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Leslie221

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Everything posted by Leslie221

  1. Welcome, Beth. So sorry your dad is going through this. I'm glad you found us and have come to share. I don't have any experience with the side effects your dad has right now, but just wanted to offer support. Leslie
  2. Welcome. No experience with the problem yet, but just wanted to welcome you. Leslie
  3. Leslie221

    A UPDATE...

    Larry, You've been missed. Good to hear from you. I'm sorry your experience has gotten rougher. Sending all caring thoughts and strength to both of you and hoping that pain and discomfort are on their way out the door as we speak. Leslie
  4. Welcome, MaryAnn, My question to you is: how have you worked your relationship with your husband in the past? Sounds like health issues and his willingness or not to take good care of himself has been an issue long before lung cancer entered the picture. Sounds like he is actually just doing what he's always done. I agree that outside counseling is probably going to get you the best resuls. Tell his doctors what's going on and insist they help you protect YOURSELF from a cigarette/oxygen disaster. Keep us posted. Leslie
  5. This just reminds of me a great web resource - Quackwatch.com I have often read some wonderfully uplifting books about different anti-cancer treatments and diets, etc. - I even got one in my radiologist's office! But, when I actually look the authors up on Quackwatch, I find a lot more info and realise just how easy it is to be "attracted" to possible cures. Some people mislead because they are greedy cons, but I suspect many start out believing their theories and want to help others. Just goes to show, you have educate yourself all the time. Leslie
  6. I remember him from the old "Moonlighting" TV show. He married "Ms. DePesto" in real life. Sad news.
  7. The pirate Red Beard was being interviewed by a newspaper reporter who was looking for juicy stories of excitement and derring-do. He told Red, "I'm sure my readers would love to hear the tale behind your pegleg." "Well, I was thrown from the ship during gale force winds, and before me mate could throw me a line, a shark bit me leg clean off." The interviewer was sort of disappointed. "What about the hook at the end of your right arm?" "I lost it in a sword fight with the Captain of the Guard." Again the reporter was disappointed. "Certainly there's an exciting story about the patch on your eye?" "One day, I was out on deck, and a bird flew over and crapped in me eye." The reporter was amazed. "That's why you wear a patch?" "Well, I'd only had me hook a couple of days."
  8. During a particularly wet winter, flood waters rise so high in one town that the national guard evacuates all the residents. One man stays behind, however, and when the water is waist-high, two national guardsmen in a boat motor past his house, checking for people left behind. "We're evacuating the town because of the flood! Jump in the boat and we'll carry you to safety!" But the man says, "No, don't bother; I've led a pious life, and the Lord will save me." The men in the boat shrug their shoulders and motor away. Later, when the water level has driven the man onto his roof, another boat appears. "Haven't you heard the town has been evacuated? Come on, we'll save you!" But the man sends them away again, saying "No, no, the Lord will save me!" The water level keeps rising until the man is standing on his chimney and barely keeping his head above water, and a helicopter, doing a final check, appears overhead. It drops a rope, and the loudspeaker says, "Grab the rope and we'll bring you to safety!" But the man waves the helicopter away, once again saying, "No, the Lord will save me!" But the water level keeps rising, and he drowns. When he gets to heaven, he is completely bewildered. He asks God, "God, why didn't you save me?" And God says, "Well, I sent you two boats and a helicopter."
  9. A middle-class man decides to go off and join a monastery which requires an oath of silence. No speech is allowed except for two words every 5 years, to sum up one's experiences to the head monk. After the first 5 years, the monk asked him what two words described his experiences and all he said was "HARD BEDS." When the next 5 year period came, the monk asked how things were and he replied "BAD FOOD." After 5 more years, he walked up to the monk and said, "I QUIT!" The monk nodded and muttered "Yes, this doesn't surprise me. You've been doing nothing but complaining for the past 15 years!"
  10. More Murphy's Laws o Trust everybody ... then cut the cards. o Two wrongs are only the beginning. o If at first you don't succeed, destroy all evidence that you tried. o To succeed in politics, it is often necessary to rise above your principles. o Exceptions prove the rule ... and wreck the budget. o Success always occurs in private, and failure in full view. o Quality assurance doesn't. o The tough part of a Data Processing Manager's job is that users don't really know what they want, but they know for certain what they don't want. o Exceptions always outnumber rules. o To steal ideas from one person is plagiarism; to steal from many is research. o No one is listening until you make a mistake. o He who hesitates is probably right. o The ideal resume will turn up one day after the position is filled. o If something is confidential, it will be left in the copier machine. o One child is not enough, but two children are far too many. o A clean tie attracts the soup of the day. o The hardness of the butter is in direct proportion to the softness of the bread. o The bag that breaks is the one with the eggs. o When there are sufficient funds in the checking account, checks take two weeks to clear. When there are insufficient funds, checks clear overnight. o The book you spent $20.95 for today will come out in paperback tomorrow. o The more an item costs, the farther you have to send it for repairs. o You never want the one you can afford. o Never ask the barber if you need a haircut or a salesman if his is a good price. o If it says, "one size fits all," it dosen't fit anyone. o You never really learn to swear until you learn to drive. o The colder the X-ray table, the more of your body is required on it. o Love letters, business contracts and money due you always arrive three weeks late, whereas junk mail arrives the day it was sent. o When you drop change at a vending machine, the pennies will fall nearby, while all other coins will roll out of sight. o The severity of the itch is inversely proportional to the reach. o Experience is somthing you don't get until just after you need it. o Life can be only understood backwards, but it must be lived forwards. o Interchangeable parts won't. o No matter which way you go, it's uphill and against the wind. o If enough data is collected, anything may be proven by statistical methods. o Work is accomplished by those employees who have not reached their level of incompetence. o Progress is made on alternative Fridays. o No man's life, liberty, or property is safe while the legislature is in session. o The hidden flaw never remains hidden. o As soon as the stewardess serves the coffee, the airline re-encounters turbulence. o For every action, there is an equal and opposite criticism. o People who love sausage and respect the law should never watch either of them being made. o A conclusion is the place where you got tired of thinking. o When reviewing your notes for a test, the most important ones will be illegible. o A free agent is anything but. o The least experienced fisherman always catches the biggest fish. o Never do card tricks for the group you play poker with. o The one item you want is never the one on sale. o The telephone will ring when you are outside the door, fumbling for your keys. o If only one price can be obtained for a quotation, the price will be unreasonable.
  11. THAT'S what we like to hear, Joannie! Sounds like pretty soon! Good, good, good news, Christmas Day especially! WOW!! All smiles here. Leslie
  12. (((Pat and Brian))) That pain relief news is the best. Hope there are people around giving YOU lots of support right now. You have been Brian's human rock throughout all this - a real soulmate. He is a fortunate man to experience fully such a bond of love with others. Sending all my caring thoughts and strength to you both. Leslie
  13. Welcome, Pam! Look at all the smiles and hope you've already dished out with s hort, introductory post! Congratulations on the 4 years! Give us some info in a history on your Profile page so we can all get to know you better and understand your background and experiences. When I know the month you were diagnosed, I'll add you to the Survivor's Anniversary database and send you a "hi-5" in the LC Survivor Forum for your big 5th!! Leslie
  14. Jan, WOOOOHOOOO!!!!!! MERRY CHRISTMAS AND HAPPY NEW YEAR Leslie
  15. Frances, What terrific news! That car must have been overflowing with smiles and high spirits. This has got to be a big boost to your dad's morale! You're family's come a long way since we all first "met," huh? Ups and downs, but I'm so glad to see your family celebrate Christmas on the upside! Leslie
  16. Cindi! WOW! I can't imagine a shy girl like you with so much good stuff to say! So glad we get the benefit of your humor, caring, and wisdom. I'm betting it won't take long before we congratulate you on 4000 posts! I know, I'll look forward to them. Free drinks tonight? Leslie
  17. Andrea, I really value your input and look for your avatar all the time! Thanks for all you share. Congratulations on pressing "submit" 2000 times! Leslie
  18. I found this to be a good read. Leslie Being a Patient Doctors' Delicate Balance in Keeping Hope Alive By JAN HOFFMAN Published: December 24, 2005 Dr. Joseph Sacco's young patient lay gasping for breath; she had advanced AIDS and now she was failing. Assessing her, Dr. Sacco knew her medical options amounted to a question of the lesser of two evils: either the more aggressive ventilator, on which she would probably die, or the more passive morphine, from which she would probably slip into death. But there was also a slender chance that either treatment might help her rally. He also knew that how he presented her options would affect her decision, the feather that would tip the balance of her hope scale. As Dr. Sacco, a palliative care specialist at Bronx-Lebanon Hospital Center, spoke to the woman on that chilly morning earlier this month, her eyes widened with terror: no intubation. He ordered morphine. He agonized about his approach. "She's only 23," he said later that day. "Maybe I was too grim. Maybe I was conveying false hopelessness to her. Maybe I just should have said, 'Let's put you on the ventilator.' I may have spun it wrong." The language of hope - whether, when and how to invoke it - has become an excruciatingly difficult issue in the modern relationship between doctor and patient. For centuries, doctors followed Hippocrates' injunction to hold out hope to patients, even when it meant withholding the truth. But that canon has been blasted apart by modern patients' demands for honesty and more involvement in their care. Now, patients may be told more than they need or want to know. Yet they still also need and want hope. In response, some doctors are beginning to think about hope in new ways. In certain cases, that means tempering a too-bleak prognosis. In others, it means resisting the allure of cutting-edge treatments with questionable benefits. Already vulnerable when they learn they have a life-threatening disease or chronic illness, patients can feel bewildered, trapped between reality and possibility. They, as well as doctors, are discovering that in the modern medical world, hope itself cannot be monolithic. It can be defined in many ways, depending on the patient's medical condition and station in life. A dying woman can find hope by selecting wedding gifts for her toddlers. An infertile couple moves on toward adoption. The power of a doctor's pronouncements is profound. When a doctor takes a blunt-is-best approach, enumerating side effects and dim statistics, in essence offering a hopeless prognosis, patients experience despair. A radiation oncologist told Minna Immerman's husband, who had brain cancer, that he had less than two years to live. "That information was paralyzing," Mrs. Immerman said. "It wasn't helpful." But when a doctor suggests that an exhausted patient try yet another therapy, in the hope that it may extend survival by weeks, the cost is also considerable - financially, physically and emotionally. "We have to find a less toxic way to manage their hope," said Dr. Nicholas A. Christakis, an internist and Harvard professor who is writing a textbook about prognosis. Efforts are being made across the medical community to grapple with the language and ethics of hope. Some medical schools pair students with end-stage disease patients so students can learn about anguish and compassion. Numerous studies have examined what doctors say versus what patients hear and the role of optimism in the care of the critically ill. Patient advocates have been teaching doctors how patients can be devastated or braced by a turn of phrase. A consensus is emerging that all patients need hope, and that doctors are obligated to offer it, in some form. To Dr. Sacco's boundless relief, his patient rallied. He began counseling her to take her AIDS medications, to find an apartment, a job. He wrote in an e-mail message: "We prognosticate because people ask us to and trust our judgment. They do not know the depth of our uncertainty or that no matter how good or experienced we are, we are often wrong. That is why choosing where to put the feather is so damn hard." False Hopelessness Robert Immerman, a 56-year-old Manhattan architect, knew that his brain cancer - a glioblastoma, Grade 4 - meant terrible news. After the tumor was removed, he asked the radiation oncologist his prognosis. "The doctor was pleasant," Minna Immerman recalled, "as if he was telling you that hamburger was $2.99 a pound. He just said the likely survival rate with this tumor was, on the outside, 18 months. "Bob purposely forgot it," she said. "I couldn't." After radiation, Mr. Immerman began chemotherapy. But after one treatment, his white blood cell count dropped so precipitously that it was no longer an option. "The medical oncologist said, 'The chances of survival with or without chemo are very, very slight,' " said Mrs. Immerman, a special-education teacher. "I think she was trying to make us feel better. What I heard was: 'With or without chemo, this won't end well, so don't feel so bad.' " Mr. Immerman got scans every two months. Mrs. Immerman watched the calendar obsessively. Twelve months left. Six months. "As time passed, instead of feeling better, I felt like it was a death sentence and it was winding down," she said. She sweated the small stuff: should they renew their opera subscription? Mr. Immerman turned out to be one of those rare people who reside at the lucky tail end of a statistical curve. In February, it will be 10 years since he learned his prognosis. He is well. For years, Mrs. Immerman was shadowed by fear and depression about his illness, before she finally allowed herself to breathe out with gratitude. Candid exchanges about diagnosis and prognosis, especially when the answers are grim, are a relatively recent phenomenon. Hippocrates taught that physicians should "comfort with solicitude and attention, revealing nothing of the patient's present or future condition." A dose of reality, doctors believed, could poison a patient's hope, the will to live. Until the 1960's, that approach was largely embraced by physicians. Dr. Eric Cassell, who lectured about hope in November to doctors in the Boston area, recalled the days when a woman would wake from surgery, asking if she had cancer: " 'No,' we'd say, 'you had suspicious cells so we took the breast, so you wouldn't get cancer.' We were all liars." Treatments were very limited. "Now when we're truthful," Dr. Cassell added, "it's in an era in which we believe we can do something." Doctors in many third world countries and modernized nations, including Italy and Japan, still believe in withholding a bad prognosis. But the United States, Britain and other countries were revolutionized in the late 60's by the patients' rights movement, which established that patients had a legal right to be fully informed about their medical condition and treatment options. Now, whether a patient comes in complaining of a backache, a rash or a lump in the armpit, many doctors interpret informed consent as the obligation to rattle off all possibilities, from best-case to worst-case situations. Honesty is imperative. But what benefit is served by Dr. Dour? "There are doctors who paint a bleaker picture than necessary so they can turn out to be heroes if things turn out well," said Dr. David Spiegel, a psychiatrist at Stanford medical school, "and it also relieves doctors of responsibility if bad things happen." The fear of malpractice litigation after a bad outcome, he said, also drives doctors to be stunningly explicit from the outset. The medical community has nicknames for this bluntness: truth-dumping, terminal candor, hanging crepe. But some social workers call it false hopelessness. Given a time-tied prognosis, many patients become withdrawn and depressed, said Roz Kleban, a supervising social worker with Memorial Sloan-Kettering Cancer Center. "Telling someone they have two years to live isn't useful knowledge," she said. "It's noise. Whether or not that prediction is true, they lose their ability to live well in the present." Health care providers debate the wisdom of giving patients a precise prognosis: "There's an ethical obligation to tell people their prognosis," said Dr. Barron Lerner, an internist and bioethicist at Columbia University medical school, "but no reason to pound it into their heads." Others say that doctors should make sure they can explain the numbers in context, with the pluses and minuses of treatment options, including the implications of choosing not to have treatment. Though many patients ask how long they have to live, thinking that amid the chaos of bad news, a number offers something concrete, studies show that they do not understand statistical nuances and tend to misconstrue them. Moreover, though statistics may be indicative, they are inherently imperfect. Many doctors prefer not to give a prognosis. And, studies show, their prognoses are often wrong, one way or the other. Where does this leave the frightened patient? Meg Gaines, director of the Center for Patient Partnerships, a patient advocacy program at the University of Wisconsin, Madison, thinks false hopelessness is more debilitating than false hope. "I tell people to ask the doctor, 'Have you ever known anyone with this disease who has gotten better?' If the answer is yes, just say, 'So let's quit talking about death and talk about what we can try!' " Some patients do triumph against grotesque statistical odds; others succumb even when the odds are piled in their favor. But willful ignorance, she cautioned, can be dangerous. "People should know about prognosis to the extent that it's necessary to make good decisions about monitoring your health care," she said. "You can't be an ostrich in the sand. When the stampeding rhinoceri are coming, you have to be able to get out of the way." False Hope Perhaps just as harmful as false hopelessness, many experts believe, is false hope. "If one patient in a thousand will live with pancreatic cancer for 10 years," said Dr. Christakis of Harvard, and doctors hold out that patient as a realistic example, "we have harmed 999 patients." False hopelessness, in the name of reality, dwells on the dark view of a patient's condition, prematurely foreclosing possibility and a spirited fight. False hope sidesteps reality, leaving patients and family members unprepared for tragedy. When Anna Kyle was in labor, the umbilical cord dropped ahead of the baby, who was deprived of oxygen for critical moments. Mrs. Kyle had an emergency Caesarean section. The baby had to be resuscitated. The nurses in the neonatal intensive care unit told Mrs. Kyle, of Lonoke, Ark., that her son was a "good baby," because he didn't cry or fuss. Later, when he had developmental delays, her hopes were at war with her nagging fears. But doctors kept saying the child might outgrow them. Her son, now 5, received a formal diagnosis last year. "Nobody wanted to say, 'Your kid has autism, your kid is mentally retarded, your kid will be in diapers most of his life,' " said Mrs. Kyle, whose husband earns $10 an hour as a truck driver. "It hurts, it's nasty, ugly stuff, but it has to be said, so kids can get the therapy they need as early as possible." Because patients hunger for good news, experts say that doctors should choose their words carefully: "If you get into the language of hope, you run the risk of over-promising things," said Dr. Lerner of Columbia. The more useful discussion for patients, he added, is, "what hopeful things can I do?" In his November lecture on hope, Dr. Cassell said that patients do not need "false hope that is personified in useless therapy with nontherapeutic effect." False hope is both a hangover from the centuries-old belief that doctors should withhold bad news, and a practice newly infused by the explosion of so many medical treatments and the tenuous promise held out by clinical trials. Consider the cost of false hope, experts note: not only the physical and emotional agony of dying patients who try last-ditch, occasionally unproven treatments, but also the depletion, financially and psychologically, of the patients' survivors. "The battle cry of our culture is, 'Don't just stand there - do something!' " said Dr. Richard Deyo, a Seattle internist and professor at the University of Washington who writes about the high cost of false hope. He added, "Physicians have a natural bias for action, whereas it may be more honest to say, 'Whether I do something or not, the result is likely to be the same.' " A 1994 study showed that Americans have greater faith in medical advances than people in many other countries. Thirty-four percent of Americans believed that modern medicine "can cure almost any illness for people who have access to the most advanced technology and treatment." By contrast, only 11 percent of Germans held the same belief. Accompanying the medical advances, however, are an increasing number of physician subspecialties. One downside is that patients hear from a variety of voices, and they can become inadvertently misled. Pat Murphy, a nurse and grief counselor who heads the family support team at University Hospital in Newark, said that, for example, when a patient has a critical stroke, a cardiologist, among others, will be called in for an evaluation: "The doctor might say, 'This is a strong heart' and then he leaves," she said. "The patient will probably never regain consciousness. But the 'parts people' talk to the family out of context, and the family thinks they're hearing good news." Another result of this medical renaissance is thousands of clinical trials. Phase 1 trials often try out doses of an unapproved drug; perhaps only 5 percent of volunteers may derive any benefit. "Most people think they don't want to be an experiment," said George J. Annas, author of "The Rights of Patients." But, he said, when desperately ill patients learn about a trial, "all of a sudden there's no difference in their minds between research and treatment." A 2003 study of advanced-stage cancer patients who volunteered for Phase I trials showed that at least three-quarters of them were convinced they had a 50 percent chance or greater of being helped by the drug. Because patients listen selectively, it can be difficult to tease out who owns responsibility for false hope: Patricia Mendell, a New York psychotherapist who works with fertility patients, noted: "A doctor can tell a patient she has a 95 percent chance of an I.V.F. cycle not working. But the patient will feel it's her right to try for that 5 percent. " Indeed, false hope can represent a complex entwining between terrified patient and well-intended doctor: both want the best outcome, sometimes so intensely that what emerges is a collective denial about the patient's condition. Hope Elissa J. Levy was a winter sports jock, with a buoyant social circle and a power job on Wall Street. But in January 2002, she received a diagnosis of secondary progressive multiple sclerosis, a less common version of the disease, for which there are few treatments and no known cures. Soon, Ms. Levy needed a cane, and could scarcely walk a block. Pain and fatigue dogged her. Her quick brain grew foggy, her right hand floppy. She cut back her new job as a deputy director of a Bronx charter school to three days a week. In the mornings, her mother had to help dress her. But though her body sagged, her neurologist helped prop up her spirits. "Often I would come in crying," Ms. Levy said, "and he would hold my hand and say, 'We'll figure this out together.' Or 'We can hope that this treatment works.' " Given the gravity of her disease, was it appropriate for the doctor to stoke her hope? "Hope," wrote Emily Dickinson, "is the thing with feathers/That perches in the soul." Imprecise and evanescent, hope is almost universally considered essential to the business of being human. Few can define hope: Self-delusion? Optimism? Expectation? Faith? And that, say experts from across a wide spectrum, is the point: hope means different things to different people. When someone's medical condition changes, that person's definition of hope changes. A hope for a cure can morph into a hope that a relationship can be mended. Or that one's organs will be eligible for donation. For so many, hope and faith are inextricably linked. "Truly spiritual people are amazing, " said Ms. Murphy of University Hospital. "Until the moment of death, families pray for a miracle and then at the moment of the death, they say, 'This is God's will' and 'God will get us through this.' " As health care providers struggle with whether, how and when doctors should speak of hope, a consensus is building on at least two fronts: that what fundamentally matters is that a doctor tells the truth with kindness, and that a doctor should never just say, "I have nothing more to offer you." More doctors are embracing palliative care specialists as partners who work with critically ill patients and their families to help them redefine their hopes, from the improbable to the possible. Many doctors, whose specialties range from neurosurgery to infertility, retain therapists to counsel patients. "Hope lives inside a patient and the physician's behavior can either bring it out or suppress it," said Dr. Susan D. Block, a palliative care leader at Harvard. "When a patient has goals, it's impossible to be hopeless. And when a physician can help a patient define them, you feel like a healer, even when the patient is dying." Dr. Spiegel, the Stanford psychiatrist, recalled a woman who knew her death from cancer was imminent: "She had 15-minute appointments scheduled all day with relatives, to set them straight on how to live their lives. Then she was going to die. This was a hopeful woman." Harvard's medical school matches first-year students with critically ill patients - in essence, the patients become the teachers. One patient, Dr. Block recalled, was a high school teacher dying from lymphoma, who agreed with alacrity to participate. When her husband came into her room, the patient said, with tears in her eyes, "Honey, I have one last teaching gig." Last April, Ms. Levy's doctor started her on a drug that is still in clinical trials, but has long been available in Europe. Shortly after she began taking the daily pill, she went for a checkup and lay down on his examining table. He asked her to lift her leg. Normally, Ms. Levy struggled to budge her leg. But having taken the drug, she flung her leg into a 90-degree angle. She gasped. Usually, when her doctor pressed one finger against her leg, it collapsed. Now he pushed with his open hand. She held steady. Both she and her doctor grew teary-eyed. Finally, she walked down the hall without her cane. Both patient and doctor wept openly. The drug does not cure her disease; it treats symptoms. But Ms. Levy, 37, now walks 20 blocks at a clip, works four days a week, goes to the gym. She is dating. A recent test showed that her disease has not progressed. In a sense, Ms. Levy's relationship with her doctor combined the best of the old and new worlds. He was hopeful but also candid. And he could offer her promising treatments, including one that, at least temporarily, seems to help. "And if I start feeling bad again?" Ms. Levy said. "I have hope that I'll feel good again."
  19. That joke sounds ED ZACHERY like one you would have told BEFORE the Decadron! I'm going to go in and tell it Mark! Leslie
  20. Charlie, I goggled and it looks like it's the Zofran causing them. But I couldn't find any Zofran-related advice about how to stop 'em. Just found generic home remedy stuff. There's also some kind of Rx that can be given if the continue, but I don't have a name. Sorry. Good luck! Info on this link: http://64.233.167.104/search?q=cache:lF ... ment&hl=en Leslie
  21. Prayers for Mike and for you. Leslie
  22. Joe, You must have a little Santa Claus in your blood, because you just gave me something I have wanted: the words to "God Rest Ye Merry Gentlemen!" No kidding! It's one of my favorites and I've been trying to remember the words. Thanks! Leslie
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