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Not just for end of life: palliative care team helped Lucy navigate her second cancer surgery

After a difficult experience during her first surgery, cancer patient Lucy Swift turned to the University of Minnesota Health Palliative Care team to help her prepare for and navigate the next procedure.
Palliative care isn’t just for end-of-life situations. Our palliative care team helped cancer patient Lucy Swift confront her pre-surgery fears and manage her post-surgery pain.
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Lucy Swift, 57, was a believer in the power of palliative care long before she was diagnosed with cancer.

As a vice president for the Twin Cities PBS affiliate, Swift worked on documentaries about integrative medicine and palliative care. At the time, she didn’t know how important those topics would become later in her own life.

On May 17, 2017, Swift was diagnosed with a high-grade liposarcoma, a tumor in the muscle on the left side of her back. She received treatment at the University of Minnesota Health Masonic Cancer Clinic, where her care was coordinated by Hematologist/Oncologist Kevin Skubitz, MD. Her treatment plan included chemotherapy and radiation therapy to shrink the tumor, followed by surgery to remove it on February 20, 2018.

Orthopedic Surgeon Christian Ogilvie, MD, and Thoracic Surgeon Madhuri Rao, MD, removed the tumor and two small portions of the pleura, the membranes that surround the lungs. During the procedure, Ogilvie noticed a sticky substance behind the tumor, which was only visible after the tumor was removed. Samples from all of these were sent to the pathology lab for testing.

Our Cancer Care team includes specialized doctors, nurses, researchers and healthcare professionals who are committed to providing life-saving care for people with cancer. Learn more about our innovative, compassionate care.

An adverse reaction

The surgery was successful, but in recovery Swift had an adverse reaction to oxycodone, the powerful narcotic she used for pain control immediately after the surgery. Swift’s blood pressure fell to unsafe levels, and her team was unable to administer additional drugs. She endured for ten hours without pain medication. “On a one-to-ten pain scale, it was an 11,” Swift said.

After the first surgery, she met with Ogilvie to review the pathology results. He gave her devastating news: The original tumor had mutated into two forms of cancer. She would need another, even bigger surgery within weeks to remove additional cancerous tissue around her ribs. The information left Swift reeling.

“In the office, I was stoic. I wanted to survive, and we focused on the treatment plan,” Swift said. “The next day, however, I had the first true anxiety attack of my life.”

Swift called her cancer team and was immediately referred to the University of Minnesota Health Palliative Care service, which is led by Palliative Care Physician Drew Rosielle, MD.

Contrary to popular misunderstandings, palliative care is not just for end-of-life situations.

Instead, palliative care programs are open to all patients with serious medical problems who are struggling with quality-of-life issues. That includes patients who are receiving aggressive cancer treatment, like Lucy Swift. The services are tailored to each patient’s specific circumstances and needs. To identify those needs, the patient meets with the team for a detailed conversation about physical and emotional well-being.

“We address physical symptoms, and we also work with the patient and his or her family to provide mental, emotional and spiritual care as appropriate,” said Rosielle.

Our board-certified palliative medicine physicians, nurses, clinical social workers and spiritual health providers offer a range of palliative care options for people facing a serious, life-threatening illness. Learn more.

Developing a palliative care plan

Before her second surgery, Swift met with Clinical Social Worker Rachael Sarto, MSW, LICSW.

Sarto counsels patients who are experiencing serious illness. She teaches non-medication coping techniques for symptoms including anxiety, nausea, pain, trouble sleeping and fatigue. Sarto also supports her patients’ mental health and emotional well-being with cognitive behavioral therapy, mindfulness-based cognitive therapy, family therapy, and other approaches.

“When I first met Lucy in the palliative care clinic, she had just learned that she needed a second surgery,” Sarto said. “She was very anxious about managing her pain after surgery, and she was struggling with feelings of deep sadness around her condition.”

Swift was familiar with mindfulness meditation, so that’s where the pair chose to start. To help Swift cope with her anxiety, Sarto developed custom guided meditations for Swift to use, recording them so that she could listen to them at home.

The palliative care team developed a pain management plan to ensure that Swift’s pain would be controlled safely and effectively following her second surgery. She underwent the second surgery in April 2018, without any pain-related complications.

Immediately after the surgery, Palliative Care Nurse Practitioner Jill Schulte, NP-C, ACHPN, took charge of Swift’s pain management plan.

“There was an order in my chart that specified every part of the plan,” Swift said.

After she left the hospital, the palliative care team continued to support Swift. Kaitlyn McMullen, a care coordinator and registered nurse with the Palliative Care team, called Swift at home to conduct daily pain assessments. This partnership enabled Swift to take the stronger pain medication for as long as she needed it, then transition to over-the-counter pain relief options seamlessly.

“Thanks to the detailed discharge planning for pain management and the support of Kaitlyn, I went home with confidence. I was off the narcotic pain relievers in 10 days.”

Swift continued to see Rachael Sarto until December 2018. She remained cancer free for just over one year—time that she spent reveling in her new role as the grandmother. Though she has since experienced a recurrence of cancer, Swift is optimistic about her prognosis. She is once again working with Rosielle and Sarto to employ all of the coping and pain management skills she has learned from them.

“To have a pain management plan that supports both my body and my soul is remarkable to healing and comforting beyond words,” Swift said.


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