Each day on Pat Miccio’s calendar lists a number, with a running total for the month on the top of the page – usually somewhere in the hundreds. It’s Miccio’s way of marking how many recyclables she has picked up on the daily walks she takes around her Pennsville, N.J., neighborhood, all carefully tabulated on the wall calendar.
In more than four years, Miccio has collected 18,000 recyclable items others dropped on the ground – soda cans, beer bottles, milk jugs, sports drink containers. But for nearly a year, from December 2010 until September 2011, those days on Miccio’s calendar were empty of anything except doctor’s appointments as she battled breast cancer with the help of the staff at Christiana Care’s Helen F. Graham Cancer Center.
Miccio’s odyssey from environmental steward to cancer patient to cancer survivor began with her daily walks more than 10 years ago. While she initially walked for the exercise benefits, Miccio quickly discovered another reason to get out of the house every day.
“I just needed to get out, and then it got to the point where I was walking and I’d see all this mess on the ground,” Miccio said. “It starts getting to you.”
Miccio saw an Oprah Winfrey special about the environment, and it inspired her to start carrying a plastic bag with her to collect some of the mess she would see.
“It started out, I brought one bag with me … and then after a couple of weeks, it would be two bags. Then, another couple of weeks, especially after Septemberfest, it jumped up to four bags,” she said. “It’s amazing what you find. It adds up.”
But the collecting was put on hold after Miccio went to her doctor for a routine mammogram in 2010. Miccio was diagnosed with stage 1 cancer in her left breast. She was sent to the Helen F. Graham Cancer Center to begin a treatment regimen. In October 2010, Miccio underwent a lumpectomy. Chemotherapy and radiation followed, lasting for nine months.
For a year, the fight against breast cancer took precedence over the mission to clean up the environment. Even after the treatment ended, she found that she didn’t have the energy to walk every day – because of the lingering effects of her cancer treatments and an ongoing battle with chronic obstructive pulmonary disease, or COPD.
“I’m realizing what a friend of mine had told me: It takes a while to get back into the full swing of life again,” Miccio said.
As the counts on Miccio’s calendar show, she is getting back. By the end of April, she had collected just 270 pieces for the year.
“I’m usually well over a thousand by that point,” she said.
By the end of August, Miccio’s count had climbed to 1,685 for the year.
“Maybe, by the end of the year, I might break 3,000 pieces,” Miccio said. That number would also put her running total at more than 20,000 recyclable items picked up.
Miccio found another cause to help her get back into the swing of life. She has donated the cans painstakingly collected, sorted, washed and crushed after her daily walk to a friend with a relative on dialysis. The money raised from the recycling effort helps to pay for the machine.
While she never expected to become so well acquainted with the Helen F. Graham Cancer Center and its services, Miccio is grateful that they were able to get her back to her daily walking and her ongoing fight against the mess others leave behind.
“It was one of those wonderful experiences I hope I never have to do again,” Miccio said.
Dear Dr. Laskowski,
I wanted to take this opportunity to share a very positive experience I had at Wilmington Hospital. I have not visited Wilmington Hospital for many years and had the opportunity on Friday to meet with Carol Briody, Infection Control, and Tyesha Rodriguez-Gist, RN in ICU for preparation for a statewide educational program in November.
I was impressed with the general cleanliness of the building, especially considering your current construction project. All areas were spotlessly clean and well marked for the visitor. As importantly, I must tell you about my encounters with your staff. Every staff member I encountered, whether just walking in the halls, at the information desk, or at nurses stations, was pleasant, smiling and greeted me with a smile and hello. I also observed staff interacting with patients in a very positive and caring manner. These behaviors seemed second nature to the staff.
My take-away was that staff at Wilmington Hospital are proud of the work they do and are well versed in the importance of customer satisfaction. In my opinion, the staff reflect a corporate culture of kindness, competency and personal responsibility.
You must be very proud of you employees.
Sally Jennings, RN
Quality Insights of Delaware
Former runner and aerobics teacher Laurie Beauchamp struggled with the forced inactivity imposed after surgery to reconstruct the posterior tibial tendon in her left ankle. But the end result – pain-free walking and exercising – made that struggle worthwhile.
“It was very intense,” Beauchamp said of her rehabilitation process. “I was basically confined to my bed with assistance from family members … I followed the letter of the directions from the doctor.”
Beauchamp had struggled with pain in her left foot for years – brought on by all of her physical activity and exacerbated by wearing the “wrong shoes,” she said.
By 2007, she was diagnosed with a ruptured posterior tibial tendon, which extends from the calf muscle through the ankle to the bones in the foot. She was finding that extended periods of walking or exercise resulted in excruciating pain.
By 2010 it became too much, and she turned to surgical options.
“Here I was just turning 50, and I thought I want to do this now when I can have a good recovery,” Beauchamp said.
So she sought the advice of an ankle specialist – Paul Kupcha, M.D., an orthopaedic surgeon with Christiana Care Health System.
“It was a huge surgery,” she said. “I just felt like [Dr. Kupcha’s office] was a very knowledgeable team. From the first phone call to getting my documents there … everyone was very attentive.”
Dr. Kupcha rebuilt Beauchamp’s posterior tibial tendon in December 2010 at Christiana Care’s Wilmington Hospital. She kept all weight off her left foot for eight weeks following the surgery.
“It was very, very scary during the whole thing, because I wasn’t used to being immobile,” Beauchamp said. “It was frustrating, but I made it fun.”
When she progressed to being able to bear partial weight on her foot and use a walker, Beauchamp decorated it with a basket to carry things around.
It took until April 2011 before Beauchamp finally graduated from physical therapy. During that five-month span, she kept in regular contact with Kupcha’s office to make sure she knew what had to be done – everything from taking care of her surgical wound to what kind of shoes to wear. Kupcha’s office also worked with the physical therapy team that Beauchamp used to keep her rehab on track.
“Every time I went to Dr. Kupcha’s office, I was just handled with the best of care. No question was a stupid question,” she said.
More than a year after she finished therapy, Beauchamp was back in the gym. She is hiking. She can do aerobics, spin class and weightlifting. She is even wearing regular shoes again – although she has forever given up on “stupid shoes.”
“Right after the surgery, I wore tennis shoes for a very long time,” Beauchamp said. “I really got educated on proper footwear. I can really wear whatever I want to [now]. … the surgery was done so beautifully that I don’t want to do anything that hurts it.”
Beauchamp makes smart footwear choices and spent months following specific instructions for taking care of her new ankle. The results, she said, have been outstanding.
“I can walk for extended periods of time. I can wear the shoes that I want to wear,” Beauchamp said. “I’m so grateful that I did it.
“I cannot say enough about Dr. Kupcha and his team. … It’s just a very comprehensive, caring program, always making sure that I had what I needed even though I was two counties away.”
A couple of years ago, Scott Reilly – an electrician in his 30s – was in an aerial bucket working on a power pole, pushing a heavy object up over his head. His job requires him to regularly lift and hold heavy cables and equipment while he installs or repairs electrical lines.
Reilly relies on a full functioning upper body to work. In this instance, the object came back down and Reilly quickly reacted, injuring his shoulder. At first, he felt pain in his back. He felt better the next day and went back to work.
Within a few days, he began to experience pain when he lifted his arm very high. He sought treatment from Evan Crain, M.D., an orthopaedic surgeon with Christiana Care’s Center for Advanced Joint Replacement. Dr. Crain initially thought Reilly had injured his rotator cuff. He treated Reilly with medication and recommended rehabilitative exercises.
Reilly kept working but still had pain, especially when lifting overhead or when pulling things such as cables. Dr. Crain treated Reilly with a cortisone shot several times, but the symptoms returned.
In January 2010, Dr. Crain performed arthroscopic surgery on Reilly’s shoulder, repairing a tear in his rotator cuff and treating the bursitis that was aggravating the situation. At the insistence of Dr. Crain, Reilly did light exercise with his shoulder the day after surgery. Within four weeks, he was able to do light work, and within eight weeks he was able to return to his normal work duties.
Reilly felt noticeable pain for a couple of days after surgery, but it subsided quickly, and full function of his shoulder returned. Reilly is back to work and able to do everything he could before. He appreciated Dr. Crain’s conservative, thoughtful approach to his injury.
“In orthopaedics, we have many therapies that help patients to quickly return to work. Reilly was an active participant in his recovery; he did all exercises and most importantly shared when he thought a therapy was not working,” said Dr. Crain.
According to Dr. Crain, many people who work in occupations that require repetitive motion, strength and stamina work through the pain. They feel pain is part of the job. Unfortunately, this often leads to debilitating injury.
Fortunately, Reilly realized that his pain was not normal and sought help from a Christiana Care orthopaedic surgeon.
John Hetherington, 53, of Lincoln University, Pa., is proof of the progress that has been made in stroke recovery. One Saturday in late March, he was showering, getting ready to go to his job as a marine technician, when he suddenly found himself leaning on one side of the shower.
“I thought, ‘I should sit before I fall,’’’ Hetherington says. He called to his wife, who saw that he couldn’t move his left side and told their daughter to summon an ambulance.
At Christiana Hospital, tests showed Hetherington had a right internal carotid artery occlusion, which blocked blood flow to the right side of his brain.
“It’s amazing I’m walking and talking,’’ he says. “I’m working. I went in on a Saturday, came home Thursday and was mowing grass on Friday.’’
Hetherington didn’t know he was at a risk for stroke – he hadn’t seen a doctor in years. But the brush with mortality has changed his life. He stopped smoking, monitors the fat and cholesterol in his diet, takes his medicine and no longer avoids his doctor.
“I’m pretty grateful to be here,’’ he says, crediting Christiana Care with saving his life. “Sometimes I get a little choked up talking about it.’’
Cathy Tharby twice heard the words “you only have months to live.”
But five years later, she is still pushing forward with her fight against the rare type of cervical cancer that led several doctors to write off her chances for living a long, full life.
“They said they can’t cure me, but they would do what they could to have me live as long as possible. We’ve all been amazed at how long it’s worked,” Tharby said.
For Tharby, the difference has been her attitude and a willingness to try a wide array of chemotherapy options and other treatments offered by the staff at Christiana Care’s Helen F. Graham Cancer Center.
“Cathy has such a great attitude about this even though they were so negative to start with,” said Sharyl Mossinger, a family member who has helped Tharby get back and forth to her various treatments over the years. “I think that’s why she’s still here and having fun, because your mental attitude can really do a lot.”
Tharby’s symptoms started so innocuously that she thought she was just going through menopause and put off a visit to the doctor.
“I let things go. I thought I was going through the change of life … It wasn’t change of life, although my mother had gone through the same thing, and that’s why I just assumed,” Tharby said. “I ignored the situation for a long time until I finally was having dizzy spells because I was losing so much blood.”
Tharby was diagnosed with a non-HPV (human papillomavirus) form of cervical cancer and initially told she had three months to live. In an effort to treat her cancer, Tharby underwent a radical hysterectomy at Christiana Hospital and was told it had been a successful intervention. But a few months later, Tharby developed problems walking and pain in her left hip. A CT scan revealed that all was not well.
“I had a huge growth that was attached to this hip and upper leg, and the reason I couldn’t walk is it was pressing on the nerve,” Tharby said.
It was back to Christiana Hospital for Tharby to begin radiation therapy in an effort to shrink the tumor before starting her on a chemotherapy regimen. Once again, the prognosis was not encouraging.
“Again they were telling me I would probably only have a couple of months to live,” she said. “Well, the chemotherapy pretty much slowed it to almost a stop.”
Numerous rounds of chemotherapy followed over the next four years. New drugs were tried as soon as the cancer showed any signs of a comeback. Tharby underwent a Cyberknife treatment to cut off the blood supply to the tumor in her hip, halting its growth.
One service in particular helped her deal with the side effects from the chemotherapy treatments. A program at the Helen F. Graham Cancer Center helps teach women various style and make-up tricks to cover up the loss of hair.
“My first chemo was the strongest and the one that hit me the most. Of course, I lost all my hair,” said Tharby, who wore her hair long all her life. “[The program] was fun … getting a lot of little tricks and things to do so you feel better about yourself. That’s important at that point.”
That positive attitude in the face of a devastating illness is a hallmark of the treatment Tharby has experienced at the cancer center.
“[The Helen F. Graham Cancer Center] has the best positive attitude of any place I’ve dealt with,” Mossinger said. “Twice in all this time, she’s been in ‘stable disease,’ where nothing has grown. It’s just amazing.”
The end result for Tharby has been five years of living with cancer rather than the bleak prognosis of a few months of dying from it.
“You live with it, but you can live,” she said. “You still have a life and you go on.”