Working together to provide hope

Rachana Tamrakar doesn’t remember being transferred to the palliative care ward at St Vincent’s in September. The mother of two was unconscious and rapidly deteriorating after renal cancer had taken over her body and left her in agonising pain.

‘I was in a haze,’ Rachana says. ‘The cancer had spread to my spine and I was in so much pain.’

Upon referral, the palliative care and oncology teams began working together, enlisting the help of their radiology and anaesthetics colleagues also, looking at different medications and procedures to control Rachana’s pain and prescribing a new immunotherapy agent to provide relief.

Throughout the whole ordeal husband Dhiraj has been by her side. A few weeks into her stay, Rachana was transferred to a single room, with space for a trundle bed. Dhiraj has slept at the hospital ever since.

Rachana and her husband Dhiraj
Rachana and her husband Dhiraj

The couple never gave up hope. Thanks to the couple’s positive outlook, and the combined efforts of oncology and palliative care, Rachana has gradually and unexpectedly improved.

However there was a night in early October when Dhiraj admits he thought Rachana may not make it through the night.

‘There was a night when I thought it would be the last,’ Dhiraj says. ‘After that night she improved each day.’

‘At first, I was the only one who noticed a change,’ Dhiraj says. ‘But then after two weeks she was getting better day by day, and the doctors started engaging the physio, started engaging the dietitian and the rest of the team.’

The St Vincent’s team that looked after Rachana wishing her a good recovery as she left hospital.  The team includes, palliative care doctors, nurses, allied health specialists and pastoral care practitioners.
The St Vincent’s team that looked after Rachana wishing her a good recovery as she left hospital. The team includes, palliative care doctors, nurses, allied health specialists and pastoral care practitioners.

Reflecting on her time at St Vincent’s on the day Rachana finally gets to go home, she is thankful for the way the various treating teams worked together.

‘The oncology team and palliative care teams have worked really hard together. They consult each other, and us, to determine a plan. They discussed everything with us in detail.’

‘The nursing staff are awesome, literally awesome,’ Dhiraj adds.

Rachana’s recovery has surprised everyone, and Palliative Care Consultant Dr Beth Russell says it’s important for clinicians to keep listening and keep setting appropriate goals.

‘Rachana’s case is an example of very tailored, integrated care,’ Dr Russell says. ‘When you get a lot of different disciplines involved in a patient’s care early, you can solve problems in different ways and keep reassessing.’

‘Even when she was very sick, Rachana and Dhiraj remained hopeful, so it was about trying to make small victories in a very difficult situation. Then as she achieved more and more, you can then reassess and hope for more.’

Excited at the prospect of going home and spending time with her two sons, aged 13 and 6, Rachana has re-evaluated and set another goal.

‘My children are desperately waiting for me at home,’ Rachana says. ‘Every day they ask, are you coming home soon… they are very excited. My next goal is to lead a normal life – doing shopping and taking my kids to school. We will take small steps.’

Rachana will undergo scans in January to see if the cancer is in remission.

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