Happy 1st Birthday to Beth’s Adventures with Carcinoid Cancer!

Today marks one year of writing my blog.  When I started posting, I was frustrated by my experience in the medical system and concerned that I did not have a doctor that I could trust.  Now I am on my third carcinoid specialist and feel comfortable that my doctor is working with me not against me and that there is a strong team backing her up.  I’m still frustrated with the medical system but have learned that I can’t change it so I will work with it. 

I didn’t really have any expectations for this blog except to discuss my experiences and vent my frustrations.  As of today, Beth’s Adventures with Carcinoid Cancer has had 10,000 visitors!  I’m quite happy that the blog reached that milestone so soon and exactly at the one year mark. Over the past year, I’ve met some nice people and learned a lot from my writing experience. Not being a super savvy computer user, I’m not sure if the 10,000 visitors are distinct users or could be 1,000 different people visiting 10 times each. 

I am a bit of a data geek so I find it interesting to look at the numbers that Google gives concerning visitors.   For example, the top 3 posts are as follow:

Post	Number of Visits
The Difference between a Flush and a Hot Flash	920
September 11th	666
Bitter Pill and Gorillas in CT Scans	325

I think a lot of people get here by asking a search engine “what is or how do you tell the difference between a flush and a hot flash?” Then my blog comes up.

When looking at where the visitors come from, it is very US focused but many visitors have also come from overseas.  Just yesterday there were 20 visitors from Jordan!  I wonder how that group found this blog on the same day – perhaps they were together in a class? The table below shows the top 10 countries visitors came from:

Location	Number
US	6,160
France	709
Germany	380
UK	355
Russia	240
Canada	172
Sweden	102
Australia	66
Mexico	49
Singapore	40

I also get information on what operating system and browser the visitors are using and it looks like this:

Operating System	Percentage
Windows	74%
iPad	7%
Macintosh	6%
iPhone	5%
Linux	2%

Browser	Percentage
Internet Explorer	33%
Firefox	28%
Safari	17%
Chrome	11%
Opera	5%

Other information that I can’t get from online users are facts such as whether more women than men are viewing my blog, their average age or the type of cancer they have. I’m guessing that more women than men are viewing it because of the popularity of the flushing vs. hot flash post.  It could also be because that post mentions “Fifty Shades of Grey”.

Overall, I’m in a better place now than I was last year at this time and I think this blog has helped me get there.  On to year two!

The Cancer of Optimism

In yesterday’s New York Times, there was an Op-Ed about doctors being overly optimistic with their patients about their prognosis.  It was written by a resident physician just starting his medical career.  He discusses a patient who unexpectedly died.  The writer called himself a “victim of irrational optimism, a condition running rampant in both doctors and patients, particularly in end of life care”

He goes on to quote some statistics from a cancer study from The Annals of Internal Medicine in 2001 that stated “doctors were up front about their patients’ estimated survival 37% of the time; refused to give any estimate 23% of the time and told patients something else 40 % of the time. Around 70% of the discrepant estimates were overly optimistic”.

“This optimism is far from harmless.  It drives doctors to endorse treatment that most likely won’t save patients’ lives, but may cause them unnecessary suffering and inch their families toward medical bankruptcy.”

“Studies have shown that patients almost universally prefer to be told the truth.  If physicians cannot deliver the hard facts, not only do they deprive their patients of crucial information, but they also delay the conversation about introducing palliative care.”

He does on to cite a study that showed that cancer patients who had palliative care combined with standard care lived a few months longer than those with standard care alone.  The writer went on to state that nonetheless, doctors usually insist on more invasive treatments even when there is little chance that they will work. 

It appears that patients are not being given truthful information about their prognosis and how effective the next invasive treatment will be. Doctors are telling patients to undergo more invasive treatments because they are hoping they might work.  The problem is that these procedures lower quality of life without much extra longevity. 

If I get to the point where a new treatment is not likely to work, I would hope that my doctor would tell me to enjoy the rest of the time I had without furthering invasive procedures if they are futile.

The Op-Ed can be seen in the link below:

http://www.nytimes.com/2013/05/05/opinion/sunday/the-cancer-of-optimism.html?pagewanted=all&_r=0