Game, Set, Match

I can't remember a time when I didn't play tennis. My Dad had been a competitive player and it came naturally to me. One summer, I remember being named the most improved tennis player at camp. Later, a friend and I played doubles on our high school team and then attended Syracuse where we also played doubles for the university. As a long time tennis player and fan, this week I have been spellbound by the U.S .Open. I had hoped to see it in person this year, but our plans didn't materialize. With each of Venus William's wins this week, the commentators spoke briefly about her diagnosis with Sjogren’s syndrome. Recognized as an autoimmune disorder, Sjogren's symptoms are diverse and can include multiple dental carries, chronic dry eye, painful intercourse and digestive problems. Researchers have linked many of these symptoms to an attack on the body’s exocrine glands, including salivary and sweat, but its cause remains a mystery. I have been told that even diagnosing the disease can be a challenge. “What we don’t understand is the root cause of the process,” says Johns Hopkins associate professor of otolaryngology and medicine and otolaryngologist–head and neck surgeon Jean Kim. “But what we do know is that this syndrome is excruciatingly debilitating for the patient Through working with numerous patients in Johns Hopkins’ Jerome L. Greene Sjogren’s Syndrome Center, the only clinic in the world dedicated to patients with this condition, she’s perfected a technique for biopsy of the minor salivary glands in the lower lip. The results from this biopsy provide the largest and most definitive clue available for separating Sjogren’s from other conditions with related symptoms. "Thousands of minor salivary glands line the mouth and upper airways, providing the mucus necessary for proper aerodigestive function. These glands are superficial and surrounded by a delicate lacework of nerves, necessitating an approach as noninvasive as possible into the right layer of tissue, rather than a simple wedge resection that often doesn’t produce any of the desired glands and can result in numbness of the lower lip," says Kim. With a standardized diagnostic approach Kim and other physicians at the Sjogren’s Syndrome Center, Kim can more quickly provide therapy to patients. Treating patients effectively often involves experts in rheumatology, neurology, ophthalmology, gynecology and numerous other areas. I hope that you will join us at the annual Johns Hopkins Medicine Women's health conference, A Woman's Journey, on November 14, to learn about inflammation and myositis, another autoimmune disorder. In the meantime, enjoy the remainder of the U.S. Open. Leslie

Life Is A Journey

Just last week, I was visiting a friend and saw a magnet on the frig: “Life is a journey, not a destination.” The past year has been quite a journey. Like so many, I have been treated for cancer. Although I have cared for others combating the disease, nothing can prepare you for confronting your mortality and undergoing the myriad of tests, procedures, radiation, chemotherapy, clinical trials and scans. Lots of scans. Monthly, I sit in the outpatient area waiting for lab work;the number of patients is overwhelming. Some come from the city, others travel significant distances. Some have insurance and may take the profound costs associated with care for granted. Others cannot afford some medications prescribed to ease nausea or other side effects. Too many patients come alone. There is nothing normal or familiar about being diagnosed or treated for cancer. Right now, I am relieved to be resuming what was my normal routine. Being at Johns Hopkins has been a lifesaver for me. As a long-time employee I know many of the physicians, the hospital, parking lots and amenities. And, through the annual Johns Hopkins women’s health program, A Woman’s Journey, I have gained a basic understanding about of cancer, its symptoms, new treatment approaches, and long term and late effects. I think how difficult it must be for other patients who haven’t had this exposure and experience. I am pleased that among the 32 sessions taught by Johns Hopkins faculty at this year’s A Woman’s Journey are two seminars that address symptoms we can’t ignore, and precision medicine, also known as targeted therapy. As women, one in three of us are destined to have some form of cancer in our lifetime. Don’t miss this opportunity to learn about cancer as well as strategies to stay well. As for me, I hope to be there to join you. Leslie