May 13, 2021: We are Here for You: A Smilow Patient and Family Forum

May 18, 2021

Information

Hosted by Nita Ahuja, MD, MBA

Presentations by Drs. Kevin Billingsley, Thomas Balcezak, Gary Soffer, Tara Sanft, and Michele Grand, LMT and Ellen McNally, RYT500, TCTSY-F

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00:00Question and answers. For those of
00:02you who may not know me,
00:04my name is Doctor Nita Ahuja and
00:06I'm the interim director of the
00:08Yale Cancer Center and Physician in
00:09chief for Smilow Cancer Hospital.
00:11I took this role over in March 1st when
00:14Doctor Charles Fuchs left the institution.
00:16My other job before this was
00:18chair of the Department of Surgery
00:20and they continued to do that.
00:22But it's been my pleasure to take
00:24the helm from Doctor Fuchs able
00:26hands and it look forward to tonight
00:28and getting to know all of you and.
00:31Spending this evening together,
00:32I also hope that this forum becomes
00:35one that we can continue on to
00:37connect with all of you as as this
00:40is an important form for us to learn
00:42bidirectionally on what things
00:43are going well and what things.
00:45Perhaps we can pay our attention to.
00:48Next, slide running.
00:53So this month it's really some exciting news.
00:56This is oncology nursing month.
00:57An May six was National Nursing Day.
01:00Think we can all say that living
01:02through the past year and almost
01:04every day for our cancer patients
01:07that the 400 plus nurses who deliver
01:09care at the Smilow Cancer Hospital.
01:11In AR15 ambulatory sites.
01:13Around Connecticut and investor Lee,
01:15Rhode Island, he couldn't deliver
01:16the care without all of her nurses,
01:19so they are central to our patient
01:21care teams and we thank them
01:23all for all that they do.
01:25I also wanted to acknowledge that.
01:28If you move to the next slide.
01:30Money is a maze.
01:32Also bladder Cancer Awareness Month
01:34and brain Tumor Awareness Month.
01:36And as some of you may know,
01:39but Yale Cancer Center has done
01:41some phenomenal breakthrough
01:42advances in bladder cancer.
01:43Especially, I want to point
01:45out the work of Doctor Dan.
01:47Petra Lack who just last year had
01:49the first FDA approved therapy for
01:51advanced bladder cancer pad set,
01:53or in four to map that better team
01:56in late 2019 and the follow up
01:58studies of these new drug combination
02:00and targeted therapies or country
02:03currently continuing clinical trials.
02:05And for brain cancer Smilow Cancer hospital,
02:08the Shanavia family Brain Tumor Center
02:10is also leading the vein with advanced
02:13surgical options for our patients,
02:15especially in intra operative MRI suite,
02:17often able to schedule surgery and
02:19difficult to treat brain tumors.
02:22Patients who may need a second operation
02:24on brain tumors and also awake surgeries
02:27for to protect those critical functions
02:30of the brain are neurosurgeons,
02:32partner with neuro oncologists and other team
02:34members to provide multidisciplinary cancer.
02:37I think these are just two cancers,
02:39but I thought it was nice to highlight
02:42these two months in for you tonight.
02:44Next slide.
02:46Now here's some nice sort of news.
02:49You know,
02:49as we hopefully many of you
02:51are getting vaccinated.
02:52I thought it was nice to
02:54share some cold with data.
02:56I know we're joined by Doctor
02:58Ballsack will share some more,
03:00but just to give you some statistics
03:02that over 25,000 of our people,
03:04employees and medical staff
03:05have now been vaccinated.
03:07And if we look at the members
03:09of the public vaccinate,
03:10it's approaching close
03:11to 200,000 since March 2020.
03:14An if you look at the our system,
03:17we've taken over taken care of around
03:1912,000 patients overall since the
03:21pandemic started in March of last year,
03:23and in the past week alone
03:25there were 219 patients.
03:27I think it's exciting to see
03:29that those numbers are dropping,
03:31but it's also important to reflect back on
03:33the last 14 months and think about what
03:36we have done collectively with as a system,
03:39and it's certainly the mortality rate is
03:42the lowest in the state and I think it.
03:45Points out all the hard work of our team
03:48members in taking care of our patients.
03:51Next slide.
03:52And then if you look at activity,
03:54I think I'm really proud to say that
03:56all of our teams that we were able to
03:59offer care to treat all of her patients.
04:01These are patient volumes starting
04:02in April of last year.
04:03You can see them in dark blue
04:05and we continue to Kate.
04:06Take care for patients,
04:07even when perhaps things were
04:09very difficult in the early days
04:10and have continued to do so.
04:12I do think we all recognize that
04:14there was some delay in getting
04:16to cancer screenings,
04:17and we're seeing a catch up,
04:19especially in the last few months or more.
04:21Patients are coming in,
04:22and I do encourage everybody to
04:24catch up with their cancer screening.
04:26Whether it's mammograms or other
04:27types of screening,
04:28and I hope you know that we're all
04:30here to make that available to you.
04:33I have a wonderful agenda tonight,
04:35moving to the next slide.
04:37As I mentioned today,
04:38we're going to have start up with
04:40talking about cancer care and
04:42covid vaccinations and how to what
04:44does it mean for immuno suppressed
04:46patients with vaccinations?
04:47So we have our very own doctor
04:49Kevin Billingsley who's speaking
04:51at the spoken at this forum before.
04:53These are Chief Medical Officer an
04:55alongside we have Doctor Thomas
04:57Balsac who is the Chief Clinical
04:59Officer for the health system in
05:01the CMO for IL New Haven Hospital.
05:03Following that,
05:04we have a delight that the integrative
05:07medicine team that really think about
05:09all of your health and how we make
05:11you recover after you go through
05:13your treatments and also being your partners.
05:15So Doctor Sulphur is joined by
05:17Michelle Brandon,
05:17Ellen McNally and then hopefully
05:19we'll have a panel discussion and
05:21Q&A and Doctor you is joining us
05:23from radiation oncology and then
05:25in the last few minutes I I we have
05:28a really nice surprise.
05:29It's a video from our integrative
05:31medicine team that I hope you'll stay on it.
05:34Stand and listen to it.
05:36So with that it's my pleasure to turn
05:38this over to Doctor Billingsley.
05:42Thank you Doctor Ahuja and I think
05:44I'm I'm going to ask my colleague,
05:47Doctor Balcerzak to lead off and give
05:49us kind of the big picture overview
05:52of where we are as a health system.
05:55With our vaccination efforts,
05:57thanks for joining us. Doctor B.
05:59Yes and thank you both for inviting
06:02me in the entire Smilow team.
06:05I'm honored to be here,
06:07so as Doctor Who you mentioned,
06:10my role is the Chief Clinical
06:12Officer for the health system,
06:15and as such I was given the responsibility
06:18for leading the efforts for the
06:21vaccine rollout at the health system.
06:23And we started that.
06:25Three days after the first
06:27emergency use authorization.
06:29So exciting back in the second week
06:31of December and we're lucky enough
06:34to get direct allocation from the
06:37federal government that we can.
06:39We began vaccinating our staff.
06:42As Doctor Ahuja mentioned in the
06:44following weeks we vaccinated first all
06:47of our high risk staff at the hospital
06:49and across the health system in our
06:52emergency departments in our ICU's.
06:54And when I say we've
06:55activated our staff there,
06:57we vaccinated everyone who came in
06:59contact with patients in those units.
07:02Didn't matter whether you're
07:03environmental services worker,
07:04a pharmacist,
07:05we tried to get everyone in and
07:08as equitable fashion as we can.
07:10And as Doctor Who also mentioned,
07:12we're very proud that we are now at
07:1580% of the entire T of our workforce,
07:18and that includes folks that
07:19work in billing offices in folks
07:21that work remotely even,
07:23and a the clinical portion
07:24of our staff is much,
07:26much higher that's vaccinated,
07:27well into the high 80s in some cases
07:30to 90% of our staff are vaccinated.
07:32Doctor Billingsley is going to talk
07:34a little bit about some of perhaps
07:37the reasons why people are waiting.
07:39There are certain conditions
07:40where we want them to wait.
07:42I'm in delay their vaccine until
07:45some clinical milestones are met,
07:47and certainly some of our.
07:49Some of our employees are falling
07:51into those domains as well,
07:53but vaccine hesitancy is real.
07:56It's something that we've spent
07:57a lot of time trying to assist
08:00folks in understanding.
08:02We have had a approach that I
08:04think is been one that many health
08:07systems in many organizations across
08:10the country have have also used.
08:12Which is we use appreciative inquiry
08:15meaning on trying to understand the
08:17reasons why people are not receiving vaccine.
08:20In some cases it's because of a
08:22inability to use technology or
08:24an inability to get access to
08:26the technology to schedule.
08:28So we've put in efforts to overcome
08:31that both with our staff but also
08:34as we pivoted to the Community.
08:36We noticed a lot of the same
08:38reasons in the community,
08:40including those kinds of access.
08:43Sometimes there are cultural barriers
08:45and we have many coordinated efforts
08:48now across the health system to
08:50use many of the cultural interfaces
08:52with our communities that have
08:54been in place prior to COVID-19 for
08:57other reasons like enrollment in
08:59clinical trials or reach out for
09:02cancer screening and those work
09:04extremely well because I think we
09:06would all agree that when information
09:09comes from someone you already
09:11have trust in someone you already
09:13have a relationship with.
09:15You're more likely to accept that
09:18recommendation rather than from
09:20someone you don't know,
09:21or someone who you're just met,
09:24and so we've worked with those folks
09:28really effectively to try to drive across
09:31all of our communities that we serve.
09:34Vaccination acceptance.
09:35We, as you saw in those early statistics
09:39that Doctor Ahuja showed between December
09:4215th and February 15th, we opened up.
09:45Eight large scale mass vaccination
09:47sites and are capable of delivering more
09:50than 50,000 doses of vaccine per week.
09:53Unfortunately,
09:53the maximum we ever reached was 48,000
09:57over a couple of weeks in a row,
10:00primarily in the beginning because
10:02we were not given an adequate
10:04allocation from the federal government
10:06the way the allocation work was,
10:09the federal government decided
10:11which states got which percent,
10:13and on the most, for the most part.
10:16They did it by a straight population density,
10:19so we are about three and a half million
10:22people in the state of Connecticut,
10:24which means we are 1% of the
10:27population of the United States,
10:28so we would receive about 1% of the
10:31production of each week's vaccine
10:32that the federal government allocated,
10:34and then the DPH did a very nice job in
10:37my opinion of making sure that there
10:40was equitable distribution across the state.
10:42So I think many people have heard the
10:45statistic that more than 75% of the
10:47population in the state of Connecticut.
10:49Has now received at least one dose
10:52of vaccine and more than 55% of
10:55the state is fully vaccinated.
10:57I think not a day goes by, or certainly not.
11:01A week goes by where there is not
11:04a major piece of new information
11:07about either the disease, spread,
11:09variance vaccine, etc.
11:10And of course 2 very big pieces of news.
11:14This past week have been first the
11:16opening up of vaccine eligibility
11:18for the Pfizer vaccine.
11:20To children as young as 12 years
11:23old and that now will add another
11:25174 approximately 1000 individuals
11:27in the state of Connecticut that
11:30are eligible for vaccine.
11:32And we've opened up as of yesterday all
11:35of our sites to individuals as low as 12.
11:39And the second piece of information
11:41which will talk about and I think
11:44it's maybe caused a little bit of buzz
11:47just a short while ago is the concept.
11:50Now that there is a really,
11:52I think large carat to earn when
11:55you get vaccinated,
11:56which is the CDC has altered
11:58its recommendation,
11:59suggesting that if you are fully vaccinated
12:01and there's an important definition there,
12:04meaning that you have been two weeks after
12:07completing your vaccine schedule so for.
12:09NJ,
12:10that's one dose an for Moderna and Pfizer.
12:13That's two doses 21 or 28 days apart.
12:16You need to add 2 weeks to the final
12:19date of that vaccine and then you
12:21would be considered fully vaccinated.
12:24So if you are in that state,
12:26the new recommendations by the
12:28CDC in certain circumstances,
12:30importantly not in a healthcare environment,
12:32not in mass transit, not on an airplane.
12:35If you are anywhere else,
12:37then you can whether inside or outside.
12:40Unless there are rules superseding it,
12:42you can not wear a mask.
12:44We can talk about some of the data behind
12:47that and we can talk about that in the Q&A.
12:50If there are questions,
12:52which I assume there is so,
12:54so this is the only haven health
12:56system has given a total of 380,000
12:58doses of vaccine to date and we have
13:01fully vaccinated 180,000 people.
13:02So it's been an incredible effort.
13:04It's been many folks I think have either
13:07been vaccinated through one of our
13:09sites or volunteered or worked there.
13:12Really, it's really particularly
13:13the very beginning was really
13:15exhilarating to be part of. That.
13:17To know that we're finally doing
13:19something to beat this disease,
13:21and I'll speak from personal experience.
13:23It feels great to be vaccinated.
13:25I was finally able to see my fully
13:28vaccinated 89 and 88 year old respectively
13:30for my mom and my dad parents two weeks ago.
13:33So that was the first time in a year.
13:37So to be able to get back to those
13:39kinds of things are really exciting.
13:42Some things are not so exciting.
13:44My daughter is moving to a fifth floor
13:46walk up in New York City on Saturday,
13:48so I'll be in less.
13:49Someone wants to help be
13:50carrying the mattress up.
13:51Those Flight 5 flights of stairs.
13:53Kevin, I know you're pretty strong.
13:54You're a runner.
13:56But with regards to vaccination,
13:58so who's eligible right now if
14:00you are above the age of 12?
14:03You are eligible Doctor Billingsley's
14:05going to get into some of the
14:07caveats with that with regard to
14:10immunosuppression and stem cell transplant,
14:12which there are some but one of the
14:14things that I'll end with before we can
14:17go and Doctor Billingslea can talk a
14:20little bit about some special cases is no.
14:23No discussion about vaccination is
14:25complete without a discussion of
14:27how are these variants which are
14:29sometimes named after the place
14:31where they emerged but increasingly
14:32being named by a number convention.
14:35To try to avoid stigma of those places.
14:38But how are these variants being in
14:41or how are these variants impacting
14:44our enthusiasm about vaccination?
14:46The short answer is, is well,
14:49there's some evidence that at
14:51least some of the variants can.
14:54In part,
14:55there's a lot of parsing my words carefully
14:58here of aid some immunity in general.
15:02The vaccine works to
15:04prevent most diseases in.
15:05All of the variants that
15:08have thus far emerged.
15:10Now it's important to understand that as
15:12long as there is widespread transmission
15:15of COVID-19 among large populations,
15:18the pop the possibility
15:20of a new variant exists.
15:22So that is in itself a major point
15:25that would want us to pursue large
15:29scale vaccination even more quickly.
15:31So that's one point I want to make.
15:36The second point I want to make in
15:39this might be germane to the second
15:41part of these comments is that
15:44there is also information suggesting
15:47that immunocompromised patients
15:49that have immunocompromised nation
15:51because of something that they are on
15:54because they have.
15:55They have inflammatory bowel disease
15:57or rheumatoid arthritis and therefore
15:59take a immune modulating medicine,
16:02or they have an immune
16:04system disorder like AIDS.
16:06Or they are immunocompromised
16:08because of chemotherapy that they
16:10may be long term reservoirs of the
16:13virus and therefore be ones that
16:15are more at risk of being spreaders.
16:17So that's new information that's
16:19that's coming out and that may impact
16:22how we think about vaccination or
16:25other strategies in the future.
16:27But then that's very incomplete science,
16:29so we don't really know much more than that,
16:33except that the virus spreads
16:35in a very uneven fashion.
16:37Let me stop there and I ask Doctor
16:39Billingsley to give some specific
16:41detail with regard to cancer
16:43patients in cancer survivors.
16:47Thanks very much and I will
16:49echo some of those comments.
16:51It has been enormously gratifying
16:53to be part of this health care
16:55system is we have rolled out this
16:58vaccine effort across the state
17:00not only for cancer patients,
17:02but for all of all of our patients
17:04and and population around
17:06the state of Connecticut.
17:08And it has been.
17:10Remarkable to see the
17:12participation and the success.
17:14Could I have the slides, Renee? So
17:19one of the
17:20things that I
17:21will just start off by saying is.
17:25Many of our patients do have concerns
17:28about if they have not been vaccinated.
17:31Is the are these vaccines safe?
17:36In the setting of the cancer
17:38diagnosis or cancer treatment,
17:40or if they're in the immediate post
17:44treatment follow-up period, and if I
17:47impart no other message this evening.
17:50I need to to really reiterate the
17:52point that these vaccines have
17:55proven to be extraordinarily safe,
17:57safe, really for everyone,
17:59and certainly for our patients who have
18:03cancer or undergoing treatment or follow up.
18:06And I would make the point that.
18:10As as our patients.
18:13People are particularly
18:15vulnerable to this infection,
18:17so the motivation to get all of our
18:22smilow patients protected is high.
18:25I would also make Canada side point that.
18:29As members of the Smilow community,
18:32patients, family members,
18:33supporters and those of us who
18:36are clinicians and caregivers,
18:38we all have a unique role and
18:41opportunity to serve as as advocates
18:44for vaccination and engage those
18:46who may be fearful or sceptical.
18:49And I think this is part of of
18:52keeping safe if we can not only get
18:56vaccinated ourselves but get our fan.
18:59Friends family members,
19:01loved ones and social circle vaccinated.
19:04We will all be safer.
19:06A couple of other key points bear
19:09emphasis for those of those of our
19:13patients who are on active treatment,
19:15there is really no reason.
19:18With very few exceptions,
19:20to disrupt your therapy or
19:22treatment to get your vaccination.
19:24Vaccination should be easel,
19:26should be easily sequenced in
19:28around your ongoing treatments.
19:31In vaccination is appropriate with
19:33really the entire spectrum of treatments
19:36that our patients are receiving that
19:40includes traditional cytotoxic chemotherapy,
19:42radiation treatment,
19:44hormonal therapy, targeted therapy,
19:46immunotherapy, steroids,
19:47and surgical treatment.
19:49I have had a number of questions
19:53from patients over the past months
19:56as immunotherapy is becoming
19:58an increasingly prominent.
20:00Element in cancer care.
20:02Would the vaccine blunt the
20:05effect of their therapy?
20:07Or Alternatively,
20:08would the immunotherapy
20:09blunt the vaccine response?
20:11The evidence overwhelmingly, is known.
20:14These are safe and effective,
20:16and they can be combined without ill effects.
20:20Next slide,
20:22please.
20:23There are a couple of small but
20:27important key populations where we
20:29need to make some modifications
20:31around the timing of vaccination.
20:34Vaccination is still entirely safe,
20:36but the timing is related to sequencing
20:39the vaccination with the cancer therapy.
20:42To optimize the protection from the vaccine.
20:46So patients with hematologic malignancies
20:49and I'm speaking specifically about
20:52our our our folks with leukemia
20:54lymphoma to a certain degree,
20:56myeloma.
20:56The timing of vaccination can be
20:59important and some treatments
21:01may be delayed for a few weeks
21:04to perform the vaccination and a
21:06few selected disease types which
21:09are slowly moving and indolent.
21:12Alternatively,
21:12some vaccinations will be deferred
21:15until after treatment if the treatment
21:19itself is immuno depleting and the
21:22treatment is of some degree of urgency.
21:26In those situations it is of
21:29course even more critical that
21:31patients maintain the appropriate
21:34precautions of mask wearing,
21:37social distancing and immunization
21:39of their social circle.
21:42Really important in these situations
21:44to speak with your hematology team.
21:46They are well aware of all of these
21:49timing issues and will work with you
21:51and your family closely to optimize
21:54the timing of your vaccination.
21:56We also, of course are a significant
21:59Center for haematopoietic
22:01set stem cell transplants,
22:02as well as cellular therapy
22:05and by cell therapy.
22:06I'm referring to CAR T cells which were
22:09using for a variety of malignancy's
22:12for people who are undergoing these
22:15treatments and or there in the
22:18immediate post transplant period,
22:20it is important to keep yourself
22:22absolutely safe and protected,
22:24because the vaccination will be.
22:27Lead for sure period of time until
22:29the immune system is reestablished
22:31and recovered after these treatments.
22:34Again, very important to discuss
22:37the timing with your team.
22:39I think you can drop the slides.
22:43So the key points to take away
22:47are vaccination is safe.
22:50It's really only a few small patient
22:53populations where we need to be mindful
22:56of the timing and please reach out and
22:59in a thoughtful ways was described.
23:01Engage friends,
23:02family and loved ones in and being
23:05a vaccine advocate.
23:07Thanks folks.
23:09Thank you doctor ballsack.
23:10Thank you doctor Billingsley.
23:11We will save the Q&A for the end and
23:13with and I'd like next to turn to
23:15Doctor Sulphur and his team to give
23:18us an update on integrative medicine.
23:31Gary, you're on mute.
23:35Alright. Thank you,
23:36thank you all so much for having me.
23:39It's really quite a pleasure and
23:41an honor to get to talk to you.
23:43Today. I'm going to talk about
23:45integrative medicine or you're going
23:46to talk about what it is and what we
23:48offered smiling to help support you.
23:50But you know, I want to start
23:52with a little bit of that one more
23:54thing. Do you wanna swap?
23:55I think you are. You may want to
23:57swap the displays and 'cause what's
23:59showing is your is my presenter.
24:01Yeah yeah, thank you.
24:02You can see all my notes.
24:06We just swapped the display,
24:07so I think it'll work great.
24:10This is above my pay grade.
24:14If you hit the swap display and
24:16it usually just flips it around.
24:21Hey.
24:24That work no. But you see it on the top left.
24:28It says swap displace. Try that.
24:32Try that.
24:36How's that there you are?
24:37You're near perfect, alright? I keep, I
24:39keep saying that I'm turning into my
24:41parents when it comes to technology.
24:44It's a little disturbing,
24:45but that's OK, so again,
24:46I'm really honored and and it's quite
24:48a pleasure to get to be able to talk
24:50to you all about integrative medicine.
24:53It's Milo, and what we offer and how we
24:55can support you through the journey and.
24:58I'd like to start off with the
25:00metaphor I really stole this from
25:02from another integrative oncologist,
25:04but it's it's an important one,
25:05and you'll also see it repeated
25:07in the video later,
25:09and I really want you to think
25:11about your cancer as a weed an
25:13you know when this weed grows,
25:15it really becomes everything
25:16that you can think about.
25:18It consumes your life and
25:19it becomes your focus.
25:23And your oncologist is phenomenal at
25:25dealing with the Sweden and the doctors.
25:27It's Milo or some of the best in the
25:29world to really take care of it and
25:31and help you through that process, but.
25:35You know, and and we know that there's
25:37so much more to you and there's this
25:40garden that really surrounds the lead,
25:42and it's easy to forget about that garden.
25:44Ann, you know we're here to help nurture it.
25:47And So what do we think about?
25:49We think about turning our attention
25:51back to the rest of this party.
25:53And how do we make the rest of this
25:56garden flourish? Shouldn't really?
25:58How do we make the soil inhospitable
26:00to more weeds?
26:01So how do we even kill the weed without
26:04necessarily focusing on the weed itself?
26:06And we want to build that for you.
26:09And if that metaphor didn't
26:10really capture you,
26:11you know I can put it simply.
26:13It's really the best of what kept people
26:15well for thousands of years combined with
26:18the best of what keeps people well now.
26:20It's really about making you feel better,
26:23whatever that might mean for you, Ann.
26:25It's about meeting you where you are.
26:28We have a huge toolbox to pull
26:30from and so for some patients,
26:32that might mean yoga and
26:34meditation and for other patients,
26:36that might mean nutrition and fitness.
26:38But we're here to support all of that.
26:42Just want to go over some definitions
26:44because we're not an alternative.
26:46We're not alternative medicine and
26:48alternative medicine is really when you
26:50use a non mainstream practice in place of.
26:53Your conventional therapy.
26:54And we don't really consider
26:57ourselves a compliment because
26:59compliment is is simply a compliment.
27:02A little addition.
27:03What integrative medicine is really
27:05about is bringing together these
27:07conventional therapies that you're
27:09getting with the complementary
27:11therapies in a coordinated way,
27:14and our role in our Department is
27:17about coordinating that for you.
27:22And so some of the modalities that
27:23fall into integrative medicine,
27:24and some of these may be familiar to
27:26some of you, and some of them may not be.
27:29Things like biologically or
27:31nutritionally based therapy.
27:32So that means diet, nutrition.
27:34It might mean vitamins and might
27:37be fitness and physical fitness.
27:39We have mind body interventions like
27:41meditation or yoga or biofeedback,
27:43and then there's manipulative
27:45or biochemical therapies such as
27:48massage therapy which we offer here.
27:50And then you have a whole realm
27:52of energy or spiritual practices,
27:54and so that may mean connecting with
27:55your religion or connecting with your faith,
27:58or it may mean something like Reiki.
28:00And then there's entire alternative
28:03medical systems which we don't.
28:05Take part in,
28:05but we pull from and we bring
28:07them into your care.
28:12And so this is our absolutely
28:15incredible team of practitioners.
28:16We have massage therapists.
28:18We have yoga practitioners.
28:20We have Reiki people trained
28:22in Reiki and meditation.
28:24Guennol to help you through your journey.
28:28So what do we offer?
28:29One of the one of the great things
28:31that we offer is oncology massage
28:34and this is really specialized
28:35massage therapy that's focused on the
28:38patient who is going through cancer.
28:40We offer this impatient and outpatient
28:42and spin shown to improve side effects
28:45of chemotherapy but also reduce pain,
28:47promote relaxation and boost your mood.
28:49I always feel better after I get a massage.
28:54Reiki so this is a light
28:56touching therapy or even a
28:57non touch therapy that comes from the
29:00Japanese tradition and it promotes
29:02relaxation and stress reduction and
29:03this is also something that we offer.
29:09Dana Brewer, who is part of our team,
29:12has created this beautiful and
29:14robust creative expressions program
29:15an I would urge you after we're
29:18done today to go look up smilow,
29:20Hartson Smiler Rocks,
29:21which are some of the projects
29:23that she's done and what these are.
29:25Are you know, collaborative installations,
29:27group projects where patients or doctors
29:30all come together and participate in some
29:33form of creativity or art expression.
29:36What we've done beautifully,
29:37and I can't take credit for it.
29:40But we've really pivoted quite well
29:42with covid towards virtual classes,
29:44and we have a whole slew of live online
29:47classes offered throughout the week.
29:49And then we have a big giant video
29:52archive that's available to you,
29:53free of cost at all times.
29:56Some of the classes that we offer,
29:58gentle yoga, restorative yoga,
30:00and that's more about sitting and
30:02relaxing poses for extended period time.
30:04We offer Tai Chi,
30:05which you can see on the upper right.
30:08Of the screen, which is a martial art
30:11and it's based in the Chinese tradition.
30:15We offer also offer a bunch
30:17of meditation opportunities,
30:18so whether that's guided meditation
30:20or beginners class or we also
30:22offer phone meditation one on one,
30:24the most important thing that you know is
30:27that no previous experience is required.
30:29All bodies,
30:30all types,
30:31all abilities,
30:31they are welcome and we really think
30:34that every person at every level of
30:37experience could get something out of this.
30:42And then finally we offer an
30:44integrative medicine consultation,
30:45and that's a one on one appointment with me.
30:48And together, you and I,
30:50we create a comprehensive plan
30:51that involves your nutrition,
30:53your physical fitness.
30:54We think about mind, body modalities
30:56and learning meditation practices.
30:57We talk about your spirituality,
30:59your religion and how that
31:01plays into your care.
31:03What we've also created,
31:04which is really exciting and new,
31:06is for those patients who feel the
31:08need to be on lots of supplements
31:10during their cancer treatment.
31:12We're working with the pharmacist
31:13and a dietitian to make sure that
31:15those supplements are safe and
31:17not going to interact with your
31:19chemotherapy or other medications
31:20that you may be taking.
31:24So how do you stay in touch with us?
31:27How do you stay on top of things?
31:29Well, we offer a weekly email that updates
31:31you on all the classes that were offering.
31:33We also again have this wonderful
31:36video archive an you can reach out
31:38to us and useless emails on top
31:40there and I'll leave it at the end.
31:43Ann to get a consultation with me.
31:44I always ask that you talk
31:46to your provider first.
31:47But if you want to call directly,
31:49the phone number is there and
31:51we have lots of virtual events
31:53that are available to you and.
31:55That's it, so thank you so much
31:57again for for giving me the time.
31:59I hope we can really contribute in a
32:01meaningful way to the journey that you're on.
32:04Thank you.
32:11Thank you Doctor Software that
32:13was an amazing set of offerings.
32:15I know there are lots of
32:17questions for all of you,
32:19and they were also questions and
32:21earlier to Renee by our patients.
32:23I'm gonna sort of probably
32:25ask all of our panelists,
32:27including Doctor You who's joining
32:29us from radiation Oncology
32:30and perhaps we can give us an
32:32update on the recent news around
32:34elector so Doctor Balls Sack.
32:36I think we're starting with you
32:38first and there's a question up here.
32:41The CDC today announced relaxing
32:43indoor masking as you mentioned,
32:45and Governor Lamont says the state
32:47will follow suit on May 19th.
32:49How is the health system planning
32:51on managing that?
32:52You didn't think you were
32:54going to get off easy tonight
32:57where you certainly not. You know.
32:59I think that as I've said as I said,
33:02a few moments ago,
33:04you know the information has really
33:06evolved on every level for every aspect
33:09of the pandemic and it will continue.
33:12To evolve and what we saw today
33:16was Doctor Wolenski at the CDC
33:20has given the entire country A.
33:23Benefit if you are vaccinated.
33:25However, in a healthcare environment,
33:27that benefit does not apply,
33:29so she was very clear.
33:31Doctor Willensky was very clear
33:33to say that this mask mandate
33:35continues in healthcare environments.
33:37So that means for all of us who
33:40work there and it means for patients
33:43and visitors if they come there.
33:46I don't think it's I think it's going
33:49to be sometime before that gets relaxed,
33:52even though.
33:53We are some the staff that is
33:55employees and medical staff are some
33:58of the most vaccinated individuals
34:00or highest density of vaccinated
34:03individuals in the world right now.
34:05But still because the fact that
34:07there are patients among us in
34:10the possibility of spread and the
34:12fact that there are vulnerable
34:14individuals because of the immune
34:17modulation and other things that
34:19Doctor Billingsley mentioned will
34:21continue to have the mask.
34:23Wearing required
34:27thank you. Doctor Balls Sack a as you
34:29mentioned it is a complex but evolving
34:31equation and and I know you keep us informed.
34:34Doctor Billingslea I have a question for you.
34:37I think this is around a vaccination in
34:39this patient asked I'm most comfortable
34:41being administered administered vaccine
34:43through my smilow care team as they
34:45best know me and my treatment plan.
34:47Will this be an option so I presume
34:50they mean if they come in for
34:53their treatment can they get their
34:55vaccination at the same time? That's
34:58a. That's a great treatment are great,
35:01great question and an appropriate
35:03question regarding integration and
35:05vaccination with the treatment.
35:07I will. Explain that we have been
35:10partnering with all of the vaccination
35:13sites established through the
35:16healthcare system and were we are
35:19actually encouraging our patients.
35:21To get their vaccination at
35:25the standard vaccination sites.
35:28And we recognize the fact that in some
35:31ways that is less convenient than coming
35:34to their traditional site of care and.
35:37We like the fact that people
35:39feel comfortable in our sights.
35:41But one of the things that we are
35:44working to to do is continue to keep
35:47our patients as safe as possible and
35:50kind of keep the flow of UN vaccinated
35:53individuals as low as possible
35:56through our clinical care sites.
35:59Our teams are available available to you,
36:02however,
36:02to help you find a convenient
36:04site for your vaccination.
36:08Kevin, just hold on there.
36:09I think you just gotta comment
36:11that going to a vaccination
36:12site puts the patient at risk.
36:14How do we respond to that?
36:17You know I am.
36:19I I know that that is a concern.
36:23I think most of the vaccination
36:25sites are at least those in our
36:27system are using all of the
36:30appropriate precautions to keep
36:31every individual coming through the
36:34site safe and secure and they have.
36:37Good protocols and practices and
36:40infrastructure set up to be debt. I'm
36:43gonna reiterate that I think Doctor Ballsack
36:45started the evening commenting around
36:47the euphoria around going to the sites,
36:49but also the community and how everyone
36:51looks out and keeps people safe.
36:53I had taken my family members to be sites
36:56and I found the same feeling there.
36:59Absolutely wonderful.
37:00It's the sterility.
37:01It's safe spaces so I think this
37:03this is the best we have sort of
37:05delivering the vaccines given
37:07especially the precautions in handling
37:09that result where you had a lot of
37:11questions around the services and.
37:13How do we get access to those services?
37:16I think I'm seeing that question again
37:18and again and I know you had some
37:21of the comments around the website,
37:22but can you give a little bit more detail
37:25on how people can get access these services?
37:29Short, so really if you just
37:32Google smile integrative medicine,
37:33it'll come right up and
37:35will be available to you.
37:37We also have Ellen here.
37:38Who's who's one of our yoga
37:40teachers and we have Michelle who's
37:43one of her massage therapists.
37:45Maybe they can offer something. Sure,
37:48Gary, thank you regarding massage.
37:49If you or a family member or an inpatient
37:52you just ask somebody from your medical
37:54team to put a console to order.
37:57It will come directly to our
37:59head coordinator and then we
38:01can get you set up for massage.
38:03If you're ambulatory you can come
38:04into the York Street campus and do
38:07that the same way we can schedule you
38:09an appointment for a table massage.
38:11So again, just ask somebody from your
38:14medical team for a konsult order and
38:16we can get that going fairly quickly.
38:18Anne Anne our online programs are available.
38:21Either lied when we do them through our
38:24calendar or most of them are also recorded.
38:27So as Gary said,
38:29if you Google either Yale Cancer
38:31Center Archive video archives or
38:33or smilow integrative medicine,
38:35you'll find all of our online
38:37programs that way.
38:40In in Michelle, it sounds like
38:41you need a referral doctor,
38:42so for someone asked the same question,
38:44do they need a referral from
38:46their oncologist to get a console
38:47with you? Not necessarily,
38:48but but I think it's the best path
38:51forward so we can work collaboratively.
38:57Thank you doctor. So Brenan cancer survivors
39:00can also come in right. It's not just
39:02recourse any any. Any current
39:04or previous patient of smile.
39:06Right, I think that analogy of
39:08the garden right bringing the
39:10healing garden that that was great,
39:12and I think a lot of people resonated
39:14with that and Renee it typed in the
39:17website address also on the chat box.
39:19So thank you, Renee.
39:20Just so as Doctor Sofer mentioned,
39:22just type it in your favorite search engine,
39:25integrative medicine smilow
39:26and pops right up.
39:27So thank you for all that stuff to you.
39:30I want to break,
39:31come back to come to you and and maybe
39:34you can tell us one a little bit about.
39:37Under the Radiation oncology services,
39:39how they are in the system and
39:41are meant to really provide care
39:43patients to patients closest to home.
39:46So maybe you can give enlightened
39:48the patients a little bit about
39:50the radiation oncology program.
39:52Sure.
39:55Well, radiation oncology
39:56is is one of the you know.
39:59Pillars of treatment with surgical oncology.
40:02Medical oncology, integrative medicine
40:04and we all work together as a team to
40:09treat patients who need radiotherapy.
40:12We have satellite locations as far South
40:16as Greenwich all the way up to water,
40:20furred, and we're traditionally.
40:22Scene after a patient sees a medical
40:26oncologist or surgical oncologists.
40:28But in some situations were seen
40:31immediately at diagnosis for certain
40:33indications like prostate cancer,
40:35radiation oncology's made great
40:38strides over the last couple of
40:41decades and so it's become a very,
40:44very technologically advanced treatment
40:46that requires a big team and I'm happy to
40:50take any questions about our Department.
40:53The challenges that we've been through and
40:56the bright future that we have as well.
40:59Thank you God for you, and I know that
41:02recently there was some information in
41:03the news around the electric system,
41:05but I I believe all their systems are
41:07back at go and in all our patients are
41:10doing really well on treatment.
41:12Yeah, I mean briefly,
41:13what happened was the elected mosaic
41:16systems of record and verify software
41:18system and what that means is it's
41:21a system that's used by the entire
41:23radiation oncology Department to keep
41:25track of radiation treatments it
41:27manage is the transfer of electronic
41:29treatment plans from planning software
41:31to the actual machines and serves
41:33as our radiation oncology chart.
41:35On April 20th, elected Mosaic went down.
41:38Nationally, over 40 sites and we
41:41were immediately unable to access the
41:43information in the cloud and we were
41:46unable to use our linear accelerators,
41:49which are radiation treatment machines so.
41:53Later that evening, on April 20th,
41:55we thought it was just going
41:57to be a brief outage,
42:00but it became apparent that it was
42:02nationwide and it was severe and
42:05at that moment yell information
42:07technology and physics jumped into
42:09action and worked through the night.
42:12On the next day,
42:13on April 21st,
42:14the physics and the information
42:17technology team informed us that they had
42:20developed a work around this work around.
42:22I want to emphasize does not
42:25use the cloud system,
42:26but is intentionally labor intensive and
42:28is done with three radiation therapists.
42:31Physicists in an MD present at the
42:33beginning of every treatment and
42:35all subsequent treatments were
42:37administered with particular care.
42:39Knowing that the electronic recording
42:41verify system was not there and
42:44so multiple checks and timeouts
42:46were performed in a very labor
42:48intensive way as we tried to adapt
42:51to this new reality that are.
42:53Our cloud system was down,
42:55I think at present time Doctor Who.
42:58Joe, you're absolutely right,
42:59we are making our way back through the
43:02Herculean efforts of our physics dosimetry
43:04and information technology staff.
43:06We have performed work that traditionally
43:09takes months over the course of weeks.
43:11We've set up a newly built on premises
43:14version of the recording Verify system,
43:17but work continues behind the
43:19scenes utilizing both the manual
43:21treatment as well as this new system.
43:24I hope patients haven't noticed
43:25because we're trying to do as little
43:28disruption to their care as possible,
43:30and this is happening during a time
43:32of increased patient volumes as
43:34shown in that slide by Doctor Ahuja.
43:37And I do want to say as we emerge from this,
43:41we have a couple exciting technology
43:43developments you'll be hearing
43:44about in the future.
43:45I'm going to tease right now and I couldn't
43:48be prouder of our faculty or staff.
43:51And I hope everyone listening
43:53is feeling some hope around.
43:55You know Covid and and feeling a
43:57little hope for us in radiation
43:59oncology that we're going to emerge
44:01stronger and more nimble,
44:02and I think the future is bright,
44:04not only for us in our Department,
44:06but also for this hospital.
44:09Thank
44:09you doctor you.
44:10I'm going to pivot back to vaccination.
44:12There are a couple of questions,
44:14one and I don't know if Doctor Balzer
44:16Billingsley are going to answer.
44:18It's around allergies.
44:19It's like an answer. Board
44:22certified allergist. That's
44:23true, of course.
44:27Covid questions,
44:28but I'm happy to answer well.
44:30Whoever wants to have
44:31allergies are raging.
44:32Should you get your
44:33vaccination?
44:33If your allergies are raising,
44:35that's on the chat box.
44:36Whoever and, of course,
44:38that is offered since you volunteer,
44:40would you like to answer
44:41that? Sure, the short answer is
44:43absolutely, allergies are not
44:44not a contraindication to getting
44:46here to giving your vaccine,
44:47and it shouldn't be a reason
44:49to delay your vaccine.
44:51I think Doctor Billingslea said it right.
44:53Can't get your vaccination and all that. I
44:56remember that from tonight but another follow
44:58up in this is maybe a little
45:01bit more detail.
45:02This is a patient who asked that.
45:04Is there one vaccine better than
45:06the other that I should get?
45:09In terms of, you know there's
45:11we have choices were fortunate
45:13to have several choices.
45:14Would either of the doctor
45:16bees like to comment
45:18on the choices?
45:19We can compare our notes openly?
45:21You know, I think someone
45:23from the CDC said this best.
45:25I think a while back the best vaccine
45:28is the vaccine that's available to you.
45:31We have seen I will report to you
45:33since the paws of the J&J vaccine
45:36because of the blood clotting issues
45:38the state has stopped receiving
45:40J&J vaccine simply because.
45:42We're all washing it.
45:43We have many thousands of doses of J&J
45:46that patients have just not gotten.
45:48We're happy to give it,
45:50but because when we open up our
45:52mass vaccination sites in the
45:54J&J is the vaccine of the day.
45:56We just don't see people show up.
46:00I think that if I was given a
46:03choice between J&J and nothing,
46:06I would absolutely take J&J.
46:08The risk is about one in a million of
46:11this blood clotting event that happens
46:14between 6 and 14 days after the vaccine,
46:18and it happens almost exclusively
46:21in women of childbearing age.
46:23There is there is a safety
46:26issue that certainly with J&J,
46:28but it is something that you can
46:31that's knowable and monitored
46:32month you can monitor for with
46:35regard to Moderna and Pfizer.
46:37They are essentially the same vaccine.
46:39They use the same sequence there,
46:42slightly differently packaged,
46:43but the way they they operate
46:46in your body is the same.
46:48I would consider them exactly the
46:51same and all of them are excellent.
46:54Just absolutely outstanding at
46:56preventing severe disease or death.
47:00Kevin, if you want to add anything to that.
47:03You know? I
47:06have very little to add to that I.
47:10I would underscore the
47:12point that that the real.
47:15The real rub is getting the vaccination.
47:17That's where we're all going to get value.
47:22And I will say that there
47:25is softbot emerging.
47:27Signs in cancer patients.
47:30The two vaccines.
47:32May have some.
47:35Negligible incremental immunogenic
47:36benefit over a single dose vaccine,
47:39which would obviously be the J&J.
47:44It is hard for us to know if that
47:47is clinically significant and I
47:49want to be very careful about how
47:51I frame that to this audience,
47:53but I will share
47:55that that's that is.
47:57Something that is emerging in our circles.
48:02Thank you Doctor Billingslea Dutch
48:03so far in your team. Back to you.
48:05I think there's a lot of interest
48:08on the on the chat on hey listen,
48:10can the fair patients families get
48:12the treatments or do you have to
48:14be patient to get this treatment?
48:17Then alongside you know a lot of like
48:20maybe let's advertise your services more.
48:22I didn't know about this,
48:24so I think this this is this forum
48:27is exactly we're raising awareness.
48:29But can patients family
48:31members get these treatments also?
48:35I'm speaking to massage.
48:36The massage is just for the
48:39patience and survivors.
48:40The other programs are open to family
48:43members such as the on line programs,
48:46anybody, family members, staff,
48:48the community can log in and do
48:51the meditation, can do the yoga,
48:53can do that. I cheat.
48:55And the creative arts programs are
48:57also open to everybody there open
49:00to the community there open to
49:02family members and patients as well.
49:05So it's really just the it's
49:08really just the massage.
49:09The hands on work is limited to patients.
49:12There's no charge table massages.
49:14You can come in for three of those,
49:17and the implications get the
49:19treatments while they're there
49:21at the hospital as needed.
49:24Thank you, Michelle.
49:25You answered one of the questions
49:27on are these massages free and
49:29then the other question is,
49:31are the other integrative
49:32medicine services billable
49:33requiring insurance optimization?
49:36Not not as of right now. So we're
49:41seeing we're seeing everybody.
49:43And I think you're also seeing for your
49:46value for your services a lot from the
49:48caregivers asking for these services.
49:50So I think this is really exactly
49:52the reason for this format.
49:53So we hear from our patients
49:55and their families as they
49:56go through this. So we, you know,
49:59again, your family is part of that
50:00garden and and so we recognize that
50:03that treating your family and involving
50:04your family in your care is is
50:07paramount to making you feel better.
50:08So the video archive is absolutely
50:10accessible and available to them,
50:12and a number of other services
50:13are absolutely available to them.
50:15And if we can support them in
50:17any way, we will.
50:20May I go ahead and do something here, yes.
50:26The yoga classes are available both
50:28to patients and their families,
50:30and the beauty part of the zoom classes
50:34is that people don't necessarily have to
50:37participate if they feel unsure about whether
50:41they want to try yoga or their capacity.
50:45If people are brand brand new,
50:47they might like to start with
50:50restorative yoga because that's
50:51done primarily on the floor.
50:53Though sometimes we do do some standing
50:56stretches just to get some of the kinks out.
50:59But the other part is everything is.
51:02I have a background in trauma sensitive yoga,
51:05so the language in trauma sensitive
51:08yoga is very different from what I
51:11would call regular yoga classes,
51:12which is more directional.
51:14So everything is done by invitation.
51:17It's all choice based.
51:18I always ask at the beginning
51:20of class you know,
51:21is there something special
51:22you would like to do?
51:23An area of your body that
51:26you would like to work with?
51:29Knowing that you know many all of my
51:31students have different health conditions,
51:34so some people can do some things
51:37other people can't do other things.
51:40So I try to create an environment where
51:43people feel comfortable making the choice.
51:46Maybe to do something differently
51:48or even not to participate.
51:51That's totally fine.
51:53So,
51:53and I really hope that people will sample
51:57yoga because it has so many benefits
52:01for stress reduction, relaxation,
52:04overall sense of well being just.
52:07And also we have managed to
52:10create over 14 months of very,
52:13very robust community of yogis.
52:17Sometimes their pets.
52:20To come to class so there is a
52:23sense of camaraderie and you know,
52:26people talk about other things
52:28you know other than cancer.
52:29And I like to create that kind
52:32of environment where people have
52:34something that is nourishing to them
52:37and supportive and and just fun.
52:39So please come,
52:40I think you will be getting
52:43the it'll be busy tomorrow. I can.
52:46I can see that from all the services.
52:49I think there's an ask
52:51for services in Trumbull.
52:53Do are these services available
52:54at Trumbull site folks?
52:56Yes, being a lot of head nodding,
52:58that's wonderful.
53:01Go ahead, Michelle
53:02on the Saint Rayfield campus
53:04on York Street campus.
53:06Tremble and we had to take a pause on
53:09some of the care centers due to covid,
53:12but that should be starting
53:14up. Hopefully at some point
53:15in time down the road.
53:17Perfect, let me pivot to a perhaps
53:19some more questions around vaccination.
53:22A question here.
53:23If someone's fully vaccinated and it
53:25says previously infected with SARS Co. V2.
53:27So I think it sounds like they had both.
53:31Covid and they are vaccinated,
53:33can they be reinfected?
53:38I see Doctor Balls like
53:40maybe reading ready to
53:42answer that question. Go ahead Tom.
53:45So there have been sporadic reports of
53:48people who have had vaccine breakthrough,
53:51even among people who have had
53:54both covid and the vaccine.
53:57But what's important to note is that
54:00those people are very well protected
54:03against severe disease and death, so.
54:07It's possible.
54:09There is some scientific evidence
54:11to suggest that they will be less
54:14likely to infect other people 'cause
54:17the duration of their disease is
54:19less than the amount of virus that
54:21they shed through their noses.
54:23Somewhat less,
54:24but most importantly for that individual,
54:26the vaccine does confer
54:28additional protection,
54:29and even if there's breakthrough,
54:31they are much more likely to
54:33avoid hospitalization or die.
54:37Thank you and doctor B.
54:38There are lots of quite billingsley.
54:40There are a lot of questions on
54:42timing and efficacy and I think
54:44there are probably 2 details and but
54:46broadly speaking there is a question
54:49on should you wait four months?
54:51Where is my immune system strong enough?
54:53Again, for most people it's fine,
54:55but obviously they should talk
54:56to their doctor.
54:57Is that your recommendation to their team?
55:00That's exactly right,
55:02and this is where it is. It really is it.
55:09Individual by individual.
55:11Some of these lymphocyte depleting
55:14therapies are the backbone of
55:16treating hematologic malignancies.
55:18They are the treatment people need
55:21for for cure Disease Control,
55:24but there is a period of time.
55:28During which we need to wait for the
55:31immune system to recover and that is
55:34going to be a somewhat variable period.
55:36Three months is often something
55:38that we hear about,
55:40but it again it is going to
55:42be quite person specific,
55:44so conversation with your care team.
55:47Thank you Doctor Billingsley
55:48and I know it's almost the top
55:51of the hour and there's some
55:52questions I probably won't get to,
55:54but I think this is important to
55:56perhaps talk to the audience today.
55:58What is a typical care team you know?
56:00Can you tell me doctors, nurses?
56:02What are their roles?
56:03Maybe Doctor Billings would be
56:05helpful to talk a little bit
56:07about the care team at Smilow.
56:09You know, I would be happy
56:11to do that, and I think that.
56:15To the point of your introductory
56:18comments relating to the excellence and
56:21the dedication of our nursing teams.
56:24Most of our care teams consist of a group of.
56:29Medical specialists,
56:30including both physicians as well
56:33as advanced practice providers who
56:36can be either physicians assistants
56:39or advanced practice nurses and
56:42those those individuals form.
56:44The primary clinical teams,
56:46but they work hand in hand with our partners
56:51in nursing to problem solve problems.
56:55Answer questions.
56:56Kind of arrange the continuity
56:59of care and and.
57:01Cover those gaps that can occur
57:04in as patients and families
57:06transition through cancer treatment.
57:08In addition to care teams.
57:13In addition to physicians, nurses,
57:15and advanced practice providers,
57:17there are an entire range of of of
57:21professionals who also add significant
57:23value and improve the patient experience.
57:26That includes people like our
57:29teams in nutrition and dietetics.
57:31Are folks in physical therapy and
57:34occupational therapy who support
57:37the care of our patients both in the
57:40outpatient and inpatient spaces.
57:42Our social workers and our mental
57:45health providers and of course,
57:48the group on this call are
57:51integrative medicine services.
57:53So I think that the term team is quite
57:57broad and there will be different
57:59members of the team in play in
58:02front and center depending on where
58:05people are in their cancer journey.
58:08But the real.
58:12Healing comes from all of us
58:14coming together with patients
58:15and families at the center.
58:18Thank you doctor Billingslea.
58:19I know it's it's almost the top of the hour.
58:23I want to thank all the panelists
58:26for sharing information as I
58:28started and said in the beginning
58:30that we hope we can keep these as
58:33frequent ways of getting together.
58:34So if you have other ideas for future,
58:37patient and family form topics,
58:39please email your questions to cancers.
58:41Answers at Yale Dot E D2 Edu.
58:44You can also follow us up on Facebook,
58:47Twitter, Instagram, YouTube.
58:48All the channels and of course for the many
58:51many questions on integrative medicine,
58:52I hope you will log on in seed
58:55all the offerings there.
58:56Stay on if you have time and I apologize
58:59if I didn't get to all of your questions.
59:01I hope we will continue to answer
59:03this and I hope you continue to
59:05come back and connect with us
59:07and share your feedback with us.
59:09As I mentioned,
59:10there's a lovely video by the
59:12Integrative Medicine Service.
59:16I had felt a small
59:18lump in my right breast and ended up
59:20finding out that I was being diagnosed
59:22with breast cancer was a stage three
59:24pretty aggressive breast cancer
59:26and the year after I retired I went
59:28for a test and a doctor said I we
59:31see something on your long weekend.
59:33It looks like ground glass.
59:35I was diagnosed as stage one at the time.
59:37It was drama.
59:40When you get that diagnosis,
59:42you really hit right between the eyes.
59:44It's very difficult at that time.
59:46I had two girls,
59:47so freshman in a senior in high
59:49school and just kind of the unknown.
59:51What comes next and where am I getting
59:54the help and what are my options?
01:00:11Here at Smilow we have cutting edge
01:00:14disease focused treatments that patients
01:00:16come to get cures for their cancer.
01:00:19The Integrative Medicine program focuses
01:00:21on the human side of the patient.
01:00:23What I see with my patients who
01:00:26use integrative medicine services.
01:00:28Is a sense of being able to reflect
01:00:30to be able to express themselves
01:00:32or be able to get physical relief
01:00:34from the services that are provided?
01:00:36One of the
01:00:37best ways to describe integrative medicine,
01:00:39especially in terms of cancer care,
01:00:41is if the cancer is a weed.
01:00:43Your oncologist is phenomenal
01:00:45at dealing with that read.
01:00:46They can focus on it.
01:00:48It's really our job to focus
01:00:50on the rest of the garden.
01:00:52Build the Flowers, make sure that the soil
01:00:54is inhospitable to the weeds anymore.
01:00:56I went through chemo and the surgery.
01:00:58And I went home and I languished for
01:01:01about 6 years just sitting around home,
01:01:04feeling whatever.
01:01:04Sorry for myself or whatever.
01:01:06And then I met the
01:01:08data Brewer, one of the highlights
01:01:10of being an integrative medicine
01:01:12practitioner is that I get to go upstairs,
01:01:15engage with patients that wouldn't
01:01:16normally choose integrative medicine,
01:01:18because maybe they are unsure of what
01:01:20we offer or they haven't heard of it.
01:01:23We do yoga classes.
01:01:24We have Tai chi Qigong.
01:01:26We have meditation classes,
01:01:27Zumba classes. We do huge,
01:01:29creative expression collaborative projects,
01:01:31an individual.
01:01:31Projects we have massage.
01:01:33We have Reiki and when I say
01:01:35there's something for everyone,
01:01:36there really is because at the
01:01:38very very least there's breathing
01:01:40and there's breathing exercises
01:01:41and there's just ways to help
01:01:43alleviate stress and feel better.
01:01:45Many of these services are
01:01:47offered online or through zoom or
01:01:49through phone based treatments.
01:01:50My patients love the fact that
01:01:52they have all these different
01:01:53services to choose from that's
01:01:55provided by the integrative
01:01:57team. When I met Dana she indicated the
01:02:00Smiler wanted to make 1000 white birds.
01:02:02As a as a project and if I'd like
01:02:04to participate, learn how to make
01:02:06that like jumped at the opportunity.
01:02:08There was a doctor from
01:02:10the Malaysia for as a boy.
01:02:11He bowfishing as he took the thousand
01:02:13birds and move them into a fishing
01:02:15net and it was displayed in the
01:02:17Smiler lobby for the longest time
01:02:19and then they took it down and cut
01:02:21the birds out and gave those birds
01:02:23to cancer patients and that now that
01:02:25I think about it that was really the
01:02:27emphasis for me wanting to do it.
01:02:29It's kind of like set planted the
01:02:31seed sometimes it's just simply
01:02:33about experiencing joy again.
01:02:34Because they've become so used
01:02:36to this pattern of chemotherapy,
01:02:37feeling ill, feeling sick.
01:02:39But if you can give them these
01:02:41Nuggets of hapiness then you can
01:02:43really transform their journey in
01:02:45who they are and who they become.
01:02:47And so everybody is always seeking
01:02:48to be happy.
01:02:49Once you get the weight of cancer
01:02:52on your back,
01:02:53it's so much more challenging to go
01:02:55into that place, but that's you know,
01:02:57that's the strength of integrative medicine.
01:02:59If we give the patients those
01:03:01tools to get back into that place,
01:03:03the support really.
01:03:04Raised me up,
01:03:05it gave me so much strength to
01:03:07clearly battle both for physical
01:03:09pain but just my emotional well
01:03:11being as much as I wasn't a yoga
01:03:14person and maybe still am not.
01:03:16I looked forward to going there.
01:03:18I look forward to the conversations
01:03:20that were held.
01:03:20I looked forward to the praise
01:03:22that was given for small little
01:03:24gains from week to week.
01:03:26I just looked forward to the comfort.
01:03:28Really that a lot of the programs provided
01:03:31me. Integrative Medicine is another
01:03:33layer of support for patients
01:03:34going through treatment and beyond.
01:03:36To help them achieve that hope and optimism
01:03:38and that connected feeling that they need
01:03:41when I walk into the room,
01:03:43I'll say hello, my name is Dessie.
01:03:45I'm volunteer here another
01:03:4713 year cancer survivor.
01:03:49During my time here,
01:03:51I learned how to make origami birds
01:03:53and today I make them for cancer
01:03:55patients and other nice people.
01:03:57Will you accept this for me?
01:03:59I couldn't give away fast enough because
01:04:01I would get this shot of dopamine
01:04:03in my brain and I walked out of the
01:04:06hospital like 6 inches off the ground.
01:04:08I think I gave 2000 birds
01:04:10away in 2818 and 19.
01:04:12I'm reminded daily that
01:04:13I'm a cancer survivor,
01:04:14but I find that I am incredibly
01:04:16resilient and and I believe that I
01:04:19am due to the strength that I gained.
01:04:21From those people that I
01:04:23met along the journey,
01:04:24I was fortunate enough to have a great
01:04:27support system already in place with
01:04:29my family and friends in my community.
01:04:31But I think I gained more strength
01:04:34as well from the doctors and
01:04:36nurses and the staff in the
01:04:37Integrative Medicine Department
01:04:38and just the people that I've met
01:04:41through becoming involved with
01:04:42the looking forward fashion show.
01:04:44It continues to show me the importance
01:04:46of the program and in giving back
01:04:48every dollar that's donated ends
01:04:50up affecting countless patients.
01:04:52Providers and family members that
01:04:53we can't even imagine we're growing
01:04:55and developing program and we need support.
01:04:57We need help to create that.
01:04:59We really do rely on the support of
01:05:02people to help us grow and help us
01:05:04thrive. He started with
01:05:06the integrated services,
01:05:07you know he just changed like that.
01:05:09He was the old Desi. You know,
01:05:11very positive and very often without
01:05:13the creative expressions program.
01:05:14I think he would not have
01:05:16been the man he is today.
01:05:18I really don't.
01:05:19I think he would have went into a deep
01:05:22depression but it was a godsend. Now
01:05:24what good is treating them on physical level?
01:05:27If you leave the emotional
01:05:28and spiritual level untouched,
01:05:30this is this touches that this gives
01:05:32us a chance to to heal completely.