A typical day in our multidisciplinary cancer clinic
by Cheryl Meguid, DNP, ACNP, Clinic Coordinator
Cheryl Meguid coordinates patient care in two of our multidisciplinary clinics (pancreas and biliary cancer, colorectal cancer). She earned her Master of Science in Nursing (MSN) from Johns Hopkins University and went on to complete her Doctor of Nursing Practice (DNP) at the University of Washington.
Through research, we are learning that patients diagnosed with cancer often benefit from a combination of surgery, chemotherapy, and radiation therapy. At many healthcare centers, patients are seen by a series of specialists in these areas over the course of several weeks, resulting in a delay of treatment. At the University of Colorado Hospital, patients are seen in one day, and their case is reviewed by all of these specialists.
Here is an example of a typical day in our multidisciplinary clinic:
- Your morning is spent getting any further tests that may be needed, such as an MRI or CT scan and labs. In order to give you the best evaluation possible, we need the radiology imaging to be of high quality, so we may ask that you get a repeat CT or MRI scan. This ensures that the surgeons and oncologists aren't missing any information when they come up with your plan of care.
- After these tests, you are then seen in clinic for a history and physical exam.
- Following this exam, patients are brought as a group to meet with our cancer support services, including a Registered Dietician and a Social Worker.
- While you are eating lunch, our specialists are reviewing your case. These specialists include surgeons, medical and radiation oncologists, gastroenterologists, radiologists, pathologists, and cytologists. Most days there are 20+ specialists in the room.
- After lunch, you then meet with all of the specialists who will be involved in your care.
Most patients are able to get their initial appointment scheduled within a week of calling us, and your treatment begins immediately after your meeting with the specialists. As your point person throughout this process, I am by your side the entire day.
To make an appointment or for further information, call 1-844-4MULTID (1-844-468-5843).
Recovery from pancreas surgery: What to expect
by Erin E. McIntyre, PA-C, Pancreas Surgery Physician Assistant
Erin McIntyre, a certified Physician Assistant, joined our team at University of Colorado Hospital in 2013.
As you prepare to undergo pancreatic surgery, we want to prepare you for what your postoperative hospital stay will entail. Not all postoperative stays are the same, so if you deviate from the schedule below, do not be alarmed. Everyone progresses at different rates.
After surgery you will likely be transferred to the surgical intensive care unit for close monitoring. You will awaken from anesthesia with a tube in your nose which goes down to your stomach to allow your gastrointestinal and digestive organs time to rest and recover. A Jackson-Pratt drain (two tubes with a bulb at the end to collect fluid) will be coming out of your abdomen. Your incisions will be covered with gauze, and you will have IVs in your arm giving you fluid and monitoring your heart rate and blood pressure.
In most cases, your pain will be controlled with an epidural catheter in your back until the fourth day after surgery. (Alternatively, pain medication may be administered through your IV.) Early each morning, your blood will be drawn to check laboratory levels, vitals will be taken, and the surgical team will come and check on you.
On Day #1 after surgery, you will likely be transferred to the surgical ward where the specialized surgical pancreas nurses will care for you. The surgical team will evaluate you daily. The nasogastric tube will be removed.
Eating and drinking
At first you will be limited to ice chips to continue to let your GI system rest and heal. On postoperative Day #3, you will start liquids. If you tolerate liquids, you will start more normal foods on postop Day #4. You will meet with a hospital dietician who will give you recommendations about what to eat for the remainder of your hospital stay and when you go home.
Length of hospital stay
On average, patients will be discharged from the hospital seven to eight days after surgery. When being processed for discharge, you will be given information on when to follow up with your surgeon, and you will be given numbers to call if you have any questions or concerns.
Pathology results are usually available 7-10 business days after surgery. Your surgeon will review the results with you when they become available.
The incentive spirometer is a simple device that you can use to increase your lung activity during recovery. The nursing team will show you how to use it.
What can you do to speed up your recovery? Walk, sit in a chair, and use your incentive spirometer (IS) as much as possible!
Some people are afraid to move after having surgery, but it is important to sit up in a chair on postop Day #1 and start walking on postop Day #2. Using your IS and walking will help your lungs function normally. (They do not fully inflate when you are lying in bed.) Walking will help stimulate your digestive tract and get your bowels functioning, which is an important step in recovering from abdominal surgery.
Multidisciplinary care includes recovery
We perform the highest volume of pancreas surgery in the region, with specialized nurses, physician assistant, and surgeons collaborating in your care. This team approach continues in your postoperative care, resulting in better outcomes due to our collective experience. We look forward to supporting you and ensuring that you have the fastest, smoothest recovery possible.