Friday, 21 April 2017

Cancer Of The Bone

hi, i'm kevin cummings at investors bank, we believe in helping our local neighborhoods and improving the lives of all we serve we're a different bank that makes a difference for our employees, clients, and communities. that's why we're

proud to support public television and the programming produced by the caucus educational corporation >>funding for this edition of one on one with steve adubato has been provided by new jersey resources the north ward center

the new jersey education association verizon communications investors bank new jersey sharing network dedicated to saving lives through organ and tissue donation and by

choose new jersey our mission is attracting companies to the garden state promotional support provided by the record north jersey's trusted source and northjersey.com njbiz all business all new jersey

this is one on one when you first heard that they were doing charlie rose and gayle king, didn't you go "what?" people like laughing at others so i don't mind if the other is me you see? you go right into the

character. that's what it is i'm bringing families together a half an hour each week i mean i'm doing something special and so i do feel successful [music playing] >>welcome to one on one i'm steve adubato

and more importantly everything you ever needed or wanted to know about healthcare you're gonna find out erhardt preitauer >>yes >>is senior vice president of government programs and ceo of horizon nj health

good to see you >>good afternoon steve thanks for having me >>we were talking about a whole range of healthcare issues right before we kicked off on the air. a more holistic approach to delivering healthcare. what does that

mean? >>really it's about understanding the member their family, and all of their needs. not just their medical needs. but a lot of people have social needs. behavioral needs physical needs. community needs it's really understanding

the member and their family by the way, and being able to put together a plan that has that member served through all the different aspects of their needs. and really, doing that well helps people live a better life. there's so many different examples where, there's a

member that i spoke with last week. he was homeless a bunch of different chronic conditions >>this is someone who is by the way, let's put it in perspective. how many members do you have? >>we serve about a million

members in government programs these are medicare, or medicaid eligible people >>got it, go ahead >>so this member was homeless and he had a bunch of chronic conditions. lung issues behavioral health issues he wasn't getting any of the

care, going to the emergency room every single day when we got him a place to live then we could start working with him on his medical issues nobody's worried about going to the doctor if they don't know where they're gonna eat tomorrow. that's the kind of

thing that we do >>it's interesting because when someone thinks about your company or any other health insurance company you don't think of a company being involved in these kinds of things. like, do you cover this procedure or not?

>>right >>that's not going to get it done anymore? just that way to look at healthcare, correct? >>and i'll tell you, i'm so honored to be a part of horizon. i mean, we focus on what the member needs. and our care coordinators, i mean

they're so passionate. we've got 175 of them out in the field, these are nurses and social workers >>what are they called? >>care coordinators field based care coordinators they're out in the communities where our members are

in community centers, in their homes, under bridges, in nursing facilities >>what do they do? >>they sit down and they really understand what this member needs. and they put together a plan for this member. and whether or not

we cover it, or not these care coordinators bring together everything that member needs to be able to live a fulfilled happy healthy life where they're at >>it's interesting. right before we got on the air i asked you what the economics

of all this are. so, covering or caring for people in this way, i'm thinking, "well okay it's gotta be more expensive" and you said "no, it's actually saving money" make that case >>there's two things one is, if we can really understand what that member

needs, a lot of times they're in the community. they're with their family. and a lot of times, families, they don't know what to do. we'll bring home care, we'll bring additional help. we'll turn ramps into, i mean, chairs [laughter] we'll bring

we'll change stairs into ramps and we'll do a lot of different things >>that's a big deal? >>absolutely. home modification widened doors. we'll be able to do a lot of different things so that this person can stay at home. they're happier at

home. their families are happier. we can support them we can bring adult day care we can bring somebody in the house to help them with chores >>but how is that cost savings? >>on average, to keep somebody in the community, versus having somebody go to a nursing

facility, it's about half of the cost. it's about half of the cost >>is that the goal? to quote unquote "keep that person in the community?" >>really the goal overall is to keep the person where they're most comfortable

where they're gonna have the right peace of mind a lot of times that is in the community. and that happens to be much cheaper than being in a nursing facility >>i'm wondering, you know what's so interesting, is you lay this out. one, you know

is likely to ask, "okay, so we know this" you know it sounds logical on a lot of levels. why do you think it took this long for leaders in the healthcare industry to say, "hey, we need to reexamine the entire way we're doing this"?

>>first, let me say, i think this program that the state of new jersey, ultimately it starts with the state, right? new jersey has set up, it's among the best in the country >>and the program is called? >>managed long term services and supports. or mltss for

short >>mltss? right? >>absolutely. so it's, in my opinion, and i've worked in a bunch of states with a lot of these different programs so new jersey, i think, for this program, is very cutting edge. very forward thinking

but to answer your question directly, it's a very complicated program. a lot of technology goes into being able to go out into the field the model, the way we go out the field based care coordinators, all of this is very very different than the

traditional delivery. so i think we're well on our way we're well on our way in new jersey, the country i believe is watching and i think you'll see more and more states go towards this model over the next few years

>>before i let you out of here you know, you used the expression, you know "it's complicated" for people who say things like "why can't they" and they always refer to "they" someone... "they" is always someone else other than the

person talking. "why can't they fix the healthcare system?" and you're arguing how complicated it is. is it complicated just because of the nature of delivering healthcare to a very diverse set of people a diverse population with all kinds of needs? and different

you know, paying is not easy either. and the fact that it's gone on for a long time the way it is, is healthcare by the nature of what it is complicated? >>let me tell you a quick story so first of all, my 94 year old grandmother wonders why i

haven't fixed healthcare >>[laughter] >>so in that case, it's not a 24135 >>why don't you fix it? [laughter] >>yeah she, i was actually in somebody's house, and this lady was about 90 years

old, english wasn't her first language. and i do ride alongs with my care coordinators cause i want to understand what's really going on >>you're right there. you see it, right? >>absolutely. so we asked this woman the care coordinator

right, our nurse, well she didn't get her drugs, and we asked her "why didn't you get your drugs?" doesn't speak english very well. she got her purse, and she opened it. and she poured out all these id cards. part d card, medicare card, medicare advantage card

discount card. her food card >>her, all these different cards. i think there were 12 of them. and you're sitting there looking at that depending on what card you show, you may or may not get different services under and unstructured type of

>>program. well part of what we do is we bring that together but the story doesn't end this lady then turns around she pulls out this huge file folder. she had saved every benefit booklet, every member guide, every piece of paper that came with all these cards

it this big. and you sit there and you realize, "how is this person gonna be able to navigate through all of this?" >>she can't? >>she can't. i couldn't right? so what our program is beginning to do, and we have more opportunity, it's to bring

>>yeah >>all that together, one care coordinator >>well, it's important stuff and we'll continue to monitor it, and try to teach people and help people and you've done that today. and i want to thank you for breaking it down

appreciate it >>thank you for having me >>stay right there one on one will continue right after this >>to see more programs, visit us online at www.steveadubato.org if you would like to express

an opinion, email us at info@caucusnj.org find us on facebook at facebook.com/steveadubatophd and follow us on twitter at @steveadubato >>we are pleased to be joined by two very special guests on my far left we have

jackie mattia and the young man, who's that guy to your right? >>my son, aj >>aj. aj, how you doing? >>good. how are you? >>i'm doing great aj, we have you and your mom here, because you are the

prudential spirit of community award winner. and that is a very hard award to win you're how old? >>16 >>16. and you have been a leader for a long time you face some challenges as a young man, and you continue

to face challenges but that does not stop you from making a difference to others. is that a fair, am i doing alright so far? >>why don't you tell us a story >>in march of 2011, i broke my femur. and then from there i found out that i was

diagnosed with cancer. so... >>and then what? was that the beginning of the story? >>that's the beginning of the story, yes. so... >>so how does, tell us a little story, so what happens after that? do you say, "i'm giving

up"? i mean this is a terrible thing >>no >>what do you do then? >>after that, we had a biopsy, and a lot of tests and then i went through several rounds of chemotherapy and 13 surgeries. then after

that, i decided that i wanted to make a difference >>you're in the middle of all that, it's obviously very challenging, and in the middle of that, you decide "i want to help other kids with cancer"? >>you, before i, listen, my producers are telling me

to go to you, but i'm not because i've gotta understand this. how is it that in the middle of that, the chemotherapy, and everything else, you decide "i want to help other people"? >>well i just saw those other kids sitting there in the

hospital room, you know wanting to, and some didn't have family there with them some were alone, so i just thought that everybody needed to feel special >>what did you have? >>i had a type of cancer called osteosarcoma

and i had a lot of family >>i was gonna ask the other part >>who did you have? >>i had a lot of family i had my mom, my siblings my family, friends >>and you end up losing your left leg?

>>mm hmm >>did that cause you to say "alright, that's enough. i'm gonna just help myself now"? >>no not really >>alright now jump in what's up with this guy? >>well, to be honest with you aj's always been the type of

kid that has been a go getter and also, somehow always was willing to extend a hand you know, captain of the safety, he's always volunteering even though he didn't play football he volunteered at the football stand. just always the one

that adults went to for help if there was a new kid in... at school, and he just was a he's beyond his years with wisdom and kindness >>he helps all? >>what do you really mean by that? >>he's put here for a special

reason, and you know, it sounds a little bit odd, but aj does feel as though that he was chosen to have, you know cancer, and this is his mission in life >>do you believe that? >>some, yeah, sometimes >>talk about that

>>i don't know, sometimes you just need to go out there and make a difference >>but do you actually believe you were chosen? >>from time to time you know if i could deal with it you know >>but when you see other

kids, have you ever really i mean, doing all these great things. by the way, you raised a ton of money, didn't you? tell me, how much money did you raise? >>over, like, 500,000 dollars >>okay, we could use you raising money for pbs but

that's another story >>tell us how you >>hey, he's looking for a job >>he's looking for a job [laughter] he'd be a great fundraiser, how did you raise this money? >>spreading the awareness selling socks, selling gold

shoelaces >>wait, say that again? selling... >>galas >>go back to the shoelaces what did you do? >>sold gold shoelaces to like sports teams and college teams >>give up the socks over here

what's the deal? >>well this is a new product so hasn't even begun this yet >>oh this is a new product? hold on >>this is a new venture >>i want you to describe this, this is new what are we looking at, aj?

>>they're, like, nike elite socks, they're gold socks that sports teams, you know will wear and sports players >>and this is a symbol for >>gold ribbon, childhood cancer >>and this is gonna help raise money? >>and you've raised over

500,000 dollars, and that money goes toward? >>kids with cancer granting wishes >>hmm, and that's why the prudential community service, community award went to you? but children with cancer, have you ever

really taken, have you ever really talked to these kids? >>describe those conversations >>i know it's hard for them most of the time, you know i don't... >>what do you mean? >>i don't know how they get through it sometimes. you know

they're fighters >>you don't know how they get through it? >>what do you say to them? >>keep fighting >>what do you see in their eyes? little kids? >>sometimes fear >>of?

>>i don't know. i guess fear of their treatment, you know are they gonna make it? are they gonna...? >>you just tell them to fight? >>be here, yup >>yeah. did you have that fear? >>sometimes >>did you have that fear?

>>absolutely >>now your brother? >>my brother had cancer when he was 11 years old as well. so i know what it's like to be a sibling, you know of a someone whose family was you know, overwhelmed with all the stuff that cancer

can do to you, and, you know >>does anything prepare you for what's gone on here? >>it did. it actually, you know the life that i live with you know, my brother, you know being sick, it definitely has taught me, you know some positives and you know

some negatives as far as where i would like for aj to go and to be as independent >>where do want him to go? >>independent. you know, we don't look at, you know, what he has been dealing with as a disability, but it's the life that we now have, and i want

him to be as independent as he possibly can, so he travels, we use uber a lot and he visits, you know the hospital, he'll go on his own, and he really is a very very independent soul. so... >>what do you want for yourself? your future?

>>i don't know, it's an undecided future >>i'm still thinking >>i'm gonna ask you this question. i spent about a year now asking all sorts of people this question i've been writing a book about leadership for a couple years

now. and i ask really special people, who i think can answer it, what the most important lesson about leadership they've learned so far is. what's the number one lesson you've learned about being a leader? >>well there's a lot of lessons >>pick anything

>>don't be afraid to ask ask for contacts, ask for help >>just ask? >>what's the worst that can happen? >>[laughter] what's the greatest leadership lesson you've learned? >>wow. watching my son, he has

so many positive leadership qualities, and that is, i really let him dictate his own future. and he really is someone who has had trial through tragedy. so, you know never give up hope, because there are blessings that have come in disguise. as hard as

life is still, at moments there... aj does not complain and just keeps moving >>do you ever look at the jimmy valvano speech from the espy awards, when he won >>i did. i actually watched it >>with my son, who's a football player. my other son is a

football player >>coach jimmy valvano when he was winning the espy awards from espn, don't ever give up. right? >>and the life he lived was very very challenging >>right. you know the speech you know the message

>>i do >>you're an inspiration you're a leader, and you deserve that prudential award >>thank you >>and you help a lot of people keep doing it. congratulations >>thank you. thank you >>stay with us, we'll be right

back. thanks >>we're pleased to welcome doctor orgori kalu who is director of breast surgery, at university hospital and assistant professor department of surgical oncology rutgers new jersey medical school. good to see you doctor

>>nice to have with us >>doctor, talk to us about the situation as it relates to young women, particularly in the city of newark, and breast cancer. there's a serious problem. what is it? >>there's a serious problem with young women and breast

cancer in this newark area is that they're being diagnosed and presenting it at much later stages. so we're seeing them at more advanced stages compared to older women who present with breast cancer i attribute that to the fact that for younger women

we don't have any screening parameters. you know, for older women we start at age 40 with yearly mammograms therefore we're able to pick up early breast cancers and because they're picked up in the early stage, their survival is much better

with younger women we don't have these modalities at their disposal >>so, you know, i know there are a lot reasons for this and it's complex, but is one of the reasons, doctor, that too many young women in the inner city, don't think that they

are candidates for breast cancer? >>exactly. i think in general just young people, just have this state of feeling invincible. you know you never think at a young age, breast cancer will affect you. i'm seeing women who are as young

as 24, who are being diagnosed >>24? >>with breast cancer. and because they don't know what to look out for, they don't know what the problems or symptoms might be, they're presenting much later and unfortunately for these

women, it impacts their overall survival >>so, combating it talk about it >>well, i think in my opinion the best way to combat it would be just education educating these young women starting at an early age

you know, part of the elementary school and middle school education is sex education. and part of overall health education for young women and young men i mean i think part of that should be educating women on how to do self breast exams

just simple basic things >>at what age would you say? >>i would say, once you start once a young woman has started having her menstrual periods once she's gone through developmental changes, where her body is changing, she should have an overall

education, the differences in her body, and the different things that can happen to her body, that could be harmful to her ultimately >>do you think knowing newark the way you do, knowing the community the way you do that such a conversation

about having that kind of education would be well received by most parents? because the children will not have a voice in that >>this is true. it won't be easy, but we do know that when we're treating young people particularly in the inner

cities, they're exposed to a lot of things that maybe other young children may not be meaning we're seeing younger women, and younger men, who are more sexually active at younger ages. and you know sometimes we could say that or at times we can attribute

this sexual activity at younger ages based on just not knowing and curiosity. and once they've reached into that part of their i guess, sort of growing up and development, they need to be educated on their bodies >>no no, i'm not arguing the value, i'm just saying how

hard a sell >>oh how hard a sell >>and i'm curious as to whether in fact there has been a concerted effort with you and your colleagues and others who are involved in the newark community as it relates to health, and health education

to try to have this dialogue >>mm hmm. how well we receive that's, it's really hard for me to say, you know, i think i'm just coming from the perspective of a clinician >>you know what needs to be done? >>yes. i know it needs to be

done >>and if it's not, do we have any reason to believe that these very alarming statistics and by the way, statistics are nothing more... they're talking about people >>young women >>that this is gonna change

>>right. i think, you know nationally, when we look at you know, the data and the information that's made available to us in regards to breast cancer, a majority of breast cancer affects women who are older post menopausal. the data

suggests that only about 7 percent of women who are diagnosed with breast cancer nationally fall under the age of 40 or 45 >>that's nationally? >>that's nationally >>what about in newark? >>however in my practice, i'm

seeing upwards of 15 percent >>oh... >>15 percent of my patients >>twice the national average? >>are under 40 between the ages of about 28 to 40 and being diagnosed with breast cancer. i don't know if it's something that's unique

to newark, versus something unique to the inner city, or just something that's not really being acknowledged you know, nationwide >>so... sorry for interrupting someone says, "okay, mammographies" >>sooner?

>>well... >>is it they're not, are they as effective with younger women? >>they're really not. and that just goes to the nature of, you know, of a mammography you know, it's no issue with that, it's just that the

mammogram itself is like you know, in simplistic terms an x-ray. and an x-ray is looking for any abnormality density on imaging to show or identify early cancers. and for younger women, women who are premenopausal, the younger

the woman is, the denser her breast tissue is. so, on a mammogram, it's hard to differentiate between what's normal breast tissue, versus what is malignancy or a tumor of the breast. therefore younger women, you know a mammography is not indicated

because it's not as effective >>final question, where's the silver lining here? bright spot? >>i think the bright spot is that, you know, for this show, having me on this show actually, you know, talking to people and letting people

know, i'm going into the communities and i'm talking to young women and even parents, and letting them know that, you know, breast cancer is not something that as a mother you should be cognizant of, or wary of you should also try and teach

your daughters about breast health and things to look out for. so the brighter side is just making people more aware and so once you become more aware there's a problem then the solutions will often follow >>one on one with steve adubato

has been a production of the caucus educational corporation celebrating over 25 years of broadcast excellence funding for this edition of transportation provided by air brook limousine serving the metropolitan new york new jersey area

>>hi, i'm peter rooney in 2006, i lost my father to renal disease. he was on the waiting list for a new kidney, but did not receive one in time. unfortunately so many like my father have lost their lives while waiting for a life saving

organ. at new jersey sharing network, we're committed to saving and enhancing people's lives through organ and tissue donation, and by informing people about this important decision. because you can make

No comments:

Post a Comment