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Posts Tagged ‘Healthcare’

7 TIPS for FRESH BREATH & HEALTHY DIGESTION

Now that the major holidays of Thanksgiving, Christmas and New Years Eve are over, here’s some WELLNESS Tips that are EASY TO FOLLOW!

7 Ways to Keep Your Breath Fresh

In addition to brushing your teeth and your tongue, flossing and visiting your dentist regularly, here are a few more ways to prevent bad breath.

 

  1. Water — Keeping yourself properly hydrated produces saliva, which keeps your mouth moist and neutralizes bad breath.
  2. Cinnamon gum — Cinnanimic aldehyde oil freshens breath and reduces the amount of  bacteria in your saliva by 50 percent.
  3. Celery,carrots and apples — Fiber rich foods produce saliva to wash away plaque.
  4. Oranges, berries and melons — Vitamin C helps to prevent gum disease and gingivitis which are both major causes of bad breath.
  5. Lemons — Whether you suck on a lemon wedge, drink water with lemon, or nibble on the rind, lemon can help freshen your breath.
  6. Black tea — Polyphenols, powerful antioxidants found in black tea, help stop plaque from clinging to your teeth.
  7. Yogurt — The active cultures found in yogurt help to  reduce the  level of odor-causing hydrogen sulfide in  the mouth.

 

Healthy Digestion Tips

Here are a few tips for getting your digestive tract back in shape without medications:

 

  • Foods with magnesium, such as spinach, broccoli, squash, and basil, can help relieve constipation.
  • Exercise can help gas move through your stomach faster.
  • Flax, when  taken with water,  helps bulk  the stool and feeds the stomach’s “friendly” bacteria.
  • Yogurt with live and active cultures can help regulate your digestive system.
  • Artificial sweeteners Beware that sugar-free foods with artificial sweeteners can have a laxative effect in some people. To counteract diarrhea, try easy-to-digest foods such as the BRAT diet (bananas, rice, applesauce, toast)
  • Licorice can reduce stress-induced stomach inflammation and ulcer-causing bacteria.
  • Extra-virgin olive oil helps prevent and treat Helicobacter pylori (H. pylori).
  • Peppermint (either candy or coated capsules) can help ease pain, bloating, and gas.
  • Chamomile tea has anti-inflammatory effects that can soothe an irritated stomach lining.

 
Now that your breath feels refreshed and your tummy has stopped rumbling, here’s some quotes to help you start off the year with a bang…. from an old favorite of mine Ben Franklin.

 

  • Don’t strive to be irreplaceable. If you can’t be replaced, you can’t be promoted.
  • Self-praise is no praise.
  • Strangers are simply friends who haven’t met.
  • After each storm there is the promise of a rainbow.
  • Individually, we  are one drop. Together we are an ocean.
  • Obstacles are those things you see when you take your eyes off the goal.

 
To the more than 1100 friends who have responded to my blogs this year, I wish you a Happy, healthy, peaceful and successful 2014.

 

A big thank you to my favorite printer The Ink Well for allowing me to reproduce most of these truisms from their monthly newsletter Press Check. If you have printing or mailing needs,there’s no one better.

THE RIGHT WAY TO END YOUR LIFE?

Drawing A Clear Map For End-Of-Life Choices!

Robert H. Laws, a retired judge in San Francisco, and his wife Beatrice, knew it was important to have health care directives in place to help their doctors and their two sons make wise medical decisions should they ever be unable to speak for themselves. With forms from their lawyer, they completed living wills and assigned each other as health care agents.

They dutifully checked off various boxes about not wanting artificial ventilation, feeding tubes and the like. But what they did not know was how limiting and confusing those directions could be. For example, Judge Laws said in an interview, he’d want to be put on a ventilator temporarily if he had pneumonia and the procedure would keep him alive until antibiotics kicked in and he could breathe will enough on his own.

What he would not want is to be on a ventilator indefinitely, or to have his heart restarted if he had a terminal illness or would end up impaired. Nuances like these, unfortunately, escape the attention of a vast majority of people who have completed advance directives, and may also discourage others from creating directives in the first place.

Enter two doctors and a nurse who are acutely aware of the limitations of most of such directives. In 2008, they created a service to help poeple through the process, no matter what their end-of-life choices may be. The San Francisco based srvice, called Good Medicine Consult & Advocacy, is the brainchild of Dr. Jennifer Brokaw, 46 who was an emergency room physician for 14 years and saw firsthand that the needs and wishes of most patients were not being met by the doctors who cared for them in crisis situations.

The communications gap was huge,” she said in an interview. “The emergency room doctor has to advocate for patients. I felt I could do that and head things off at the pass by communicating both with patients and physicians.” Sara C. Stephens, a nurse and Dr. Lael Conway Duncan, an internist, joined her in the project. Ms Stephens flew to LaCrosse, Wis., to be trained in health care advocacy at Gunderson Lutheran Health System. Through its trainees, tens and thousands of nurses, social workers and chaplains have been taught how to help patients plan for future care decisions.

 

A Necessary Decison Process

People often need help in thinking about these issues and creating a good plan, but most doctors don’t have the time to provide  this service,” said Bernard Hammes, who runs the training program at Gunderson Lutheran. “Conversation is very important for an advance care plan to be successful. But it isn’t just a conversation; it’s at least three conversations.” Dr. Hammes,editor of a book, “Having Your Own Say: Getting the Right Care When It Means the Most,” said that while he is especially concerned that people 60 and older make their wishes known  to family members and develop a cohesive plan, the same steps should be taken by someone who develops a serious illness at any age.

People need to sit down and decide what kind of care makes sense to them and what doesn’t make sense, and who would be the best person to represent them if they became very ill and couldn’t make medical decisions for themselves,” Dr. Hammes said. “If for example, you had a sudden and permanent brain injury, how bad would that injury have to be for you to say that you would not want to be kept alive?” he continued. “What strongly held beliefs and values would influence your choice of medical treatment?’

Divisive family conflicts and unwanted medical interventions can be avoided when people specify their wishes, he said. His own mother “told us that if she had severe dementia, it would be a total waste of her life savings to keep her alive. She would rather that her children got the money. We help people work through the decision process and involve those close to them so that the family shares in their goals,” Dr Hammes said. “When patients have a care plan, the moral dilemmas doctors face can be prevented.”

At Good Medicine in San Francisco, Dr. Brokaw and her colleagues have thus far helped about two dozen people explain their goals and preferences, at a cost of $1,500 for each person. “In  today’s health care systems, families will be asked when patients can’t speak for themselves, and many families are very unprepared to make these decisions,” she said. Her colleague Ms Stephens pointed out that only about a quarter of American adults have advance care directives of any kind, and only half of them have them in hand or know where they are should they be needed.

 

Furthermore, only 12 percent had any input from a physician when filling out forms which are often alone or with a lawyer. “Our lawyer shouldn’t be writing a medical contract any more than you’d want your doctor to write a legal contract,” Dr. Brokaw said. The kinds of questions she said people should consider: What was your state of health at the start of the illness? What state are you likely to be in at the end of the illness? What, if anything, can provide a soft landing?

 

Proper Planning Helps Avoid Troubles

 

Judge Laws writes in the directive he is preparing,” After family, I value clarity of mind and the capacity to make decisions. To live well is to continue to possess  the ability to converse, to read, to retain what I learn and to coherently reflect and understand. I do not want my life prolonged if I undergo a marked lessening of my cognitive powers.” Judge Laws also does not want “to live with severe distracting pain.”

 

His directive will request that any treatment he receive be compatible with these goals. He also writes that he expects his sons and wife to support his decisions even if they disagree with them and  not let any quarrels over his care cause a rift in the family. Studies have shown that advance care planning reduces stress on patients, their families and health care providers. It also results in 30 percent fewer malpractice suits, greater patient and family satisfaction and a lower incidence of depression, drinking problems and other signs of complicated grief among survivors.

 

Ms. Stephens said that advance directives are “organic documents that can be changed at any time if circumstances or a person’s wishes change.” They should be reviewed at least once every 10 years”, she added.

This Personal Health column written by Jane E. Brody appeared in the New York Times last year.

 

Good advice here and the best time to plan for this is while you’re still in good health.

 

HOW TO BECOME A MAIL ORDER MILLIONAIRE

A Complete Guide To Starting Your Own Home Base Busine

 

Long time Mail order expert, Fred Broitman has written the definitive guide to success in a business of your own. If you would like to start a business you can operate from your home no matter where you live and sell to men and women all over the world this book on MAIL ORDER is all you need to get started.

 

You’ll Learn:

  • HOW TO GET STARTED
  • HOW TO FIND GREAT PRODUCTS
  • HOW TO MAKE YOUR BUSINESS PROFITABLE RIGHT FROM THE START
  • HOW TO PRICE YOUR PRODUCT FOR BIGGEST PROFITS
  • SECRETS OF CREATING WINNING MAIL ORDER ADS
  • 14 SURE FIRE CHECK OFF LISTS THAT GUARANTEE HUGE PROFITS

and included in  this newly revised edition is: COMPLETE UP-TO-DATE INFORMATION ON HOW TO USE THE INTERNET AND SOCIAL MEDIA TO SUPER-CHARGE YOUR NEW BUSINESS.

 

How to Become A Mail Order Millionaire is available from Amazon at its published price of $39.95 plus s&h or you can save $10 and order it direct from the publisher for only $29.95 and shipping is FREE. Send check or money order along with your name and address to: SUPERIOR PRESS 333 N. MICHIGAN AVENUE SUITE 1032 CHICAGO IL 60601. The book is sold on a 100% money back guarantee of satisfaction or return it for a complete no questions asked refund.

HOW TO FAIL… THE KEY TO SUCCESS!

A String of Failures Is Far More Valuable Than A String Of Wins.

Very early in my advertising career, a client taught me a very important lesson.

At the first agency I worked for my boss, the man in charge of recommending which magazines should carry this clients first advertisements asked me to make these recommendations. A little scared and not wanting to make any mistakes, I did my best to do some research. My boss went on vacation and was not available. Not wanting to delay my task, I recommended 5 magazines for their first advertising with our company. Shortly after their ads ran I called the client to find out how their advertising performed and was told that 4 did well but the 5th did so poorly they would never ever place another ad there. I was devestated and apologized for making this mistake.

 

Not a mistake at all, our client said. When this magazine failed to produce sufficient profits from our investment we learned that other similar magazines should also not be used. You probably saved us far more dollars than the cost of this one magazine. How To Fail… The Self-Hurt Guide Augusten Burroughs #1 New York Times Author of Running With Scissors newest book THIS IS HOW explores age old questions in his delightful easy to read book. From his cover blurb. “If you’re fat and fail every diet, if you’re thin but can’t get thin enough, if you lose your job, if your child dies, if you are diagnosed with cancer, if you always end up with exactly the wrong kind of person, if you always end up alone, if you can’t get over the past, if your parents are insane and ruining your life, if you really and truly wish you were dead, if you feel like it’s your destiny to be a star, if you believe life has a grudge against you, if you don’t want to have sex with your spouse and don’t know why, if you feel so ashamed, if you’re lost in your life.  If You Have Ever Wondered HOW AM I SUPPOSED TO SURVIVE THIS? THIS IS HOW Proven Aid in Overcoming Shyness, Molestation, Fatness, Spinsterhood, Grief, Disease, Lushery, Decreptitude & More. For Young and Old Alike.”

 

One of his chapters is headed HOW TO FAIL. Mr. Burroughs writes: “You will learn much more from failing than from making straight A’s in life. A string of failures is far more valuable than a string of wins. The reason is that our brains were programmed in the factory to look for and pay special attention to novelty. Which is to say the unique.”

 

“So if you’re a straight A student in school or a metaphorical straight-A student in your adult life, that’s a whole lot of same old, same old. One A+ paper blends right into the next. It’s when you get a D that you learn something valuable. It’s when you fall on your ass that you actally make progress. I am a complete and total fuck-up. Which is exactly why I am equipped to write this book and tell you how to live.”

 

“I make rings out of gemstones and bronze and I never went to school for this. I never took a design class and I have no business, actually handling 1,525 degree metal and chrysoberyl cat’s eye gems. But I do it anyway. And when I began, I made one hideous disaster of a ring after another until I had made maybe three hundred. Each time, I tried  to make one nice ring. Each time, I totally failed. Until ring number 301. Which was suddenly, inexplicably cool.”

 

“Now I make more good rings than lousy ones. There are always new mistakes to make. But I never make my old rerun mistakes. Perfectionism is the satin-lined casket of creativity and originality. If you’re a perfectionist, at least stop telling everybody you’re one and try to get over it yourself, alone in your home with the lights off.”

 

Here’s just a few other chapter headings in THIS IS HOW:

 
How To Find Love
How to Be Fat
How To Be Thin
How To Feel Sorry For Yourself
How To Be Confident
How To Get The Job
How To End Your Life
How To Get Over Your Addiction To The Past
How To Finish Your Drink
How To Hold On To Your Dream Or Maybe Not
How To Identify Love By Knowing What It’s Not

 
This is just a small sampling of what this book contains. Mr. Burroughs book is published by St. Martins Press and is available from Amazon as is my book HOW TO BECOME A MAIL ORDER MILLIONAIRE. Lauded by industry experts as “the definitive guide to success in direct response/mail order” If you have always had the desire to start a business of your own there is no better time than now. Using the power of the Worldwide Web you can sell a product or service to anyone no matter where they live and you can start your own business where you live.  In the beginning you can do it without employees or outside office expense… This newly revised edition will help you learn:
 
How To Get Started
How To Find Great Products
How To Make Your Business Profitable Right From The Start
How To Price Your Product or Service For Biggest Profits
Secrets of Creating Winning Mail Order Ads
14 Sure-Fire Check Off Lists That Guarantee Huge Profits
Complete Up-To-Date Information On How To Use The Internet To Make Easy Sales

 

HOW TO BECOME A MAIL ORDER MILLIONAIRE is available from Amazon at its published price of $39.95 plus s&h…. or you can save $10 and order it direct from the publisher for only $29.95 and shipping is FREE. To order send check or money order along with your name and address to: Superior Press 333 N. Michigan Avenue Suite 1032 Chicago, IL 60601. Sold on a 100% Guarantee of Satisfaction or your money back.

Beware the Placebo Effect!

It’s All In Your Mind!

Everyone knows that a placebo — a fake medication or sham procedure, typcially used as a control in a medical trial — can nonetheless have a positive effect, relieving real symptons like pain, bloating or a depressed mood. The placebo effect is a result of the patient’s expectation that the treatment will help.

But expectations can also do harm. When a patient anticipates a pill’s possible side effect, he can suffer them even if  the pill is fake.  This “nocebo” effect has been largely overlooked by researchers, clinicians and patients. In an article recently published in the journal Deutsche Arzteblatt International, we and our colleague Ernil Hansen reviewed 31 studies, conducted by us and other researchers, that demonstrated the nocebo effect. We urge doctors and nurses to be more mindful of its dangers, particularly when informing patients about a treatment’s potential complications.

The placebo effect is a result of the patient’s expectation that the treatment will help.

Consider the number of people in medical trials who, though receiving placebos, stop participating because of side effects. We found that 11 percent of people in fibromyalgia drug trials who were taking fake medication dropped out of the studies because of the side efects like dizziness or nausea. Other researchers reported tht the discontinuation rates because of side effects in placebo groups in migraine or tension drug trials were as much as 5 percent. Discontinuation rates in trials for statins ranged from 4 percent to 26 percent.

In a curious study, a team of Italian gastroenterologists asked people with and without diagnosed lactose intolerance to take lactose for an experiment on its effects on bowel symptons. But in reality the participants received glucose, which does not harm the gut. Nonetheless 44 percent of people with known lactose intolerance and 26 percent of those without lactose intolerance complained of gastrointestinal symptons.

In one remarkable case, a participant in an anti-depressant drug trial was given placebo tablets — and then swallowed 26 of them in a suicide attempt. Even though the tablets were harmless, the participant’s blood pressure dropped perilously low.

The nocebo effect can be observed even when people take real, non-placebo drugs. When medical professionals inform patients of possible side effects, the risk of experiencing those side effects can increase. In one trial, the drug finasteride was administered to men to relieve the symptons of prostate enlargement. Half of the patients were told that the drug could cause erectile dysfunction while the other half  were not informed of this possible side effect. In the informed group, 44 percent of the participants reported that they experienced erectile dysfunction; in the uninformed group, that figure was only 15 percent.

In a similar experiment, a group of German psychologists took patients with chronic lower back pain and divided them into two groups for a leg flexion test. One group was told that the test could lead to a slight increase of pain, while the other group was told that the test had no effect on pain level. The first group reported stronger pain and performed fewer leg flexions than the second group did.

Just knowing that a drug can have side effects may increase your chances of suffering them.

A doctor’s choice of words matters. A team of American anesthesiologists studied women about to give birth who were giiven an injection of local anesthetic before being administered an epidural. For some women, the injection was prefaced by the statement, “We are going to give you a local anesthetic that will numb the area so that you will be comfortable during the procedure.” For others, the statement was, “You are going to feel a big bee sting; this is the worst part of the procedure.”  The perceived pain was significantly greater after the latter statement, which emphasized the downside of the injection.

“Words are the most powerful tools a doctor possesses, but words, like a two-edged sword, can maim as well as heal.” – Dr Bernard Lown

The nocebo effect presents doctors and nurses with an ethical dilemma: on one hand, they are required to tell patients about the possible complications of a treatment; on the other hand, they want to minimize the likelihood of side effects. But if merely telling patients about side effects increases their likelihood, what is to be done?

Better communication is the answer. When talking with patients, doctors and nurses often say things with intended negative suggestions, like “it’s just going to bleed a bit” or “you must avoid lifting heavy objects — you don’t want to end up paralyzed.” We recommend more extensive training in communication for doctors and nurses, to help them use the power of their words appropriately. As the great cardiologist Bernard Lown once said, “Words are the most powerful tools a doctor possesses, but words, like a two-edged sword, can maim as well as heal.”

This article writtenby Pail Enck, a professor of psychology at the University of Tuebingen and Winfried Huser, an associate professor of psychosomatic medicine at the University of Munich first appeared in the August 12, 2012 issue of The New York Times.

The 4 Risk Factors To Avoid Stroke or Heart Attack

Blood Pressure, Cholesterol Level Among Key Factors!

 

Having just one risk factor — such as high cholesterol or smoking — can significantly increase the odds of suffering a stroke or heart attack in your lifetime, according to a new study in The New England Journal of Medicine.

The research tracked more than 250,000 participants from 18 different studies over a period of 50 years. It is the first study to look at  the risks for white and black men and women across the generations. Previously clinicians would calculate a patient’s risk by projecting into the next decade. Now with a broad data pool, doctors can predict the likelihood of a major cardiovascular event well into the future, explained Dr. Donald Lloyd-Jones, chair and associate professor of preventive medicine at Northwestern University’s Feinberg School of Medicine and the study’s lead investigator.

In an interview of Lloyd-Jones reported by Chicago Tribunereporter Bonnie Miller Rubin, he shared his findings with the Tribune.

  • What does the study tell us now  that we didn’t know before?

A.  We have known for decades that four risk factors — blood pressure, cholesterol levels, smoking and diabetes — are related to cardiovascular disease, which is the No. 1 killer for men and women in the U.S. What we hadn’t appreciated is the long-term risks. We now know that whether male, female, black or white, the effect of the risk factors remained consistent in determining lifetime risk, regardless of when you were born.

  • What do  these findings mean?

A. That regardless of your age, sex or race, if you have all optimal risk factors, your chance of having a heart attack or stroke is really low. And if a peer of the same age, sex and  race has even one of these factors, he or she has a dramatically higher chance of developing a cardiovascular event during their life span.

  • How do you define optimal cholesterol and blood pressure levels?

A. Total cholesterol level of less than 180, blood pressure is less than 20 on top and 80 on the bottom.

  • Can you give me an example of how having even one risk factor increases your likelihood of heart attack or stroke?

A. Men who  are 45 years old and have all four factors at optimal levels — in other words, optimal blood pressure, cholesterol and no smoking or diabetes — have only a 1.4 percent risk of a heart event in their lifetime. In contrast, adding just one risk factor raises the chance to 40 percent for men and 20 percent for women. With two, it increases to 50 and 41 percent, respectively. 

  • How  much do genes play in all this?

A. At a certain point, genes do influence factors like cholesterol levels. You can’t completely change everything but you can trump a lot of that. By keeping these other things healthy, you can delay the day when, say you might need medication to take care of the part that you can’t accomplish solely through lifestyle changes.

  • Are there other factors that play a part in cardiovascular disease?

A. Sleep and stress clearly play into the incremental risk. We also know that shift work can mess up a person’s metabolic profile. There is some important research going on in these areas, but at the end of the day, it’s by maintaining the four big factors that you can dramatically reduce the risk.

  • If you have less than ideal levels of the Big Four, can you undo the damage?

A. Once placques start forming in the artery walls, you can slow them down and stabilize them with lifestyle change and medication, but you can’t make them go away completely. They’re still there, taking up space and potentially obstructing blood flow. So you can be a 35-year old and have the arteries of a 55-year-old.  That’s why it’s so important that young people understand the importance of their choices. That we really need to get our foot in the door now—while they’re in their 20’s and 30’s, even though heart disease might not get them until their 50’s or 60’s.

  • Do you ever eat a hot dog or a cheeseburger?

A. Unfair question! Of course I do. But that has to be done in moderation and it means I have to make a trade-off to reduce calories, fat and sodium elsewhere, and that I should go burn it  off with  a good brisk walk.

If You Could Choose Would You Die Like A Doctor?

It’s Not Like the Rest of Us, But It should Be.

                                  By Ken Murray, MD Clinical Assistant Professor of Family Medicine at USC

The following is excerpted from ZOCALO PUBLIC SQUARE

“Years ago Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five year survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with his family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him. It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little.  For all the time they spend fending off the death of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices and they generally have access to any sort of medical care they could want. But they go gently.

                         Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure when the time comes, that no heroic measures will happen—that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right). Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me”. They mean it. Some medical personnel  wear medallions stamped “NO CODE” to tell a physician not  to perform CPR on them. I have even seen it as a tattoo.

                              To administer medical care that makes people suffer is anguishing. Physicians are trained to gather information without revealing any of their own feelings, but in private, among fellow doctors, they’ll vent. “How can anyone do that to their family members?” they’ll ask. I suspect it’s one reason physicians have higher rates of alcohol abuse and depression than professionals in most other fields. I know it ‘s one reason I stopped participating in hospital care for the last 10 years of my practice How has it come to this—that doctors administer so much care they wouldn’t want for themselves? The simple, or not-so-simple, answer is this: patients, doctors, and the system. Imagine a scenario in which someone has lost consciousness and been admitted to an emergency room. As is so often the case, no one has made a plan for this situation, and shocked and scared family members find themselves caught up in maze of choices. They’re overwhelmed. When doctors ask if they want “everything” done, they answer yes. Then the nightmare begins. Sometimes a family really means ”do everything, “ but often just mean “do everything that’s reasonable.” The problem is that they may not know what’s reasonable, nor, in their confusion and sorrow, will they ask about it or hear what a physician may be telling them. For the most part doctors told to do “everything” will do it, whether it is reasonable or not. The above scenario is a common one. Feeding into the problem are unrealistic expectations of what doctors can accomplish. Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles, walked out of the hospital. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming. Poor knowledge and misguided expectations lead to a lot of bad decisions. But of course it’s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Some doctors are stronger communicators than others and some doctors are more adamant, but the pressures they all face are similar.

                            When I faced circumstances involving end-of-life choices, I adopted the approach of laying out only the options that I thought were reasonable (as I would in any situation) as early in the process as possible .When patients or families brought up unreasonable choices, I would discuss the issue in layman’s terms that portrayed the downsides clearly. If patient s or families still insisted on treatments I considered pointless or harmful, I would offer to transfer their care to another doctor or hospital. Should I have been more forceful at times? I know that some of those transfers still haunt me..

                        It’s easy to find fault with both doctors and patients, but in many ways the parties are simply victims of a larger system that encourages excessive treatment. Several years ago my older cousin had a seizure that turned out to be the result of lung cancer that had gone to his brain. I arranged for him to see various specialists, and we learned that with aggressive treatment of his condition, including three to five hospital visits a week for chemotherapy, he would live perhaps four months. Ultimately, he decided against any treatment and simply took pills for brain swelling. He moved in with me. We spent the next eight months doing a bunch of things that he enjoyed, having fun together like we hadn’t in decades. He even gained a bit of weight  eating his favorite foods. He had no serious pain, and he remained high-spirited. One day he didn’t wake up. He spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20. My cousin knew he  wanted a life of quality, not just quantity. Don’t most of us?

                        If there is a state of the art of end-of-life care, it is this: death with dignity; As for me, my physician has my choices. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my cousin. Like my fellow doctors”.

Please share with me your comments about this subject we will all have to eventually address. However in the meantime while still in good health, if you’d like to consider starting your own business and even becoming one of the MAIL ORDER MILLIIONAIRES featured in the newest revised edition of my book, here’s my special offer to you.

A special offer only available to you.
You can buy my book HOW TO BECOME A MAIL ORDER MILLIONAIRE directly from me for the special price of $29.95. Regular price is $39.95… plus $3.50 for first class postage and handling. Send a check or money order in the amount of $33.45 payable to SUPERIOR PRESS along with your name and address to: Superior Press 333 N. Michigan Ave STE 1032 Chicago IL 60601 and I will promptly ship the book. Or you can purchase the book at the regular retail price from Amazon.

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