Cat Forum / Cat Anecdotes / July 2005
UPDATE4: Jean Hobbs
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Yowie - 21 Jun 2005 05:48 GMT Jean continues to want to thank everyone for the gorgeous cards.
She's not having a good time. The staff have not been listening to her, and have not prescribed the correct medication regime. As a consequence, she's got a nasty infection inher legs (where they took out the veins) and possibly in the chest cavity too. She was in *alot* of pain.
She's furious at them, naturally, because she had told the doctors that she needed special medication, and they said they understood, but never received the extra medications she needed and implied she was just being a whiney old woman when she complained.
Thankfully, she managed to contact her regular doctor, who managed to kick some serious butt, and she's now on more appropriate medication *for her*, so the pain has subsided somewhat and the legs and chest have stopped burning and aching, but is furious that she had to resort to this, and also furious she had to ask for it even after it was re-prescribed, rather than it just being added to the list of medications she is being given whilst in the hospital.
She's feeling better now that the medication is sorted out, but could do with some concentrated purrs at the moment. She can't get wait to get out of hospital and start looking after herself and Wilson again (ie, up to the standard she has come to expect)
Yowie
Adrian - 21 Jun 2005 11:31 GMT > Jean continues to want to thank everyone for the gorgeous cards. > [quoted text clipped - 23 lines] > > Yowie Sending concentrated purrs for Jean and litterbox offerings for the staff that didn't listen. Purrs for Wilson, I hope he's not too unhappy without her.
 Signature Adrian (Owned by Snoopy & Bagheera) A house is not a home, without a cat.
Tish Silberbauer - 22 Jun 2005 09:50 GMT Not to usurp Yowie's most excellent updates, but I spoke with Jean today (on the phone). She's still in hospital and still in considerable pain, but all she wanted to talk about was how things were going with RPCA - particularly Tweed. She is enjoying all the cards she gets. I believe Tweed's card had arrived today.
She is worried about Wilson, but hears from her daughter and son that the place where he is being boarded is being kind to him and has given him a space that even has a hidey-hole so that he can get away from people if he wants to. He doesn't have to share it with any other cats, which is a good thing. She can look out of her hospital window over to where he is staying (it's right next door).
She's, naturally enough, sick of being in hospital and is looking forward to getting OUT!
Cheers, Tish
polonca12000 - 22 Jun 2005 22:40 GMT Lots of purrs and best wishes for Jean to recover really well and come home really soon,
 Signature Polonca & Soncek
> Not to usurp Yowie's most excellent updates, but I spoke with Jean > today (on the phone). She's still in hospital and still in [quoted text clipped - 14 lines] > Cheers, > Tish Christina Websell - 23 Jun 2005 00:28 GMT > Not to usurp Yowie's most excellent updates, but I spoke with Jean > today (on the phone). She's still in hospital and still in [quoted text clipped - 14 lines] > Cheers, > Tish If you get a chance to talk to her again, please tell her I took a walk round the field at the bottom of my garden for about 15 minutes. I had to lie down when I came home, but hey, that's progress, isn't it? I'm glad she got my card. I hope she is home soon. Although it was nice at my aunt's, and she looked after me so well, home was the place I wanted to be. I maybe came home a bit too early as I am struggling a bit with some things but I think it's offset by how happy I am to be home with my cats and some of my chickens. My neighbour does not look after them to my standards, but I am so grateful that he agreed to do so in this emergency. I don't like their drinking water deteriorating into bacterial soup, only topped up and not renewed. I called my friend June to help, I could scrub the drinkers but not carry water yet. So we set about it. Fresh water for all, and clean drinkers. I said to June I hoped Stan would not come and see us as it would look like a criticism. We were just finishing when Stan came.. We both froze at such an embarrassing situation. I said "I thought we would save you a job" June said "I was visiting anyway so thought I would help.."
Dire situation, that.
Tweed
Karen - 21 Jun 2005 12:51 GMT > Jean continues to want to thank everyone for the gorgeous cards. > [quoted text clipped - 22 lines] > > Yowie Gah! It makes me sooooo mad how women get discounted in medical situations. It's well known that ONE of the reasons more women die from heart problems is because doctors don't take what they tell them seriously and often brush them off as "stress" or just phantom woman problems. Grrrrrr. Purrs for better treatment now. :(
Howard C. Berkowitz - 21 Jun 2005 22:48 GMT > > Jean continues to want to thank everyone for the gorgeous cards. > > [quoted text clipped - 44 lines] > them off as "stress" or just phantom woman problems. Grrrrrr. Purrs for > better treatment now. :( In this particular case, it isn't limited to women. Cardiovascular surgeons consistently understate the discomfort that comes from the vein stripped from the leg. It hurt me far longer and far worse than the chest incision. Unfortunately, it took about two years before I stopped having random pain, while the chest twinged only for a couple of weeks.
Karen - 22 Jun 2005 00:15 GMT >> Gah! It makes me sooooo mad how women get discounted in medical >> situations. [quoted text clipped - 10 lines] > chest incision. Unfortunately, it took about two years before I stopped > having random pain, while the chest twinged only for a couple of weeks. Why is this? It's not like they don't have enough subjects to study in regards to pain levels. I just don't understand.
Christina Websell - 22 Jun 2005 00:35 GMT >>> Gah! It makes me sooooo mad how women get discounted in medical >>> situations. [quoted text clipped - 13 lines] > Why is this? It's not like they don't have enough subjects to study in > regards to pain levels. I just don't understand. It's an illusion that you will be taken best care of in hospital. First my experience with rubbish pain care, then Jean's.
Years ago someone said to me "when you go into hospital you get better in spite of them, not because of them." I laughed at the time. Now I've been in hospital I believe it. Someone died on my ward while I was there. Gynaecology. We are supposed to recover from that, bad as it is.
Tweed
Howard C. Berkowitz - 23 Jun 2005 00:50 GMT > >> Gah! It makes me sooooo mad how women get discounted in medical > >> situations. [quoted text clipped - 13 lines] > Why is this? It's not like they don't have enough subjects to study in > regards to pain levels. I just don't understand. That's a good question. Pain research seems to be one of the areas of medicine that doesn't get a lot of respect. There's never been a Nobel Prize in Medicine or Physiology awarded to pain researchers, although I think that the gate control theory by Melzack & Wall is thoroughly Nobel character. I'm searching the Lasker Awards, which are considered just-below-Nobel, and can be awarded for clinical research rather than basic research, and not finding any in the pain area -- the data base is not easy to search.
I can even think of some research strategies for the leg pain, and I really should try a few letters to journals.
Christina Websell - 23 Jun 2005 01:03 GMT >> >> Gah! It makes me sooooo mad how women get discounted in medical >> >> situations. [quoted text clipped - 28 lines] > I can even think of some research strategies for the leg pain, and I > really should try a few letters to journals. Howard, once someone said to me "We don't get better because we are in hospital, we get better in spite of it."
I laughed at the time. Now I know what they meant.
Tweed
wafflycat - 02 Jul 2005 10:58 GMT > That's a good question. Pain research seems to be one of the areas of > medicine that doesn't get a lot of respect. That is *so* true. On another NG I frequent, alt.support.headaches.migraine, many of the posts are about how our pain, although very real, simply is not taken seriously and often rubbished by too many of the medical community, who we think, *should* know better. My personal view is that if there's a gaping wound... blood all over etc., etc., then medical staff seem to have a greater comprehension that this may be a cause of pain and are more willing to deal with this for the benefit of the patient. However, where the pain is effectively hidden from view, as there is no obvious wound, no blood... then they simply refuse, or are incapable of accepting that the pain level can be very real and very high. As a result, patients *suffer* and suffer unnecessarily. Chronic migraines kept me virtually bedridden for almost a year at one point, yet I was refused pain relief. It was "all in my head" apparently... I was refused strong painkillers on the grounds I *would* become addicted. When I pointed out to the doc that should I really be interested in becoming addicted, I could acquire strong painkillers on on virtually any street corner (albeit illegally) and as I had not done this, perhaps that should be telling him something... When I was asked by a different medical person as to what my level of pain was during a migraine attack, I said, "Put it this way, I've broken a bone and I've gone through childbirth and these were *nothing* compared to the pain of a bad migraine." Combine this with the fact that the migraine lasted almost a year...The person concerned said he actually found the pain comparison I'd given a useful one as it placed it in terms he had a better understanding of.
In another field of dealing with pain, I had my eyes opened when my mother-in-law was in the final stages of her life due to terminal cancer. The time she spent in a normal hospital was hell. The staff frequently refused to give her adequate pain control. She *suffered*. I got the distinct impression that they did not like admitting that as they couldn't heal her, they should actually make what time was left to her as comfortable as pssible - that to admit that was to somehow admit they'd failed in their jobs - which is stupid of course. Once she was placed into a hospice... what a difference!! The staff were totally dedicated to giving my MIL dignity and as pain-free a time as possible in the time she had left. A totally different attitude and a much welcome one.
>There's never been a Nobel > Prize in Medicine or Physiology awarded to pain researchers, although I [quoted text clipped - 3 lines] > basic research, and not finding any in the pain area -- the data base is > not easy to search. Now there's an opportunity for research funding if ever there was one :-)
Cheers, helen s
> I can even think of some research strategies for the leg pain, and I > really should try a few letters to journals. Howard C. Berkowitz - 02 Jul 2005 18:24 GMT > > That's a good question. Pain research seems to be one of the areas of > > medicine that doesn't get a lot of respect. [quoted text clipped - 5 lines] > taken seriously and often rubbished by too many of the medical community, > who we think, *should* know better. Several factors can go into whether or not a clinician takes pain, especially nontraumatic pain, seriously. Among these are training/specialization, and often how recently they were trained if they don't get frequent exposure to new research. I'm lucky in that all of my current and recent physicians either are at medical schools or research centers, or, when in private practice, are on the clinical faculty of medical schools. Of the physicians I've known that are clinical faculty, they uniformly say that having students and residents in their offices, asking good questions, keeps them sharp.
Not surprisingly, the people that get the most pain training are anesthesiologists, probably next followed by neurologists. Pain management is officially a subspecialty of anesthesiology, but people can come to the advanced pain training from assorted specialties, such as psychiatry, internal medicine, etc.
In fact, full-time pain management clinics don't rely on any single specialty. Much of the work of pain management clinics is on chronic rather than acute pain. I've been surprised how many clinicians don't understand that chronic and acute pain are physiologically different -- traveling over different nerve cells and often needing different therapies.
Headache is something of a special case for pain management, as it's more repeating episodes of acute pain rather than chronic pain. There's some subtle language there -- migraine, certain sinus, muscle contraction, cluster, etc., headaches are chronic DISEASES, but show generally acute PAIN.
A number of types of headaches aren't purely in one case or another, because there is the aspect that chronic use of certain drugs, without very subtle management, can make the drugs ineffective and even worsen the headache. This is less a worry about addiction than that pure painkillers, not used appropriately, interact with the mechanisms of certain headaches.
My personal view is that if there's a
> gaping wound... blood all over etc., etc., then medical staff seem to > have a [quoted text clipped - 11 lines] > apparently... I was refused strong painkillers on the grounds I *would* > become addicted. This is an example of how it becomes complex. Strong (opioid, narcotic) painkillers are perfectly appropriate for "breakthrough" or "rescue" pain relief in true migraine, but, if used too often, can make the headaches more frequent and more painful. The first goal of migraine treatment, by a competent clinician, should be prevention.
There are a wide number of drugs that can prevent most or all episodes of migraine and certain other headache types, but, unfortunately, there's no way to predict which will help which patient, and some experimenting, often over several months, is needed.
>When I pointed out to the doc that should I really be > interested in becoming addicted, I could acquire strong painkillers on on [quoted text clipped - 10 lines] > person concerned said he actually found the pain comparison I'd given a > useful one as it placed it in terms he had a better understanding of. Yes. Unfortunately, we don't have an instrument (yet) that measures pain. Not all clinicians are trained in proper interviewing to assess pain. With many adults, asking how something hurts on a scale of 1 to 10 is a good start, but, without knowing how bad a pain the patient has experienced, it's only relative. There are pediatric versions of this, asking the patient to pick which un-smiley face most describes their pain, and these are surprisingly useful with adults.
The way you described your pain is a perfect textbook example of an excellent description of pain. You gave references to your level of pain, and you also didn't use exotic language. Pain specialists have told me that when someone describes something like "ten thousand little dwarves are taking red-hot pokers from their anvils and driving them into my head, while elephants walk on me" rather than "this hurts more than getting my arm broken", there's probably a significant psychological component to the first. People in severe pain tend to describe it simply.
Now, there are certain specific dramatic phrases that are red flags. If a patient, especially in an emergency room, says something like "this is the worst headache I have ever had," and seems sick, you mark them at the highest priority until you've ruled out cerebral hemorrhage. Franklin D. Roosevelt's last words, for example, were "I have a terrible headache".
If someone says "It feels like an elephant is standing on my chest", again you rush them into an emergency cardiac evaluation. The key to that image is that it invokes a sense of pressure as well as pain.
> In another field of dealing with pain, I had my eyes opened when my > mother-in-law was in the final stages of her life due to terminal cancer. [quoted text clipped - 12 lines] > as pain-free a time as possible in the time she had left. A totally > different attitude and a much welcome one. Underlying what you describe is that hospice people are very aware of the difference between chronic and acute pain, and long-term cancer pain is usually chronic and needs different treatment than severe acute pain. Such treatment has many aspects, including the schedule on which the direct painkillers are given, the use of other drugs to make them more effective, the use of drugs and nursing techniques to minimize side effects of the pain drugs, and the use of an assortment of techniques to stop, rather than mask, cancer pain.
SuzQ - 21 Jun 2005 13:00 GMT Purrs for Jean to be better soon. Suz&Spicey
Irulan - 21 Jun 2005 16:36 GMT Please tell Jean that we are furiously purring and praying for her and have been since she entered the hospital. Tell her we love her. Jazz & his mama
 Signature Irulan from the stars we come to the stars we return from now until the end of time
> Jean continues to want to thank everyone for the gorgeous cards. > [quoted text clipped - 29 lines] > > Yowie polonca12000 - 21 Jun 2005 22:50 GMT I'm so sorry to hear Jean on top of everything else is having so many unnecessary problems in the hospital. Hopefully things will go well from now on. Lots of purrs and best wishes,
 Signature Polonca & Soncek
> Jean continues to want to thank everyone for the gorgeous cards. > [quoted text clipped - 22 lines] > > Yowie Elise - 22 Jun 2005 00:43 GMT > Jean continues to want to thank everyone for the gorgeous cards. > [quoted text clipped - 20 lines] > hospital and start looking after herself and Wilson again (ie, up to the > standard she has come to expect) Purrs for Jean still going out. We'll add litterbox offerings for the staff that didn't care for her properly!
 Signature Elise (supervised by Gossamer & Jeeves) pics: http://photos.yahoo.com/dragonandthistle@snet.net
Sam Nash - 22 Jun 2005 03:48 GMT > Jean continues to want to thank everyone for the gorgeous cards. > [quoted text clipped - 3 lines] > got a nasty infection inher legs (where they took out the veins) and > possibly in the chest cavity too. She was in *alot* of pain. Purrs continue that she gets it sorted out with the docs and the meds. Sam, closely supervised by Mistletoe
Debbie Wilson - 22 Jun 2005 07:18 GMT > She's feeling better now that the medication is sorted out, but could do > with some concentrated purrs at the moment. She can't get wait to get out of > hospital and start looking after herself and Wilson again (ie, up to the > standard she has come to expect) Concentrated purrs continuing for her treatment to improve and for her to feel better soonest.
Deb.
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"He looked a fierce and quarrelsome cat, but claw he never would; He only bit the ones he loved, because they tasted good." S. Greenfield
Christine Burel - 23 Jun 2005 16:58 GMT Many purrs for poor Jean -- glad her doctor was able to advocate for her and get her what she needs. Christine
> Jean continues to want to thank everyone for the gorgeous cards. > [quoted text clipped - 22 lines] > > Yowie
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