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Q. Why is it that I cannot read “the writing on the wall” and get out of this relationship? It makes no sense. I continue to chose the same kind of man. Why do I do this?

A. There actually is a reason you stay; there are probably many but the one that usually hooks us is the following: We continue to be attracted to people that trigger our unresolved childhood issues. For example: Katie came to counseling to talk about her controlling, non-nurturing mother. She described how her mother never praised her, encouraged her or offered any physical affection. Katie always wanted (and NEEDED) her mother’s love and fought hard to get it.
She described how, occasionally her mother would show an interest in her causing her to feel, “my mom does love me,” then push her away, once again feeling rejected. Katie lived her entire childhood with this mother-daughter dynamic.
When Katie began dating, what kind of men do you think she was attracted to…….if you said, “emotionally unavailable, loving then not so loving, controlling” you would be right. Katie did not have the emotional ability to choose an emotionally connected and loving man.
Katie’s father traveled most of her life and her relationship with him was loving but not in a very demonstrative way. He also played a very passive role to her controlling mother. So Katie was playing more of her dad’s personality in her relationships.
The “writing was on the wall” usually at the beginning of her relationships. She always found herself “fighting to be loved.” So it makes sense that when we continue choosing the same type of people to have relationships with……the results will always be the same.
Katie described the day she had what she called “an epiphany” and she realized the connection between her mother and the men she chose. She was able to gain more insight and learn that she was not stupid but under the spell of her childhood experiences that she played out in adulthood. We either play them out or go to the extreme opposite…..both being dysfunctional.
It is more difficult than it sounds to “let someone love us” when we don’t know how. But we can learn. We can find courage to let it happen. Until then, stop having those dysfunctional relationships until “your picker” is healthier.

Vicki L Mayfield, M.Ed., R.N., LMFT Marriage and Family Therapy Oklahoma City

If you would like to send a question to Vicki, email us at news@okcnursingtimes.com

FULL TIME STAFFING COORDINATOR
Village on the Park is hiring a Full Time Staffing Coordinator Monday-Friday, ACMA is required to join our AMAZING Family.
Apply in person at 1515 Kingsridge Dr., OKC 73170. Call Tammie, Director of Resident Care at 405-692-8700, or Email resume to tbohanan@rcmseniorliving.com

Miniaturized Heart Device Provides Patients with the Most Advanced Pacing Technology Available

INTEGRIS Heart Hospital is one of the first hospitals in Oklahoma to offer the world’s smallest pacemaker for patients with bradycardia. The Micra® Transcatheter Pacing System (TPS) is a new type of heart device, approved for Medicare reimbursement, that provides patients with the most advanced pacing technology at one-tenth the size of a traditional pacemaker.
The first procedure at INTEGRIS Baptist Medical Center was performed by Terrance Khastgir, M.D., a cardiac electrophysiologist with INTEGRIS Heart Hospital, on Aug. 7, 2018.
Bradycardia is a condition characterized by a slow or irregular heart rhythm, usually fewer than 60 beats per minute. At this rate, the heart is unable to pump enough oxygen-rich blood to the body during normal activity or exercise, causing dizziness, fatigue, shortness of breath or fainting spells. Pacemakers are the most common way to treat bradycardia to help restore the heart’s normal rhythm and relieve symptoms by sending electrical impulses to the heart to increase the heart rate.
Comparable in size to a large vitamin, physicians at INTEGRIS Heart Hospital have elected to use Medtronic’s Micra TPS because unlike traditional pacemakers, the device does not require cardiac wires (leads) or a surgical “pocket” under the skin to deliver a pacing therapy. Instead, the device is small enough to be delivered through a catheter and implanted directly into the heart with small tines, providing a safe alternative to conventional pacemakers without the complications associated with leads – all while being cosmetically invisible. The Micra TPS is also designed to automatically adjust pacing therapy based on a patient’s activity levels.
“This device will allow our patients to get the most advanced technology in pacing the heart for slow heart rate,” stated Khastgir.
The Micra TPS also incorporates a retrieval feature to enable retrieval of the device when possible; however, the device is designed to be left in the body. For patients who need more than one heart device, the miniaturized Micra TPS was designed with a unique feature that enables it to be permanently turned off so it can remain in the body and a new device can be implanted without risk of electrical interaction.
The Micra TPS is the first and only transcatheter pacing system to be approved for both 1.5 and 3 Tesla (T) full-body magnetic resonance imaging (MRI) scans and is designed to allow patients to be followed by their physicians and send data remotely via the Medtronic CareLink® Network.
The Micra TPS was approved by the U.S. Food and Drug Administration in April 2016, and has been granted Medicare reimbursement, allowing broad patient access to the novel pacing technology.

At the Stephenson Cancer Center, Mike Schuster receives weekly infusions of an experimental brain cancer drug developed at the Oklahoma Medical Research Foundation. (Photo courtesy Oklahoma Medical Research Foundation)
Since he began receiving infusions of OKN-007, Mike Schuster has grown strong enough to take his wife, Teresa, to dinner and to start working out again. ‘I feel really good,’ he said. (Photo courtesy of the Oklahoma Medical Research Foundation)

Last month, Sen. John McCain died from glioblastoma, a form of brain cancer. The same disease took the life of Sen. Edward Kennedy.
But here in Oklahoma, Norman’s Mike Schuster continues to live with the disease. As he nears the three-year anniversary of his diagnosis with the deadly cancer, he’s already doubled the life expectancy for patients with glioblastoma.
Doctors can’t say why Schuster has lived where others have succumbed to the disease. But they believe it may be because of an experimental drug he received—one that was developed by scientists at the Oklahoma Medical Research Foundation.
For Schuster, the first clue that something was awry came in the fall of 2015, just past his 50th birthday. While at work, he passed out with no warning.
He was rushed to the hospital, where an MRI revealed a brain tumor the size of a kiwi just above his right eye. “I’d been healthy all my life,” Schuster said. “No medical issues at all. I just couldn’t believe that this was happening.”
Of the more than 120 types of brain and central nervous system tumors, Schuster’s type, known as a glioblastoma, is the most aggressive. The standard treatment regimen involves surgery to remove as much of the tumor as possible, followed by radiation and chemotherapy. Still, the tumor almost always grows back.
With treatment, the median survival—which means half of patients live longer, and half die sooner—is 12 to 18 months. Only 1 in 20 glioblastoma patients will live five years.
In a procedure that lasted six hours, doctors removed as much of Schuster’s tumor as they could. When Schuster regained consciousness, his surgeon explained that he’d succeeded in excising most of the tumor. But, he said, like most glioblastomas, this one had “tentacles.” Tiny arms of the tumor had grown into surrounding brain tissue and could not be removed.
Schuster began follow-up radiation treatment at the Stephenson Cancer Center at the University of Oklahoma. Even though Schuster couldn’t feel the electromagnetic waves pulsing through his brain, “you could smell it,” he said. He also started chemotherapy, taking a pill called temozolomide. Together, the treatments were intended to kill the tumor cells that remained in the fissures of his brain.
“If you leave even a single cancer cell in the brain, it can regrow,” said Dr. James Battiste, the neuro-oncologist who oversees Mike’s care at Stephenson. “The brain is fertile soil for these tumors. That’s why chemo and other therapies are so important.”
Following radiation—doctors limited his treatment to six weeks for fear of triggering a secondary cancer—Schuster stayed on temozolomide. But just after the one-year anniversary of his diagnosis, an MRI revealed a new tumor.
A second surgery once again removed the primary tumor. This time, doctors kept Mike awake throughout the procedure to ensure they didn’t damage crucial areas of his brain. Still, many glioblastoma tentacles had escaped surgeons’ reach, remaining lodged in Schuster’s brain.
Schuster knew those tentacles were, in essence, seeds that could sprout another full-blown tumor in a matter of weeks. He told Battiste he was willing to try anything to beat back the glioblastoma. He’d read about clinical trials of experimental medications. Was there one that might help him?
Battiste, in fact, was testing a new drug that, he said, “just seemed suited for Mike.” It was an investigational medication for glioblastoma that had been born just down the block from Stephenson, in the labs of the Oklahoma Medical Research Foundation.
Known as OKN-007, the experimental medication was discovered by OMRF scientists Drs. Rheal Towner and Robert Floyd. In pre-clinical glioblastoma experiments, the compound dramatically decreased cell proliferation (spread) and angiogenesis (formation of new blood vessels), and it turned on the process of removing damaged cells so they can’t become cancerous.
“Those are the three major factors needed in a cancer drug,” Towner said. “This compound seemed to do all of them.”
Oblato, Inc., a New Jersey subsidiary of Korean biotechnology company GTreeBNT, has acquired the rights to OKN-007 from OMRF. It will move ahead with further trials of the drug in glioblastoma.
At Stephenson, Battiste has been cautiously optimistic about the performance of OKN-007 in Schuster and his other patients. “We’ve gone to the highest dosage levels the FDA would allow, and we haven’t seen any negative effects from the drug.” Although evaluating the medication’s effectiveness at stopping the regrowth of tumors is not a primary focus of the early phases of the trial, “it’s helpful to see things looking good” on this front, too, he said.
In August, Schuster celebrated his 53rd birthday. When he sees other patients with brain tumors, he said, they appear thin and frail. He, on the other hand, has added 15 pounds since beginning OKN-007 infusions. “I’ve had no side effects at all,” he said. “I’ve also been able to get back to the gym and am doing some yard work. I feel really good.”
He continues to travel to Oklahoma City each week for infusion treatments with OKN-007. “I really appreciate all of the support we’ve received from Stephenson and from people at OMRF,” he said.
While fighting glioblastoma has brought numerous challenges, Schuster said the experience has also revealed silver linings. “My friends and family and their prayers for me have turned into blessings.”
Of course, neither Schuster nor his doctors can know for sure if the drug is responsible for keeping his cancer at bay. Nor can they say if, or when, the disease might recur. “I can’t worry about stuff,” Schuster said, “that’s out of my control.”
Still, he feels certain he made the right decision when he opted to participate in the clinical trial. “Let’s just say I’ve been very blessed. It’s pretty cool how this stuff is working.”

Health care professionals, community partners and others interested in health care quality improvement in Oklahoma are invited to attend this free, in-person conference event, hosted by TMF Health Quality Institute, the Medicare Quality Innovation Network Quality Improvement Organization (QIN-QIO) in Oklahoma. The TMF QIN-QIO is hosting four free, in-person conference events throughout Oklahoma between September and November 2018. Attendees will have the opportunity to earn free continuing education credits (CME, 2A for DOs, CNE, Pharmacy and medical ethics and professional responsibility) while attending sessions on the following topics.
„* Examining the opioid crisis in Oklahoma „* Implementing motivational interviewing techniques to help patients make lasting changes * Identifying and treating patients with sepsis„* Reducing antipsychotic medication use in older adults across care settings
Receive free assistance with Merit-based Incentive Payment System (MIPS) reporting
In addition to attending the conference sessions, attendees will have the opportunity to meet with TMF quality improvement consultants throughout the conference and for an hour at the end of each conference day. TMF consultants will be available to answer questions and provide assistance with reporting for MIPS. TMF consultants will also be available to answer questions about any other TMF QIN-QIO task or project.
Event Dates: All events are scheduled from 8 a.m. to 4 p.m. CT
Wednesday, Oct. 17, 2018, Tulsa, Wednesday, Oct. 24, 2018, Lawton, Wednesday, Nov. 7, 2018, McAlester

The Association of Oklahoma Nurse Practitioners announced that early registration is now open for the organization’s annual conference. The conference will take place Oct. 17-19 at the Renaissance Hotel and Convention Center in Tulsa.
“After several years at the same venue, we wanted to give our members a new experience, and this makes the conference more accessible for those in the Tulsa area who couldn’t attend in the past,” said AONP President Margaret Rosales.
The annual AONP Conference has grown to host nearly 400 nurse practitioners from across the state. The conference will offer workshops and seminars on a range of health care topics, including hypertension, obesity, coding and reimbursement and legislative advocacy.
“This year’s sessions cover everything from keeping up with the latest advancements in medicine, to running a practice, to advocating for the profession in halls of the State Capitol,” Rosales said. “There will be sessions to benefit every nurse practitioner at every level of experience.”
Conference organizers are offering discounted registration rates for students and for AONP members. Early registration discounts continue through Sept. 30. Conference sessions will be submitted to the American Association of Nurse Practitioners and to the Oklahoma Board of Nursing for continuing education credits.
For more information or to register for the conference, go to npofoklahoma.com.

Melissa Walker, PA-C

SSM Health St. Anthony Hospital is pleased to welcome Melissa Walker, PA-C, to the urology practice of SSM Health Medical Group.

Walker earned her undergraduate degree in marketing from Oklahoma State University. She then went on to complete a Master of Physician Assistant Studies from Oklahoma City University.

The urology practice for SSM Health Medical Group is located at 608 NW 9th St., Suite 5000, in Oklahoma City. To schedule an appointment please call 405-772-4533.

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