Archive for Comorbidities

Diss, Dys, and Hospice

btm0idnrkehdvvrcu5ok“Don’t ‘diss’ me, man.”

I first heard the slang diss in the 1980s, probably in a film or on TV. I’d always assumed it began in the raucous hip-hop music movement. An abbreviation of disrespect, the shorter diss made for easier rhyming and—at first—insider language for the hip-hop world. But lexicographer Jonathon Green found a reference for diss in a 1906 Australian newspaper. Could the slang term have actually emerged from the land “down under?”

Because of my hospice work, I think of different phrases. Instead of “diss,” I learn new-to-me appearances of the prefix “dys” on a regular basis.

“Don’t ‘dys’ me,” I might wish for our patients, but dys never disappears for too long as we confer about our patients’ health issues. In a meeting this week, a nurse explained—clinically and efficiently—the long list of comorbidities for a new hospice admission. The patient had, the nurse said, dystonia.

Dystonia . . . dys-what? Read More →

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I Don’t Know

I-Dont-KnowOn the weekly list of hospice patients and their myriad illnesses, one disease seemed to stare back at me . . . Idiopathic pulmonary fibrosis.

What was it? I’d never heard or read about this illness.

Later, I scoured the Internet and found this description from the Cleveland Clinic’s website:

The cause of IPF is unknown. In some patients the disease is genetic (you inherited the disease from your parents). Environmental factors (particularly exposure to certain types of dusts) may also play a role. What is known is that IPF changes the lung’s ability to function normally. Typically, mild scarring of the lung tissue occurs first, but over months to years, the normal lung tissue is replaced by more heavily scarred lung tissue, which makes it difficult to breathe and deliver needed oxygen to the body. Read More →

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Comorbidities

bucket-listA person enters hospice based on a primary diagnosis. Multiplying cancer cells will lead to the death. Or, the heart grows weaker. Maybe lungs are compromised. Dementia can demolish normalcy.

However, as we get older, as we get sicker, as we become more vulnerable, there’s typically more than one illness eroding the sturdy walls of our vitality. When a hospice team first reviews a patient’s history, her or his comorbidities are discussed along with the primary disease. In other words, we are alert to the many life-limiting conditions that assault fragile flesh and brittle bones. As a non-medical participant in the care of a patient, the number (and numbing names) of the comorbidities that can afflict someone often flabbergasts me.

Let’s say Patient A, a lovely 60-something teacher, is dying from breast cancer. But she also has . . . diabetes, hypertension, AAA, CVA and DJD and more.

Let’s say Patient B, a once feisty 80-something, struggles with congestive heart failure. But he also has . . . Alzheimer’s, CBBG, Hypothyroidism, Acute MI and COPD and more.

So many things can harm or kill us. (Can harm or kill . . . me.) Read More →

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