A Kidney Named “Joy”

In a matter of moments, Melanie Graham went from back pain to end-stage renal failure. Her story is one of multiple surgeries, the loss of a loved one and finally a new kidney named “Joy.”

Dressed in a sapphire blue dress, Melanie Graham stood at the altar of First Baptist Church in Muncie. With her father officiating, Graham exchanged wedding vows with the love of her life, Michael Graham.

The two met through a dating site around Christmastime in 2011. They were engaged four months later and married Oct. 20, 2012. Melanie was 38 and Michael was 42. It was a first marriage for both of them.

“He was the first person I met on the dating site. We both love sports and we both have a strong faith. I was addicted to him from day one. When you know, you know,” said Graham. But the day she had long dreamed about, took a turn shortly after her dad started the service. As she turned to face her guests, Graham was overcome with back pain.

“I looked at my dad and I said, ‘I can’t.’ He knew what I meant,” said Graham. There was a bench on the altar. As part of the ceremony, she was to sit on the bench while Michael washed her feet as a symbol of his devotion. As Graham grimaced in pain, her sister – one of eight bridesmaids – moved to position the bench so Graham could sit.

“It squelched my pride. I had been waiting so long for this day and then, I just couldn’t stand. I couldn’t do it,” said Graham. Her bridegroom remained calm and even joked with her. It helped ease her frustration, but not the pain.

***

It turned out that her wedding day was a day of reckoning for Graham. Fourteen years earlier she had been diagnosed with lupus. Extended complications followed but things seemed better until the beginning of 2012. When the back pain was at its height, Graham visited a chiropractor and got on with life. That is until her wedding day. The pain continued and about the time the couple planned a delayed honeymoon to Cancun, it was apparent that her health issues needed immediate attention.

It was Mother’s Day weekend, 2013 when Graham thought she had the flu. The couple raced to urgent care and then onto ER. A urine test showed that her kidneys were functioning at five percent.

“Over the next few days I ceased and coded and was in a coma for 72 hours. Then things started looking up a little more. I had never even heard of the term ‘dialysis’ before but I started three days a week, four hours at a time,” said Graham. She was under the care of IU Health urologist Dr. Jeffrey C. Ulrich. Her nephrologist is Dr. Swapna Katipally.

It was June 2013 and she was in end-stage renal failure. For six months she was in the hospital six times with infections. By November, she began consults with the transplant team and by December – just two days before Christmas, she underwent surgery to remove, not one but both kidneys.

“I’m a rare case. It’s mind blowing. People say, ‘there’s no way you could be functioning without kidneys,’ but I have pictures of both of them to prove it,” said Graham. “I lived and breathed dialysis.”

She also faced another challenge. She weighed 425 pounds. In order to be considered a viable candidate for a kidney transplant she needed to lose half of her weight.

“Through all of this, my husband was my strength. He was by my side encouraging me from the day we chose each other,” said Graham.

***

Raised in Muncie, Graham graduated from Cowan High School. Her father, Doug Gregg, is an ordained minister and together with her mother, Debbie Gregg, the couple raised three children in a close-knit faith-based home.

“I was the oldest and I was a leader. My siblings might even say I was ‘bossy.’ I was a good student but was more into having a social life.  I am very extroverted and don’t like to be alone,” said Graham.

After high school she enrolled in Anderson University and completed her degree in mental health from Ivy Tech. With a burning desire to live in Atlanta she took a nanny job and moved to Georgia for 10 years.

In July of 2014, faced with the challenge to reach a healthy weight, she underwent bariatric surgery. In April of 2017 she had a second revision surgery and reached the weight necessary to be listed for a kidney transplant. A year later she was added to the transplant list.

Just as things were beginning to look up, she faced tragedy – something she feared, something she disliked – being alone.

***

Michael Graham was born with Mobius syndrome, a rare neurological disorder that affects muscles that control eye movement and facial expressions. Because it is so rare, there are some symptoms that have not yet been fully identified, said Graham. One of those issues is respiratory failure.

In July 2018, Michael Graham was hospitalized for 12 days.  He died on Aug. 4, 2018 – a month before his wife was scheduled to receive a kidney transplant.

Sitting in her sister’s Muncie home, Graham talks about the love of her life and how that life changed without warning. She doesn’t cry. She wears a shirt with the words: “Choose Joy.” The words say a lot about who she is.

“Through marriage we chose each other. The joy comes from my faith. It is what has sustained me and it is a choice I make,” said Graham. She started her search for a kidney donor through a Facebook page, “Melanie’s Mountain, the journey to a kidney.” The page is filled with dozens of other people wearing the same “Choose Joy” t-shirt – all wishing her well as she approached her surgery. There were prayer groups at the YMCA, in school carpools, and a bible study she belonged to when she lived in Atlanta. One of those participants in the bible study saw her post on Facebook and began testing as a donor.

“She didn’t even know her blood type; she just knew that she was meant to donate her kidney to me,” said Graham, who nicknamed her friend “Sister Christian.” The Sunday before her transplant Graham’s 41-year-old friend and donor attended a prayer service led by Graham’s father. It was a moving time for Graham and her family. On September 27th Graham received a kidney from “Sister Christian” and she named that kidney, “Joy.”

“I look back and I think I have had a lot of setbacks, a lot of challenges. I’ve lost my husband at a point I’m able to live fully. I could be bitter but instead, I choose joy.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email tfender1@iuhealth.org.

She Knows Mommas and Their Babies By Name

She’s spent nearly 30 years dedicating her career to nursing – most recently with Coleman Center for Women at IU Health University Hospital. Now Rhonda Potts is retiring.

She’s seen expectant moms who return for office visits carrying newborns in their arms. She’s watched those newborns grow and welcome siblings. It’s not unusual for patients at Coleman Center for Women to seek out Rhonda Potts for a quick “hello” or a hug. She’s pretty much dedicated her career to women’s health, starting as a post partum nurse.

Over the years, she’s celebrated with women who have delivered their first child, and she’s also mourned with those who have lost their precious little one.

“A good day is when a patient says, ‘I feel so much better after talking to you.’ That’s my ‘wow’ card,” said Potts. A bad day is when we have a baby loss – someone suffers a miscarriage.” She dabs at tears as she remembers the worst day of her career – when a mom lost her infant at 37 weeks.

“It was maybe 12-15 years ago, but it could have been yesterday. It will always stay with me,” said Potts. “I am thankful that I was able to stay calm and yet cry with her. Since then she has had two more babies and she always says, ‘you people know me. I couldn’t have gotten through it without you.’”

Such compassion is what endears patients and team members to Potts.

“She’s awesome. She is a very strong leader and excellent resource for staff, patients, and doctors. She is well versed in sound clinical judgment and knowledge,” said Leisa Tremper, a nurse who worked with Potts first in ambulatory triage and then at Coleman.

“We’ve made a great tag team. When I first started as front office supervisor at Coleman, Miss Rhonda was there to teach me,” said Kay Blackwell. “And when I became interim director at one point I had to go back to Kay and ask for help,” added Potts.

Nursing was a career choice that began with a love for science, said Potts, who grew up in Central Kentucky. In high school she was president of several clubs and started nursing school at Eastern Kentucky University while she was in her senior year.

“Science was a means to an end. I started working in a nursing home when I was in high school. I knew if I could make it there I’d make it anywhere,” said Potts. “I liked bedside care but I’ve always been interested in helping people but I also like to manage and organize.”

That attribute has served her well as her career evolved. In recent years, her primary role is providing medical consults through phone calls – averaging 60 a day.

“There are many patients who don’t want to come to the office so they call and ask lots of questions or send messages through the patient portal. Sometimes, I just ask them if we can talk. I learn a lot more when I hear their voice – the pain,” said Potts. There have been occasions when patients have asked to send her pictures of their condition – that can be compromising when dealing with women’s health.

“ They don’t know me. They’re not going to run into me at the grocery store so they feel comfortable asking questions about sexually transmitted diseases, birth control and hormone replacement therapy. I’m glad they feel so comfortable but sometimes I just say, ‘you need to make an appointment and come into the office to be seen,’” said Potts. Sometimes she breaks the news to patients that their tests have come back abnormal and additional testing may need to be done.

“The main thing they want is confidence. They want to know the person they are talking to will everything she can to help them get the best care.  My job is to reassure them but also to make them understand how important it to follow through with their appointments,” said Potts.

Her caring ways have made Potts standout among her co-workers.

“I’ve worked with her 26 years. She’s sweet and kind and she’s also knowledgeable and straight forward,” said Kim Manuel, a patient care assistant. “We just love her to death and my favorite quote from Rhonda is, ‘Kim are you making the coffee or am I?’”

More about Potts:

  • She is married to Brian Potts. They have two adult children – a son and a daughter – and one grandson.
  • She will be retiring in Arizona to be closer to her children.
  • What would surprise people to learn about her? “I was a disco queen in the 70s and my husband and I have taken ball room dancing lessons.”
  • Advice to new nurses: “Pick a specialty. Decide what you want to do early on and stick with it. Learn all you can and you will excel.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at T.J. Banes or on Twitter @tjbanes.

Do You Have Prediabetes? Check Yourself

The holidays are approaching and many gatherings are centered on food. Did you know that the choices you make could impact your chances of preventing diabetes?

Here are the facts: One in three people have prediabetes and nine in 10 people don’t know they have it. Here’s some more news – IU Health offers a free workshop to help people at risk of prediabetes, learn about those risks and how to avoid them.

Following the slogan – “It can cut your risk in half,” the workshops offer insight into who is at risk, why they are at risk, and how they can avoid diabetes.

“The year-long program is designed to help you make necessary lifestyle changes with a focus on healthy eating, physical activity, weight management, setting personal goals, and problem solving,” said Britney Merchant, diabetes program coordinator and a certified lifestyle coach. The IUHP Diabetes Prevention Program is a Centers for Disease Control (CDC) approved curriculum of 16, one-hour classes in the first 6 months of the program and an additional six classes in the next six months of the program.  Two specific goals of the program are to lose 5-7% of body weight if overweight, and achieve 150 minutes of physical activity a week.

Each week the meetings are facilitated by a Certified Lifestyle Coach and Registered dietitian and include a topic of discussion; participants are encouraged to create a support network throughout the course of meetings. The Lifestyle Coach also checks on the participants between meetings to see if they have questions or concerns.

The first program kicked off in October. The second one will begin Jan. 12, 2019 at IU Health West. In addition to the Diabetes Prevention workshop, IU Health offers free support groups throughout the city – the second Tuesday of the month from 6-7:00 p.m. – for persons diagnosed with diabetes. The next support group will meet November 13 at Nora Library. The topic: “Surviving the Holidays With Diabetes.” 

This month is National Diabetes Month – a time to educate and bring attention to a disease that impacts millions of Americans. In Indiana, Diabetes has continued to increase affecting 10.7% of the population and is the seventh leading cause of death. Research has shown that Type 2 diabetes can be prevented or delayed.

What you need to know:

  • The Best candidates to learn more about the risks of prediabetes are people with family histories of diabetes; people over the age of 40, woman who have had gestational diabetes in the past, those who are overweight, and those who have had any medical history of such issues as high blood pressure.
  • Non-candidates (those disqualified for the workshops) – anyone diagnosed with Type 1 or Type 2 diabetes; anyone who has ever been on insulin; and anyone who is under the age of 18.

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email tfender1@iuhealth.org.

He Traveled More Than 10,000 Miles For Treatment

Eason Yang was diagnosed with testicular cancer and traveled from Beijing, China to seek care from IU Health’s Dr. Lawrence Einhorn.

There’s a gold Mylar balloon banner announcing the occasion: “Happy Birthday.” In front of it stands a smiling Eason Yang, his wife of six years, Chloe Zhang beside him, holding their two-year-old daughter Piaopiao.

What isn’t known about the picture is that Yang was over-the-moon to be part of Piaopiao’s birthday. Her name is the Mandarin word for “beautiful.” And for Yang, that beauty is beyond his imagination. Every day is a blessing.

She was born January 7 – a day after Yang ‘s surgery for testicular cancer. He missed the birth. It’s painful for him to talk about. It’s difficult for him to grasp his life before his diagnosis and focus on life now.

A graphic artist and former marketing designer for Uber in Beijing, China this father traveled to Indiana twice seeking treatment for his diagnosis. His parents Shiqiang and Iaoqin Yang joined him during his recent month-long stay. His wife and daughter will meet him in California where he will remain indefinitely.  The distance – a little more than 2,000 miles from Indiana – is closer than his home in Beijing, some 10,000 miles away.

“I told Dr. Einhorn, ‘I want to be close to you. Psychologically it makes me feel safe,’” said Yang, who learned of Dr. Lawrence Einhorn by researching doctors throughout the world. Dr. Einhorn is known for successful treatment of testicular cancer – germ cell tumors – using a mix of high does chemotherapies and peripheral stem cell transplant.

It was the last day of 2016 when Yang was diagnosed.

“I felt something was wrong. One of my testicles was hard as a rock. I went to the hospital the next day. I did a urology work up first. They checked my testis and got an 80 percent diagnosis. At first I couldn’t believe it so I went to three of four other hospitals,” said Yang. Testicular cancer is rare, but one of the most common cancers in American males between the ages of 15 and 35. Symptoms include a lump or enlargement in either testicle; a feeling of heaviness in the scrotum; a dull ache in the abdomen or groin; and sometimes back pain.

After surgery, Yang was told his tumor markers were high so he went through six rounds of chemotherapy. Things seemed to be back to normal. Then three months later, he had a re-occurrence.

“My whole world collapsed and I was getting mixed messages from my doctors. I lacked confidence. Even in the hospital that is known for treating cancer patients, it’s sometimes very chaotic – like going to Wal-Mart on Black Friday. It just didn’t feel like I was getting the best care,” said Yang. “It sounds like easy treatment but I think besides all the chemotherapy and surgeries, the biggest thing that happened to me and my family is fear. It’s something we never dealt with our whole life and hopefully don’t have to deal with it again in the future.”

His first call to IU Health was to Maria Siddons, a clinical coordinator with destination services. From that first conversation, Yang said he felt more at ease, like he was heading in the right direction for his treatment options.

“I didn’t make the decision immediately. I talked to Maria, and Dr. Einhorn reviewed my records and told me what he recommended – high dose chemo and stem cell transplant. I worried about how far I could travel and I also hesitated because of the cost,” said Yang. After another round of high-dose chemotherapy, Yang said he continued to lack confidence in the hospital and providers.

In April he came to IU Health.

“I had no choice. I needed a back up plan if I had another reoccurrence. I felt like the doctors in China weren’t as experienced as here. Just talking to doctors here gave me the assurance that I was in the right hands. It was a question of ‘what if it returns. What are the next options?” said Yang.

Those options began in September. He returned to Indiana for surgery to remove infected lymph nodes.

“I would tell other men that they need to take care of things as soon as possible. It’s not something you can avoid or ignore. You have to do something. Do your research,” said Yang. “I wasn’t 100 percent confident with my doctors and I began reading papers by Dr. Einhorn and his team. I do whatever he tells me to do. He’s spent his life researching and I trust him.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email tfender1@iuhealth.org.

Two Veterans, Three Children, One Family That Serves

LifeLine crewmember Tasha Shafer is one of many members of the IU Health team who serve our country. Her husband Jason Shafer joins her in service. Today, on Veterans Day, we honor all those who serve our country.

She wears a jacket with a single word printed on the right hand side just below her shoulder: “Crew.”

That one word accurately describes Tasha Shafer. Not only is she a valuable member of the LifeLine crew; she’s also a member of a much larger corps – the United States Military. Today, on Veterans Day, we honor Shafer and other IU Health team members who serve our country.

For Shafer, being part of a team comes second nature. She and her husband of six years, Jason Shafer, are both in the military and together they are raising three children – Aiden, 8; Mackenzie, 6, Amaya, one. The team is different from many family units. Jason Shafer is deployed through August.

It’s something they’ve grown accustomed to.

A native of Texas, Tasha Shafer moved to Indiana during her sophomore year of high school. She joined the Jr. ROTC at North Central High School and a week after graduation; she started basic training with the US Army National Guard. During 9/11 she continued training as a medic.

“I had some good instructors in the ROTC,” said Shafer. “They taught me a lot about life goals.” She finished medic school in 2001 and enrolled at Indiana State University planning for a career in nursing. But that planned changed when she was deployed to Africa for 18 months. She first met Jason, who serves in the Marines, when they were stationed on the same base.

“We were in Somalia and Ethiopia working on a humanitarian mission. We’d set up aid stations where we distributed meds, and saw patients – a lot of pregnant women who didn’t have prenatal care,” said Shafer. They also distributed food, toys, and stuffed animals and played soccer with the children.

She met Jason when he came to the clinic with back problems and she gave him an injection to ease the pain. Jason was a resident of Michigan; Tasha said she wouldn’t have met him if it hadn’t been for the service.

But after that tour, they both went their separate ways. Tasha returned to Indiana to continue with nursing school – until she got the call again. She was again deployed, this time to Iraq, where she again worked at a clinic on the base.

Seven years after they met, Jason found Tasha on Facebook. He proposed on Sept. 11, 2011 and they were married the following April. Tasha hasn’t been deployed since they had children; Jason is serving his sixth deployment with the infantry division.

“I know I could be deployed. I know we could both be deployed at the same time,” said Shafer “It’s a reality that we have to prepare for. Our life is a little different. We have three kids we are responsible for so it’s complicated and involves a lot of planning. We have things that most 30-year-olds don’t have – family care plans, wills, powers of attorney.” They have one family care plan in place in case she is deployed; one in case he is deployed; and one in case they are both deployed.

She was almost finished with nursing school, when she was last deployed. She knows that being part of a military family means that life changes – even when you are making plans. She joined LifeLine in 2015 where she serves as the team lead for communications. In that role she trains communications specialists and fills in for team members when needed.

“My dream was always to work for LifeLine. At one point I thought I’d work as a medic because that’s been my experience for 18 years. But I like working in a different capacity,” said Shafer. “It’s given me the best of both worlds – I’ve worked as a medic and now I’m working behind-the-scenes – helping everyone I come into contact with – patients, doctors, crew members. It’s really about being part of a team.”

More about Shafer:

  • About keeping in touch with loved ones who are deployed: “We do a lot of Face time. My first deployment we had to wait in line at the Internet café to connect with our loved ones. Thank goodness for cell phones.”
  • Where’s dad? “We have a world map on the wall and we use a piece of yarn to travel with dad. We also have an Indiana clock and a clock with dad’s time.”
  • Advice to dual-military families: “Keep calendars and plan to stay organized. Routines are big. Let your kids be independent; let them help out and accept help from others.” Friends from her son’s baseball team recently set up a meal train with their church to fill Shafer’s freezer.
  • Where did her sense of teamwork start? “I used to run lights, sound and music for high school plays. It was part of working behind-the-scenes but being part of a larger group.” She’s worked with the cast of “Funny Girl,”  “Fiddler on the Roof,” and “The Lion King.”   

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at T.J. Banes or on Twitter @tjbanes.

Tobacco, Opioids Killed More Than 14,000 Hoosiers Last Year

IU Health is on the front lines in the fight against
addiction.

A pair of
reports released last week by the Richard M. Fairbanks Foundation paint a
dismal picture of the opioid and tobacco epidemics that are killing Hoosiers,
but IU Health Simon Cancer Center employees who are on the front lines
of treatment are not surprised.

Tobacco and
opioids claimed 14,200 Hoosier lives in 2017 and cost the state $12.6 billion
annually in healthcare costs, lost productivity and other economic damages,
according to the reports.

There were
1,700 deaths linked to drug overdoses last year, a 75 percent increase since
2011, the report said. The vast majority were attributed to opioid misuse.
Despite that sobering statistic, tobacco claims seven times as many lives each
year. Smoking and second-hand smoke cause a combined 12,500 Hoosier deaths
annually.

When Debi
Hudson reviewed the reports, she said, “I wanted to stand up and cheer.” Not
because it was good news, but because she’s on a mission to reduce
tobacco-related deaths. Tobacco doesn’t get the attention that many other
addictions do, said Hudson, director of the IU Health Simon Cancer Center Tobacco
Treatment Program, “even though more people are dying from tobacco every day
and every year.”

Hudson, a
tobacco treatment specialist for 21 years, said during that time, Indiana has
always been in the top 10 for “highest adult smoking prevalence.”

The two
addiction crises are the root causes of Indiana’s poor health outcomes and
burdensome healthcare costs, said Claire Fiddian-Green, president and CEO of
the Fairbanks Foundation. “All Hoosiers must realize the urgency and work
together to address them.”

While there has
been a steep decline since 2011 in the number of fatal overdoses that involve
prescription opioids, Indiana has seen a rapid rise in the synthetic narcotic
fentanyl. The presence of fentanyl in Marion County overdoses increased from 6
percent in 2013 to 46 percent in 2017.

Linda Bond,
lead therapist in IU Health’s Chemical Dependency Program, said the OD numbers
listed in the report actually seem low to her. “Everybody who comes in here
pretty much knows someone who OD’d.”

The intensive
outpatient program housed at IU Methodist is five hours a day, five days a week
for four to six weeks. Within that window are activities including group
counseling, art therapy, yoga, physical therapy and meditation. Currently, 22
are enrolled in the program. A similar program is offered in the evenings.

About half of
the participants are being treated for alcohol abuse, the remainder for
methamphetamine and opioid addictions, she said. But it’s not like a lot of
drug treatment programs.

“We’re not a pill
mill,” Bond said. “We don’t give out suboxone or methadone,” two medications
often used to treat pain and addiction.

The program
uses opiate blockers such as vivitrol and naltrexone to reduce the craving for
drugs and alcohol. It has a 79 percent completion rate, Bond said, though
overall success rates are difficult to measure.

“Intense work
gets done in a very caring, comfortable environment,” she said.

Andrew Gaddie
is a peer recovery coach in the same program. Since January, he has been on the
front lines in the addiction fight, meeting people in the emergency department
at Methodist when they have overdosed and presenting them with treatment
options.

Gaddie knows what
they’re going through. For 20 years, he battled addictions to alcohol, cocaine
and heroin. He’s been clean for 12 years, though he admits to still being a
smoker. “That’s one of my vices I have not been able to put down and it’s
probably the most deadly one.”

As a recovering
drug addict, though, he delivers a dose of reality to the patients he sees in
the ED.

“We have found
that peer recovery coaches can reach the addict better than a doctor or nurse
or technician because we’re people with lived and learned experiences. We’ve
been in their shoes.”

But not
everyone is receptive. Some are hostile when he tries to talk to them, Gaddie
said. He has been there when people have been saved with Narcan, which helps
reverse an opioid overdose. “I’ve heard people say, ‘Why’d you bring me back?’ A
lot of people just want to go back out and use. They’re not looking at the fact
that they have another chance to live life.”

Gaddie knows what
it’s like to get another chance at life. He might be on his ninth life already
– having survived multiple heart attacks, a gunshot wound to the head and other
health crises. Now if he could just kick the cigarette habit.

Like drugs,
tobacco has a devastating effect on Hoosier health, the Fairbanks study said.
More than one in five Hoosiers smoke, a decline from 25.6 percent in 2011, yet
Indiana consistently places among the 10 states with the highest smoking rates
nationwide.

IU Health has been at the
forefront in treating tobacco-related lung disease and cancers, said Dr. Khalil
Diab, IU Health pulmonologist. A large number of patients with smoking-related
diseases, including COPD, asthma and lung cancer, are treated at IU Health
facilities across the state, he said.

Research by pulmonologists
and lung cancer specialists at the IU School of Medicine aims to understand the
mechanisms of DNA damage and repair in cancer cells. “We have multiple clinical
trials with cutting-edge therapies for lung cancer patients in Indiana,” he
said.

A lung cancer screening
program also has been developed to improve the survival rate of Hoosiers who
are current or former smokers, said Dr. DuyKhanh P. Ceppa, associate professor
of thoracic surgery for the IU School of Medicine. The multi-disciplinary
treatment program, funded by a two-year grant from the National Cancer
Institute, launched Nov. 1 at the IU Health Simon Cancer Center, and the goal is to
eventually expand it to include all IU hospitals.

Still, Ceppa
said, “The data are very clear that more strict smoking laws have a direct
effect on decreased lung cancer rates in our states.”

The key is
prevention and early diagnosis, Diab agreed. “And state laws are urgently
needed to address that.”

Tobacco use is
the leading preventable cause of premature death and disease in the United
States, causing more deaths annually than alcohol, HIV, car accidents, illegal
drugs and firearm-related incidents combined, according to the Tobacco
Prevention and Cessation Commission.

Each year,
3,700 children under 18 become new daily smokers, the Fairbanks study cited.
Nearly 14 percent of women in Indiana smoke while pregnant, ranking the state
11th worst in the U.S.

Action steps
suggested by the Fairbanks study include: increasing the cigarette tax by $2
and the legal smoking age to 21; expanding access to medication-assisted
treatment; increasing syringe exchange programs and safe disposal sites for
opioids; and boosting prevention programs in schools.

— By Associate Senior Journalist Maureen Gilmer
   mgilmer1@iuhealth.org

Melanoma –Beyond Skin Deep

A Lafayette resident and patient of IU Health Dr. Theodore F. Logan is fighting melanoma and the side effects of her life-saving therapy.  

Her long brown hair is now platinum blonde. Her skin – once sun-kissed – is now creamy white. The transformation is one of many changes that Lindsey Frazer has learned to accept.

There’s been weight loss, diabetes, blurred vision and colitis too – all side effects of the immunotherapy that is helping her body fight melanoma. The whole body therapy is Frazer’s hope of activating her immune system so that is can go to battle and destroy the melanoma cells. The side effects were so difficult for her that she suspended treatment for two years. She’s back at it now.

“Of all the side effects the vitiligo was the most interesting, the biggest change. It’s like I went from one look, one person to something completely different,” said Frazer, 27. Vitiligo occurs when pigment-producing cells (melanocytes) that give color to skin, hair and eyes, die off.

The transformation is especially an adjustment for Frazer given her path to adulthood. Born in Indiana, she moved to Florida at the age of five and spent her teen years soaking up the sun. When she later moved back to Indiana, she made regular visits to tanning salons to help her maintain her golden glow.

In March 2015 she was diagnosed with metastatic melanoma – a type of advanced Stage IV skin cancer that has spread to other parts of her body. The diagnosis didn’t come immediately. A nurse at a Lafayette hospital, Frazer first visited her family practitioner when she noticed a small blue lump near the crease of her right arm.

“They said it was a fatty deposit but six months down the road I developed more larger blue bumps on my chest They took a biopsy and it came back as Stage IV skin cancer,” said Frazer, who has been married to her Jefferson High School sweetheart, Robert for two years. They’ve been together for nine years.

“She was in nursing school when she was diagnosed and has never given up,” said Robert. “She has stayed strong and positive.” He remembers after one of her first treatments – 14 hours of cerebral radiation – Frazer wrapped her head in gauze and drove straight from treatment to one of her classes. Scans have identified two tumors in her brain and in practically every organ in her body. One of the largest – in her adrenal gland, is 12 centimeters.

“When the scans showed progression we started the immunotherapy. This time it’s been a little better. I can still work and that’s something I love,” said Frazer who works in a medical/surgical unit and hopes to work in oncology some day.

“I was in shock when I was first diagnosed. I didn’t expect this to happen to me,” said Frazer. “I was given about six months to live. I’m still here and we’re hoping that we can keep shrinking the tumor and I can keep going.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at
 T.J. Banes or on Twitter @tjbanes.

Dad’s Advice: “No Matter How Bad It Gets, Be a Role Model”

Baltimore resident Waleed Stewart, the father of five boys, knew there was only one place to go when he was diagnosed with testicular cancer. He came to Indianapolis and IU Health Simon Cancer Center.

Nurses say he might be one of the happiest patients they have met. Entering the hospital room of Waleed Stewart is like walking through the front door of his Baltimore, Md. home. Even from his hospital bed he is quick to arrange for additional chairs. He wants his guests to feel comfortable.

And Stewart is always smiling.  

“I’m happy to be here,” said Stewart as he picks out cords on a ukulele and joins CompleteLife music therapist Adam Perry for a jam session. At the age of 34, Stewart was diagnosed with testicular cancer. He came to IU Health Simon Cancer Center where he is under the care of Dr. Lawrence Einhorn, known for successful treatment of testicular cancer – germ cell tumors – using a mix of high does chemotherapies and peripheral stem cell transplant.

“He’s the man. God sent me here. My oncologist got in touch with Dr. Einhorn and he said ‘bring him here.’ It’s the best news I’ve heard – him accepting me and treating me. I was busy feeding my children and ignoring the signs of my disease,” said Stewart. It’s been hard being away from his wife Chira Stewart and his boys, ages 11, 9, 6, 3 and one but his mother Kathy Randall accompanied him to Indiana.

“He is the oldest of my three boys and he was a sweet little boy with a lot of energy,” said Randall. “He smiles all the time and he’s always so helpful everyone falls in love with him. The man you see now is the little boy that he was.”

In high school Stewart loved business. He played lacrosse but was always conscience about helping his mom, raising the three boys as a single parent. As early as age 13 Stewart got a job and started helping with the bills.

“I got involved with the Futures Program, a drop-out prevention program and they paid me to go to school. It was a summer thing and from that point on I got a job every summer,” said Stewart. “At the age of 15 I was working at the census bureau and I was the youngest guy getting $250 a week. I thought I was the man.”

What he didn’t know was that his mom was putting the money into a savings account that helped Stewart pay for school incidentals – his junior prom, yearbooks and graduation.

“She taught me a valuable lesson through that – the importance of being responsible. It’s a lesson I want to pass along to my own boys. No matter how bad it gets, always be a role model,” said Stewart. He graduated from high school on a Sunday and on Monday started working for UPS. He’s been there ever since.

Work and family are his life. His first date with his wife was over ice cream and he said he fell in love with her energy right then and there. They’ve been married for 12 years. A perfect family weekend is throwing a football in the park or fishing with his boys, and enjoying a big family meal of fried chicken or rib-eye steak. He hopes to teach his boys to swim and pass on a few things he said he missed growing up.

It was about a year ago when he noticed one of his testicles was enlarged. He ignored it for a few months but by Christmas things started going down hill. He became sick but his insurance was changing so he held off going to the doctor. On March 9 he was diagnosed with testicular cancer. He was preparing for surgery but his blood pressure skyrocketed to what was considered stroke level He ended up in ICU and discovered his cancer was at Stage 3. It was traveling up his body toward his organs and his chest cavity. He started chemotherapy and surgery followed. He received a bone marrow transplant August 28 and 29.

“I’ve focused on everything here – chemotherapy, music therapy, yoga therapy . . . I want to get healthy,” said Stewart. “I’m blessed to be in a place that is so caring and to be surrounded by such caring people. All I need to do is chill and maintain and focus on getting better.”

— By T.J. Banes, Associate Senior Journalist at IU Health. 
   Reach Banes via email at T.J. Banes or on Twitter @tjbanes.

Why You Need to Get the Flu Vaccine This Season

An unexpected illness could ruin holiday or travel plans before they even get off the ground. Getting your flu shot is the best way to protect yourself from this serious disease that affects millions of people every year. We collected a list of the more common questions about influenza and its vaccine.

What Is Influenza?

Influenza — more commonly known as the flu — is a widespread and potentially serious disease that can lead to hospitalization. According to the Centers for Disease Control and Prevention (CDC), an estimated 80,000 Americans died of the flu last year, which is the highest death toll in over a decade.

This contagious, respiratory illness is brought on by the flu virus and can show symptoms quickly. It’s important to identify the signs of flu when they appear.

Influenza symptoms include:

  • Fever
  • Feverish feeling and/or chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Vomiting and/or diarrhea (more common in children)

The flu is caused by a virus, and the best way of preventing infection is an annual vaccination.  

What is the flu vaccine?

The flu vaccine is designed to prevent infection from the most common flu viruses. While it’s still possible to get the flu after receiving the vaccine, the vaccine will usually lessen the severity of flu symptoms.

The vaccine is designed to protect against the strains of flu virus likely to be most common throughout the upcoming year.The vaccine can be administered either as an injection or a nasal spray.

Who should get the flu vaccine?

The CDC recommends that anyone older than 6 months should get an annual flu vaccination. For groups determined to be at a higher risk for developing complications from the flu, it is especially important to be vaccinated.

These groups include:

  • Children aged between 6 months and 5 years
  • Adults 65 and older
  • Women who are pregnant
  • Residents of nursing homes or long-term care facilities
  • Anyone with existing medical conditions such as asthma, lung or heart disease or diabetes

Generally speaking, it’s a good idea for everyone older than 6 months to get the flu vaccine, with only a couple rare exceptions, including a severe allergy to antibiotics. If you’re concerned about an allergic reaction, consult with your doctor before getting the vaccine.

Why do I need to get a flu shot every year?

Flu viruses are constantly changing, and each year’s flu vaccine is updated to keep up with changing strains of the flu virus. Also, your body’s immune system response from vaccination weakens over time. An annual vaccine is the best way to maintain optimal protection.

Don’t wait to get the vaccine. Once you begin to experience flu symptoms, it’s too late for the vaccine to protect you. If you do get sick, chances are you will expose other people in your life to the virus, including those that may not be able to receive the vaccine, like infants or the elderly.

What’s in the flu shot?

The flu vaccine contains dead or severely weakened flu viruses that train your immune system to quickly recognize the virus and prevent an infection. Every year, the flu vaccine you receive is is different than the year before.

This is because each year, the vaccine is updated to keep up with the constant changes in the flu virus. Seasonal flu vaccines protect against the strains research indicates will be most common throughout the upcoming season.

Flu vaccines usually contain virus cells grown in eggs. If you have a severe egg allergy, consult with your doctor before getting a vaccine. Cell-based vaccines are available for those with severe egg allergies.

Can the flu vaccine give me the flu?

No, the flu vaccine is made with dead or weakened viruses that cannot cause a full flu infection. Some people do report experiencing a low grade fever, aches or redness, soreness or swelling at the site of the vaccine injection.

Side effects of the nasal spray can include running nose, wheezing, headache, vomiting, muscle aches, fever, sore throat or coughing. Side effects for both the shot and the nasal spray are mild, and most quickly subside.

Side effects of the flu shot are no fun, but you can think of it as a good sign. It shows your body needed the extra help to fight the virus and that the vaccine is working. If symptoms do persist, consult with your doctor.

What are the benefits of the flu shot?

A flu shot is the best way to protect yourself and your family from the flu this season.

  • Keep you from getting sick
  • Reduce risk of hospitalization for children and senior citizens
  • Preventive measure for individuals suffering from other chronic conditions
  • Protection during and after pregnancy
  • Protect people around you who don’t have or can’t receive the flu shot

Can I still get the flu if I get the vaccine?

It is rare, but, unfortunately, it is still possible to get the flu even if you’ve been vaccinated. There are a few reasons this can happen.

First, it can take up to two weeks for the vaccine to become fully effective, so exposure before or during that time can result in a flu infection. The symptoms may be less severe in this situation, but you should still consult your doctor.

Each year’s vaccine is formulated to protect against the most common strains of the virus. If you are exposed to a less common strain, the vaccine may not be as effective in preventing infection. Although, evidence shows vaccination can reduce the severity of symptoms in these cases.

Finally, it’s possible to get a strain of the flu the vaccine is designed to protect against. Again, though, vaccination can help to lessen the severity of symptoms.

Vaccines are not 100% effective all the time, but they are the best tool we have to prevent seasonal flu. Last year, it’s estimated vaccinations prevented 5.3 million illnesses and 85,000 hospitalizations.

$25 Flu Shots on Your Schedule

Right now, stop by an IU Health Urgent Care and get a flu shot for only $25. Available to ages 9 and older. High dosage flu vaccine not part of $25 promotional offer. Visit one of our convenient Indy area locations open 7 days a week. No appointment necessary.

  • Broad Ripple
  • Brownsburg
  • Greenwood
  • Lawrence/Fort Ben
  • Noblesville
  • Plainfield

Do you have a question we didn’t answer? Reach out to jkukolla@iuhealth.org for more information. We may even add your question to the blog.

Find Urgent Care Locations Near You

Protect yourself and your family this flu season. Get your annual flu shot at any of our 10 convenient locations in Central Indiana and across the state for only $25. Shorter wait times mean you can be in and out in less than 40 minutes. Walk-in or schedule an appointment.

Find Nearest Urgent Care Location »

Want to know more about IU Health Urgent Care or need to pay your urgent care bill? Learn more here. 

Firefighter Spreads The Word – Learn The DNA, Slay Cancer

A retired fireman from California, and a patient of IU Health’s Dr. Milan Radovich has made it his mission to spread the word about the importance of gene sequencing and cancer treatment.

It was the weekend of the Indy 500 Mini Marathon when California resident Michael Balash and his wife Debbie wandered into Simon Cancer Center looking for the precision genomics wing. They didn’t know exactly what they were looking for on that Saturday afternoon, but as long as they were in Indianapolis, they decided to check out one of IU Health’s newest cancer units.

Balash, who was diagnosed with lung cancer in August 2016, still shakes his head at the chance meeting during that Mini Marathon Weekend. During his random visit to IU Health, Balash bumped into Dr. Milan Radovich, Vice President for Oncology Genomics at IU Health and a co-leader of the IU Health Precision Genomics program. The clinical program is dedicated to the integration of cutting-edge genomics – the care of patients with metastatic cancer.

That meeting resulted in a long-term commitment that spans more than 2,000 miles; long-distance consults; and additional face-to-face office visits. It extends well beyond Indiana and California. Balash has made it his mission to educate fellow firefighters about gene sequencing as an option for specialized treatment of cancer. He and his wife write about their experience and findings in a website: Cancerbeast.com. His vision is to have gene sequencing available as a standard of care for all cancer patients.

The website expands on that vision: “The gene sequencing process will lead to cancer breakthroughs – another tool in the cancer prevention and treatment toolbox. It is the future of all medical care,” they write.

***

Coming to IU Health is like coming home in a sense for Balash, 68. He and his wife grew up in northern Indiana – 30 miles outside of Chicago. They attended their senior prom together and graduated from East Chicago Roosevelt High School. Then they went their separate ways. Both married and had families of their own – Debbie has a daughter from her previous marriage; Michael has a son and daughter from his previous marriage.

Time went by, and another chance meeting. Debbie was working as a cardiac sonographer at a hospital where Michael’s dad was treated. When Michael’s dad passed, Debbie left her shift and, still dressed in her uniform, drove to the wake. She returned for the funeral the following day. That reunion resulted in a marriage that spans 14 years.

With ties to Indiana, they returned to Indianapolis to watch family members participate in the Mini Marathon. Michael also takes part in the annual FDIC, firefighters instructional conference – an event that brings about 34,000 firefighters to Indianapolis.

***

He wasn’t always a firefighter. Balash joined the Navy and was sent to California in January of 1972. He made that his new home and began work as an accountant. Some of his clients were firefighters and as he began listening to their stories of heroism, he thought that he’d like to join their ranks. So at the age of 34, he changed careers – one that he remained with for 24 years and served part of that time as an assistant chief with the Sacramento City Fire Department.

When a spot was found on his lung, Balash began researching the men and women in uniform touched by cancer. The results were astounding. According to his website one multi-year study conducted by The National Institute of Occupational Safety and Health (NIOSH) of 30,000 firefighters from San Francisco, Philadelphia, and Chicago indicates that firefighters have a higher rate of certain types of cancer than the general population.

The name “Cancer Beast” is a direct reference to the Chicago Fire Department’s description of fire. “You have many firefighters fighting the fire beast and now you have many firefighters fighting the cancer beast,” said Balash. Together with his wife, he has visited various fire departments including Cleveland, Chicago, and Noblesville advocating for cancer awareness and training. Their campaign has taken them to The National Cancer Community Summit in Washington, D.C. and next year they will travel to Spain to speak on the topic.

So, why the interest in gene sequencing?

“I believe there will come a day when cancer is not defined by a body part, but the genes in the mutation. A tumor may start one place but then spread to other parts of the body,” said Balash. “The more we know about gene sequencing, the better prepared we can be to advocate for specialized treatment options.” 

The more they research, the more they share. Articles on cancerbeast.com include new developments such as blood-based testing to assess tumor mutation burden (TMB) that accurately identifies non-small cell lung cancer – a discovery that could lead to immunotherapy treatments. That’s hopeful news for Balash.

And even as they advocate for the care of fellow firefighters, Michael and Debbie Balash look to IU Health to help them navigate Michael’s treatment options.

“When our oncologist back home suggests a treatment option, we will call back here for advice and opinions,” said Debbie. “They are amazing here. They have what we need to stay on top of the latest clinical trials and recommendations. We are in good hands.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at
 T.J. Banes or on Twitter @tjbanes.