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Care For Serious Symptoms

Studies in breast care palliation—the One Hoss-Shay Project

From The Deacon’s Masterpiece (The Wonderful One-Hoss Shay)

By Oliver Wendell Holmes

Have you heard of the wonderful one-hoss shay,
That was built in such a logical way
It ran a hundred years to a day,
And then of a sudden it — ah, but stay,
I’ll tell you what happened without delay,

What do you think the parson found,
When he got up and stared around?
The poor old chaise in a heap or mound,
As if it had been to the mill and ground!
You see, of course, if you’re not a dunce,
How it went to pieces all at once, –

All at once, and nothing first, –
Just as bubbles do when they burst.

The overall goal of this project is to create palliative care patient and caring- physician user-friendly cell phone application and software packages to facilitate frequent monitoring of patients’ symptomatic status and caretaker action to improve this status. (To move palliative care for cancer patients in the direction implied by the classic poem—such that patients live with their symptoms well-controlled until close to the ends of their lives.)

Current Activities

During the year from August 2012-July 2013 we have two principle areas of work. First we are conducting a cross sectional study of the one-time use of a cell phone-based 15 item questionaire, the IBCRF symptom survery, and cell photo facial photos to assess current level of pain and mood, in 1000 men and women in Bangladesh, Nepal, South Dakota with Lakota Sioux Indians and in Wisconsin. Second we are completing development of cell phone applications to monitor 1. Activity levels, particularly of low level where patients are not walking much but spending large amounts of time sitting or in bed; 2. Sleep; and 3. Tissue perfusion and hemoglobin levels (non-invasively).

We anticipate having these cell phone applications for patients and complementary computer software for physicians to receive and organize these kinds of information in late 2013.


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