Join Us at the Third Annual JCCSF End of Life Resource Fair

The Jewish Community Center of San Francisco is hosting the event on Nov. 12, 1017

Banner for the End of Life Resource Fair

SevenPonds is excited to announce “Embracing the Journey,” the Jewish Community Center of San Francisco’s third annual End of Life Resource Fair. Presented in conjunction with a number of Bay Area businesses and nonprofits, the event will be held at the Jewish Community Center, located at 3200 California Street in San Francisco, from 9:30 a.m. to 4:30 p.m on Nov. 12, 2017.

Presentations will include a two-hour Advance Care Planning Seminar & PREPARE Workshop by Dr. Rebecca Sudore, M.D., a professor of medicine and palliative care physician at the University of California, San Francisco. A concurrent session will feature advice from Dr. Steven Pantilat, M.D., the author of the critically acclaimed book, “Life After the Diagnosis: Expert Advice for Living Well with Serious Illness for Patients and Caregivers.

Path through the woods end of life resource fairOther speakers will include Dr. Ron Wolfson, who will explore Jewish customs and traditions around supporting people during times of grief. Also speaking will be Rabbi Mel Gottlieb, who will examine how religion, spirituality and culture impact our ability to accept mortality and remain resilient at the end of life. There will also be a several workshops devoted to estate and financial planning, including a one-hour presentation by attorney Deborah L. Fox, Esq., followed by a discussion by certified financial planner Chris Remedios.

Attendees will have the opportunity to meet with local businesses and organizations that offer a wide range of end of life services in the Pottruck Family Atrium from 10:30 a.m. to 2:00 p.m. These will include an “Ask the Expert” session with Maggid Jhos Singer and a Death Cafe moderated by marriage and family therapist Diane Wilson. Janie Friend, MFT, will also be available for confidential counseling sessions for those who want to talk about issues related to end of life. And, of course, SevenPonds’ Suzette Sherman will be there too, and looks forward to seeing you there!

Attendance at the Resource Fair is free, and presentations fill up quickly, so it’s a good idea to register in advance. If you’d like more information before signing up, contact Shiva Schultz, MSW, at sschulz@jccsf.org or 415-292-1260.

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Heart Surgery May Be Best Performed In the Afternoon

A new study shows that patients who underwent heart surgery in the afternoon fared better than their morning surgery counterparts
Surgeons performing heart surgery

Credit: intermountainhealthcare.org

Researchers  who have studied the effect of the body’s circadian rhythms on patients undergoing complex heart surgery have found that the time of day has an effect on the outcome of the surgery. Collecting data on nearly 600 patients who underwent aortic heart valve replacement over the course of six years, authors of a study recently published in Lancet found that patients who undergo open-heart surgery in the afternoon have better outcomes than those who have surgery in the morning. In the 500 days following surgery, patients who underwent afternoon heart surgery had half the risk of major adverse cardiac events (cardiovascular death, myocardial infarction, or admission to the hospital for acute heart failure) as those who had surgeries earlier in the day.

The team also conducted a randomized study of 88 valve surgery patients, half of whom had surgery in the morning, half in the afternoon. Researchers found lower levels of myocardial ischemia-reperfusion injury (tissue damage caused by blood supply returning to tissue in repaired areas of the heart) in patients who underwent heart surgery in the afternoon.

heart lung machine used in heart surgery

A heart lung machine oxygenates blood while doctors perform heart surgery. Tissue damage may occur when the blood is rerouted to the heart.
Credit: medgaget.com

The researchers took heart tissue samples from 14 morning surgery patients and 16 afternoon surgery patients in an effort to understand the reasons behind the different outcomes. When put in conditions replicating a heart refilling with blood, tissue from the afternoon surgeries recovered its ability to contract more quickly than the tissue from the morning surgeries. The researchers believe this discrepancy is linked to variation in gene expression in heart tissue throughout the day. The team identified close to 300 genes linking the body’s circadian clock to heart damage. A genetic analysis showed that these genes were more active in the afternoon than in the morning.

Blocking Gene Expression Improves Results

In a statement about the study, its lead author, University of Lille-France professor David Montaigne, said “There are few other surgical options to reduce the risk of post-surgery heart damage, meaning new techniques to protect patients are needed. Our findings suggest this is because part of the biological mechanism behind the damage is affected by a person’s circadian clock and the underlying genes that control it.”

Researchers tested the theory on mice by artificially removing or administering drugs that block the effects of the relevant genes. Mice given the drug or who had the gene removed recovered more quickly from morning surgeries. While further confirmation is needed to see if the findings translate to humans, the results indicate that developing drugs which target the relevant genes could help protect the heart during surgery.

Dr. John O’Neill, an expert in circadian rhythms from the MRC Laboratory of Molecular Biology, who was not involved in the study, says the study’s findings backed up research done on mice and fruitflies, which looked at genes’ involvement with the body clock. “The biological clock, the circadian rhythm, is in every single cell of the body, therefore it affects the biological activity of each cell type, commensurate with the function of those cells.” Dr. O’Neil also said that healthy hearts follow a pattern of activity throughout the day, and that in the morning the heart is not functioning at optimum performance.

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“Death is more universal than life; everyone dies but not everyone lives.”

- A. Sachs

A man stands in a field of wheat at sunset

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Monday Hearts for Madalene

Page Hodel creates beautiful hearts as a tribut to enduring love
handmade heart

There will never be another you

It’s an honor for SevenPonds to share with our readers the story of the Monday Hearts for Madalene project, a true account of the power of enduring love.The project began in 2005, when Page Hodel first met Madalene Rodriguez and fell “instantly, dizzyingly in love with her.” Soon afterwards, Page began leaving handmade hearts on Madalene’s doorstep every Monday.

“To start her week with a visual reminder of our beautiful love.”

Just seven months later, Madalene was diagnosed with ovarian cancer. She died on June 20th, 2006. To remember her, Page continues to make a heart every Monday in celebration of her life.

To learn more about Page and the Monday Hearts for Madalene Project, please visit her website, Monday Hearts for Madalene.

See more Monday Hearts for Madalene here.

 

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A Chance to Make Memories

After the roller coaster of emotions slows down, there is time to decide how you want to be remembered
Outer banks at sunrise is a place to make memories

Credit: thrillist.com

It could be argued that there is no upside to learning that you have a terminal illness. Coming face to face with your own mortality is terrifying and disorienting. And while it’s an experience that each one of us will face at some time in our lives, it’s not one that most us would actively seek out. We know death will come for us someday. But until we hear “the news” from a person wearing a somber expression and a white coat, we can, for the most part, stave off that knowledge with a firm “Yes, but not now!”

And yet, the truth is that learning that you’re going to die sooner rather than later can be a blessing in disguise. Since we are all going to die someday, the person who gets advance notice has options that those who die unexpectedly simply don’t get. There is the option to apologize to the people you have wronged; the option to say things that have been too long left unsaid. There is the option to let go of pretense, and to give and receive love in a truly authentic way. And, perhaps most important, there is the option to make memories with those who will be left behind when you’re gone.

Tim was 60 when he learned he had ALS. He had a particularly aggressive bulbar form of the disease that was attacking the nerves in his upper body relentlessly. He was still able to walk short distances with the aid of a walker. But he had difficulty swallowing or speaking and had limited use of his arms and hands. His neurologist told him that his prognosis was not good. He would likely live only another 18 months to 2 years.

Tim took the diagnosis very hard. He had planned to retire to Palm Springs the following year and spend his days playing golf. Instead, he was looking at progressive paralysis, increasing disability and certain death. He was despondent, terrified and incredibly angry.

But when that first wave of intense emotional turmoil had passed, Tim decided that he wasn’t going to spend the next year and a half feeling sorry for himself. And so he came up with a plan. He and his family had vacationed in the Outer Banks of North Carolina every summer for many years when the children were young. And he still cherished those memories more than any he could recall. There were lazy days at the beach playing in the surf, barbecues on the deck, and plenty of down time to hang out and enjoy life with his wife and kids. And as he thought about the fact that what would likely be his last summer was fast approaching, Tim decided to take his whole family to the Outer Banks one last time before he died. 

Sand dunes at the beach are a place to make memories

Credit: photoshelter.com

Making the arrangements for the trip was easy. Summer was still a few months away, and Tim easily accomplished most of the organizing online. But the execution proved far more difficult than either Tim or his family thought it would be when they made plans. Tim’s disease had been progressing fairly rapidly, and when their departure date finally arrived he was very weak. The trip to the airport wore him out so badly that by the time he was seated on the plane he could barely hold up his head. The four-hour journey was terribly uncomfortable for him and incredibly stressful for his family: What would they do if Tim suddenly couldn’t breathe?

But Tim made it to his destination, and his wife rented a van and drove the whole family 50 miles to the beach. For the next seven days, Tim sat in a lounge chair watching his children and grandchildren play in the surf. Despite his difficulty swallowing, he ate burgers and barbecued chicken and washed it down with sips of his favorite Scotch. And each night after dinner, he took his grandchildren in his lap and listened to them tell him all about their day.

Meanwhile, Tim’s wife and children took photos constantly, determined to preserve the memories they were making with their husband and father for the very last time.

To this day, Tim’s daughter Marie says those photos are an enormous comfort to her. “They aren’t just pictures, “ she explains. “They are pictures that remind me of who my dad was. When I look at them it’s like he never left us…I can’t tell you what a gift that is.” 

In a perfect world, making memories would not be something we put off to the end of life. In a perfect world, each of us would cherish every moment and savor the joy of simply being alive. We would make more time for the things we love to do and let go of the petty annoyances that steal our time and our joy.

An empty beach chair...time to make memories is over after you're goneBut sadly, we do not live in a perfect world. And most of us stay firmly rooted in the denial of death until some monumental event like a terminal diagnosis wakes us up. Even then, it can be very, very difficult to navigate through our complex emotions and come to terms with the reality that the time to make memories and enjoy life is now. 

If you’ve been told you have a life-limiting illness, take all the time you need to grieve. Feel the fear and the sadness and the anger, and don’t be afraid to reach out to your loved ones for support. But as the roller-coaster of emotions begins to slow down, try to look to the future and think about how you want your last days to unwind. How can you make them memorable for the people who love you? How can you leave a legacy that will remind them of who you were? What memories can you make with them that will sustain them when you’re gone?

You don’t have to plan a trip across the country to leave a lasting legacy of love. 

“The past beats inside me like a second heart.”
~ John Banville

About Kathleen

Each month Kathleen Clohessy, R.N., offers a new perspective on living with a terminal illness. Kathleen comes to SevenPonds with 25 years experience as a registered nurse caring for families and children facing life-threatening illness. She began her career in the Pediatric Intensive Care Unit at Nassau County Medical Center in New York. After relocating to California, she spent 15 years as an R.N. and Assistant Nurse Manager at the Pediatric Oncology & Bone Marrow Transplant Unit at Lucille Salter Packard Children’s Hospital at Stanford. She uses her knowledge and expertise to enlighten our readers about the challenges associated with chronic illness and its effects on family relationships.

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“I hate funerals and would not attend my own if it could be avoided.”

- Robert T. Morris
mourners at a funeral

Credit: naturalburial.org

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