Marsha Olsen’s grandmother always used to say, “You have one body, take good care of it.” And for most of her life, Olsen has spread that message as a middle school physical education and health teacher instilling healthy habits in her students.
“I wanted all my students to have a positive experience in physical education, no matter their abilities,” she recalls. “It was important that they continue physical education outside of my class.”
Eventually she became a principal, but up until she retired, she remained a constant fixture at her school in Connecticut, making sure to be at every after-school athletic event, school play, and concert.
Being a teacher is what Olsen does best. But after a Whipple procedure — the removal of part of her pancreas, gallbladder, and small intestine — she became a student again.
Misdiagnosed causes
For years, Olsen had struggled with bouts of pancreatitis, a painful swelling of the pancreas, which resulted in more than a dozen hospitalizations. Every time, she was told it was due to her diet or lifestyle. Pancreatitis can sometimes be caused by excessive alcohol consumption or high fat levels in the blood, but all her life Olsen had tried to follow her grandmother’s advice and ate healthy, exercised daily, and never consumed more than one alcoholic drink at social gatherings.
She tried cutting out almost all fat, stopped drinking alcohol altogether, and made sure to stay hydrated, but the swelling kept coming back. Finally, a pancreatic specialist found the cause: a cyst in the pancreas duct.
This so-called intraductal papillary mucinous neoplasm is usually benign but can sometimes lead to pancreatic cancer. To show the best way forward, Olsen needed a care team with the right expertise and experience. She found it at the Dana-Farber Brigham Cancer Center Pancreas and Biliary Tumor Center, a multidisciplinary clinic dedicated to evaluating and treating both benign and cancerous pancreatic and biliary (liver, gallbladder or bile duct) tumors.
Physicians there determined Olsen should undergo a Whipple procedure. Removing parts of the pancreas, gallbladder, and small intestine would ensure that Olsen no longer experienced pancreatitis. A biopsy at the time also revealed a small cluster of cancer cells in the cyst. Fortunately, it was removed during the surgery, but Olsen was referred to a Dana-Farber oncologist for surveillance.
New digestive system, new lessons
Since these organs play key roles in the digestive system, the Whipple procedure has major effects on the digestive system, including increased difficulty absorbing nutrients.
For many patients, the diet they need to be on following the surgery, coupled with a digestive system adjusting to a new normal, results in weight loss. Olsen was no exception.
This is why all patients who have the surgery at Dana-Farber have access to Dana-Farber’s oncology dietitians. Olsen’s Dana-Farber oncologist referred her there, and she came to Elizabeth Prentice, MS, RD, almost 20 pounds underweight and with questions about what and how to eat.
Together, they worked on a plan that began with frequent small meals and addressing any symptoms she experienced.
“Liz had answers for every one of my questions,” Olsen says. “She is an outstanding nutritional expert.”
When Olsen worried about some lower abdominal pain she experienced, for example, Prentice encouraged Olsen to introduce more probiotics in the diet to counteract a build-up of harmful bacteria.
Olsen had also developed osteoporosis, a condition which causes bones to become weak. Prentice suggested a calcium supplement, along with adding some weighted exercise to her workout regimen.
Olsen’s lived experience left her with some misconceptions about food. She avoided eggs because of a family history of heart disease and kept away from fat because of her struggles with pancreatitis. Prentice understood her concerns.
“We don’t eat in a vacuum,” she says. “Our eating habits are influenced by many factors and experiences.”
To support her pancreas in breaking down fats, Prentice helped Olsen find an appropriate pancreatic enzyme supplement that works similarly to the lactase enzyme someone who is lactose intolerant might take before ingesting dairy.
But more importantly, she shared the latest research on healthy fats with Olsen, ensuring that she understood it completely and dispelled her lingering concerns.
This is an essential part of a dietitian’s role at Dana-Farber.
“It’s about creating trust,” Prentice says.
Back to teaching
Olsen is now back to her normal weight and feeling her healthiest self. Most days she can be found just after sunrise on a Cape Cod beach going for her daily walk before returning home to her work: developing and offering courses for teachers pursuing professional development at a state university in Massachusetts.
After her Whipple procedure, Olsen credits much of her good health today to Prentice.
“My goal has always been to be active and productive and live to 100,” Olsen says. “Working with Liz and my care team, I still have the opportunity to reach my goal.”