Showing posts with label DNR. Show all posts
Showing posts with label DNR. Show all posts

Wednesday, August 28, 2013

Reiki And The Hepatorenal Patient


The patient was jaundiced. 'Jaune' is the French word for 'yellow'.

When liver disease gets advanced, not only the liver but the kidneys fail too. This combination is lethal, but it takes some time for the end to happen.

Recently a patient was DNR, but 'wanted everything done' for palliation. The GI doc and I had a heart to heart for a good long time before--because 'this could be IT'--death due to sudden massive blood loss that was unable to be stopped.

We decided together on conservative management for the anesthesia, which involved intubating the patient, who didn't want mechanical ventilation.

Everyone had to be on board to proceed.

This is what happened:

  • a conference call with family, durable power of attorney, patient, GI and anesthesia in presence of the RN.
  • The DNR was rewritten to allow for the procedure and possible cardiac arrest--yes to electricity, chemicals, chest compressions and intubation until stable after the procedure.
  • This took three phone calls to high-ranking nurses and much documentation
  • A chaplain came before the procedure
  • I went to the washroom and sent Reiki ahead 'for the highest good'.
It took a while to get my equipment ready. Due to risk of infecting myself with a blood-transmitted disease the patient had, I put on a full gown, gloves, and mask with eye protection. As I walked over to the head of the bed, the patient said, 'I figured it out! You know who you look like, doc? The lady from Heat, you know, the movie with Al Pacino...'

It was surreal. I was all gowned up and expecting Rene Russo in one of those Ebola Virus movies! Instead it was 'you look like some famous actress' (I get 'you look like somebody' often.) I gave some off-handed  comment about looking Italian (I am half Sicilian), and positioned myself at the head of the bed. I instructed Respiratory to start preoxygenating the patient. I took a big deep breath myself, asked everyone if they were ready, and committed to starting anesthesia for the case.

When I gave the drugs to start deep sleep of anesthesia, I made sure the patient was comfortable and ready. I had selected my safest drugs in advance to keep the hemodynamics stable while on pressors. Tube went in, it got secured, and the vent started to go.

Surgeon came in and looked. A big nothing! No blood. No terrible findings. 

It took about forty-five minutes to get everyone together enough to 'take the risk'. And about seven once we did.

Reiki is of immense help to the healer such as myself. It is 'zen' that calms the room and the patient. It allows for 'the situation to play itself out' with complete and total acceptance on all parties involved.

We didn't want for that patient to pass today during the procedure, although it could have happened.

We are most fortunate that it did not.

I will never forget the sister crying on the phone when we agreed 'it was a go'.

The first thing I asked the nurse to do after it was over was to 'call the sister and tell her the patient is still alive'.

The nurses in the unit thought that was funny.

I didn't think it was funny at all.

Aloha and Mahalo,
Namaste,

Reiki Doc

Friday, March 15, 2013

Au Secours!

Moose is the Totem for Strength

I got out of work today before two. That used to be the time all of us in anesthesia went home--start early in the morning and finish by two. Then you could go to the beach! Well, today I left, but everyone else is still stuck there till way past dinner.

Spirit guided me to the local health food market to buy some fresh fruit. Once I got there, a wave of sleepiness overwhelmed me. I did my thing I love to do: I went in the back seat, covered myself with a blanket, used the pillow, and took a nap in the car. The sun was very bright, and streamed in through all of the windows and both sunroofs. I had wanted a Cayenne but when I went car shopping I was appalled how inside it was so dark! My car, a Mercedes E350 station wagon lets in so much light it is almost like being outside, and I adore this.

While I slept, strange sensations tingled all over my body. I was getting an energy upgrade. That is how it works, with spirit and the Ascension process. Download, upgrade, physical changes...rest to assimilate, then repeat. Exposure to sunlight is important in this; more information can 'get in'.

When I got up, I went to the local drug store. I smiled because ever since I was a child I loved drug stores. In my nana's neighborhood there was the pharmacist Bill, who would always make a big fuss over me. When I am emotionally 'down', that is where I go, any local drug store. I just wander around looking at things until I feel better. That is how I self-soothe, or used to.

This time was different. Much different. I could see--my consciousness did not 'buy' the 'status quo' this time. I saw it with new eyes. This is what I 'saw':
  • The scary Jesus in the bathroom. No, I was not hallucinating. Someone had tacked up a picture to scare the heck out of me and buy my belief with random quotes from the Bible at the bottom. It was a photocopy, and the eyes were really strange. I 'smelled fear-mongering' and 'control'. The REAL Jesus is handsomer than a movie star. And radiates such warmth and light. There is no doubt for one second who he is--and that He knows everything there is about you and loves you no matter what. But the image of scary Jesus set the tone for the rest of the store.
  • I followed the money. This is by a major retirement facility. Imagine that the store layout was a pie chart, with the amount of retail space dedicated to what sells best. The biggest slice would be Pharmacy--prominently located in the back of the store, with aisles and aisles of over the counter paraphernalia. Next came Alcohol, with one full aisle for liquor, both sides, top to bottom, in BIG bottles. The next aisle over was for Wine. After that was Makeup/Beauty/Personal Care, Incontinence supplies, and Family Planning--all of them were right next to each other and I laughed at the human condition of it all. In the middle was a 'slice' of Stuff For the Grandkids--cards, Easter candy. I smiled at the 'Cadillac of Shopping Carts' by the door for only $19.99. This my friends, is a well-planned out means to extract money from the population and at the same time keep the general Vibration DOWN.
  • The old chinese lady in front of me, with the nasty long toenails, Tory Burch bag, and Dior sunglasses, sent not one but TWO money grams. With cash. The first was for $550 (cost $573 to sent) and the second was $150 (cost $167 to send). The clerk knew her. She had done this every week. She smiled an apologized for the wait as she started her second one. I just watched, taking it all in. It was fascinating.
  • I bought sunscreen sticks for the kids. They hate to wear sunscreen. I have tried the sprays and I have tried the lotions with no success. When they were little I would not have been surprised if someone called the authorities on me the way they howled when I put that stuff on. I have seen the reports--I forget the name--but apparently these sticks are 'bad'. But my thirty dollar Lavera I bought at Target last year was crappy. It streaked and was greasy and made me white in the face. I know a good product when I see one. Our friends in the Natural Products business need to step it up. My dish soap was awful, my dishwashing detergent packets formed a lump of blue goo at the bottom of the dishwasher instead of working properly, and I noticed the surfactants in my 'Lorax-promoted' Seventh Generation High Efficiency detergent are exactly the same as the ones I used in product development fresh out of college. Not plant based. They were petrochemicals. Read the labels, and don't get fooled into using sub-optimal products just because you think they are helping the environment. Shop around all of the labels until you find one that is Green AND works for you.
  • The overhead music was filled with advertisements. It was horrible. Every other song was an ad.
Au Secours! was given to me by Spirit as I walked through the parking lot to the drug store. Here is what it means: http://en.wiktionary.org/wiki/au_secours


Next I went to buy the fruit at my local market. Here are some thoughts about that:

  • You have to hunt between Organic and not organic. They are labeled on the produce, but the word for Not Organic is like, a euphemism. I think today it was 'conventional'.
  • Today I asked myself when I looked at the products that were available, 'Is this from Nature?' A lot of products were not. Although I adore the taste of Teriyaki soy steak that is sold like jerky and cost six dollars a bag, it seems highly processed. I am on the fence about 'fake meats' now.
  • The Vitamin and supplement aisle is the money maker for the store. (Just like at the drug store, oui, n'est-ce pas?) The stock is endless supply. I recognized the pills I had been given for my headache. I think they were mushroom. Anyhow, although the sales people are highly knowledgeable, if you have any medical history whatsoever, in particular, liver or kidney disease, you might want to check with somebody in a medical field (naturopath, DO, chinese medicine, or someone like me) first before you add some of these supplements to the mix.  There is chance of interaction with drugs you are on, and also, that your clearance of the drug might not be normal due to your condition. Be safe. Be smart. Be wise. You only have one body, mother used to say; might as well take good care of it.
  • On second thought, ask somebody AND use your intuition/Reiki guidance. That is the safest way to be, all around.
  • There are two ways to grow old. The pharmacy way. And the health-food store way. But either way, you are not getting any younger. The difference is in your VIBRATION. Higher Vibration = Health, maybe not in body exactly, but you are more than a body, so keep that Vibration UP.
Here is the reason why I was sent. There are no chance meetings!

man in parking lot:  you look familiar. Do I know you from somewhere?
me: um. no.
man: Are you sure?
me: I work in a hospital. Maybe you know me from there. I hope not though, for your sake.
man: what is your name?
me: (I tell him)
man:  My name is Dan. (he is very large and very Jewish). Where do you work?
me: (I tell him)
Dan:  (tells me a horror story about his mother. He calls one particular chain of hospitals 'nazi euthanasia plants'. He goes on and on about how the hospital realized his ninety-two year old mother wasn't rich or profitable, and had a meeting where there was no opportunity to oppose the 'plan of care' for 'comfort'. The administrators knew that his brother was weaker psychologically, divided and conquered. His mother was kidnapped--his words--to a new nursing home because of the 'inability to pay'. He said that 'inability to pay' was a civil matter, not a criminal one, and the police should not have been involved. He said his mother said the caregivers kept asking her about her money. When they figured out that there was no money 'on record', they changed the course towards euthanasia--as he says, a medically-assisted death. Tell everyone FAR and WIDE today what I told you!.

And so I am.

Did you know that some oncologists are upset when a patient is admitted through the ER with such advanced cancer that they die before the oncologists have a chance to pump some expensive chemotherapy drugs into them? Even when the prognosis is poor and they know the patient is soon going to die?

Did you know that utilization of Hospice in Medicare patients has gone up three hundred percent in the last few years? It is a BIG money maker for the long-term care facilities.

Did you know the friendly nurse at nana's place, a personal friend of my sister, abruptly changed her interactions with me around the time nana started to take a 'turn for the worse' and 'go in decline'? This was right before the 'Hospice' 'extra layer of care' was suggested by the doctor. She couldn't look at me. She knew how to 'follow the money' and 'what was up'. My sister and I, at the family meeting, politely declined Hospice on the basis that nana was already a soft DNR, and she liked her caregivers. 

Did you know that I believe Dan with his conspiracy theory about collusion on the part of the health care business, the police, and the politicians?

'Being old is a full-time job' mother said to me, with a sigh.

She is right. The system, like Dan says, treats you like a race horse. When it can no longer win, it is sent out to stud and make some new money making babies. When it has lost the desire to reproduce, it is off to the glue factory.  It is like chickens that no longer lay eggs and are turned into broth. Without the aged, hospitals would not exist. And when there is no more money to be had off a patient, here comes the morphine in the name of 'comfort', according do Dan.

As a physician, I have seen the 'morphine drip' in action. Basically, the attending physician deems a medical problem as 'going to make you die'. And when the problem gets worse, with the patient's consent, the morphine drip is begun. You dial it up higher over time, until the patient stops breathing, gets cardiac arrest, and passes. One day I was a medical student, bright and happy in my new work, and I remarked to a patient, 'a beautiful day, isn't it?'. He gruffly said, 'I don't agree' and explained today he was going to die. His COPD was end-stage, there was no lung transplant in the works, and they were turning on the morphine drip with the consent of his Durable power of attorney. He was angry, bitter, and afraid. I didn't know what to say to him, except a quiet, 'I am so sorry'. 

Follow the money.

You'll be glad you did.

Namaste,

Reiki Doc

Tuesday, January 22, 2013

My Twenty Hour Day



It is one fifteen in the morning. I have been awake since five a.m. The alarm went off at four a.m., but  I kept hitting the snooze. (I went back to the bedside, finished until the patient went safely to the floor from PACU, and briefly slept until I wrote the rest...)

I didn't eat an actual breakfast. I had my favorite, vanilla Spirutein, in milk and a cup of coffee in a travel mug as I went out the door.

It was a hurry. Because of the holiday for MLK, there was no school. I took the kids in pajamas to the sitter who lives ten minutes away, in the opposite direction from work.

From seven o'clock in the morning, until three in the morning (all the way through midnight), I saved lives. I did anesthesia on people, almost ten of them; except for one, the surgery was to  save their life. In these situations, anesthesia is a technical challenge. It takes great concentration and vigilance to get a high-risk patient through.

My food for the day was:
six graham crackers in little packets
coffee
one cup of peach kefir
a pear
one small black bean burrito from home
six saltine crackers
one bottle of water
honeydew melon and four orange slices
a small green salad from the salad bar
a small carton of overcooked wheat pasta with flavorless sun dried tomato and baby spinach


All of it was eaten in a hurry--there were no scheduled 'breaks'.

All of this was worth it.

I did not see my kids.
I slept in my own bed (for only three hours--now I get to go back to work after taking the kids to school)

There were two hours of critical care I did in the recovery room, without compensation (recovery room is kind of like an ICU)--it is included in the anesthesia fee from the O.R.

Why was it worth it?

I got to learn a new disease. One that for privacy I can't share here and now, but perhaps later. This disease stopped me in my tracks. It was a surgical disease. The patient was DNR already, and had lived a good life. But the findings! And how easily it was curable! I had come close to canceling the case, the risk was so much.

I am so glad I didn't.

And I hope through my sacrifice of time, energy, and healing, I earned/repaid some Karmanic debt to those who are taking such good care of my mom.

There is nothing I like more than getting into someone's aura and doing some great energetic work. Today, in the day, I did exactly this.

But at night, it was 'living the dream', a phrase we say, when the going gets tough in medicine and you are at the end of a long day. Less Reiki, more Doc. I didn't even have time to Reiki my back when I pulled it moving a patient. I took some ibuprofen instead.

This is how you earn the title of 'healer' in our society. It is not that different from Kahuna in Kanaka Medicine in Native Hawaii--those who stay up all night, healing, using their knowledge of procedures and plants in their work. After many long years of training to be able to become a healer.

Unfortunately our 'healing' is tied to a petrochemical-pharmaceutical economic industry.

But the heart of a healer is always the same: to relieve suffering--to restore Balance and Health.

My 'five pillar table' is greatly imbalanced. Sleep, nutrition, movement, emotions and environment are out of whack. I slept in my clothes after I changed back into them, drove home, and went right to bed.

It will take some time to recover my own balance.

By contrast, Reiki healing work does not deplete.

I look forward to the future of medicine. And I am holding my own in the Medicine we have of today.
Until we can connect it to the healing of Tomorrow. Blessings, Love and Light.

Namaste,

Reiki Doc