Moffitt “Angels” Supportive Care Medicine Helps South Florida Woman Win Fight Of Her Life

By Michelle Bearden

Prematie Jebodh Never Felt More Scared Than When She Was Diagnosed With Breast Cancer.

Prematie Jebodh

The Boynton Beach, Fla., woman had no insurance. She and her husband,
Ricky, both natives of Trinidad, lived with their son, who helped support his parents. Jebodh had no idea how to navigate the complicated American health care system. Surviving a fast-growing, aggressive stage 3 cancer meant she didn’t have the luxury of time.

She had a mastectomy and 24 lymph nodes removed at a south Florida hospital but needed specialized follow-up treatment. Where to turn?

A devout woman of faith, she says she found her salvation five hours away at Moffitt Cancer Center.

“Someone suggested I call. I did it without much hope,” she admits. “Tampa was far away. Why would they want to take care of me?”

With a mission to contribute to the prevention and cure of cancer for all, Moffitt opened its doors to Jebodh and provided essential cancer care. Doctors and nurses researched and delivered the recommended chemotherapy and radiation. To manage the cancer with the best treatments available, the Moffitt oncology team also referred her to the Supportive Care Medicine Department. The approach of the specialized team of health care professionals at Moffitt is whole-person care. While oncology clinicians focus on controlling the cancer, the Supportive Care Medicine providers address the physical, emotional and spiritual challenges that accompany the cancer diagnosis and treatments. Jebodh became the focus of Moffitt professionals dedicated to her well-being.

Social workers helped her with financial aid and arranging nearby hotel rooms for overnight stays when Ricky drove her up for treatment sessions. A palliative specialist prescribed the best medications to control the pain. A psychologist talked her through her depression; a chaplain gave her spiritual solace.

Without them, Jebodh believes she never could have survived the rigors of cancer. They gave her peace of mind and the guidance she sorely needed to survive the toughest fight of her life. She is still waging the battle, but not alone.

Simply put, Jebodh says tearfully, “They are angels. The people who work there, they are making miracles every day. I am one of them.”

Ann Guastella, ARNP, is one of those angels.

For three years, she has worked as an advanced registered nurse practitioner in the department of Supportive Care Medicine. Before coming to Moffitt, the Valrico woman spent two decades working in hospice programs.

Guastella says she has always been drawn to the care of the whole person, not just the disease.

Given her longtime work in hospice, she knows myriad challenges can be draining on both the patient and the family coping with a medical crisis. Treatment alone can be overwhelming, as well as other issues that must be considered: emotional, social and spiritual.

It is at this critical juncture where Guastella feels she is most needed.

“A serious illness can be so isolating,” she says. “Without a support system, even more so. In cases where there is no family, we become that support system.”

Invariably, the first question a person asks when given a diagnosis for a serious disease is “What are my treatment options?” Once that is discussed and explored, Guastella says the rush of other questions begins. How will this impact my family? How can I pay for this? What if I can’t handle the pain? How can I handle everyday life while I go through treatment? If I die, where am I going?

Those questions are typically out of the realm of the health professional treating the patient. Not so in the Supportive Care Medicine Program. Being part of an interdisciplinary team that addresses those concerns is the most satisfying part of Guastella’s work.

“That’s why I went into this profession in the first place,” she says. “I want to make a difference in improving the quality of the patient’s life and help ease that journey, whether it’s at the beginning or the end.”

That compassion is also evident in her personal life. When she and her husband aren’t doting on their two Siberian Huskies, she’s volunteering with her Krewe of Pair O’ Dice, which works with Good Samaritan Mission, the Animal Coalition of Tampa and low-income schools.

Team members like Guastella make Diane Portman, M.D., proud.

As leader of the Supportive Care Medicine Department, Dr. Portman says patients who have a serious illness not only suffer from the disease itself but also from a variety of physical, social, emotional and spiritual challenges that together cause unnecessary misery.

“When we treat the whole person, we alleviate pain and other symptoms that compromise well-being, and also reduce the patient’s and family’s stressors,” she notes. In turn, that can enhance the patient’s ability to pursue treatments that may lessen the disease burden and even improve overall longevity. 

And she has yet another reason to be proud of the program that combines the three sectors of palliative, behavioral and integrative medicine. Last May, the program achieved Joint Commission advanced certification — the only separate department joint commission accreditation at Moffitt.

Jebodh and her husband came to the United States 14 years ago, looking for a better life. She worked occasionally cleaning houses; he worked in a service station.

Their three children, now grown, live and work here. But money was always tight. Jebodh dreamed of returning to visit her homeland and to see her kin again. She would shut her eyes and smell the ocean, feel the island breezes and hear the calypso music. One day, she promised herself.

Then in April 2013, that dream skidded to a halt. Breast cancer sent her life spiraling in another direction. Now any hopes of going home had to be shelved, replaced by a far more urgent goal: surviving the disease.

She says making that call to Moffitt is why she’s alive today. Fourteen chemotherapy treatments and six weeks of radiation, under the direction of medical oncologist Loretta Loftus, M.D., gave her hope that she could beat this disease. Her social worker, Amy Burke, kept her spirits up. The Supportive Care Medicine Program experts helped her combat her pain, depression and spiritual concerns. And just when she thought she was winning, Jebodh was dealt another blow last May.

The cancer had spread to her lungs. In the fall, she began yet another regimen at Moffitt to continue the battle. With the support of her Oncology and Supportive Care Medicine teams, she is still fighting.

She doesn’t dwell on what she’s been through. Instead, Jebodh counts her blessings. And she says she has plenty.

In December, in a trip funded by extended family, she and Ricky went home to Trinidad for two weeks. Though she didn’t have the energy to do much traveling or celebrating, Jebodh got enough hugs from loved ones to last a lifetime. Her dream, at last, fulfilled.

She says her Moffitt angels made it happen.

“We have a saying. God couldn’t be here, so he put angels all around us,” Jebodh says. “I know it’s true. They have lifted me up and given me hope. I do not feel alone anymore. They are right here with me.”