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You can make a huge difference in your skin health by eating a clean food diet.
Additional Info
- Segment Number 3
- Audio File clean_food_network/1623cf1c.mp3
- Featured Speaker Makoto Trotter, ND
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Guest Bio
Dr. Makoto Trotter, ND, is a licensed naturopathic doctor and proud dad. Alongside his wife (also a naturopathic doctor) he co-founded Zentai Wellness Centre, a multidisciplinary health clinic located in downtown Toronto.
He graduated on the Dean’s Honours List with an Honours Biochemistry-Biotechnology degree from the University of Waterloo. Subsequent to this, he continued his journey to become a naturopathic doctor, graduating summa cum laude from the Canadian College of Naturopathic Medicine in Toronto. He is currently a member of the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors and is a peer review board member of Integrated Healthcare Practitioners publication.
Makoto has always been passionate about holistic medicine and strives to share his knowledge with others. Prior to authoring books, he had his own weekly live TV health segment on CP24 news with a daily reach of 1.5 million viewers.
He is dedicated to educating his patients to understand and maintain a healthier lifestyle, using realistic means and a rationale approach. He strongly believes that prevention and health optimization are the cornerstones to individual wellness and long-term health.
Makoto resides in Toronto, ON.
Whatever your health goals might be, there are simple swaps you can make to turn your junk food to joy food.
Additional Info
- Segment Number 2
- Audio File clean_food_network/1623cf1b.mp3
- Featured Speaker Joy Bauer, RD, MS
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Guest Bio
Joy Bauer is a registered dietitian with more than 25 years of experience. She is a #1 New York Times best-selling author and the health and nutrition expert for NBC’s TODAY show. She hosts the program’s popular “Joy Fit Club” series as well as the new hit segment, "From Junk Food to Joy Food,” which inspired her latest book and PBS special. Joy is a monthly columnist for Woman’s Day magazine, founder of Nourish Snacks, and the official nutritionist for the New York City Ballet.
When she's not dishing out health info or sharing delicious recipes on TV, you'll find Joy making a mess in her kitchen or spending quality time at home with her husband, three kids, and cuddly puppy, Gatsby.
Jonny Bowden's Truth About Fat Loss Summit features the advice from 38 leading health and wellness experts.
Additional Info
- Segment Number 1
- Audio File clean_food_network/1623cf1a.mp3
- Featured Speaker Jonny Bowden, PhD, CNS
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Guest Bio
Best-selling author, Jonny Bowden, PhD, CNS, is a nationally known expert on weight loss, nutrition and health. He is a board-certified nutritionist with a master's degree in psychology and the author of 14 books on health, healing, food and longevity, including The 150 Healthiest Foods on Earth, Living Low Carb, The Great Cholesterol Myth, and his new book, Smart Fat.
A frequent guest on television and radio, he has appeared on Fox News, CNN, MSNBC, ABC, NBC, and CBS as an expert on nutrition, weight loss, and longevity. He is a past member of the Editorial Advisory Board for Men's Health magazine, is the Nutrition Editor for Pilates Style, and is a regular contributor to AOL, Vanity Fair Online, Clean Eating Magazine, Better Nutrition, and Total Health Online.
Additional Info
- Segment Number 2
- Audio File city_hope/1622ch5b.mp3
- Doctors Gernon, Thomas J.
- Featured Speaker Thomas J. Gernon, MD
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Guest Bio
Thomas J. Gernon, M.D., is an associate clinical professor in the department of surgery, specializing in head & neck surgery. Dr. Gernon joins City of Hope from the University of Arizona College of Medicine, where he was an assistant professor in the department of surgery, division of otolaryngology. Dr. Gernon graduated Phi Beta Kappa from the University of Washington (UW) in Seattle prior to receiving his medical doctorate from UW School of Medicine. While in medical school, he was inducted into the Alpha Omega Alpha (AOA) National Medical Honor Society. Dr. Gernon continued his training with an internship in general surgery at the University of Michigan in Ann Arbor, where he also pursued a residency in head and neck surgery. In 2011, he completed a fellowship in head and neck surgery and microvascular reconstruction from the University of Washington, Seattle.
Learn more about Thomas J. Gernon, M.D -
Transcription
Melanie (Host): Treatment of head and neck cancer can alter a patient's quality of life by changing the way they look, speak and eat. Microvascular surgery can provide a new frontier in head and neck reconstruction. My guest today is Dr. Thomas Gernon. He’s an Associate Clinical Professor in the Department of Surgery specializing in head and neck surgery at City of Hope. Welcome to the show, Dr. Gernon. Tell us a little bit about head and neck surgery. What’s going on today? How many people are you seeing generally? What are you seeing?
Dr. Thomas Gernon (Guest): We typically see a broad range of cancers of all parts of the head and neck, particularly the oral cavity, which includes the tongue, the jawbone; the maxilla, which is the upper jaw; or the mandible, which is the lower jaw. We see a lot of cancers these days related to HPV related tumors of the tonsil and the tongue base. Then, we oftentimes see salivary gland cancers involving the parotid glands, which are the major salivary gland; the submandibular gland; and the sublingual gland. We also see widely advanced or locally advanced cutaneous malignancies from sun exposure; as well as malignant melanoma and thyroid cancer. We have a surgeon here who’s very specialized in thyroid cancer. The real trends in head and neck cancer these days are the HPV-related tumors. As you know, some high profile people such as Michael Douglas or George Karl have both had tonsil and tongue base related HPV related tumors. That’s really kind of the forefront of the field at this point.
Melanie: This type of cancer can be especially scary for people as it does affect, sometimes, how they look and then speaking and eating – two of the more important things. What symptoms, first of all? Let’s actually back up and start with risk factors. Who’s at risk for these types of cancers?
Dr. Gernon: Traditional head and neck cancers of the anterior tongue, not the back of the tongue. The anterior tongue is different than the back of the tongue. So, the anterior tongue, the jawbone, the portion we all the “floor of the mouth”, which is underneath the tongue, the real true risk factors for those are smoking and drinking. That’s more of our traditional types of tumors. The incidence of those are actually decreasing as people realize that smoking and drinking are not good for you. We’re seeing a decrease in those over years. The risk for HPV-related tumors, that is something that we all get exposed to most commonly in our teenage years; and then, the virus lies dormant in that tissue and it expresses itself most typically in males more than females anywhere from 50-60 years of age. You can see a range of ages on either side of that as well. That’s why there’s a lot of emphasis on getting your children vaccinated both boys and girls against the HPV virus at this time.
Melanie: What symptoms should people be looking for if they are concerned about or if they have any of these risk factors?
Dr. Gernon: For the traditional types of tumors--the tumors of the anterior tongue and the jaw and the floor of the mouth and the upper jaw—typically, it will be a pretty painful sore on the side of the tongue or the front of the tongue that can cause difficulty with eating such that it becomes painful. Sometimes, they’ll have an ulcerated lesion that will bleed. If the tumor gets large enough, they may start to notice speech disturbances as well. If the tumor gets really large they might have difficulty with swallowing. Those are mainly for the tumors of the front of the tongue and then the jaw. The tumors of the back of the tongue and the tonsils, oftentimes patients won’t even notice they have anything going on in the tonsil or the back of the tongue. They’ll just notice a neck mass and that is typically from a lymph node that has become involved. So, they may be completely asymptomatic and then they’ll go to their doctor or they’ll see somebody and they’ll randomly notice that there’s a neck mass which is a lymph node which is very typical for that type of cancer. Some other symptoms those patients may have, though, if the tumor does get too big is really some pain and then some difficulty with swallowing.
Melanie: What is the first line of defense if they get a diagnosis and then you start treatment? I want to make sure we get into this microvascular surgery that you do. It’s absolutely fascinating. So, speak about treatments.
Dr. Gernon: It all depends on the size of the tumor at first. For tumors of the anterior tongue and the jaw, if they are small enough and it’s clinically indicated, you can often times undergo an excision of that tumor and then just close the tissue up and then the patient will do fine as far as their follow up function. If the tumor of the anterior tongue or jaw or the floor of the mouth is too large, then if you think about it if you try to just close that tissue up then you’ll have a large gap of tissue and everything you and I are doing on the phone right now is because we’re using our tongues, we’re talking, we’re communicating. You need to place, in essence, a spacer where that tumor was to prevent significant contractions such that the patient’s swallowing and speech will not be impacted. We can take tissue from other parts of the body. One typical place that we take the tissue from is the forearm, the under surface of the forearm, with an associated artery and a vein. Then, we can transplant that tissue to fill in the defect. Then we can hook up the artery in the vein from the arm with an artery in the vein from the neck. It’s literally a transplant on your own body. The great thing about that is one, it’s your own tissue so you don’t need any type of immunosuppressant drugs. When it heals, the remainder of your tongue or jaw will function well enough that your speech swallowing, although it may be somewhat impacted, over time patients typically do fairly well and their overall cosmesis looks very well from an external standpoint. We can do a lot of this through the mouth and through an incision through the neck. If the jaw is involved, oftentimes there are two bones in the leg – we are able to take the fibula bone which is the bone on the outside and its associated blood supply and transplant that to recontour it. We can break the bone and recontour it towards the shape of the normal jaw and then revascularize that tissue and then you can rebuild the jaw and the tongue and the tissue as it’s needed. That’s really something that’s been done over the past 20 to 30 years. That really minimizes the impact on patients with these types of tumors that need treatment. The other real area of treatment that we’re moving towards is these HPV-related tumors. They all seem to respond well to treatment. Most patients who get them do well. They can be treated either surgically or without surgery with chemo and radiation. Standards of chemo and radiation that we used to treat head and neck tumors with, we’re finding that these doses are often times leaving long-term side effects with patients. They will have difficulty with swallowing, difficulty with saliva production long-term down the road. We’re trying to reduce the impact of treatment. Now, we’re oftentimes treating these tumors, if it’s feasible, with use of multi-disciplinary tumor boards and staging, with the use of either robotics or with transoral laser--surgery with a laser through the mouth--to remove these tumors and decrease the subsequent therapy with radiation or chemotherapy afterwards. The patient doesn’t have long-term side effects. I mentioned earlier that the patients are often times in their 50’s. If you think about it, these patients may live quite a long time, so we’re really looking at minimizing the impact of treatment on their long-term survival. So, you want to decrease their functional morbidity in a way. That’s really where the field is moving.
Melanie: That’s absolutely fascinating. You mentioned vascularization and getting that blood supply. Is that even an issue because you’re dealing with head and neck and people think “big arteries around there”. How does that work and can it really work to improve their quality of life? Kind of wrap it up for us.
Dr. Gernon: Definitely. The microvascular aspect of it – so the vessels that we take out of the arm or the leg, they are fairly--small 3 -4 mm blood vessels and the arteries in the head and neck are actually fairly small--the ones that we use to hook up the transplant to in the neck. We have to use a microscope. We place very small sutures under the microscope and then we make sure that that anastomosis of the artery and the vein is patent and we watch the flap in an ICU setting oftentimes. We make sure that the flap has good blood flow. We have different ways of monitoring flaps. The ways that centers monitor them vary throughout the country. It’s just kind of a feel thing that you get used to as you get farther and farther out into your practice.
Melanie: How cool is that?
Dr. Gernon: It’s definitely something that really improves patient's’ qualities of life. You can remove the majority of a tongue and rebuild it with the tissue of the forearm. Six months to a year down the road oftentimes, these patients will be able to eat and drink a normal diet. Over time, oftentimes the tissue can start to look like normal tongue tissue. The skin of the arm will actually start to look like tongue tissue. That’s on a case by case basis but I’ve seen that happen where that patient is 3 or 4 years out and this is really something that’s in their rearview mirror as far as their life is concerned. They come in and get checked ups and they go home and they’re eating, drinking, speaking. They have time to spend with their loved ones and they’re having pretty much normal quality of life.
Melanie: Amazing. Why should they come to City of Hope for their care? Although you’ve given really some of the most amazing reasons. You tell the listeners.
Dr. Gernon: City of Hope, particularly the Head/Neck Cancer Division we have myself, my colleague Robert King. He is also a microvascular surgeon and then Ellie Mgamie. She trained at Memorial Sloan Kettering. We all have had excellent training in head/neck cancer treatment as far as the resection and the reconstruction are concerned. I think you can find that anywhere throughout the country. The important thing, though, is that we have a real strong team approach where we work with our radiation and medical oncologists to really come to a consensus on your treatment. We review all your films, all your treatment, all your pathology reports before any decision is made about surgery at a multi-disciplinary tumor board. We come to a consensus on what the treatment should be and we move forward as a team with that treatment. Afterwards, we all review your path report; we make sure that your post-surgical treatment or, even if you’re not undergoing surgical treatment, that the treatment is correct to the clinical stage that you have. We’re also enrolled in clinical trials which are at the forefront of treatment for head/neck cancer. We are really trying to push the field forward and give the best possible treatment we absolutely can.
Melanie: Thank you so much, Dr. Gernon. I certainly applaud all the great work that you’re doing at City of Hope. Thanks for being with us today. You’re listening to City of Hope Radio. For more information you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.
- Hosts Melanie Cole MS
What's the difference between HMOs, PPOs, EPOs and POS?
Additional Info
- Segment Number 1
- Audio File health_radio/1622ml5a.mp3
- Featured Speaker Marianne Eterno, President of Government Relations for GTL
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Guest Bio
Marianne Eterno began her insurance career in 1987 at the former Golden Rule Insurance Company in Indianapolis, Indiana, and moved to Chicago in 1992, when she accepted a position with Celtic Insurance Company.
Marianne came to Guarantee Trust Life Insurance Company (GTL) in 1996, as a compliance and government relations consultant, and formally joined the company in 1997. As Assistant Vice President of Government Relations, she represents GTL in both the state and federal arenas, drives coalition development for the company, and serves as the company's media and public relations spokesperson.
In addition to sitting on committees for every major insurance trade association, Marianne serves on the Board of Directors of RetireSafe, a 400,000 member grassroots advocacy organization for senior citizens and as the Executive Director for the Council for Affordable Health Insurance.
Additional Info
- Segment Number 1
- Audio File city_hope/1622ch5a.mp3
- Doctors Warner, Susanne Gray
- Featured Speaker Susanne Gray Warner, MD
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Guest Bio
Susanne Gray Warner, MD, is an Assistant Clinical Professor, Division of Hepatobiliary Surgery and Department of Surgery.
Learn more about Susanne Gray Warner, MD -
Transcription
Melanie Cole (Host): If you or a loved one has been diagnosed with pancreatic cancer or if you’ve been told you’re at high risk for developing the disease talk to City of Hope. It’s important to learn about your options and take action right away. My guest today is Dr. Suzanne Warner. She’s an assistant professor in the Department of Surgery at City of Hope. Welcome to the show, Dr. Warner. Tell us a little bit about pancreatic cancer. What’s going on in the world now? People hear that term and right away they’re very, very scared. Speak about pancreatic cancer. What’s going on today?
Dr. Suzanne Warner (Guest): Well, we are making some really great strides at City of Hope both in our labs and
clinically but the disease remains a very formidable opponent. We’ve been working as scientists and medical care givers for the last 30 to 40 year trying to find the right weapons against pancreatic cancer and we’ve really done kind of a crummy job because we still have a 5-year survival taking all comers of only 7%. We’re trying to push that envelope with new therapies but it’s a slow going process. Right now, what we’re working through with the scientific community is many different things along the disease continuum. What we know is that the vast majority of patients who present with a diagnosis of pancreatic cancer are, unfortunately, already going to have Stage IV disease, meaning that the disease has spread outside of the pancreas. For those people, we don’t have treatments that can cure them right now. We only have treatments that can prolong their lives. What we’re working together as a community, is to try to do is try for things that can give us early detection – laboratory evaluations, imaging and things that are practical for a broad population-based test that we can find. We’re also working to find new treatments that can help patients who already have the cat out of the bag, so to speak, with the disease having spread. What myself and my surgical colleagues are doing is, we’re working in the avenue for those lucky few about 25-30% of patients who present with disease that might be able to come out one day, either when they present or after some chemotherapy. We’re working on new surgery techniques that can minimize the morbidity of the operation, meaning the amount of complications that you can have and how aggressive the operation has to be to get the cancer out.
Melanie: Currently, there’s no early detection screening of any kind. What do you want patients to know about looking for something, symptoms that might signal?
Dr. Warner: It’s really a difficult diagnosis to make because the symptoms themselves are very vague and somewhat general. In many cases, when you start having alarm bells in your body and symptoms that are vigorous enough to seek medical attention, in some cases, it can already be too late. What you really have to do is know your body and listen to your body and if you feel like something’s not right, you’ve to go and tell your doc and you’ve got to be persistent because you’re going to have a vague complaint and a lot of times, we as physicians, like to be optimistic and tell you it’s probably not a big deal. I hate to inspire neurosis amongst the listeners but in many instances people can say, “I just felt like something wasn’t right for the last year or so and then I started losing weight and then I started getting back pain.” I would advocate the minute you feel like something is a little off, just be persistent with your providers and say, “I would really like an investigation.” The problem with investigations for pancreatic cancer is that even if you get a CT scan, for instance, of the abdomen a lot of inexperienced radiologists who don’t look at pancreases all the time might say, “That looks normal. I don’t see a mass there.” That’s the other problem that we have. Even the tools we have in place that are expensive, meaning a CT scan or MRI’s that aren’t appropriate for broad population screening tools, are sometimes not even used appropriately when you’re not seen at a specialty center. The best thing patients can do is listen to their bodies and make sure that when they have a test, if a provider is worried about pancreatic cancer that they make sure that they’re getting second opinions from appropriate places like City of Hope or other institutions that see a lot of pancreatic cancer. Mostly things for patients to watch for, to answer your original question, include things like weight loss that’s not intended, back pain, fullness in what people refer to as the solar plexus or the upper area of the abdomen. Of course, if you turn yellow or your urine starts to darken when you’re not dehydrated, that can be a sign of jaundice which is a sign of a bile duct being blocked off and that sometimes, in lucky patients, is a sign of early pancreatic cancer. Sometimes, it’s a sign of later pancreatic cancer, too. Certainly, turning yellow is a problem. Any kind of change in your stools – a lot of people don’t like to look down there when they’ve had a bowel movement but it can be really important in helping you get clues as to what’s going on inside your abdomen. We look for stools that are lighter in color. We also look for things that would indicate that the pancreas is not working correctly. If the stools float in a funny way or smell different than they normally do for a consistent period of time, I know it’s funny to talk about, but those can be things that need to be brought to the attention of your physician.
Melanie: That’s really important and such great information put so succinctly, Dr. Warner. I really appreciate you saying it like that. People need to hear it like that way. What about if you do get diagnosed? What do you do as far as surgery? They hear these big, long procedures, speak about the surgical interventions necessary.
Dr. Warner: For those lucky few patients, somewhere along the lines of 30% of patients who present with a tumor that can come out, meaning that we have a chance at curing the disease because we can remove it, those patients need to be seen at a center that does at least 10-30 Whipples per year. The tumor can occur anywhere in the pancreas. The pancreas is an organ that fits right in the middle of our abdomen. If you were to pick a midpoint between the belly button and the breast bone, the pancreas hits about right there. It starts in the middle of the abdomen and kind of dives back over towards the left back up under your left rib cage and nestled by your spleen. Tumors can actually occur anywhere where there’s a head, a neck, a body and a tail. There’s also an extra little tongue called the “uncinate process” and the tumors can be anywhere there. If it’s in the head or neck, then you have to have something called a Whipple procedure. That is the crème de la crème of general surgery operations. We take everything apart and put everything back together, basically up in the upper abdomen. If it’s in the tail of the pancreas, that’s a much easier operation. You just have to kind of lop off the tail of the pancreas. Most of the time, you take the spleen with you in the case of cancer because lymph nodes that drain the pancreas live right next to the spleen. Those are your basic two surgical options. There is a very rare procedure called a “central pancreatectomy” that can be appropriate for some more benign lesions or very early stage cancers. That is shied away from in most centers except for places that do it fairly often because what happens if you leave two cut edges of the pancreas is those can cause risks that we’ll talk about here in a minute when we talk about complications related to surgery. In general, once a patient gets a diagnosis, we want to know as physicians is it resectable, meaning can it come out; is it border-line resectable, meaning is there something that’s telling me I shouldn’t go straight to surgery? I should give this patient what we call “neoadjuvant therapy”, which is therapy that happens before surgery. So, chemotherapy or radiation or both. Or, is it metastatic, meaning it has spread somewhere else so we’re not going to get to cure. There’s one last bucket that’s kind of rare and that’s the “locally advanced unresectable” bucket and that’s people whose disease has not spread outside of the pancreas but who are not eligible for resection based on what the tumor is doing to the surrounding structures. That brings us to the next question. How to we decide what is resectable and what isn’t? When we’re looking to see if I can take something out safely, we’re basically looking at some major blood vessels that live right next to the pancreas. I told you before, the pancreas is right in the middle of the abdomen and it’s kind of like union central for blood vessels and lymphatic channels and nerves that do some pretty important things like provide oxygen to all of our small intestines and parts of our colon in addition to providing nutrients to our liver and getting things sent to our liver from our bowels to be cleaned out. One of the big veins that runs there is called the “portal vein” and if a tumor is touching or deforming the portal vein to varying degrees--and there’s a little bit of debate on this in the surgical community--many people consider that borderline resectable. If it’s touching an artery called the “superior mesenteric” artery which supplies our small intestines, then that also kind of lumps it into the borderline resectible group. If it’s encasing either of those structures, mostly the artery, that kind of puts you in that locally advanced unresectible bucket. There’s a few other vessels that, if they are touching in a certain way, that kind of determines which bucket you go in. Bottom line is, if it’s touching a blood vessel, that’s a big deal and many institutions will then sign you up to have chemotherapy and radiation or one or the other or both, depending on the institution. Then, that will take about 4-6 months and then you’ll come to surgery. Some patients, a very lucky few, can go straight to surgery. The most important thing to know is that if you don’t get it out you’re not going to have a chance at cure.
Melanie: Wow. What a great explanation that was. In just the last few minutes, Dr. Warner, kind of cover for us what happens post-surgery. Is this person now at risk for diabetes because the pancreas controls your insulin levels? Speak about post-surgery and give your best advice for people listening.
Dr. Warner: Sure. That is a really great thing to bring up. First and foremost, I want to talk about there’s a few different techniques out there. When you talk about Whipples everybody hears about the robot and the minimally invasive surgical option. There are definitely minimally invasive options for the Whipple. There are just a few centers in the United States that are doing this right now. City of Hope is talking about moving towards doing robotic Whipples but what it really requires is a dedication from the institution and two attending surgeons who want to move that way. We’re working towards that as a group as we get more robotic experience. We’re not going to go there until we know it’s safest for our patients. For distal pancreatectomies, meaning taking out that tail and the spleen like we talked about before, laparoscopic or robotic surgery is essentially the standard of care at this juncture, except for big, huge tumors that might be doing something inventive. For the most part, you should be offered a minimally invasive resection for those and if you’re not then you should ask about why and if you’re not at a specialty center you should get yourself there. What happens after surgery, really the amount of complications and the likelihood of you dying from the operation has actually directly correlated with surgeon volume of pancreatic resection. Again, it’s so important to get yourself to a center that has a lot of experience with this. I know everybody wants to stay close to home because your communities are there but it’s so important to have surgery at a major center. Some of the more common complications after a Whipple procedure, specifically, include something called delayed gastric emptying which just means that the stomach sort of forgets for a little while how it’s supposed work. The stomach is kind of a dumb organ. A lot of the other intestines know that they need to move things forward and they do it in a concerted manner. The stomach is a churner. So, the stomach just sort of has this dopey, march along attitude and sometimes when you cut nerves and arteries that go to the stomach, which you have to do for the Whipple, it kind of forgets it’s job for a little bit. That happens in about 25% of patients. That can be tough because eating is no longer what you thought. You’ll have a new normal, the same way gastric bypass patients have a new normal for exactly how you’re going to eat in the future. As far as the diabetes risk that you asked about, which is a great question, if you already are diabetic and you’re not needing insulin, it depends on how much medicine you’re using, but there’s about a 25-50% risk that you’re going to need insulin once you’re done with the Whipple. If you are not diabetic, you’re going to have about a 10% risk of being diabetic or needing insulin after the surgery. Some people need insulin in the hospital that don’t wind up needing it long term. On the whole, taking all comers, there’s about a 15-20% risk of diabetes after a Whipple procedure. With distal pancreatectomy, it varies based on how much pancreas you wind up having to take. Another big risk that we talk to everybody about is when we take everything apart and put it back together anytime you have a cut edge of the pancreas, that pancreas is designed to help you digest things. The body does a very good job of keeping pancreas juices inside the intestinal tract. Of course, when we go and cut it open in surgery, those juices can get out and because they’re really good at digesting things they can actually hinder the healing process after surgery. You can have leaks from the pancreas edge. That can happen in Whipples and in distal pancreatectomies. After the Whipple, it depends on the data that you read and it also depends on the texture of the pancreas but the risk of leak can be somewhere between 10-25%. After a distal pancreatectomy, it’s the same thing, the risk is a little higher around 20-30%. Those leaks can keep people in the hospital, can make things like delayed gastric emptying happen more frequently and can also cause some more catastrophic consequences in terms of eating away at blood vessels. Those are much more rare but things that the clinicians need to be thinking about. Most of the time, those leaks can be manages with drains but people should not expect but be prepared for the possibility of having kind of a drain live with them for a little while after the resection. In general, to answer what to expect post-operatively, you’ve got to train for this surgery in advance like you’re going to run a marathon because your body is going to be on overdrive for a while. There’s just going to be a new normal. Most people tell us that it takes about 12 weeks to sort of wake up one morning and forget that you had surgery when you’ve had a big Whipple like that. After that, unfortunately, many times we then once you feel better have to hit you with chemo. What people should prepare for is a long road. If you’ve got the right surgeon and the right medical team, they can get you through it and it’s just a very intense experience that we go through together and get people on the other side with a chance at care.
Melanie: Wonderful information. Thank you so much, Dr. Warner, for being with us today. You’re listening to City of Hope Radio. For more information you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.
- Hosts Melanie Cole, MS
Most people think of mason jars for preserving foods, but they are also ideal for making and taking portable meals.
Additional Info
- Segment Number 5
- Audio File clean_food_network/1621cf1e.mp3
- Featured Speaker Tanya Linton
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Guest Bio
Tanya Linton grew up with lifestyle content in her blood. Her mother, Marilyn Linton, was the lifestyle editor for the Toronto Sun and passed on a passion for cooking, decorating and entertaining. It was that blend of passions that enabled Tanya to pursue a career in television specializing in all things lifestyle.
As a producer, Tanya created and produced, Sugar, one of Food Network Canada’s first television shows. From there, she went on to produce many food and renovation series before landing a corporate job as the Director of Lifestyle Content for Food Network and HGTV Canada at Shaw Media.
While at Shaw, Tanya was in charge of some of the biggest lifestyle television brands: Holmes on Homes, House of Bryan, Income Property and The Real Housewives of Vancouver, to name a few. She created and developed numerous shows including Canada’s Handyman Challenge, a format that was sold internationally.
In February 2015, after 17 years of working in the corporate world, Tanya left to join forces with her husband at Architect Films, a television production company specializing in lifestyle and factual programming. At Architect, she is a partner and executive producer in charge of their latest series, Home to Win for HGTV Canada, airing in Spring 2016.
In addition to working in television, Tanya is an accomplished writer and has appeared in many publications including House and Home, The National Post, Style at Home, Canadian Living and Fashion.
She’s is the co-author of The Ice Cream Bible (Robert Rose 2008) with her mother. When she’s not busy at work, Tanya spends her time at home with her husband and three little boys.
Smoothie bowls are the perfect way to add fresh fruits, superfoods, fiber and proteins to everyday fare.
Additional Info
- Segment Number 4
- Audio File clean_food_network/1621cf1d.mp3
- Featured Speaker Alison Lewis
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Guest Bio
Alison Lewis is also an internationally published author of two cookbooks, a professional recipe developer, nutritionist, and the owner of Ingredients, Inc., a food and travel media company based in Birmingham, Alabama.
Alison is Founder and Publisher of Healthy Travel, a travel magazine that launched in print in March 2013 and Publisher of her blog, Ingredients, Inc.
She has worked with Fitness, Southern Living, Cooking Light, Better Homes & Gardens, Clean Eating, Oxygen, Travel & Leisure, Coastal Living, Turks and Caicos Magazine, Tempus Magazine, USA Today and Fitness Republic.
Alison resides in Birmingham, AB.
Your diet is intimately connected to eye health and vision.
Additional Info
- Segment Number 3
- Audio File clean_food_network/1621cf1c.mp3
- Featured Speaker Scott L. Philippe, DO
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Guest Bio
Dr. Scott L. Philippe attended the University of Kentucky in Lexington, Kentucky for his undergraduate studies. He earned his Doctor of Optometry degree from Southern College of Optometry in Memphis, Tennessee in 1988.
He was named North Carolina Young Optometrist of the Year in 2001 and North Carolina Optometrist of the Year in 2009, as well as the 2010 recipient of the John Robinson Award for Clinical Excellence. He has also received several national leadership awards and serves as a clinical preceptor for Southern College of Optometry. He remains very active with civic work serving as Chairman of the Swing for Sight Golf Tournament from 1997-2003, and serving on the NC Governor’s Early Childhood Vision Comission from 2006-present. Some of Dr. Philippe’s interests include golf, rugby, volunteering as a youth baseball coach and spending time with his wife Michelle, and three children, Zack, Brit and Taylor.
Dr. Philippe’s Memberships and Associations include: American Optometric Association, American Optometric Society, North Carolina Optometric Society (Past President), Piedmont Optometric Society (Past President), Prevent Blindness NC (Board of Directors) and TLC Laser Eye Centers (Advisory Board), Tear Film and Ocular Surface Society, Ocular Surface Society of Optometry, Ocular Nutrition Society, and The American Society for Nutrition. In July of 2015, Dr. Philippe was appointed by the Governor to the North Carolina State Board of Optometry.
Want to look and feel your best? You may want to give clean eating a try.
Additional Info
- Segment Number 2
- Audio File clean_food_network/1621cf1b.mp3
- Featured Speaker Jane Wilkens Michael
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Guest Bio
Beauty, health and fitness expert, Jane Wilkens Michael, is host of the Jane Wilkens Michael Show on iHeartRadio Talk and the author of Long Live You! Your Step-by-Step Plan to Look and Feel Better Than Before.
Starting with the International Herald Tribune based in Paris, and then creating the monthly "Beauty Talk" column for Town & Country Magazine, Jane has continued to contribute her columns and articles to an extensive list of publications, newspapers and websites the world over. She has also written Breakfast, Lunch and Dinner of Champions, for which she interviewed athletes in ten major sports and discussed their nutritional needs and ideal diets.
