Baragwanath Nurses Course: day 2

Day 2 of the nurses course was just as good as day 1.  I was thrilled to see that 28 nurses turned up early in the morning on a Saturday.  They were keen to learn.  We started the day off with lectures and
Allison Dendy teaching massage
spent the rest of the morning having a lymphoedema practical session.

Sue Serebro teaching a student to bandage Anchen Laubscher
 It was run by 2 physics: Sue Serebro and Allison Dendy.  They are both well known lymphoedema therapists in Johannesburg and gave up their Saturday to share their knowledge.  They worked with 2 other physiotherapists.  After a short lecture going over the pathophysiology of lymphoedema and the principle of management, the group split up into 4 groups for lots of hands-on work.  First they practised massage and then they started bandaging.  Sue also brought along sleeves to wear.  It was interesting to wear a sleeve and see what it feels like.

We had a visitor: Dr Anchen Laubscher from Netcare head office.  She took time off from her wedding planning to (literally) roll up (or off) her sleeves and take part in the practical lymphoedema bandaging session. It gave the nurses a chance to say thank you to Netcare who were sponsors of the course.

Beulah and Maryann from Reach for Recovery
In the afternoon, we had a session on community work.  We had 2 visitors from Reach to Recovery (Beulah and Maryann).  Maryann spent time telling us about the work Reach for Recovery does.  She told me that when she started, she saw very few patients from Baragwanath.  now she sees hundreds every year

At the end of the discussion, Karen (one of the nurses) made me realise how valuable the course is.  She concluded the session on community networking by saying that she has reaslised that it is up to her to do something about the problems within our system.  She urged all of us to identify an area that we can improve on and not to feel daunted by trying to tackle everything.

I am really looking forward to going back to Bara next year and hearing what this impressive group of nurses have done to try and improve the situation.

The course was very well run and I have to thank Sheila Correia, Herbert Cubasch, Michelle Norris, Lieske Wegelin, Karen Hill, Maureen Joffe and Lucille for their enormous amount of work.

The whole group wearing our T shirts.  The T shirts were designed by Amy Leigh Jordaan and printed very efficiently by Freeline.  Thanks to both of them.

More pictures will be posted on our facebook page by the end of the week.


Day 1 Baragwanath breast course for Nurses

We are in Johannesburg at Chris Hani Baragwanath Hospital, Soweto, for the residential part of the breast course for nurses.  Dr Ronelle de Villiers, Sr Correia, Michelle Norris and I flew up from Cape Town.  We have been very warmly welcomed by Dr Herbert Cubasch and his team.  We started the day with lectures and then Dr Blanchard came to teach us about the management of palliative care patients.  One point that came up in the discussion was that the availability of morphine is an indication of whether or not palliative care facilities are available in a particular country.  Only 11/60 countries in Africa have morphine available.
Dr Sarah Nietz

Dr Blanchard and her team give an excellent service to patients at Baragwanath Hospital.  We thank her for spending time going through the management of palliative care patients
Dr Herbert Cubasch teaching the technique of FNA

Dr Louella Ritz teaching US guided tru cut biopsy

After an excellent lunch (thank you Herbert, Maureen Joffe and Lucille), we had practical sessions.  Participants had an oportunity to do FNAs and tru cuts.  We were privileged to be joined by Dr Louella Ritz who is a radiologist who specialises in breast radiology.

Dr Ronelle de Villiers

Sarah Nietz from Morningside Clinic and Charlotte Maxeke Hospital joined us for the session.   With her colleagues she had seen 135 women in the breast clinic reminding us how important it is for us to train the nurses.
The practical session was sponsored by Bard and Impilo Medical systems.  A huge thank you to Brendan Marshall and his team and Charles Clark and his team.

Louella Ritz standing with Marilize le Roux
We spent an hour with Sr Corriea who expertly took us through the principles of wound care.

The day was finished with cocktails and snacks kindly donated by Bard.  We must thank our 2 main sponsors who continue to give us so much support: Netcare (particularly Christiaan Barnard Memorial Hospital) and Carecross.  Thank you Chris Tilney and Ian Black.

Page 3

In the last two weeks, 2 stories have come to my notice.  One is from England where the the most notorious tabloid newspaper is the Sun.  It is known for it's headlines and it's Page 3 "girls".  Since November 1970, there has been a topless women featured on Page 3 every day.  Most women would agree that it a tired feature that does nothing to enhance the stance of women in society.

Two weeks ago, it reinvented the page and now has launched"Feel 'em Tuesdays".  It is a campaign to encourage women to examine their breasts and is being run in conjunction with an organisation called "Coppafeel".

What to do?  On the one hand, it is encoraging breast cancer awareness.  On the other, it can be seen as a crude way to relaunch a feature that is tired and has lost it senstaionanlism over the years.  There have been a number of columns written in the weightier newspapers and even David Cameron has been forced to comment.  His official spokesman said: “He would support all initiatives designed to increase awareness about such an important public health issue.”  His bland comment is in line with the fence sitting most others have done.  Personally, I think it is cheap and an example of cause related marketing.  What do you think?

Nearer at hand, I heard that once a year a local night club offers one of it's members a "boob job".  this year, the competition has been hijacked by DJ Das Kapital.  He has offered to give R30 000 towards paying for a woman who needs a breast reconstruction.  I am really impressed.


A warrior or a breast cancer survivor?

As a surgeon, I do not follow up a lot of women who have been diagnosed with breast cancer.  I tend to be involved at the start of the process.  However, I do have interactions with enough women to remind me that life after the diagnosis with breast cancer is not the glorious pink picture of survivorship that the popular press would have us believe.

A number of women adapt their careers as a result of their experiences.  I will mention 2 here.

Last week, I came across an article written by Madhulika Sikka. She is a journalist who works for NPR and was diagnosed with breast cancer several years ago.

She wrote a book "A Breast Cancer Alphabet". When being interviewed about her book, she said, "I'm not a warrior. I'm a woman who had breast cancer". 

In her more recent article, she referred to the "blush-hued" world of breast cancer campaigns and the "over amped hyper consumer marketing of breast cancer awareness".  

Have you heard of her or read her book?  Please let us know what her book is like.

Another woman who has altered her career as a result of her experience is Kate Squire-Holmes. She  has commented on some postings on this

She was a counsellor before her diagnosis of breast cancer and has adapted her career as a result of her diagnosis. She uses different techniques to support women who have had breast cancer including laughter yoga.

Have you altered your career path as a result of having had breast cancer?  Please let us know if you are offering services in the Cape Town area so we can include you in our blog.