Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Dear friends, colleagues and teachers, I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. Sincerely, Yehuda Take the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 That's a tough one. Of course, high doses of opiates can kill people. Junkies die every day from opiate overdoses. On the other hand, painkillers can be very helpful to somebody in the late stages of cancer. Once the cancer gets into the bones, it can be very difficult to treat the pain with acupuncture alone. Painkillers plus acupuncture actually works. This is jus my limited experience, of course. - Bill , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non- smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of > you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > > Sincerely, > > Yehuda > > > > > > > > > Take the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 I don't doubt that there may be something to the opiate overdoses but I have two other tough alternatives. I'm wondering if they were doing so well just a day before if the family members weren't experiencing the patient's false Shen. I've seen this happen a day or two before passing away. I think it's not impossible that you have made the patients comfortable enough to pass away. , " bill_schoenbart " <plantmed2 wrote: > > That's a tough one. Of course, high doses of opiates can kill > people. Junkies die every day from opiate overdoses. On the other > hand, painkillers can be very helpful to somebody in the late stages > of cancer. Once the cancer gets into the bones, it can be very > difficult to treat the pain with acupuncture alone. Painkillers plus > acupuncture actually works. This is jus my limited experience, of > course. > > - Bill > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > >>>>> You also need to remember it is common for people to suddenly show remarkable positive change just before they die. Opiate tolerance is very individual and toxicity symptoms are caused by huge variation in dosage. It depends on how long some has been on them and individual metabolism. Death is from respiratory depression - bill_schoenbart Sunday, August 19, 2007 8:51 AM Re: cancer patients and strong analgesics That's a tough one. Of course, high doses of opiates can kill people. Junkies die every day from opiate overdoses. On the other hand, painkillers can be very helpful to somebody in the late stages of cancer. Once the cancer gets into the bones, it can be very difficult to treat the pain with acupuncture alone. Painkillers plus acupuncture actually works. This is jus my limited experience, of course. - Bill , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non- smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of > you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > > Sincerely, > > Yehuda > > > > > > > > > Take the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Hi Yehuda, That's the protocol in Hospice Care, in the name of " to assist the pt & family for a peaceful passing " Pts are given heavy doses of narc, usually morphine, to induce coma, then death. It takes 24-48hrs to work. Yes, the pt die in that time frame. I'm an RN, worked for Hospice few months. Quit after examining my moral issues. Take care. amy ************************************** Get a sneak peek of the all-new AOL at http://discover.aol.com/memed/aolcom30tour Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Yehuda, Are you sure it was not coincidence of timing with morphine? I had treated an elderly person who had breathing problems yet slept the best they had in years a few days before they also passed. Sometimes people appear to be getting better right before they pass. A last flash of brightness (yang) and then they pass (yin). Mike W. Bowser, L Ac ; Chinese Traditional Medicine: : Sun, 19 Aug 2007 01:07:27 -0700cancer patients and strong analgesics Dear friends, colleagues and teachers,I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any ofyou had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention.Sincerely,YehudaYehuda L. Frischman, L.Ac, CST, SERTake the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Hi Yehuda, Morphine, etc. does, indeed, have the effect of moving a fragile patient closer to death. I was my grandmother's " night nurse " many many years ago when she was dying at home of colon cancer, and the attending MD explained to us carefully that, while we should not hesitate to give her additional shots as she showed signs of discomfort, we should know that each shot, in her condition, would bring her that much closer to death. I knew nothing about Chinese medicine then, but I assume that as one of the effects of morphine, etc is to relax and slow down the functioning of the organs, in one with extreme qi deficiency (as one would have after battling cancer and western cancer treatments for a long time) at some point there's not enough left to counter the unrooting effects of the drug, and the spirit simply slips loose of the body and floats away. ---Deb Marshall Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 On 8/19/07, Deb Marshall <taichideb wrote: > > I knew nothing about Chinese medicine then, but I assume that as one of > the effects of morphine, etc is to relax and slow down the functioning of > the organs, in one with extreme qi deficiency (as one would have after > battling cancer and western cancer treatments for a long time) at some point > there's not enough left to counter the unrooting effects of the drug, and > the spirit simply slips loose of the body and floats away. > You can read up on Ying Su Ke for more info on how TCM sees the opium husk and to a certain extent the effects of morphine. " This unrooting of the spirit which slips loose and floats away. " That's a lovely image. I got no problem with this sort of intervention at the end of a painful disorder and intuitively see a bed-ridden death as this very experience. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Yehuda, Not based on my experience as an acupuncturist, but based on the experience of both my mother and sister who are nurses working with the elderly, this is common. When the patient is diagnosed as declining without hope of recovery, morphine is given and within a few days the patient passes away. Sincerely, Cheryle, L.Ac. wrote: Dear friends, colleagues and teachers, I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. Sincerely, Yehuda Take the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Wow. This is a heavy topic. I thought euthanasia was illegal... and the moral considerations are another complicated layer. A good topic for discussion. Amyc144 wrote: Hi Yehuda, That's the protocol in Hospice Care, in the name of " to assist the pt & family for a peaceful passing " Pts are given heavy doses of narc, usually morphine, to induce coma, then death. It takes 24-48hrs to work. Yes, the pt die in that time frame. I'm an RN, worked for Hospice few months. Quit after examining my moral issues. Take care. amy Got a little couch potato? Check out fun summer activities for kids. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Dear group, What nurse Amy confirms is exactly as I have suspected: Western medicine's primary task in cases beyond its ability to resolve is pain control. " Hi Yehuda, That's the protocol in Hospice Care, in the name of " to assist the pt & family for a peaceful passing " Pts are given heavy doses of narc, usually morphine, to induce coma, then death. It takes 24-48hrs to work. Yes, the pt die in that time frame. I'm an RN, worked for Hospice few months. Quit after examining my moral issues. " Shocking, no? I'll never forget, that a few years ago, when seeing a neurologist at UCLA, seeing her wearing a button (like the no-smoking butttons) with the word " PAIN " and a line through it. In other words, pain must be SUPPRESSED at all costs! When they ultimately give up, their agenda calls for heroic doses of analgesics which means euthanasia. They may deny it, it may not be politically correct to admit it, but that IS their protocol. Shades of " Dr. Death " , the infamous Jack Kevorkian. I feel we must do something! Our medicine and other related and complementary therapies are able to ameliorate pain without side effects. At the very least, dialogue must be initiated with the medical community to have them consider the benefit of alternatives to heroic dosages of strong analgesics used alone which DO kill. Just like " goldilocks " a new protocol needs to be developed to offer patients in unrelenting pain, relief that can be achieved using small doses of analgesics which are " just right " , together with acupuncture, herbs and other modalities. Not only will the patient suffer less, but more importantly, this will give us the time to make a difference, to affect a change and to give our medicine a chance to work. I am just a little guy. I am a relatively new practitioner and an not well connected. Some of you do work with oncologists regularly and others of you do work in lobbying and legislative reform. Do you want to effect a change? Or are there other, bigger issues that YOU consider priorities such as medicare or insurance reform? Personally, if you want to involve me in this process, I will gladly make myself available, but who am I? Sincerely, Yehuda Frischman, L.Ac, CST, SER < wrote: Wow. This is a heavy topic. I thought euthanasia was illegal... and the moral considerations are another complicated layer. A good topic for discussion. Amyc144 wrote: Hi Yehuda, That's the protocol in Hospice Care, in the name of " to assist the pt & family for a peaceful passing " Pts are given heavy doses of narc, usually morphine, to induce coma, then death. It takes 24-48hrs to work. Yes, the pt die in that time frame. I'm an RN, worked for Hospice few months. Quit after examining my moral issues. Take care. amy Got a little couch potato? Check out fun summer activities for kids. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 What about pulses, Alon, in all 3 cases, there was a dramatic improvement in the patient's pulses. As far as opiate tolerance, I strongly question how high the threshold of tolerance is for patients already weakened by cancer, chemo and radiation. BTW, as I posted about 6 months ago, (and again, this is only concerning methadone, not vicodin or morphine), there have been published studies clearly showing that Methadone causes severe damage heart and liver tissue. Yehuda Alon Marcus <alonmarcus wrote: This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > >>>>> You also need to remember it is common for people to suddenly show remarkable positive change just before they die. Opiate tolerance is very individual and toxicity symptoms are caused by huge variation in dosage. It depends on how long some has been on them and individual metabolism. Death is from respiratory depression Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2007 Report Share Posted August 19, 2007 Al Stone <al wrote: Dear Al, You may have no problem with it, but I have a big problem with it: 1. The decision is made by the western physician rather than the patient. My patient had specifically told me that she wanted to live and was willing to endure pain, as long as she had a chance to live. Then when she was sent home, she was sent home with instruction to start the Morphine drip immediately. That was the beginning of the end. And,BTW, it only made her incoherent and spacey. There as terrrible groaning and pain, which never ended until the end, from the onset of the IV, which began about 2 hours after I left. Let the patient make an informed decision. If the CM physician feels that a)quality of life can be improved and b)there is what to be done to give the patient a chance (even though the Western docs had given up) , then certainly don't dogmatically automatically begin the drip! Again, I see very little difference between this and euthanasia, which to me, is unacceptable, though I don't believe this is an appropriate forum to engage in debate as to its merits or not. Yehuda You can read up on Ying Su Ke for more info on how TCM sees the opium husk and to a certain extent the effects of morphine. " This unrooting of the spirit which slips loose and floats away. " That's a lovely image. I got no problem with this sort of intervention at the end of a painful disorder and intuitively see a bed-ridden death as this very experience. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Hello Yehuda, Not sure what you were treating with the herbs / acupuncture - but I'm assuming it was pain? I'm also going to assume it was stage 4 lung Ca beyond western treatment based on your reporting. Assuming that is all correct, do you consider your treatment a failure? Your patient said they felt better shortly before passing away after battling a hideous disease - that sounds like a success to me. The morphine was probably very helpful for comfort, and sometimes if the dose is quite high - to help passing on as well. After treating a few late stage cancer patients, you loose any thoughts that you are going to bring them back from the brink of destruction - all I can pray for is a swift comfortable death at home with their family around them. I am not an expert, but defer to the expertise of the oncologists working with the patient to get a good idea of what the treatment plan should be - fight or get ready to pass on. Julian Scott taught us that sometimes you just help give the patient enough Qi to pass away. You see a lot of people in the hospital that are too weak to die, which is a terrible way to go. Geoff , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of > you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > > Sincerely, > > Yehuda Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Hi Geoff, Yes and no. because I integrate CranioSacral therapy and SomatoEmotional release into my treatments (among other things), I feel comfortable utilitzing my hands-on therapies to address co-existing pain issues, while at the same time unblocking some of the blockage the cancer has caused. Also, I feel very strongly that cancer is a process, often long term which results from the sympathetic nervous system being under constant vigilence, working overtime. With CranioSacral therapy, patients are able to let go and maybe for the first time in years get out of fight or flight. As far as the herbs and acupuncture I use, I don't treat Western conditions rather I try to determine the patient's patterns in order to establish differential diagnosis. This patient presented with severe lung, stomach and kidney yin xu, which had transformed into toxic heat in the lungs. Furthermore, this patient originally had 5 years previously a history of colon cancer and chronic constipation. She was very thirsty, had a chronic non-productive dry cough, low grade fever, had severe night sweats, dyspnea and rapid breathing. She had developed pneumonia over the past week as well. After taking the herbal medicine, her sweating stopped, her cough virtually stopped, her breathing slowed down, she had much more strength, and was able to talk without using oxygen. Also, not to be underestimated, she smiled. Was the treatment a failure? No way! Again, as I implied in an earlier post, what I learned from this experience, is to begin treatment as early as possible, and to engage the attending physician and/or hospice nurse in dialogue as to my experience in previous hospice patients with Morphine, Methadone and Vicodin. Also, I would involve family members, so that they too will be knowledgable and not intimidated into capitulating to the pressure on them. So often decisions are based upon default. I want to avoid irreversable actions, which can cost a life. If the patient doesn't make it, it's heartbreaking. But knowing that I did everything I know how to to proactively help my patient in some way regain balance, while at the same time preventing harmful therapeutics, gives me the comfort in knowing that I have fulfilled my responsibility. I believe that we are detectives, translators, tour guides and messengers. As detectives it is incumbant upon us to read all the clues given to us. As translators, we need to learn how to listen to our patients, the words of their mouths and body language, as well as learning to hear with the proprioceptors in our fingers the language of their bodies. As tour guides, we need to not have agendas, but follow the intelligent guidance that is given to us by our patients, " really " listening! and we must always be humble enough to know that we are just messengers, not healers. If we follow this guidance, our egos will not get in the way. Failure then can only come from not following instructions due to ignorance, ego, negligence, or incompetance. Respectfully, Yehuda G Hudson <crudo20 wrote: Hello Yehuda, Not sure what you were treating with the herbs / acupuncture - but I'm assuming it was pain? I'm also going to assume it was stage 4 lung Ca beyond western treatment based on your reporting. Assuming that is all correct, do you consider your treatment a failure? Your patient said they felt better shortly before passing away after battling a hideous disease - that sounds like a success to me. The morphine was probably very helpful for comfort, and sometimes if the dose is quite high - to help passing on as well. After treating a few late stage cancer patients, you loose any thoughts that you are going to bring them back from the brink of destruction - all I can pray for is a swift comfortable death at home with their family around them. I am not an expert, but defer to the expertise of the oncologists working with the patient to get a good idea of what the treatment plan should be - fight or get ready to pass on. Julian Scott taught us that sometimes you just help give the patient enough Qi to pass away. You see a lot of people in the hospital that are too weak to die, which is a terrible way to go. Geoff , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of > you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > > Sincerely, > > Yehuda Need a vacation? Get great deals to amazing places on Travel. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Yehuda, I just lost my father two weeks ago to cancer at 71 years old. He had an oligoglioblastoma that was diagnosed a year and a half ago. He lived in California and came out to visit my family for a month visit when he passed. He had been doing acupuncture, two hours of qi gong a day and a number of different supplements, but in the end the tumor still grew to the point that it compressed his right hemisphere enough to cause a stroke. In his case he was kept on a pretty low dose of morphine over the week where he eventually passed. I know you aren't looking to start a debate here (and neither am I), but there was no chance of recovery for him so we had decided to pull his IV fluids. He continued to eat a bit with some assistance for a short time. I couldn't help but think that although he was comfortable, his death was facilitated by starvation and dehydration. I think we treat our dogs better than this, but I know a lot of this may hinge on ones religious beliefs. Respectfully, Sean _____ On Behalf Of yehuda frischman Sunday, August 19, 2007 11:47 PM Re: re: cancer patients and strong analgesics Al Stone <al <al%40gancao.net> > wrote: Dear Al, You may have no problem with it, but I have a big problem with it: 1. The decision is made by the western physician rather than the patient. My patient had specifically told me that she wanted to live and was willing to endure pain, as long as she had a chance to live. Then when she was sent home, she was sent home with instruction to start the Morphine drip immediately. That was the beginning of the end. And,BTW, it only made her incoherent and spacey. There as terrrible groaning and pain, which never ended until the end, from the onset of the IV, which began about 2 hours after I left. Let the patient make an informed decision. If the CM physician feels that a)quality of life can be improved and b)there is what to be done to give the patient a chance (even though the Western docs had given up) , then certainly don't dogmatically automatically begin the drip! Again, I see very little difference between this and euthanasia, which to me, is unacceptable, though I don't believe this is an appropriate forum to engage in debate as to its merits or not. Yehuda You can read up on Ying Su Ke for more info on how TCM sees the opium husk and to a certain extent the effects of morphine. " This unrooting of the spirit which slips loose and floats away. " That's a lovely image. I got no problem with this sort of intervention at the end of a painful disorder and intuitively see a bed-ridden death as this very experience. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Yehuda, Early treatment is great - and the best chance you have to attack the cancer. I get the feeling you are blaming the narcotics for the patients death. Cancer killed the patient, and at some point nothing is going to change that. Alon noted the 'off-label' use for the respiratory suppression. God only knows where the cut-off point is. As for the patient wanting to fight, that's great, and hope helps! Paraphrasing an earlier post by Alon on another topic he said you have to objectively evaluate the results of your treatment independently from the patient's desire (and ours!) that it's working. Treating terminally ill patients, it's hard to not to let your personal feelings prevent you from seeing the true nature of the disease. Personally, after working with several terminally ill patients and having some friends in town who are in hospice nursing, I know it takes a very special kind of person to endure that labor - and I'm just not one who could do it day in and out like they do. As for sharing your experience with the docs who are experts in their field about their medicine and informing the family contradictory to what the oncologists are informing the family about, that will be another war you will decide to wage. It can have some serious personal, professional, and malpractice ramifications. The " maybe you should ask your doctor about the side-effects of this medication " can easily become " my acupuncturist told me to stop taking this medication " - regardless of how well you document in your chart! Best regards, Geoff Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Yehuda A patient can always refuse medication or any other treatment. Also, i have seen pt in severe pain change their mind all the time about what they want done. When they feel a little better they think they can stop treatment when pain returns they bag for more medication - yehuda frischman Sunday, August 19, 2007 8:46 PM Re: re: cancer patients and strong analgesics Al Stone <al wrote: Dear Al, You may have no problem with it, but I have a big problem with it: 1. The decision is made by the western physician rather than the patient. My patient had specifically told me that she wanted to live and was willing to endure pain, as long as she had a chance to live. Then when she was sent home, she was sent home with instruction to start the Morphine drip immediately. That was the beginning of the end. And,BTW, it only made her incoherent and spacey. There as terrrible groaning and pain, which never ended until the end, from the onset of the IV, which began about 2 hours after I left. Let the patient make an informed decision. If the CM physician feels that a)quality of life can be improved and b)there is what to be done to give the patient a chance (even though the Western docs had given up) , then certainly don't dogmatically automatically begin the drip! Again, I see very little difference between this and euthanasia, which to me, is unacceptable, though I don't believe this is an appropriate forum to engage in debate as to its merits or not. Yehuda You can read up on Ying Su Ke for more info on how TCM sees the opium husk and to a certain extent the effects of morphine. " This unrooting of the spirit which slips loose and floats away. " That's a lovely image. I got no problem with this sort of intervention at the end of a painful disorder and intuitively see a bed-ridden death as this very experience. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Yehuda How many hospice patients have you treated cancer pain - yehuda frischman Monday, August 20, 2007 1:43 AM Re: Re: cancer patients and strong analgesics Hi Geoff, Yes and no. because I integrate CranioSacral therapy and SomatoEmotional release into my treatments (among other things), I feel comfortable utilitzing my hands-on therapies to address co-existing pain issues, while at the same time unblocking some of the blockage the cancer has caused. Also, I feel very strongly that cancer is a process, often long term which results from the sympathetic nervous system being under constant vigilence, working overtime. With CranioSacral therapy, patients are able to let go and maybe for the first time in years get out of fight or flight. As far as the herbs and acupuncture I use, I don't treat Western conditions rather I try to determine the patient's patterns in order to establish differential diagnosis. This patient presented with severe lung, stomach and kidney yin xu, which had transformed into toxic heat in the lungs. Furthermore, this patient originally had 5 years previously a history of colon cancer and chronic constipation. She was very thirsty, had a chronic non-productive dry cough, low grade fever, had severe night sweats, dyspnea and rapid breathing. She had developed pneumonia over the past week as well. After taking the herbal medicine, her sweating stopped, her cough virtually stopped, her breathing slowed down, she had much more strength, and was able to talk without using oxygen. Also, not to be underestimated, she smiled. Was the treatment a failure? No way! Again, as I implied in an earlier post, what I learned from this experience, is to begin treatment as early as possible, and to engage the attending physician and/or hospice nurse in dialogue as to my experience in previous hospice patients with Morphine, Methadone and Vicodin. Also, I would involve family members, so that they too will be knowledgable and not intimidated into capitulating to the pressure on them. So often decisions are based upon default. I want to avoid irreversable actions, which can cost a life. If the patient doesn't make it, it's heartbreaking. But knowing that I did everything I know how to to proactively help my patient in some way regain balance, while at the same time preventing harmful therapeutics, gives me the comfort in knowing that I have fulfilled my responsibility. I believe that we are detectives, translators, tour guides and messengers. As detectives it is incumbant upon us to read all the clues given to us. As translators, we need to learn how to listen to our patients, the words of their mouths and body language, as well as learning to hear with the proprioceptors in our fingers the language of their bodies. As tour guides, we need to not have agendas, but follow the intelligent guidance that is given to us by our patients, " really " listening! and we must always be humble enough to know that we are just messengers, not healers. If we follow this guidance, our egos will not get in the way. Failure then can only come from not following instructions due to ignorance, ego, negligence, or incompetance. Respectfully, Yehuda G Hudson <crudo20 wrote: Hello Yehuda, Not sure what you were treating with the herbs / acupuncture - but I'm assuming it was pain? I'm also going to assume it was stage 4 lung Ca beyond western treatment based on your reporting. Assuming that is all correct, do you consider your treatment a failure? Your patient said they felt better shortly before passing away after battling a hideous disease - that sounds like a success to me. The morphine was probably very helpful for comfort, and sometimes if the dose is quite high - to help passing on as well. After treating a few late stage cancer patients, you loose any thoughts that you are going to bring them back from the brink of destruction - all I can pray for is a swift comfortable death at home with their family around them. I am not an expert, but defer to the expertise of the oncologists working with the patient to get a good idea of what the treatment plan should be - fight or get ready to pass on. Julian Scott taught us that sometimes you just help give the patient enough Qi to pass away. You see a lot of people in the hospital that are too weak to die, which is a terrible way to go. Geoff , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of > you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > > Sincerely, > > Yehuda Need a vacation? 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Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Geoff, IMVHO, I don't believe that the understanding you have of my post is completely clear. The statement that narcotics killed the patient, is just not accurate. Nor is the statement that cancer killed the patient, completely accurate. Cancer is not some monster that invades the body like an aggressive exterior pathogen. It is a long unrelenting, insidious excruciatingly complicated process, that sometimes takes 20 or 30 years before its ugly face reveals itself openly. The question is not blame, either. It is rather incredibly important to begin to understand the pathogenic factors in order to stop and hopefully reverse them as early as possible. So, in viewing a cancer patient I feel it is inappropriate to judge like in a court of law. There was a bootleg Bob Dylan song that I used to listen to called, " Who Killed Davy Moore? " In it all the different killers of a prize fighter give excuses that " it wasn't me, I was just doing my job! " , including the fighter who knocked him out, the manager, the doctor, the promoter, the fan asking for more blood, etc. The same here. I feel that blame doesn't change anything. Rather we need to ask ourselves, what elements have contributed to and accelerated a given patient's functionality, quality of life and ultimately death. I say that heroic pain killers in the context of a hospice patient must be used with greater thoughtfulness and humility, and should not be administered automatically! Of course, relief of pain is incredibly important, but everything is not a straight forward black and white! As far as relating to family members, again, you have to set your own priorities, and risks for that matter. I am not afraid of giving a patient's family, information either orally or in writing, for them to make an informed decision on the use of Methadone, morphine or other heroic analgesics and the risks involved. I am not afraid of engaging a hospice nurse or attending physician in an informative civil conversation empowering them with information that they may not have had heretofore. The decision is yours. Respectfully, Yehuda G Hudson <crudo20 wrote: Yehuda, Early treatment is great - and the best chance you have to attack the cancer. I get the feeling you are blaming the narcotics for the patients death. Cancer killed the patient, and at some point nothing is going to change that. Alon noted the 'off-label' use for the respiratory suppression. God only knows where the cut-off point is. As for the patient wanting to fight, that's great, and hope helps! Paraphrasing an earlier post by Alon on another topic he said you have to objectively evaluate the results of your treatment independently from the patient's desire (and ours!) that it's working. Treating terminally ill patients, it's hard to not to let your personal feelings prevent you from seeing the true nature of the disease. Personally, after working with several terminally ill patients and having some friends in town who are in hospice nursing, I know it takes a very special kind of person to endure that labor - and I'm just not one who could do it day in and out like they do. As for sharing your experience with the docs who are experts in their field about their medicine and informing the family contradictory to what the oncologists are informing the family about, that will be another war you will decide to wage. It can have some serious personal, professional, and malpractice ramifications. The " maybe you should ask your doctor about the side-effects of this medication " can easily become " my acupuncturist told me to stop taking this medication " - regardless of how well you document in your chart! Best regards, Geoff Pinpoint customers who are looking for what you sell. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Alon, I agree 100%. But the problem is when a patient is given pain medicine unbeknownst to them or their family. Yehuda Alon Marcus <alonmarcus wrote: Yehuda A patient can always refuse medication or any other treatment. Also, i have seen pt in severe pain change their mind all the time about what they want done. When they feel a little better they think they can stop treatment when pain returns they bag for more medication - yehuda frischman Sunday, August 19, 2007 8:46 PM Re: re: cancer patients and strong analgesics Al Stone <al wrote: Dear Al, You may have no problem with it, but I have a big problem with it: 1. The decision is made by the western physician rather than the patient. My patient had specifically told me that she wanted to live and was willing to endure pain, as long as she had a chance to live. Then when she was sent home, she was sent home with instruction to start the Morphine drip immediately. That was the beginning of the end. And,BTW, it only made her incoherent and spacey. There as terrrible groaning and pain, which never ended until the end, from the onset of the IV, which began about 2 hours after I left. Let the patient make an informed decision. If the CM physician feels that a)quality of life can be improved and b)there is what to be done to give the patient a chance (even though the Western docs had given up) , then certainly don't dogmatically automatically begin the drip! Again, I see very little difference between this and euthanasia, which to me, is unacceptable, though I don't believe this is an appropriate forum to engage in debate as to its merits or not. Yehuda You can read up on Ying Su Ke for more info on how TCM sees the opium husk and to a certain extent the effects of morphine. " This unrooting of the spirit which slips loose and floats away. " That's a lovely image. I got no problem with this sort of intervention at the end of a painful disorder and intuitively see a bed-ridden death as this very experience. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Alon, As I have said on multiple occasions, I am a relatively new practitioner. This was my 5th hospice patient. Alon Marcus <alonmarcus wrote: Yehuda How many hospice patients have you treated cancer pain - yehuda frischman Monday, August 20, 2007 1:43 AM Re: Re: cancer patients and strong analgesics Hi Geoff, Yes and no. because I integrate CranioSacral therapy and SomatoEmotional release into my treatments (among other things), I feel comfortable utilitzing my hands-on therapies to address co-existing pain issues, while at the same time unblocking some of the blockage the cancer has caused. Also, I feel very strongly that cancer is a process, often long term which results from the sympathetic nervous system being under constant vigilence, working overtime. With CranioSacral therapy, patients are able to let go and maybe for the first time in years get out of fight or flight. As far as the herbs and acupuncture I use, I don't treat Western conditions rather I try to determine the patient's patterns in order to establish differential diagnosis. This patient presented with severe lung, stomach and kidney yin xu, which had transformed into toxic heat in the lungs. Furthermore, this patient originally had 5 years previously a history of colon cancer and chronic constipation. She was very thirsty, had a chronic non-productive dry cough, low grade fever, had severe night sweats, dyspnea and rapid breathing. She had developed pneumonia over the past week as well. After taking the herbal medicine, her sweating stopped, her cough virtually stopped, her breathing slowed down, she had much more strength, and was able to talk without using oxygen. Also, not to be underestimated, she smiled. Was the treatment a failure? No way! Again, as I implied in an earlier post, what I learned from this experience, is to begin treatment as early as possible, and to engage the attending physician and/or hospice nurse in dialogue as to my experience in previous hospice patients with Morphine, Methadone and Vicodin. Also, I would involve family members, so that they too will be knowledgable and not intimidated into capitulating to the pressure on them. So often decisions are based upon default. I want to avoid irreversable actions, which can cost a life. If the patient doesn't make it, it's heartbreaking. But knowing that I did everything I know how to to proactively help my patient in some way regain balance, while at the same time preventing harmful therapeutics, gives me the comfort in knowing that I have fulfilled my responsibility. I believe that we are detectives, translators, tour guides and messengers. As detectives it is incumbant upon us to read all the clues given to us. As translators, we need to learn how to listen to our patients, the words of their mouths and body language, as well as learning to hear with the proprioceptors in our fingers the language of their bodies. As tour guides, we need to not have agendas, but follow the intelligent guidance that is given to us by our patients, " really " listening! and we must always be humble enough to know that we are just messengers, not healers. If we follow this guidance, our egos will not get in the way. Failure then can only come from not following instructions due to ignorance, ego, negligence, or incompetance. Respectfully, Yehuda G Hudson <crudo20 wrote: Hello Yehuda, Not sure what you were treating with the herbs / acupuncture - but I'm assuming it was pain? I'm also going to assume it was stage 4 lung Ca beyond western treatment based on your reporting. Assuming that is all correct, do you consider your treatment a failure? Your patient said they felt better shortly before passing away after battling a hideous disease - that sounds like a success to me. The morphine was probably very helpful for comfort, and sometimes if the dose is quite high - to help passing on as well. After treating a few late stage cancer patients, you loose any thoughts that you are going to bring them back from the brink of destruction - all I can pray for is a swift comfortable death at home with their family around them. I am not an expert, but defer to the expertise of the oncologists working with the patient to get a good idea of what the treatment plan should be - fight or get ready to pass on. Julian Scott taught us that sometimes you just help give the patient enough Qi to pass away. You see a lot of people in the hospital that are too weak to die, which is a terrible way to go. Geoff , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of > you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > > Sincerely, > > Yehuda Need a vacation? Get great deals to amazing places on Travel. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Would that be the same Qi that caused the Birth operating till Death? Just a thought. Take care. amy RN.LMT.AP.DOM ************************************** Get a sneak peek of the all-new AOL at http://discover.aol.com/memed/aolcom30tour Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Yehuda I would therefore be careful not to come to any conclusion as of yet. And by the way cancer pain is not considered to be sympathetically mediated, related to facilitated segments or dural related. It is by definition none of the above being a true nociceptive lesion - yehuda frischman Monday, August 20, 2007 11:17 AM Re: Re: cancer patients and strong analgesics Alon, As I have said on multiple occasions, I am a relatively new practitioner. This was my 5th hospice patient. Alon Marcus <alonmarcus wrote: Yehuda How many hospice patients have you treated cancer pain - yehuda frischman Monday, August 20, 2007 1:43 AM Re: Re: cancer patients and strong analgesics Hi Geoff, Yes and no. because I integrate CranioSacral therapy and SomatoEmotional release into my treatments (among other things), I feel comfortable utilitzing my hands-on therapies to address co-existing pain issues, while at the same time unblocking some of the blockage the cancer has caused. Also, I feel very strongly that cancer is a process, often long term which results from the sympathetic nervous system being under constant vigilence, working overtime. With CranioSacral therapy, patients are able to let go and maybe for the first time in years get out of fight or flight. As far as the herbs and acupuncture I use, I don't treat Western conditions rather I try to determine the patient's patterns in order to establish differential diagnosis. This patient presented with severe lung, stomach and kidney yin xu, which had transformed into toxic heat in the lungs. Furthermore, this patient originally had 5 years previously a history of colon cancer and chronic constipation. She was very thirsty, had a chronic non-productive dry cough, low grade fever, had severe night sweats, dyspnea and rapid breathing. She had developed pneumonia over the past week as well. After taking the herbal medicine, her sweating stopped, her cough virtually stopped, her breathing slowed down, she had much more strength, and was able to talk without using oxygen. Also, not to be underestimated, she smiled. Was the treatment a failure? No way! Again, as I implied in an earlier post, what I learned from this experience, is to begin treatment as early as possible, and to engage the attending physician and/or hospice nurse in dialogue as to my experience in previous hospice patients with Morphine, Methadone and Vicodin. Also, I would involve family members, so that they too will be knowledgable and not intimidated into capitulating to the pressure on them. So often decisions are based upon default. I want to avoid irreversable actions, which can cost a life. If the patient doesn't make it, it's heartbreaking. But knowing that I did everything I know how to to proactively help my patient in some way regain balance, while at the same time preventing harmful therapeutics, gives me the comfort in knowing that I have fulfilled my responsibility. I believe that we are detectives, translators, tour guides and messengers. As detectives it is incumbant upon us to read all the clues given to us. As translators, we need to learn how to listen to our patients, the words of their mouths and body language, as well as learning to hear with the proprioceptors in our fingers the language of their bodies. As tour guides, we need to not have agendas, but follow the intelligent guidance that is given to us by our patients, " really " listening! and we must always be humble enough to know that we are just messengers, not healers. If we follow this guidance, our egos will not get in the way. Failure then can only come from not following instructions due to ignorance, ego, negligence, or incompetance. Respectfully, Yehuda G Hudson <crudo20 wrote: Hello Yehuda, Not sure what you were treating with the herbs / acupuncture - but I'm assuming it was pain? I'm also going to assume it was stage 4 lung Ca beyond western treatment based on your reporting. Assuming that is all correct, do you consider your treatment a failure? Your patient said they felt better shortly before passing away after battling a hideous disease - that sounds like a success to me. The morphine was probably very helpful for comfort, and sometimes if the dose is quite high - to help passing on as well. After treating a few late stage cancer patients, you loose any thoughts that you are going to bring them back from the brink of destruction - all I can pray for is a swift comfortable death at home with their family around them. I am not an expert, but defer to the expertise of the oncologists working with the patient to get a good idea of what the treatment plan should be - fight or get ready to pass on. Julian Scott taught us that sometimes you just help give the patient enough Qi to pass away. You see a lot of people in the hospital that are too weak to die, which is a terrible way to go. Geoff , yehuda frischman < wrote: > > Dear friends, colleagues and teachers, > > I want to compare notes with those of you who have treated cancer patients. Last week, I treated a lung cancer patient (a non-smoker, BTW) , who had been given up on and sent home to die by her Western physician--except that he insisted that she receive a high dose of IV morphine to " help her cope with pain. " She and her family will very cooperative, and excitedly called me each evening to report on how much better they felt she was doing. The level of her pain was down significantly Friday, after my second treatment with her (I also brought her a decoction of herbs which her family faithfully gave to her), but nonetheless, her Western physician said that since her signs and Xrays were so discouraging, he felt it would be beneficial to increase the IV morphine. After that it was all downhill, and she passed away this morning. I strongly suspect that the Morphine may have just too strong for someone in her fragile state, and did her in. My question is, have any of > you had similar experiences with strong pain killers such as Methadone, Morphine or Vicodin? This is my 3rd " coincidence " when a patient who was showing significant improvement, passed away after receiving the analgesic Western intervention. > > Sincerely, > > Yehuda Need a vacation? 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Guest guest Posted August 20, 2007 Report Share Posted August 20, 2007 Alon, I am constantly learning and re-evaluating. I would point out, though, two considerations which have been articulated in our groups which are the basis of my conviction: 1. There is clearly an agenda in hospice medicine " to assist the pt & family for a peaceful passing " Pts are given heavy doses of narc, usually morphine, to induce coma, then death.It takes 24-48hrs to work " quoting nurse Amy, an insider in hospice care. 2. The literature clearly indicates that Methadone and Morphine do damage internal organs and hasten death. Yehuda Alon Marcus <alonmarcus wrote: Yehuda I would therefore be careful not to come to any conclusion as of yet. And by the way cancer pain is not considered to be sympathetically mediated, related to facilitated segments or dural related. It is by definition none of the above being a true nociceptive lesion - yehuda frischman Monday, August 20, 2007 11:17 AM Re: Re: cancer patients and strong analgesics Alon, As I have said on multiple occasions, I am a relatively new practitioner. This was my 5th hospice patient. Alon Marcus <alonmarcus wrote: Yehuda How many hospice patients have you treated cancer pain Quote Link to comment Share on other sites More sharing options...
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