By Susan Guynn Special to the News-Post
In 2012, the unthinkable happened to Lorraine Stoltz.
After seven years of being cancer-free, Stoltz was diagnosed with breast cancer a second time. Both times, the cancer was detected during yearly mammogram screenings.
“I believed I had conquered it and was ready to move on,” said Stoltz in an email. “Yes, I was devastated, angry and disappointed but this time prepared to face it!”
Stoltz, who retired from teaching at Maryland School for the Deaf, was born deaf. Her parents and sister are also deaf. Her first breast-cancer surgery, a lumpectomy, was in 2005 at Johns Hopkins in Baltimore followed by radiation treatments in Frederick.
“My partner and my sister were my most faithful supporters,” said Stoltz, 58, of Frederick. “They were there every step of the way.” And the hospital provided a sign-language interpreter “who was always there for every meeting, surgery and post-surgery.” She also had a mentor at the hospital, a 25-year breast cancer survivor. “Even though she was wonderful,” Stoltz said, “I felt limited because she did not know sign language and I did not know what questions to ask because it was all new to me.”
In 2012, again with the support of her partner and sister, Stoltz was referred to Dr. Susan Bahl, breast surgeon and medical director of the FMH Center for Breast Care in Frederick.
“Dr. Bahl was outstanding! She was like a teacher,” said Stoltz, who taught at MSD for 30 years. “She had the images of my breast on the light wall next to a white board and a sign-language interpreter ready. With a lot of confidence and knowledge she gave us all a clear picture of what was happening and choices to make.”
Stoltz opted for a double mastectomy and to take the BRCA test to determine if her breast cancer was genetic. That test was negative, she said.
“To my surprise (the double mastectomy) was not a hard decision because of all the support I had around me,” she said. “Yes, afterwards, I did have a moment of ‘reality check’ that I no longer had both breasts, but this passed quickly because I wanted to be healthy and lead a full life again.”
Communication is essential
Language barriers, whether sign or spoken, are a concern for medical providers nationwide.
“Interpreters in a health-care setting is quite essential,” said Nan Principe-Crockett, FMH Regional Health System’s interpreting services manager. It’s not only the right thing to do, it’s the law, she said. Health-care providers who receive federal monies (such as Medicare and Medicaid) must provide interpreters fluent in the patient’s language.
With MSD in Frederick, Gallaudet University in Washington and the high number of federal employees in the area (the federal government is the top employer of deaf persons), the need for medical sign language interpreters is great, Principe-Crockett said.
In 2007, Frederick Regional Health System had 254 deaf patients; that rose to 546 in 2012, she said. In encounters (the number of providers and staff contacts during a visit), the number rose from 818 in 2007 to 3,342 in 2012. The need also exists in spoken languages, including Spanish, where patient encounters increased from 1,722 to 7,675 between 2007 and 2012.
Principe-Crockett said it would be a wonderful career for young people who are bilingual to consider, though being bilingual does not always make someone an effective interpreter. Understanding the culture and a respect for confidentiality are also important.
In addition to Spanish and sign language, there is a need for interpreters in Burmese, Mandarin, Russian and French. To become a medical interpreter, a person must be fluent in English and another language. “Once that’s been established (through testing), then there are various kinds of training,” Principe-Crockett said. The Registry of Interpreters for the Deaf has its own certification program.
“The law is clear that family and friends should not be used as interpreters,” Principe-Crockett said. It violates patient confidentiality and patients may not be willing to reveal all the facts to their medical provider in front of a family member and a family member may withhold information from a patient in order to “protect them.” And family and friends often don’t have the medical terminology necessary, she said.
Dr. Bahl said talking to patients through an interpreter is not as personable, “however it does get across” what the patient needs to know. “That’s why interpreters are so important,” she said.
“Having a sign language interpreter opens doors and frees the doctor, therapist and oncologist to communicate with me openly and vice versa,” Stoltz said. “Interpreters for any language is very important in the well-being of a cancer patient. It definitely helps us get through the unknown.”
Bahl saw that Stoltz would be a good mentor to other deaf women. “The concept of being a mentor is very important in breast cancer patients,” Bahl said. “Despite what providers can do, nothing is comparable to an actual patient calling you and relating about what to expect with a mastectomy or prosthesis.”
Stoltz met with the Survivors Offering Support (SOS) volunteer coordinator Denise O’Neill and received training.
“Since becoming a mentor, I have spoken to high school girls and boys about breast cancer and strongly encourage ‘self-test’ as well as getting mammograms,” Stoltz wrote. She also participated in a panel discussion on cancer at the Deaf Senior Citizens of America convention in Baltimore this past summer.
Stoltz said she has become involved in the “pink world” with pride. She has run two 5Ks for breast cancer awareness, and emails information on breast cancer and workshops at the FMH Center for Breast Care.
She also created two paintings about her experience — one for a therapist and the other for her surgeon. Bahl’s painting is titled “My Surgeon’s Blessed Hands” and uses dark spikes to represent cancer and hands throwing pink ribbons to destroy the spikes.
Stoltz also has two works, both photos, in the “Art Heals” exhibit at FMH Crestwood art gallery. “Petals of Healing” is a photo of tulips she received following her double mastectomy. “Friends” was taken six months after her surgery when she and friends walked in the 2012 Pink Ribbon run/walk.
“This is the beginning for me toward my healing process,” Stoltz wrote. “It hit me recently while visiting a physical therapist, when leaving his office he said, ‘You have been through a lot!’
“He understood what I have been through because he had cancer too, but both of us know that this experience can only make us stronger and reach out to others,” she said. “I look forward to facing the unknown throughout my lifetime … and playing golf.”
Article Originally Posted by the Frederick News-Post