Can We Talk: Organ Donation (The Basics)

Hey everyone – We are back with another Can We Talk series! *cues Tevin Campbell*

This time the topic is organ donation. Organ donation can have a bit of a bad wrap – especially among people of color. And that means there is no better timing for some candid conversation about the topic. This will be a three part series. Part one will give an overview of organ donation. Part two will be about common myths surrounding organ donation. Part three will be about the social media ethics and organ donation.

So let’s jump in!

What is organ donation? It’s giving one or more organs to an individual without compensation. You can also donate bodily tissues. Signing up is easy – you can either go to your their neighborhood motor vehicle association but you can also sign up online as well ( link here ). The benefit of signing up online is that you can decide which organs you would like to donate. If you have an organ donation card, that’s not enough documentation to make sure you are in the donor registry and such. You must go through either the MVA/DMV or online registry. If you change your mind about donating, you can remove yourself from the registered donors list at anytime. In most states, you have to be over the age of 18 to sign up for organ donation. Just make sure you let your family know that you are an organ donor, so there are no surprises. Also – organs aren’t matched by race or ethnicity (i.e. black recipients do not just get organs from black donors). Here is a list of organs and tissues that can be donated –

  • Heart
  • Kidneys (2)
  • Lungs (2)
  • Liver
  • Intestines
  • Cornea
  • Skin
  • Heart valves
  • Bone
  • Blood Vessels
  • Connective Tissues
  • Bone Marrow
  • Stem Cells
  • Umbilical Cord Blood
  • Peripheral Blood Stem Cells (PBSC)

There are two types of organ donation – deceased donation and living donation (totally not as scary as it sounds). There are about 125 million people registered up for deceased donation – but only 3 in 1000 can actually become donors upon death. There are only about 6000 living donations per year. SinceI live for a good diagram/chart – here is a plain language step-by-step for each type of donation –

DECEASED DONATION LIVING DONATION
·      You’re admitted to a hospital (severe illness or accident) ·      Evaluated by transplant center to make sure no negative physical or mental effects will come with the donation
·      The medical team does everything they can to save you ·      If everything is okay, the surgery is scheduled and competed
·      If you die and are unresponsive, the medical team runs tests for brain death ·      Your organ is transferred to another individual (Congrats you saved a life!)
·      The Organ Procurement Organization (OPO) and Organ Procurement and Transplantation Network (OPTN) are contacted and organs are artificially maintained until surgical removal
·      If the OPO and OPTN identify you as a donor and identify a match, organ is surgically removed for transplant

You’re welcome.

It’s really important to become an organ donor. There are about 119,000 people on the transplant waiting list list. Over half of the people on the list are minorities. Just over a quarter of minorities are deceased donors. But, statistics are moving in the right direction. In 2010, African-Americans have a higher organ donation per million compared to Whites, Hispanics, and Asians. It is the highest it has been and most of the improvement has been attributed to organ donation educational programs geared towards African-Americans.

We all know that knowledge is power. Knowledge about organ donation is crucial for minorities because we have real reasons for being mistrustful of medicine. But now we have current reasons to move past that mistrust. Anyone can wake up one day and need a transplant – a mother, father, or a sibling. In case you missed it – the transplant waiting list is long. I know I sound like a cheesy motivational speaker, but signing up does make a difference. You can potentially save eight lives by just making the choice to become a donor. Signing up to be an organ donor will give someone a new life, figuratively and literally.

Next week, we will tackle organ donation rumors!

Until next time,

The Neighborhood Bioethicist

 

HELPFUL LINKS

OrganDonation.gov – www.organdonation.gov

SOURCES

Callender, C. O., N. Koizumi, P. V. Miles, and J. K. Melancon. “Organ Donation in the United States: The Tale of the African-American Journey of Moving From the Bottom to the Top.” Transplantation Proceedings 48, no. 7 (September 2016): 2392–95. doi:10.1016/j.transproceed.2016.02.094.
“How Organ Donation Works, Organ Donation Information | Organdonor.gov.” Html. Accessed June 19, 2017. https://www.organdonor.gov/about/process.html.
O’mally, Aisha K., and Tracy R. Worrell. “Statistics or Stories, Black or White? Examining Influences of African American Organ Donation.” Howard Journal of Communications 25, no. 1 (January 2014): 98–114. doi:10.1080/10646175.2014.864209.
“Organ Donation.” Encyclopedia Britannica. Accessed June 20, 2017. https://www.britannica.com/topic/organ-donation.
Quick, Brian L., Nicole R. LaVoie, Allison M. Scott, Dave Bosch, and Susan E. Morgan. “Perceptions About Organ Donation Among African American, Hispanic, and White High School Students.” Qualitative Health Research 22, no. 7 (July 1, 2012): 921–33. doi:10.1177/1049732312439631.
Robinson, Robinson, and Dana H. Z. Robinson. “Understanding African American’s Religious Beliefs and Organ Donation Intentions.” Journal of Religion and Health 53, no. 6 (201412): 1857–72.

Compassionate Care: The Icing, Swagger, and Finesse.

(A special thank you to Autumn Fiester – the professor who made sure we knew that healing physical ailments is just the first step. Compassion and empathy changes everything.)

Get comfortable cause we are having story time.

I was running to my Uber, trying to avoid an additional charge and my driver leaving me, when I rolled my ankle. But by the time I sat down in the car, the pain had subsided. So what did I do? I went about my day – rock climbing, grocery shopping, and to a networking event. But by the time I got to the networking event, I was in excruciating pain. I embarrassingly (and literally) dragged myself out of the event and asked the security guard where I could easily catch an Uber to go to my neighborhood urgent care. He took one look at my face and suggested that I go to the hospital across the street instead.

So I staggered to security desk in the hospital to ask for directions to the emergency room. What the security guard didn’t know was that I am terrible with directions and got lost within five seconds. Picture this – a random black girl, dragging herself down a hallway, half-fussing with my parents on the phone to tell them I was fine, and half-gasping in pain – clearly not fine, in a hospital in a new city. I looked a hot mess. Definitely not that polished-networking-ready-black-girl magic-powerhouse I was when I walked in (y’all better let me feel myself in peace – I was killin’ it before my injury.)

I finally waived down a hospital employee in a suit to see if I was any closer to the emergency room. He looked at me, apologized for my pain, apologized for the length of the hall, and sent me down said hall in the direction of the ER. I told him thanks and kept staggering. I went a little further and waived down a woman in scrubs to see if I was going in the right direction again. I also mentioned that I was pretty sure that I had sprained my ankle. soon She similarly apologized for my pain, looked at me in pity, and told me to keep walking down the same hallway and that the ER was further down. I thanked her and kept staggering.

Right after that, a younger woman in business attire stopped me and said she overheard me talking to the woman in scrubs. She said there were a set of stairs coming up soon and asked if I needed help. I almost shouted yes because I had no idea how I was going to get down the stairs with the pain. She helped me down the stairs, got me a wheel chair, and wheeled me the rest of the way to the ER – which was much farther away than I thought. She got me inside, made sure I was properly settled into the ER, and waited until the nurse called me in. I asked her name and her position at the hospital – she said she was an administrative assistant. Not a doctor or a nurse, but an administrative assistant. To be truthful, I had too much pride to ask for a wheelchair myself even though I needed one. But this woman looked beyond my exterior willingness to struggle and identified my need immediately. And she literally didn’t have to – it was not in her job description to help me. But her choice to show me compassion was the difference between a very miserable and lonely evening and one where I left the ER with a smile.

I have worked and studied at community hospitals and academic teaching hospitals – with my fourth location coming up this summer. My bioethics’ professors always pushed the importance of advocating for compassionate care in medicine. But for the first time in my life, I experienced why compassionate care matters. Here’s the truth – everyone who I spoke to at the hospital had the same agenda of making sure I received the care I needed. When I left the hospital, I got the ankle brace, the crutches, and the painkillers. So the job got done. But I was impacted the most through the compassionate care I was given. It’s the difference between a suit off the rack and a custom made suit. Intentional compassionate care is the icing, the swagger, and the finesse. It takes healthcare from ordinary to extraordinary. You could always get away with providing ordinary care. After all – the goal is to get patients’ healed efficiently and effectively. But I would dare say that side-stepping compassionate care is just mediocrity with a nicer name. Why not take it to the next level?

Cake with icing tastes better. Presence with swagger looks better. A touch with finesse feels better. Healthcare with compassion – well just is better.

Recovering from a Sprain,

The Neighborhood Bioethicist

 

Why You Need a Health Accountability Partner.

True confession: I hate going to the dentist. I don’t like the sounds of the tools, the toothpaste they use tastes gross, and God forbid if my sensitive teeth need a filling *insert scrunched up face emoji*. Mind you, I am totally grateful that I actually have dental insurance. But hey – some people don’t like their vegetables. I don’t like the dentist. It’s a personal problem. Lately, I have noticed that I am less and less motivated to try to go to the dentist. Life gets busy and you realize that you don’t even like going – so you don’t make an effort to go. But I also don’t want to be 90% gums before I’m 30 and should therefore drag myself to the dentist. Talk about a internal conflict of interest.

There are so many reasons why people like myself don’t insert themselves into the healthcare system. Here are the statistics according to a 2015 study:

  • Traditional Barriers (High Cost of Healthcare, Not enough time, Lack of Insurance, Inconvenient Hours) – 58.4%
  • Unfavorable Evaluations of Healthcare (Physician factors, Fear, Organizational factors, Expected negative results) – 33.3%
  • Low Perceived Need to Seek and Medical Care – 12.2%

The study theorizes that all of these factors create general avoidance of the healthcare in the  United States. Some of these factors a person can control (like fear). Some of these factors we can’t (like cost). But tackling these issues can be easier if you have a health accountability partner. A health accountability partner is someone in your life that makes sure you are really taking care of yourself and vice versa. They can be a sounding board and a general resource for you. Health is more than healthcare – it’s your well being and your day-to-day sanity. Here are some other benefits of including someone else in your journey to better health.

  1. It is making you a priority. Whether you are a millionaire or have $0.05 in your bank account, self-care is crucial and should be a priority. Self-care is a huge part of your health in general. Eating well, drinking water, sleeping, seeing your doctor, getting your exercise – all of that goes in that category. Also, these are preventative as well (and preventative care is easier on the pocket than buying medication). Of course, self care can be done alone. But having another person checking to see if you are taking control of your health can help motivate you to really make a difference in your life.
  2. Support is a good thing. No man is an island – everyone needs support and community. Speaking to the black community, we usually keep a dual mindset. On one hand, we believe it take a village to create an edifying community. We love our extended families and we tend to raise our children in community. However, there is also the mindset that we have to always be looking out for ourselves and it is a sign of weakness to ask for help. Support is not a sign of weakness. It is a sign of strength and self-realization. You cannot carry the weight of the world on your shoulders – it will break you eventually. A healthcare accountability partner can help provide support in a very sensitive area of your life.
  3. It provides a safe space. The great thing about having a healthcare accountability partner is that it’s a no-judgment-zone. You can be honest when you are scared. You can ask weird questions. You can compare eating and exercise habits, get their opinions on different doctors, and learn about insurance options. Two minds are better than one when it comes to health. General health and healthcare is hard to navigate. If both of you are just trying to learn how to live healthier lives, there are no dumb questions. Matter of fact – everyone learns by asking questions. So it pays to have a place when you can.
  4. Sharing experiences helps normalize healthcare conversations. We have to get better at talking about health and talking takes practice. In the African-American community specifically, oral tradition has historically been used to educate, preserve, and to connect. I think ancestors had the right idea. Talking about healthcare with someone else fosters connection and knowledge. Learning how to talk to someone while they keep you accountable helps you learn how to hold others accountable. Sharing stories is essentially starting a dialogue. And the more you talk, the more normalized the conversation becomes.

In essence, obtaining and maintaining good health is harder alone. We all need people who will be in our corner, keep us informed, and fight for us to be better – even when we don’t want to be. For me, I have a circle of about six people where we all rejoice in our health victories and ask questions when we are lost. But it can also be just you and one other person who makes sure that you see your therapist once a week like you promised. Whoever you pick just know that you don’t have to do life (or your health) alone.

Sitting amongst friends,

The Neighborhood Bioethicist

 

SOURCES

Almendrala, Anna. “Here’s Why Men Don’t Like Going To The Doctor.” Huffington Post, June 13, 2016, sec. Healthy Living. http://www.huffingtonpost.com/entry/why-men-dont-go-to-the-doctor_us_5759c267e4b00f97fba7aa3e.
Khazan, Olga. “All the Reasons Women Don’t Go to the Doctor, Other Than Money.” The Atlantic, May 15, 2014. https://www.theatlantic.com/health/archive/2014/05/all-the-reasons-women-dont-go-to-the-doctor-other-than-money/370952/.
Taber, Jennifer M., Bryan Leyva, and Alexander Persoskie. “Why Do People Avoid Medical Care? A Qualitative Study Using National Data.” Journal of General Internal Medicine 30, no. 3 (March 2015): 290–97. doi:10.1007/s11606-014-3089-

Can We Talk: Family Health History – Part 2

Hi guys! So this is Part 2 in the Can We Talk series. In the first post, we talked about how to start a conversation with your family about family health. If you haven’t checked out Part 1, read it here! This particular post will focus the actual meat of the conversation. Like I mentioned in Part 1 – we will talk about mental health and having effective conversations about the that soon. But I’m saving that for a separate post so we can really go in depth on the topic. So on with the questions!

  1. Ask about the relatives you do not know. Both of my grandfathers are deceased. One of them I knew very well, but  I never knew the second one. I know that I am not the only person who has a similar story. This is a good time to ask about the grandpas and grandmas and aunts and uncles that you have never met. You can ask about their health directly, but a lot of information can be gleaned just from stories. And story telling is way easier on the stomach than some of the heavy duty conversations.
  2. Ask about sicknesses you know/heard about in your family. I’m sure there are some health challenges that you already know exist in your family. So if your aunt had a heart attack or if your dad has high cholesterol, try to ask questions that give you clarity about what that specifically means for them. Questions like, “when did X start?” or “Does Auntie just have X or do you think Uncle has it too?” It’s also not a bad idea to do some basic Googling. I’m not advocating for diagnosing yourself – thats a health care professional’s job. But just like you Google quick questions for basic knowledge, you can do the same here.
  3. Ask how often they go to the doctor/emergency room/urgent care. Now this is a touchy one. Seeing the current state of healthcare in this country, everyone doesn’t just go to the doctor. Shoot, I use my local urgent care all the time because I am between doctors. But – it’s important to get an idea of how much of your family’s health is being managed on their own. It can also give you an idea of if they are managing on their own by choice or by circumstance.
  4. If/when they go to the doctor, what do the doctors say about their health. This a pretty self-explanatory question. You want to get an idea of where your family’s health currently is. Blood pressure, diabetes, anemia, predisposition to other diseases. – all of the general information a doctor can give you.
  5. Medications – what they are being prescribed, taking, or not taking. This is also a good time to find out what medications your folks are currently using or have been prescribed. This is obviously sensitive cause they may not want you to know what they are taking (or not taking!). But it is important to just put it out there and see where the conversation can go. Its valuable information to have on hand. Don’t forget to ask about the side effects!
  6. What kind of health paperwork does your family have on hand. Its important to know what kind of paperwork your family is working with. For example – my mom is the queen of copying. We have copies of literally every medical visit for a scraped knee since the 90s. But if thats not your story cause you aren’t my mother or if your family had extenuating circumstances (i.e. fire, flood, lost while moving) this is a great time to figure out where you and your family stands. So, do your parents have insurance? Shoot – do YOU have insurance? Paper documentation of vaccinations? Copies of medical records? Advance Directives? If you do have it – Great! If you don’t have this information, now you know in advance and can actually get a handle on it before an emergency.
  7. Listen, Listen, Listen! Granted this is a list of questions to ask, but I think it is just as important to really listen during these conversations. You are asking your family for information because they know a bit more than you. Seeking knowledge requires an open heart, mind, and ears.

Of course ya’ll are free to embellish or streamline this list – these are just suggestions. Just like any conversation, once it starts to move, questions and comments will happen organically. And again –  this isn’t usually a one time conversation. You may have to pick it up a few times. But I hope you liked the series and good luck with your family chats. Candid conversation and communication are the keys to growth and progress.

Good luck,

The Neighborhood Bioethicist

Can We Talk: Family Health History – Part 1

I’m obsessed with 80s and 90s R&B. Give me some Mint Condition and New Edition and I am fully in my happy place. One of my singing-and-dancing-in-the-shower favorites is Can We Talk by Tevin Campbell. If you ever have the pleasure of seeing me (preferably not in the shower) when this song comes on, I’ll probably look like this:

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Don’t judge me. It’s a classic.

It’s also the perfect way to bring up this topic of family and health. How do you talk to your family about their health? Being a 20-something, I struggle with this. I was raised under the premise that “I ain’t grown” and health is “grown folks business.” But as I got older, I realized that your family’s health is really your business – regardless of age. Your parents’ health issues can easily and usually do become yours. It doesn’t benefit anyone for you to wait until these issues manifest themselves on their own. So how to you ask the hard questions to the folks who usually ask YOU the hard questions? This is gonna be a two part answer. Part 1 will give suggestions for how to start the conversation and part 2 will focus on specific questions to ask once the conversation is started. We won’t address mental health in these posts. Thats a completely different conversation with separate issues. But don’t worry – I definitely didn’t forget about the topic! So on to the conversation starters –

  1. One way to start the conversation is to just ask. Hey, sometimes being direct is the way to go! Give your mom a call and just say, “Hey mom can we talk? I want to know a bit more about our family’s health.” Keep it simple out here.
  2. You can ease in by emphasizing that you want to know what you are getting into as an adult. If the direct approach isn’t your thing, you can always try the “I’m getting older and more responsible approach.” We all know family usually will appreciate a willingness to take on more responsibility. So you could say, “Hey dad. So you know that I’m getting a little older now and I’m trying to be a better me. But part of that is me taking more responsibility for my health. Can we talk about grandma? I know she was sick last year…”
  3. Another way is to ask a trusted member of the family who may have insight. Maybe your family won’t be ready to talk about health right away. Or maybe you are not comfortable talking to your parents/guardians because you are afraid of how they will react. If that’s the case, you can also ask a close family member or family friend that you can trust some of these questions. That’s always nice because they may have insight into why your folks may be avoiding the topic and can still be an objective source of information. Then you can gradually work your way to talking with your immediate family.
  4. Be HUMBLE. As Jesus and Kendrick taught us – be humble. Family health history is touchy, touchy, touchy. Remember, you don’t know how your family’s health may have hurt or negatively impacted the person you are asking. There could be feelings of shame for not sharing information earlier. So be humble. It’s great that you are taking initiative on your health, but make sure you think about how this conversation can effect the people you are asking.

Starting the conversation is the first part of the process. It may not solve every problem or answer all of your questions right away. But it is always worth a try. These are suggestions of course and I hope they help!

Happy Chatting,

The Neighborhood Bioethicist

Welcome to the Neighborhood Bioethicist!

Hi everyone! Welcome to The Neighborhood Bioethicist. If you aren’t just reading out of sheer support for my hopes and dreams, I’m sure you are wondering 1) what is bioethics and 2) what is the point of this blog?

Bioethics is literally what it says – the ethics of biology. It covers topics of autonomy, beneficence, justice, nonmaleficence, history, and moral philosophy. This is all a fancy way of saying that bioethics makes sure that you are treated with respect and justice. When it comes to healthcare, bioethics makes sure that you can do what you want with your body, be informed every step of the way, and ultimately live a more healthy life. And you should have access to that – because good health is a game changer.

Ten percent of me created this blog because I am tired of responding to the classic – “You have a Masters in WHET. What does bioethics even mean?.”  All jokes aside, I mainly created this blog because I am passionate about having candid conversations about life, bioethics, and health. How do I encounter bioethics on a day to day basis? What does good health look like? Why do I view healthcare this way? So part of content of this blog will be general bioethics information and commentary. We will chat about bioethics in every day life. Bioethical issues on TV, in the news, or on social media are up for discussion. However, part of this content will also talk about health and healthcare in general. As a person of color, it is even more critical that we have more candid conversations about life and health. The reality is that the historical relationship that people of color have with healthcare has been more than rocky. That means that we have more fear in our communities of the healthcare system, less information about the said system, and a lowered chance of finding good health.

Navigating healthcare and bioethics isn’t easy, but it doesn’t have to be insurmountable. At the end of the day, all of us are trying to get well. At some point, we won’t just be responsible for our own wellness – but also the wellness of others. And if we want to get well, we gotta be willing to talk about what “getting well” means.

That’s what The Neighborhood Bioethicist is about. Sitting on your front steps and just having a good talk with your neighbor, friend, or family member is informative and healing. Real conversation builds bridges and life is too short to be uninformed. So let’s sit on the steps and talk.

Come chat with me,

The Neighborhood Bioethicist