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Laura Ann

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    Comment on Hospice

    in GRIEF

    Posted

    but they are people that are doing a job. A job that brings great support and comfort to the entire family during this very trying time.

    It must be a Kentucky thing....the care that my mother received was anything but comforting.

    Laura

    Advance Directives for those who are Catholic

    in GENERAL

    Posted

    Catholic Teaching on Extraordinary Means

    The natural law and the Fifth Commandment1 requires that all ordinary means be used to preserve life, such as food, water, exercise, and medical care. Since the middle ages, however, Catholic theologians have recognized that human beings are not morally obligated to undergo every possible medical treatment to save their lives. Treatments that are unduly burdensome or sorrowful, such as amputation, or beyond the economic means of the person, or which only prolong the suffering of a dying person, are morally extraordinary, meaning they are not obligatory.

    The many advances in medicine during recent decades, however, has complicated the decision whether to undergo or forego medical treatment, since medicine can now save many people who would simply have been allowed to die in the past. Further, having saved them, many people continue to live for long periods in comatose or semi-conscious states, unable to live without technological assistance of one kind or another. The following Questions and Answers will address some of the complexities of this issue.

    --------------------------------------------------------------------------------

    Q. When may medical therapies, procedures, equipment and the like be withheld or withdrawn from a patient.

    A. The Catechism of the Catholic Church states,

    2278. Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

    The key principle in this statement is that one does not will to cause death. When a person has an underlying terminal disease, or their heart, or some other organ, cannot work without mechanical assistance, or a therapy being proposed is dangerous, or has little chance of success, then not using that machine or that therapy results in the person dying from the disease or organ failure they already have. The omission allows nature to takes its course. It does not directly kill the person, even though it may contribute to the person dying earlier than if aggressive treatment had been done.

    --------------------------------------------------------------------------------

    Q. Does this also apply to artificially provided nutrition and hydration?

    A. Yes, when the moral conditions noted above are met. We must, therefore, ask the question "will the withdrawal of nutrition and hydration allow the person to die, or kill the person?" When it will allow a person to die from an underlying condition, rather than unnecessarily prolonging their suffering, it may be removed. So, for example, in the last hours, even days, of a cancer patient's life, or if a sick person's body is no longer able to process food and water, there is no moral obligation to provide nutrition and hydration. The patient will die of their disease or their organ failure before starvation or dehydration could kill them.

    However, when the withdrawal of nutrition and hydration is intended to kill the person, or will be the immediate and direct cause of doing so, quite apart from any disease or failure of their bodies, then to withdraw food and water would be an act of euthanasia, a grave sin against the natural law and the law of God.

    --------------------------------------------------------------------------------

    Q. What about the case of Terri Schiavo?

    A. In Terri's case, while there was some disagreement as to her exact medical condition, she was not dying. The withdrawal of her food and water directly caused her death, and thus was a violation of the natural law and the law of God.

    --------------------------------------------------------------------------------

    Q. You mention the natural law, what is it?

    A. The natural law is morality which reason can determine from the nature of man, without the assistance of God's revelation. An example is the right to life. Almost all human societies throughout history, both religious and non-religious, have recognized that it is wrong to kill an innocent person. This is a conclusion which reason can easily come to, since all human beings have an inborn desire to live. From this natural law principle we can easily see that any action that directly and intentionally kills an innocent person is an unjust taking of a human life. Therefore, withdrawing food and and water from anyone who is not about to die and who can still tolerate it, has no other reasonable name than murder.

    --------------------------------------------------------------------------------

    Q. What does the Church say about this?

    A. The Pope addressed this issue in an address to a group of physicians who were in Rome in March 2004 precisely to discuss it. Note how he both uses the language of the natural law and the language of faith, which also tells us what we may do and not do.

    I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.

    The obligation to provide the "normal care due to the sick in such cases" (1) includes, in fact, the use of nutrition and hydration (2). The evaluation of probabilities, founded on waning hopes for recovery when the vegetative state is prolonged beyond a year, cannot ethically justify the cessation or interruption of minimal care for the patient, including nutrition and hydration. Death by starvation or dehydration is, in fact, the only possible outcome as a result of their withdrawal. In this sense it ends up becoming, if done knowingly and willingly, true and proper euthanasia by omission.

    In this regard, I recall what I wrote in the Encyclical Evangelium Vitae making it clear that "by euthanasia in the true and proper sense must be understood an action or omission which by its very nature and intention brings about death, with the purpose of eliminating all pain"; such an act is always "a serious violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person" (n. 65). [Pope John Paul II, To the Congress on Life-Sustaining Treatments and Vegetative State, 20 March 2004)

    (1) Congregation for the Doctrine of the Faith, Iura et Bona, p. IV)

    (2) cf. Pontifical Council "Cor Unum", Dans le Cadre, 2, 4, 4; Pontifical Council for Pastoral Assistance to Health Care Workers, Charter of Health Care Workers, n. 120

    --------------------------------------------------------------------------------

    Q. What can a person do to ensure that their wishes and their religious beliefs are respected by their family, medical personnel and the courts?

    A. The best way is by means of an Advance Directive which states the patients wishes with respect to aggressive medical treatment. There are two basic kinds, a Living Will by itself or an Advance Directive with a Durable Power of Attorney (or Proxy) for Health Care Decisions. The merits of each are as follows:

    1. Living Will. By this document a person decides completely in advance whether they want to be kept alive by technology. It is a "yes" or "no" statement, which then places the matter in the hands of the medical community. Many Catholic bishops and moralists consider this an unsatisfactory approach, as it does not provide for unforeseen circumstances. Despite the enthusiasm of the media, many medical professionals, and sadly even some Catholic institutions, Living Wills are NOT the way to go!

    2. Advance Directive with a Durable Power of Attorney or Health Care Proxy. These documents give to a friend or family member the authority to make health care decisions according to one's mind as expressed in an Advance Directive. By appointing an agent, or giving someone durable power of attorney, the patient allows for unforeseen circumstances. By stating in an Advance Directive that one wants Catholic teaching adhered to, one can ensure that neither the agent or the medical institution will disregard that teaching. Together they ensure that a trusted person, rather than strangers, will make circumstantially appropriate decisions, in keeping with the Faith.

    Whose choice is it?

    in GENERAL

    Posted

    Doctors say futile cancer treatment rising By MARILYNN MARCHIONE, AP Medical Writer

    Fri Jun 2, 7:35 PM ET

    ATLANTA - Doctors are reporting a disturbing rise in the number of cancer patients getting chemo and other aggressive but futile treatment in the last days of their lives.

    Critics of the practice say doctors should be concentrating instead on helping these patients die with dignity and in comfort, perhaps in a hospice.

    Nearly 12 percent of cancer patients who died in 1999 received chemotherapy in the last two weeks of life, a large review of Medicare records revealed. That is up from nearly 10 percent in 1993, and the percentage probably is even higher today, researchers said.

    "Patients don't like to give up," and neither do physicians, said Dr. Roy Herbst, a cancer specialist at the University of Texas' M.D. Anderson Cancer Center in Houston who had no role in the study.

    Overly aggressive treatment gives false hope and puts people through grueling and costly ordeals when there is no chance of a cure, cancer specialists said.

    "There is a time to stop," said Dr. Craig Earle of the Dana-Farber Cancer Institute and Harvard Medical School. "It's sometimes easier to just keep giving chemotherapy than to have a frank discussion about hospice and palliative care."

    Earle led the federally funded study and presented the findings Friday at a meeting in Atlanta of the American Society of Clinical Oncology.

    He examined Medicare records on the care of 215,488 people who died of cancer in the 1990s.

    Admissions to hospital intensive care units in the last month of life climbed from nearly 8 percent in 1993 to 11 percent in 1999. Emergency room visits rose from about 24 percent to more than 28 percent.

    The number of cancer patients entering hospice in the last three days of life also rose, from roughly 12 percent to 15 percent.

    "That's like a waste of the whole hospice process," which stresses preparing the patient emotionally and physically for death, Herbst said. "People have to be ready to do that."

    Part of the problem is that doctors cannot predict how soon an individual patient will die, even when they know the cancer has spread widely and is incurable.

    The study found variations around the country in how aggressive doctors were, but researchers would not give specifics.

    This study focused on traditional chemotherapy and was done before newer medicines like Herceptin, Avastin and Gleevec, which more precisely target cancer, came into wide use.

    "They're clearly not as toxic as the chemotherapy," so a patient's quality of life may not be harmed by late treatment with these drugs, Earle said.

    Still, Ellen Stovall, president of the National Coalition for Cancer Survivorship, said doctors and patients have to be more realistic.

    "I see, in cancer care, so much treatment being used in the last three months of somebody's life that doesn't really help," she said.

    However, another study presented at the cancer meeting on Friday showed the opposite problem: people not getting enough care.

    A survey of nearly 700 primary care doctors in Wisconsin found that only 11 percent would refer a patient with advanced lung cancer to a cancer specialist and only 25 percent would refer a woman with advanced breast cancer.

    "We also found a general lack of knowledge about the benefits of newer treatments" that can help such patients, said Dr. Timothy Wassenaar of the University of Wisconsin-Madison, who reported on the study at the cancer meeting.

    "That's horrible," Herbst said of the unwillingness to refer such patients. He noted that newer chemotherapy treatments have extended lung cancer survival from 20 percent at one year to nearly 50 percent now.

    Dr. Sandra Horning, a Stanford University cancer specialist who is president of the oncology group, said the good news is that doctors in the survey were not influenced by whether a lung cancer patient had smoked. The notion that smokers bring the disease on themselves should not interfere with treatment, she said.

    ___

    To Fay A

    in GENERAL

    Posted

    Hi Fay,

    I just wanted to let you know that I am thinking of you and praying for you every day. I need to take this time to tell you of the great respect and admiration I have for you. You have been and always will be the epitome of what this site means to me. I will never forget you.

    Laura Ann

    Another Non/Never Smoker!

    in GENERAL

    Posted

    'All I can do is fight'

    Lyden, UK's diving coach, battling stage four lung, brain cancer

    By Michael Smith

    mssmith@courier-journal.com

    The Courier-Journal

    LEXINGTON, Ky. — Michael Lyden's nightmare began with a persistent cough.

    The University of Kentucky's diving coach couldn't remember the last time he had been sick. After all, his nickname is "Iron Mike."

    When the Wildcats' divers ran stadium steps in the off-season, he was at the front of the group. When they went for two-mile runs, he was with them stride for stride. He considered himself somewhat of a fitness fanatic.

    So when a group of three doctors in long white coats walked into his hospital room and told him that he had lung and brain cancer, Lyden, 49, couldn't believe it.

    "I still don't understand it," he said. "I've always been in good shape, I've never smoked, I've taken good care of my body. Then for a doctor to come in and tell you that you've got stage four lung cancer … it just didn't make sense."

    That was more than three months ago. Lyden, now bald from the aggressive chemotherapy treatments, thinks he's on the road to recovery. About two weeks ago he returned to his team's 6 a.m. practices and now works the better part of a normal day, although exhaustion sometimes gets the better of him and he retreats home for a long nap.

    He's still learning how to listen to his body to know when to scale back. Sometimes that means missing a practice, which in Lyden's world is the equivalent of a preacher taking Sunday off.

    But considering how far he's come in a relatively short period, he'll take whatever time by the pool he can get.

    "My attitude is that I'm going to beat it," Lyden said. "All I can do is fight."

    And along the way, Lyden has learned that more than a few people have his back.

    He was honored on Saturday at UK's Lancaster Aquatic Center for his contributions to the Wildcats' diving program in 13 seasons as its coach.

    The night before he thought he was going out for a quiet dinner, only to walk into a room full of ex-divers who came from as far away as Portland, Ore., St. Louis and Montgomery, Ala., to surprise their former coach.

    His former athletes, with the help of assistant coach Margo Lynch, combined their efforts to make a huge poster with a collage of pictures. At the bottom, it read, "We love you, Mike."

    "The funny thing is that it's pulled all of us back together," said Beth Thomas, a former UK diver who lives in Louisville. "I hate that it had to be something like this to make it happen, but it shows the impact Mike has had on all of us.

    "When I came to UK I didn't have a lot of self-confidence, but when I left I did. Mike has so much strength in him, and he makes everyone around him stronger. He helped make me the person I am today."

    Platform for success

    Tina Johnson Ybarra, a former All-American, was a UK diver in 1994 when Lyden was hired. Until that time, most of UK's divers preferred the springboard to the platform, but Lyden changed that. He challenged Ybarra and her teammates to take on platform diving.

    By the time Ybarra finished at UK, she was second in platform diving at the NCAA meet.

    "When he told us that we were all going to do the platform, I was like, 'Oh, no.' None of us did that," Ybarra said. "But Mike showed how much he believed in all of us to do it. That really shows you the power of a coach to help others reach their potential. Mike did that for all of us."

    The same way Lyden pushed his divers, he's pushing himself, leaving no stone unturned in his pursuit of information on the disease that's trying to kill him. Between 15 and 35 percent of those diagnosed with stage four lung cancer survive a year, according to cancerhelp.org. About 2 percent make it five years.

    The early returns from his radiation and chemo have been encouraging. Eighteen radiation treatments killed the seven lesions in his brain, and so far the chemo has shrunk the tumors in his lungs and lymph nodes by anywhere from 10 to 30 percent.

    He also believes that an herb-based diet, which includes roots from the Amazon, red clover, apricots and 32 ounces of carrot and celery juice a day, has given him the strength to fight cancer.

    "The first week and a half, I was given the worst scenario," he said. "I'm way too young to throw in the towel. I just looked at the stats and threw them out the window."

    Lyden still was trying to come to grips with the news that he had cancer last October when one of the doctors put the odds against him in perspective.

    "He told me that a lot of people in my position choose to do nothing," Lyden said. "That's not what you tell a patient."

    The doctor clearly didn't know Lyden. He used all of his contacts and within days met with a team of cancer specialists from the school's Markey Cancer Center.

    Soon, it was determined that Lyden's cancer was inoperable.

    "And the thing is that I felt totally normal, except for the cough," he said. "It was just a shock."

    Dealing with chemo

    For now Lyden is learning to live with the draining chemo treatments every 21 days. For about 4-5 days after the treatments, he feels like he's got a severe case of the flu. Steroids help marginally.

    He took a dose of chemo on Dec. 23 and spent Christmas Day wanting to do nothing more than stay in bed.

    "I felt like a vegetable," he said. "I didn't want to talk; I didn't want to move."

    But sometimes Lyden thinks the good days are starting to outnumber the bad. Or at least that's the approach he's taking. His fellow coaches and diving pupils are amazed at his attitude and determination.

    The way he looks at it, though, what other choice is there? His wife, Emily, and three children, ages 7 to 15, know only "Iron Mike."

    "When we found out, we just decided it was time to get Team Lyden gathered up and get a game plan," Emily Lyden said. "Cancer doesn't hit just one person, it hits the whole family. We've just tried to be very honest with the kids. When they ask questions, we do our best to explain.

    "It's just been a roller coaster of emotions, lots of ups and downs. It's been very difficult, and it still is, but we've received so many cards and phone calls, a lot of support that's just been invaluable."

    It's funny, Michael Lyden said, that without cancer a lot of his most rewarding moments as a coach might never have happened.

    In December, Lyden rushed over to the pool after a chemo treatment for a meet that already had begun. He walked into the Lancaster Center and struck up a conversation with another coach.

    After a few minutes of talking, Lyden started looking around the pool. Everyone was wearing blue T-shirts that read "Iron Mike."

    Show of support

    The UK athletic department also purchased blue wristbands with "Iron Mike" stamped on them, similar to the yellow "Live strong" wristbands that honor Lance Armstrong. Proceeds from the sales have helped the Lyden family deal with mounting medical expenses.

    Even the athletes got into the act. Many of the male swimmers and divers shaved their heads in a show of support at a meet last November.

    "Emotionally, I've been a basket case," Lyden said. "Every time the team leaves for a meet and I can't go, I just look down and cry. I'm just so thankful; the support has been so good.

    "Whenever I'm feeling down, I start reading the hundreds of cards that everybody has sent and that makes me feel better."

    Imagine having to stay at least six feet away from your children for 24 hours because radiation treatments have made you a walking Chernobyl. Imagine doctors purposely collapsing your lung so they can poke and prod some more. Imagine catching a run-of-the-mill ear infection that causes you to stay in bed for a week because your immune system is so weak.

    Back in August, Lyden was body surfing in the Atlantic Ocean as Hurricane Katrina passed over the southern tip of Florida. He felt as strong as ever.

    Then this.

    "Everything my family does, everything my team does, all the plans are made with the idea that I'm going to be here," Lyden said. "And I'm going to be here."

    For the libs........

    in JUST FOR FUN

    Posted

    Dear Abby,

    My husband is a liar and a cheat. He has cheated on me since the

    beginning, and, when I confront him with it he denies everything.

    What's worse, everyone knows that he cheats on me. It is so humiliating.

    Also, since he lost his job four years ago, he hasn't even looked for a

    new one. All he does is smoke cigars, cruise around all day,

    and gab with his buddies while I have to work to pay the bills. Since

    our daughter went away to college he doesn't even pretend to like me and

    hints that I may be a ****. What should I do?

    Signed,

    Clueless

    Dear Clueless,

    Grow up and dump him. Good grief, woman. You don't need him anymore.

    You're a United States Senator from New York. Act like it!

    Wife's Update again !!

    in GENERAL

    Posted

    Larry,

    I found this for you. I don't know if you have heard of Sister Faustina, but we would recite the Devine Mercy Chaplet for my mother when she was dying. The information below was taken from Faustina's diary.

    Laura

    The Chaplet of The Divine Mercy

    In 1935, Saint Faustina received a vision of an angel sent by God to chastise a certain city. She began to pray for mercy, but her prayers were powerless. Suddenly she saw the Holy Trinity and felt the power of Jesus' grace within her. At the same time, she found herself pleading with God for mercy with words she heard interiorly:

    Eternal Father, I offer You the Body and Blood, Soul and Divinity of Your dearly beloved Son, Our Lord Jesus Christ, in atonement for our sins and those of the whole world; for the sake of His sorrowful Passion, have mercy on us and on the whole world (Diary, 476).

    As she continued saying this inspired prayer, the angel became helpless and could not carry out the deserved punishment (see Diary, 474, 475).

    The next day, as she was entering the chapel, she again heard this interior voice, instructing her how to recite the prayer that our Lord later called "the Chaplet." From then on, she recited this form of prayer almost constantly, offering it especially for the dying.

    In subsequent revelations, the Lord made it clear that the Chaplet was not just for her, but for the whole world. He also attached extraordinary promises to its recitation.

    Encourage souls to say the Chaplet which I have given you (Diary, 1541). Whoever will recite it will receive great mercy at the hour of death (Diary, 687). When they say this chaplet in the presence of the dying, I will stand between My Father and the dying person, not as the just Judge but as the Merciful Savior (Diary, 1541). Priests will recommend it to sinners as their last hope of salvation. Even if there were a sinner most hardened, if he were to recite this chaplet only once, he would receive grace from My infinite mercy (Diary, 687). I desire to grant unimaginable graces to those souls who trust in My mercy (Diary, 687). Through the Chaplet you will obtain everything, if what you ask for is compatible with My will (Diary, 1731).

    Prayed on ordinary rosary beads, the Chaplet of Divine Mercy is an intercessory prayer that extends the offering of the Eucharist, so it is especially appropriate to use it after having received Holy Communion at Holy Mass. It may be said at any time, but our Lord specifically told Saint Faustina to recite it during the nine days before the Feast of Mercy (the first Sunday after Easter). He then added: By this Novena, [of Chaplets] I will grant every possible grace to souls (Diary, 796).

    It is likewise appropriate to pray the Chaplet during the "Hour of Great Mercy" three o'clock each afternoon (recalling the time of Christ's death on the cross). In His revelations to Saint Faustina, Our Lord asked for a special remembrance of His Passion at that hour.

    getting nervous again

    in NSCLC GROUP

    Posted

    I was watching TV the other day and I can't even remember why this was said, but the tip was,that when getting a shot or having a needle put in, if you cough just prior to the insertation of the needle you will feel no pain. I know don't if it works, but it might be worth trying. I would make sure and tell the nurse/tech what you are going to do before the procedure so that they are expecting the cough.

    I've been thinking about you. You seem like a sweet and gentle person.

    Hope everythng works out for the best.

    Laura

    Radiation starts tomorrow

    in GENERAL

    Posted

    Bill,

    Don't deprive yourself of the support and awesome information that is provided in this forum. You could stay on the computer, at the library, whatever?? all day long and not begin to get the information you get here from those who are living this nightmare. Just ignore this person. Can't you tell they just live for the drama. You leave and they win.

    Wishing you the best.

    Laura

    P.S.

    We have to show everyone that us Kentuckians are tuffern' that!

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