A survivor's story that underscores the impact of early intervention

In August 2014, Judy O. received a reminder from ARC's Family Nurse Practitioner, Sybil Haydon, letting her know that she was due for a Medicare Wellness Assessment. Judy tossed the letter onto the kitchen counter and forgot about it. Judy, an ARC patient for over 25 years, had recently seen ARC Rheumatologist, Anurekha B. Chadha who treats her for scleroderma.

"My bloodwork came back great and I was in good health so I didn't think I needed a wellness visit," Judy explains.

A couple of weeks later, she was cleaning the kitchen counter and came across Sybil's letter again. She decided to schedule an appointment with Sybil. It's a good thing she did. "That visit saved my life," she says.

The purpose of a Medicare Wellness Assessment is to review and evaluate the patient's health and to counsel and recommend preventive services where needed. Sybil, who has been seeing ARC patients for Medicare Wellness visits since 2012, talks to patients about issues that may impact their health, safety, and long-term care. She also makes sure patients are up to date on adult vaccines and screens them for illnesses, including: depression, high cholesterol, diabetes, and cancer.

Judy was impressed with her visit. "Sybil takes her time and does a wonderful job," she says.

Sybil told Judy that she seemed to be in great shape. "She said ‘your weight's good, your bloodwork is good. You eat well. You exercise.'" However, Sybil noticed Judy had not had a recent mammogram.

Judy, who was 76, hadn't had a mammogram because she'd read that the current recommendation was that women over 75 did not need routine mammograms. Sybil explained that the recommendation Judy was referring to applies to women who are at "average risk" for breast cancer, but "Judy had a significant family history of cancer."

Sybil performed a clinical breast exam. During the exam, Judy noticed that something changed on Sybil's face while she was doing the breast exam. Judy remembers. "After the exam, "Sybil spoke in a very calm voice and said, ‘I really think you ought to have a mammogram done. Let's schedule it and tag on an ultrasound, just in case you need one.'"

Judy scheduled the mammogram and ultrasound for the following day. After the procedure, she was told to wait in a small room. Soon, a radiologist came in and told her that she had tumor tissue in her right breast and in the lymph nodes on her right side. He recommended an ultrasound biopsy "immediately."

"It was Friday afternoon and I couldn't get an appointment immediately." Judy says. "I wasn't sure what to do so I went to Central Market and had an iced tea." Judy remembers feeling nervous. "I knew it was serious," she says.

The following Monday morning Judy saw her primary care physician, ARC's Derrick J. Garcia, who advised her to see a breast surgeon. After researching, she decided on Dr. Jane Nelson at Austin Cancer Center. Dr. Nelson diagnosed Judy with breast cancer and recommended chemotherapy to shrink the tumor, followed by a lumpectomy, and radiation.

The treatments lasted ten months. "It's never fun but you do what you have to," says Judy. Despite her illness, Judy was determined to continue doing the things she loved. One of them was to volunteer at Hospice Austin's Christopher House. "I loved visiting patients. I also enjoyed arranging the flowers that Whole Foods donated twice a week. But I was told that during chemotherapy I couldn't visit patients' rooms or work with flowers because both activities put me at risk."

Judy shifted her volunteer activities to office and phone work at Hospice Austin. "I kept that up the whole time," Judy says. Volunteering helped her to keep perspective. "It reminded me that I was not that bad off."

"My inspiration is my granddaughter Katrina," Judy says. "Katrina was diagnosed with colon cancer at the age of 20 and her motto was, ‘Cancer won't define me.' That was my motto too." At 26, Katrina, is cancer-free, has a master's degree in public health, and works at UT's Health Science Center.

One year after her diagnosis, Judy got another letter from Sybil for a Wellness Assessment. By that time, she had completed her cancer treatments. "I went right in and told her thank you," Judy says.

Twenty-one months after her diagnosis, Judy is in remission. She continues to volunteer at Christopher House and has returned to her former duties, visiting with patients, and arranging the donated flowers.

Judy is grateful to ARC for sending out reminders for Wellness Assessments. She says, "Without that letter in 2014, I would never have thought to go in." Judy says. "Thank you ARC."

Mostly, Judy is grateful to Sybil. "Sybil Haydon saved my life, she says. "I didn't think I needed to get a mammogram after the age of 70, or to do self-exams, but I was wrong."

Judy has become an outspoken advocate for breast self-exams. "I hand out the little shower hangers to every woman I talk to," she says. To date, two of the women she has educated about breast self-exams, have found tumors and are undergoing breast cancer treatment.

"I love people like Judy," Sybil says. "I do my best to talk people into early detection and prevention. Not only breast screenings but colonoscopies as well. We need to improve our rates of screening in this country. To catch things early in treatable stages.

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