Re: Response to Aletta - intuition and your doctor

[Guest guest]

Aletta, it appears that the problem you mention is gaining prominence world

wide. We in Australia are having repeated references in the Media to this

problem of people who have had enough and need to be able to die with

dignity and as much comfort as possible, while some Politicians and various

other organisations such as some Churches are determined to keep the poor

people alive at any cost and any inconvenience other that their own.

If they maintain their attitude there will be more futile attempts by people

who cannot do the job properly and there will be many more botched attempts

leaving more pain and suffering for the patients and their sympathetic

relatives. There will also be more criminal cases I guess with well meaning

people being victimised and " punished " for helping.

I think half the problem is that too many politicians are fence sitting,

knowing what should be happening, but not game to offend some of the

powerful lobbyists, who may be able to lose them votes.

We had one State, The Northern Teritory, in Australia who had the " Guts " to

pass Euthenasia Laws, but the Federal Government passed other Laws that

over-ruled the original ones.

Regards from Bill Pilgrim

Deb; short term memory depression vs stress; gasping;

intuition and your doctor

> Deborah;

> I'm voting for allergy - but in some cases and allergy reaction can be

> triggered and the culprit itself is long gone - our sensory reactions are

> not 'normal' so even if nothing is found the rash may still be an

> 'allergic' one. The gall-bladder is an organ we have in common only with

> the rat, which is why it is so good to use on lab experiments - function

> has to do with bile production. Used to be as popular a reason for

surgery

> as appendicitis but seems to have become less popular - it is one of the

> less well understood organs, like the appendix, tonsils and spleen, life

> can go on nicely without it.

>

> Doctors can be just as vacuous as the rest of us (especially when tired

and

> underpaid). Last year my 'rash' was met with dismissiveness - I also had

> fever - two doctors and nearly a week later the next doctor I saw

> immediately identified it as pettichael hemmorage (less evident by then

> since it was starting to fade). Now I know if it blanches (pales) when

> pushed down it is not a hemmorage those stay red pressed or not. You may

> never know what you have, ride out the wave and get home, sounds like

> hubby does a spectacular job keeping and eye on you. Try ice packs to get

> body temp (which may or may not be a fever) down.

>

> The last dream I remember (ref: crusty eyes), was of my eyes having dried

> up inside my head I woke up with crusted eyes and was frightened to open

> them and find my dessicated eye-balls, since then I've used eye drops

> constantly.

>

> Is everyone not just a bit quick on wanting everyone who 'seems' depressed

> on anti-depressants?? It is only depression if real-life events are

> insufficient to cause depression - only those will react to meds. For

> instance you cannot cure grief with meds, just time and talk therapy.

Short

> term memory loss happens with many other 'stressors' such as sleep

> deprivation, illness, anxiety, exhaustion and pain. My memory is

adversely

> affected by pain and sleep deprivation it stops as soon as those are dealt

> with. Too many doctors won't deal adequately with a patient's pain and

> discomfort - I forgot which of you knew someone with ALS, he improved

> markedly when given more control over morphine for pain even gaining

> abilities thought to have been lost.

>

> I've slacked off from the voice exercises and am paying for it (at least I

> hope this is the reason), my tongue seems to be blocking much of my

> windpipe and I often feel as though my head is kept under water, if I open

> my mouth a bit an consciously push my tongue forward air rushes in nicely,

> but I have to make it a fully conscious effort - does this happen to

> others, is there something surgical (like shortening the tendons) that can

> keep the tongue from sliding back when it shouldn't?

>

> New meds still no adverse affect and no loss of bowel control (no.1 fear),

> and the pain is dying down slowly.

> _____________________________________________

> Came accross these two articles today, thought they were poignant:

>

> New York Times

> November 9, 2001

>

> Separating Death From Agony

> By Jerome Groopman

>

> BOSTON - Not long ago, a cancer specialist I know faced a situation that

> chilled those of us who care for people with terminal illness. A young

> woman close to death lay suffering in a hospital bed, her husband at her

> side. Her leukemia had defied bone marrow transplant and experimental

> drugs. She had begun to bleed into her lungs and was gasping for air.

>

> Months earlier, following common practice, the oncologist had had a frank

> discussion about dying with the woman and her husband. The greatest terror

> for her, as for most other patients, was that the final days of her life

> might be spent in unrelenting pain. An understanding was reached among the

> patient, the doctor and the family that if the time came when there was no

> real hope of surviving and she faced only pain and debility, no

> extraordinary means would be taken to sustain her and sufficient doses of

> drugs like morphine would be administered to ease the pain, even if that

> meant reducing her breathing or lowering her blood pressure and thereby

> expediting her death.

>

> That time had clearly come, but when the doctor ordered morphine, a

> respiratory therapist at the bedside vehemently objected. He asserted that

> the morphine, because it inhibited her breathing, was nothing more than a

> thinly veiled disguise for physician-assisted patient suicide. The

> patient's husband, aghast, reiterated the promise given to his wife. The

> doctor was not deterred and prescribed as much morphine as was required to

> alleviate the painful suffocation that occurs when the lungs fill with

> blood. Within a day the young woman peacefully died.

>

> The physician felt that he had fulfilled his moral and professional

> obligation to relieve suffering, and the family was satisfied that their

> loved one's death occurred with as much dignity as possible. But the

> respiratory therapist then accused the physician of nothing less than a

> crime, and the husband of being an accomplice. The charge was judged

> unfounded first by a hospital review board and later by the district

> attorney's office. Yet the step by Attorney General Ashcroft this

week

> in response to Oregon's legalization of physician-assisted suicide could

> have dictated a different outcome.

>

> Mr. Ashcroft authorized the Drug Enforcement Administration to take

> punitive action against physicians who prescribe lethal drugs for

> terminally ill patients; the doctors' licenses would be suspended. This

> action, which is being challenged by the state, represents a striking lack

> of understanding of how physicians help patients to die, and it risks

> making the last days of the terminally ill a time of panic and pain rather

> than calm and comfort. While this legal policy may be directed at a single

> state where patients can obtain prescriptions for the lethal drugs under

> certain circumstances, Mr. Ashcroft endangers what has become a

> compassionate, if tacit, mode of dying throughout the United States.

>

> Nothing could be further from the truth than Mr. Ashcroft's statement that

> a federal drug agency could readily discern the " important medical,

ethical

> and legal distinctions between intentionally causing a patient's death and

> providing sufficient dosages of pain medication necessary to eliminate or

> alleviate pain. " In fact, it is medically impossible to dissociate

> intentionally ameliorating a dying patient's agony from intentionally

> shortening the time left to live.

>

> In the case of the young woman with leukemia and pulmonary hemorrhage, the

> doses of morphine needed to ease her suffering also depressed her

> breathing. And death is rarely a gentle process of simply closing one's

> eyes. Rather, there are potent physiological reflexes, graphically termed

> " agonal. " Narcotics like morphine are essential in dampening these death

> throes, and in doing so, they facilitate death.

>

> Mr. Ashcroft's action also threatens the very essence of the hospice care

> that in recent years has allowed so many terminal patients to die at home,

> with doctors and nurses easing the passage through the prudent use of pain

> medications.

>

> Some opponents of the attorney general invoke states' rights, arguing that

> federal agencies should not meddle with Oregon's law. This skirts the more

> fundamental issue. Helping nature take its course is not criminal, and it

> should be outside governmental regulation. Decisions about when and how to

> die are best left to patients, families and health professionals, not

> legislators and litigators. Committees of doctors and nurses already exist

> in hospitals and hospices that can exercise sound judgment in

controversial

> cases and advise on the parameters for the process of dying.

>

> If the Justice Department's action is a political bone thrown to religious

> conservatives, it shamefully miscasts health professionals as disciples of

> the devil rather than angels of mercy. If it represents an earnest attempt

> to protect the dying, it in fact makes them more vulnerable. Death will

> ultimately come, but without the skilled hands of physicians and nurses to

> ease the release of the soul.

> ______________________________________

> INTUITION: Does your doctor use intuition?

>

> An old time hunch is a good partner for science, says prominent med school

> teachers.

> -----------------------------------------------------------------------

-

> USA Weekend. May 12-14, 2001 page 14. By Ann Japenga.

>

> FOR THE FIRST TIME, prominent physicians are declaring that intuition--

> nowledge not based on conscious reasoning or test results -- is

alegitimate

> medical tool.

>

> " I'm a rationalist and a scientist, " Harvard Medcial School professor and

> author of Second Opinions: Stories of Intutition and Choice in a the

> Changing World of Medicine. " But there have been many instances when I've

> had a deep sense about a patient that is not informed directly by lab

> tests. It is a gut sense. "

>

> This gut sense is gaining ground: On Wednesday, the annual meeting of the

> conservative American Psychiatric Association will hear about intuition

> from Los Angeles psychiatrist Judith Orloff, author of Dr. Judith Orloff's

> Guide to Intuitive Healing.

>

> At UCLA, where she is an assistant professor, Orloff is coaching

psychiatry

> resident Meredith Sagan in intuition-based medicine. " I can't image how

I'd

> practice medicine without intuition, " Sagan said. " This is the direction

> medicine is heading. "

>

> Some see it veering in the opposite driection. Over the past decade,

> enthusiasm has grown for " evidence based " or " outcome-based " medicine --

> the use of tests and treatments proven through rigorous research.

>

> Manged-care companies maintain that evidence-based medicine will reduce

> costs. Yet Harvard's Groopman says intuition also saves money. Example: A

> man with bone-marrow failure was being treated with blood transfusions. In

> an intuitive leap, Groopman determined the patient would benefit from

added

> testosterone (the hormone is vital for production of red blood cells in

> men). Soon the man required only a third as many transfusions.

>

> " My intuition saved this patients' insurance company hundreds of dollars

> per unit of blood, plus all the hospital and nursing costs that go with

> transfusions, " says Groopman.

>

> At the University of Virginia, associate professor Slawson, M.D.,

> teaches that skilled physicians are like skilled musicians. A physician

> needs to be grounded in science but also must have the ability to

> improvise. The result, according to Slawson: " Good clincial jazz. "

>

> -----------------------------------------------------------------------

-

> How to find an intuitive physician

> Doctors Judith Orloff and Jerome Groopman say an intuitive doctor will...

> Take time to listen: Inutition isn't majic. It relies in part on a

> heightened sensitivity to subtle verbal and non-verbal cues expressed in

> ordinary conversation.

>

> Encourage second opinions: An intuitive doctor realizes medicine has

hidden

> dimensions and accepts that another doctor may be able to tune into

aspects

> of your case he or she has overlooked.

>

> Honor your hunches: about your well-being, even when they seem irrational.

> In the most effective collaborations, your doctor will graft his intuition

> onto yours.

>

> Keep up with science: Some doctors may rely too much on intuition. Each

> week, a wealth of new scientific information is available to doctors;

yours

> should take advantage of the lastest studies. " Intuition shouldn't be an

> excuse for not keeping up, " says Haynes, M.D., editor of the

journal

> Evidence-Based Medicine.

>

> -----------------------------------------------------------------------

-

>

> aletta mes

> vancouver, bc Canada

> web: http://aletta.0catch.com

>

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