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BANGKOK 20 April 2019 01:33
webfact

Saying it like it is or dashing a patient's hopes? Cancer patient told to prepare for death

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7 hours ago, ratcatcher said:

There is a lot of alcohol of substandard quality consumed, especially lao khao upcountry. 

The last two funerals I went to were due to liver cancer. Neither people drank but did eat Pla Ra as others have already posted, raw fish and liver flukes. Very common in the North east but thankfully awareness is growing and we should see this diminish in the near future.

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7 hours ago, blazes said:

 

 

Yes, well put.  The thing is, every single person in the world (and on this thread!) is a dying human being.  As Shakespeare put it: "we are born astride the grave".

The problem is that, especially in the West, we somehow expect to be immortal.  Only the other guy, down the street, has to die.  And if some doctor tells me I have X months to live, I  will "battle" this horrible enemy called Death (Cancer whatever).

This notion of "battling" Death is what makes us miserable (and allows the pharmaceutical companies (not to mention the Naturopaths and all such quacks)  to make millions from our fear of Death.

 

 

 

I might be a little out on the exact figure but I recall reading 75% of the Oz health budget is spent on people in the final three months of their life.

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7 hours ago, wombat said:

as required.

Sadly that might not be available in Thailand. Certainly not opiate based is my understanding, so forget morphine.

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26 minutes ago, emptypockets said:

After 20,000 posts you are a leader in the field.

Wrong mr troll. 

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5 hours ago, Christophers200 said:

How is bad news imparted "gently"? 

There was an excellent hospital documentary on Oz tv a few years ago. Some people recovered, some died but the show followed them through to the end, with their permission presumably.

One guy was dying from melanoma which had riddled his body. He knew the specialist well and after brain surgery the specialist simply said the prognosis was poor. The guy accepted that without emotion - he knew it too. Another doctor had to tell a patient she was dying - he use used the words, telling her what had now developed in her case - we can't cure that. Same response from the patient

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Just now, emptypockets said:

Mr Troll to you.

Nope.

 

You’re the cross thread stalking troll. 

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4 hours ago, Jaggg88 said:

It was always thought that they could never repair injured spinal cords but they are making great progress with regenerating nerves injuries so don't give up hope Colin.

Not sure about regenerating nerves but digitally bypassing the broken area is showing promise.

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9 hours ago, Shiver said:

Remember also that the doctors can tell their truth, whilst at the same time being wrong.

 

I was told by no less than 4 independent doctors that I was screwed (huge cirrhosis of the liver "entering end stage" was the phrase of one of them) and that a transplant was the only option, which would be difficult to find.  One even said "you have 12 months, 15 at the outside".

 

I chose not to accept their truth, and after a very shaken and disturbed few days (I had to sign a waiver to be allowed on the plane home to Udon as I was so unsteady and so yellow and weak, which would be fine if I could actually write at that time), I got my act together and started 'google researching' (yeah the kind doctors don't like you to do).

 

My last scan was 2 months ago, and the results were same as the year before and the year before - It's fine, fully functional and no signs of any issues.

 

"Must have been a misdiagnosis" - yeah all 4 of them, each with their own ultrasound and bloodwork.


What I'm getting at is, if a doctor tells you you're gonna die in x weeks/months, and you believe them, then they're probably right.

If you choose to believe in yourself, then they might still turn out to be right, but cross that off your list of choices and don't give it any thought or energy - starve that thought, and get your mind to work towards your intentions.  You've got to dig deep and really believe in yourself, that you can do, or at least learn to do whatever it takes.


In my case I found a mushroom powder that was in Materia Medica but had little exposure to the alophatic world. Cost me all of $85 and faithful administration each morning in a small glass of water for the first 90 days, and after turning that corner it was a cake walk.  For people with different issues then of course the assist would likely be different.  Heck, if you're going to ground soon anyhow, why not have a good 'ole fight and die laughing?

 

My father was given 2 years to live when he was 50. He turned 83 a few weeks ago. Stubborn old bugger says he still has a few more left in him yet.

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Thais don’t like to be up front and will lie if given the chance for several reasons, including to save your face and not their own.

 

But from a doctor... give it to me straight.

 

Thats also what 2nd and 3rd opinions are for. Just in case.

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15 hours ago, sweatalot said:

I have been working with a lot of dying humans - they all knew.

It is not simply telling the truth or lying - there is a third way: withholding the truth until it is requested, and there is a difference between offering a fatal truth - or force it on someone

Patients sometimes are not ready to hear the truth. And you don't know. Then it could be a good idea to start slowly, giving them a piece of truth that would make them ask for more or just the full truth. If they don't ask I'd leave it this way. May be next time they will be ready. I don't think it is a good idea to force the truth on someone who does not want to know. But always be ready to tell the truth when it is wanted. If you want to find out you could start with a question "what do you think how your ailment will go on?" 

I understand what you are saying, but I am not sure I agree:  as you say "they all knew" -that they were dying. So why not start the conversation right away: "You are dying, how do you want to spend you're last days".  Some, i am sure, would not appreciate this approach immediately, but it would help them realize and live with reality of their situation.  Why wait.  Why support a lie?

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16 hours ago, robblok said:

I think the doctor is right by telling the truth. Lying should not be done by doctors.

I agree. But there are more ways to skinning a cat. Showing some compassion would help. Let's hope the patient lives as long as a relation did after being told she would die soon. She stopped taking the prescribed medicine and went on herbal treatment. She lived for more than five years with a decent quality of life.

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Usually Thais can't face uncomfortable truth, and would rather lie, so I'm going to congratulate the hospital worker for her honesty. Good job being an adult and confronting reality. 👏👏

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