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#28266 10-04-2006 06:30 AM
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My fianc


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I suspect you will run smack into the privacy wall that is now erected around patients. When my husband had heart surgery and was in the CICU I wanted to take his picture so he would know what had happened, but because I did not obtain his notarized written permission I was not allowed to. As sad as it is, I think you are out of luck.

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He set up permission for me to speak to his MD Anderson Business Consultant. Wonder if I could route the questions through her. Might be work a try.

Something else I wanted to include (but was to late to edit) in my original post. . . .

We've not even received formal TNM info. The head surgeon did inform us he was stage IV but I was only able to pick up informal TN info as radiologists talked amonst themselves during consult (informal in that they bantered around like shop talk the patient & family would not be expected to understand, therefore pick up on). M value was never discussed in any of the consults.

Thanks,
R-


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Well someone needs to start asking a lot of questions. Keep us posted and as always GOOD LUCK.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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He (and everybody) needs an Advance Healthcare Directive, part of which names an Agent for Healthcare who is empowered to receive all medical information.


dx 2/13/06. modified radical neck dissection 3/9/06 multiple biopsies of upper airway and direct laryngoscopy. 1 of 47 lymph nodes positive for metastatic undifferentiated carcinoma (lymphoepithelioma). Unknown primary. Finished radiation 5/24/06.
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Riley, you are absolutely correct and we have had those for years, and I never even thought of it. That is what happens when you think you are operating on all cylinders, but worry is actually making you (me) stupid. Thanks for the reminder.

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Hi R,
I think you will still run into the HIPPA privacy regulations. The only way around that is to have him sign an advance directive as suggested that names you as his medical representative OR have him write a note that gives you permission to discuss his medical condition with the health professionals.

Pretty much you have to ask for information on staging and prognosis but they sould be discussing test results on the next visit. It's possible that the doctors are picking up on your finance's reluctance to bring these subjects up. Everyone watches the patient to try to get a "feel" for what they want to know. If he's waiting for them to bring it up, and they're waiting for him it's a situation ripe for miscommunication.

Perhaps you could talk to him and agree on who who will be the person asking questions during or after appointments. I used to write the questions out in advance and go over them with Jack. Both of us had copies of the questions so that if one of us forgot it or just got overwhelmed that appointment, the other could stil get the information we wanted to know.

We found we needed to work as a team but in the beginning I wanted a lot more information than Jack did. He was in such shock that he didn't want to hear any more than the immediate next step. He didn't want to discuss radiation until he was through the surgeries etc. That phase passed but it was pretty tense until we started being honest with each other on what we both needed to get through this.

I guess my best advice is that you need to talk to each other so that you're in agreement before you talk to the doctors. He is being treated in an excellent facility for what's it worth. They are leaders in treating head and neck cancers.

Good luck, JoAnne


JoAnne - Caregiver to husband, cancer rt. tonsil, mets to soft palate, BOT, 7 lymph nodes - T3N2BM0, stage 4. Robotic assisted surgery, radical neck dissection 2/06; 30 IMTX treatments and 4 cycles of cisplatin completed June 06.
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R, read JoAnne's post to your fiance-she is absolutely right on! Dealing with the HIPPA laws can be nightmare when you are married and the caregiver-so your situation will be even more stressful. Last week after chemo, we stopped by the hospital to pick up a copy of John's last PET scan and I had to take a permission slip out to the car for him to sign, produce my driver's liscense for them to copy[even tho I had picked one up 45 days ago and gone through the same routine AND I am listed on everything as his medical representative.] Explain to him that once the treatment gets going, neither of you needs the hassle of plowing through the regulations. Also, talk about who can deal with the Insurance Co. in his behalf if he is too sick to handle "issues". He needs to understand that he may not want these pressures over the next few months, and now is the time to address them. Amy


CGtoJohn:SCC Flr of Mouth.Dx 3\05. Surg.4\05.T3NOMO.IMRTx30. Recur Dx 1\06.Surg 2\06. Chemo: 4 Cycles of Carbo\Taxol:on Erbitux for 7 mo. Lost our battle 2-23-07- But not the will to fight this disease

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Also, go to all the consults and examinations -- this gets you into the loop -- I never had any probems with HIPPA at any of the places we went (including local hospital) but my husband did have an advanced directive /durable power of attorney document. The State of Maryland has one on their web page which is accepted at all medical institutions in the state. The laws in other states probably differ.

You may well have to take the lead on asking questions and helping your fiance make decisions on treatment -- he is going to have enough on his hands dealing with the treatment and its side effects. MDAnderson has social support people to help you deal with hospital bureaucracy as well...

The more you know the better you will be able to help and support your fiance through treatment.

Gail


CG to husband Barry, dx. 7/21/05, age 66, SCC rgt. tonsil, BOT, 2 nodes (stg. IV), HPV+, tonsillectomy, 7x carboplatin, 35x tomoTherapy IMRT w/ Ethyol @ Johns Hopkins, thru treatment 9/28/05, HPV vaccine trial 12/06-present. Looking good!
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I would, as Joanne did, write any/all questions I could think of even while riding in the car to the appt. My wife also attended every appt I had with all docs. As each question was covered I would check it off. Having written down in advance is the only way to go. My wife was the one that usually talked on the phone to the nurses or docs and we never ran into a problem. I was treated at Moffitt Cancer Inst.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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