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Showing posts with label Children's Hospital of Philadelphia. Show all posts
Showing posts with label Children's Hospital of Philadelphia. Show all posts

Wednesday, December 03, 2008

Dream Team


For the fifth time in six years, I addressed second-year medical students at the University of Pennsylvania today. Here I am with some of the usual suspects, part of the "dream team" from the pulmonary department at the Children's Hospital of Philadelphia. In back (from left) are Dr. Jason Caboot, who is making his second appearance on Winheld's World, and Dr. Hank Mayer, who took care of me when I was hospitalized for my tracheotomy in 2002. Next to me is my friend Pat Hilferty, a fellow DMD'er who also addressed the students.

As always, it was something of a whirlwind tour, as I spoke to four classes in the course of an hour, but I thoroughly enjoyed the experience. It helped that, despite staying up late last night, my voice was very strong today. But what helped even more was that the students asked excellent questions, both medical and social. As a speaker, this showed me that they were interested, but as a patient, it showed me that these future doctors will soon join the ranks of medical professionals who "get it." After all, any good doctor, in my opinion, must ask good questions.

Of course, as those who know me will attest, even if you don't ask me questions, chances are I'll think of something to say. My legs may not work, but my mouth does!

Saturday, October 18, 2008

Breathe Easy



I remember some of the misconceptions I had about tracheostomies before I got one six years ago -- that I would be more prone to infection, unable to speak or eat easily (if at all), that the trach would be painful, that it would drastically alter my way of life.

So as I addressed a group of parents whose children have trachs, today at a conference sponsored by the Pediatric Airway Program at the Children's Hospital of Philadelphia (CHOP), I did my best to allay their concerns as much as possible, although every situation is obviously different from mine. I must admit that, despite the fact that I am still a patient at CHOP (pictured above with me is my otolaryngologist, Dr. Karen Zur), I was worried that my experiences might not translate very well to the experiences of parents with infants or young children with trachs. However, it isn't always possible for such parents to know how things like suctioning or changing a trach feel from their children, who cannot communicate on an adult level. No parent wants to subject her child to pain, so hearing from me that say, changing my trach doesn't hurt, is important.

Look, no one would choose to have a trach if it wasn't necessary. It was never something I really wanted and if there were a realistic option, I would have it taken out. However, I doubt that I would be here today had I never gotten a trach. With it, though, I am able to enjoy a pretty decent quality of life. At the end of the day, that's really all that matters.

Tuesday, August 05, 2008

Graduation Day


No, I haven't finished my master's degree. For that, check back next spring. Today was hopefully the last time I had my feeding tube changed at the hospital. Normally, a g-tube "button" such as the one in my stomach could be changed at home by a nurse. However, about a year or so after I had the surgery to place the tube, I developed what is known as a "false tract" and when we tried to replace the tube, it ended up going somewhere in the abdominal wall instead of in my stomach. Obviously not a good thing and let me tell you, when we flushed the tube, it hurt like hell!

On a couple of occasions, we all thought that the false tract had closed, only to find out that it had not. Then I would have to get to the Interventional Radiology (IR) department at The Children's Hospital of Philadelphia (CHOP) as quickly as possible so that the hole in my stomach would not close up.

Eventually it was decided that I would just go to IR on a regularly scheduled basis (every three months), where they would change the tube over a guide wire and then introduce a contrast solution so that they could check placement. However, it is always a bit of an ordeal. I have to get out of my chair and lay on a table. As I don't get picked up, I bring my Hoyer lift (my lucky nurse has to lift in and out of my van). Then it takes a while to position me on the table. When I first started doing this, it caused me a great deal of anxiety, as I was worried about hurting my legs, which are extremely contracted. Now, I don't worry at all. I know that my nurse isn't going to hurt my legs and the IR staff is always helpful in positioning me. They take their time and now know exactly what I need -- towels, pillows, straps, etc. -- to be comfortable.

But after three years of doing this, the doctor is confident that I should be able to change the tube at home again. So today, I had my nurse try to change it while I was on the table in IR. Everything went well, so it looks like we're good to go. To celebrate my "graduation," I decided to get a group shot of me with some of the IR staff. Here I am with (clockwise, from bottom left) Dr. Anne Marie Cahill, Corinne Leitheiser, Karla DiTomasso, and Jayme Whitaker. You'll have to excuse my open mouth -- it is such a great photo of everyone else that I had to use it.

Although they are a nice looking bunch (the female staff, anyway), I would still rather be able to have my g-tube changed at home. Come November, it looks like that's going to be possible. Wish me luck!

Wednesday, February 20, 2008

Exciting Times


Some things are truly worth the wait. Today, the New York Times story about DMD research and treatment for which I was interviewed several weeks ago finally ran. The article and video can be found here. I thought it was a great piece that highlighted the fact that without a cure for Duchenne's, doctors are now focusing on managing the disease, "making better use of available therapies to eke out longer lives for their patients." There is no doubt that it is this philosophy that has been responsible for keeping me around.

Naturally, I was most impressed with the video segment that ran with the story because it featured me! Just like the print article about me that ran in the Philadelphia Inquirer on Monday, the story was not overly dramatic, but offered an honest account of my life. Not only did it address the medical issues that I face, but it also focused on some of what I've been able to accomplish in spite of my disease.

Still, I would be remiss if I did not raise an objection to the part of the article that described how one boy, whose ability to walk appeared gone forever, regained that ability. While this is a wonderful thing, I think that parents often get too carried away with the fact that their son is going to be a wheelchair. Obviously, no one wants to be in a wheelchair. But the fact of the matter is that you can accomplish much in the wheelchair and I think it's important that parents of children with DMD, one of the audiences targeted by this blog, understand.

Today's world is becoming more and more accessible. And let me tell you, when I started using my wheelchair, it was a tremendous relief. Sure, I was able to walk before that point, but it certainly wasn't easy. I was terribly unsteady on my feet, constantly afraid of falling.

My point here is that, yes, we need to cure all aspects of this disease. But let's not forget that being unable to walk will not kill you, but the pulmonary, cardiac, and nutritional aspects of the disease will.

Perhaps with stories like the one that appeared in the New York Times today, hopefully one day soon, we won't have to talk about any such aspects of DMD because there will be an effective treatment for the disease.

Thursday, January 24, 2008

Genetically Speaking II


How many times can I show a picture of me talking to a class? I decided to change things up and have the genetic counseling students I spoke to today surround me in the above photo. I don't know if you noticed that they're all of the female persuasion. I did, though I didn't happen to get any phone numbers!

Still, they were nice enough to listen to me for an ENTIRE HOUR. Prior to my appearance, the students learned about Duchenne's from one of the doctors at The Children's Hospital of Philadelphia. My job was to share the more personal side of the disease. I used a PowerPoint presentation containing photographs at various points in my life.

But as this was a class on genetic counseling, I also shared my thoughts about genetic testing and pregnancy termination. I took some heat from a few readers for my comments on this to last year's class. I told the students that I would personally not want to bring a child into this world knowing he would have DMD. That doesn't mean I'm rejecting my life or the lives other guys with the disease. There was no genetic testing when many of us came along. Once you're here, I believe you must live your life to the fullest. But nobody wants to have Duchenne's. I would not knowingly want to subject my child to it.

That's just my opinion, though I would think there are others out there who feel the same way. So criticize me if you will, but please respect my opinion as I'll respect yours.

Wednesday, November 28, 2007

Welcome Back




In what has become an annual tradition, I joined several pulmonologists from Children's Hospital of Philadelphia in addressing the second year students at the University of Pennsylvania School of Medicine, where I have seemingly become a regular speaker. In fact, some of today's students remembered me from my spring presentation, when they were in their first year of school. I might just have to change my material next year -- maybe I'll an outrageous foreign accent or something!

As usual, my favorite part of speaking to the students was answering their questions. As the work that I do involves assistive technology, I enjoyed answering the question I was asked about how I use my computer (voice recognition software and an infrared camera mouse). But I thought that the most interesting question I received was when someone asked me when I knew I would attend college and how that decision came about. That was easy. I always planned on going to college. My parents expected me to do so. Where I attended high school, it was practically unheard of not go to college. I saw myself as no different from anyone else. Plus, while I was in a motorized wheelchair, and I missed some time to have spinal fusion surgery, I was relatively healthy.

I would love to be as healthy and energetic as I was back then. Even so, I felt fortunate just to be here, doing what I do best: talk. Whether anything useful actually came out of my mouth, well, I'll let the students be the judge of that!

Wednesday, October 24, 2007

A Captive Audience


Oddly enough, when I talk, people actually listen to me. Well, unless I'm at the dinner table with my family! Today, I addressed a group of pulmonary nurses at Children's Hospital of Philadelphia (CHOP). Drawing upon my experiences as both a teenager and an adult, I talked about what it's like for someone like me to be hospitalized.

For example, at home, my environment has been adapted to my needs. In the hospital, there's not much that I can do for myself. I can't change the channel on the TV. I can't read anything because I can't hold a book or turn its pages. I can't feed myself. I feel bad asking the nurses for help with these things because I'm not their only patient and they have more important things to do than to find me something interesting to watch on TV.

Help using the bathroom isn't something I have a problem asking for, but there's nothing like having a full bladder and you have to wait for the nurse to arrive. As a result, I would drink as little as possible. However, eight hours later, they would want to catherize me because I had not urinated!

Even calling the nurse is an issue because I cannot physically push the nurse call button. At CHOP, they now have sip-and-puff devices that allow you to trigger the nurse call systems with your breath, so that does help -- unless, of course, the device slips out of the range of your mouth.

One of the nurses brought up the issue of positioning. For many of us, it can take a lot of time to get comfortable in bed. I know that I often need my head moved several times. The pillows supporting my legs need to be placed in exact position. It can be very frustrating for caregivers.

"But trust me," I told them, "We find it just as frustrating as you do!"

On the subject of positioning, I also talked about the fear that people like I have of being moved by nurses because many of us have contracted arms and legs. It's not just that my legs are locked in place; it hurts when they are moved too much. One wrong move and I could be injured.

But I think that the biggest message that I tried to get across was that when you are in the hospital, you tend to act differently than you would at home. I explained how I became a lot more emotional when I was in the hospital for two months. Things that ordinarily would not have bothered me did just that. I only wished the nurses and doctors could have known me outside of the hospital because they would have liked me!

During that hospitalization, I was an adult. So if it was bad for me then, just imagine what it's like for a child. One of my most vivid memories from my hospitalization at age 15, following spinal fusion surgery (other than being in pain), was one of the nurses wanting to give me a bath. I felt awful and the last thing I wanted to do was get washed. All I wanted was to be left alone and I was less than pleasant to deal with. At that moment, whether I smelled badly was hardly the first thing on my mind.

Not a fun experience, to say the least. Let's just say that I was much more pleasant today -- and I smelled a whole lot better, too!

Thursday, October 05, 2006

Out with the Old, In with the New



I had the my feeding tube changed today in the Interventional Radiology (IR) department at Children's Hospital of Philadelphia (CHOP)*. Through the feeding tube, also called a g-tube -- "g" is short for gastrostomy -- I receive medicines and liquid nutrition similar to Ensure. Normally, the 4 cm long tube (pictured above by itself on the left and in my abdomen on the right with a gauze pad against my skin) could be changed at home, but because I have what is known as a "false tract", the new tube tends to end up in that tract instead of in the stomach (not good). So every three months, I go the hospital, where a wire is inserted through the old tube while still in my stomach. The balloon holding the tube in place is deflated using a syringe and the tube is pulled out. The new tube is then slid over the wire and its balloon inflated. To confirm placement, an x-ray of the stomach is taken while a contrast dye is injected through the g-tube.

Piece of cake? You try having someone yank something out of your stomach sometime! Not only that, but getting on the table is complicated by the fact that my knees are contracted and I cannot keep my hips from flopping out to the side. I need restraint ties and several towels and pillows to safely position me. I bring my Hoyer lift from home because it's the safest way to move me. But it does not reach the level of the table, so some careful maneuvering is required!

It's not exactly my idea of fun, but with the help of my nurse and the considerate IR staff (thanks guys -- you're the best!), I get through everything just fine. As for the discomfort from the tube change, it's relatively mild and is usually gone within a day or so.

*You may be wondering why I still go to a pediatric hospital at age 28. The reality is that until fairly recently, few Duchenne's patients reached adulthood. That's obviously changed, but the best clinic remains at CHOP, so doctors, nurses, and other staff are familiar with the disease.