*When terminal cancer patients can't eat, the doctor recommends gastroostomy, the result?
Woman (Patient daughter): Hello, Dr. Bi, my mother is 70 years old. Five years ago, she suffered from stage 3 of breast cancer. The first three years she took a very expensive medicine, the condition is stable, but this medicine is only At the end of last year, the doctor said no chemotherapy or electrotherapy, he would go quickly and start treatment. Two hospital admissions this year, because of the side effects of chemotherapy, mouth swallowing is difficult (the mouth is difficult to open) and resists the nasal and stomach tubes, so I have been relying on my family for Recently, sudden loss of food, rapid loss of weight, and feeling of dementia, the emergency doctor suggested gastroostomy (the doctor also said before that we don't put a nasal and gastric tube is starved to death by her love words). Actually I'm not a big fan of appetite, hope for your valuable advice, thank you!
B: Is mom aware? Ask her opinions and thoughts first. If you are already unconscious, then of course don't force it.
Woman: I don't know that consciousness is clear, because I can't speak for unknown reasons
B: Mom lives with you guys, with what you know about mom, would she want to have an appetite? Would she wish to live a little longer, or would it be so hard and don't want to be sick anymore? With your observation of the illness, is there a chance for mommy to improve, or is it just going in the bad direction? With an appetite, can you improve quality of life, improve the condition, or prolong the days of dragging. I don't see the patient, I don't know what's best for her. Please stand in her position, imagine for her, find out what is best for her.
Woman: Thank you Dr. Bi for taking the time to answer me, I also have no help but the doctors I met in reality seem to do their best, but my mother's situation is getting worse, I can't bear to my mother's suffering, Dr. Bi's words, I will
After all: Doctors are work-based, trying to save the end is the ethos of the entire medical community, please honestly communicate your thoughts with the doctor.
Two days later (family refused to have an appetite)
Woman: Thank you Dr. Bei, mom is already home to complete her life. Thanks for the shortness of pain, with reserved dignity.
After all: hard work, everything is full, blessed! Just a few days before the deathbed, doctors also recommended an appetite, a process worth sharing. Do you guys agree?
Woman: Agree to share. I wish more people could trust their intuition about their loved ones more at the fork. In March, my mother was hospitalized for sepsis for half a month, the doctor felt that nutrition was not enough, asked to insert the nose and stomach tube, directly accused the refusal, we were starving to death, and then my mother would soon send the emergency clinic again, so that his evaluation was affected (the discharge and re-hospitalization rate Later back home, my mother pulled off the nose and stomach tube, we all manually feed, so that about three months slowly, the less and less, the last week and a half the body naturally repels food and water.
Case study:
First, the patients with the terminal stage of aging and severe illness often do not eat much, and the nutritional status is indeed bad. Instead of providing more food, it will be better for the condition, may not be able to load the body (hydration, vomiting), may have dyspepsorption (abdominal cramps, eating still However, Easterners are particularly attached to food, and it is difficult to accept the sick to eat less and be slim. It is very inappropriate to describe this situation by starving to death, it is to deepen fear and cause family guilt, not good communication.
Second, cancer malignant disease is an expendable syndrome that causes weakness, fatigue and loss of skeletal muscle (also known as sarcasm) and fat. Unlike malnutrition, cancer malpractice cannot reverse this with nutritional support alone.
Third, the Health Insurance Bureau has many indicators to evaluate the quality of hospital care, such as average number of days in hospital, infection rate, discharge rate, mortality rate, etc. Hospitals also have a lot of requirements for doctors: bed share, examination rate, etc. So there are many things to consider outside the practice of doctors. For the family, our only consideration is how to choose what is best for the patient? So medical common sense and medical communication are very important.
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