Guest guest Posted July 21, 2004 Report Share Posted July 21, 2004 Usually oncologists orchestrate a show of aggressive treatment for metastatic cancers. The pretense and the fantasy is that these treatments are of curative intent. Once a cancer is metastatic (especially if there is distant metastasis) there is very little to hope for under the conventional model of treatment. The major intent here is to extend life a few months, maybe more, if the chemo doesn't kill in the process. As the patient is usually ravaged by the chemo process -- and there is no hiding the fact that chemo only works for a while because of multiple drug resistance -- this period of time is used by the patient and the family to slowly come to grips with the fact that death is the outcome of this ordeal, not health. Once the real prognosis can no longer be hidden, then the treatment becomes openly palliative. The insurance funds and personal assets become depleted, and hospitals and oncologists sometimes become a bit less aggressive in hustling the patients into expensive treatments. Hospice may be recommended. If the patient has a good PPO insurance then one last slam with chemo is usually mandated. This will send the patient to ICU with multiple whammies. Myelosuppression and narcotics invite intractable pneumonia and respiratory paralysis. This calls for intubation, ventilation, and antibiotics. Nausea and cachexia bring more meds with more unwanted side effects. Stressed kidneys and liver lead to ascites and edema. The breathing may become additionally labored with pleural effusion. Tapping the thorax or the abdomen drains the body of much-needed albumin. The patient tries to rip the tubes out of the nose, the mouth, the chest, the abdomen, the arms, and any place else that was dreamed up by the staff. Of course this calls for restraints for the writhing patient. When the patient starts to come down from pain killers, tranquilizers and deliriants, they rage and must be placed in deeper stupors. The patient is pumped with dextrose which feeds the tumor and increases the chances of any number of obstructions. The patient's family begs God to end this patient's misery, and the oncologist complies. Now if the patient happens to come from money, then the hospital administration and oncologists call for a meeting with the distressed family while they are still at the hospital. The family is told how much the hospital needs that new wing to help with the research and patient care to make sure that such agonizing deaths won't happen to any more of God's children. They want to put the family name on a large brass plaque in the lobby where it says Patrons. Most oncologists have an impressive variety of demigod-like posturings for the public, but at the conventions they show themselves to be regular good old boys. One oncologist once asked me if I knew why coffin lids are nailed down. I didn't know. It's to stop the oncologists from trying to give more chemo ! Such thigh-slapping humor. I'll save the hospice discussion for another day -- the myth that is painted for the patients and donors, verses the reality. At 07:35 AM 07/21/04, you wrote: >In a message posted yesterday Vince stated.... " Victims are all >those polite people who are laying on the conveyor belt that >channels them to hospice. Winners are among those who wake up and >bolt. " > >I have been in contact with our local hospice to see what they have >to offer. I learned our hospice is made up of volunteers, home >support nurses and pallative care doctors...they are there to assist >those coping with a fatal disease through counselling and home >support, but have no pallative care residences or beds like some >areas have. I was assured they accept whatever treatment choices >the sick person has chosen for themselves...traditional or >alternative and their only goal is to help those who are ill and >their friends and family. > >Your statement sounds like you are not in favour of hospice >Vince....could you explain why, if that is the case. Could others >also share their hospice experiences good and bad. > >Thanks... > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2011 Report Share Posted August 26, 2011 Does anyone know what it's like to work in a hospice pharmacy? Thanks! Quote Link to comment Share on other sites More sharing options...
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