IN THE INTERIM

Mani, Pedi, Chemo aka Nailing It

My best friend, as you will know, was diagnosed with breast cancer in late 2016 and, after having surgery went on to commence a regime of chemotherapy. Early on in the process, Heather was told some anecdotal evidence that dark nail polish could protect nails from the rigours of chemo (yep, don’t forget hair and nails are made of the same stuff and we all know what chemo does to your hair). Working on the principle “nothing ventured, nothing gained” Heather embraced the dark side and had her nails painted a gorgeous, glamourous gothic black. Her nails looked amazing. And so we waited. Her nails stayed strong, with only intermittent softening, and scarcely any flaking or peeling. There was a little staining of the nail bed – despite using a base coat – but only to be expected when using a dark pigmentation. Black nail polish was swapped on occasion with sophisticated maroon and the nails stayed strong. Is it the dark polish, the fact that they have any kind of nail polish, or is it the fact that dark colours are so high maintenance that you take extra care of your hands and feet anyway? Who knows, but all I can say is, it appears to work. I gave Heather a refresh of her maroon polish a few weeks ago and her nails were looking good. Which brings me back to hair, eye lashes and brows to be precise. A further anecdote led Heather to try a product called M2. A tiny, tiny bottle with an even tinier brush that you glide onto the base of your eyelashes and over your brows. Heather was just starting to lose her lashes and brows when she started using M2 and, three weeks later, the fall out stopped. Even at the end of six chemo sessions, her lashes fluttered, brows were there to be nonchalantly raised and nails were gleamingly intact. Mani, pedi, chemo....she nailed it. This is far from a scientific study, it’s far too emotional and close to home for that, but I’m putting this story “out there”. Perhaps you are a cancer nurse specialist, perhaps you are involved in a support group, perhaps you are about to embark on your own treatment journey – to me, this is worth a try. Or should that be a flutter?

IN THE INTERIM

Amazing Grace, aka Witnessing the Random Act of Kindness

My blog is usually reserved for my professional life – my work in healthcare management as an interim. Today, however, is different. I want to share with you all how I spent last Saturday, and what I witnessed. By 4.00pm on Saturday 25^th March 2017, my best friend, Heather, and I came to the joint conclusion that, as Saturdays go, this one was certainly different. You see, my friend of 39 years was diagnosed with breast cancer late in 2016 and had surgery just before Christmas. Chemotherapy follows and with it the loss of Heather’s long wavy hair. Heather, being Heather, decided not to waste it and so donated it to make wigs for those who want them during their treatment. She set up two Just Giving pages (links at the bottom of this blog) so that people could donate to her two favourite charities, and filmed her story. The day was set for Heather to go to her hairdresser and have her head shaved – and have it filmed. How brave it that? I was to provide make up and muffins for the occasion. The day dawned, a bright and sunny day in Stratford Upon Avon, Heather’s home. I arrived in the morning to do a practice run of the make up. As I walked into Heather’s home I was greeted by the sounds of Lady Marmalade. Yep, that’s my best friend for you! Colours for the make up chosen, Heather, myself and Heather’s husband, John, set off for town. A quick stop off for a cocktail in the bar at the RSC (of course!) and then over to the hairdressers where we were met by Heather’s film crew. What could have been a scary situation was turned into a celebration by my best friend. She laughed and joked throughout, I helped tie her beautiful long hair into pony tails as it was cut off and placed in a bag to be sent off to help someone who needs a wig and having completed the task, we all settled for a moment to drink some bubbles and toast the future. Heather, I must tell you, looked amazing! So much so that the idea of wearing a bandana was quickly jettisoned. Having spent almost an hour with Heather’s hairdresser, his next client (a young lady) was waiting and we all exchanged pleasantries before she walked through from reception to the main salon. And then, his client walked back into reception and this is what happened….. Heather was sitting on the sofa, and this lady bent down to her and placed a pearl bracelet in her hand. “Um, excuse me, would you like this?” she said, “I gave one to my mother when she was diagnosed with cancer and she wore it all the time. You will get through it, you really will”. There was a moment’s silence and then, of course, the tears flowed. Heather first, then me, then her hairdresser. This lady’s name is Grace. Amazing Grace. Her random act of kindness filled the room with love and hope and comfort. John took a photo at just the right moment. Grace’s random act of kindness captured for all of us. I hate the term “reaching out” but here’s what I learnt last Saturday. Have the courage to “reach out” to someone, to perform that random act of kindness, to demonstrate that nobody is alone, to walk that path with them, if only for a moment. Thank you, amazing Grace. If you would like to donate to either of Heather's charities, please go to: http://www.justgiving.com/fundraising/heathersstory1 http://www.justgiving.com/fundraising/heathersstory1

IN THE INTERIM

What a difference a year makes…..

I think it’s safe to say that 2016 has been a memorable year for all of us; cultural icons lost, political norms questioned, Zika, Brexit, Trump. For me, it was the year that my fledgling company grew its flight feathers and transported me, albeit briefly yet successfully, on a global adventure. So what did my company’s second year teach me? And, more to the point – from me to you, what are my top tips for (to paraphrase the wonderful Maya Angelou ) not just surviving but thriving and in some style… Organisation is everything Truly. At one point I juggled three very different, very demanding and very rewarding contracts. One in Hampshire, writing a major report on mental health services, one in Brighton for a Trust challenged not only by special measures but also financial special measures and one in Lisbon, Portugal. Top tip? Plan, plan and plan again. Everything – from the flight, the drive to the airport and/or hotel, car parking, currency, a fully charged phone and iPad (and take your chargers and adaptor), somewhere to grab a bottle of water and a sandwich (and chocolate – forget the sugar police), factor in a sleep, a strong espresso, a call to your nearest and dearest. Picture the scene; I drove on a Thursday night to the outskirts of Heathrow from Brighton (after a 14 hour day), found the hotel, parked my car (having pre-booked the car park for the weekend plus a little bit more in case of delays), crashed out at the hotel, up at 3.30am, got a cab to T2, the 6.00am flight to Lisbon, car to the conference venue and commenced work at 10.30am, finished at 11.30pm, grabbed a bite to eat, hit the pillow, up at 6.30 and did a straight 12 hours. Sunday, up at 6.00am to get the flight back to Heathrow….which was delayed…then drove straight back to Brighton to commence work on Monday morning. Top tip? Expect the unexpected – it honestly takes the stress out of it. Diversify – it’s the name of the game for 2017, especially if your game is being a contractor. 2016 saw me successfully business coach four professionals to new heights, pastures new, or a refresh of their existing business. It’s genuinely fulfilling to see people grow in confidence and take that leap into developing their own businesses. When the interim market grew tricky in 2016 I looked at my own skill set and used it to help others. Top tip? Think out of the box; your skills and experience can be used in more than one way. Oh, and for those of us who are healthcare interims? Remember this in 2017 when faced not only with agency caps but also the delights of IR35. Diplomacy. Yet again, dear reader, I ask you to picture the scene…..I’m in a conference call (transatlantic, no less) with two very demanding clients who, may I add, just happen to be paying my wages (good to remember that, by the way). They each have a very clear agenda – one wants to promote a new product, one wants to market themselves as a specialist global leader in healthcare comms. Me? I want to champion the patient and their families (this being related to the healthcare, specifically cancer, sector). Top tip? Engage brain before opening mouth. Always. Learn to listen, learn to be patient. The result? I was co-architect and expert facilitator for a global initiative for patient centric clinical care and pioneering pharmaceutical developments. So, for 2017? I am armed with the knowledge that I have physical, emotional and mental resilience; I can be both team player and a leader. My company can, actually, work on a global level. I have a skill set that can genuinely be used to launch the aspirations of others and I have an arsenal of skills and experiences that can be used to transform organisations the appear to be broken and dysfunctional. I’m curious – what were your business achievements in 2016? Can I help you achieve your goals in 2017? Jan Lawry is Director of J Lawry Healthcare Management Ltd; she has over 20 years business experience in programme management and is a service review expert, business coach and mentor. More details on her work can be found on her website https://jlawryhealthcare.com/ Recent work has included a major report into mental health services for West Hampshire and highly successful business coaching helping to launch a new healthcare consultancy and training organisation. To gain the edge on your hard earned business, invest in business coaching with Jan Lawry. Book your free Discovery Call here: https://calendly.com/jlawrycoaching/discoverycall

IN THE INTERIM

Our patients, ourselves

I’m very choosy with the conferences that I attend, all too often they consist of dry presentations delivered without enthusiasm, and all the time the delegates sit there, surreptitiously checking their phones or, like me, thinking about the work they could be doing. Tuesday was different. So different. I attended the Patient Experience Insight conference in Manchester (organised impeccably, by the way, by Healthcare Conferences UK); the conference opened with a presentation by a gentleman called Tommy Whitelaw. Tommy’s presentation was probably the most genuine, heartfelt and honest that I’ve ever heard. He spoke of his experiences in caring for his mother, Joan, who had vascular dementia and his words, spoken with total passion, moved most of us to tears. So this made me think about patients, service users and carers – my own experiences in caring for them, working alongside them and how they have shaped and influenced my work. Tommy’s words also resonated with me on a different level – the isolation, desperation and sheer heartbreak of being a carer for someone you love. Although I had a lifelong background in health and fitness, I actually moved into healthcare initially in a voluntary capacity as a member of a Patient and Public Involvement Group. I had been a full time “informal” carer for my mother, who had colon cancer with secondary tumours in her oesophagus. As with Tommy and Joan, my mum and I had a long journey of isolation, despair, pain and bewilderment punctuated by visits from our GP or District Nurse. Somehow, I’m still not sure how, we fell through the net when it came to real, structured support and care. So I had to beg a neighbour to sit with mum while I collected her prescription and, towards the end, I simply did not sleep – I didn’t dare close my eyes in case my mum needed something. After an experience like that you can do one of two things – either implode or decide to contribute, to actually strive to make a difference. That’s the route I’ve chosen ever since. The hallmark of my work has been patient and carer involvement, from writing patient facing information to designing integrated services, I ensure that the patient and carer have a voice. Now, after a long time in healthcare, I believe I am witnessing a real change where patients, service users and carers are genuine partners in the design of healthcare in the UK. Gradually, I am seeing targets and spreadsheets and funding being counterbalanced by experiences, and conversations and compassion. So here’s the thing, now we need to look at the detail of how we view those we care for. Our patients, first and foremost, are individuals – the mother, sister, daughter, best friend not the colon cancer, the dementia, the MS sufferer, the paraplegic. They are defined not by their diagnosis but by the years of working living, loving and giving. And how we label and perceive our patients – the words we use – can have a lasting impact. Tommy gave a great example; someone had written on his mum’s notes that she was “challenging”. Challenging. Think about that word. We use it now because we feel it sounds better than “difficult” “problem” or “demanding” but it’s not exactly a positive word, is it? What are your expectations on reading that word? You would expect to be challenged. Tommy’s mum wasn’t challenging, she was a frightened woman. Similarly, our patients, carers and service users who display aggression or frustration are all too often actually scared, lost or bewildered. Our healthcare professionals do an incredible job in one of the finest professions that I believe exists. Never underestimate the importance of the small ways that they show kindness and compassion. So, in the changing environment that Brexit will bring, let’s give our healthcare professionals the space they need to care, to ask our patients and carers what matters to them, the time to truly listen to what matters and to DO what matters. [embed]https://youtu.be/iBLQnThJ6w0[/embed]

Cancer and Recurrence; winning the battles

My blog today has been inspired by a story in the BBC News earlier this week. http://www.bbc.co.uk/news/health-36455818 A major trial is about to commence in the US and Canada to discover the potential link between cancer recurrence and obesity. It reminded me of my own, much smaller, trial in 2010-2011 in England when I was a Service Improvement Facilitator at the Dorset Cancer Network. I co-managed a survivorship project with the aim of introducing an exercise and dietary management programme for women after diagnosis and treatment of breast cancer that would lead to a lasting beneficial change in health behaviour, weight reduction and improvement in quality of life. Drawing on the many national and international studies on healthy lifestyle choices and breast cancer at that time, a breast cancer unit at a Dorset hospital was chosen to expand on this body of work by exploring the impact of a specific physical and dietary intervention. At that time there were no exercise/dietary rehabilitation programmes available to patients following breast cancer treatment yet, increasingly, evidence suggested that physical rehabilitation could lead to patients returning to normal lifestyle more quickly and that exercise and weight reduction (by following a low fat diet) may have a role in reducing recurrence of breast cancer. Furthermore, there was evidence to suggest that exercise may reduce symptoms such as depression, arthralgia, hot flushes, low bone mineral density and other side effects of treatment. We introduced a four week introductory Nordic walking exercise programme under instructor supervision together with a weight management programme under the care of community dietetics. At both the beginning and end of the project patients were weighed and measured (BMI and waist circumference). A visual analogue scale was completed in terms of symptoms of arthralgia (bone pain) and hot flushes. A HAD scale to assess psychological status was also completed as were qualitative dietary changes assessed by food frequency questionnaires and/or food diaries before and after intervention. Finally, a patient questionnaire survey assessed satisfaction with the intervention. The results were fantastic; the cohort of patients either maintained or reduced their BMI over the period of the programme. One patient in particular, lost a total of 4.5st with greatly improved lymphoedema. The work with the dietician was particularly appreciated by the patients as this had not been previously available in such depth. Reduction in medication for conditions such as depression were also reported as were less tangible benefits such as feelings of “a return to society” as opposed to being in “patient mode”. Follow up clinics were also felt to be more positive in terms of a more individualised approach to each patient – assessing and meeting their needs more accurately. The patient and clinician relationship was also felt to be more of a partnership in making decisions regarding future treatment. There was also the benefit of more relaxed carers and families. Patients gained an understanding of the principles of a healthy low fat diet whilst not compromising Vitamin D and Calcium intake. They felt empowered to self-care in terms of exercise and following a healthy, low fat diet. Patients reported improved satisfaction with their post treatment and quality of life was improved for all patients post intervention. And, of course, good health and the reduction in recurrence isn’t just good for the patient, it’s also good for their families, for the economy and for the NHS. I hope this trial in the US and Canada brings about similar results – I feel sure that it will – and I cannot wait to hear how patients’ lives have been improved.

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