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!


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