Better to prepare for the worst or to have hope?

I read an interesting article, When Doctors Steal Hope. It appeared in the New York Times on October 22, 2007. I thought it was a good read. I can see both sides of the issue from both the professional side and the personal side.

Is it better to be prepared for the worst and be happy that it didn’t come to be? Or is it better to know the best and worst, and be hit with the emotions that come with having an outcome that you hadn’t hoped for?

Ideally, the healthcare professionals would have time to sit down and explain everything, including helping you prepare for the worst outcome. This doesn’t always happen though, so how do we address this issue?

I’m wondering if this is also part of the problem with preparing people for palliative care. While in some illnesses, we know that there is no other outcome other than death, like ALS (Lou Gehrig’s disease), the diseases like cancer can have other outcomes. So, the issue of palliative care is not usually brought up until it becomes obvious that death is imminent – and even then this may not happen because then, death is considered to be a failure.

News for Today:

Bayer halts trial of drug for cardiac patients
Russia told it is losing AIDS battle
Infliximab scheduled treatment has proven to be an effective strategy in IBD patients
Women still face cancer risk 25 years after treatment [for precancerous cervical lesions]

What drives the news?

I’m stuck today. I have absolutely no idea what to write about. There wasn’t much interesting news to pick; I just wrote about pot yesterday, I’ve already written about sleep problems and sleeping pills, and I've also written about my opinion on the flu shot.

If there’s one thing I’ve noticed it’s that much of the news, many of the studies are about the same things. We keep reading about the same illnesses, the same disorders, and the same problems. But there are so many other issues that need to be addressed. I wrote about the big problem of suicide, for example. Thousands of people are dying from the results of mental illness, but you don’t read much about that. What drives the decisions about what to research? What pushes the researchers to devote their time and effort into each specific problem?

(PS, am I the only one irritated by the headline: US FDA OKs nasal spray flu shot for very young? Is it an injection or an inhalant? Obviously, they're not *injecting* the vaccine!!)

News for Today - Slim pickings!

Smoking pot can have antidepressant effect at low doses: study
U.S. FDA OKs nasal spray flu shot for very young
Daylight savings time disrupts humans' natural circadian rhythm
Procedure helps to eliminate sleep apnea

Marijuana for medicinal use

I’ve long not understood why there is even an argument against the legal use of marijuana for medicinal purposes. I’m not going to debate about recreational use, but I just don’t understand the adamant refusal of our governments in the Western world to acknowledge that marijuana has its place in treating the symptoms of several illnesses.

One argument is that it’s not safe to stock marijuana. Hello? We stock morphine, we stock opium and belladonna, we stock methadone – and we’re afraid of stocking marijuana?

If someone is dying of a terminal illness and we have a substance that can help them with nausea and general discomfort, don’t we have an obligation to provide it? It’s not like we can’t access the stuff. It’s not like it costs a fortune.

I don’t understand it. The governments would rather fight a war on drugs – all drugs – than to allow dying people live more comfortably in their final days. Oh sure, in Canada, there is “access” to medicinal marijuana. If you’re well enough to jump through all the flaming hoops, that is.

Just as a doctor can prescribe a strong opioid like Fentanyl®, he or she should be allowed to prescribe marijuana if there is a legitimate medical reason for it. In my opinion, there are no ifs, ands, or buts about it. Unless you mean “butts.” :-)

Today's News:

Cancer care providers need to proactively address patients' psychological and social needs
Baby bags may boost preemie survival
More women with breast cancer opting for double mastectomies: study
Pot's antidepressant effects reverse at high doses
Religion and Health Care Should Mix, MU Study Says

Yet more studies on lack of sleep

There have been several studies announced lately about sleep and health. The most recent, Lack of sleep hinders coping skills, logical reasoning: study, again, really tells us what we already know, doesn’t it?

The first paragraph kind of say is it all, in my opinion:
“Scientists have confirmed what every newborn-cradling, sleep-deprived parent knows: that lack of sleep is connected to an inability to cope with normal emotional challenges.” So, did we really need scientists to confirm this? We don’t even need newborns to keep us from sleeping – a bad night with loud neighbours, a snoring spouse, or just not getting comfortable is enough to let us know what it’s like not to get a good night’s sleep.

The second paragraph: “They also theorize that sleep deprivation is linked to psychiatric ailments such as anxiety, depression and bipolar disorder.” also seems pretty obvious to me. If you can’t sleep, you are going to be disturbed somehow. The longer the sleep deprivation, the worse it will get. Why else is sleep deprivation considered to be a form of torture?

Anyway, the article goes on to explain the findings. But, once again, I feel that this is just money thrown at something we already know. Look at the sleep deprived doctors in the hospitals, pulling overnight call after working all day. Look at the nurses who are working night shift after night shift. Heck, look at teens who try to party all night and then get through the day.

It’s obvious, we need sleep. The body craves it and needs it, or it’s not going to function properly.

Now, is it nap time yet?

News for Today:

Exercise and psychological counseling could ease cancer-related fatigue
Lack of sleep hinders coping skills, logical reasoning: study
High spending on lung cancer in elderly buys little time: study
Adult weight gain linked to breast cancer risk
Improvement still needed in HIV testing in high-risk groups
HIV is spread most by people with medium levels of HIV in blood, says study
More educated people who develop dementia lose their memory faster
Hypnosis for smoking cessation sees strong results

New concern about diabetes: rising rates of gestational diabetes

We’ve all heard about the rising rates of type 2 diabetes, what used to be called adult-onset diabetes. We’ve also heard about how teens and children are developing this disease that used to only affect adults. But now we’re hearing more about gestational diabetes, diabetes that occurs during pregnancy (Instances of diabetes during pregnancy on the rise).

Luckily, in most cases, gestational diabetes goes away after the baby is delivered, but there are risks to both the baby and the mother during the pregnancy and, it’s believed, after.

The American Diabetes Association reports that 4% of pregnant women in the US develop gestational diabetes. Four percent may not sound like a lot, but that is about 135,000 women.

The most common result of gestational diabetes is a large baby. While this may not seem to be an issue at first glance, the larger the baby, the more difficult it is to deliver naturally and the baby is at higher risk of birth injuries. As well, researchers are finding that there may be long-term effects, such as obesity and type 2 diabetes in adulthood.

Most pregnant women undergo blood glucose (sugar) testing during the 24th to 28th week of pregnancy to catch diabetes before it is out of control. (Info from MedLinePlus.) However, it is good to know the symptoms. They are the symptoms of type 1, type 2, or gestational diabetes:

- Feeling very thirsty all the time or much more frequently than ever before
- Urinating frequently
- Feeling very fatigued despite resting
- Nausea and vomiting
- Losing weight despite eating normally
- Infections
- Blurry vision

Unless there is a reason to start aggressively right away, most women with gestational diabetes begin treatment through lifestyle changes. This means changing the diet, preferably under a dietician’s supervision. The mother’s will still include foods that provide nutrients to her and the baby, but restrict the amount of sugar that her body needs to process. Lifestyle changes also include exercising as much as possible. However, it is important that the exercise program be checked and approved by the doctor first.

Women with gestational diabetes are usually taught how to monitor their blood sugar and have to be tested regularly and monitored closely. If the lifestyle changes don’t work, then insulin will be needed. Once the baby is born, however, the body usually goes back to its pre-pregnancy state and usually the diabetes disappears. Although this is usually the case, it is important that women always tell their physicians, no matter at what age, that they had gestational diabetes as they could be at an increased risk of developing type 2 diabetes later on.

Today's News:

Increased sun exposure halves risk of advanced breast cancer: study
Instances of diabetes during pregnancy on the rise
Scientists find predisposition to bronchiolitis in some babies
Watching Funny Shows Helps Children Tolerate Pain For Longer Periods
Penn researchers find emotional well-being has no influence on cancer survival
New heart surgery helps frail patients
Millions Of People With Wet AMD Face Blindness, Social Isolation And Psychological Ill Health