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February 2012 Archives

Counting for a Cure

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pennykids.jpgBy Victor Scott, MD Anderson Staff Writer

Pennies on Monday, nickels on Tuesday, dimes on Wednesday, quarters on Thursday and counting on Friday.

It's called "Coins for a Cause." Four times a year students at the Harrison Avenue Elementary School in South Glens Falls, N.Y., scour for loose change to bring to school for this fundraising tradition.

"Our 'Coins for a Cause' program is exciting not only because we're raising money, but also because it teaches our students to be caring, compassionate citizens," says Alissa Bevivino, student council sponsor.

For each of the four fundraising coin drives, members of the fifth-grade student council are encouraged to campaign for a cause they feel is important to support.

During the week of Jan. 31, 2011, the students collected $680 in coins and chose to honor their beloved former principal, Jim Baker, by donating to MD Anderson's lymphoma research.

Kids support search for a cure
In 2008, Baker was diagnosed with mantle cell lymphoma and began treatment at MD Anderson. The students' donation supports research led by Baker's physician, Larry Kwak, M.D., Ph.D., professor and chair of the Department of Lymphoma/Myeloma at MD Anderson.

By Janet Ruffin

whenlifeturns.jpgJanet Hull Ruffin is an artist, arts educator and poet. She is finishing a book of poems showing what it's like to work with critically ill children in a major cancer center. She focuses on hospital culture, the therapeutic nature of art and spirituality.

I retired from MD Anderson in January 2009 after serving as the art teacher in the Children's Cancer Hospital for more than 10 years. My position was special because the time I spent with patients and their families was not about diagnoses, examinations or treatments. We made art together. Currently, I volunteer with the Children's Art Project working with pediatric patients.
 
I used to work at the Harris Country Juvenile Detention Center, so I was accustomed to making art with children in crisis and to working in intense situations. Nevertheless, I wasn't prepared for the emotional ups and downs I felt when working with children beset by serious illness. I also wasn't prepared for the grief and anxiety I felt for their parents.

Shifting emotional energy
The creative process has always been my passion, and I'm amazed at how quickly the simple process of making art can shift emotional energies.

It doesn't matter whether it's painting, drawing, writing, dancing, making music, shooting photography or cooking. Whatever creative activity takes you out of yourself for a time will work.

andrewalking.jpgBy Andrew Griffith

Andrew Griffith has mantle cell lymphoma and has had an auto (November 2009) and an allo (August 2011) stem cell transplant. He lives in Canada and is married with two young adult children. He blogs at www.lymphomajourney.wordpress.com and can be followed on Twitter @lymphomajourney.

We all grapple with what kind of recovery and rehabilitation we should follow after cancer treatment. While one's general health, age, treatment and other factors determine what's doable, the key thing is to find a program that works for you, getting you as active as possible.

In addition to keeping in touch with friends and family (so important on the emotional side), my experience during two transplants has taught me the following:

  • Know what you like to do: It's trite, but if you like doing something, you will do it. Before cancer, what was your exercise routine? What were your hobbies? Your interests?

    Assess these against what you and your medical team think is realistic. Likely, you will need to scale back and allow for more time to rest.
  • Develop a routine, but don't be slavish: I found it easier to have a general routine of regular sleep, including naps, time for working on my blog and other projects, and walking. While clinic visits and events interfered, it gave me some structure and focus.

  • Start with walking: The easiest form of exercise is walking, and all the evidence suggests that half an hour of walking each day gives most exercise benefits. Walking can be done alone or with family and friends, giving you more connection time. It's easily scalable. When I'm feeling weak, short walks just to get me out of the house help. When I'm stronger, I take longer walks for more exercise.

By Alejandro Chaoul, Ph.D., and Lorenzo Cohen, Ph.D.

meditationfeb24.jpgThe belief that what we think and feel can influence our health and healing dates back thousands of years. The importance of the role of the mind, emotions and behaviors in health and well-being was part of many ancient cultures, from the Greeks to the Chinese. 

When people are in a state of stress, we enter what some Tibetan teachings call the "monkey-mind" mode; our minds go from thought to thought and emotion to emotion, like a monkey travels from branch to branch.  The monkey-mind pervasive even when people are not experiencing stress. 

When experiencing stressful life events -- situations that pose challenge, harm, loss, or lack of control -- the monkey-mind is our default and our fight-or-flight instinct takes over, and increases stress levels even further.

The fight-or-flight response is useful in managing acute stressors, but when the stressors become chronic the response becomes destructive to our health and overall functioning. 

Chronic stress literally has a negative effect on every physiological system in the body. It has been well documented that stress influences all cells in our body -- changing gene expression and the tumor microenvironment to create a more hospitable terrain for tumor growth.

cohenprofile.jpgLorenzo Cohen makes breakfast for his family every morning.

But not for him the easy lure of cereal and milk, pancakes or bacon and eggs.

"Most mornings, I sauté vegetables -- broccoli, cauliflower, Brussels sprouts. I look in the fridge and see what we have, and cook it up with seasonings," he says.

His three young children "love it," he adds. "It disappears in a second and, in fact, my children will not eat their eggs without veggies mixed in."

Cohen, Ph.D., professor in the departments of Behavioral Science and General Oncology, also directs MD Anderson's Integrative Medicine Program.

As his choice of breakfast foods implies, Cohen is an unabashed promoter of a healthy lifestyle. He meditates, practices yoga and carefully chooses what he eats and drinks, sticking to a mainly plant-based diet, whole grains and no sugar as much as possible.

Changed by year in Italy with grandmother

He started out a typical, meat-eating kid, then teenager. "I worked as an assistant butcher when I was in high school," he says.

He didn't get serious about watching what he ate until he went to live with his grandmother, Vanda Scaravelli, in Italy for a year when he was 24. She was a yoga master and a vegetarian. Cohen joined her in a daily yoga practice and gave up meat for the whole year.

The experience gave Cohen insight into how lifestyle changes can help people strengthen their defenses against cancer -- getting it, or having a recurrence.

By Will Fitzgerald, MD Anderson Staff Writer

avastin.gifLast week, the maker of the widely used cancer drug Avastin, issued a warning that a counterfeit version of the drug was discovered in the United States. The announcement revived concerns among hospital officials, government regulators, doctors and patients about the growing threat of fake drugs.

Upon learning of the notice, MD Anderson pharmacy staff examined their supply of Avastin and confirmed that none of the counterfeit drug was found on the main campus, or in the regional care centers. As an additional safety procedure, pharmacists contacted their wholesale provider and determined that none of tainted drug entered the supply chain that MD Anderson purchases from.

AR Graphic 4.jpgIf you had to design a space that appealed to a 5-year-old as well as a 25-year-old, what would it look like?

That is exactly the question architects, patients, volunteers and parents have worked to answer for the past year about the renovation of MD Anderson Children's Cancer Hospital.

Along the way, they've learned that having access to an abundance of electrical outlets is as important as hot coffee. Primary colors aren't as kid-friendly as originally thought.

Inpatient rooms should be equipped with more storage, and sicker patients want a quiet space to wait separate from healthier patients. In addition, young adults want their own unique area to hang out with peers.

Architects partnered with parents and patients to get the new pediatric floor design right, meeting with the hospital's Adolescent and Young Adult (AYA) Advisory Council and Family Advisory Council to get feedback on plans and concepts.

A bedside perspective

Lymphoma survivor Greg Alquiza, 25, voiced his suggestions for the new pediatric inpatient floor to architects at the AYA Advisory Council meeting in June 2011.

"For me, I wanted to see more inspiring stories on the walls about survivors my age," Alquiza says. "It's also important to have creative ceiling décor in the rooms and large artistic structures around the hospital that give patients something else to think about besides their condition."

fighting cervical cancerBy Sarah Pants

On July 19, 2011, I was diagnosed with cervical cancer. It was a Tuesday and I received a call from my gynecologist asking me to come in that afternoon to discuss the test results from a recent biopsy.

After an abnormal pap test, I knew the news couldn't be good. So, I called my mother and asked her to meet me at the doctor's office for moral support during the appointment.

I wasn't expecting the diagnosis I got.

I tested positive for the HPV virus years ago, but I never had any symptoms, and at times my exams came back with no evidence of HPV.

I'd undergone cryocautery once to freeze out some abnormal, pre-cancerous cells soon after the initial HPV positive test results. But my doctor informed me that those cells would need a decade or longer to become cancer cells.

I figured my test results consultation would be along these lines, perhaps one or two steps beyond this stage. I hadn't had a well-woman exam in a few years, but it hadn't been anywhere near the 10 years my previous doctor said those cells would need to become cancerous.

The 'C' word

I joked with Dr. Brian Blonder about being OK with the idea of never having to deal with another period. But I was confused when he replied that I'd never have to worry about that again. Then, he said the word: cancer.

Way back in 1991, longtime volunteer George Vietor had an idea. More than 20 years later, that idea has become a multi-million dollar source of support for MD Anderson patients and caregivers.

Heart_movement.jpgWith an original goal of building an endowment to $1 million in 10 years, the target was achieved in just nine years. Under the guidance of the Department of Volunteer Services, the Volunteer Endowment for Patient Support (VEPS) now stands at more than $2.6 million.

Each quarter, the interest generated from the endowment is returned to fund patient-oriented programs and services at MD Anderson. VEPS has disbursed more than $1.8 million since 1992.

In 2011, 33 programs received a total of $287,229. Among the programs that benefited are:

marybell.jpgWhen Mary Belle Wooddy began volunteering at MD Anderson Children's Cancer Hospital, the five-year survival rate for children with cancer was less than 60%. Wooddy, who has volunteered in the pediatric playroom for 35 years, has seen that survival rate rise to 80% along with a lot of other changes at the hospital.

Now, the 83-year-old resident of the Memorial area in Houston has hung up her blue volunteer jacket at MD Anderson. She's leaving behind hundreds of smiles she has brought to young patients' faces and is taking with her as many memories.

"I don't see myself as anybody special," Wooddy says. "I just hope I have helped the patients and parents a little along the way."

Making a difference
When Wooddy moved to Houston in the 1970s, she was looking for a way to contribute. She soon found that opportunity with her Tri Delta sorority alumni chapter, which had begun a pediatric volunteer program at the Children's Cancer Hospital.

Wooddy recalls that initially when she volunteered, the Children's Cancer Hospital didn't have a playroom designated for children.

"We would purchase toys as a sorority and play with children in the hospital stairwell, while they were waiting on doctor appointments or treatment," she says.

Since then, the importance of play has become a central focus for the children's hospital. With support from MD Anderson Children's Art Project, the Child Life Program was launched and a playroom was built in the pediatric outpatient clinic. Wooddy continued to volunteer and worked alongside child life specialists playing board games and making arts and crafts with the children.

By Johnny Rigg, MD Anderson Staff Writer

Massachusetts.jpgMaking people laugh is the inspiration behind 13-year-old Shelby Taylor's book, "America the Funny," a collection of puns and riddles about the 50 states.

In July 2010, Shelby was a patient at MD Anderson Children's Cancer Hospital when Martha Askins, Ph.D., associate professor in the Department of Pediatrics, noticed her.

"I started seeing Shelby in psychotherapy. She had acquired some side effects from the treatments, but she had certain well-developed functions -- her sense of humor and her spontaneity," Askins says. "She's very creative and thoughtful."

Askins believed that the young girl would benefit from the Arts in Medicine Program, where the primary goal is to foster joy through artistic expression.

"She had an amazing sense of humor, even as a little kid, and was always good with playing on words," says Diana Taylor, her mother. "She was writing stories at 5 years old. We have journals full of them."

Askins put Shelby in touch with Arts in Medicine Program Director Ian Cion.

"I'd meet with Shelby to work on illustrations for sessions that usually lasted about an hour. As we got closer to completion, we'd often work several hours at a time, going back and forth with drawings and ideas," Cion says.

carlaandedfinal.jpgBy Carla Fallick

Carla Fallick is the daughter of patient at the MD Anderson Regional Care Center in Katy. She works and lives in New York City and when her father was diagnosed with oral cancer, she came up with creative ways to help him get through cancer treatment.

About a month ago, when life seemed to be going as perfect, as it could for a carefree 23-year-old living in New York City, my dad was diagnosed with oral cancer.

Initially, I was shocked. I just couldn't believe it. My dad, my hero, my rock and the strongest, kindest, most intelligent man I know has cancer. How could this be?

I had never been so scared.

The only way I can describe my emotions, since that day, is like riding on a roller coaster. I have my ups and downs that all depend on how my dad is feeling that day.

One of the hardest things about having a loved one with cancer is feeling helpless. You know you can't do anything to change his diagnosis and you wish you that you could receive the treatment for him so he wouldn't have to go through it.

Tips to make the journey easier
Here are some suggestions, based on my experience, for helping a loved one cope with cancer:
1. Offer support. Whether it's a quick phone call or a home- cooked meal, figure out what that person needs and offer it to him.

Methotrexate.jpgA news story recently in the New York Times has unveiled a growing concern among pediatric oncologists and health care institutions at large. The injectable form of preservative free methotrexate, commonly used to treat pediatric patients with leukemia and osteosarcoma, is in short supply.

The bigger drug shortage picture
Drug shortages are an increasingly frequent and serious problem affecting health care organizations across the country. 

"A number of contributing factors are causing these shortages, such as raw material unavailability, manufacturing difficulties and regulatory issues, voluntary recalls related to manufacturing problems, changes in medication formulation, and industry consolidations and economic decisions," says Wendy Heck, Pharm.D., manager of drug information and drug use policy at MD Anderson Cancer Center.

Regardless of the cause, drug shortages create great frustration for everyone involved, including purchasing agents, pharmacists, nurses, physicians, and patients. Fortunately, not all national drug shortages will go on to affect MD Anderson. 

"We meet weekly to review current drug shortages. If a shortage does reach MD Anderson, our team works diligently to develop a management plan to minimize the impact on our patients," says Joel Lajeunesse, vice president of the Division of Pharmacy. "For now, we have sufficient supplies of methotrexate for our patients."  

AR Graphic 3.jpgBy Mary Jane Schier, MD Anderson Staff Writer

Andria Schibler hopes the yeast she uses every day will do much more than make bread dough rise. Her ultimate goal is to help improve leukemia patients' survival.

Instead of a kitchen, Schibler works in a laboratory at MD Anderson's Science Park in Smithville, Texas. Her tools include test tubes, incubators and beakers.

Schibler, whose parents were both school teachers, intended to be a marine biologist when she went to Suffolk University in Boston, where she earned a bachelor of science degree in biology. But during an internship at Harvard Medical School/Massachusetts General Hospital, she got hooked on molecular biology.

"After learning about MD Anderson, I applied to GSBS (Graduate School of Biomedical Sciences) ... and moved to Houston in August 2007. I've never been so hot," she relates.

Schibler took rotations with several MD Anderson scientists who train students at GSBS, which is jointly operated by MD Anderson and The University of Texas Health Science Center at Houston. She was delighted when Sharon Dent, Ph.D., then professor of biochemistry and molecular biology, agreed to be her mentor.

When Harry Met Marie

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whenharry.JPGHarry Moore, an 84-year-old leukemia patient, never thought he would get remarried after his wife of 66 years passed away two years ago. He'd finally accepted the fact he would be alone. "I had decided I'd spend the rest of my life alone. I didn't want anybody else," Moore says.

Marie Hazel Hargis, 71, had lost her husband only a year before she attended the Champion Employee Retiree Luncheon on Oct. 19, 2011.

Even though Harry and Marie's husband had worked together for 30 years, and the two couples attended the same church, they'd never met.

Fate brought them to the same table that day, as they sat next to each other and talked during the entire meal. "I love him very much. It was love at first sight," Marie says.

Too soon for sparks

But the love wasn't welcome in her heart -- not yet, anyway. She was still dealing with the loss of her beloved husband. When sparks flew between her and Harry, she knew she needed to get out of there, fast.

A few days passed and Marie received a Children's Art Project card, with a red flower on the front, from Harry. He told her how much he enjoyed meeting her and learning about her life with her husband, his former co-worker.

By William Fitzgerald, MD Anderson Staff Writer

A group of pediatric cancer patients from MD Anderson Children's Cancer Hospital took a special field trip to Crave Cupcakes to celebrate Valentine's Day and decorate their own delicious treats. The outing provided the young patients with an exciting opportunity to spend some time away from the hospital and enjoy the company of their peers.

"We believe providing different opportunities to our young patients and artists is important for their development," says Shannan Murray, executive director of the Children's Art Project (CAP). "Even though these children are dealing with a difficult illness, they're still kids and want to have normal experiences."

After disembarking from the hospital shuttle, the patients walked into a store filled with colorful frosting, candy and other toppings. With help from the gracious staff at Crave Cupcakes, the children jumped right in with wide smiles. 

The trip coincided with CAP's 2012 Valentine's Day Collection, a variety of gifts based on artwork created by MD Anderson's pediatric patients. A new collection of products is released each February, with sale proceeds supporting scholarships, summer camps, a rehabilitative ski trip to Utah and other patient programs.

Heart of Hearts

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Duggan_Finished.jpgBy Linda Duggan, office manager, Department of Melanoma Medical Oncology

Cancer has broken my heart too many times.

Almost 26 years ago, a cancerous brain tumor killed my beautiful daughter, Sarah, before her second birthday. She was so little and precious. She spoke in three-word sentences, loved life and laughed a lot. 

Cancer took her speech, sight, ability to walk and her life way too soon.

Two weeks after Sarah passed, I was hired at MD Anderson. 

Over the years, while working here, far too many of my family members have faced the battle with cancer.

My mother fought breast cancer, but is now classified a long-term survivor.

My father passed away from melanoma shortly after he retired. He'd worked hard as a successful design engineer, saved well and was looking forward to his golden years, but cancer ripped that away from him.

My husband is a frequent patient at MD Anderson's Mohs clinic

My brother-in-law is currently fighting a valiant battle with lung cancer, with my sister by his side. 

These experiences have broken and continue to break my heart. However, they've also served to forge my resolve that "we must win this battle."

Be Fit to Beat Cancer

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DePinhofitness.JPG"We'll kick cancer butt." That's what Ronald DePinho, M.D., MD Anderson's new president, said in a recent interview. And, as a Tae Kwon Do master, DePinho probably could do literally just that.

While he may not be kicking and punching his way through the research lab, DePinho does give significant credit to his martial arts training for teaching him the fundamentals to a fulfilling life. This includes the importance of taking care of one's health.

By working in at least 30 minutes of vigorous physical exercise - weight training, elliptical, or martial arts training every day, DePinho takes an active role in lowering his chances for many common cancers.  And, he encourages others to do their part to maintain better health and a more balanced life.

Here's what DePinho said about how he embraces work-life balance in a recent employee blog post:

"Central to functioning on a high level is to invest in one's health. I try to exercise every day, eat properly, avoid excessive alcohol and coffee. I do admit that I often fall short on getting a good night's sleep.

On the job, I am compulsive about time management. A great source of stress derives from the feeling that you do not have control over the demands of your life. At work, I work to ensure that each meeting or activity has a goal and an impactful outcome. To do the best possible work on key tasks, it's important to prioritize and focus until the task is complete. Finally, never stop learning -- education is a lifelong process and the world is not standing still. Invest in one's development.

At home, it's simple -- the key is to ensure you spend quality time with your spouse and children. When with them, BE WITH THEM. It's important to be there mentally and communicate in a deep and meaningful manner
."

AR Graphic 2.jpgBy Lauren Schoenemann, MD Anderson Staff Writer

When Joseph Nates, M.D., joined MD Anderson's faculty in 2002, he discovered a high incidence of ventilator-associated pneumonia.

By 2009, he and his team had brought its occurrence to zero.

In the Intensive Care Unit (ICU), 90% of pneumonias occur while patients are ventilated. Ventilator-associated pneumonia (VAP) increases the length of hospitalization by an average of 23 days, with an associated cost per patient of approximately $150,000.

In the United States, the mortality rate attributed to this complication is estimated to be as high as 30%, the greatest among all health care-associated infections.

Nearly 10 years ago, MD Anderson's ICU VAP rate was 34.2 cases per 1,000 ventilator days in the Surgical Intensive Care Unit, equivalent to more than 10 cases per month -- double the national average for trauma ICUs.

"Using the most conservative estimate, two of every 10 patients with VAP could die from this complication," says Nates, professor in the Department of Critical Care and medical director of the ICU. "Preventing these cases could save the lives of 24 patients in the ICU each year. The problem needed to be addressed urgently."

By Ed Steger

pillboxes.jpgEd Steger was diagnosed with head and neck cancer in mid-2005. After a few rough patches, he has had no evidence of disease for more than four years and has been in remission for more than two years. He writes about his cancer experience at www.hncancer.blogspot.com.

There's a lot we can learn from one another. There are five simple tools I use to manage my ongoing health care. It's more common sense than rocket science and on average I literally spend less than two minutes a day using them. Yet, these tools have saved me countless hours, reduced my stress level and addressed some thorny insurance issues.

Medications
1. Keep a daily medication log. I began my log more than five years ago. It started as a paper log in a spiral notebook, but is now a simple Excel spreadsheet filled with more than 20,000 rows of data. The spreadsheet has eight columns: date, day, time, generic medication name, actual medication name, dose, number of pills (or liquid) and a comments field.

I take medication three times a day and typically spend about 30 seconds updating the log after I take my morning, afternoon and evening pills. I use the copy and paste function to make a new set of rows each day from the prior day's set. This log helps me in the following ways:

  • I don't miss taking my meds.
  • I don't take my meds twice.
  • I can filter the log to see a history of "as needed" meds.
  • I have a complete record for all upcoming doctor visits.

mindfulmeditation.jpgBy Donna Suckow, Department of Social Work

Patients living with cancer often feel worried, anxious and scared about doctor's visits, follow-up exams or treatment. For some, these feelings can translate into physical symptoms, such as sweaty palms, a racing heart or shortness of breath.

Distressing events in our past sometimes lead to worry about similar events in our future. This is called anticipatory anxiety.

However, by employing coping strategies, seeking helpful support and facing -- not avoiding -- worrisome events, you can overcome your fears.

In fact, many people report finding a renewed sense of strength and a deeper belief in themselves after facing these challenges head on.

Distraction and attraction
Research has shown that many adults and especially children have found "distracting techniques" helpful when facing an anxiety-provoking event. Finding something "attractive" to do helps take the mind off an "unattractive" event, such as chemotherapy or lab work.

The distraction differs from person to person because of activity levels and interests. For example, you may want to listen to a special playlist on an MP3 player, read a good book, watch a movie or play a favorite video game.

Talk to your medical team to see if it's OK to do the activity during your appointment. If so, you will most likely find that you are more relaxed.

scienceofimprovement.jpgAsk survivors to place a value on a future free from cancer, and they will say it's priceless.

Put the question to a growing number of faculty and employees, and many will point to a wide range of initiatives designed to define, measure, share -- and improve -- the value of MD Anderson care.

"Value is defined as cost of care as a function of the desired outcome -- achieving the best possible outcome for the patient's cancer at the lowest cost necessary to achieve that desired outcome," says Randal Weber, M.D., professor and chair of the Department of Head and Neck Surgery.

Known as the "science of improvement," this new dimension of research is helping prepare MD Anderson for an era of health care laws, reduced reimbursements, tougher competition and a mandate for public transparency.

Such research and data also can drive policy, improve care and enhance patient satisfaction.

Working in partnership with MD Anderson's quality and performance improvement groups, the Institute for Cancer Care Excellence has launched initiatives to look for ways to eliminate waste, reduce costs, quantify quality care and increase revenues.

pedi-education.jpgWhen families first enter the doors of MD Anderson Children's Cancer Hospital, they have one thing on their minds - eliminating their child's cancer. What they get is so much more. An entire team, comprised of not just medical experts, but specialists in education, child life and other supportive services, work to keep their child's life on track.

Alaska at arm's length

Using a Polycom video conferencing system, students at the Children's Cancer Hospital accredited school have the opportunity to interact regularly with experts from the Houston Zoo and Downtown Aquarium to the Metropolitan Museum of Art in New York.

Video conferencing allows kids to travel virtually across the country to places they wouldn't be able to visit while undergoing treatment. In one of their farthest virtual field trips, patients connected with an indigenous community from Alaska and learned about their native dances and cultures.

Homework a click away

Being able to stay connected with friends is essential for patients, especially those from out of town. For many patients, the Polycom system allows them to connect with their school back home.

For patients who aren't up for leaving their hospital room, they can view programming from the classroom or PediDome on a closed-circuit television system. This is a welcomed resource for patients isolated to their rooms due to compromised immune systems.

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