Prostate Cancer Radiation Treatment is Over


I finished my 37 days of treatment last week and it was an unusual experience, a little emotional almost like leaving a job. They told me I was a model patient, I had followed all the instructions about diet and exercise and only had to get off the table once over the two months (because of wind). The average I’m told is 6.

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The faces in the lounge were changing and the people I had started to get to know had moved on and like me will be waiting for news of successfully shrinking or obliterating tumors. I had my last walk past the electric aquarium designed to relax you as you walk to the table. IMG_3489

I thought about asking if I could take some photos while the giant machine was rotating around my body, but I decided I didn’t have the energy and the answer would probably be no, because you can’t move an inch while it is operating, or risk damaging healthy parts of your body. I won’t ever forget it anyway. Mercy Scanner

When I finished, they gave me a lovely card full of congratulations handwritten by a dozen or more of the staff I had come to know, goodwill messages and instructions not too work too hard. It was like leaving a job. Very touching. I can’t tell you how important it is to have good people looking after you, who really make an effort to get to know you and keep your spirits up, whilst prepping you, which can be intimidating and embarrassing.

IMG_2153So I was out of my lava-lava for the last time and off to see the nurse.

lava lava He told me that my side effects are going to peak in around two weeks. I got a form telling me that the tiredness Apparently despite taking a drug to reduce the may last up to a couple of months after the treatment, then I should start feeling my normal self again. There are other side effects that may develop several months or years later, but lets get rid of the cancer first!

We discussed that the drug I am taking that reduces the side effects like having to pee painfully every hour and having to go again 20 seconds after I thought I had finished, my blood pressure was fairly high. Kind of understandable given what my body is dealing with but a side effect of the drug is that it lowers your blood pressure. That’s a little bit of a worry because my GP is always telling me that my blood pressure is usually low and better than his. I’ve had the odd moment when I get up and get that blood gone from the brain wooziness, but I’ve learned to get up more gently. It wouldn’t do to find myself on the floor in the middle of a business meeting!

He told me to take it easy with my diet because my body has now adjusted to the changes and I will suffer if I try to go back to everyday food too quickly. He was right, but that’s another story.

 

 

Coping with stress in Christchurch


Never before have we experienced a situation such as exists in Christchurch today. As was seen on Campbell Live last night people are at breaking point. Even the ambulance officers who were interviews, some of whom  had lost their own homes appeared to be close to losing it, fighting on because they are trained to, because “my uniform says I am there to help”. Men saying they “Cried last week for the first time in 20 years”.

The situation is looking incredibly serious. We have our 2nd largest city full of people suffering from Earthquake Syndrome. Interestingly it is very difficult to find information about the psychological impact from a New Zealand perspective, which I blogged about yesterday it seems as if the authorities are keeping it as quiet as possible, worried that it will get worse if people start talking about it.

In the absence of anything else, I think that is exactly what they should be doing, but more on that in my next blog. Maybe its naive of me, but today as a citizen of NZ with no mandate or authority I emailed Dr Martin Seligman of the Positive Psychology Centre at Penn University. In the US they experience repeated incidents of natural disasters in certain areas and of course with their military forces they also have extensive experience in PTSD. In NZ we really have no skills to understand or deal with repeat natural disasters and their human psychological consequences at a level like this, which in my opinion is why we are doing very little about it. We aren’t coping with the demands of repairing buildings, deciding which suburbs stay or go. We still aren’t dealing with the damage to buildings and the EQC is not paying trades people who are close to losing their businesses for trying to help people keep their homes habitable.

If you haven’t seen the Campbell Live tent recordings where they left people in a tent without any interviewers prompting them, to say how they feel, watch the following video and tell me you are not moved.

I feel sick and sad this morning


Footnote to my story in November called “Why don’t auckland hospitals work smarter rather than harder.” and the previous one The Hospital is the best place to be when you are sick, or is it?

My friend passed away this morning after an agonising battle with cancer. One has to wonder how much easier it would have been for her if she had received the treatment she was entitled to at the times she was turned away due to strikes and staff shortages. I’m sure she would still be with us today if she was able to receive the treatments and surgeries she was scheduled for.

Her husband is one of those nice old school Kiwi guys who listens to what he is told and didn’t want to rock the boat. He refused to fight through the management or the media to get the treatment his wife needed because he felt that was not the way you behave. Now he has lost his wife and soul mate too soon. We had to respect his right to be true to himself, but I’m not sure we have to accept the system that put him in that position.

My advice, if you are in a situation like that, where lives can be saved or prolonged and the bureaucratic penguins and the system is holding stolidly fast to this is where the line starts and if you’re not there anymore when you get to the end of the line, will the next patient shuffle forward, make a noise like someone’s life depends on it, especially if it does. People who go to the media miraculously get the treatment they need and sometimes before its too late.
We Kiwis need to stop being PC and accepting the bs that comes from our health industry. Note its not the wonderful hospital staff, they are put in an invidious position by the administrators, by the beurocrats and by the politicians who sleep sound at night and whose close ones are probably not getting turned away because “a registrar is off sick and the shift couldn’t run”. They are the ones who have to lie to the patients and their families when cost cutting measures, old fashioned systems full of lost paper files and ancient systems, and cost cutting means many people don’t get their surgeries, live or die in pain.

This person’s story is over. We won’t be going to the media or fighting because it is not what her husbands wanted. I respect that and much as it burns me, I will not add to his grief or risk creating feelings of guilt to him to make matters worse. He came from a generation who said yes sir, I know you are doing your best and genuinely trusted that. She may still have died, in fact probably would have, but she might have had a few more years and she certainly wouldn’t have suffered the degrees of agony of that she did over the last 4 months. We don’t do that to animals.

If you find yourself in a situation like this, make a noise, get your loved ones help, let the media know and as a country we have to get our government and administrators to invest in the new technologies that in the long run will cost less and save more lives.

Why don’t Auckland Hospitals Work Smarter Instead of Harder

 

 

3D Bioprinting


3D Printing is no longer news although I suspect most people haven’t heard of it yet. In fact there is a company within a couple of km of my office in Albany already successfully offering a variety of 3D printing services, incidentally called 3D Print. Another Aucklander, well known internationally in the  3D printing with RepRap is Vik Oliver, seen here with one of his machines.

When I heard that Richie McCaw was injured and after surgery was going to miss around 6 matches after having a titanium screw in his foot, my first reaction was, as most Kiwis, just what we need in Rugby World Cup year as he is such an amazing skipper and we want him there leading the All Blacks. Then I thought about so many other sports people who suffer injuries all the time given that they are putting their bodies on the line professionally.

Imagine a technology that rebuilds or repairs body tissue, bones, ligaments, even organs in vivo, using micro surgery techniques that mean people recover far more quickly, naturally and potentially therefore stronger than before.

Using the same types of technologies as conventional 3D printing, it will soon be possible to pattern and assemble, layer by layer, functioning living tissue, as well as non living substitutes such as ceramic and titanium according to Vladimir Mironov, an associate professor and director of the Advanced Tissue Biofabrication Center at the Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina. He is also currently making waves about growing in vitro meat, something I have previously blogged about.

So this is a relatively new technology and I don’t know that it has been tested on humans yet, but the technology is already commercially available from companies such as envisionTEC.

Imagine the good this technology could do for people with problems from injuries, burns, through to the huge numbers of people who die for lack of organs for transplant.

The following video shows how bioprinters will be used in the long term. The technology will also be used to create human tissues which can be used for drug testing instead of using animals.

Of course if tissues and organs are made using material from the host, we can eliminate problems such as donor organ rejection.

Robots to learn human emotions


At the University of Hertfordshire they have been working on a model of children’s early attachment behavior for robots. Their goal is to apply nature and nurture with artificial intelligence so that robots can become caregivers for children in hospital.

“What the Hal?” I thought when I read about this in The Futurist. If you follow my blog, you will have read previous posts such as the one I wrote about Singularity. AI is obviously going to come, but the concept of nurture applied to a robot is something I struggle with, especially with children and even more so sick children who are in pain or stressed.

In principle the idea of a robot that can play games with children, have unlimited patience and intelligence, makes total sense and is a great idea. But when it comes to EQ, I’m not sure how it would interpret immature and potentially irrational behavior.

There have been a number of studies suggesting that children and even teenagers are often unable to understand the consequences of their actions. Many people argue that risk taking is a natural growth path in the development from children to adults. This makes me wonder what would happen if robots learn from children and interpret their behavior as normal. Imagine for example if a robot goes from learning paper, rock scissors, as in this video and then learns to pillow fight or throw objects, from the children.

I’m not being a Luddite, I love new technology, but I do have some concerns about singularity and whilst I would love a robot to vacuum, mow the lawns, cook and do other chores for me, I would prefer them without the emotional senses.

I’ll leave the last word to HAL 9000

Would you like HAL looking after your sick child?

Why don’t Auckland Hospitals Work Smarter Instead of Harder


A friend of mine was prepped for 2 days with nil by mouth a month or 2 ago for urgent cancer surgery. The first day she got bumped and the 2nd day was the start of a radiographers strike. Last night she was prepped for an 8 hour operation and got bumped due to a critical case that suddenly appeared. We thought she was criticial, but obviously that’s not for us to judge.

I’ve asked the question before “Is hospital the best place to be when you are sick?” and pretty  much decided unless it was a private hospital, possibly not. But of course most of us don’t have any choice especially as we get older.

It is nice to see that some things are improving. For example Auckland Health Board has decided to send some patients to private clinics for radiation treatment to reduce waiting times.

I had blogged previously about waiting times at North Shore Hospital based on experiences waiting with family members in A & E and subsequently in corridors in some cases for days, without being assigned to wards. Each time we were told that it was an exceptional case and we were just unlucky. A registrar was sick and therefore his team couldn’t operate was a common excuse. Think about it, an entire team doesn’t operate because one person doesn’t turn up? Maybe they were stretching the truth, being they are short staffed and can’t afford another registrar, and they didn’t turn up because they didn’t exist.

According to the reports, North Shore Hospital is improving and it is now only the 3rd worst in New Zealand. North Shore Hospital supports North Shore and Waitakere with an excess of 400,000 population and rapidly growing. Of course things will change with the new Super City, but the problems won’t go away.

As you can see in previous blogs I’ve written such as ‘76 Deaths, Surgical Mistakes in New Zealand Hospitals‘ I have been pushing for more specialized technology to streamline processes for many years. The technology has been around for a long time, yet we still seem to rely heavily on paper. Tablet and handheld computing has been around for a long time. Most of us use WiFi in the home, in cafe’s, at the airport and understand the power of dealing with information once, accurately and allowing instant access to anyone who needs it in a timely fashion. That’s how we live.

I now see bar codes on patient wrist bands, but I don’t see them being read by a handheld computer to check for allergies, conditions etc at the bedside. This technology could have saved many NZ lives at a tiny fraction of the cost of their lost lives, productivity etc.

When I started promoting this technology, it was with Pocket PC, Palm and Symbol technologies (handheld computers, 3D Bar Code Readers, Portable Printers, Digital Cameras which were being used in many US and European hospitals and that was 20 years ago!

Today there is superior technology such as the Panasonic Mobile Clinical Assistant CF-H1 which runs on Windows 7. The video is pretty corny but it really does illustrate how efficient it is to use mobile technology. Of course this technology has a rugged drop spec, is chemical resistant, lasts 6 hours on a standard battery.

This technology means everyone is in sync and has access to critical data on demand. Paper gets misplaced in hospitals. I had one visit with a daughter that was delayed by 90 minutes simply because someone had misplaced her file. Data can be shared with specialists and medical staff in and out of hospital, including images such as scans, x-rays, photos, test results, charts and graphs. Allergies and condition interactions can be monitored to minimise risk of causing new problems, doses can be confirmed, approvals provided remotely. Pretty much the whole world’s medical knowledge is available online today.

Today’s world should be about harnessing technology to work smarter rather than harder. I suspect the focus is on cost of the technology because our hospitals are run by administrators tasked with saving money. Of course they are largely man aged by politicians. If health is a major election platform every election, why is it that the performance is still so poor?

Next time you are in hospital, have a look at how they use or don’t use technology. Think about how you operate in your business. Think about what’s at stake and ask them why they do things the way they do.

We have national elections next year. They will be talking about improving the health system. Will they be talking about improving the ICT structure and putting information in the hands of the clinicians? Or will they be talking about saving money, improving the monitoring of staff performance and measuring waiting times in A&E?

We have an ageing population and growing population. They are going to need more services and we could increase our throughput, reduce patient risk, significantly improve outcomes by harnessing technology, working smarter rather than harder, expecting great results from staff working double shifts several times a week.