AAA Standard Diameter Measurements

Referral for surgery varies slightly on patient condition but in general it is about 5 cm for women and 5.4cm for men.  If the aneurysm has grown 1cm or more over the past year, this is another indication.

 

Pre-operative imaging should evaluate and document key aneurysm morphology, access vessel size, and patency including:

  • Aortic tortuosity
  • The proximal and distal landing zones. Ideally, these should be a minimum of 2 to 3 cm apart [6] to ensure an adequate seal and decreased rates of endoleaks, aneurysmal degeneration, and device migration.
  • The proximal and distal landing dimensions as well as the aortic diameters over the graft (to determine endograft sizing).
  • In the abdomen, care must be taken to assess for possible stent coverage of major branch vessels.  If abdominal visceral branches are involved, and there is potential for the celiac trunk or superior mesenteric artery to be covered by the stent graft, then the presence of collateral vessels must be documented. In the absence of collaterals, an open surgical or hybrid approach may be necessary to avoid visceral ischemia [6].
  • When the distal landing zone is located within one or both of the common iliac arteries, the diameter and extent must be documented.
  • For conventional endovascular repair to have an adequate proximal graft seal, an aneurysm neck size of >10 to 15 mm in length and <30 mm in diameter.  Over 50% of patients have aneurysm morphology unsuitable for conventional endovascular repair.  Unfavorable neck anatomy, based on its diameter, length, angulation, morphology, and presence of calcification, is the most frequent cause of exclusion.
  • Mural thrombus and atherosclerotic calcification covering more than 90° of the circumference of the aortic diameter in the proximal neck is associated with a higher endoleak and stent-graft migration risk.
  • It is also necessary to evaluate the access path from the femoral artery through the iliofemoral vasculature [6]:
    • The minimal external iliac artery intraluminal diameter should be ≥7 mm to safely accept AAA delivery sheaths.
    • Since thoracic aorta endografts are larger than their abdominal counterparts, their insertion sheaths can have outer diameters up to 27 French and require a minimum vessel diameter of at least 8-9 mm.

Increased vessel depth, degree of femoral artery calcification, and iliofemoral tortuosity are negative predictors of percutaneous repair success.

 

Dissection:

Aortic dissection may be classified according to either the Stanford and DeBakey systems. Stanford is more widely used for TAAs; it classifies dissections into those that involve the ascending aorta as type A, and all others distal to the left subclavian artery as type B.  The DeBakey system may be used for both TAAs and AAA;  this system classifies dissection based on the site of origin and is divided into types I, II, IIIa, and IIIb.

 

The majority of dissections arise from ascending aorta – either first few cm or just distal to the origin of left subclavian.  On pre-operative imaging, in addition to identifying the start and end locations, the following morphology should be described:

  • Aortic dilatation
  • Dissection flap (linear mobile structure within the aorta which moves more than the aortic wall)

As well as flow (Color Doppler or multi-phase imaging) characteristics:

  • Flow in true and false lumens will be different and may be able to localize entry and exit points.
  • There may be thrombus in false lumen (partial or no flow)

And finally, look for complications of dissection:

  • Aortic rupture

Eon + Epic

It’s not Eon vs. Epic, it is Eon + Epic, and Eon pairs well with Epic to make Essential Patient Management seamless, efficient and effective. While Epic does some things really well, it does not have a focus on data science. So, when identification of patients based on free-text is needed, Eon excels. Eon also excels at imbedding guidelines and automation for longitudinally tracking patients, thereby ensuring no patient is overlooked or does not receive evidence-based care. Conversely, Epic relies on the radiologists appropriately flagging these patients. At Eon, data science is our lifeblood, and our mission is to make patients healthier and healthcare affordable.

 

Eon is a powerful supplement to Epic. Eon’s sophisticated implementation team works closely with your hospital’s IT group to build the most proficient Eon EPM solution available. Depending on the scope of the project, the internal technical IT capabilities, and required clinical behavior, Eon can provide a customized solution that exceeds expectations. The Eon solution incorporates high precision linguistics and guideline based automation to streamline clinical workflow and achieve documented patient outcomes.

 

Here is why the Eon + Epic integration solution is vastly superior to an Epic-only build:

 

  1. Identification of Abnormalities

    Best in class Computational Linguistics (CL) that does not require radiologist workflow disruption or behavior modification Specifically, the Eon CL solution does not require use of macros or structured radiology reports to identify patients with abnormalities found on imaging. CL is a superior form of Natural Language Processing (NLP) because it is contextual (see Figure 1). Eon CL achieves a higher Positive Predictive Value (PPV) by understanding complex medical ontologies and identifies abnormalities with high precision and accuracy.

    Epic-only solution requires radiologists to utilize Macros and Structured reports that are used as flags. These trigger phrases are required because Epic is not focused on data science and has not created data science models for this space. Because of this, an Epic-only solution is highly dependent on Radiologist Adherence, creating the potential for false negatives and patients slipping through the cracks.

    Epic-only solution is labor-intensive because Epic creates a list of patients for manual Coordinator curation of actionable patients versus patients with previous or known findings.

    Specifically,

    • Computational Linguistics extracts pertinent data to inform the Coordinator about the finding so they can make quick decisions without looking in disparate systems to collate information. This data also helps to determine next steps for the patient’s care pathway, as defined below in #2. Please see Exhibit A for all CL Models and Data Extraction.
    • Computational Linguistics also extracts Lung Cancer Screening Registry specific data from radiology free-text reports. Between this and supplemental EMR data, subsequent submission to the registry can be fully automated.

    Figure 1: Computational Linguistics (CL) is a superior form of Natural Language Processing (NLP) because it is contextual. Contextual information integration is shown below.

  2. Automation of Care Pathways

    Eon is able to remove approximately 80% of the Coordinator’s repetitive tasks and manual tracking using advanced business logic. The logic is based on YOUR clinical requirements, not the care plan or guidelines we require. This logic automates and streamlines clinical workflow by 80%, allowing your resources to focus on the patients most at risk and who need immediate care coordination. Eon EPM is not rigid and can customize care pathways based on how you treat patients. Epic does not utilize business logic to automate redundant tasks and requires manual efforts for data collation, expected next steps, and care pathway decisions.

    Specifically,

    • In Eon EPM, patients are automatically triaged based on pertinent clinical information extracted from the CL models. Based on the collation of this information, patients are risk stratified, the clinically appropriate next steps (chosen and approved by you) are auto-populated and the patients are placed on the appropriate worklist.
    • Low-risk patients have the expected next steps automatically entered. In addition, your requirements for provider and patient communication are automated including pre-populated letters, faxes and texts. These documents can be batch created and sent, as well as forwarded to Epic (level of integration will depend on routing configured by your IT team). In addition, any phone calls documented in Eon can be forwarded to Epic as phone encounters (again configuration by your IT team).
    • High-risk and indeterminate patients can be sent directly to a Subject Matter Expert (SME) worklist for review and expected next step entry. Upon completion, the patient is sent back to the Coordinator for care coordination and communication to provider and patient.
  3. Longitudinal Tracking

    No more spreadsheets, no patients left behind. Eon’s cloud-based dashboard allows for multiple stakeholders to view patients at different times in the patients care pathway. Once Patient Identification and Care Pathway Automations have occurred, Eon ensures insight and oversight of patient processes — ensuring follow-up exams occur and guidelines are adhered to (as approved by you).While Epic is the main hub for ordering and scheduling, Epic does not create carepath-specific worklists and provide automated expected next steps for patient care. This means Epic cannot provide an overview of patient adherence. For example, Epic will not know when a carepath-specific event was supposed to be scheduled and wasn’t, and does not identify patients who were scheduled to receive a care pathway exam but did not show up for it.

    Specifically,

    • Eon EPM knows exactly what event should happen next for every patient and when. EPM is constantly listening for that order to be scheduled and completed. If an order or scheduled exam does not occur, the Coordinator is notified to intervene. If an exam is scheduled, the Coordinator knows and does not require further action.
    • If the patient misses a specific care pathway event, with Eon, the Coordinator will be notified and the patient auto-added to the Overdue Worklist.
    • Patients move between worklists depending on their care plan and what is required next.
    • Discrete Deactivation Reasons for Care Pathways ending are always captured in Eon, allowing for real-time program review and analysis.
  4. Real Time Analytics

    Eon offers powerful reporting and data analysis that does not require IT analyst data extraction or take weeks, or even months, to produce. All reporting is real time as well as date-range based.

    • In-dash data export
    • Canned reporting
    • Custom reporting

  5. Fast Implementation

    Eon is able to implement within complex Hospital Networks quickly and efficiently. Epic sites can be some of Eon’s best integrations. While Eon can implement as fast as seven days, complex implementation requiring bi-directional feeds and multiple patient cohorts will require 12-16 weeks. Typically client IT timelines control the implementation process and determine time to completion. Eon always provides a Project Manager during the implementation and requires a minimal amount of Hospital Resources to achieve success. In contrast, when a facility decides to build a solution within Epic, an Epic build can require nine or more resources on multiple project calls for a minimum of six months and take up to 17 months before the project can be live. See the requirements for an internal Epic solution build:

    Internal Epic Solution Build Requirements

    • Staffing: Your system will need to staff at a minimum of 9 resources
      • Project Lead
      • Project Manager
      • Clinical Informatics Specialist;
      • Clinical Operations SMEs x2 minimum
      • IT staff including Epic Clarity Analyst (reporting), Epic Clindoc analyst (Hospital & ED build), Epic Ambulatory analyst (Outpatient build);
      • Quality Assurance staff;
      • Training staff
      • And, potentially other technical resources.
    • Project Manager Time Allocation: A Project manager will take 2-3 months working with Informatics Specialist and Clinical SME’s to design the desired workflow before activating IT services.
    • Project Prioritization: Build requirements as evaluated by IT staff for feasibility and scheduling
      • Because this is typically an operational project – NOT CAPITAL – the IT staff will schedule the changes with other priorities and build may not start for at least 6 months…
    • Clarity/Reporting Analysts: These will be needed to build an Epic Registry to identify patients, and Metrics to capture critical observations for clinical staff
      • Typically > 6 month project for any new registry to make it to production in Epic. The majority of this time is building logic that Eon already has
      • Epic Report analysts are paid ~$100k and will be required for post project maintenance
    • Supporting Team: Additional Epic analysts will be required to configure workflows, this is a different skill set than the report analyst.
      • Workflow build can happen in parallel, but will require the same change time frame > 6 months for release
      • This requires a hospital build analyst and ambulatory analyst as the workflow will cross these areas
      • Workflow will use patient workqueues (lists) to guide users in follow up requirements
        • These are often exported from epic and addressed on spreadsheets.
    • Once the build is done by Reporting and Application analysts, QA and Training can start.
      • Additional changes may be needed after QA extending the timeline
      • QA will take at a minimum one month, training another month
        • Additionally this build must be evaluated with every Epic upgrade that happens, which is quarterly for most organizations.

    Exhibit A – Computational Linguistics Available Models and Data Extraction

Second Leading Cause of Lung Cancer & How to Protect Against It

Did you know that Radon is the leading cause of lung cancer in non-smokers and the second leading cause of all lung cancers in the United States, contributing to over 20,000 lung cancer deaths per year?

 

Radon is a radioactive gas released from the normal decay of naturally occurring elements found right beneath our feet. This invisible, odorless, tasteless gas seeps up through the ground into the air. The level of radon varies greatly in different parts of the United States depending on the characteristics of the rock and soil in the area. Radon gas usually exists at very low levels outdoors, but can be found at dangerous levels indoors as the gas given off by rock or soil can enter buildings through cracks or gaps in the floors and walls. These levels of radon are often highest in basements or crawl spaces. 

 

According to the Environmental Protection Agency (EPA), the average level of radon outdoors is about 0.4 picocuries per liter (pCi/L) compared to average indoor levels of 1.3 pCi/L. The EPA recommends taking action to reduce radon in homes that are at  or above 4.0 pCi/L. It is estimated that about 1 in 15 homes are at or above this EPA action level. Scientists estimate that lung cancer mortality could be reduced by up to 4% by lowering radon levels in homes at or above 4.0 pCi/L.

 

The best thing you can do today to reduce your risk of harms associated with radon is to test your home. EPA and the U.S. Surgeon General recommends all homes in the United States be tested for radon. Winter is a good time to test your home when windows and doors are sealed tightly which can cause radon levels inside your home to rise. Contact your state radon office for information on how to obtain a test kit. Some states offer free or discounted test kits to the public. You can also visit http://www.sosradon.org to order test kits and obtain information.

 

If you think you have been exposed to high levels of radon over an extended period of time, talk with your doctor. Regular health checkups can look for possible signs of lung cancer including shortness of breath, a new or worsening cough, hoarseness, or trouble swallowing. If you are a current or former smoker, you may be eligible to receive a Low-Dose CT for Lung Cancer Screening.

Eon’s Centralized Management Drives Efficiencies & Revenue

Eon Centralized Management is the first and only market-available product to manage every aspect of a lung cancer screening and incidental pulmonary nodule program—so you don’t have to.

With Eon Centralized Management, you can:


Offload resource-intensive tasks to Eon’s team of highly skilled providers


Capture more patients and ensure patients don’t fall through the cracks


Improve outcomes by focusing on care over manual administrative tasks

Eon Offers the First and Only Solution to Identify Incidental Pulmonary Nodules on Multiple Radiology Modalities

Empowering facilities to capture more incidental pulmonary nodules and identify lung cancer earlier is at the heart of what Eon does every day. That’s why Eon expanded its data science models to now identify incidental pulmonary nodules on Magnetic Resonance (MR) and  X-Ray radiology reports in addition to CT. 

 

Eon’s Essential Patient Management platform uses Computational Linguistics to identify incidental pulmonary nodules on computed tomography (CT) reports with 98.95% accuracy, and 97% accuracy on MR and X-Ray radiology reports. This game-changing update allows facilities to capture approximately 25% more incidental pulmonary nodules and empowers providers to identify lung cancer earlier when treatment is most effective.

 

“Any imaging that covers a lung field can identify an unexpected pulmonary finding, such as an IPN. Hundreds of thousands of IPNs each year are identified on CT and MR exams, often of anatomy other than the chest. Suspicious or concerning areas of abnormal density on radiographs are also common. Unfortunately, these nodules and abnormal regions are frequently lost to follow-up or inappropriately followed ,” said Dr. Erika Schneider, Chief Science Officer at Eon. “Our goal is to create technology that identifies disease before symptoms present, at its earliest and most treatable stages. By expanding our linguistics model, we now offer the most sophisticated solution on the market for early detection of lung cancer.” 

 

Eon uses Computational Linguistics, a data science discipline that interprets text similar to how the human brain does, to engineer the most advanced models on the market today. This approach allows providers to positively identify and track incidental pulmonary nodules with more accuracy than other forms of artificial intelligence like Natural Language Processing (NLP) and Computer Aided Detection (CAD). The technology is developed by a team of physicians and data scientists to provide incidental patient identification and management solutions with embedded evidence that decrease administrative burden and improve patient adherence to follow-up exams.

 

“By expanding our linguistics model, we now offer the most sophisticated solution on the market for early detection of lung cancer.”

— Dr. Erika Schneider, Chief Science Officer at Eon

 

With Eon’s proprietary Computational Linguistics data science model, EPM also extracts clinically relevant findings from radiology reports. The IPN model documents nodule location and characteristics like density, shape, edge, and calcification and automatically populates the information into the EPM dashboard. This allows evidence-based Fleischner Society guidelines to be automatically applied to create an actionable worklist. This approach helps providers by removing excess noise (false positives, low-risk nodules), ensures appropriate patient tracking, and automates complex follow-up.

 

Schneider adds, “Computational Linguistics is the gold standard for language understanding, in particular for lung nodule identification and characteristics extraction. By embedding evidence, the nodule characteristics focus providers’ attention on patients with a high probability of having lung cancer. The high accuracy and reproducibility of our model reduces false positives and does not require radiologists to use a structured report. This approach, along with the embedded risk prediction and automation, should enable providers to prioritize patients and improve their outcomes.” 

 

Eon continues to be at the forefront of raising the bar on incidental disease identification and management solutions. And, expanding its data science models to multiple radiology modalities is another way to identify catastrophic disease earlier and improve patient outcomes. 

Eon EPM Lung Cancer Screening Solution – Save Time, Achieve More

FTEs find themselves in a constant push-pull between administrative tasks and true patient care coordination. However, with the right technology partner, FTEs can prioritize patients with significant Lung-RADS scores and automate longitudinal care and communication with patients at a lower risk.

 

See how Eon’s fully compliant lung cancer screening (LCS) solution saves FTE time by eliminating manual data collation and entry. Eon EPM empowers FTEs to automate routine LCS management tasks like entering and submitting to required registries, tracking follow-up procedures and exams, and creating unlimited custom letters for patients and providers. It is the most powerful technology on the market to maximize time while improving patient outcomes and boosting screening programs’ bandwidth.

Eon Delivers for Patients and Hospitals Alike New ROI Tool Estimates Value of Technology

More than 90% of pulmonary nodules are discovered by accident—or incidentally—and of those, 40% turn out to be cancerous. This is an astounding statistic and the crux of why we do what we do at Eon.

 

When pulmonary nodules are discovered incidentally, they are most likely spotted in a chest x-ray or CT scan that was performed for a purpose other than suspicion of lung cancer. Usually, early-stage lung cancer is asymptomatic and patients don’t begin to present symptoms until the disease has spread. For critical pulmonary nodule patients, the delay in diagnosing lung cancer can have detrimental effects and may even decrease survivability. This fuels our passion for creating superior solutions that help identify at-risk patients to ensure they have the best chances to fight—and beat—a potential lung cancer diagnosis.

 

Eon has developed the only actionable findings Essential Patient Management (EPM) platform to positively identify incidental pulmonary nodules with 97% precision. EPM ensures longitudinal care coordination, resulting in earlier cancer diagnoses and giving patients an advantage to fight the disease. Not only does Eon empower clinicians with the identification of these patients, but it automates routine follow-up necessary to save lives.

 

Saving lives is of utmost importance, but there’s additional value our technology brings. By ensuring patient capture and preventing leakage, Eon boosts hospitals’ bottom line. A retrospective analysis done by our hospital partners found that an identified pulmonary nodule brings on average $3,491 in new downstream revenue to a hospital, and an estimated contribution margin of $1,326.

 

With this information, Eon has developed a return on investment (ROI) tool that allows facilities to easily project the financial implications of using Eon’s end-to-end patient management platform. The Eon ROI Tool allows for any facility to enter their hospital size and CT volume to pragmatically estimate the return for that hospital.

 

Identifying, managing, and tracking pulmonary nodule patients is the key to a positive lung cancer stage shift and a prosperous thoracic oncology service line. To do so requires a coordinated balance between technology and human intervention.

 

To learn more about EPM and how it can help you positively identify incidental pulmonary nodules with 97% precision while boosting hospital revenue streams, contact the Eon Success Team at success@eonhealth.com.

The Story of Michelle Blood – Overcoming Cancer with Grace & Courage

Michelle Blood has always been in control of her life. She’s a mom to three young girls, has a successful career in pharmaceutical sales, and lives a healthy lifestyle. But at 39 years old, everything changed with three simple words: You Have Cancer.

 

“Cancer wasn’t even on my radar. I knew something may be wrong because I was having some bleeding—I thought I had IBS or allergies. But cancer, no way. I didn’t even have an inkling,” she said of her shocking diagnosis.

Michelle’s journey started after her third daughter was born. She was having some bleeding and mentioned it to her PCP at her annual physical. Her doctor referred her to a GI doctor to get checked out, which she did right away. She described her GI exam as a “light check” with the doctor who did not recommend additional tests or follow-up.

 

Michelle recalls, “I specifically remember the doctor saying, ‘nothing warrants me to think you need a colonoscopy.’ Then a year went by until my next physical when I mentioned at the very end of my appointment that I was still bleeding. My PCP dropped everything and told me I needed a colonoscopy. She literally saved my life.”

 

A few days after the test, Michelle received the dreaded news from the doctors that they found a tumor and thought it was cancer. She describes feeling very helpless and in a fog when she was diagnosed with stage 3-plus colorectal cancer. She remembers a doctor handing her a phone number of a specialist to call and “try to get on their schedule.” This was completely uncharted territory for Michelle. No one in her immediate family has ever been diagnosed with cancer. She was at a loss and said, “My head was spinning. I didn’t even know where to start.” Luckily, she had a friend whose husband had a similar diagnosis and quickly put Michelle in touch with her husband’s care team at UC Health.

 

“Once I got into the system, they handled everything. I was expedited because I was stage 3-plus. I was hooked up with a coordinator the first day and they handled everything. They had it all mapped out. I didn’t have to think—I just had to show up. I was taking in the enormity of it all and I needed someone to tell me what to do.”

“They told me that they didn’t think I’d be able to work. In my head, I said, ‘watch me…watch me.’ That was the thing that got me through it all. It was a distraction.”

—  Michelle Blood, Colorectal Cancer Survivor & Eternal Optimist

 
She began an aggressive treatment regimen that included eight rounds of chemotherapy, radiation, and two surgeries where 12-inches of her colon was removed. As a result of her treatment, she suffered severe neuropathy, facial twitches, nausea, and felt extremely run down from it all. Yet, somehow Michelle didn’t miss a beat at work and continued to show up every day even though she was fighting for her life. “They told me that they didn’t think I’d be able to work. In my head, I said, ‘watch me…watch me.’ That was the thing that got me through it all. It was a distraction,” she said.

 

What’s more, her girls also needed their mom and were old enough to know what was going on. Michelle remembers, “I put on a happy face as much as I could. I was so grateful the day they told me that I wouldn’t lose my hair. It would thin, but I wouldn’t lose it. I felt such a sense of relief for my kids. They didn’t need another visual reminder that Mom is sick.”

 

Throughout all of this, Michelle also found strength in those around her. “I truly believe in the power of friendships and family. I got some really amazing advice from a friend. She told me that now is my time to receive. As women, as moms, we are so proud and think we can do it all. I took her advice and let people in. That was the turning point for me. So much love was felt,” she said tearfully.

 

Michelle battled cancer with all she had and won. Her determination and will to live undoubtedly fueled her fight. She is cancer-free and now on a mission to pay it forward whenever given the opportunity to help. And, even though she fought to the brink, she has no regrets. “I wouldn’t trade this journey for anything. It taught me and my girls so many lessons. Every day is a gift. You just don’t know and must live with kindness and graciousness.”

 

There was one thing Michelle had to do before moving beyond her cancer experience. She had to get back in touch with the GI doctor who initially missed her diagnosis. It was her “calling to save others” and after a few attempts to get in touch, she finally got the doctor on the phone. “I said, ‘I’m not calling out of anger. I’m calling because I need to tell you that there is never a too young anymore.’ I told her she missed the mark and I was fighting for my life.”

 

Of course, the doctor was beside herself and completely devastated. But Michelle’s intention was to tell the doctor that cancer doesn’t care how old you are or what your family history is. It’s ruthless and indiscriminate. “Nine times out of 10 it’s nothing, but what if it is something? You just never know and it’s always better to know for sure,” Michelle said.

 

Michelle is a warrior who faced cancer with grace, courage, and ultimately kicked its butt. She is unstoppable and an inspiration to anyone who faces adversity. Thank you, Michelle, for sharing your courageous story. You’re truly amazing!

The Story of Halle Markel – Modern-Day Wonder Woman and Thyroid Cancer Survivor

Hi there! I am Hannah Markel, marketing intern here at Eon. June is Cancer Survivor Month, and we are honoring survivors everywhere by highlighting the stories of cancer warriors. I am so excited to share the story of my role model, hero, and older sister, Halle Markel.

 

It’s hard for me to describe Halle without using clichés and metaphors that people normally use to describe their role models; Brave, strong, and resilient are the first ones to come to mind when thinking about my sister and not-coincidentally the same ones little kids use to describe a superhero. Though she has all the qualities of a modern-day Wonder Woman, it was her wit, confidence, and spirit of adventure that made me sure she had what it takes to save the world. It wasn’t until her cancer diagnosis during her sophomore year of college did I truly realize the sheer power of my sister.

 

My sister left our hometown of Chagrin Falls, Ohio, for Atlanta, Georgia, in the summer of 2014 to attend Emory University. Halle’s transition to college was seamless. She was a standout runner on the Emory University cross country team and led her team to the national championship meet in her first season. She began studying environmental science and economics, and found a tight group of friends.

 

I remember visiting Halle for my spring break during her freshman year. I admired how perfectly she juggled the academic, athletic, and social demands of college so effortlessly. Everyone on her dorm floor knew and loved her. Her cross country coach talked about her grit and toughness. Halle returned to campus the next fall excited to pick up where she left off.

 

During the start of her sophomore cross country season, Halle found herself sleeping more and having less energy. “I just started feeling kind of run-down”. After undergoing testing at Emory Hospital, Halle was diagnosed with thyroid cancer. She had just turned 21.

 

Halle recalls, “It was a pretty crazy, weird time for all of that to be happening. Since I was over 18, I had to be the one to tell my parents.” Despite our family being in Ohio, Halle decided to stay at Emory to keep her life as normal as possible. Although she could no longer compete on the cross country and track team, Halle continued a rigorous course load while incorporating cancer into her college routine. “The hospital was right on campus, so I would almost just treat going to the doctor as my next class.”

 

Not only did Halle have to deal with the physical and emotional stress of cancer, but she also had to manage the stress of college. “You’re stressed out because you have a final, but you don’t actually care that much because you just had a doctor’s appointment that was way more important.”

 

Halle says she would have gone home to get treatment if it wasn’t for the incredible advocacy and effectiveness of her nurse navigators. “I had an awesome team. It was kind of a weird case, I had all these different endocrine issues going on and they just wanted to take care of me. They were exhausting a lot of brainpower and making sure that they were being creative and innovative. Honestly, the majority of it was how transparent they were with me the whole time. That was huge.”

Though she has all the qualities of a modern-day Wonder Woman, it was her wit, confidence, and spirit of adventure that made me sure she had what it takes to save the world. It wasn’t until her cancer diagnosis during her sophomore year of college did I truly realize the sheer power of my sister.

 

Halle’s first surgery was a partial lobectomy. “I went home for surgery over fall break and thought I could recover after fall break and have my finals perfectly lined up. That, of course, didn’t happen.” Unfortunately, later tests showed the cancer metastasized to the remaining half of her thyroid and lymph nodes. “Instead of having this ‘Found out, got it fixed, done with’ (experience), it spread it out through a good chunk of my college experience.”

 

During all of this, Halle was mourning the loss of that sport that she has been competing in her whole life, as well as mourning the loss of life as a normal college student. I have always looked up to Halle for her ability to use her own light to brighten times of darkness, but even during this, she was focused on shielding me from the trauma she was experiencing.

 

“One of the things that I would go back and do over is change how I internalized a lot of it because it wasn’t a fun conversation I wanted to have. I think that is something I would do sometimes in the beginning, but then I just realized that is never going to work. If I wanted to have fun and keep my friendships, I was going to have to be a little more open about what was going on.” With our family 700-miles away, Halle had to learn to lean on her friends. “I would try to have fun with my friends, go on walks, go out if I felt up to it—just trying not to set my entire focus on this”.

 

Halle underwent radioactive iodine treatment that she described as “you basically take a pill of radioactive iodine and for the next 30 days you’re radioactive” to make sure the surgeries worked.

 

Directly after treatment, she was quarantined for a week and a half in an American Cancer Society home, which was located near Emory’s campus. Halle remembers her friends leaving her treats and presents at her door daily. Our parents were able to come down and quarantine with her after the risk of contact radiation decreased. After 30 days, Halle went back to the doctors. On February 15 of 2017, Halle was declared cancer-free.

 

“I feel brave,” Halle said confidently. “It was something I did and a lot of it on my own. It was scary, but I feel like there are a lot of things I can do now because I overcame this.” Halle said she learned a lot about herself through her experience. “I learned I can empower people through my story so making them feel a little more comfortable in helping people who have gone through something hard like that or need to empathize with something that is going on in their life.”

 

Despite all of this, Halle graduated from college a semester early and moved to Denver, CO, a few weeks later to begin a consulting program with Oracle. Halle became a “Love Your Melon” ambassador and is committed to destigmatizing cancer.

 

“I have a pretty funky scar that goes over my neck, so whenever I see someone that has a similar scar, I ask about it, which some people think is rude. So much of what has helped me is believing that it’s a shared experience.” She says making cancer “a little more normal” helps her and others overcome.

 

This month, and every month before and after, I have been the proudest little sister. I am extremely honored to celebrate my sister’s story and all other cancer warriors during Cancer Survivor Month.