Archive for Doctors

Medications Near Midnight

different meds

The nurse arrived in my mother’s dimly lit hospital room.

Near midnight, even his soft voice seemed loud. One of the first things he said was, “This won’t hurt.”

He lied. This was in 2013. Seven years after her death, I still remember his false assurances.

The nurse was there to place a peripherally inserted central catheter (PICC, or “pick”) into Mom’s upper right arm. My mother been offered Dilaudid—a brand name for hydromorphone, a narcotic comparable to morphine—for pain management. The medication would be housed in a CADD pump (Computerized Ambulatory Drug Delivery) connected to her PICC line. The linked pump and the catheter would give a predetermined, regular amount of medication to ease her physical agony. A “button” could be pressed on the CADD pump for additional dosages.

Are your eyes glazing over with all the medicalese?

Mom’s body was riddled with cancer and the two surgeries undertaken for “comfort” had added complications. As I calmly write this years after her death, I understand why she said “Yes” to that PICC line: she wanted the wrenching pain to end and she was ready to die.

But the nurse, who seemed rightly weary in the near midnight hour when he entered Mom’s room, first caused more pain.

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The Hospice Doctor Didn’t Mean Mac & Cheese

Mac & Cheese
Food is not a humorous subject with hospice patients and their families . . .

When the hospice medical director reminded the patient’s nurse to get a mac, my stomach grumbled.

The nurse nodded. There seemed to be an immediate, unspoken agreement.

A mac? What did the doctor mean? They couldn’t mean a Macintosh computer from Apple, could they? That didn’t make sense. But thoughts of digital apples made me think about real food: had they meant Mac & Cheese? While I’m not a fan of the packaged pasta and cheese, it is one of my wife’s favorite comfort foods.

My food wondering continued. What about a Big Mac? Could the doctor have been recommending a fast food burger? (When younger, I loved McDonald’s flagship burger. The Big Mac debuted, with fanfare and a high calorie count, around the time I started college. If I could scrounge a few extra quarters, I’d always go for the extra all-beef patty and special sauce!)

But we hospice professionals couldn’t have been talking meal deals . . . right?

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Do I Have Months (Weeks, Days) to Live?

In the weekly review of our new patients, time contradictions are frequently part of their stories.

A nurse or social worker will include a variation of, “Just before he went to the hospital, his physician told him he had months to live.”

I immediately think . . . of course that’s what the doctor said, since Medicare regulations unambiguously state a person appropriate for hospice has six months or less to live.

My thought occurred in split seconds, and before I’m finished thinking it, the same nurse or social worker continues their summary with, “However, while our patient was in the hospital, his surgeon told him he had less than a week to live.”

Months to live . . . one doctor said.

Less than a week to live . . . another doctor said. Read More →Facebooktwitterredditpinterestlinkedinmailby feather