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Nursing a Culture of Caring

May 24, 2014

Despite the huge bay window before me, when 26-year-old Kacey Allain walks into room 4419 the brightness level goes up about 50 percent.

The petit brunette RN is back on the morning shift and enters with a gleaming smile. It’s early, just before 7 a.m. and Dr. Gerald Miletello has been standing by my bedside for about five minutes.

“Kacey,” he says, greeting her with a tone of endearment as he returns her smile with his.  As a cancer patient I like it when my oncologist smiles.

Accompanying Dr. Miletello this morning is RN Kory St. Pe’, a tall, strapping nurse who single females everywhere would love to make their Mr. Right.  I find out later he’s married.  Sorry ladies.

Kory’s a handsome kid with dark hair.  He stands arrow straight, sentinel-like, arms folded near my bed, as though protecting Dr. Miletello and me from harm.  I like a doctor, especially an Italian one, who travels with muscle.

But there’s much more to these two nurses than radiant smiles and cut biceps.  They are outstanding young medical professionals who have answered the call to caring.  And the Baton Rouge General knows it.

Dr. Miletello continues his consultation.  My treatments are progressing perfectly, he says.  Then, while informing me about an additional medication that’s been added to my regimen, a question arises about my body’s reaction to the chemo.

He quickly engages Kory and Kacey.  For next 30 seconds much medical speak is exchanged.  The nurses each present their interpretations.  Gerald, one of the South’s premier oncologists, is in agreement with the RNs’ assessments.  He thanks them and reassures me again that things are on track.

This is the kind of culture the Baton Rouge General and the Pennington Cancer Center has fostered over the years.  Despite both the accepted and perceived hierarchy in the healthcare world, the General and its entire medical and support staff see themselves as a team.  Everyone’s role is valued, everyone’s opinion matters.

This culture is further reinforced later in the morning when I meet “Mrs. Karen,” one of the many PCAs who attend to the daily comfort and cleanliness of patient rooms.  As a personal care assistant, she’s been with the General just three years and says she loves her job.

As she enters my room she’s quick to explain the protocols she’ll be adhering to as she cleans and restocks my room.  She sanitizes her hands as she prepares to work.  She exercises great care as she sprays down countertops, shielding any overspray with her gloved hands.  From the wastebasket she carefully removes the plastic bag, wraps it, places it aside and quickly inserts a new one.  It almost appears to happen in a single motion.

But it’s not until she reaches for her dust mop that something truly amazing and prophetic happens.  She begins sweeping the floor, humming softly while moving the mop in perfect figure-eight patterns.  But suddenly she pauses as she reaches the sofa on which Renee is sitting.

“I won’t sweep under your feet because they say if you sweep under a woman’s feet she won’t get married,” she jokes.

Renee and I look at each other and smile, working to contain our laughter.  Miss Karen doesn’t know that in three days we’ll be married.

“Sweep away!” Renee says, lifting her feet.  “We’re getting married Monday!”

Miss Karen is shocked.  “Really?!” she asks.  “Yes, right there,” Renee says, pointing the center of the room.

The two begin to talk about marriage and family.  Karen says she and her husband have been married 20 years.  “How he put up with me all those years I don’t know,” she laughs.  “But I would not trade him for the world.”

I think I know why he’s kept you all these years Karen.  And I just met you.

Until next time…

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A Sweet Suite

May 21, 2014

Suite 4419 of the Pennington Cancer Center is unchanged from my last extended stay here two years ago.

While I was actually in the room next door during my recovery here in 2012, I remember the big corner suite because it had a balcony, leather recliners, full entertainment center, a large sitting area and brass fixtures.  I had to walk past it on my physical rounds each day.  “Must be reserved for big donors,” I remember thinking.

So where else would they stick the Baton Rouge General’s poster boy for cancer survival this second time around to battle his leukemia?  Room 4419.  Big-time score.  Yes, Room 4419 is definitely an upgrade, a kind of “on-the-house” comp as they say in casino-speak.  I immediately put in a request for a BBQ grill for the balcony for a Memorial Day cookout.  I want to kick off the summer right and some traditions just can’t be overlooked.

The magical 30 percent pre-leukemic cell count was reached yesterday, so it was off to the upgraded suite with me.  After a brief consultation with Dr. Miletello this morning, I got checked into the room at 11:11 a.m. (Is it just me, or do any of you see this time of day on the clock more than any other?)

The plan is to be hospitalized for at least the next 30 days.  The chemo began flowing at 3:30 p.m. today and will do so around the clock for the next four days.  First up, something called the Red Devil, although not the Red Devil chemo of 20 years ago, I’m told.  That stuff, according to 21-year breast cancer survivor Michelle Miley, just scares the cancer out of you.  There was a time when that level of chemotherapy represented the most aggressive of treatments.  Today it’s just another tool in the toolbox.

The four-day regimen will be followed by a two-week recovery, followed by another bone marrow test to check for remission.  If there is remission, I’ll follow up with four more chemo treatments, then home for R&R.

Dr. Miletello said I could have visitors on a limited basis.  However, if you even think you might have the sniffles, I’ll see you in July.  We’ll shake hands, hug and kiss then.  Also, I can’t have flowers, plants or other foliage delivered to the room.  Apparently they can carry diseases.  Chocolates however…

Thanks today to my sister Tammy who was with me when Dr. Miletello gave me the news.  She spent the afternoon at my side and her presence means so much to me.  A big shout out to John Boudreaux of Cancer Services of Greater Baton Rouge for personally delivering me an Angel Food Smoothie with a shot of yogurt.  Made all the difference my friend.

And thanks to everyone for your words of encouragement, texts, emails and calls.  Having all of you in my life is really making this easier and I sincerely appreciate it.

On a much more personal note, there will be two milestones celebrated during my 30-day stay here at Pennington.  The first will be on Memorial Day, Monday May 26.  On that day, 54 years ago, at 1:10 p.m., Amelia Soulier Danna gave birth to her first child, Michael.  He was welcomed by his father Nick, who nearly burned up a ’57 Chevy Belair getting them from Rougon to Our Lady of the Lake Hospital as his mother screamed “You have to drive faster!”  Mom, dad, son and the Chevy were doing fine.

Unlike the first, the second milestone to take place here in the hospital won’t require a fast car.  It will, however, require a minister, a ring and an “I do.”

Until next time…

Bikinis, Kisses and Camaros

May 19, 2014

It happened exactly 40 years ago this week and the only thing I remember was bikinis.  Lots of bikinis.

It was the end of the second week of May 1974 and Mark Stafford and I were high atop the tower of the Miracle Strip Amusement Park in Panama City, Florida.  The one thing I don’t remember is the photographic record of that day.  I never knew such a photo ever existed, but now, on this Monday, here it was in my inbox, a Kodachrome memory from my lifelong Baker High School classmate.

According to Mark the photo of us was snapped by Tammy Bishop, who was either the oboe player or the lead baton twirler for the majorettes who always accompanied the Baker High School band.  It was our annual end-of-the-school-year band trip to Panama City, a less than melodious affair since it was the only time we actually got on a bus without our instruments.

This band trip in 1974 was purely R&R.  It was five days of sneaking beer, cigarettes and make-out sessions, all the while listening to older boys lie about all the girls whose imaginary zippers they’d managed to lower.  Mark was in possession of a moment in time that would forever be part of my family’s photographic past and he’d sent it to me as a gesture of friendship and remembrance.

At first I was surprised.  But the more I looked at the photo, the more melancholy I became.  Mark and I were both 14 at the time, although with him towering over me I looked like I was about 7.  No matter.  It was Panama City baby, and the Miracle Strip was the place to be.  The Baker Band would make three more such trips there during our high school years and the band would continue to do so until the trial lawyers stepped in and the school could no longer afford the liability insurance.

But the summer of 1974 was one to remember.  I’d just finished my freshman year of high school.  I’d avoided getting beaten up, had made first-chair third-trumpet, was about to get my first job and was now spending five days watching girls who normally donned wool band uniforms run around on the beach in polyester bikinis.  In my pocket was $60 and on the day of that photograph my life was perfect.

But as I stared at Mark’s photograph in my inbox I couldn’t help but think that inside that small boy in the visor, running through his spaghetti-string arms and throughout his entire wraithlike being, was a monster keeping a close eye on the hands of my biological clock.  A creature nestled deep in the recesses of my bones, listening to a 1.26 billion-second countdown that could not be aborted.  A countdown that would be reached May 12, 2014 no matter what.  Yes, the photo is of Mark and me, but also present is a dark, misshapen, hideous specter, hidden, unable to be brought forth by any of Kodak’s chemicals.

My cancer was with me in that photo, I’m certain.  The genetic die already cast, so to speak.

“It was inside you even then,” I thought as I continued to look at the image on my computer.  I could see those freckles I hated so much, a broad smile before my teeth began to shift with puberty.  The visor slung low, my shirt and shorts a perfect match, sunglasses dangling coolly from my right pocket.  Eased back in the corner of the tower taking it all in.  Mark and I would soon be back on the beach watching the bikinis.  But with us, high above Panama City’s major attraction of the 1970s, was leukemia.  It paid the bikinis no mind.

And in that moment I was there on that band trip in 1974.  I remembered how simple things were.  No cares, no worries.  Friends, sun, sand, waves, amusement parks, mopeds, kisses, beer and bikinis. I was back in Panama City the day of that photo, its Miracle Mile crowded with teens, beach bums, hippie holdouts, Mustangs, Monte Carlos, Grand Funk Railroad’s “We’re An American Band” blaring from Jensen 6x9s, jacked-up Novas and bad-ass Camaros with Cragar rims and hood scoops letting the 427s breathe.  I closed my eyes.  Let me be there, right now, knowing then what I know now.

The wave of nostalgia continued.  I could hear the amusement park rides below; the screams of teenage girls as the tilt-a-whirl flung them from one side of the rotating steel slingshot to the other.  There was the smell of scorching asphalt and suntan lotion and Pabst Blue Ribbon; cigarettes, lipstick, Miss Bojangle’s  $3 perfume and Brute from a green plastic bottle; a girl, older than me but willing, I was told.

Then my phone rang.  A reporter.  He was saying something about the death of longtime ag commissioner Bob Odom and our upcoming convention.  As I listened I thought how, at 14, we really do have all the time in the world.  And we should.  That’s why God starts us at birth and counts up.

But right now, today, at 54, I find myself counting down.  That’s not a defeatist attitude by any means, it’s just the natural progression of things.  Life invariably reaches a tipping point.  All things do and no amount of bikinis, kisses or Camaros can change that.  But a photo from the past certainly slowed the process, if only for a moment.

I had my second blood test today.  The results should be known tomorrow.  I want to thank all of you who sent me texts and emails wishing me well over the weekend.  A special thanks to Nolan and Gwen Babineaux for burning a candle for me this weekend.  Thanks Mr. B.  I hope you’re well.  Thanks also to Father David of Holy Family Catholic Church and to Renee who’s standing by my side with love and words of encouragement.

And thanks to my dear Baker High classmates Mark Stafford, Rhonda Langlois, Mark Sturges and Paula McAllister Plaisance for commenting on and sharing that photo.  Mark, it might have been taken 40 years ago but its value to me today can’t be overstated.  Thank you.

https://www.youtube.com/watch?v=Xz9KVcLCUek

 

 

 

In This Corner…

May 15, 2014

When heavyweight champ Joe Frazier stepped into the ring in Kingston, Jamaica on Jan. 22, 1973 the smart money was on him to beat George Foreman.

Who dared bet against the man who 10 months earlier dealt Mohammad Ali his first professional boxing defeat? And although Frazier beat Ali by unanimous decision, a win was a win. He’d stood toe-to-toe with the legend for 15 rounds and emerged victorious, even if no knockout punch had been delivered. Joe Frazier was now the undisputed heavyweight champion of the world.

So it was no wonder the boxing world and those who were watching the fight that night on a new cable station called HBO were stunned when Foreman’s uppercut dropped Frazier to the canvas in the early seconds of the first round.

The scene was immortalized by ringside announcer Howard Cosell, who screamed out, “Down goes Frazier! Down goes Frazier! Down goes Frazier!” as the champ hit the mat.

I’ve been a boxing fan for as long as I can remember. I was 12 in January of 1973 and didn’t see the Frazier-Foreman fight, but have watched the scene replayed for years on various TV programs about heavyweight boxing’s golden decade of the 1970s.

And it was “Down goes Frazier!” that came to mind last week the minute Dr. Gerald Miletello told me I had leukemia. Then the question immediately became, “Who would be Frazier; me or this new cancer?

For many with a cancer diagnosis, the disease seems overwhelmingly powerful. Unbeatable even. We all know someone who lost his or her battle with cancer. There was a time when cancer was the undisputed heavyweight champion of the medical world. It never lost.

Not today.

I’ll admit I was dazed by that first blow delivered by Dr. Miletello with the AML diagnosis. Since it had nothing to do with my previous cancer there was an air of confusion surrounding the whole thing. Was AML just biding its time, waiting to strike? It seemed so.

Two cancer diagnoses in two years. What were the odds? Apparently astronomical. Only 15,000 people will be diagnosed with AML this year, with 8,000 being 65 or older and about 1,000 children and teens. That means only 6,000 people in the remaining age group, among 315 million Americans, would have to hear their doctor tell them they have leukemia. Lottery ticket anyone?

After a few days the reality of this second diagnosis set in. The range of emotions ran from stunned disbelief to quiet anger. But I’d beaten esophageal cancer.  Nothing could change my mind about that.  And again I recalled the Frazier-Foreman bout. Although Foreman had been strong in his previous matches, he was going up against the man who’d beaten Mohammad Ali. Many wrote off the future grill master promoter before the first bell ever sounded.

In his later years Foreman would say his defeat of Frazier would define him as a boxer and not his loss to Ali in the “Rumble in the Jungle,” as the former Cassius Clay reclaimed the heavyweight title.

So like Foreman I now wait for my opening bell to sound. The crowd is anxious. My emotions are high. My heart is racing. The opponent in the other corner is formidable. He stares me down. I know I’ve got just one shot at hearing “Down goes cancer! Down goes cancer! Down goes cancer!”

Let round 2 begin. http://www.youtube.com/watch?v=JZEIMQ42-oU

 

 

Cancer, Round 2

May 14, 2014

Family, friends and my Farm Bureau family,

For the second time in less than two years I again find myself facing a cancer diagnosis.

On May 12 I was diagnosed with AML, acute myeloid leukemia.  Interestingly it was not related to the esophageal cancer.  This AML cancer, according to my oncologist Dr. Gerald Miletello, was simply waiting in the wings.  My last blood test showed a massive drop in white blood cell count, which was confirmed by a bone marrow test.  After 18 months of perfect scans and blood tests, AML decided to manifest itself exclusive of my previous cancer.  I guess the good news is that had I not been under a physician’s care for the esophageal cancer I might have waited until it was too late.

Currently, my white blood cell count is 1,100.  Not good, even for a former chemo patient.  The bone marrow test confirmed that I have 20 percent pre-leukemic cells currently floating around in my system.  Dr. Miletello, while not 100 percent certain, expects that percentage to increase sooner rather than later.  Once the level of pre-leukemic cells reaches 30 percent I will be admitted to the Baton Rouge General on Pennington for either 30 or 60 days of chemotherapy.  This will be an around the clock procedure requiring a minimum hospital stay of 30 days.

Essentially, the first seven days will be spent knocking my white cell count (resistance) to zero.  The next two weeks will be spent bringing me and my immune system back to life, so to speak. The last seven days will be a repeat of week one, again, bringing my white cell count to zero.  At day 30 they’ll know whether the cancer has gone into remission.  (Don’t ask me how, they just know.) If the cancer hasn’t gone into remission, the 30-day process starts all over again immediately.  The good news is that about 60 percent of patients respond in the first 30 days, while about 88-90 percent of patients see remission after 60 days.

I’m confident I’ll be finished after 30 days for several reasons.  First, I’m healthy (other than the cancer).  I have no other health conditions such as heart, lung or other organ issues.  This means the recharged white cells won’t have to “waste energy” fighting off something else.  By “resetting” the marrow to start producing healthy white blood cells, remission is a very real possibility the first time around.

If neither of these sessions produces remission the next step is a bone marrow transplant.  Siblings, on average, are only a 30- to 35-percent match.  However, my sister Tammy is standing by.  Next they’ll look to my children, Chase and Taylor.  My mother is not an option due to her age.  But unlike organ transplants, where only a few hundred organs might be available at any given time, the U.S. bone marrow registry currently contains 10.5 million registrants.  The odds are in my favor that a match will be found quickly.

The best thing about this is that nurse Renee is standing by.  There’s no better caregiver on the planet.  She’ll be by my side every step of the way.  I don’t know what I ever did to deserve her, but I’m so blessed to have her in my life.

In an effort to monitor the white cell count I will have a blood test every Monday until the level reaches 30 percent.  Yesterday I got my first piece of good news.  Since last week the count has remained at 20 percent.  And the white count could remain at 20 percent for months, even years, according to Dr. Miletello.  A second such miracle would be nice, it just depends on what my body decides to do with this disease.

I tell all of you this because you are my closest (got it right this time, Steve Miley!) friends and family members.  Until I reach the magic number I’ll be at the office, doing the usual things. Hopefully I can make convention in June and get that behind me before I have to send the post office a change of address card reading “Baton Rouge General Medical Center.”

Due to my reduced immune condition, I won’t likely shake your hand or hug you if I see you.  I know you’ll all understand and I promise to make up those lost hugs and handshakes when all this is behind me.

If and when the magic number is reached, Neil Melancon will the con, as they say.  He’s my No. 1 and I know he’ll run the PR department in the same professional manner we’ve always prided ourselves in.  I know he sent out an email yesterday on my behalf about protocols regarding visitors, hand sanitizer and the like.  I’ve already been in touch with some of you.  I know I may have missed some friends and acquaintances on this email list.  Please forward this to those who might want to know what’s going on with me and apologize on my behalf

Again, to all of you, thanks so much for your thoughts, prayers and words of encouragement.  My Farm Bureau family has stood by me though every one of life’s challenges.  It’s what we do here at the Bureau.  The love of the Farm Bureau family is a powerful thing and I know that with your prayers and words of support I’ll beat this cancer again.

Besides, how would it look if the poster boy for cancer survival just upped and died?  Someone would have some serious explaining to do.

 

Sincerely,

Mike

Central America: An Epilog

February 6, 2014

I trust everyone made it safely home, got some well-deserved rest and is readjusting to being back in the greatest country on earth.

There’s nothing like seeing the world for what it truly is, but there’s also nothing like sleeping in one’s own bed safe in the knowledge that, essentially, we have it made.

Having traveled on AgLeadership international tours for the last 10 years I can honestly say this was one of the best.  I know we ran hard and got little sleep, but that’s really the whole idea behind the program: to craft leaders who will always go the extra mile to promote farming and ranching, to never take a day off when it comes to letting the world know about the importance of agriculture.  Commitment, as they say, never takes a holiday.

And when it comes to leaders you’ll not find a better one than Dr. Bobby Soileau.  There’s not much more I can write or say about the man who holds the reigns to the AgLeadership program.  Bobby is a man of many talents; a writer, reporter, news videographer, producer, organizer and most importantly, a teacher.

Like his father before him, Bobby understands the role of education, no matter the venue.  AgLeadership is about education; educating those who will take their newfound knowledge to the masses.  As the number of farmers and ranchers continues to decline there’s never been a more important time to remind all Americans, and the world for that matter, that agriculture matters.  Thanks brother.

Thanks also to Cheryl Duplechain for keeping us organized along the way.  Managing the flights, the tours and the hotels wasn’t easy.  On trips like these even the smallest missteps are multiplied ten-fold.  Cheryl kept us on time and on track.

A big shout out to Dr. Phil Elzer.  His knowledge of agriculture and his penchant for timely, engaging discussion was a value-added bonus to this trip.  His comic relief was also a welcomed respite from the long hours on the bus.  And thanks again Phil for helping me stay in the game.

For the last 28 years I’ve had the privilege of calling Jim Monroe not only my boss, but also one of my closest friends.  I can’t tell you how much his friendship has meant to me, both professionally and personally.  Jim and I have traveled the world, shooting photos, producing programs and documenting Louisiana agriculture’s reach across the globe.  When you need the shot, Jim’s got it.  When you need a friend, Jim’s there.  And for the last 40 years he’s been one of the most outspoken advocates for Louisiana agriculture.  Thanks boss.

And a big thank-you to Farm Bureau President Ronnie Anderson. Like Jim, Ronnie has been a true friend and the man I have proudly served for the last 25 years.  Ronnie and the Farm Bureau wholeheartedly support the LSU AgLeadership program and will continue to do so.  Thanks for letting me be a part of AgLeadership and continuing to support the program through my travels with it.

Finally, thanks to all of you for allowing me and Jim to travel with you and to share in your experiences.  It was great getting to know each of you and I know I speak for Jim when I say that with leaders like you, the future of Louisiana agriculture is in good hands.

Congratulations on completing Class 13 of the LSU AgLeadership Development Program and I look forward to seeing you all at graduation Feb. 22.

Until next time…

La Pura Vida Comes To An End

February 2, 2014

The last voyage of the famed explorer Christopher Columbus found the worldly Italian landing in Costa Rica. 

The man probably thought about retiring here.  Who wouldn’t want to spend his golden years in one of the most beautiful places on earth.  It isn’t called the rich coast for nothing.

As Class 13 packs away the last of its souvenirs and makes ready to head home, I’m certain each would say Costa Rica was their favorite stop along the three-country tour.  Few can say they’ve dined on fine Central American cuisine while gazing upon an active volcano, steam slowly puffing from its cone.  How many of us have walked through a rain forest teeming with life, navigating narrow cable bridges high above the forest floor as creatures call out to one another that visitors have come a calling?

The sights, the sounds, the food, the drink and the pineapple.  Oh, the pineapple.  How that innocuous grocery store fruit has garnered new respect. Organically grown, hand-harvested, opened with a blade and eaten with the fingers, just like the native peoples of Brazil did when they first discovered the fruit all those centuries ago.  Lucky for us the pineapple found its way to Costa Rica; the fruit of royalty now fit for commoners who seek out a splash of rum to perk up the pineapple’s punch.

Here in Costa Rica the locals have a saying: “Pura Vida,” which loosely translates to the pure life, the good life, that all is right with the world.  And depending on one’s inflection it can take on many meanings and emotions.  You’ve just one the lottery! “Pura Vida!”  You’ve lost your passport! “Aye, pura vida,” the emphasis low and worrisome.

But pura vida is really an attitude and it’s become the roadmap for those who live in this little slice of heaven.  The last four days have been incredible, but tempered by the reality that we’re just visitors here, of our own device.  Central America is still many decades behind the U.S. in just about every important aspect, and seeing it firsthand has given many a class member a greater appreciation for the place we call home.

“It was eye-opening,” said Mardell Sibley.  “I couldn’t get over how patient people were, particularly when you look at the pace at which they worked.  How hard the work was too, for such low pay.  We’ll never know what that’s like.”

“It makes me really realize just how truly blessed we are in America,” said Drew Wiggers.

No truer words were ever spoken Drew.  No need to elaborate.

No doubt members of Class 13 will reflect on what they saw over the last 13 days;  abject poverty in Nicaragua, a canal in Panama that generates $6 million a day in revenues, and a Central American labor force that works for the same hourly wages Henry Ford paid his autoworkers in 1922.

As I’ve often told my children, being born in America is 95 percent of the battle.  It’s what you do with the other 5 percent to protect our way of life that matters most.

For most class members the takeaway boiled down to this; America is the greatest country on earth.  But America’s changing.  We’ve lost a part of ourselves to the welfare state, particularly when you look at the work ethic of many in Central America.  In Panama there are no social programs.  To quote one of our guides, “You don’t work, you don’t eat.”

We saw Nicaraguan cigar factory workers glad to have a $9 a day job.  Despite their low wages it was obvious they took pride in their abilities to create a quality cigar, even if they were doing it in a country that tortured and murdered those of differing opinions.

There’s a growing sentiment in our country that success is something to be frowned upon, as if you have to apologize for it because you’re better off than someone else. I know some folks who feel that way, and no matter how hard I try to convince them otherwise, their attitude remains that if there’s enough for one, there’s enough for all.

Those in Class 13 know otherwise.  They are the lucky ones, the committed and the empowered; the impassioned  and the innovative.  They are the ones who will lead the charge, and by extension, hopefully lead the change our country so desperately needs right now. 

But changing the world can wait another few days.  Right now we’re tired but happy, missing those back home whom we know will be waiting with open arms, a warm smile and an embrace that always reminds us that be it ever so humble…well, you know the rest.

So leave the porch light on, baby.  We’re coming home.

San Jose station…signing off…