We have “arrived” at the Fred Hutch Bone Marrow and Stem Cell Transplant Unit. We’ve left Andrew Cowan and his myeloma oncology team for now, but will return to them when the transplant is complete and I am stabilized in about three months. The attending physicians in the Transplant Unit rotate on the first of each month, so teams are named for colors, not doctors. We are on the Aqua Team.
The transplant unit is a wrap-around approach to treatment. It takes a lot of people to pull this off. The core group includes Attending Physician, Primary Provider, Team Nurse, Scheduler, Dietitian, Social Worker, Pharmacist, and Spiritual Health. Beyond that, the players are almost innumerable.
Attending Physician
My first attending is Leona Holmberg, MD, PhD. It is clear that she is one brilliant woman. We met Thursday. It was interesting to see she was working on paper, using print outs that were quite marked up with notes and comments. Old school. I understand that level of considering information. When I use paper and pen like that, I am deep into the work. Focused. It’s a small thing, but it gave me great comfort. From her statements and questions, it was clear she reviewed everything about my case and she had several things in mind about how to proceed.
Primary Provider
Rebecca Hayman is our APP (Advanced Practice Provider). APPs are either nurse practitioners (NPs) or physician assistants (PAs) who serve as stand-in and right-hand to and under the physician. Becca is the person who will implement Dr. Holmberg’s plans and help provide my treatment. She will play a major role in helping manage the effects of myeloma and the treatment. Becca will be part of our care team most, if not all, of the time we are in the care of the Aqua Team.
Team Nurse
Let’s just say that the Team Nurse Sarah Kleier is the Battle Captain of the outfit. She is our first point of contact and go-to person for so many things. Whenever in doubt, and for issues definitely medical, Sarah is the one who will give us information, unravel confusions, and do whatever needs to happen to get things done.
Scheduler
Joan Bristow is our scheduler. What a job! Particularly in this evaluation phase, there are dozens of appointments to coordinate. Joan owns the calendar, my calendar. When we first started treatment on the oncology side of the house, I learned early that the scheduler rules supreme. When you get a call about scheduling an upcoming appointment, it’s not to ask what is convenient for you; it is to advise you when the appointment will be. Rightly so, the assumption is that, during this phase of treatment, everything else on your schedule is second priority to managing cancer. I made a quick adjustment to this mode of operation. In fact, Joan is so awesome at this, she’s reminding me of an assistant I had once who managed my days and freed me up to get stuff done. Same.
Dietitian
I’ve already formed a relationship with my Dietitian, Mary Rasmussen, during my early days at Hutch. She is easy to talk with and understands my concerns about nutrition and weight management before and during stem cell transplant and beyond. I was only 15 pounds from my goal weight when we met. I’d systematically worked at altering my food habits and perspectives and achieved and sustained a weight loss of 85 pounds over 5 years. Mary is extensively trained in cancer care. She is all about helping manage treatment-related symptoms and proactively helping me maintain my strength and healthy body tissue, both during treatment and afterward. Mary joins the ranks of outstanding food and nutrition counselors along side my Weight Watcher coaches, Barbara Lee and Roger Blackmore.
Social Worker
We have yet to meet our social worker Colleen Landis and we look forward to it. From what we can figure out, if cancer had a truly excellent concierge crossed with a therapist, it would be a cancer social worker. These folks help you find and obtain cancer related services and resources. They understand and help you navigate social and emotional issues pertaining to illness and treatment. They run education programs and co-facilitate various support groups.
Pharmacist
This is not like the pharmacist at Walgreens. The Hutch Cancer Center pharmacists have access to my chart and it is their job to know the ins and outs of what pharmacological solutions might be good solutions for my specific treatment side-effects and complications. For example, these are the people who help the physician and primary provider figure out ahead of time which antibiotics to use for anticipated infections and they try to avoid using an antibiotic to which I’m allergic. (A full-body allergic reaction on top of septic shock was a real bummer in May.)
Spiritual Health
The spiritual health clinician is another member of our team we will meet soon. Elisabeth Geschiere has been assigned to us for chaplaincy care (spiritual, religious, emotional, existential care) and I’m excited to meet her. Of course, I’ve researched her (as well as every team member I can) and have piqued my curiosity. The Internet says that Elisabeth is “ … a descendant of Dutch, Protestant, working class, immigrants who were mostly farmers. She is a queer educator, activist, and community organizer whose passions include her/history, music, writing, movement, and healing through connectedness to self, community, and the Earth.”
In general, I’m neutral about the idea of having chaplaincy care but am glad it is available should I lean in that direction. Besides, some of my best friends (again, calling out Roger Blackmore) are professional spiritual people who I love dearly.
Palliative Care
We’ve already begun work with Kim Harlow in Palliative Care. Palliative Care is not just for hospice. Kim has been instrumental in helping me find non-narcotic, mostly non-pharmaceutical solutions for pain management, in particular. She has a lot of tools in her bag. She engenders the sense that she wants to and does understand what is important to me and to Jackie. Kim is clearly committed to making my cancer treatment as comfortable as possible.
That’s not all!
There is still so many more that comprise my care team. The Daytime Clinic and After Hours Clinic ensure there is an actual human on the other end of the line when help is needed.
The Alliance Lab is staffed by a great team of phlebotomists and reception staff that makes being needle poked not such a bad thing. These are the folks I see most often when I go to Hutch. This is the group that has most consistently received one of my Caregiver Gratitude Box of cookies. I am now known there as “the Cookie Lady” and each one I’ve worked with has been pleased with this small gesture of recognition.
The other services we’ve already become acquainted with includes Radiology, Integrative Medicine, Psychological Services, and Physical Therapy. I am soon to add Gastroenterology, Dermatology, Gynecology, Endocrinology, and Dental Services to the team.
Wow--that is a comprehensive Care Team! I appreciate the bios and pictures. You will be in caring and capable hands. Plus, the color "Aqua" feels healing. Sending sparkles, energy and hugs to you and Jackie. <3<3<3