Focused on the patient - Baylor Health Care System

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18<strong>Focused</strong> on specialized careLarry CrumlishReceiving a cancer diagnosis is never easy. Larry Crumlishshould know: he went through it twice.This 68-year-old man from Dallas has a loving, supportive,and tight-knit family. Until February 2007, he was feelinggood about having battled and beaten bladder cancer.Larry Crumlish’s granddaughters, Troy, left, and Riley, are theapple of his eye. “How can you not get better?”“I have three brothers who have survived prostate cancer,so I’m aware of how important it is for me to be screenedregularly for the disease,” Larry said. It was during a routinefollow-up exam for the bladder cancer that his doctor,Joshua Fine, MD, a urologist on the medical staff at BaylorUniversity Medical Center at Dallas, discovered that hisprostate-specific antigen (PSA) level had spiked.Dr. Fine performed a biopsy of Larry’s prostate and confirmed that he had prostate cancer. “Because the cancer was soaggressive, I wanted to act fast, but I was determined to be cautious in my decision-making,” he said.Larry did a lot of research about cancer, physicians, and medical facilities during his first battle with cancer. “The Internet isa great tool,” he said. “I learned so much and I met so many people who became my extended family. I’ve discovered thatprayer, a positive attitude, and loving support all add up to increased odds. That extended family was there for me againafter my prostate cancer diagnosis.”Mr. Crumlish looked to Dr. Fine, the surgeon he had grown to trust and respect during his battle with bladder cancer, toguide him. “Dr. Fine suggested having robotic-assisted surgery to remove my prostate,” he explained.Using the robotic system to remove the prostate allows the patient a shorter hospital stay, faster recovery, less blood lossduring the operation, and less chance of infection. “I knew from my research,” said Larry, “that the odds of success werevery high with this procedure and the risk of nerves being damaged was minimal.”After a short hospital stay, patients are typically back to their normal routines in 1 to 2 weeks. Once they are home, walkingat least one mile a day is prescribed, something that got easier each day for Larry. Patients are encouraged to get up andmove the same day as their surgery. “A lot of people go through pain with surgery,” he explained. “I’d say for me, it was alittle inconvenient and uncomfortable. It was an incredibly easy surgery and recovery.”Larry stressed the importance of a support group for dealing with cancer. “It’s always good to have a sense of humor justto help get through the tough times,” he chuckled. “In addition to support from my wife, daughter, and family, I receivedencouragement and well wishes from the Baylor Dallas medical team and so many people I met along my journey. I’m trulyblessed.”
<strong>Focused</strong> on specialized care 19The urologist works through several half-inch incisions, or ports, that accommodate a cameraand robotic instruments. The camera magnifies the field of view about 10 times andprovides a three-dimensional image. Sitting at a nearby console, the urologist controls therobot’s “wrist,” which holds the instruments and mimics movements of the human hand.“The magnification and dexterity of the robot allow for better control, more precise tissueremoval, and less trauma to the surrounding nerves and tissues,” Dr. Shuford said. Sparingthe nerves and tissues is critical, because damage may be linked to the erectile dysfunctionthat can accompany traditional prostate surgery.Palliative Care: A Key Component of Care and Treatmentby Maureen PorterThe American Hospital Association recently named Baylor Dallas a 2007 Circle of LifeCitation of Honor recipient for innovation and excellence in palliative care. The Circle of Lifeprogram recognizes only a few palliative care programs a year and it is most impressive thatthe Baylor team, led by Robert Fine, MD, has received such a prestigious citation.Dr. Robert FinePalliative care focuses on relief of complex physical, psychological, social or spiritual problemsrelated to life-limiting, terminal, or irreversible illness. Unlike hospice care, palliative careservices may be provided simultaneously with all other medical treatment, including life-sustainingtreatments, or may serve as a transition to hospice.The Baylor Dallas Palliative Care Consultation Services (PCCS) team works with the primarytreatment team to support the patients and their families to improve physical, psychosocial,and spiritual issues associated with advanced illness. The interdisciplinary team includesphysicians, nurses, social workers, occupational therapists, speech therapists, nutritionists,chaplains, pharmacology consultants and complimentary therapists. The team providesexpertise in symptom management; emotional, psychological and spiritual support for thepatient, family, and staff; advance care planning; and assistance in coordination of care withhome care, extended care facilities, or hospice care. Palliative care also may include occupationaltherapy, speech therapy for swallowing or other issues, nutritional assistance, andrelaxation techniques and complimentary therapies.Palliative care focuses onrelief of complex physical,psychological, social, orspiritual problems relatedto life-limiting, terminal,or irreversible illness.Laurie De Lalio, RN, clinical nurse specialist for palliative care explains, “Caring for patientsinvolves so much more than just medicine, and our Palliative Care Team can help connectpatients and families with the support they need to cope and make care plans anddecisions.”
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Focused on the patient - Baylor Health Care System

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