Friday, October 17, 2014

Hospice

This weekend, I’m flying out to Houston to visit my ninety-seven year old grandmother.   Granted, it is not a great time to fly right now with all the crazy things going on in the news… but this trip was planned a while back and it may be the last time I get to spend time with my grandma.  She now has end stage dementia and I feel it may be time to introduce the idea of hospice to the extended family.  I am approaching this topic with some hesitation because I realize there may be a lot of misconceptions and fear associated with hospice.

So the basic 101 about hospice that I hope to convey include:

-    -  most patients could probably benefit from being put on hospice a lot sooner than the family realizes
-    -  just because a patient is on hospice, doesn’t necessarily mean that death is days or even weeks away
o   in fact, some perk up and improve so much from the extra attention, they may even get disqualified from continued service
-       
  -  goal is comfort for the patient and support for the family
o   to make the patient as comfortable as possible with as much dignity as possible… so that the days can be spent hassle-free without a lot of extraordinary measures and invasive procedures
o   to give family and caregivers support, encouragement, and a resource from professionals with tremendous experience with end of life issues




It will be challenging to convey all this with a language and cultural barrier, but we’ll see how it goes.

In the meanwhile, I hope to spend some quality time just being with my grandmother.  Simple things like the sound of ones voice or the feel of ones hand… can go a long way in communicating love and offering comfort.  I also hope to give some relief and provide emotional and physical support to my aging aunt who is the primary caregiver… and the same to my other aunt who carries a lot of the logistical and physical responsibilities associated with the care.

Leaving my four children behind on this short weekend trip is not easy.  I am forced to rely on other caregivers to manage the day to day logistics and needs of my kids.  At the same time, I look forward to sleeping in!  I admit I am a “control-freak” and often feel the need to call or text multiple times a day just to find out what is going on and whether things are smooth.   It so happens that my phone developed an issue and I cannot currently make calls or receive calls and texts on the cellular network.  I am sitting here on the plane typing this hoping to fix the problem the minute I land.  I realize that at the end of the day, even if things are not going as smooth as I like back home… what can I do?  Maybe not having contact for a while can be a good lesson for me to let go and let be.  Oh… let’s see if I can do that.

So back to my earlier comment about it being a crazy time to fly… at least on this flight from Philly… no one seems to be acutely ill or overly worried about contracting anything =)

Tuesday, October 14, 2014

Enterovirus D68

I've been meaning to blog for a while now... and although it is near midnight I feel compelled to jot down a few thoughts.
Crazy things in the news lately... and since so many patients are asking... let's talk about it!  Here is a quick 101 on the Enterovirus D68...

What is it?
The enterovirus is a virus that typically causes cold like symptoms around autumn.  This particular strain, D68 seems to cause more severe respiratory symptoms especially in kids with asthma leading to more hospitalizations and even death.

What are the symptoms?
Starts off as typical cold symptoms like cough, runny nose, sneezing, body and muscle aches.  It can lead to more severe symptoms like wheezing and difficulty breathing.  There are 9 cases in Denver so far where patients with the virus developed paralysis-like symptoms.

Who gets it?
Anybody can get it but this particular virus is causing more critically ill children requiring intensive care.  Spreads from respiratory secretions from cough, sneeze etc.

How do you treat it?
The basic treatment is supportive care and treating the symptoms.  There are no current antiviral treatments for this virus.

How do you prevent it?
There is no vaccine yet for this virus.  Protective measures include:  

  • Need to wash often with soap and water for at least 20 seconds.
  • Avoid touching eyes, nose, mouth with unwashed hands.
  • Avoid close contact with those who are sick.
  • Cover cough and sneezes with sleeve (not your hand)
  • Clean and disinfect frequently touched surfaces often
  • Stay home if sick
These all sound great but getting preschool age children to do them can be a real challenge.  Usually if one of my kids get sick... they all eventually get sick!


Tuesday, August 5, 2014

101 on Ebola

Perhaps you have been reading about Ebola in the news.  In my opinion, the scariest thing about Ebola is the fatality rate (up to 90%) and the fact that there is still no definitive treatment nor vaccine for it.  Don't want to create unnecessary worry but I believe having some understanding is key in prevention of spread.

So what is it?
It is a disease caused by a virus and used to be called Ebola hemorrhagic fever.

What are the symptoms?

  • sudden onset of fever
  • intense weakness
  • muscle pain
  • headache
  • sore throat
  • vomiting
  • diarrhea
  • rash
  • impaired liver and kidney function
  • sometimes internal and external bleeding
How do you get it?
transmitted originally from wild animals then human spread by:
  • blood
  • secretions
  • organs
  • other bodily fluids
How do you treat?
often requires intensive support.  There is yet no definitive drug treatment.

How do you prevent?
Since there is no vaccine yet, best way to avoid spread in humans is by raising awareness.  Avoiding close contact with infected or suspected infected persons is key.  Health care workers have to implement extra precautions with protective garments and other measures.

Can read more about it here at the WHO website.


The two Americans who got infected with Ebola both worked as missionaries in Africa treating patients infected with the virus.  This tugs at my heart because doing missions played a key role in my decision to become a physician.  Here is an article by CMDA about Dr Kent Brantly, one of the Americans who is infected with Ebola.  After reading the article this verse keeps echoing in my head...

"For me, to live is Christ and to die is gain."  - Philippians 1:21

Monday, August 4, 2014

Sunscreens and Kids

Been crazy busy... I've been finding no time to post!  Summer is flying by.  Here is a short blog to get some info out  Caution and avoid if possible when using spray sunscreen on kids!  See this link.

If you are like me... it's so much easier to spray than it is to keep wiggly giggly kids still and apply lotion sunscreen.  However, we are reserving sprays for beach time only now...

Have a great rest of the summer!  Come on weather... we need more sun...




Monday, July 14, 2014

Our Experience with Au Pairs

So for the past four years around this time, we welcome a new member to our family.  This time I'm not talking about a new baby!  Working part-time hours as a family doc and caring for four kids six and under would be a much more challenging task without the help of our live-in au pair.  July is when we started our contract and we're now on our fourth.

I had written an entry about why we were considering going with an au pair for childcare back in 2011.  All those reasons are still true... the cross cultural experience, availability, and finances... however, it became much more than that.

Granted, it is difficult initially transitioning and getting to know and live with someone new every year.  We're in the process of getting to know our new au pair right now.  There is much adjustment from their end to a different culture, way of thinking and caring for young kids while we adjust to another personality.  However, overall our experience has been very positive and rewarding.  Thankfully, our kids have taken to all our different au pairs and they often refer to our previous au pairs with much fondness and love.

Our past au pairs have each brought something different to our family with the varying talents and personalities they have.  Our kids have learned a lot of the Chinese language because of their interactions with them.  My oldest, especially, is very fluent in mandarin Chinese because of them.

Last month, we threw a reunion and 'goodbye' party for our au pairs.  All three au pairs from previous years were here!



We are excited to see what this year will bring with our current au pair.  It is no easy task to help care for our four young children but we hope the experience can be fun and rewarding for both parties.

Monday, June 16, 2014

Little Kids and All-You-Can-Eat Buffets

Recently I had a good laugh reading this circulating blog about people at the beach either with kids versus without kids.  Got me thinking there are many things that fall into this category... including eating at buffets!

We just got back from a trip out to Lancaster.  Those of you who've been out there will know what a smorgasbord is.  Well, we went to a huge smorgasbord for dinner the first night at Shady Maple.  There is no way you can walk out of a all-you-can-eat place like this feeling hungry shortly after... unless you have little kids!  Well, maybe if you have one or two and if they are older... different story.  But I have four and my oldest is six years old... so no wonder I was still hungry looking for ramen noodles about two hours after we got back to our vacation rental and the kids were finally sleeping!

Seriously... the first ten minutes was just taking each kid to the bathroom to potty and wash hands.  Then while one adult is watching the baby the other is getting the kids' food one or two plates at a time.  Now once the kids are all sitting and eating... my turn to get food!  However, after like two bites, this kid needs a drink... that kid wants more mac n cheese... the other one wants some soup.  It is just non-stop back and forth to the HUGE buffet spread.  Uh-oh... need more napkins... dropped a fork... need to potty again... ready for ice cream!  I think I burned more calories just running back and forth from the table to the buffet spread than I actually ate that night.  And if it weren't for eating dinner with other adults, I'd probably not get to eat at all.  I get why some folks just prefer the sit down and just serve me places!



Sunday, June 15, 2014

Happy Father's Day!

Shout out to all the dads out there... especially you, Joseph Kim!  You are awesome.  It takes great sacrifice, character, and perseverance to be a good father...


I can only manage a link to Dove's dad commercial this year... made me tear... 
https://www.youtube.com/user/dovemencareus
OK... trying to catch up on sleep... but have a few things I plan to write about this week...






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