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Let’s Eat! RPCI’S DIETITIANS CAN HELP YOU MAKE THE MOST OF EVERY BITE Most people know that nausea can be an unwelcome side effect of cancer therapy, causing loss of appetite and poor nutrition. But treatments can also cause constipation, diarrhea, altered sense of taste, early satiety (feeling full very quickly), or even increased appetite and weight gain. “Everyone gets different symptoms,” explains RPCI Clinical Dietitian Rachel Simson, MS, RD, CDN. “We have to assess what the patient needs and look at where they are in their treatment. Some people start chemotherapy and feel fine, and all of a sudden, a few weeks later, they feel the effects.” Simson and her colleagues help by recommending foods that are “best tolerated with the patient’s symptoms — possibly colder foods, roomtemperature foods, or bland foods that don’t worsen the nausea. We also make sure they are taking any prescribed anti-emetics [medications to control nausea].” Dietitians can also point out foods to help prevent or relieve constipation or nausea. “Metallic taste is common in patients who receive radiation,” Simson adds, “and acidic foods make it worse. For those patients, we also recommend using plastic utensils.” Cancer Diagnosis? MARCH 2015 THINK ABOUT YOUR DIET’S LONGTERM EFFECTS If your appetite isn’t up to par, it’s important to choose foods that deliver more calories or nutrients per serving, Simson says. You can also try eating smaller but more frequent meals throughout the day, or adding nutrition-supplement drinks to your diet. Because a patient’s appetite can change over time, an RPCI dietitian assesses every inpatient at the time of admission to the hospital and then follows up on a regular basis to make sure the patient continues to eat well. Outpatients can receive a nutritional assessment on the recommendation of a nurse or physician. No matter where you are in your treatment plan, remember that eating well “is really important,” Simson says. “It’s like the gas in your car — it keeps you going!” March is National Nutrition Month. We are grateful to the RPCI dietitians who help our patients stay healthy through cancer treatment and beyond. RPCI patient Linda Pajak, left, talks with Clinical Dietitian Rachel Simson, MS, RD, CDN, about meal choices on the inpatient room service menu. “More and more people are surviving cancer, so survivors — just like everybody else — have to think about the effects of diet on their long-term health,” says James Marshall, PhD, Senior Vice President, Cancer Prevention and Population Sciences. That means protecting yourself against heart disease in particular, which claims more lives than cancer. Dr. Marshall’s advice: “Increase your intake of vegetables and fruits. The plant-based diet is the way to go.” Along with James Mohler, MD, Chair of Urology at RPCI, Dr. Marshall is investigating whether a plant-based diet could also affect the course of the disease in men with low-risk prostate cancer who choose active surveillance (“watchful waiting”) instead of entering treatment right away. Learn more about the Men’s Eating And Living (MEAL) study at roswellpark.org/clinical-trials/ list/1914. Early Treatment, Specialized Care: A BALANCING ACT IN SPINAL DISEASE Think of your spinal cord as a cable that carries orders and messages between your body and your brain. It’s enclosed and protected by 33 vertebrae, the bones that run down the center of your back. When disease affects the spinal column, you may experience pain, numbness, muscle weakness, difficulty walking, or bowel or bladder incontinence (inability to hold urine or bowel movements). This may be caused by: • Tumors, either malignant (cancer) or benign (not cancer). If the tumors are malignant, they may be primary (starting out in the spine) or metastatic (spreading to the spine from other parts of the body). Metastatic spinal tumors are usually associated with lung or breast cancer, but can also arise from prostate, gastrointestinal, or kidney cancers, lymphoma or melanoma. • Fractures (cracks) in the vertebrae, which can be caused by osteoporosis (brittle bones) or as a side effect of radiation therapy or the use of steroids. If medical imaging shows that you have disease in your spine, it’s important to see a neurosurgeon who is specially trained in treating spinal disease. The types of treatments you receive — and the order in which they’re given Stay Connected: Questions? Comments? Contact 1-877-ASK-RPCI or [email protected] 28615 — will determine how well the disease is controlled and pain is managed, your level of mobility, and your overall quality of life. In some cases, removing tumors that were pressing on the spinal cord can even restore neurological functions that were lost. Roswell Park’s Spinal Oncology Center is staffed by expert neurosurgeons who work together with other surgical oncologists as well as specialists in pathology (diagnosis of disease), pain management, medical imaging, medical oncology, and radiation oncology to review your case from every angle and develop a treatment plan based on your unique needs. “Before you receive any radiation treatments, you should be evaluated to determine whether you might need surgery in the future,” explains Andrew Fabiano, MD, FAANS, director of the Spinal Oncology Center. Because radiation treatments can affect tissue, “if you receive surgery after radiation therapy, you may be at greater risk for complications, including the level of pain you experience after surgery.” RPCI’s Spinal Oncology Center is equipped to provide the most advanced treatments. The O-Arm® imaging system increases safety and accuracy by enabling the neurosurgeon to see real-time images of the spine during surgery. Stereotactic body radiation therapy (SBRT) delivers high doses of radiation with minimal side effects. For patients with spinal fractures, a minimally invasive outpatient procedure called balloon kyphoplasty can be used to relieve pain. And you can see several specialists in one day, all at the RPCI hospital. If you’ve been diagnosed with spinal disease, remember that it should be treated early for the best outcome. LEFT: Andrew Fabiano, MD, right, director of RPCI’s Spinal Oncology Center, in the operating room with neurosurgery resident Gursant Atwal, MD. RIGHT: Dr. Fabiano with patient. Patient Education Notes Work, Cancer & Your Legal Rights Research shows that cancer survivors who continue to work are as productive on the job as other workers, and most who are physically able to work do go back to their jobs. But whether they’re returning to an existing job or starting a new one, some are treated unfairly in the workplace. What are your rights as an employee? Get your cowboy boots ready for WYRK’s June 12 Taste of Country concert — featuring Dierks Bentley, Joe Nichols, and other stars — and help our pediatric patients at the same time. When you buy your tickets online, you’ll be invited to add a $1 donation to your ticket total to help us create the new Pediatric Hematology Oncology Outpatient Center at Roswell Park. AMERICANS WITH DISABILITIES ACT (ADA) Planned in partnership with the new John R. Oishei Children’s Hospital, the outpatient center will be based at Roswell Park to provide our little ones with easy access to chemotherapy, radiation therapy, and Gamma Knife radiosurgery. This federal law forbids discrimination in any aspect of employment (hiring, firing, pay, job assignments, promotions, layoff, training, fringe benefits, etc.) based on a disability or history of a disability. A disability is a physical or mental impairment that substantially limits a major life activity, such as seeing, hearing, eating, sleeping, walking, breathing, thinking, immune system function, normal cell growth, and endocrine and reproductive functions. Learn more at roswellpark.org/countrymusic Remembered Beloved Physician To Be AT APRIL 24 MEMORIAL SERVICE Meir Wetzler, MD, Chief of the Leukemia Section at Roswell Park Cancer Institute (RPCI), unexpectedly passed away on Feb. 23, 2015. He is remembered as a physician and researcher who helped raise the standard of care for leukemia patients across the nation, and who worked tirelessly to make the most advanced treatments available to his patients. Dr. Wetzler will be honored at a memorial service on Friday, April 24, from 3-5 p.m. in the Research Studies Center (on Carlton Street, across from the hospital). Everyone is welcome, but if you plan to attend, please RSVP by calling 716-845-8182 by April 20. To continue his legacy, RPCI has established the Dr. Meir Wetzler Memorial Fund for Leukemia Research. A tree will be planted in his memory in Kaminski Park & Gardens, adjacent to the hospital. You can read about Dr. Wetzler’s impact on his patients and colleagues at roswellpark.org/media/news/he-was-like-a-father. One Mission delivers news, information, and stories of hope and inspiration to the patients and families served by Roswell Park Cancer Institute (RPCI), in keeping with RPCI’s mission to understand, prevent, and cure cancer. This patient newsletter is written, created and designed by RPCI’s Department of Marketing, Planning, Public Affairs and Customer Relationship Management with content contributed by various departments at Roswell Park. Questions? Suggestions? Email [email protected] or write to: Public Affairs Office, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263. The ADA covers employees of state and local governments and private companies with 15 or more employees. If you have cancer, this law covers you if: 1) you choose to tell your supervisor about your diagnosis and 2) require reasonable workplace accommodations. Reasonable accommodations may include a different work schedule, reassignment to a position with fewer physical demands, or a more comfortable chair. You keep the right to reasonable accommodation even if your condition is intermittent (comes & goes), under control (you have no symptoms), or in remission. Learn more about the ADA at www.eeoc.gov/eeoc/publications/fs-ada.cfm. For questions about cancer in the workplace and the Americans with Disabilities Act, visit www.eeoc.gov/laws/types/cancer.cf. THE FEDERAL REHABILITATION ACT The Federal Rehabilitation Act prohibits employers from discriminating against employees because they have cancer. It applies only to employees of the federal government and private and public employers who receive public funds. Learn more: www.hhs.gov/ocr/civilrights/resources/factsheets/504.pdf. FAMILY MEDICAL LEAVE ACT (FMLA) The Family Medical Leave Act gives you the right to take time off due to illness, or to care for a dependent who is ill, without losing your job. The law applies to workers at all government agencies and schools, as well as private companies with 50 or more employees within 75 miles. It guarantees that eligible* employees: • Get up to 12 weeks of unpaid leave. • Keep their health insurance benefits while on leave. • Can return to their previous position (or equivalent) with the same salary and benefits when they resume work. *Eligibility: you must have worked for your employer for at least 12 months and have worked at least 1,250 hours during the last 12 months. Learn more: www.dol.gov/whd/fmla Cancer and Careers gives people with cancer the tools and information they need for the workplace. Their “At Work” page, www.cancerandcareers.org/en/at-work, covers a wide range of topics: •C reating an action plan • Tips on sharing the news about your diagnosis •M anaging treatment side effects • L egal and financial issues • Your mindset/coping with cancer Information on this page is provided by Roswell Park’s Patient Education Department. Questions or comments? Please call 716-845-8784. THE PAT I E NT EXP ERIENCE MAKING THINGS BETTER FOR FUTURE PATIENTS Survivors on advisory board promote a patient’s-eye view of RPCI Veronica Meadows-Ray, center, with her aunt, Evelyn Smith, left, and mother, Mary Meadows; all three are breast cancer survivors. Through her work on RPCI’s Patient and Family Advisory Board, Meadows-Ray works on behalf of current and future RPCI patients. Photo by Doug Levere. On the first Monday of every month, Veronica Meadows-Ray heads to Roswell Park Cancer Institute (RPCI). At 5:30 p.m., she and about 23 other people enjoy a catered dinner together, and then it’s time to get down to business — the business of looking at the hospital through the eyes of patients and caregivers. the Patient/Family Experience, often shares with the committee the actions that RPCI took based on the committees’ recommendations. These members of RPCI’s Patient and Family Advisory Board put their heads together to identify ways of improving programs, services, clinical care, and physical spaces — almost every aspect of what patients experience at RPCI from the moment they enter the front doors of the hospital. “We get the meeting agenda ahead of time,” says Meadows-Ray, “so we have time to think about what’s going to be discussed, and if we want to, we can research a topic before we come to the meeting.” I love Roswell so much, and they’ve done so While some committee members are caregivers, most are survivors. Meadows-Ray and other breast cancer survivors on the committee have made important suggestions for both the design of the new Breast Center and the training program for its staff. Survivors of other types of cancer often make suggestions for improving the clinics where they received care. But while personal experience with a particular clinic can be valuable, committee members are encouraged to contribute to decision-making about improvements in all of RPCI’s patient-care areas. The experience has been “much more hands-on than I ever expected,” says Meadows-Ray, adding that the committee’s recommendations are making a real impact. She says Kara Eaton-Weaver, Executive Director of the Office of “It’s nice to see positive change based on our input,” says Meadows-Ray. “You can see that something is actually being done. much for me, so anything I can do to help means a lot to me. It’s been really fulfilling to be part of making things better for future patients. – Veronica Meadows-Ray I encourage them and let them know they’re not alone — that somebody really cares and is praying for them. Two New Chaplains Bring Spiritual Comfort TO RPCI PATIENTS & FAMILIES Rev. Melody Rutherford, M.Div., knows firsthand that illness can separate patients and caregivers from their faith congregations. When her father was very ill, caring for him made it impossible for her mother to attend church on a regular basis — at a time when she needed that support most. “Sometimes you miss being with the people who enrich you spiritually,” says Rev. Rutherford. If you’d like to join the Patient and Family Advisory Board so you can help influence future patientfocused projects at Roswell Park, please call the Department of the Patient/Family Experience at 716-845-8114. As one of two new Protestant chaplains at Roswell Park, she hopes to fill that empty place for patients who find themselves in the same situation. “I encourage them and let them know they’re not alone — that somebody really cares and is praying for them. Sometimes they ask me to contact the pastor of their own church or to read scripture or a poem, or to just sit and hold their hand. Touching — that human connection— is very important.” It’s a blessing, she says, when patients and families “let me enter their journey. I don’t take that lightly.” Breast Cancer Survivors: The FDA Wants to Hear from You If you’re a breast cancer survivor, the Food & Drug Administration wants your opinion about available treatments and your perspective on how the disease has affected your daily life. Comments may be submitted online until June 2, 2015. Visit www.regulations.gov/#!docketDetail;D=FDA-2014-N-2137 and click on the blue “Comment Now!” button near the top of the page. If you’ll be in the Silver Spring, Maryland, area on April 2, you’re invited to attend a public meeting on the same topic. (You must register by March 23.) For full details, visit the link above and click on the blue link for “Public Meeting on Patient-Focused Drug Development for Breast Cancer Request for Comments.” Since 1992 Rev. Rutherford has served in ministry in various capacities, including as host of a live Christian radio broadcast. She has 27 years of experience in healthcare, in such areas as chaplaincy services, clinical pastoral education, and mission services. For Rev. Elena Delgado, M.Div., ministry is a family affair: her father was a Presbyterian pastor. But she herself didn’t enter the seminary until later in life, after establishing a career. That decision was influenced largely by a 1983 journey to Central America, when Guatemala was embroiled in a civil war and the Sandinista revolution was causing upheaval in Nicaragua. “The opportunity to hear stories of RPCI Chaplain Rev. Melody Rutherford, M.Div., right, visits with Garnet McConnaughay. hope, struggle, and faith challenged me to reassess the purpose and direction of my life,” she says. “What appeals to me about ministering to people with cancer are the questions that arise when confronted by disease, the courage of the human heart and mind in the face of cancer, the honesty that can come when facing fear, the hope and faith of family, and the power of love to overcome despair and transform life.” A graduate of Union Presbyterian Seminary in Virginia, Rev. Delgado served previously as a chaplain at Hospice Buffalo. Rev. Rutherford earned a master of divinity degree from Northeastern Seminary and is an associate minister at a local church. The two new chaplains join a team that also includes a Roman Catholic priest, chaplain, and two deacons, as well as faith leaders who provide spiritual support for patients who are Buddhist, Greek Orthodox, Hindu, Jewish, Native American, Jehovah’s Witness, Muslim, or Sikh, among many other denominations. To request a visit from a spiritual leader of your faith, call Pastoral Care at 716-845-8051. Rev. Delgado 1 PALM SUNDAY /HOLY WEEK BEGINS (CHRISTIANITY) 29 22 15 SUNDAY Catholic Mass (Chapel - 1st flr.) Tobacco Cessation: 5-week class (845-8667) Noon Noon1:30pm Tobacco Cessation: 5-week class (845-8667) Pet Therapy: Nitro (Doberman Pinscher) Noon1:30pm Noon2pm Tobacco Cessation: 5-week class (845-8667) Noon1:30pm Look Good Feel Better program, Jacobs Conf. Rm., Hospital, 1st flr. (Call to register: 1-800-2272345.) Tobacco Cessation: 5-week class (845-8667) Catholic Mass (Chapel 1st flr.) Noon1:30pm Noon Pet Therapy: Maddie (Springer Spaniel) 11am1pm 9:3011:30am National Doctors’ Day - 30 Pet Therapy: Nitro (Doberman Pinscher) Tobacco Cessation: 5-week class (845-8667) Noon1:30pm Noon2pm Catholic Mass (Chapel 1st flr.) Noon 23 Catholic Mass (Chapel 1st flr.) 16 10amNoon 17 Pet Therapy: Sierra (Beagle) TUESDAY Pet Therapy: Pepper (Labrador Retriever) “Understanding Multiple Myeloma: Diagnosis, Treatment & Side Effects Management” - Ephesus Ministries, 341 Grider St., Buffalo. Pre-registration required: 249-3004 or 800-784-2368, ext. 4662, or [email protected]. Grief Education Evening: “Cleaning Out Your Closet - When the Reality of the Death Hits You,” Westminster Presbyterian Church (845-8051) Kevin Guest House Spring Flower Sale, Hospital, main lobby 7:30am3:30pm Kevin Guest House Spring Flower Sale, Hospital, main lobby Pet Therapy: Sierra (Beagle) 7:30am3:30pm 10amNoon 31 Pet Therapy: Pepper (Labrador Retriever) 9:3011:30am 24 MARCH 17th is ST. PATRICK’S DAY 6:30pm 9:3011:30am 5:308pm 10 “US TOO” Prostate Cancer Support Grp.; Speaker: Dr. Raja S. Cheruvu of Windsong Radiology, VA Medical Ctr., Bailey Ave., Rm. 301 (743-7595) 7-9pm 3 Pet Therapy: Sierra (Beagle) TUESDAY 10amNoon Noon Pet Therapy: Maddie (Springer Spaniel) MONDAY Catholic Mass (Chapel - 1st flr.) Noon 9 Pet Therapy: Maddie (Springer Spaniel) 2 9:3011:30am MONDAY 9:3011:30am 8 Protestant Communion Daylight Savings 11am SUNDAY Roswell Park Cancer Institute Stay connected with RPCI: Facebook.com/RoswellPark Twitter.com/RoswellPark March 4 Ostomy Support Grp., Jacobs Conference Room, Rm. 1320, 1st flr. Call Kate (845-8022) or Melissa (8454891). Cancer Survivor Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) 12:302pm 6-7:30pm Cancer Survivor Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) Artists-inResidence program takes place Monday – Friday from 9am-5pm. Artists can be found throughout the hospital, including clinic areas. For more info, call 8451550. THE LIFE TRANISITIONS CENTER HAS MOVED TO 150 BENNETT RD., CHEEKTOWAGA (836-6460) Unable to attend a support group? Visit our online patient community: www.cancerconnect.com/roswellpark. Support Groups – find more details at: www.roswellpark.org/support-groups. Pet Therapy: Chloe (Golden Retriever) 6-7:30pm 9-11am Pet Therapy: Taz (Golden Retriever) 26 Pet Therapy: Charlie (Golden Retriever) 1-3pm Muslim Friday prayer, chapel 1st flr. Also any time chapel is available. 1:30pm Muslim Friday prayer, chapel 1st flr. Also any time chapel is available. 1:30pm 28 “Coping with Childhood Blood Cancers,” Holiday Inn, 620 Delaware Ave., Buffalo. RSVP by 3/18 at 249-3004 or mary.walls@ lls.org. RAM NAVAMI, BIRTH OF LORD RAMA (HINDUISM) 8:1511am GUDHI PADVAFUGADI, NEW YEAR (HINDUISM) 21 SATURDAY 14 7 SATURDAY Pet therapy dogs can be found in designated areas throughout the hospital, including the lobby and clinic areas. For more info, call 845-5708. Please note: pet therapy dog visits are subject to change. Breast Resource Center (845-4432) is located in the Breast Center on the 2nd floor. The Resource Center for Patients and Families (845-8659) is on the 1st floor, in the Sunflower Café. Tobacco Cessation Support, Rm. H1320 (Other times by appt. – call 845-8803.) Pet Therapy: Miki (Bichon) 27 Muslim Friday prayer, chapel 1st flr. Also any time chapel is available. Tobacco Cessation Support, Rm. H1320 (Other times by appt. – call 845-8803.) Noon1pm 9-11am 1:30pm Noon1pm NO PET THERAPY Spring Equinox - 20 FRIDAY Tobacco Cessation Support, Rm. H1320 (Other times by appt. – call 845-8803.) Pet Therapy: Miki (Bichon) 13 Noon1pm 9-11am 1:30pm Noon1pm Noon NO PET THERAPY 29th Annnual Hospice Spring Bouquet Sale, Hospital, main lobby (6868090) Catholic Mass (Chapel - 1st flr.) Tobacco Cessation Support, Rm. H1320 (Other times by appt. – call 845-8803.) Muslim Friday prayer, chapel 1st flr. Also any time chapel is available. Lymphedema Awareness Day - 6 FRIDAY 10am3:30pm Need a place to relax? Please visit the newly remodeled hospitality room on the ground floor of the hospital, near Radiation Medicine (HG-550). Refreshments are provided by hospital volunteers. Cancer Coach Program via the Cancer Wellness Center is available daily. A Cancer Coach is a trained volunteer cancer survivor who is matched with a patient with a similar diagnosis. To participate, please contact the Cancer Wellness Center at 694-1395. 25 Kevin Guest House Spring Flower Sale, Hospital, main lobby Noon-2pm 7:30am3:30pm Young Breast Cancer Survivors Networking Group, Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) 6:30-8pm Cancer Survivor Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) 6-7:30pm Bereavement Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) Caregiver Support Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) Pet Therapy: Sophie & Macie (West Highland Terriers) 9-11am 19 THURSDAY Bereavement Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) 6-7:30pm Pet Therapy: Bear (Golden Retriever) SIKH NEW YEAR 12 Books Are Fun sale, Medical Research Complex connector Pet Therapy: Sophie & Macie (West Highland Terriers) 29th Annnual Hospice Spring Bouquet Sale, Hospital, main lobby (6868090) Pet Therapy: Charlie (Golden Retriever) “US TOO” Prostate Cancer Support Grp., St. Joseph campus, 206 Harlem Rd., 1st flr. (743-7595) All Blood Cancer Support Grp., Westminster Presbyterian Church, 724 Delaware Ave., Buffalo (249-3004) 6-7:30pm 6-8pm 5 6-7:30pm 1-3pm 7-9pm 1-3pm 10am3:30pm 9-11am 7am-3pm Head & Neck Cancer Support, Mary & Ralph C. Wilson Counseling Ctr., 150 Bennett Rd., Cheektowaga (Amy: 845-4947) Catholic Mass (Chapel - 1st flr.) Noon THURSDAY HOLI/RANGAPANCHAMI - FESTIVAL OF COBRA/SPRING (HINDUISM) LANTERN FESTIVAL (CHINESE) PURIM (JUDAISM) 4:30-6pm Pet Therapy: Rorie (Goldendoodle) 9-11am 2015 For more information about our events, please visit RoswellPark.org/Awareness COLORECTAL, KIDNEY & MYELOMA CANCER AWARENESS MONTH Patient Activities Calendar WOMEN’S HISTORY MONTH Kick Butts Day - 18 WEDNESDAY March 2015 Pet Therapy: Chloe (Golden Retriever) Patient Signature Society, Pressman Conference Rm., RSC, Baily Muto (845-3916) 11 Pet Therapy: Rorie (Goldendoodle) 29th Annnual Hospice Spring Bouquet Sale, Hospital, main lobby (686-8090) Books Are Fun sale, Medical Research Complex connector Catholic Mass (Chapel - 1st flr.) Metastatic Breast Cancer Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (845-4432) Caregiver Support Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) Cancer Survivor Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) Bereavement Grp., Life Transitions Ctr., 150 Bennett Rd., Cheektowaga (836-6460) “Spirituality & Healing” - Speakers: Drs. Nosek & Sabatino, Daemen College, Wick Ctr., 1st flr. (694-1395) Noon2pm 9-10am 6:308:30pm 6-8pm 6-7:30pm 6-7:30pm Noon 5:30-7pm 9am-4pm 9-11am 9am-4pm WEDNESDAY NATIONAL NUTRITION MONTH SOCIAL WORK MONTH