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May 26, 2004

Cancer Survivor Credits County Nurses for Her Recovery at Home

Frances Richmond hasn't had anything to eat or drink since Aug. 25, 2002. The 64-year-old woman lives at her home in Granby and receives a liquid nutritional supplement fed through a tube in her stomach several times a day.

Fran had been bothered with a sore throat and difficulty swallowing when she visited her doctor in March 2002. She went into the hospital in August, thinking she was going to have her tonsils out. Instead, her surgeon, Dr. Jack Ming Hsu, MD, found many malignant tumors in her mouth and throat. The cancer was so extensive it required removal of a large area from the right side of Fran's neck and half of her tongue.

When she finally returned to her home that November, Fran required extensive care. "It took a long time to even start to heal," she said.

Today she is going to be just fine, she says, thanks to the care of her friends, family and physicians, and to the nurses in the Oswego County Health Department's certified home health care program.

"The Oswego County Health Department has the ability to care for patients who have complex medical needs when they are released from the hospital," said Kathleen Smith, Oswego County Health Commissioner. "We provide care on a range of levels and have the capacity to serve more people."

Smith said that home health care is often ordered by a physician following surgery or a hospital stay. The county's nursing staff visits the home to provide care for pressure sores or surgical wounds, physical and occupational therapy, intravenous or nutrition therapy, and other services to help patients recover and get back on their feet.

"The goal of Oswego County's home health care is rehabilitation," said Smith. "The health of the patient should improve, and ideally, they should regain their independence and become as self-sufficient as possible."

Arrangements were made while Fran was still in the hospital for nurses from the health department to visit her as often as prescribed. Fran's case manager at the time was Steve Sabatini, RN. Steve worked closely with Dr. Hsu at Upstate University Hospital to develop a plan of care for her so everything was in place when she returned to her home.

When she first came out of the hospital, Fran needed someone to dress her surgical wounds, monitor feeding and drainage tubes, check her blood pressure and follow her care. At first, nurses visited twice a day. Fran has had additional surgeries since then, including skin grafts to close the wound on her neck, reconstruct the inside of her mouth, and remove another tumor from the left side of her neck.

Chantel Eckert, a registered nurse, has been Fran's case manager for over a year.

"Chantel and the nurses follow me very, very closely," said Fran. "The nurses are wonderful and they explain everything you want to know. They take the time to tell you what they're going to do, and that's important to me."

"She required pretty in-depth care," said Chantel. "She's come a long way. She's really done remarkably well considering all she's been through."

Fran and Chantel have developed a close friendship. "She's very strong. She takes good care of us too," said Chantel.

Fran speaks with effort and uses a note pad and pencil to write down words when others have trouble understanding her. She expects to have more surgeries to reconstruct portions of her mouth and her lips so that she'll be able to eat and drink.

She carefully monitors her own fluid intake, blood pressure and blood sugar, and reports any changes or concerns to her nurse. Despite the fact that she needs more surgery, Fran is optimistic about her recovery.

"I can't say it's minor, but compared to what I've already been through, it's nothing," said Fran. "Every day I get closer to the end of my ordeal. With the help of my family, friends and great nurses, I'm fine. I'm okay."

Fran is the mother of six children adult children, 19 grandchildren, and six great-grandchildren. Fran's live-in companion, Ruben Ortiz Vega, has been by her side since she came home from the hospital. She said their roles were reversed a few years ago, when Ruben was treated for a tumor on his neck.

"I took care of him then," she said. "He takes care of me a lot more than I take care of him."

Each of the home health care staff members uses a laptop to monitor medications, the patient's weight and other details. The health department's LPNs report back to their case managers on each patient's progress after every visit.

"Ultimately when you have a client, all the services that are provided are your responsibility," said Chantel. "So if I can't make a visit, someone else does and reports back to me."

In 2003, the Oswego County Health Department's nurses, social workers, home health aides and other staff made over 40,800 visits to patients in the certified home health care and long-term home health care programs.

For more information on the Oswego County Health Department's certified home health care services, call the department at 349-3545 or 1-800-596-3200, ext. 3545.

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