Diagnosis to death in 28 days: KOMO's Larry Nelson silenced by cancer

A broadcasting career that is one for the record books is the legacy left for us by Larry Nelson who, for 30 years served up the friendliest, guy-next-door, morning show from the KOMO Breakfast Table on AM 1000. Larry died overnight, 3:28 a.m., Thursday, November 29, after being diagnosed only 28 days earlier with end-stage, inoperable lung cancer that had metastasized to his spine and elsewhere. The diagnosis was a shocker, but the elapsed time from diagnosis to death was absolutely stunning.

Larry was the consistent, familiar, reliable friend who got the morning started through every season of the year not only in Seattle, but throughout the vast expanse of the geographic coverage area of the 50,000 watt KOMO Radio signal.

Additionally, I had the privilege of being the warm-up act for Larry’s show with my own program for nearly a decade, The Overnight Club with Jaynie Dillon, from 1981 through 1990. Having been the one to prepare the way for Larry and the morning news team, headed by Stan Orchard, each and every weekday, I’d like you to know that Larry was the same person in-person as he was on-the-air. He arrived in the studio eager to start the day, always with a kind word, a smile, a focus, and pure joy at the simplest things in life: a place to go, something to do each day, a heart filled with gratitude, an appreciation for motivational and inspirational books, and always sharing with the audience the day-to-day things in his own life that others could relate to and learn from; it was a winning combination. Stan has created a Web site in memory of Larry, http://LarryBNelson.com

Stan Orchard and I both went to KOMO from Tacoma radio stations. We had worked together at KTNT and KNBQ-FM starting in 1976. I was at KTAC & KBRD-FM when I was called to come to KOMO for an interview. Stan and I both were brought on board at KOMO by the (then) new Program Director Ken Kohl. It was a magnificent, magical time in radio with Ken Kohl's visionary, innovations in programming such as the hiring of the very first female announcer in the nearly 60-year history of the radio station (Yes, that was me).

The KOMO tailgate parties prior to the Huskies’ games were memorable for the hilarity, spontaneity, and the over-the-top production done by Production Director Eric McKaig week after week. The creative output was beyond comprehension. Eric is with CBS Radio, in Seattle, now as Creative Director and that he is.

Larry Nelson and the KOMO Morning Show were often on the road -- and beyond -- including remote broadcasts from international locations. Notably, we had recorded quite literally thousands of Northwest listeners’ greetings and wishes for peace. Then Larry and KOMO’s Michael Hamilton hand-delivered the Geneva Peace Tapes to the Russian and U.S. delegations in Geneva at the Peace Talks between Reagan and Gorbachev.

Formerly with KOMO Radio News, Patti Payne, now a columnist with the Puget Sound Business Journal could tell you endless stories about traveling with Lar. Patti and I shared an office at KOMO. She was a terrific office-mate and treasured friend. We shared many a laugh over the years and many a tear in recent days.

It was a grand time, that era of Larry Nelson’s radio career at KOMO. Those of us who worked with and around Larry were all blessed for having been in his presence. He was the heart and soul of KOMO Radio at its finest.

Share your memories of Larry Nelson and The KOMO Breakfast Table. Lar has left the world a better place for having been here, and the Northwest a better place than anywhere else.

An October sunset on Mount Rainier

What else needs to be said? It was fabulous!

Peanut Butter and Chocolate Oatmeal Cookies

Over in the blogosphere among my postings on The News Tribune's site under the "In The Neighborhood" section, I've been enjoying some lively exchanges with other locals about coffee, why people drink it, why they are willing to pay so much for their espresso and latte concoctions, and then somehow the topic turned to chocolate.

I wrote about the great recipe I tried recently. It was found on the bag of Snoqualmie Falls Lodge Oatmeal. Those are the best oats you'll find. Great for oatmeal and maybe even better for baking.

I want to share the recipe for Peanut Butter and Chocolate Oatmeal Cookies and the one modification I made to it. I had no chocolate chips on hand, so I finely chopped some rich, pure, dark chocolate into the mix in place of chocolate chips and achieved an excellent result. It's an interesting cookie recipe also, because it contains no flour whatsoever, just the oats. No added salt either, just baking soda.

I wanted so much to show the cookies and share the recipe, but was confounded by just how to go about uploading images. Previously, on The News Tribune's blogs it was a snap, but there was a system crash awhile back and I think that perhaps it is no longer possible to upload images there. If it is possible, it was beyond my ability to figure it out. Then it dawned on me that I can post the image here on one of my other blogs and then simply include the link to Emerald Princess Online over on The News Tribune's "In The Neighborhood" blog so anyone who wants it can find it and bake a batch. Mmm-mmm good! Yummy, crun-chewy, satisfying mouth-feel... Munch, munch, munch...

P.S. If the print is a wee bit too small for you to read and write down the ingredients, let me know and I'll reprint the recipe in another posting.

USPS Evergreen Station, Tacoma: Closes 24-Hour Self-Service Unit

(Depicted are two paintings that were found inside the 24-Hour Self-Service Unit at Tacoma's Evergreen Station, July 2007) But now this...

A vital, essential, useful, absolutely necessary (how many ways can I say it???) time-saving, customer convenience of immense value, an important facility-within-a-facility is a thing of the past.

Postal officials in their infinite wisdom (no, let's make that finite wisdom) have SHUT DOWN the 24-Hour Self-Service Unit at the Evergreen Station.

Way to go, postmaster! NOT!!!

All that is left now is the electronic machine inside the main building by the post office boxes that requires a credit or debit card to make a purchase.

• Real money is out; plastic is the only kind accepted.

• No longer are you able to purchase stamps from a coin-operated vending machine.

• No longer are you able to purchase a book of stamps from a vending machine that accepts paper money.

• No longer are you able to purchase as few as one or two individual postage stamps at a time during any hour of the day or night at the 24-hour Self-Service Unit, because it is no more!

It has ceased to exist.

In its place now is a sheet of paper that lists retailers around town that you can drive to and purchase books of stamps from instead.

Congestion at Evergreen Station, the Regional Mail-Handling Facility on Pine Street between Tacoma Mall and 38th Street (RMF, for short) and what many think of as simply "the big post office" in Tacoma is bad at almost all hours that the facility is open.

• Traffic is heavy.

• Parking is inadequate.

• Count on an almost unbearably long line waiting in the serpentine queue to get to the counter and conduct any business with a postal employee.

• The dread pushes one's endurance and frustration level to the max -- not only the annoyance of the long wait for service, but the aggravation of NOT being able to do all the other things you need to be doing, but instead stymied, trapped like stockyard cattle in the chute or stanchion waiting in the merciless line to reach the counter.

• Top that off with the apparent lack of adequate staffing to handle the volume of traffic inside the Evergreen Station and it only makes it worse.

If you have been there, you know the drill: there might be two or three people working, and then even with the ridiculously long line, maybe a 45-minute wait for your turn to get up to the counter for service, you can almost be assured that one of those two or three workers will announce that he/she is going on break just about the time you get to the counter.

Okay, so that's the day-in, day-out scenario at Evergreen Station during business hours.

The FABULOUS thing about Evergreen Station has for years been the 24-hour Self-Service Unit on the north end of the building where you could buy stamps in any quantity from one to a bookful or multiple books of stamps, receive change, weigh a package, calculate its necessary postage, and a large, bin to deposit packages into once you've taken care of all the necessary details. The clanging of that big metal bin was as reassuring as it is when you place a bank deposit into the night depository and you hear the clanging of the bin after you have dropped your deposit envelope down into it, and then pull the flap open again to make sure your deposit has dropped. There's a bit of reassurance and security in that clang and in the second clang when you recheck it.

That's the way it WAS in the Self-Service Unit at Evergreen Station, too.

Clang!!! And you KNEW that your parcel had been securely deposited inside the facility and would soon be winging its way to its intended recipient.

• The vending machines in the Self-Service Unit accepted paper money and coins of every denomination.
• Interestingly, they also dispensed cash-back in the form of golden Sacagawea dollar coins, which you don't see anywhere else.

Perhaps you'd only have a $20-bill with you and may only have needed a small quantity of stamps, let's say $5 of stamps and you could count on hearing the cha-ching, cha-ching, cha-ching of 15 of the golden Sacagawea dollars dropping into the change slot.

The 24-hour Self-Service Unit allowed anyone to expeditiously handle many of the same things that would otherwise require waiting in that queue inside to do during regular business hours.

The Self-Service Unit was an oasis.

An oasis!!!

Countless times over the years I have been there at night perhaps to send a payment out in the nick of time before its due date, trying to beat the deadline of the last pickup time or processing business mailings and either been able to help someone else who a) needed a stamp or didn't have the right change, or b) been helped by another patron when I might have needed a stamp or a coin.

People who used the 24-hour Self-Service Unit during the evening or overnight hours always exhibited an attitude of gratitude. Call it pure joy that they could access the facility and still get their items into the mail in time before the last pickup for the day.

Now the Self-Service Unit is no more.

Closing the Self-Service Unit was an ill-thought-out concept and I hope others will join me in raising a hue and cry over the closure of it. This is a 24-hour world we live in today. Never has it been more important or more necessary than it is right now to have that 24-hour facility.

Jaynie Dillon Jones Voice-0ver Demo Sampler

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African-Americans have higher mortality and morbidity than Caucasian Americans: I know why that is. It is no secret.

This is my husband, Charles Jones, at St. Joseph Hospital, in Tacoma, Washington, with severe congestive heart failure, kidney failure, and having a stroke.





I'm Jaynie Jones, http://emeraldprincessonline.blogspot.com/ and am happily married to an absolute gem of a gentleman, Charles Jones, who has complicated, disabling medical problems and was hospitalized at St. Joseph Hospital, in Tacoma, Washington, last week under his health insurance plan with Group Health Cooperative. He was treated for severe congestive heart failure, runaway high blood pressure, chest pain, kidney failure in "iminent" need of dialysis, and went on to suffer a stroke while hospitalized on Tuesday that was verified by CT Scan.

To the family's dismay, Charles was discharged from the hospital the day following his stroke even though he was still suffering symptoms. Jaynie was so distraught about the physicians' decision to send him home so soon after a stroke that she wrote the following letter to St. Joseph Hospital, Group Health Cooperative, all of the doctors, and the nursing staff to have this letter placed in his hospital record for future reference if any adverse events occurred subsequent to Charles' early release from the hospital.



When Charles called me at 3:30 in the afternoon and announced that he was being discharged and that I was to be there at 5:30 to bring him home, I was in a state of shocked disbelief. But in the time before I dashed over to the hospital, I wrote a letter of protest to have placed in his hospital record. With having had a stroke one, needing dialysis, and being sent home the following day with still some of the same symptoms unresolved, and having not been seen by a neurologist to even evaluate the sequelae of his stroke, this was deeply troubling to me. Charles was too weak and confused to put up a fight.


When I picked him up at the hospital to bring him home I handed the letter to the nurse and asked her to see to it that it was placed in his chart. Apparently someone read the letter late that evening, because a nurse called him at home to discuss it. Subsequently we have received several calls from Group Health. Hopefully this trend will continue and Charles will not suffer more ill effects from mismanged or marginally managed care.

________________________________________________________________________________


Let the record show that…Charles called to inform me this afternoon that he is being discharged to home from St. Joseph Hospital today. Discharged to home where we have one flight of 15 stairs and another flight of 8 stairs for him to climb up and down.

His discharge is premature and alarming to me as his wife and now caregiver that he is seemingly being discharged so soon when his runaway blood pressure (224/117 when first brought in on Saturday) has only been down in a more nearly normal range for less than a day.

Charles told me that Dr. Hwang had been in to see him today and informed him of the results of the CT scan of Charles’ head yesterday.

The CT scan was performed on an urgent basis due to the sudden onset of severe pain behind his right eye, coupled with diaphoresis, nausea and vomiting.The doctor reported the findings of the CT scan to Charles today stating that it revealed that he has had a CVA, but that it was his opinion that the radiologist had “over-read it.” How dismissive!

Charles has severe congestive heart failure, high-output failure, a fistula in his upper arm that measures 29.9-cm in greatest dimension, no surgical plan for revision of that to reduce the pressure or the heart failure that is now severe, end-stage renal disease despite having had a kidney transplant after four years of dialysis, but now the transplanted kidney is failing.Charles creatinine’ last week was 2.6, 3.8, 4.1, and now nearly 5. Dr. Hwang informed Charles that with the rapid elevation of his creatinine to nearly 5, he needs to go on dialysis “imminently.” This imminent need for dialysis has arisen out of the high-dose diuretics that have been used in recently days bringing his blood pressure down.

At Group Health Urgent Care, we cautioned Dr. John Vandegrift about how Charles’ transplant had gone into shock in 2000 when he had become dehydrated in Eastern Washington and on our return to Tacoma had presented to the ER at St. Joseph Hospital and had been loaded up with Lasix to pull the fluid off and that further compromised the kidney function, nearly destroying it. Dr. Vandegrift was in complete understanding of that and agreement and was judicious trying to get his blood pressure to a safe range.

After transfer from GHC Urgent Care by ambulance for admission to St. Joseph Hospital, Dr. Bonnie Sand met with both Charles and me in his room and we shared his history in detail with her. She was a thoughtful, completely engaged, intelligent physician who truly seemed to understand not only the history, but the complexity of what was happening at that point in time. She was well-informed and she inspired our confidence not only by how much time she spent with us, but by how carefully she listened to both of us and our concerns. She, too, recognized how precarious it could be, if Charles was diuresed too rapidly and the toll it could take on his renal allograft.Sadly since admission to St. Joseph Hospital, the rapid diuresis has once again brought the transplanted kidney to nearly complete failure with need for dialysis again being “imminent.”

We well recall what it is like to start back on dialysis. The cramping, weakness, light-headedness, the renal diet, all of these adjustments are ahead.When Charles first developed ESRD in the early ‘90s, he was admitted to the hospital and time was taken to get his dialysis going and get this smoothed out.

Now, here he has had a stroke one day and is being discharged from the hospital the next day with the same symptoms he had yesterday at the onset of the CVA, and he is still suffering from the head pain, nausea, et cetera, but he is being sent home in this condition and given Vicodin.

• What kind of logic is involved in this?
• And yet he needs to be on dialysis, but is being sent home?
• In this condition?
• Symptomatic?
• Having just had a CVA by CT?

• He feels devalued as a human being and as if he is being kicked to the curb.In our experience (his and mine as his wife) every doctor always says (in various office settings and in the hospital) that they just don't know why African-Americans have poorer outcomes, dramatically shortened life expectancy and so on, but that research statistics show that it is true that from the standpoint of morbidity and mortality, African-Americans with an array of chronic diseases such as CHF, heart disease, diabetes, prostate cancer, other cancers, kidney disease, et cetera, do not do as well as whites, they will suffer more complications and they will die sooner, at an earlier age than Caucasians.

  There is an answer to the ‘mystery’ and I can tell them that the answer is no mystery at all: It is because of the way the care is managed for African-Americans, not just relative to access to health care, but how such care is managed. That's what shortens their lives. The decision to discharge Charles to home from the hospital today is one such example.

  How can the hospital or physicians involved in this decision send a patient who has had a documented CVA one day sent home to the rigors of stair-climbing and the need for dialysis when that has not been implemented?I called Group Health and made an appeal to four different people there that Charles’ needs better care, closer monitoring, and consistent follow-up because of the nature, severity, and complexity of his various medical and health care issues.

  Were it not for their failure to follow-up and maintain continuity of his care, monitoring his blood pressure, et cetera, this could have been managed and prevented. Instead, he has not seen in clinic by a Group Health physician since last year.

  There has been no scheduled follow-up.

  He had no idea about how dangerously high his blood pressure had become, because Group Health just keeps renewing his medications and standing orders for lab work once a month.

  The failure by Group Health to consistently and aggressively manage Charles’ extremely complicated medical conditions has resulted in where we are today with Charles, a 41-year-old African-American man who has had:

• one kidney transplant now in failure again,
• facing dialysis,
• having had a stroke,
• rampant, runaway blood pressure, and now he has been left
• feeling hopeless and depressed,
• like his life is futile and
• there just is no hope to get better.
• He has been told to limit salt and
• lose weight,
• lose weight,
• lose weight,
• but no one offers any direction for that, no suggestions about how to accomplish that and no recognition for the fact that he has dropped 35 pounds on his own over this past year.
• He has asked repeatedly about being considered for lap band bariatric surgery. His requests for lap band have been ignored or put down.

So why are African-Americans consistently the ones who come out on the short end of the stick relative to their health care and the outcomes they experience in contrast to the Caucasian-American population? It is decisions such as the one today at St. Joseph Hospital, to discharge someone to home the day after a stroke, when dialysis is “imminent” (but not started), and when astronomical blood pressure has been brought down for less than a day.

Let the record show that the mystery is solved about the research statistics and why blacks have those bad outcomes.

Charles and I hope that this will not be one of those times, but just as a patient would be required to sign a form stating that they were refusing recommended medical care and by their own volition going AMA (Against Medical Advice), this situation is essentially the flip side of that. Charles is coming home from the hospital against our better judgment.

We both want to go on record that we oppose this plan. I am a blog writer for The News Tribune and I intend to blog about how Charles’ care has been managed.

The nursing care at St. Joseph Hospital has been excellent. The nurses have been consistent and professional in every way. They are compassionate and good communicators.Should there be any adverse consequences of the physician’s decision to discharge Charles today, it is now documented that Charles and I both objected to it and informed you of our concerns this day for all of the foregoing reasons.

Signed by: Jaynie Jones, Dated: March 14, 2007

Machine-dispensed information 24-hours a day

Totally blogalicious! The News Tribune has invited a select group of citizen journalists (including moi) to blog for the newspaper. What a hoot! I just posted my first blog there. Below you can read the text of it. What fun! EmeraldPrincessOnline

http://blogs.thenewstribune.com/neighborhood

During the years of my career in broadcasting I had occasion to become acquainted with countless interesting characters. Not just my coworkers, but the listeners who called in and/or wrote to me.

One listener used a customized rubber stamp on the back flap of every envelope. The rubber stamp said, “machine-dispensed information 24-hours a day.” There were two phone numbers on the next line.

I tried to imagine what sort of “machine-dispensed information” he was making available to those who would call either of those two numbers, but I never could have imagined just how bizarre it could actually be.

Eventually my curiosity got the best of me and I dialed the numbers to see what on Earth it was about.

One of the numbers played a 3-minute recording of him detailing not only his vital statistics, but even what his annual income, how much he budgeted for food, et cetera. He explained in the first recording that he had made these two numbers available for anyone to dial-in and listen to his thoughts, just in case anyone might want to know his thoughts.

Anyone.

He worked in a cannery where his only contacts were the people at work, but due to the noise of the machinery, there was no conversation that could be heard. He had no social life outside of work, but longed to be connected in some way. So he had devised the “machine dispensed information” concept. (The second recording was a full 30 minutes in length and he changed it out daily with rambling messages about various scenarios, all simply top of mind.)

I reflect back on his desperate effort to reach out, to find someone who would care to communicate somehow.

As bloggers we write what is in our hearts and on our minds as a means of potentially reaching out and connecting with the unseen and unknown reaches of the Internet. He had his “machine-dispensed information” and now we enjoy the modern equivalent of it that we call blogging.