Archive for Symptoms

Hospice and Reflexive Eating

We talked about “reflexive eating” in a hospice meeting.

It’s when nourishment is automatically eaten.

I immediately thought about my next meal.

It’s when opening the mouth for food or liquid is more from habit than need.

I eat too much.

If food is placed before me, I might take a bite or ten without even being hungry. Could I be a reflexive eater? Could I blame this problem on Mom? As a kid, we not only had three nice meals a day, but after school there was usually a plate of cookies. It was such a Leave It To Beaver stereotype, with me home from a grueling day in fourth grade. There, ready for me, were a cool glass of milk accompanied by freshly baked chocolate chip cookies (with walnuts, of course).

There’s more.

What about declining dessert after dinner, but scheming for—while later watching Bonanza or The Twilight Zone on ye olde TV—a bowl of ice cream? One scoop? Two?

What about my lifelong chips and salsa relationship? Read More →

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Ascites and Other Less Obvious Ailments

How easy it can be to downplay our emotional or spiritual anguish.

Occasionally, a nurse at the hospice team meeting will give an incomplete report about a patient. The team leader will prompt the nurse to make sure all the basics are covered. Though my medical knowledge is limited (and that’s a generous assessment), I’ve gone to the meetings long enough to ask a few of the predictable questions . . .

  • Does the patient require oxygen? Is it continuous or as needed?
  • Is he bedbound?
  • What is her F.A.S.T. score?

Because of situations with several recent patients, I’ve added another subject to ask if a nurse forgot to include the information in her overview.

  • Any sign of ascites?

Huh? First, let’s get to the simple, safe stuff: ascites is pronounced uh-site-teez. Read More →

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Death Isn’t the Kind of Thin We Want

When cachexic was first spoken to describe a patient during a hospice team meeting, I had no clue what it meant. Nonetheless, as someone who, long-ago and far-away, studied Latin and Greek, I figured the odd word had roots in those languages. Indeed, it does. But I probably would have tossed in extra “Ks” if I’d tried to spell it. And if a nurse demanded I repeat it back to her, I would’ve also failed the pronunciation test.

It’s a clunky, marbles-in-the-mouth type of word for a cruel condition. Here’s what Amber Dance wrote in a still relevant 2012 article for the Los Angeles Times:

“Cachexia (pronounced kuh-KEK-see-uh) is commonly defined as the unintentional loss of 5% or more of a person’s weight within a six-month period. Crucially, it’s muscle that slides off one’s frame, often with fat as well. It’s associated with advanced cancers as well as HIV, heart failure and kidney disease. In layman’s terms, it means “the patient looks awful, they look weak, they’ve lost much of their body mass . . .”

Now I’ll bet it’s easier for you to pronounce the word. Maybe you could even pass a spelling bee. But all things considered, I’d rather never hear the word in a spelling bee or hospice meeting. With those Greek roots wrapped around some of the worst of what can happen to you or a loved one, it won’t surprise anyone to learn it’s similar to pyrexia (an abnormal elevation of body temperature) and dyslexia (a condition of the brain that makes it hard for a person to read, write and spell). Read More →

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