? The Death Panel?

choices medicalI have been out of the loop for several days. Had thyroid surgery on Friday and am feeling good…just tired. After a fall season of chaos I hope we are moving into a winter season of rest and joy. I now have to catch up on reading everything that I missed.

I hadn’t been involved in the hospital system for a while and had forgotten how dehumanizing it can be. The hospital was good, care was good it is just how the system operates. It is so easy to feel like someone out of one of the dystopian novels. Especially the older ones like 1984 and Soylent Green. It is easy to imagine yourself discovering that the light embedded in your arm has just lit up and it is time for you to go and be floated up to bliss.

It has been under discussion and very much under wraps having a Death Panel decide who will be left to die. The majority of money is spent on end of life care. Sometimes the kind where life is extended but not necessarily for the better.However, judgement needs to be made based on health and choice. If we are lucky the medical system will continue to allow us to make out own choices and not force the elderly but active to be told that nothing is allowed at their age.

Terrible topic. So sorry. It is just something that I know could come if we don’t have a say about what happens.

I promise more pleasant topic tomorrow.

Preparing for surgery with new focus

The events of the last few weeks have been stressful but organized. I am to have surgery on Friday to remove the other half of my thyroid. It is pressing on my trachea. The Dr. visits and pre-surgery were especially good with pleasant, wonderful, caring people and greatly efficient. The whole process has gone exceedingly smooth. It was moved from Tuesday Dec. 3 to this Friday as the Dr. decided to work that day. Now just to get it done and headed back to my ??normal?? self. The surgery itself it not difficult we just don’t want to find any unexpected problems.

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As part of my journey I have worked hard on finding new ways to reduce anxiety in my life and some of it is paying off. My consistency with prayer, meditation and focus on each day has really improved. That doesn’t mean that there haven’t been moments but nothing like before I started this journey.

Consistency and a determination to live more fully and joyfully are making a difference. I may succeed in conquering it before I shuffle off the planet. The lesson learned it that no matter how many times spent backsliding getting up and going on it what matters. Each day is progress….maybe not so visible but it is there.

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If you pray keep me in your prayers and if not send good thoughts my way.

We are a whole being

For years the common thinking among physicians was that anxiety and depression caused digestive symptoms such as IBS, constipation, diarrhea and possibly even Crohn’s Disease or Ulcerative Colitis. Now the pendulum is falling the other way. the Brain/Gut connection is becoming more important in treating people with such problems. I have long realized that my IBSD causes anxiety and if bad enough depression. I am glad that treating the whole person is becoming part of how medicine thinks.

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We are definitely complex beings and anything that affects us physically or mentally cannot be separated out into one or the other. Physicians have divided up into specialties and seem to focus on that area. It is understandable as medicine has become so complex. You can’t know everything about everything. We need a different specialty the “wholeness doctor” who tries to put the pieces together. I know that there are now DO’s and other categories of people who look more at the whole person but we need more of it.

I hope that in the future we have those physicians who take the information from all of the specialists and put it all together. This is what Internists would like to do but getting the reports and information from other doctors is like pulling teeth. This has to be worked out also.

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We are not parts stuck together but a whole just waiting to be understood.

 

Quit worrying

worriedDo you want to worry? I am sure if you try hard enough you can find something. I know that I can. I am having some medical issues that may be nothing or something. That is enough for me to stress about. Logic goes out the window.

I will, however, step back and remember the things I need to do to keep the worry in check. When it comes to health no amount of worry can change anything so it is wasted time. Will everything else going on time wasting is not an option.

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Soooo back to meditation, positive thinking, prayer and spending time with those I love. What works for you when you are worried?

The insurance fog

Insurance companies are so much fun. They approve claims unless…… somewhere in the fine print they don’t. The policies are difficult to read and parse the intangibles. I am sure it is deliberate. In the case of property etc it is aggravating enough but in medical issues it can be life and death.

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When I worked as a Case Manager I had to be able to read and understand the policies. One of the best things I learned in my life. I can’t do it with property but I can read through the details on medical insurance and find the little catches that are used to avoid approving things. So very useful in today’s world.

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As in most things it is the squeaking wheel that gets action but doing that can take time and much aggravation. Confusion is one of the tools used to make us think there is no way through the fog. Usually there is but finding it is tricky. If you are struggling with a problem like this see if you can find an advocate who understands the system and can help. Sometimes physician’s office staff can help.

Testing and worry

I hate medical tests! I don’t care if they are simple or not. The thing is they are finding out if there is something wrong with you. Apprehension is the name of the game. There is also the thing that the medical community can be so slow on reporting the results. You sweat and worry only to find out there was nothing. I may do this worse than others since I am a nurse. However, testing is done and I will more on from there. These were routine and I can check it off my list.

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Medicine is certainly not set up to help anxiety. Some tests require extensive time for results and that can’t be helped but for others there must be a better way. It is hard to watch someone who had tests for recurrent cancer have to wait a week to find out the results. The people doing most things like MRI’s and CT’s have instant results. The delay is getting it read by a physician and reporting the results to the ordering physician and then to the patient. Surely we can find a way to streamline this process.

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Maybe they will report the results in my autopsy.

 

 

 

 

My daughter goes to a clinic that does Mammograms, Bone Density Studies, X-rays, etc all in the clinic. You have those done and then see the physician who ordered them right after. What a great system. We need more of this! I think I will move to where she is!

 

Searching medical information

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The doctor’s office put me on a new medication for IBSD. It really seemed to help but now I have been fighting some symptoms that disturbed me. I looked up the drug for side effects and discovered that the problems I am having are related to the drug so I have stopped it.

It is so important to pay attention when starting a new drug for you may discover that even though it works for the initial problem you may have problems that seem unrelated. Make use of the internet but be careful that you reach a web site is one that you can trust.

When I a curious about a medical issue the first place that I look is the web site belonging to the Mayo Clinic. In my experience they have the most accessible site and you know their information is correct.

When looking up drugs if you have any doubt about the information you are finding search the site for the manufacturer. I may be somewhat harder to get through but you can skip a lot of things and just hunt what you need.

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It has been my experience that doctors can’t read all the information on every drug. There are just too many and each of us is different and responds to things differently.

As a nurse patient advocate if anyone need help finding information I would be glad to do what I can.

We are a whole not parts

It has been two weeks since I was so sick with IBSD. I have been so well in general that the episode completely blind-sided me. Now I am experiencing the hangover. Since these particular episodes always occur between 9 and 10 in the evening I get anxious each night around that time.

The irony is that this kind of episode only crops up, at the most, once a year. It will take weeks for it to fade from my mind and then I will be fine.

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It is so amazing what we can do to ourselves. I am fine physically but my mind clings to the latest event. So what to do? I have increased my prayer and quiet time, continued my regular routine and let that event become a memory that will fade. Learning and using coping skills is such a critical piece to our health and wholeness. We must remember that we were created as whole beings….not separate parts. Everything that we do affects our entire being.

One of the problems with out medical systems today is that we are not see this way but as different parts managed by different physicians. Not only do they not see beyond their specialty but they seldom communicate with each other.

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We must learn to be our own advocates. Even if a physician ignores or puts you down for your concerns and conclusions about your care remember who sees the end result. Don’t ever be afraid to speak your mind and if you have someone who can’t accept that change to someone else. Never let a caregiver dismiss you. Each of us is just a important as the person caring for us. Never forget it.

New York abortion law?

(I hope in the following I will be able to talk about the new law as I have heard it. I have no intention of discussing opposing views on the topic. I am just trying to wrap my brain around what I have heard. It seems that politics has now invaded medical ethics.)

(There are moral side issues that influence the issue such as rape and mother/fetus problems. These are not the ones I am addressing.)

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A hot topic is in the news again (and again)…abortion. I am going to try to talk about this from my perspective as a nurse. If I understood how the law in New York is phrased an abortion may be performed up to and including labor. If this is correct then it seems we have totally gone off the rails.

There are many people opposed to abortion in its entirety. They see conception as the creation of a being and that happening the moment a sperm and a cell join.

Others feel that it is not a life until it is viable…usually after at least 12 weeks. My recollections of earlier abortion ideas are there would be no abortions after 12 weeks except for extreme reasons. If a fetus is not old enough to survive outside the uterus it could be aborted.

Those seem to be the two sides previously as far as I can tell.

Now it seems that abortions can be performed on those old enough to survive outside the womb. Even to the point that the “baby” is about to be born. I find this idea unbelievable. I cannot imagine why anyone who could want an abortion would want to carry until labor and then decide to end a life. Are we talking about a “full term” infant? As a nurse I could not stand by and see that life snuffed out. Why would you not just give the baby up for adoption?

Am I understanding this law correctly?

Am I in the twilight zone or does this sound the least bit rational?

No matter my stance on abortion in general (not for discussion on Word Press) taking the life of a child while mother is in labor with a baby considered full term surely must be murder. P.E.R.I.O.D/

Our emphasis  has for too long been on political views and some sane alternatives are not being addressed.

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We have to reach the understanding that attention must be placed on preventing unwanted pregnancies. Prevention is the key. Practically little money or interest is on the necessary methods of pregnancy prevention. Help must be easily accessible to everyone and free. Education must begin early and be offered freely.

It seems to me that this is the only way to begin to address the problem no matter your position on the topic.  This will not be easy or quick but we have to start now making this a priority.

 

Question: Do I understand this law correctly?

Core values and end of life

medical_business_partners_core_valuesThere are times when I reflect on someone else’s life and wonder how they manage. There are so many tragic stories out there. I have wondered how I would react if asked to live life as a paraplegic…if I could not longer feel anything but my face. What would be my reaction to being trapped in my body with only a mind to make me feel alive? Would I cope or would I seek to end my life?

How would I react if my husband required 24/day care and I didn’t have the money to hire someone to help?

In life there can be some living nightmares. Scenarios that we not only wouldn’t want to be in but also wouldn’t wish on someone else.

It is an ethical dilemma to make decisions when things like this happen. Would you be willing to help someone die? (Assuming of course that their life was full of nothing but pain and imminent death.)

These are core questions. The kind that we hope we never have to come up against but they are real.

What are your core values? If faced with this kind of decision how would you decide?  It can be difficult to envision this ever happening to you but this kind of thinking does help you to understand deep moral questions. For those of us with a faith underpinning we hope that we would turn to that for guidance.

decisionIn my time as a nurse I have seen families struggle with decisions that can tax their moral ground. I have seen them divided over the answers and sometimes torn apart by it. Many times we would like for the doctors to tell us what to do but that is not their decision to make. Most of them will avoid giving an opinion which makes it harder.

If you have never considered having a living will to take the burden off of those around you please think about this. We tend to think that this sort of thing is for older people but the worst struggles come when something happens to someone young. You are never too young to fill out this important document. It seems morbid but it is important.

If you don’t know how to get an advanced directive leave a comment and I will answer.