOT victims- not a one. They are champions and proud of their own work toward wellness. When they joined on stage, the energy was infectious. As they sang out: “Cause I’ve still got a lot of fight left in me” I doubt there was a dry eye.

Congratulations Pink and Teal committee- the monies raised stay at the hospital to help cancer patients – always the best way to donate to a cause. The devoted committee members now have oxytocin to spare and their strength built a wall of protection. Thank you for an amazing experience. Anthony said he is blessed to work with outstanding physicians and staff, while caring for wonderful patients and brave survivors. God Bless you all for your inspiration and Congratulations Anthony!