This month we celebrated the 238th birthday of our country. This summer is also the 50thanniversary of the Freedom Summer – a time when the Congress on Racial Equality and the Student Non-Violent Coordinating Committee mobilized to register Black voters in the U.S. South. Both “revolutions” required upsetting the status quo so the country could move forward.
As we focus on national and personal freedoms, let’s not forget that “upheaval” is also needed in health care. With patriotism must come national self-reflection; a collective look at our failure to ensure equitable health care for all. I continue to wave the flag of freedom from inequitable health care for people who are poor and elderly, or otherwise treated differently. Continue reading →
Inflammatory bowel disease (IBD) is an umbrella term used for diseases that involve chronic inflammation of all or part of the digestive tract. Crohn’s disease and ulcerative colitis are two most common forms of IBD. IBD is different from IBS (irritable bowel syndrome), which can have some of the same symptoms, but does not cause inflammation or permanent damage to the digestive tract.
Symptoms of IBD include rectal bleeding, abdominal cramping, fatigue, weight loss and diarrhea. Most people with IBD begin experiencing symptoms before the age of 30. It is more common in Caucasians, but can occur in any ethnic group. Those with family members with IBD are also at higher risk. There may be environmental factors involved as well, as people who live in an urban area or industrialized country are more likely to develop IBD.
IBD is diagnosed after ruling out many other potential causes of the symptoms. Doctors may use several diagnostic tests, including blood tests, stool samples, colonoscopy, sigmoidoscopy, and various imaging tests.
As a geriatrician, I have helped counsel families who are in one of the most difficult stages of caregiving: when their loved one’s advanced dementia has progressed so far that eating without help is no longer possible.
Naturally, people want their family members to be comfortable and from the beginning of life, we have learned that being fed – whether through a shared homemade meal or hot bowl of soup when you’re ill – is among the greatest expressions of love.
In up to 20 percent of patients with Crohn’s disease, the disease is isolated to an area of the small bowel that is out of reach of an upper endoscopy (a procedure where a scope is passed through the patient’s mouth and into the esophagus, stomach and upper part of the small intestine) or a colonoscopy (a procedure where a tube is inserted into the patient’s rectum and passed through the colon). This makes getting a proper diagnosis challenging. Without a correct diagnosis, we can’t know if we are treating the right disease.
We have made strides in imaging techniques that allow us to see a patient’s small bowel. During a capsule endoscopy the patients swallows a pill-sized camera. As the capsule passes through the patient’s body, Continue reading →
Resources from Thoracic Surgery at U-M helped Mike McFarlane and his wife get back to the things they enjoy–like riding his motorcycle.
In October 2010, I was diagnosed with esophageal cancer by doctors here in Saginaw. They referred me to the University of Michigan for further evaluation and treatment. The treatment plan involved a combination of radiation and chemotherapy, which I received in Saginaw, followed by surgery at the University of Michigan.
I tolerated the chemo and radiation well. I went in for treatment in the morning and then to work. I work in the tent rental business and the winter is our slow time, so it was mostly answering phones and office work, but I was happy to be able to continue working through my treatment. On February 17, 2011, Dr. Reddy removed most of my esophagus. During the procedure, called a transhiatal esophagectomy, he pulled my stomach up and reattached it to the remaining top of my esophagus.
Although the surgery sounds awful, I feel I personally handled it well. I was in the hospital for a total of seven days and was able to walk the day following surgery. I had a feeding tube, but only used it during my stay in the hospital. Dr. Reddy’s team and everyone at the hospital prepared me and my wife for the surgery and what to expect afterwards. This made my recovery easier to handle.
The first week at home was pretty rough, but my wife really helped me that week with things that were too hard to do myself. I adjusted to the new way of eating. I had to eat smaller portions and really chew up my food well. I only had a few eating restrictions including bread, carbonated beverages, etc. Only by trying different foods after the surgery did I learn what was tolerable for me. And now, as long as I can swallow it I can eat it.
In May of that year, I started to have trouble swallowing. We went to see Dr. Reddy who told me I had a stricture (a tightening) from where the surgery was healing. He put a tube down my throat to stretch the stricture and break up the scar tissue. He taught me and my wife how to do that at home. Putting a tube down my throat isn’t my favorite thing to do, but it helps keep the new passageway to my stomach open, so I do it. At first, I did it every day for 30 days, then I tapered off. Now I do it about once every five weeks.
Because we live in Saginaw, I wasn’t able to participate in some of the patient support groups at the University of Michigan, but I did connect with a videoconference support group once. It was interesting to hear other people who were dealing with a similar situation. It was helpful to hear other people talking about the issues they faced and how they dealt with them. It gave me comfort to know I was not alone.
Three years after my surgery, I’m healthy and grateful to Dr. Reddy and his team for their expertise. When he told me back then that I’d be fine and things would get easier with time, it was hard to believe — but he was right, things really do get better! My wife and I enjoy riding my motorcycle, working in the yard, and spending time with our children and grandchildren. As previously stated, I eat much smaller meals now. Also, I try not to eat or drink after 8 p.m. I’m much healthier now.
For anyone facing a similar situation, my advice is to go into it pumped up with a good attitude and follow the doctor’s orders. It’s worked for me!
Mike MacFarlane lives in Saginaw, Mich. with his wife of 37 years. They have three children and four grandchildren. They enjoy riding Mike’s Harley-Davidson on trips around Michigan. His experience as an esophagectomy patient relied heavily on the support services and insight available from U-M Thoracic Surgery.
Thoracic surgery at the University of Michigan is a nationally recognized leader in the surgical treatment of patients with diseases of the esophagus, lung, mediastinum, trachea and diaphragm. We are dedicated to providing patients the type of supportive care they need to regain their lifestyle after a serious procedure, including esophagectomy.
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