Category: Pain Management

Receiving Hospice AND Curative Treatment

May 16th, 2010 · Dr. Brian Byrd · Death, Pain Management Comments Off

The new health bill sets up 15 studies to look at offering curative treatment to hospice patients.  That sounds counter-intuitive, but there is a reason for the provision.

Most of the time, there are no curative options for hospice patients.  Good examples are emphysema patients that have exhausted all possible lung treatments.  These folks need relief from air hunger, spiritual and social support, and a hospice nurse on call 24/7.

However, many people would like the option of receiving hospice to relieve pain, while pursuing a aggressive treatment for their disease.   Medicare feels this option may save money because these patients, who have a hospice nurse available to them, will not end up in emergency rooms as often.

This scenario is most-often played out in people suffering from cancer.  Consider someone who has lung cancer which has spread to the bone.  The bone involvement causes severe pain, and a good hospice team can help like no other service.  And, the patient may live longer if they receive aggressive chemotherapy.

It sounds good up front, but there are two problems I can see.  It introduces another opportunity to abuse the system: hospices may try to put on chemotherapy patients whose pain level really doesn’t require hospice.

The other “problem” is that allowing  both treatments may make it more difficult for patients and families to come to terms with the life-limiting nature of their illness.  They are on hospice but still fighting for longer life.

I have to say that I would want the dual-treatment option.  Or at least I would want the ability to choose it.  Having an extra week or two on this earth can be the most precious of times.

I have written here about people who are near death hanging on longer than anyone expects.  In one of those cases, their loved ones’ prayers were holding them here, so to speak.  We all know people who can pray, I mean really pray.  I would want those folks to hang around as long as possible and petition our Lord to reign down grace from heaven.

That brings me to a disputable assertion about prayer in the afterlife.  Can believers who have died intercede for people who are still alive?   No one know for sure, of course.  Catholic brothers and sisters ask Mary, the mother of Jesus, to pray for them.

“Since we are surrounded by so great a cloud of witnesses . . .”  This line follows the eleventh chapter of Hebrews, in which the writer describes heroes of the faith who have died.  They are observing us, it seems to say.  It would follow that they could intercede for us.

Doesn’t talking about this after-life activity soften the finality and sadness of death?  It does for me.  Something needs to.  Grieving the death of a loved one is often the most difficult experience in life.  When I die, if I am able to observe and pray for my earth-bound loved ones,  I hope I pray well.  I should practice more now.

Comments Off  |  Add Comment

Happiness Level Four

April 18th, 2010 · Dr. Brian Byrd · Death, Pain Management, Spirituality 2 comments

The Kansas City Star reported on a special graduation ceremony held for a terminally-ill high-school student:

Connor Olson graduated from Tonganoxie High School on Thursday. He was the only graduate.

He brought his parents, his grandma — and his hospice nurse.

Connor has spent an exhaustive year fighting bone cancer, with one round of chemo, radiation and surgery after another. Forty weeks in the hospital over the last year.

His condition worsened in recent weeks. Then, over the weekend, the 18-year-old, newly minted Eagle Scout suffered a stroke that paralyzed his left side and left him largely unable to speak.

On Wednesday, the principal and faculty of the school arranged a spur-of-the-moment graduation ceremony for Connor because he never took his eyes off the prize.

His diploma.

I was moved by several aspects of this story:

  1. The young man’s hospice nurse, who joined him on stage and administered the morphine.  He couldn’t have experienced the ceremony without his nurse present throughout.
  2. The students’ support, shown in their presence, cheers and hugs.
  3. His last word before leaving, which was “home.”

There is not much solace when a young person succumbs to a painful and debilitating disease like bone cancer. I suspect we will have to wait until we are face-to-face with our Lord before we will understand completely.

Jesus offered some words that provide healing: “I go to prepare a place for you,” and, “Today you will be with me in paradise.”  These words direct us heavenward, where our thoughts don’t normally go.

We live and think in our world, our skin.  Our hopes tend to be earthly, such as children and spouse relationship health, financial shape, and meaning within our vocation.  Heavenly concerns don’t gain traction in our day-to-day, minute-to-minute race.

“Show me, O Lord, my life’s end and the number of my days; let me know how fleeting is my life.”  That is the Psalmist talking there.  It sounds like good wisdom, and freshness within a temporary life.  I think my friends who are at the end of their lives agree.

It is a good thing to say it loud, to say, “Lord, teach me to number my days.”  To practice it is to understand that our speech has power to make one wise.

Robert Spitzer, at Gonzaga, organized happiness into four levels.  Level one is basic happiness, such as eating when we are hungry.  Level two is better, because it something only humans can do, such as setting and attaining goals.  Level three is special because it is attainable only to those who sacrifice for another.  But level four is the only happiness level that doesn’t have a corresponding “unhappiness.”  Level four is knowing God.  Really knowing the Creator.

I recommend Brother Lawrence’s “Practicing His Presence,” for those wishing to know God in a way where there is open and honest communication with Him.  It is a fast read that pushes the reader into putting down the book and beginning a life of dialogue with the One who is preparing a place for them.

Comments (2)  |  Add Comment