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I was talking to this gentleman who sat across me in the OPD a month ago.His mother has been diagnosed with breast cancer and I was going over the details of treatment with him. He wanted to know how much the entire process would cost and how his mother was morbidly scared about the whole process, considering the fact that his father had recently completed treatment for Cancer of the voice box.During the conversation, I gathered he was their only son, working as a lecturer in an Engineering college and taking care of his parents. He had a sister, who lived in another city. What amazed me was his cool demeanour, his highly organised approach to the problem, his intense concern for his parents and the urge to get things done at the earliest. I could not help but ask him if this situation did not stress him out.He had a job to perform, his own young family to look after and if that was not enough, two ageing parents with cancer. His response was, to say the least, like a whiff of fresh air, in times where many old parents are left to fend for themselves in Old People’s’ Homes. He said, ‘Doctor, I look at this as my good fortune. I see this as a blessing as not many get the opportunity to serve their parents. I feel no stress’. He meant every word of it as I saw him handhold his mother lovingly throughout the process of treatment. I am honoured to know this gentleman. I thank him for restoring my faith in humanity and epitomising the real meaning of ‘Sevabhav’! #Breast Cancer #Max Hospital #Patparganj #Vaishali #East Delhi #Sevabhav
Another year comes to an end.... a year full of challenges, some met ....some transferred to the next year.Professionally, I made an important decision ... of focussing my energies at one centre instead of hopping between two. Now, I head the breast services at Max Cancer Centre, Patparganj, alone. I am able to be involved in the entire process of entry to exit of my patients with breast cancer.The Support Group meetings, the academic meetings, the surgical work, the post operative care, the process of auditing my own work to constantly improve the care, have taken off and I believe these are a few steps in the right direction.The endeavour to excel continues...... The new year beckons.....It will be 2015 in a few hours. Tomorrow will be the first Breast support group meeting of the year. The enthusiasm of my champions is all pervasive and we will, together, celebrate life with renewed vigor and new hopes.Breast cancer will be a forgotten word....smiles, chatter, dancing, eating, sharing and a sense of camaradarie will dominate proceedings. I am looking forward to it..All are welcome to join!!! For further details, please contact Dr Geeta Kadayaprath, Head, Breast Services, Max Cancer Centre, Patparganj, Delhi
It was Breast Support Group meeting on Thursday, 18.12.14.The Champions who had been through the journey of breast cancer had come in to encourage the ones who had just started treatment. What is exceptional about this interaction is that the conviction of being able to go through treatment goes up manifold when the ones who have gone through the process and have recovered completely, counsel the new kids on the block. I believe it is the fear of the unknown and the feeling of isolation that puts you on the back foot. The interesting methods of coping with the situation related by the champions, is very encouraging. The smiles, laughters, jokes...... all give the impending process of treatment, the much desired sanity!!! For more information on breast cancer, please contact Dr Geeta Kadayaprath, Delhi, India
Yesterday I visited my niece and was on the phone talking to my patients, sorting things for them. When I finished, she asked me, ‘Isn’t your profession stressful?’ I was quick to say NO. The conviction in my tone has taken many years to come. I recall my early days as an oncologist and in particular, this vivacious young lady who had a relatively advanced colorectal cancer with involvement of her ovaries. She had undergone surgery elsewhere, 4 weeks prior to coming to our unit. Her abdominal wound lay open and was pouring out fecal matter and abrasive intestinal juices, consuming her skin.I could not come to terms with the unfairness of the situation, then. Why was this young lady with the most sparkling, hopeful eyes dealing with this horror? I wanted to pull her out of this mess and diligently did my best to improve her nutrition, take care of her wound and her medication. She and I would talk a lot- her dreams, her aspirations, her twins, her loving husband, her family...we became good friends! Her surgery was planned and executed well. She was recovering well and she wanted to be home to celebrate her twins’ birthday. I assured her she would. And then that day arrived, when she walked. She walked for the first time after 8 weeks. I was thrilled and went home thinking she would be out of the ICU the next day. I was going up to the hospital the next day when I got a call that she had had a cardiac arrest. I thought I had heard wrong. I ran up to the ICU and before I reached, she was gone. Pulmonary embolism had taken her away. I was distraught and I cried, rather howled, like I had lost one of my own.An elderly physician put an arm on my shoulder and said, ’ This is certainly not the last time you will have to deal with this. Don’t get attached to the outcome of what you do. Do your best but remain detached from the outcome’. Those words have stuck and I have grown since. My focus is entirely on what I can do for the person who sits across the table and entrusts his or her life to me. I do my best to understand the problem, execute treatment, handhold them and try and do whatever I can to make the experience as seamless as possible. Cancer outcomes are never a 100%. You do lose some at the end of the day but if I have contributed to making their life easier through their suffering, I have done something worthwhile. While it is easy to be overwhelmed by these difficult situations, I need to remain detached from them so that I can do more for those who need help. I have come a long way since, but it is not as if I am not affected by what happens to my patients, anymore. It is just that I have taken better charge of the emotional me and replaced it, not entirely, with the professional me!
Breast cancer is a growing problem in India and all of Asia and threatens to deluge our health services by 2030.What is worrisome is that we do not have the resources to match the growing incidence. We have to start looking for indigenous solutions to our problem of breast cancer. We do have a good pool of talent especially in the autonomous institutions and the private sector, doing good work but there is very little support to encourage them to pool together data and make sense of it. The numbers that we see every year should, ideally, have provided us with a lot of answers, had we pooled our data and presented it to the world. In an attempt to push this possibility, I brought together like minded surgeons and created a group, the Delhi Breast Oncology Group (DBOG), on 6th November, 2014.We are in the process of giving it a formal shape and the first step in this direction will be taken on the 3rd of January 2014, when we meet again. Max Cancer Centre will host this meeting and the first CME(case discussions) as well on 3.1.15. All clinicians with an interest in breast cancer ( Surgeons, medical oncologists, radiation oncologists, radiologists, pathologists etc.)are cordially invited to attend this program. For further information, please contact Dr Geeta Kadayaprath, Head , Breast Surgical Oncology, Max Cancer Centre, Patparganj, Delhi, India
Does cancer give you a new lease of life? Today, a patient, Mrs Sharma (name changed), I had treated 2 years back, came for follow up to my clinic with her very beautiful and supportive daughter.When I saw her two years ago, I was taken aback by the fact that an educated lady like her had ignored a lump in the breast completely to let it grow to the size she came to me with. Big it was....ulcerated, infected and bleeding. She had large lymph nodes in her armpit.She was weak and it made me wonder if it was the anemia due to chronic blood loss from the breast cancer or spread of disease to other organs which was contributing to this. I was almost certain she would have spread to other organs. Fortunately for her, her PET CT did not show spread to the other organs.The lady was amazing....she knew she was in big trouble, but she was most cheerful and accepting. She was dealing with a lot in life already....a husband confined to bed for two years prior to her diagnosis and a son who had lost his bearings.I knew then her reason for self neglect. She went through the entire treatment, cheerfully and recovered. She went back to looking after her ill husband till he passed away a few months back. Today she surprised me. She looked well.....and I thought a bit relieved.I examined her, went through her reports ....she was absolutely fine. She was her happy self. She dug out a packet from her bag and gave it to me.She said she had made that bag and told me how she had started this NGO to support women in Haryana. They made the bags according to her specifications.... Beautiful bag! She was putting her talent to good use and just talking about it lit up her face.Mrs Sharma had rediscovered herself and will soon embark on fulfilling yet another dream -to paint and hold an exhibition.And then she is off to Canada to meet her friend of 50 years.Wow!!I can only salute her resilience! I want her to know, she really made me proud!! For more details, please contact Dr Geeta Kadayaprath, Head Breast Surgical Oncology, Max Cancer Centre, Patparganj, Delhi, India
While the level of breast cancer awareness in our country is low, there are various myths that need to be busted as well. Creating awareness needs to be a slow and sustained process. I strongly believe there is light at the end of the tunnel. Read on.. https://www.patientsengage.com/news-and-views/learn-right-method-breast-self-examination-bse
Today I complete 22 years of marriage and I thought this an opportune time to look back at my life with satisfaction. My marriage was arranged by my parents through mutual friends. My husband is an engineer and the one time we met before the process began, he had decided and I was still unsure. I was trying to peer into the crystal ball, hoping to figure out how this arrangement would work for me. I was training to be a surgeon, not a choice many sensible women at that time made. The questions kept me awake- would he understand the demands of my profession, the late hours, the middle-of-the-night zipping to hospital to deal with an emergency etc? Would he understand my need to study further, maybe go abroad and work hard to give myself a full fledged career? His being an engineer did not help the cause at all. And then I stopped thinking and gave in to the wishes of my parents. When I look back at those 22 years gone by, I have plenty to be grateful for. For a woman to pursue a full fledged career is never easy anywhere in the world.What you make of it has plenty to do with the support you have. The support I had was truly unconditional. I completed my post graduation after marriage. My in-laws wanted me to carry on, unhindered, with my studies.FRCS soon followed with my parents chipping in to look after my little daughter. I went for a year long fellowship to London, leaving my daughter behind with my husband and mother in law. And did I stop? And did he stop me from pursuing my dreams? Not once! We are all imperfect in our own ways but valuing people for their strengths is what sustains relationships. His presence in my life has been the star and I can only wish him the very best that life has on offer!!
RISING TO THE OCCASION Yesterday, this beautiful young lady of 33 walked into my room. I could see she had had chemotherapy as a smart bandana adorned her bald head. She was accompanied by her mother and her husband. Her dazzling smile and her confidence as she took me through the journey of nursing a 6 month old baby, of discovering a lump which was labelled benign at first, of the lump growing in a month and she, of her own volition going for a biopsy and discovering she had breast cancer, shook me! She had visited 3 or 4 hospitals for various reasons and is on the verge of completing chemotherapy. She had come to meet me to discuss the surgical options and the implications. She told me that she was scared of needles and pain but her composed demeanour conveyed something else. I could see, I was having the privilege of interacting with a woman of utmost strength, resilience, poise and maturity way beyond her years. Her smile never left her face. Her mother contributed positively in equal measure but the sadness in her eyes of seeing her little girl suffer did not escape my notice. She required to have an injection to up her white cell count. She went to the nurse in the treatment room for the same and showed her a prescription for the same on her mobile, from a different hub of the same centre as ours. She refused without thinking what she could have done to help her-a cardinal mistake! The nurse was following a process, which said no medication without prescription, which was fine. What she did not do, was figure out a method to solve the problem. She could have got a print out, on our institute’s letter head and cross checked with the prescribing doctor and administered the medication. What happened next was no surprise. The mother was outraged. She had accompanied her daughter across half of Delhi for a consult and this Nay from the sister, truly rocked her frail boat. She truly took the nurse to task for being unhelpful and uncaring. The situation was brought to my notice.The matter was sorted out, a printout of the prescription was taken and the injection was done. However, the bitter taste in the mouth remained! I know for a certainty, that the only people who go to hospital, happily, are doctors and the staff at work. The ailing come, as they don’t have an option. They entrust us with the job of sending them back, cured or relieved of their ailment. We, as caregivers, should never forget to look beyond and see the footprints that they have left behind, as they walk the difficult path to meet us. There is a story, sometimes, most heart rending, that we need to know- a story that should only raise our level of empathy. Each one of us has to walk that extra mile, go beyond our call of duty to ensure that we do our best for the person sitting across the table, entrusting us with making some of the toughest decisions of their lives. We, as professionals, have to really rise to the occasion, every single time!
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