Yesterday I arrived to the Operating Room by 6:30 a.m. I had been told the night before that I had a seven o’clock start. I was on time. But my room was a ghost town, although the patient was ready and I had my preoperative assessment complete and my equipment ready, nothing was set up.
I started to wonder. It turns out the case was scheduled for eight, and the surgeon was late until eight thirty.
There are no accidents. I used the free time to read up on the basics of care to relieve the suffering of the dying—those who have terminal disease. It could be cancer, it could be chronic obstructive pulmonary disease, it could be heart failure, it could be something like Lou Gehrig’s disease (ALS)...something for which there is no cure.
I am exquisitely sensitive to pain in those around me. And of all the pain, the emotional pain and psychological distress is the worst.
You can imagine my surprise when there is a specialty, with terms and words to describe, everything I ‘pick up’ through my empathy and intuition clinically in my work.
We are all going to die (or perhaps a few will do like Ascension of body—that’s another story) in this paradigm. Death isn’t real. We are Spiritual Beings who live forever and our environmentally friendly bodies are like ‘rental cars’ we borrow for our learning and growth.
When the bodies reach their ‘best by’ date, it isn’t fun. This is what I learned. The cancer can invade and damage tissues which is painful. The metastasis to the brain causes terrible headaches. Bone metastasis is exquisitely painful. The dry mouth from the chemo, the side effects of the radiation, and even obstruction of the bowel by tumor...this is what my cancer patients have been enduring every single day.
They smile.
I always have looked to the spirit inside the body, and connected with that when I am at the bedside. But now I understand the whole picture.
At the end of life, there can be something called — it starts with an m and it looks like depression but differs from depression in that the patient is capable of enjoying the moment. I forgot the term and will look it up later. But both this and depression are frequently present. Some people cope by talking about their situation, others by denying the situation/avoidance.
An originator of the field described ‘total pain’ —mental, physical, psychological, emotional, financial, and with the family. So the palliative care specialist helps make it easier for the patient and the family, and gently guides them through their worst challenges, by relieving pain, offering support, helping everyone to set realistic expectations, to discuss Spirit (how would you like to be remembered?)..It’s good. If you are suffering, or a loved one, there are specialists who know and understand and can make things better for you, called Palliative Care specialists.
I found a pain option for my friend, fentanyl 12.5 mcg/hour patches every three days. It’s less constipating than other long-acting pain options, and besides my friend will benefit by not having to swallow it. Fentanyl needs to be absorbed into fat, so the patch must go on a ‘meaty’ spot for it to go to the bloodstream and not be eaten up first by the liver. We will adjust the dose in three to six days.
It took many hours of reading, more than the free morning time, to understand this and make a recommendation. It is safe and my other friend agrees it is a good approach.
Today I have a class. I worked all day and night, got some sleep fortunately, and now I need to take the class to renew the little card that says I can help someone if their heart stops in a hospital. Without it, I can’t show up to work. It has to be current. Administration sent me a reminder it expires at the end of the month. It’s my ACLS, BLS card. My PALS card recertification is later this month. Everything two years I must do it. It is a business expense of four hundred dollars, or two hundred a year, just to be able to work. The medical profession has many of these hurdles, for example the license, the malpractice insurance. Some employers cover these but not all of them do. So be kind to your caregivers. There is a whole layer of people who extract from them financially and get away with it that you’ll never know unless someone like me tells you.
If you are wondering the symbol on my neck, it’s ORKA, it’s from Iceland and their alphabet. It stands for Energy. I like it because it helps me feel close to the orca whales. Normally this time of year I am visiting them in British Columbia on the Salish Sea. A day spent whale watching for them is like Heaven. They used to have open air speedboats we would take. Now they are getting more like our California style bigger boats... change is good I suppose but I enjoy the old style ones. If you ever go I recommend making sure your boat has a toilet of some sort in it. Otherwise it makes for a long and uncomfortable trip. P.S. if you love whales, never eat farmed salmon. Orcas especially in the resident ones in the Pacific Northwest eat salmon only. And the wild salmon is being decimated by the illnesses in the waters spread by the farming salmon who are caged and stressed. The Canadian researcher who discovered the DNA proof was threatened and moved to another job. So—read the labels, always ask, and know that ‘farmed’ is a euphemism that makes what actually takes place sound a whole lot better for the fish and for the environment than it actually is.
Ross wants me to get ready for class!
Clap! Clap!
Aloha and Mahalos,
Namaste,
Peace,
Ross and Carla
The Twins
