Ray of Hope...
Janice Ray seemed the least likely person to get breast cancer. She was a fit healthy eater with no family history or genetic markers for the disease. But working many years for a family physician who emphasized wellness meant Janice did a regular self-exam, which, one month in 2008, led to the diagnosis of a malignant mass. It was the beginning of a long road back to health.
After a double mastectomy and the removal of 25 lymph nodes (two of which were positive for cancer), she began six cycles of chemotherapy in February 2009, followed by six weeks of daily radiation therapy that summer. “It was a long year,” she recalled. After taking most of 2010 off to rest and regroup, late that year Janice began the process of reconstruction which began with a 13-hour microsurgical ‘TRAM flap’ procedure and was completed with implant surgery in June 2011. Except for the specialized microsurgery, all procedures and treatments were performed at Rideout Memorial or the Rideout Cancer Center.
It was the Cancer Center that became Janice’s home away from home, and she cannot speak highly enough of everyone who works there, from medical staff to administration. “Oncology nurses there are definitely a very special breed, but everyone there is caring, helpful, gentle and hopeful, and you need all of that when facing a terrible illness. It’s an amazing place, from beginning to end.”
Her treatment team was led by her oncologist, Dr. Pamela Oster, whom Janice calls “my phenomenal woman.” She says, “you really get that she deeply cares about what she does, and about her patients. She encourages second opinions, always has an answer or gets one immediately, and will call you after a visit just to settle your mind. Whatever it is, she’s on it. ”
Now cancer-free, and happy to know she did not pass on a breast cancer gene to her children or granddaughter, Janice still returns regularly to the Cancer Center as a volunteer and serves on its Patient and Family Advisory Council. She recently completed her training as a “Peer Navigator” in the WeCARE! program that matches newly-diagnosed cancer patients with trained cancer survivors who act as confidential and compassionate guides through uncertain waters. The program is available to any newly-diagnosed cancer patient, regardless of where they receive treatment.
“The Cancer Center was my rock, and so I’ve gone from patient to volunteer to trained Peer Navigator to help others through their own journeys,” said Janice.
Jim Smith, a veteran of two U.S. military services (Marines and Air Force), looks like a big, tough guy, but he has a sunny disposition and a real soft spot for special people. They include his wife, their kids and 14 grandchildren, and now, added to that list, all the staff on Four Main at Rideout Memorial Hospital. While he does have a bad back from an old injury, at only 56 Jim hadn’t been expecting any life-threatening illnesses.
But this February, chest pains brought him down from his foothills home in Brownsville to the Rideout Emergency Department, and tests revealed a narrowed artery that was going to require a stent. He was whisked over to a cardiac cath lab in Rideout’s Heart Center, and from there to a patient room on Four Main.
He has much praise for Doctors Singh and Chin, but offers special compliments to the nursing and support staff on his floor, whom he calls “phenomenal and beyond.”
Sonia, Joy, Carly, Bill, Jennifer, Eric, Cinnamon, Rochelle. Denise, Lauren, Sarah. Jim ticked off the names, apologizing for not remembering them all. “I was a little out of it that first day,” he explained.
“They all stood out; they were efficient, kind and friendly. I’m a pretty big clown and they could take it and give it right back to me. It cheered me up, even though some of them were carrying needles,” Jim recalled with a smile.
“And when my family came to visit, they made them comfortable, too, and reassured us all that everything would be fine. I’d been a patient years ago and remember how Rideout used to be. It’s a whole different world now; I felt like I was a VIP at the Hilton,” Jim said.
“And, of course, they saved my life.”
Most of us keep track of time and work by the hour. Some must count the minutes.
In early May, retired San Jose police officer Hank Schriefer, 70, was working in his Lake Wildwood garden when he felt a familiar pain in his chest. He’d had a mild heart attack the year before, so he knew the signs. That time, he’d been taken to a local hospital, stabilized and transferred to Sacramento for angioplasty. This time was different. As his pain worsened, Hank took an aspirin and nitroglycerin, and asked his wife to dial 911. Then, as Hank put it, “Everything went to heck.”
When paramedics from the Penn Valley Fire District arrived, just five minutes later, Hank was barely conscious, with low blood pressure and a heart rate of only 28 instead of the normal 60-100 beats per minute. Hank recalled, “My eyeballs had rolled back in my head. I knew I was on my way out.”
The three-man team, led by Firefighter/Paramedic Eric Suarez, gave him oxygen and began ‘pacing’ his heart with external electrical stimulation. “Eric did a super job. Even though I was out of it, I could see that he really took charge,” said Hank. The ambulance was soon heading down Hwy 20 to the Emergency Department at Rideout Memorial, a certified STEMI-receiving center equipped and staffed to treat extremely serious heart attacks. They would make the winding 35-mile trip in just 30 minutes.
Every minute counted.
Just six weeks before, the Penn Valley FD rigs had been equipped with wireless EKG machines, and the paramedics trained by Rideout’s ED Clinical Nurse Educator, all funded by the Rideout Foundation. This was the first time they would be used in the field. While en route, Hank’s precarious cardiac status was being transmitted to the Rideout ED, where a multi-disciplinary team of emergency and cardiac specialists — physicians, nurses and techs — were already mobilized. Every minute counted.
Upon arrival, Hank was surrounded by the STEMI team and taken straight to the cath lab, where interventional cardiologist Dr. Karanbir Grewal inserted a temporary transvenous pacemaker. The blockage in Hank’s right coronary artery was 100%. They aspirated the clot in his artery and put a stent in place. The circulation to the heart was restored in only 17 minutes from arrival to the hospital.
“He was in cardiogenic shock, a condition with a mortality rate greater than 80%,” said Dr. Grewal, who began practicing at Rideout in 1998.
After a night in Rideout’s Cardiac ICU and a second in the cardiac “step down” unit, Hank went home to his wife and his garden. “Everyone at the hospital was great, and they were really good with my wife. I was very impressed. After three years as a Firefighter/Paramedic, Eric Suarez already considers the outcome of this 911 call “the highlight of my career.”
From the time the paramedics reached Hank in Lake Wildwood to the restoration of blood flow to Hank’s heart at Rideout, only 88 minutes had elapsed. Every minute counted.
“The sooner, the better,” stressed Dr. Grewal, who is Board-certified in both clinical and interventional cardiology, is how quickly one should seek help for a heart attack. Heart damage is a function of time. “Everyone must be educated to call 911 immediately and take an aspirin.” Every minute counts.
Now retired from the Nevada County Dept. of Public Works, Nevada City resident Dennis Shank has focused more recently on rebuilding his health rather than roads. His cheerful demeanor belies the fact that he has been battling Chronic Lymphocytic Leukemia, which this year was compounded by a lung cancer diagnosis. Because it was detected early, surgery was an option, but his case was not routine. When he was five, Dennis had received radiation treatments to his neck and chest for an ear and throat infection, which left his vessels and lungs delicate and difficult to dissect.
Dennis and his wife, Betty, thought he would have to go far afield for the sophisticated lung surgery he required. But his oncologist recommended that Dennis first consult with Dr. Royce Calhoun who had just joined Rideout Health after eight years at UC Davis, where he had been an Associate Professor of Surgery and Surgical Director of UCD Cancer Center's Thoracic Oncology Program. Dr. Calhoun, who did his cardiothoracic surgical residency at the world-renowned Cleveland Clinic, performed the first minimally invasive lobectomy for lung cancer in Northern California in 2006 and hundreds more since. The procedure, known as Video Assisted Thoracic Surgery (VATS), enables a surgeon to access the chest cavity without spreading or cutting ribs or cutting much muscle, allowing a much faster, less painful recovery instead of the three months usually required by traditional surgery.
When they met, Dr. Calhoun had just moved into his new office. Dennis recalled that the surgeon "had not yet unpacked, so he drew a diagram with a felt pen on a paper towel. He was very detailed in his explanation about how the surgery would go. He's full of humor. He lightens up the situation. His confidence filled me with confidence about the surgery."
Soon after that meeting, using the VATS technique he pioneered in the region, Dr. Calhoun performed the surgery to remove the cancerous lower lobe of Dennis' right lung with just four small incisions, each about an inch or smaller. Dennis was up and walking the same day. Two days later, he was home, with no activity restrictions. "If Dr. Calhoun says you can do it, you can do it, and I did." Three weeks later, Dennis and Betty were on their way to Arizona to root for grandsons Tyler and Logan in Chandler High's final game of the season. Life is back to normal in Nevada City, Dennis reported. "Betty organizes everything; I just bring in the wood."