Archive for February, 2014

Food & Fun in San Diego

In just two short weeks nearly 2,500 attendees will be arriving in San Diego for the 2014 AAHPM & HPNA Annual Assembly. Everyone is looking forward to another year of top notch education sessions and some sunshine after a long winter. Below are suggestions for restaurants and hot spots that the locals love and can’t miss attractions for everyone.

Restaurants
Extraordinary Desserts in Little Italy
Café Coyote in Old Town
Casa Guadalajara in Old Town
Lotus Thai
A.R. Valentien – fine dining
Bandar Persian – try their amazing chicken shish kabob
Candelas Gourmet Mexican
Hexagone – French cuisine
Old Town Mexican Café
Blue Point Coastal Cuisine
The Fish Market & Top of the Market (upstairs)
McCormick & Schmick’s Seafood & Steaks
Ocean Beach
Phils BBQ
South Beach Bar & Grille
Oscars- go to the Newport Ave Location
Hodads- burgers
BO-beau Kitchen & Bar
Sushi Ota- need a reservation
Hane Sushi
Winstons fun bar with good music

Neighborhoods
Hillcrest- lively, great restaurants
Gaslamp Quarter- tons of restaurants and is easy walking from the convention center
Seaport Village- near downtown has shopping and restaurants along the bay

Other Attractions
Shopping- Fashion Valley and Las Americas Premium Outlets
Sea World
Legoland
San Diego Zoo
San Diego Zoo: Safari Park
DisneyLand
La Jolla Cove and La Jolla Children’s Pool
Whale watching- Hornblower Cruises and Flagship Cruises
Midway Museum and USS Midway the retired aircraft carrier is fascinating
Padres baseball at Petco Park
The New Children’s Museum
Coronado- there is a ferry that goes from the convention center to Coronado. Bicycle rental is available at the ferry landing on Coronado. There are also three nice restaurants near the ferry landing. Home to Hotel Del Coronado from Some Like it Hot. Check out Miguels across from the Hotel Del Coronado

For more information about everything that San Diego has to offer check out the San Diego Convention Center and the San Diego Tourism Authority.

If you have recommendations please leave them below.

Highlights of the February Issue of the Journal of Pain and Symptom Management (JPSM)

Listed below are a few articles from the most recent issue of the journal:

Web-Based Symptom Management for Women with Recurrent Ovarian Cancer: A Pilot Randomized Controlled Trial of the WRITE Symptoms Intervention
Heidi S. Donovan, Sandra E. Ward, Susan Sereika, Judith Knapp, Paula Sherwood, Catherine M. Bender, Robert P. Edwards, Margaret Fields, and Renee Ingel

Self-Reported Physical Symptoms in Intensive Care Unit (ICU) Survivors: Pilot Exploration Over Four Months Post-ICU Discharge
JiYeon Choi, Leslie A. Hoffman, Richard Schulz, Judith A. Tate, Michael P. Donahoe, Dianxu Ren, Barbara A. Given, and Paula R. Sherwood

Adequacy of Opioid Analgesic Consumption at Country, Global and Regional Levels in 2010, Its Relationship With Development Level, and Changes Compared With 2006
Béatrice Duthey and Willem Scholten

To access the articles, you must subscribe to JPSM or be a member of the American Academy of Hospice and Palliative Medicine (AAHPM). For further information on the Academy, call 847.375.4712 or visit aahpm.org.

Submitted by: David J. Casarett, MD, MA, Senior Associate Editor, JPSM

Advance Planning: More Than Care Decisions

There is much talk in health care, especially in the fields of palliative and end-of-life care about “Advance Care Planning”. And rightly so. For those with advanced illness, this process is critical to patients receiving the treatment they want and only the treatment they want. The process done well clearly improves patient’s perceived quality of life, reduces the burden of suffering, raises patient satisfaction, and also seems to reduce overall health care costs.

For a medical treatment team, whether palliative care or other, the process often needs to be focused on decisions about health care choices. Those are our immediate concern and often those concerns truly need to be addressed in the very short term such as making decisions about resuscitation with an elderly patient suffering from heart failure and pneumonia.

However, there is also a class of “patients” emerging who, while they have a diagnosis of HIV/AIDS or “terminal” cancer are not necessarily near death and, because of maintenance therapies that can often have very controllable side effects, look and feel fairly healthy. They can therefore do lots of “normal” things and lead a “normal” life. The other day I saw Magic Johnson on TV announcing he has purchased yet another sports team in LA. These people may not be so different from someone like me. I’m healthy for my age but will soon be at the age where I will be forced to begin accepting Social Security payments whether I like it or not. I clearly have a lot less of my life ahead of me than I have behind me.

In this situation, certainly the decisions we generally associate with advance care planning are critical. Under what circumstances do I want to be kept alive if I can no longer make decisions for myself and by what methods? But as I begin to seriously engage this phase of my life, I increasingly realize that there are questions that go far beyond this which, if I engage them seriously, will make all of the life I have left more complete and fulfilled. The first issue for me seems to be that if there are things I want to do or a way I want to be sometime in my life, I need to be about creating that reality for my life now. And I can create much of that reality if I plan for it. However, this planning also means re-examining some assumptions about how I have lived my life. Do I really need the “security” of a steady job and is that security coming at a price that I no longer need to or want to pay because it is keeping me from other things I want to do? How many of my possessions would I really miss if I didn’t have them anymore? Do I continue to need to own a house with the responsibility that brings or can we be free of it?

These are not simple or easy questions. I have no intention to ever retire in the normal sense. I don’t even play golf and I don’t like either Florida or Arizona. I want to cook more and maybe learn Spanish. And I want to continue my professional journey down a road I still have intense passion for.

My point in all this is that, while advance care planning in the medical context is important, it is really only a part of a larger conversation. And this is not just about a bucket list either although that can be part of it. Ideally, it should be the end product of a much longer and intricate process of deciding how you want your life to be whether you have some idea of how much longer that life will be or not.

Certainly, for us as chaplains, I think we need to be much more intentional than we have been about engaging our patients and their caregivers in these larger issues for themselves. To the extent we can help patients explore whatever these kinds of questions are for them, we will help, not only make the decisions about Advance Care Planning, but create the lives that they want for themselves and those they love.

George Handzo, BCC, CSSBB
President, Handzo Consulting
Senior Consultant, HealthCare Chaplaincy